1.2 Establish the level and type of support and individual needs for personal care

This guide will help you answer 1.2 Establish the level and type of support and individual needs for personal care.

Personal care means supporting someone with daily tasks related to their body and appearance. Common examples are washing, dressing, using the toilet, oral hygiene, hair care, shaving and helping with eating. Each person’s needs are different, depending on their health, mobility, culture, age and preferences.

Personal care is not just about physical help. It includes respect for dignity, privacy and independence. Some people need help with every task. Others only need support with certain things or now and then. Establishing what sort of support is needed is important for giving safe and respectful care.

Why Assessing Needs Matters

People using health and social care services should be involved in decisions about their personal care. Assessment forms the foundation for planning care. It helps make sure the support given:

• Matches the person’s abilities
• Fits their wishes
• Reduces risks
• Encourages independence
• Respects dignity

Failing to understand a person’s support needs can lead to harm or distress. For example, giving unnecessary help can lower confidence and independence. Not enough support can result in accidents or neglect.

Steps to Establish Support Needs

Workers should use a structured approach when finding out about personal care needs. This usually means following workplace procedures, and applying national care standards. It is important to be clear and focused.

The main steps are:

1. Gather information
2. Talk with the individual and their circle
3. Observe
4. Consult professionals
5. Assess risks
6. Record findings

Let’s look at each part in detail.

Gather Information

Start by collecting facts about the person. This may come from:

• Written records (such as care plans and hospital notes)
• Their GP or other health staff
• Relatives and friends (with consent)
• Previous assessments

Gather information about:

• Physical health (mobility, strength, sensation)
• Mental health and capacity to make decisions
• Sensory needs (sight, hearing)
• Communication needs (language, speech, preferred methods)
• Emotional wellbeing

By building a full picture, you help identify areas where support is needed.

Talk with the Individual and Circle of Support

You should always involve the person needing care in discussions about their needs. This is known as person-centred care. Ask simple, direct questions. Listen to what the person says. Encourage them to describe what they can do alone, what they wish to do, what they find hard, and any worries.

Some people cannot express their needs directly, due to conditions such as dementia, learning disabilities or speech problems. In these cases, involve advocates, family, or others who know the person well. Their insight helps ensure nothing is missed.

Observe

Check the person’s daily living skills in a respectful manner. For example, watch how they:

• Move from bed to chair
• Dress independently
• Use the bathroom
• Eat and drink

Look for signs of pain, distress, confusion or fatigue. Notice their mood and reactions.

Observations reveal needs that might not be spoken. Keep notes and respect privacy.

Consult Professionals

Work with other members of the care team. This may include:

• Occupational therapists (who assess mobility and equipment needs)
• Speech and language therapists (who examine communication or swallowing)
• Doctors or nurses (for medical issues)
• Dietitians (to check for nutrition concerns)

Their expertise helps tailor support so it is safe and suitable.

Assess Risks

Think about possible dangers linked to personal care tasks. Factors include:

• Falls when moving or showering
• Skin breakdown due to poor hygiene or pressure
• Infections
• Choking when eating
• Allergic reactions to products

Balance these risks with the person’s choices and freedoms. Use risk assessment forms if your workplace has them. Always explain to the individual and respect their right to take risks, provided they understand the possible outcomes.

Record Findings

After assessing, write down all relevant information. Good records:

• Guide the care team
• Prove care has been agreed
• Help spot changes over time
• Provide evidence if there is a complaint

Stick to facts. Include both strengths and needs. Use clear language. Remember, records must be confidential.

Types of Support with Personal Care

The type and level of support needed depends on assessment findings. Support ranges from prompting to full hands-on help. It is helpful to think of support as a spectrum.

Prompting

Some people can carry out personal care, but need a prompt to start or finish the task. Prompting might mean a friendly verbal reminder, or offering simple instructions.

Common situations needing prompting:

• Memory problems or confusion
• Low motivation
• Mental health concerns
• Unfamiliar settings

Example: A worker reminds someone to wash their hands after using the bathroom.

Supervising

Supervision is watching over someone as they do the task themselves. You may give encouragement or help only if they ask or struggle. This suits people who are mostly independent, but at risk of falling, forgetting something, or making mistakes.

For example: You watch someone brush their teeth to check their technique and ensure safety but do not take over.

