• Firstly, discuss with the nursing team the day before the intended washing and dressing assessment so they don’t get that person washed and changed. 

• Gain information about how the individual has been, asking if there have been any changes in presentation including any improvements or difficulties reported to or noted by the team/carers/family members. 

• Discuss with the assessment with individual and gain consent. Due to the nature of assessing /supporting the individual's personal care needs, reasonable effort must be made to ensure that the individual's preferences are respected about who delivers their care and treatment, such as requesting staff of a specified gender (female/male staff members for intimate/personal care). 

• Consider the social, cultural and religious preferences of the individual. (please see further resources to widen your knowledge in this topic )   

• On the day, check with the nursing team that the individual is well enough to complete the assessment as planned also confirm with the individual that they feel well enough. 

• Decide how you are going to do the assessment.

• Decide how many people you need; one or two? this information will be gained from your baseline assessment. For example; if the individual currently requires two people to assist from sit to stand, two staff will be required for this part of the assessment. You’ll be doing sit to stand as you wash and dress. If their sit to stand is poor then start with a bowl at the bedside as if you took them to the therapy bathroom they would have to do more attempts of sit to stand, unless you felt that this was something they needed to practise and you feel that they are ready for it (more of a rehab approach).

• Think about how they normally get washed at home. Try and replicate what they do at home.  If in doubt, start with a stripwash at the bedside.

• Ask them to select what items that are needed for the washing and dressing assessment. This will be things like soap, flannel, toothbrush, clothes and pads. observe here to see if they can plan a task and recall what items they need.  Dependent on their mobility, when they identify the item, encourage them to get it out themselves unless unable to. If they identify they need an item and they haven’t got it, then have a look to see if the ward has supplies for them to use.

•  Fill the bowl with soapy water (if doing it by the bedside), put all the items needed on the overbed table and then only intervene if they need you to, remember the assessment is to see how independent they are.  Take a few towels for covering the individual for dignity while they are getting washed.

Prompting and assisting

• Ask before you help, be an observer and hold back on supporting unless there are indications the individual is having difficulty then ask if they would like help. 

• Use your judgement from the baseline assessment. If someone recently needed assistance of 2 for sit to stand then assist with this and not wait to be asked.  If someone stands with effort with a zimmer frame then they will need support pulling down their underwear and pyjama bottoms, changing their underwear or pad and washing their lower body as they will need to keep their hands on the zimmer frame in stand. Part of this could be seated until required to stand if needed. 

• Assessing cognition, only prompt with the next stage of the task if needed. During the assessment observe whether they can plan, sequence and problem-solve . Start with subtle hints and get more obvious as needed.

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