Scope of this chapter
Everyday healthcare describes the things that we all do as part of our daily lives to stay healthy, well, and reduce the risk of a serious health need developing.
- Oral hygiene-cleaning teeth and dentist visits;
- Eye tests;
- Hearing tests;
- Sexual health (e.g., contraception, testing);
- Screening (e.g., cervical, breast, bowel);
- Annual health checks and vaccinations;
- Taking prescription medication;
- Weight management;
- Footcare and nail care;
- Eating a healthy, balanced diet;
- Showering and bathing;
- Seeking advice from a GP when needed.
This chapter will explain how to support and encourage people to meet different everyday healthcare needs, and how to work in partnership with health and social care professionals when needs cannot be met, or a healthcare concern arises.
Regulation 9: Person-centred care
Regulation 10: Dignity and respect
Related Chapters and Guidance
The information in this section is based on the national recommendations and advice of the NHS. They may not apply to everyone. People with certain health conditions, or that take certain medications may need to vary from the norm.
The specific requirements relating to each person should be based on their specific needs and set out in their individual care or support plan.
If you are not sure which healthcare routines apply to someone, or how they should be meeting those needs you should seek advice from the person’s relevant healthcare professional.
Teeth should be brushed twice a day. This should be every night before bed and then on 1 other occasion throughout the day. It does not matter if this is in the morning.
Teeth should be brushed for around 2 minutes, using an adult fluoride toothpaste. People should try to clean every surface of all teeth.
After cleaning teeth, people should not rinse straight away. Leaving some toothpaste on the teeth helps prolong the positive effect of fluoride.
People also should not use mouthwash straight after cleaning teeth for the same reason as above. It is OK to use mouthwash at a different time of day. For example, after eating. You shouldn’t eat or drink for 30 minutes after using a mouthwash.
Flossing is encouraged, as it can remove plaque from along the gumline, where brushing is less effective. It is best to floss before brushing teeth.
If people get food stuck between their teeth, this should be removed using floss or an interdental brush. Toothpicks are discouraged as they can damage the gum and cause infection.
Some people will have dentures. These are removable false teeth. Dentures can be partial (used to replace 1 or just a few teeth) or complete (a whole upper or lower set).
It is important to remove plaque and food deposits from dentures regularly. Unclean dentures can lead to bad breath, gum disease, tooth decay and oral thrush.
Dentures should be cleaned as often as teeth should be cleaned:
Step 1. Brush dentures with toothpaste or soap and water.
Step 2. Soak the dentures in a fizzy solution of denture cleaning tablets (follow manufacturer's instructions).
Step 3. Brush them again with toothpaste.
Visiting the dentist
Routine visits to the dentist should take place in line with the recommendations of the dentist. Some people will need to visit more often than others.
The time between check-ups can be as little as 3 months or as long as 2 years.
Most people should have an eye test every 2 years. However, this should be more frequent if someone:
- Has diabetes;
- Is over 70;
- Is over 40 and there is a history of Glaucoma in the family.
If someone is unable to travel to the Optician, a home eye test can be arranged.
Most people under the age of 40 should have a hearing test every 2 years.
People over the age of 40 should go every year.
Hearing tests can be carried out by the NHS, but a lot of Opticians now offer this service, meaning people can use the same service for their hearing and eye tests if they want to.
If someone is unable to travel to the Optician, a home hearing test can be arranged.
It is important not to put off having a hearing test, because if hearing deteriorates too much, things like hearing aids may be less effective.
Contraception is a way of preventing pregnancy. Condoms can also prevent the transmission of STI’s (see below).
If someone being supported is known to be having sex without using contraception, they should be encouraged to get contraceptive advice from their GP, a contraception clinic or a sexual health clinic.
For further information, see:
STI’s (sexually transmitted infections) can be very painful and, if left untreated, can have a detrimental effect on other areas of health.
If a person is known to be sexually active, and has any of the following symptoms they should be encouraged to have a STI test:
STI tests can be carried out at a sexual health clinic. Some GP surgeries, contraceptive clinics and other sexual health services can also do tests.
For further information, see:
NHS: Find a sexual health clinic
The NHS offers a range of screening tests to different people.
A screen negative result means that a person is at low risk of having a condition.
