washing hands after wiping oneself when using the toilet

My client has severe OCD and despite being able to manage using the toilet normally, gets ‘stuck’ when trying to wash her hands afterwards, in her cleaning rituals, often having to start again repeatedly if she loses count or a finger touches something before being washed to her satisfaction.
DWP say ‘For the purpose of this activity washing your hands is not considered’ but I disagree, as it is always considered unhygienic and likely to spread germs if not done.
Shouldn’t this be considered as necessary as wiping oneself?

I am aware that difficulties with cleaning yourself afterwards is sufficient to allow points - in this case, under Reg 4d, I am thinking.

Does anyone have any relevant caselaw?
Rose

So you would be arguing that they meet 5C, as they need prompting to complete the activity within a reasonable time frame?

The nearest case law I know is probably that removing and putting back on clothing is not considered within activity 5 even though, obviously, it is also a necessary part of going to the toilet - 2015 UKUT 498 AAC. See https://pipinfo.net/activities/managing-toilet-needs-or-incontinence for this and other cases.

Maybe the wording “cleaning oneself afterwards” in schedule 1 of the PIP regs, or the end of para 29 here, could include handwashing in relation to 4B of the regs as well as 4D. The above para seems to refer to cleaning yourself in relation to managing incontinence, although schedule 1 states that cleaning yourself comes within ‘toilet needs’ rather than incontinence. Which is a bit confusing.

I suspect that ultimately it may be seen as double counting with activity 4, would be interested to know what others think.

There is no PIP case law as far as I know but it was held in Cockburn (reported as R(DLA)2/98 ) that laudering soiled sheets would not count as ” attention” re incontinence although removal and changing of soiled linen could

The PIP descriptor is of course more limited than the DLA concept of attention so even the removal of soiled linent would not count.

The DWP seem to think that washing hands is akin to dealing with the aftermath as in Cockburn, but that is not the point because as you say ones hands are clearly part of ones person.

Getting dresssed does not form part of the defined activity as was explained by Judge Hemingway in GP v SSWP (PIP) [2015] UKUT 498 (AAC) but I can see nothing in GP that would detract from the argument that washing ones hands does count

I guess your argument would be that the time taken in hand washing is such that your client cannot manage toilet needs in a reasonable time, applying regulation 4(2A), rather than that he meets descriptor 5b, c or d. The problem is that “toilet needs” are specifically defined in para 1 of Schedule 1 to the PIP Regulations as:
(a)getting on and off an unadapted toilet;
(b)evacuating the bladder and bowel; and
(c)cleaning oneself afterwards;

So you would have to argue that washing your hands is part and parcel of cleaning yourself afterwards.

I don’t know of any direct authority on this point, one way or the other but you might get some help from RB v Secretary of State for Work and Pensions (PIP) – [2019] UKUT 0186 (AAC) –
CPIP/2574/2018. The facts were very different. The claimant’s problem was that as a result of his medical condition he was clumsy in wiping himself, so at risk of getting faeces on his hands. The First-tier tribunal decided that that didn’t matter, because he could always wash his hands, but In paragraph 9 Judge Hemingway held:

“9. As to what seems to have been an alternative conclusion reached by the tribunal to the
effect that if the only problem for the claimant was getting faeces on the hands rather than
wiping himself clean, such would be remedied by the washing of the hands, it is not now
necessary for me to reach a firm view. But ordinarily it seems to me one would expect to be
able to accomplish such a task without a difficulty of that nature arising. If such a problem
does arise at least with regularity there might conceivably be health concerns. It will probably
come down to a question of fact and degree but I would have thought in appropriate
circumstances it will be open to a tribunal, having made appropriate findings, to conclude that
that sort of difficulty either of itself or in conjunction with other related problems can justify a
finding that the management of toilet needs is not being accomplished to an acceptable
standard.”

Maybe Judge Hemingway was just being delicate or polite here but “wiping himself clean” veers away from the statutory language.

Sch 1(1) interprets “toilet needs” to include “cleaning oneself afterwards”

The commentary in Sweet & Maxwell Vol 1 suggests that different toilet arrangements that arise from cultural differences should be taken into account.

The use of a bidet shower will typically involve holding the shower head in the right hand and using the fingers of the left hand to assist with cleaning the anal area.  That being the case it is inevitable that some faecal material will be deposited on the fingers

Although the fingers may be cleaned to a large extent by the shower, I don’t think anyone would suggest that this would be enough.