Applying Least Restrictive Practice in Personal Care and Daily Routines
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Personal care routines present one of the greatest risks of over-support in adult social care. Tasks delivered automatically by staff can unintentionally reduce independence, confidence and dignity if they are not regularly reviewed and adjusted.
This article links closely to wider person-centred approaches explored within Support Planning & Reviews and Recording & Evidencing Person-Centred Care.
Identifying Over-Support in Daily Routines
Over-support often develops gradually, particularly where staff turnover is high or routines are not clearly documented. Tasks that could be partially supported or prompted become fully delivered by default.
Common indicators include:
- Staff completing tasks without prompting the individual
- Lack of documented progression goals
- Minimal review of personal care approaches
Operational Example: Supporting Independence in Personal Hygiene
A supported living service identified that staff were fully assisting with bathing despite the individual demonstrating capability in parts of the routine. The support plan was updated to focus on prompting, sequencing and environmental adjustments.
Within weeks, hands-on support reduced significantly while maintaining safety and dignity.
Balancing Safety and Autonomy
Least restrictive practice does not mean withdrawing support prematurely. Providers must balance autonomy with safeguarding responsibilities, particularly where risks relate to mobility, continence or health conditions.
Clear documentation of risk mitigation strategies is essential.
Operational Example: Medication-Related Personal Care
A provider introduced supported self-administration following competency assessment. Staff retained oversight through spot checks and recording systems, reducing restriction while maintaining compliance.
Regulatory Expectations
CQC inspectors expect providers to demonstrate how personal care promotes independence and dignity. Inspectors frequently review care plans and observe practice to assess consistency.
Governance and Review
Providers should audit personal care plans regularly to ensure least restrictive approaches are actively implemented and reviewed as part of quality assurance processes.
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