Intimate Care Policy

2023-24

CHILDREN’S INTIMATE CARE GUIDELINES

DEFINITION

Intimate care is any care which involves washing, touching or carrying out an invasive procedure that most children carry out for themselves but which some are unable to do due to physical disability, special educational needs associated with learning difficulties, medical needs or needs arising from the child’s stage of development. Care may involve help with drinking, eating, dressing and toileting. Help may also be needed with changing colostomy bags and other such equipment. It may also require the administration of rectal medication.

In most cases intimate care will involve procedures to do with personal hygiene and the cleaning of equipment associated with the process. In the case of a specific procedure only a person suitably trained and assessed as competent should undertake the procedure.

AIMS

The aims of this document and associated guidance are:

∙ To provide guidance and reassurance to staff

∙ To safeguard the dignity, rights and wellbeing of children and young people

∙ To assure parents that staff are knowledgeable about intimate care and that their individual needs and concerns are taken into account

PRINCIPLES

This document embraces tenets of Every Child Matters.

∙ Every child has the right to feel safe and secure

∙ Every child has the right to be treated as an individual

∙ Every child has the right to remain healthy

∙ Every child has the right to privacy, dignity and a professional approach from all staff when meeting his or her needs

∙ Every child has the right to be accepted for who they are, without regard to age, gender, ability, race, culture or beliefs

STAFFING

Staff must receive Safeguarding training every year (In addition identified staff members should be able to:

 ∙ Access other procedures and policies regarding the welfare of the child Identify and use a communication system that the child is most comfortable with

∙ ‘Read’ messages the child is trying to convey

∙ Communicate and involve the child in the toileting programme

∙ Offer choices, wherever possible

∙ Develop, where possible, greater independence

∙ Maintain confidentiality with children unless it is a child protection issue when Safeguarding Procedures must be followed

Treat every child with dignity and respect and ensure privacy appropriate to the child’s age and the situation. Privacy is an important issue. Much intimate care is carried out by one staff member along with one child. This practice should be actively supported unless the task requires two people. Having people working alone does increase the opportunity for possible abuse. However, this is balanced by the loss of privacy and lack of trust implied if two people have to be present – quite apart from the practical difficulties. It should also be noted that the presence of two people does not guarantee the safety of the child or young person – organised abuse by several perpetrators can, and does, take place. Therefore, staff should be supported in carrying out the intimate care of children alone unless the task requires the presence of two people. For older children it is preferable if the member of staff is the same gender as the young person. However, this is not always possible in practice.

These guidelines should be viewed as expectations upon staff, which are designed to protect both children and staff alike. In situations where a member of staff potentially breaches these expectations, other staff should be able to question this in a constructive manner.

If staff are not comfortable with any aspect of the agreed guidelines, they should seek advice from the Headteacher. For example, if they do not wish to conduct intimate care on a 1:1 basis, this should be discussed, and alternative arrangements considered. For example, it may be possible to have a second member of staff in an adjoining room or nearby so that they are close to hand but do not compromise the child’s sense of privacy.

PARENTS/CARERS

Each child, for whom it is appropriate for example changing due to incontinence, is to have a written ‘Intimate Care Plan’ included in their individual programme. This includes pupils requiring any oversight, assistance and supervision.  Close involvement of parents/carers and child/young person are essential in developing ‘Intimate Care Plans’ and written consent must be given by them.

The plan should be disseminated to all staff involved in the intimate care of the pupil. Care plans must be renewed regularly, at least once a year at the Annual Review.

The school Nursing team may be brought into school to carry out specific training where pupils have specific physical needs. Toilet plans may be produced and followed in school. These may not require recording daily but monitoring alongside the SENDCo (Nicky Zielinski) and team around the pupil.

RECORDING

A pupil changing record sheet should be signed (where a child is not being toilet trained) by all staff involved in any intimate care tasks. Copies will be kept in a file in the hygiene suite/toilet area (these are coded to protect the identity of the children), and completed sheets stored in pupil’s individual confidential files There is also a section on the sheet to record any comments or observations. For example – skin impairment – changed bowel or urinary pattern

If you are concerned that during the intimate care of the child:-

• You accidentally hurt the child
• The child seems sore or unusually tender in the genital area
• The child appears to be sexually aroused by your actions
• The child misunderstands or misinterprets something
• The child has a very emotional reaction without apparent cause (sudden crying or shouting)

Report any incident as soon as possible to another person working with you and make a brief written note of it. Then please discuss immediately with a senior member of staff or Designated Safeguarding Officer.

FACILITIES

• Facilities are to be easily accessed by the child and designed with the appropriate advice from relevant professionals where necessary, for example, Occupation Therapist, Physiotherapist, School Nurse, or appropriately trained professionals.

• Hand washing facilities are to be provided within the room for the child/young person and staff. Liquid soap and paper hand towels are to be available alongside hand sanitizers.

• All waste bins are to be fitted with a lid to be foot operated.

• A secure area for clinical waste awaiting collection must be available.

• The importance of privacy is maintained by ensuring the room can be seen to be in use and be secured from intrusion.

• All equipment is to be stored safely but easily accessible to the child where this is necessary. It is important to take into consideration the privacy of the individual children/young people and the safety of others.

• Facilities must be regularly inspected and maintained.

• All notices must be laminated.

• Any spare clothing must be stored in sealed containers.

EQUIPMENT

The list of equipment detailed below is not exhaustive but gives examples of types of equipment available for use.

1. Rise and fall bed, with suitable sides.

2. Changing mat, suitable for younger child, covered with intact waterproof material.

3. Moving and handling equipment.

4. Gloves – if direct contact with blood or body fluids is anticipated, staff to wear seamless, non-sterile gloves (e.g. latex and non-latex which are powder free)

5. Aprons – disposable plastic aprons. The use of cotton is not recommended.

6. Disposable paper towels.

7. Disposable wipes – the product as agreed in the ‘Care Plan’.

8. Cleansing agent – appropriate for use and as agreed on the ‘Care Plan’.

9. Continence care products.

10. Yellow Clinical Waste Bags for waste that has come into contact with body fluids. Large amount of waste to be disposed of using yellow plastic bags. Green bins for weekly collection by Leeds City Council. All bags should be labelled, secured with self-locking tie and stored in an appropriate secure area awaiting collection for incineration.

11. Where children may need toilet seat covers these are provided through occupational health

INTIMATE CARE PLAN

ADVICE ONLY

If your child needs cleaning, plain water will be used with a few drops of liquid cleanser added to the water.

Name of liquid cleanser –

Please advise if this is not suitable for your child and send in an alternative.

I/we have read, understood and agree to the plan for Intimate Care

Signed ………………………………………………………………

Name ………………………………………………………………

Relation to child ……………………………………………………

Date ……………………………

CHANGING RECORD

PUPIL ___________________________________

WEEK BEGINNING ________________________

W(wet), D(dry), B(bowels open), M(menstruation), U(urinated), S(soiled)

Please remember – if you have any concerns, then please discuss immediately with a senior member of staff or child protection co-ordinator

Approval Date: October 2022

Reviewed 13/10/23 HC/SLP

Review by: October 2023