A screen positive result indicates a higher risk. Diagnostic tests are then carried out to confirm whether the condition is present. If it is, early treatment can be provided.
Diabetic eye screening
Anyone with diabetes should be offered an annual diabetic eye test to screen for signs of diabetic retinopathy.
Cervical screening is offered to all women and people with a cervix aged 25-64. It checks the health of cells in the cervix to look for signs of cancer.
Those aged 25-49 are offered a test every 3 years.
Those aged 50-64 are offered a test every 5 years.
Breast screening if offered to women aged 50-70 to detect early signs of breast cancer. Women over the age of 70 can self-refer for further tests if they want them.
Bowel cancer screening
Bowel cancer screening is a self-administered test that takes place at home. Anyone aged 60-74 is offered the test every 2 years. From the age of 75, people can request a kit every 2 years if they want to.
Abdominal aortic aneurysm screening
AAA screening is offered to men once, during the year they turn 65. An AAA is a dangerous swelling in the aorta that is life threatening. Men over the age of 65 can self-refer for further tests if they want them.
NHS Health checks
NHS health checks are offered to most adults between the ages of 40-74 every 5 years.
The health check assesses the risk of heart disease, stroke, kidney disease, diabetes and dementia.
Anyone that already has any of the following will not be offered a NHS health check:
- Heart disease;
- Chronic kidney disease;
- High blood pressure (hypertension);
- Atrial fibrillation;
- Transient ischaemic attack;
- Inherited high cholesterol (familial hypercholesterolemia);
- Heart failure;
- Peripheral arterial disease;
People who have a diagnosed respiratory issue such as asthma or chronic obstructive pulmonary disease (COPD) should receive a yearly health check to make sure they are managing the condition and still on the correct medication type and dose.
Annual health check (people with a learning disability)
Anyone with a diagnosed learning disability should be offered an annual health check, normally by their GP.
- A physical check-up (weight, heart rate, blood pressure);
- Sometimes a urine sample or blood test;
- Advice and information about staying well;
- A review of medication, particularly whether the person is taking any medication they do not need;
- Checking vaccinations are up to date.
For further information, see: Annual health checks
People that are overweight are at increased risk of developing conditions such as heart disease, type 2 diabetes, stroke and certain types of cancer.
The NHS offers a range of weight management services and support for people that are overweight.
For further information, see: Managing your weight
Good foot and nailcare can help prevent common nail conditions:
As a person gets older, their nails become thicker or more brittle. If it becomes difficult to manage nail care, a podiatrist can help. A person’s GP can make a referral on the NHS. Alternatively, services can be arranged and funded privately.
Eating a healthy, balanced diet is an important part of maintaining good overall health and reducing the risk of developing certain conditions.
Most people should try to:
- Eat at least 5 portions of a variety of fruit and vegetables every day;
- Base meals on higher fibre starchy foods like potatoes, bread, rice or pasta;
- Have some dairy or dairy alternatives (such as soya drinks);
- Eat some beans, pulses, fish, eggs, meat and other protein;
- Choose unsaturated oils and spreads, and eat them in small amounts;
- Drink plenty of fluids (at least 6 to 8 glasses a day).
For further guidance and advice, see: Eat well
Poor hygiene can cause discomfort, skin complaints and infections, and can lower self-esteem. Keeping clean is therefore essential.
- Wash hands after going to the toilet;
- Wash the genitals and bottom area every day;
- Wash the face every day;
- Have a bath or shower at least twice a week.
There is a chapter of this Handbook dedicated to providing personal and intimate care:
As many as 1 in 3 people have difficulty with continence itself, or with getting to the toilet in a timely way because of reduced mobility.
Continence problems can cause skin irritation and infection but can also impact on dignity because they can be embarrassing.
A person’s GP can refer them to a continence care specialist, who can help someone access the right kind of continence aids and advice to enable them to maintain dignity and independence.
- Covers to protect bedding;
- Waterproof underwear;
- Disposable or washable continence pads.
Occupational Therapy services from the local authority can also help with things like rails, commodes and raised toilet seats.
Some local authorities can help with laundry services if someone is finding this difficult to manage.
Support should only be provided if the person needs it or asks for it.
