2.3 Explain how and when to access additional support in relation to the management of continence

This guide will help you answer 2.3 Explain how and when to access additional support in relation to the management of continence.

Continence is the ability of a person to control their bladder and bowels. Being able to do so allows the individual to choose when and where to empty their bladder or bowels. When someone experiences continence problems, they may lose urine or faeces involuntarily. This is known as incontinence.

Loss of continence can affect anyone. It is more common in older adults but can happen at any age due to illness, injury, disability, or pregnancy. Loss of control can affect a person’s dignity, health, and quality of life. Supporting people to manage continence needs sensitively is an important role in health and social care.

Managing continence involves recognising problems early, supporting the person in ways that promote dignity, and knowing when to ask for help. Sometimes care workers need to access extra support. This could mean seeking advice or getting help from other professionals.

When to Access Additional Support

Workers should recognise when extra help is needed. Continence support should not be managed alone if there are risks or if the person’s needs change.

Situations where you may need extra support:

• The person has new or worsening symptoms.
• There are changes in the amount or colour of urine or faeces.
• There is blood in urine or faeces.
• The person is showing signs of pain or discomfort passing urine or faeces.
• Continence aids or toileting approaches are no longer working.
• The person has a new health condition or diagnosis that affects continence.
• The person is at risk of skin breakdown, such as redness, sores, or infections.
• The person or their family feels concerned or distressed.
• Medicines may be affecting the person’s bladder or bowels.
• You feel out of your depth or do not know what to do next.

Never ignore signs that someone’s continence needs are changing. Not getting help may put the person’s health, dignity, and emotional wellbeing at risk.

Who to Access for Additional Support

Support can come from many sources. Knowing the right place to go for help keeps the person safe and ensures the best care.

People or services to consider:

• Line manager or supervisor
• This is usually the first point of contact. They may have the experience to advise or may escalate concerns to someone who can help.
• General Practitioner (GP)
• The GP can assess for infections, review medications, and refer to specialist services.
• District nurse or community nurse
• Nurses often assist with care plans, continence assessments, or wound care.
• Continence advisor or specialist nurse
• These professionals provide expert advice. They assess, recommend aids, and offer training.
• Occupational therapist
• They may help with equipment or adaptations to aid toileting.
• Pharmacist
• They can advise on medicines that may worsen incontinence or suggest alternatives.
• Social worker
• May become involved if continence issues impact care needs or risk levels, like requiring home adaptations or residential care.
• Family or advocate
• Sometimes close relatives or advocates have extra insights or can support accessing services.

Be clear when raising concerns. Use specific information and examples. This speeds up assessment and makes extra support more effective.

How to Access Additional Support

Procedures vary between organisations. Workers should follow agreed workplace protocols. Usually, these include:

• Reporting concerns to your manager through official channels, such as incident report forms.
• Recording observations and concerns in the individual’s care plan or electronic care record.
• Alerting the relevant healthcare professional, for example by telephone or secure email, as set out by the organisation.
• Attending team meetings to raise ongoing issues.
• Requesting a review of the care plan if continence needs have changed.
• Referring through the agreed form or system to request assessment by a continence specialist.

Always keep clear, accurate records. Note what changes you noticed, when, and what you did. This provides an audit trail and helps others understand the situation.

Why It Is Important to Access Extra Support

Sometimes, staff hope continence problems will resolve without action or feel embarrassed raising such needs. Delaying or avoiding help can result in these problems:

• Rapidly worsening continence due to undiagnosed medical conditions like infections, constipation, or dehydration.
• Increased risk of pressure ulcers (bed sores) from prolonged wetness or soiling.
• Breakdown of skin leading to pain and infection.
• Emotional problems such as embarrassment, isolation, depression, or loss of dignity.
• Fall risk increases if the person tries to rush to the toilet without help.
• Missed opportunities for support, such as finding better products or aids.

Good practice means acting quickly. Always take concerns seriously.

Signs That Need Immediate Professional Attention

Be alert for warning signs that require urgent help:

• The individual cannot urinate or open their bowels (a possible emergency called urinary or faecal retention).
• There is blood in urine or faeces.
• The person has severe pain in their abdomen or back.
• There is sudden, large loss of urine or faeces, especially with confusion or a change in mental state.

If any of these signs are present:

• Contact the GP or out-of-hours medical service for urgent advice.
• Call 999 if the person is very unwell or in severe pain.

Inform your line manager straight away. Document what has happened and any actions taken.

Support for Workers

Supporting continence can be challenging and sometimes upsetting for workers. People may feel uncomfortable dealing with incontinence. They may also be unsure how best to care for a person’s dignity.

Extra support is available for staff:

• Training on continence care and using equipment safely.
• Guidance from senior staff or in-house continence leads.
• Shadowing more experienced colleagues.
• Access to policies and best practice guidance.
• Supervision sessions for discussing worries or questions.

If you are uncertain about a continence issue, ask your manager or a senior colleague as soon as possible.

Legal and Organisational Responsibilities

Workers have a duty to promote health, comfort, and dignity. Acting promptly if you notice continence problems forms part of this duty.

Key responsibilities include:

• Maintaining dignity and privacy during care.
• Avoiding harm or neglect, such as ignoring soiled clothing or failing to report concerns.
• Following the Mental Capacity Act 2005 if the person cannot make decisions about their care.
• Keeping records up to date and confidential.
• Working within role boundaries, knowing when to refer to more qualified staff.

Ignoring continence needs breaches duties of care. It can also be viewed as neglect or abuse if support is not accessed when required.

Barriers to Accessing Support

Sometimes, obstacles prevent timely access to extra help:

• Embarrassment or stigma felt by staff or individuals.
• Lack of training or confidence.
• Not recognising that continence needs have changed.
• Poor communication between staff or teams.
• Assuming problems are a normal part of ageing and ignoring them.
• Lack of access to specialist services.

Workplaces can overcome these barriers by:

• Providing regular training.
• Encouraging open communication about personal care.
• Having clear systems for raising concerns.
• Supporting staff to reflect on their own biases or discomfort.
• Making information about available support visible and accessible.

What to Do if Support is Not Available

If you cannot access support immediately:

• Explain the situation clearly to your manager or duty team.
• Record your concerns and actions.
• Support the individual’s dignity and comfort as best you can.
• Use temporary aids or alternative approaches if safe to do so.
• Keep monitoring the person closely and escalate if the situation gets worse.

Advocacy organisations can sometimes help if services are not supporting the person’s rights. Raising a safeguarding concern may be needed if delays put the person at risk.

Examples of Good Practice in Accessing Support

Good practice means not waiting too long to ask for help. For example:

• Noticing new leakage during the night and reporting it for review the next day.
• Contacting the district nurse when a pressure sore develops along with wet skin.
• Referring to the continence advisor for a review of aids following weight loss or gain.
• Seeking advice from the pharmacist if medicines seem to be causing constipation.

These actions keep the person safer, more comfortable, and better supported.

Final Thoughts

Getting support for continence management helps people to live healthier, more dignified lives. Recognising changing needs and acting early may prevent medical problems and reduce distress. It also builds trust between the person receiving care and the worker.

Never feel embarrassed or alone when facing continence challenges. There is always support for both the individual and the care worker. Acting quickly and communicating well brings the best outcomes for everyone. Remain aware of your own role, know when and how to refer, and never be afraid to ask for help when unsure. This approach makes all the difference in providing respectful, person-centred care.