Assisting

Assistance means giving practical help, but not doing the task entirely for the person. Assistance might include:

• Laying out clothes
• Passing a flannel or soap
• Helping with hard-to-reach zips
• Steadying a person as they step into the shower

You support the person’s efforts while respecting their abilities.

Full Care

Some individuals need all personal care done for them. This includes washing, dressing, continence care and feeding. Workers carry out each task while maintaining the person’s dignity, comfort and safety.

Full care is usually needed for people who:

• Are very physically disabled
• Have advanced dementia
• Are unconscious or severely ill

Each step should be explained, and if possible, the person should be involved (for example, choosing clothes).

Specialist Support

Some care needs are more complex. A person may require:

• Help with stoma care (a surgical opening in the stomach for waste removal)
• Catheter care (a tube to help urinate)
• Use of hoists or special beds
• Tube feeding
• Skin care for pressure injuries

Specialist support often needs extra training and strict hygiene.

Individual Needs and Preferences

Good personal care is not just about physical needs. Each person has preferences based on habits, culture, gender, religion and privacy. Respecting these factors improves comfort, trust, and wellbeing.

Examples of individual differences in personal care:

• Preferred time to wake, bathe, or eat
• How much privacy is wanted
• Bath or shower choice
• Use of special creams, soaps or hair products
• Who provides care (some people want male or female carers)
• Clothes and appearance
• Special needs during menstruation
• Observing fasting, prayer, or other religious practices

Talking openly about these issues prevents distress. It helps people feel seen and respected.

Supporting Independence and Choice

Supporting independence is important in health and social care. Everyone should do as much as possible for themselves, even if this takes longer. Encourage choice at each step, for example:

• What clothes would you like to wear?
• Would you like to wash your face or shall I help?
• Do you want the water hotter or cooler?

Minimise taking over or making assumptions. Even small choices increase confidence.

Challenges in Assessing Needs

Working out personal care needs is not always simple. Barriers may include:

• Fear, anxiety or embarrassment
• Language barriers
• Memory and communication problems
• Cultural misunderstandings
• Fluctuating health (needs change day to day)
• Reluctance to accept help

Workers need patience, respect and good communication skills. Non-judgemental questions, written materials, interpreters or advocates can help break down barriers. Take time to build trust.

Keeping Safe and Maintaining Dignity

Safety and dignity are fundamental rights. Approach each person with care and respect. Steps to protect dignity include:

• Explaining each action before starting
• Gaining consent
• Covering the person as much as possible during washing
• Not rushing or talking over people
• Offering privacy (draw curtains, close doors)
• Using the right titles or names

Report any signs of neglect, discomfort, abuse, or changes in need.

Legal and Ethical Factors

Several laws and codes guide support for personal care in the UK, including:

• The Care Act 2014 (focuses on person-centred support and wellbeing)
• The Mental Capacity Act 2005 (protects those who cannot make decisions for themselves)
• Equality Act 2010 (prevents discrimination)
• Human Rights Act 1998 (protects dignity, privacy and autonomy)
• Health and Social Care Act 2012

Ethical codes from regulators like the NMC (for nurses) or HCPC (for allied professionals) also apply.

Workers must:

• Gain consent
• Respect confidentiality
• Support rights to make choices
• Share information only with those who need to know

Reviewing and Adjusting Support

Personal care needs are not fixed. Illness, ageing, mental health, family circumstances or equipment changes can affect what people can do. Care should be reviewed regularly.

Review questions might include:

• Has the person’s mobility changed?
• Are they happy with the support?
• Are there new risks?
• Does the carer relationship work?
• Are there new preferences or habits?

Ask those who know the person well. Keep records up-to-date. Be ready to change approaches as needed.

Involving Others

Other people may play a key part in personal care, such as family members, informal carers, advocates, and community nurses. Involving them supports continuity and confidence. Always ask the individual who they want involved, and respect their wishes.

Sometimes, care at home is provided by both paid workers and relatives. Clear communication helps avoid misunderstandings.

Final Thoughts

Establishing the level and type of support for personal care is a core skill in health and social care. Workers have a duty to find out what each person can do, how much help they want, and how best to support their independence, comfort and dignity.

Effective assessment uses information from many sources, including the person, their family, health professionals and direct observation. The needs are not just medical; they reflect the whole person—their history, culture and preferences. Support should be flexible, respectful and guided by the law.

Listening, observing, recording and following up are all important. By working in this way, you help people live their lives with as much autonomy and dignity as possible.