Debate:Personal Care (Resolution)

The Care Quality Commission (CQC) in England defines personal care as “the provision of personal care for people who are unable to provide it for themselves, because of old age, illness or disability, and which is provided to them in the place where those people are living at the time when the care is provided”. For some people, this type of care will be delivered in their own home, for others it may be the care they receive whilst living in a residential home. This Resolution focusses on professional personal care, rather than personal care from unpaid friends or family members.

The types of personal care which an individual requires varies from person to person, but may include assistance with washing, dressing, personal hygiene, continence support and help with eating and drinking. This assistance may include prompting or supervising an individual to complete those activities, or providing more direct help. In Scotland, the definition expands to include, for example, assistance with simple treatments such as eye drops or applying creams and dealing with the consequences of being immobile or substantially immobile. There are similarities with Virginia Henderson’s definition of nursing, and the RCN’s 2014 definition of nursing as “…provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death”. (Royal College of Nursing, 2014)

In Scotland, free personal care for over 65s has been available since 2002 to those who have been assessed by social work service staff and found to be in need of the service. (Scottish Government, 2018) This was extended to include everyone, regardless of age, from 1 April 2019 under what has been termed ‘Frank’s Law’.

In England, Northern Ireland and Wales, individuals or their families can request a needs assessment to identify what type of care is required, and then a means test to assess the financial contribution of the individual. The NHS continuing health care scheme pays for the personal care of some of those with significant ongoing health needs.

Personal care is increasingly delivered by carers working in care and nursing homes, or who may visit or live-in at the individual’s home. It should be planned and delivered in a way that involves the individual, and maximises choice, control, dignity and respect for the individual. Personal care is a regulated activity, meaning that agencies providing these services are assessed against national regulatory frameworks. Increasingly, national policies and guidance recognise the role of registered nurses within the management and coordination of personal care.

Carrying out personal care is not just a series of tasks – it forms part of the wider support which people with long-term health needs receive. Each personal care activity provides the opportunity for a health professional to observe a change in an individual’s condition, which may require further action. Record keeping is an important part of the carer’s role, and is essential for observing changes and trends. There is also a role to signpost the individual to other services or types of support. Registered nurses may be involved in assessment, in the creation of a care plan or package, and in coordinating its delivery. They may also be involved in training and supervising staff who carry out personal care.