Healthy Footsteps

NHS Fife Podiatry service provide advice and support to patients, carers and staff within care homes to deliver personalised and patient centred foot care within the care home setting. All care home patients, carers and staff can receive training on how to carry out personal footcare within the care home setting.

The podiatry department offers all care homes in Fife regular foothealth training sessions.  All care home staff, residents, friends and family are welcome to attend these sessions. These can be booked through your local podiatry care home team.  The training resource is a national package by the Scottish Government

For residents who are unable to self care free personal footcare will be carried out by care home staff or if you prefer a family member/friend can be shown how to carry this out for you

Scottish Government policy states it is the care homes responsibility to provide personal footcare as set out in the Free Personal and Nursing Care Policy. This includes Personal Hygiene - bathing, showering, hair washing, shaving, oral hygiene and nail care.

Please see below to view the NHS Fife Personal Foot Care DVD. Please click on the version you require.

English  

English subtitles

Urdu

Mandarin

Cantonese

 

Who We Are

There is a team of 1 full time podiatrist, 3 part time podiatrists and a level 3 carer covering the Fife area.

 

What We Do


The podiatry service provides care for patients who have a clinical need, including patients who require:

  • wound management
  • reduction of callous and corns
  • ingrown toenails
  • diabetes lower limb annual assessments
  • falls prevention including footwear advice

 

How to refer into the Service

Members of the public can self-refer to the Podiatry Service. 

To complete an electronic self referral please click here.  The completed referral will then be submitted directly to the service. The forms are completely secure and confidential. The service will respond within 14 days. Contact 01592 647199 (Mon-Fri 08.00-16.30) with your reference number if no contact has been made by the service within this time.

 

Paper referrals can also be picked up from your local clinic, health centre and GP Practice or printed out using the link below.  A new patient appointment letter will be sent by post to you once your referral has been triaged and accepted for treatment. In the event that your referral is not accepted or further information is required to process your referral you will be contacted either by telephone or letter.

NHS Fife Podiatry Referral Form

NHS Fife Podiatry Referral Form Guidance

A care plan will be agreed jointly by the podiatrist and the resident patient and/or the designated carer, indicating the roles and responsibilities of both the podiaty service and the care home. We will discuss the impact of current foot problems and what the desired outcome for the patient would be. We then set realistic goals for the patient.  A copy of this will then be kept in the residents file in the care home.

 

What Happens After I Refer Into The Service?

When a referral is received we will assess the patient and determine if the patient has a podiatric need or requires personal footcare. We try to see all referred patients within a 4 week timescale.

 

NHS Fife Healthy Footsteps

Healthy Footsteps is a national training resource developed by NHS Fife Podiatry in conjunction with Medical Illustrations.  This rescource helps people manage their footcare needs and identify when they need further help.

Self Care is when an individual looks after their own personal care needs; such as combing their hair, brushing their teeth, shaving and cutting their own nails.  We want to help care home residents to achieve this! Below are some handy tips to help.

 

 

Personal Foot Hygiene - Keep feet clean and dry.  If you a resident struggles to get in the bath or shower why not try sitting them down with their foot in a basin of warm soapy water.  Remember not to have the water too hot!

 

 

 

 

Mosturising Cream - to gain the best results a moisturiser should be used on feet daily. Cream should be placed all over the foot but not in between toes.  Make sure the cream is completely rubbed in and it can no longer be seen.

 

 

 

Nail Clippers - Cut nails whenever  they are becoming too long.  There is no set rule for when they should be cut, everyone is different.  Try to cut to the natural shape of the nail.  Do not cut down the sides.  There should be a white line at the edge of the nail left which will make sure the nail is not being cut too short. It is best to cut the nails after after the resident has been in the bath or shower as the nails are softer and therefore easier to cut.

 

 

 

Emery Board - If a resident is unable to cut nails filing daily will help to keep nails short. It is best to file when the nail is dry as it is much easier.  If the resident has thick nails file the top of the nail as well as the length.

 

 

 

Podiatry Service

The podiatry Service is here for patients when they need us.  Our aim is to reduce foot pain and keep people as mobile and independent as possible.  By focusing on foot heath problems and not social care such as cutting toenails we can help those who need us the most, as quickly as possible.

 

What Can We Help You With?

  • Corns
  • Callous
  • Ingrown Toenails
  • Foot Ulcers
  • Infections
  • Skin Conditions
  • Foot Pain
  • Falls Prevention

All of these conditions can affect mobility and impact on general health.  Foot ulcerations in particular have significant effect on a person's health.  These can be painful and lead to infection.  It is recommended that all foot ulcers are referred to the podiatry department for assessment and implementation of appropriate care plan. Working closely with residents, care home staff, family and other healthcare professionals we aim to heal these with appropriate dressings, pressure relief, pain relief and dietary input.

Non-healing wounds may be referred onto hospital services if required. Unfortunately some of these wounds may lead to amputation.

Prevention is better than cure!

 We would rather prevent these problems where possible and we actively provide training to care home staff residents and families/friends.  Advice on footwear, healthly lifestyles, pressure relief and environment can reduce the risk of developing foot problems.  When problems do develop a referral can be made to us.  All care homes have a copy of the podiatry self referral form these can be completed by residents, care home staff, family/friends or other health professionals.  A referral can also be made online

CPR For Feet

The service actively promotes CPR for feet. This is a national programme aimed at reducing the risk of ulcerations developing. CPR for feet stands for Check, Protect and Report. We recommend everyone’s feet be checked on a daily basis. Should any changes in skin condition be noted offloading devices should be put in place and a referral made to podiatry immediately. Please refer to our CPR For Feet poster in our publications section below.

