Hi Sheila, what time in the morning, should night staff have to start to change pads. Our manager want us to start to change pads at 5:00am, This is in a care home for 36 service users and only 3 care assistant working. Many service users are sleeping at this time.

Answered by Sheila Scott

Dear J,

Thank you for your question.

It poses a number of interesting questions.

Those of you who are regular readers of this column will know that I actively discourage the waking of service users to wash and dress them to help the day staff.

There is a separate issue here though and that is about people who are incontinent and how long they may lie in a wet bed.

I am presuming that you regularly change people through the night who are incontinent.

I think that you might aim to change those people who are awake or restless at round about 5:00am. The example that you are giving doesn’t say that people have to be got up or dressed but as part of a plan to be changed because they are in a wet bed.

I think you should have further discussions with the Registered Manager to decide what to do where people are fast asleep.

You might be interested to read guidance that I have found on the internet about the impact of lying in a urine soaked bed from the Continence Foundation of Australia:

Good skin care is essential for people with incontinence and their carers. Urine and faeces can damage the skin, causing redness, irritation and soreness. This can be distressing, uncomfortable and socially isolating.

Skin areas most at risk are around the genitals, between the buttocks, and the inner thighs. Damp, warm skin is unfortunately a good place for bacteria, including fungal infections and urinary tract infections.

Damaged skin is vulnerable to infection and skin can easily break down in people who:

• Have continence problems
• Are older
• Have dry skin
• Have limited mobility
• Have cognitive impairment
• Take medicines for other illnesses
• Are unable to care for themselves.

Continence Foundation UK is another good source of information.

I hope this is helpful.

Best wishes.

Sheila