We’re aware that cleaners at Karingal have been asked to tick a chart that indicates whether there has been evidence of bowel movements in the toilet when they go to clean a resident’s bathroom.

We wrote to Trent recently and said that this makeshift bowel chart is not a clinically accurate indication that the resident may have used their bowels. Stopping doing this extra task would save cleaners some time on their already extraordinarily busy days.

Trent has responded and suggested this practice is for the benefit of the residents. Here is his explanation:

The purpose of this process is to save residents from having unnecessary invasive procedures like enemas and other aperients which can cause discomfort and loss of dignity for the resident. Having aperients when there is an empty bowel can cause stomach pain and be uncomfortable as the aperient is trying to work and cannot due to an empty bowel.  Whilst I acknowledge the tick sheet is not 100% accurate, it does prompt additional investigation for the clinical team if there is some form of evidence to be considered. Given the resident’s well-being is at the core of our roles, I am unsure why we would cease this harmless and collaborative process.

Clarity on the process:

This tick sheet is not part of a formal clinical process.  It is solely for cleaners to record if they see faecal matter in the toilet and spark further investigation from the clinical team. Some residents are unable to tell staff if they have used their bowels.

This information is passed onto the NUM who is able to speak, with the resident and visitors and try to determine if the resident has used their bowels.  Equally, it could identify if care requirements need to change.

Any formal recording is done via a bowel chart on iCare and the form the cleaners are using is not kept.

In terms of visitors, if we have concerns about a resident using their bowels, we are conscious of visitors and have the means to check who has or has not visited.

Addressing staff concerns:

This also addresses the Cleaner’s concerns about ECA staff not cleaning the toilet after assisting residents. The member’s comments about the chart being a waste of time are contradictory to the cleaner’s concerns about the faecal matter not being cleaned off toilets by PCAs.  These concerns were raised in the Cleaner’s meetings on more than one occasion.

If the NUM checks the information the cleaner provides against the bowel chart and sees it is already documented and no need to investigate, we can then go back to the PCA and offer additional education on the process of cleaning the toilet.

PCAs have also expressed that some of the new staff have not been cleaning the toilet bowls after assisting residents.

If you disagree with Trent about the tick box exercise and feel that it is of no value to the residents, feel free to raise it with Trent in the first instance or give HACSUassist a call to talk about it.