Support should be provided in line with the individual care or support plan.
Support should promote independence and maximise choice and control at all times.
Consent must be sought before doing anything to, or on behalf of a person.
Dignity and respect must be always upheld.
Often, people that need support to carry out everyday healthcare tasks will need some gentle encouragement. We all have times when we don’t feel in the mood to do something we know we should. For example, eat well, drink enough or clean our teeth.
Staff should make sure that they are supporting the person in line with their individual care or support plan, their preferences, in a dignified way and using appropriate methods of communication.
They should remind people of the benefits of doing a particular activity (or the potential consequences of not doing it) and think of ways in which they can perhaps make it a little more enjoyable/bearable.
- Getting someone involved in choosing and preparing a healthy meal for themselves;
- Going somewhere like a café after a health appointment;
- Using scented lotion after a bath;
- Painting nails after cutting them.
Despite our best efforts, sometimes people that need support with everyday healthcare will decline it and the activity or task will go uncompleted.
If they have the mental capacity to do so, they can make this choice and it must be respected.
See: Mental Capacity
If they routinely make this choice and doing so puts them at risk of harm, a self-neglect safeguarding concern should be raised to reduce the risk of serious harm occurring.
See: Disclosure and Raising a Concern
If a person lacks the mental capacity to make decisions about carrying out a healthcare task, a decision will need to be made under the best interests principle of the Mental Capacity Act 2005. This decision will be whether to carry out the task, and, if so, what the best way of doing so is. Depending on the nature of the healthcare task, this decision may need to be made by a relevant healthcare professional e.g., a dentist or a GP.
Some people decline to attend scheduled health appointments because they are afraid of the clinical environment, the health professional (or their uniform), the procedure (e.g., a dental examination or blood test) or the potential outcome (e.g., a diagnosis).
Any anxiety the person has should always be recognised. Never downplay what is clearly worrying them or tell them they have nothing to worry about.
It may be necessary to ask a health professional to speak to the person about what is worrying them. They may be able to explain step by step what is going to happen, why and what the potential outcomes may be. This can allay fears.
It may also be necessary to ask a health professional to consider other ways in which any necessary health intervention can take place. For example, at the person’s home.
Health professionals should be open to any reasonable requests to adapt how they do things in order to engage the person and enable them to access the healthcare they need.
Johnny has autism and a learning disability. He finds it difficult to communicate in words. Lately, Johnny has seemed confused, tired a lot of the time and is not walking as well as he normally would.
Staff think Johnny needs to see his GP. However, they know that Johnny does not like going to see the GP. They also believe he will probably need to have a blood test or other screening and know that he has a deep fear of needles.
Staff decide to contact the GP to explain the situation and agree the best way forward. Johnny’s GP agrees that a blood test would be helpful, to test for possible dementia. He also agrees that Johnny is unlikely to respond well to visiting any healthcare setting to have the test.
The GP liaises with the Community Learning Disability Team. Johnny already has an allocated nurse who he gets on well with. The nurse agrees to visit Johnny at his day service to carry out an initial health check. She agrees with the staff that Johnny is not his usual self and a blood test would help to rule out any underlying health issues.
The nurse arranges to do the blood test at the day service. She uses pictures to explain to Johnny what is going to happen. She reassures him that a numbing cream will be used so that he won’t feel any pain at all. Johnny agrees to the procedure but is clearly still very anxious. A member of day service staff sits on the other side of Johnny and distracts him with a video whilst the nurse does the blood test.
If a person’s health needs appear to be changing or deteriorating, it is important to seek medical advice from a relevant health professional as soon as possible.
This should be done with the consent of the person.
If someone does not provide consent, advice should still be sought if there is a risk of harm. We have a duty of care to protect people from harm, even if they are causing it to themself.
The health professional should be told that the person has not given consent. They can then provide the person with information and advice that can help them to reconsider or reaffirm this. They can also assess mental capacity if this is a potential issue.
The person’s individual care or support plan should detail all the health professionals they are currently supported by, the health issue they are helping to manage, and how/when they can be contacted.
Any advice given by the health professional should be recorded and followed by everyone involved in the person’s care and support.
For advice and guidance about working well with others, see: Partnership Working
Last Updated: March 23, 2022