<p>Aim The aim of this audit was to determine the adequacy of diagnosis for patients with a continence problem and the provision and appropriateness of treatment; and to assess the knowledge of healthcare staff with regard to incontinence.</p> <p>Method Standards of management of urinary incontinence were investigated in a sample of 200 older patients on the basis of patient interviews, as well as inspection of patient records. Nurses’ knowledge of incontinence and its management was assessed by questionnaire.</p> <p>Results Of the 200 patients in the sample, 66 had urinary incontinence, of whom 17 were also faecally incontinent. A further 19 patients had indwelling urinary catheters, of whom two were faecally incontinent. The study identified a range of deficiencies in the quality of incontinence management. No diagnosis of the underlying cause of incontinence had been made in 53 of the 66 cases (80.3 per cent). The most prevalent treatment was the body-worn pad, used in 58 cases (89.2 per cent), whereas interventions such as anticholinergic medication and bladder re-education were used only rarely, in seven patients (10.6 per cent) and three patients (4.5 per cent) respectively. In 14 cases (21.2 per cent), no treatment had been instigated. Response to treatment was not recorded in the patients’ notes. The knowledge of nursing staff about incontinence and its management was also inadequate.</p> <p>Conclusion These findings indicate that urinary incontinence remains poorly managed in this trust, with inadequate standards of care, under-use of active interventions and insufficient nursing knowledge.</p>