NHS Fife podiatry service has also created an offloading document to educate and guide people on choosing the correct offloading device. Please refer to the document in ourpublicationsbelow.

 

Diabetes  

On admission to a care home every resident should be tested for diabetes. It is important to know if the resident has diabetes as it can affect their foot health. It can cause damage to the blood supply and nerve endings in the feet. This can lead to foot ulcerations and possibly amputation.

If a resident is diagnosed with diabetes or move into a care home and already have diabetes they will be referred to the podiatry service for a lower limb foot assessment. This assessment will be carried out yearly to determine any risk there may be to the resident's foot health.

The resident will be given a risk category, the higher the risk the more changes have occurred in their feet. This increases the risk of foot ulceration.  Please click on the links below for more information regarding each risk category.

Low Risk

Moderate Risk

High Risk 

 

For further information please refer to the diabetes pages of our website or the following resources:

SIGN GUIDELINE 116

Diabetes UK

My Diabetes, My Way

NHS Fife Care Home Guidelines for Diabetes

 

Myths

Everyone has heard myths about feet, here are a few of the most common we have heard, do you know any others? 

 

Q    Podiatrist won’t cut my toenails?    

A    TRUE - Podiatrists are trained health care professions who aim to manage foot pain and maintain mobility.

      Nail care is a social care need rather than a medical condition.

      If you are unable to cut your nails, family or friends may be able to help you. In a care home, staff are trained to do so.

 

Q    I can’t cut my toenails if I am diabetic.          

A     FALSE - To keep your feet healthy it is recommended you cut your toenails regularly.

       You will receive personal advice on your foot health at your lower limb annual review.

 

Q    Cutting a V in your nail will help an ingrown toenail.   

A     FALSE - If you have an ingrown toenail you need the piece of ingrown nail removed, cutting a V shape will not remove the ingrown piece of nail.

 

Q     Corns have roots.  

A      FALSE - Corns are caused by excessive pressure to your foot. This can be caused by the shape of your foot and footwear.

        If painful a podiatrist can remove the corn and advise on how to reduce the risk of it returning. 

 

Ill Health - Emotional Ups and Downs

As we age we are more likely to develop problems with our health. If you live in a care home it is likely your health is impacting on your ability to manage some aspects of daily living

 

Dementia

Dementia can be one of the main reasons someone looks to move into a care home. Dementia is a term used to describe a decline of the brain and its abilities; there are several forms of dementia. Dementia can impact on a person’s ability to carry our normal day to day living, affecting memory, understanding, language and judgment.

The podiatry service aims to help people maintain a good quality of life following a diagnosis of dementia and those further on in their journey. Members of the podiatry care home staff actively participate in dementia care and progressing services for those with dementia. One member of the team sits on the Scottish Government AHP group, whilst another is a trained Dementia Champion.

People with dementia created a charter of rights and the podiatry department ensures we try to achieve these for our patients.   We as a service strive to be patient centered and involve you in your care plan. With later stage dementia that can be difficult, but working with carers, families and friends who know you well we try to help achieve your goals/wishes.

 If you have a ‘Getting to Know’ me document these can be useful in learning about you as a person and your wishes.  

For further information on dementia please visit: Alzheimers Scotland

Other health conditions can impact on your general health and the podiatry service is well trained to help you with your needs. All care is patient centered and your rights and wishes will be respected as we try to work with you to reach achievable goals. 

 

Falls Prevention

As we get older the risk of having falls increases. Having a fall or the fear of having one can make you lose your confidence and you may become frightened or worried about walking.

 As a service we want to help you maintain your mobility, we can help by giving advice on good footwear, treating pain in your feet and giving advice on physical movement. We can also advise on environment to reduce the risk of tripping over obstacles.   

 Smoking

As a health service we actively encourage people to stop smoking. Smoking can affect the circulation to your feet, which can cause you pain in your leg muscles when you walk. You may also develop rest pain due to poor circulation and if you develop any foot ulcerations smoking can reduce the rate of healing or prevent it from healing.

If you wish to stop smoking resources are available to help you at NHSSmokeFree

 

Exercise

Exercise and a good diet is important to keep you healthy.  Most care homes will provide movement and exercise classes which you can participate in to keep you active. If you cannot walk exercises will be specific to your needs so you can take part and benefit. Ask your care home staff about exercises and what they can do for you.  If you are able to get outside, walking is a good form of exercise which you can do at your own pace. In areas of Fife there are walking groups if you wish to join.

 

Contacts

What to do if you wish to discuss any of the above or would like more specialist information:

Please contact the Podiatry Care Home Specialist team using the details below:- 

 

Dunfermline & West Fife Area Kirkcaldy & Levemounth Area Glenrothes & North East Fife Area
Lynebank Hospital Fair Isle Clinic St Andrews Community Hospital
Halbeath Road Fair Isle Road Largo Road
Dunfermline Kirkcaldy St Andrews
KY11 4AX KY2 6EE KY156 8AR
T: 01383 565307 T:001592 265889 T: 01334 465567

 

 Related Websites

Scottish Government Guides on Personal Footcare: Personal footcare is part of personal hygiene such as shaving or bathing and covers a set of tasks that an adult, whatever their age, would normally do for themselves if able to. This includes a range of things such as toe care and skin care.

Guidance on Charging for Residential Accommodation: The Scottish Goverment guidance on charges within residential accommodation.

 

To find out more about your care home please refer to the Care Inspectorate

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