Working hand in hand with care homes to help residents with continence

The continence in care homes project team

People of all ages can have a problem controlling their bladder or bowel – and this can have a real impact on their daily lives.

Some people avoid going out and plan their activities around being near to a toilet. People can be reluctant to talk about it and can find it embarrassing.

Urinary incontinence increases with age and is common with care homes residents. To be there for those who need us most, our community nurses here at Kent Community Health NHS Foundation Trust (KCHFT) have been working closely with care homes, to support their staff, so that together we can be sure that residents are getting the very best help and care possible.

In July 2021, we started a project with five care homes in the Sevenoaks area, to see if making a few changes would make a difference. We will be analysing the results this summer (2022), one year on, and if successful, which we expect them to be, the trial will be rolled out.

We asked each care home to identify a continence champion, who would the expert within the home and a link to us. We arranged continence products training for the champions and other care home staff, taking this from one home to the next, in a day.

The work was the idea of Catherine Coulson from KCHFT’s Sevenoaks District Nursing Team, who worked with Philippa Brown, Primary Care Network Lead for Sevenoaks and healthcare assistant Jenny Evans. Their aim was to improve awareness and knowledge of continence, along with strengthening our bond with care homes.

Catherine said: “Managing someone’s continence issues makes a big difference to people. When it’s managed right, they no longer need to worry or be embarrassed.

“A high number of care home residents have continence pads and it’s important they have the right pad, for their specific need. If the pad isn’t the right size, it won’t work properly. If it’s not the right product, it could result in moisture on their skin, which could then lead to a skin condition. The pads must also be stored properly and not in humid bathrooms, where they will absorb moisture.

“We wanted to give more support to care home staff regarding continence and give them the knowledge and skills to help them do their very best for every single resident, which is something we all strive for.”

Philippa added: “This is something which is very important to people and their families. Incontinence can be embarrassing, whatever age. It is important the right products are used and that people have their individual needs met, for patient dignity, independence and wellbeing and so they have the ability to go about normal activities. If it can be fixed, it makes people’s days better and this might be as simple as using a different pad, or putting a commode by the bed.”

Our colleagues are now encouraging the care homes in the trial to work together, to share ideas, knowledge and best practice.

A quality improvement (QI) approach was taken with the project. One of the trust’s QI advisors, Kayleigh Hartshorn, provided support. She helped the project team to establish a SMART aim, to make sure they had measurements in place so that improvement could be shown and worked with them on a driver diagram, to establish how they would achieve their target. A survey of care home staff was carried out at the start and another will be done at the end of the project, so improvement can be shown.