Pressure Area Care Policy & Procedure

What is pressure area care?

Pressure area care protects the skin over bony parts of the body, such as the heels, hips and the base of the spine, so that pressure ulcers do not form. You may know these as bedsores or pressure sores. This pressure area care policy sets out how a care home prevents them, spots skin damage early and works with health professionals when an ulcer develops. It follows NICE guideline CG179.

For homes with and without nursing

The template is for care homes, and it splits the clinical work two ways. In a home with nursing, registered nurses assess risk, plan care and treat ulcers while care staff carry out the plan. Without nursing, the community nursing team assesses and treats. Care staff then give prevention care and report changes.

From admission to reassessment

1. Complete a risk assessment within a timescale you set after admission. NICE suggests a validated scale, such as Braden, Waterlow or Norton, to support clinical judgement.

2. Check the skin, with consent, and record what you see on a body map.

3. Write a care plan for any resident at risk, with how often staff help them change position by day and by night. NICE recommends encouraging people at risk to move at least once in 6 hours, and people at high risk at least once in 4 hours.

4. At each personal care visit, look for changes in colour, heat, firmness, swelling or broken skin. Redness may look different on darker skin.

5. Reassess at your set interval, and after illness, a fall, a hospital stay or any change in condition.

When skin damage is found

Staff tell the nurse or senior straight away and mark the damage on a body map. In a home without nursing, the senior refers the resident to the community nursing team the same day. Each new ulcer gets an incident form, and staff consider whether neglect may be the cause, in which case the safeguarding policy applies. CQC must hear without delay when a health professional judges the injury meets the regulation 18 tests for a serious injury.

The procedure also covers residents who decline repositioning, and what to send with someone going into hospital.

Before you use this policy

Choose the line for a home with or without nursing. Then add your risk assessment tool, review intervals and community nursing contacts.

Record marks on the Body Map Form. If a resident turns down repositioning and may lack capacity for that choice, the Mental Capacity Assessment Form records the test. Poor nutrition is a risk factor too, so keep the Nutrition & Hydration Policy close to this one.