This procedure should be followed when working with anyone who is having difficulty maintaining continence.

1. Principles

Losing control of continence can be immensely distressing for the person concerned. If you believe that someone may be having difficulty maintaining continence, you should discuss this with them privately, discreetly and sensitively in a way which upholds their dignity.

Any support given to help someone maintain continence or to manage the consequences of losing continence must also be given in a way which upholds the person’s dignity.

2. Procedural Steps

Step Action By Whom
1. Difficulty maintaining continence could be caused by a range of factors including impaired mobility, illness or infection. The person should be encouraged and supported to seek advice from their GP to identify or rule out a medical cause. Care staff/ keyworker
2. If someone is having difficulty maintaining continence for a non-treatable reason, advice should be sought from the GP, Community Nurse or Continence Specialist on the best way for that person to manage the effects or be helped to manage them. This should be recorded and incorporated in the person’s care or support plan. If the person appears to lack Capacity to make decisions in this area, an assessment must be made under the Mental Capacity Act and any decisions made must be in their best interest. See also Mental Capacity Act 2005: Policy and Practice Guidelines (Including Mental Capacity Assessments). Senior staff member to seek advice
3. As a lack of continence can cause skin and tissue problems, and can make the person more prone to pressure ulcers, advice must be sought from their GP or community nurse about the best way to care for their skin. The Pressure Area Relief Procedure must be followed. Senior staff member
4. Any actions agreed must be recorded and incorporated in the person’s support plan and reviewed regularly. All staff
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