Intimate Care

 Policy

Issue 1   |  3rd September 2023

Intimate Care Policy

Introduction

Intimate care is any care which involves washing, touching or carrying out an invasive procedure (such as cleaning up a student after they have soiled themselves) to intimate personal areas. In most cases such care will involve cleaning for hygiene purposes as part of a staff member’s duty of care. In the case of a specific procedure only a person suitably trained and assessed as competent should undertake the procedure.

The issue of intimate care is a sensitive one and will require staff to be respectful of the student’s needs. The student's dignity should always be preserved with a high level of privacy, choice and control. There shall be a high awareness of child protection issues. Staff behaviour must be open to scrutiny and staff must work in partnership with parents/carers to provide continuity of care to children/young people wherever possible.

Our approach to best practice

The COOP Academy Stoke on Trent is committed to ensuring that all staff responsible for the intimate care of students will undertake their duties in a professional manner at all times. We recognise that there is a need to treat all students with respect when intimate care is given. No student should be attended to in a way that causes distress or pain.

The management of all students with intimate care needs will be carefully planned. The student who requires intimate care is treated with respect at all times; the student's welfare and dignity is of paramount importance.

Staff who provide intimate care are trained to do so (including Child Protection and Health and Safety training in lifting and moving) and are fully aware of best practice. Apparatus will be provided to assist with students who need special arrangements following assessment from physiotherapist/ occupational therapist as required.

Staff will be supported to adapt their practice in relation to the needs of individual students taking into account developmental changes such as the onset of puberty and menstruation. Wherever possible staff who are involved in the intimate care of students will not usually be involved with the delivery of sex education to the student in their care as an additional safeguard to both the staff and the student involved.

The student will be supported to achieve the highest level of autonomy that is possible given their age and abilities. Staff will encourage each student to do as much for him/herself as he/she can. This may mean, for example, giving the student responsibility for washing themselves. Individual intimate care plans will be drawn up for particular students as appropriate to suit the circumstances of the student.

Each student's right to privacy will be respected. Careful consideration will be given to each student's situation to determine how many carers might need to be present when a student is toileted. Where possible one student will be catered for by one adult unless there is a sound reason for having more adults present. If this is the case, the reasons should be clearly documented.

Wherever possible the same student will not be cared for by the same adult on a regular basis; ideally there will be a rota of carers known to the student who will take turns in providing care. This will ensure, as far as possible, that over-familiar relationships are discouraged from developing,

whilst at the same time guarding against the care being carried out by a succession of completely different carers.

The Protection of Students

If a member of staff has any concerns about physical changes in a student's presentation, e.g. marks, bruises, soreness etc. s/he will immediately report concerns to the designated safeguarding lead. If a student becomes distressed or unhappy about being cared for by a particular member of staff, the matter will be looked into and outcomes recorded. Parents/carers will be contacted at the earliest opportunity as part of this process in order to reach a resolution. Staffing schedules will be altered until the issue(s) are resolved so that the student's needs remain paramount. Further advice will be taken from outside agencies if necessary.

If a child makes an allegation against a member of staff, all necessary procedures will be followed (see Safeguarding Policy).

Health and Safety

Staff should always wear an apron, gloves and PPE when dealing with a student who is bleeding or soiled. Any soiled waste should be placed in a polythene waste disposal bag, which can be sealed. This bag should then be placed in a bin which is specifically designated for the disposal of such waste. The bin should be emptied on a weekly basis and it can be collected as part of the usual refuse collection service as this waste is not classed as clinical waste.

Special needs

Students with special needs have the same rights to safety and privacy when receiving intimate care. Additional vulnerabilities that may arise from a physical disability or learning difficulty must be considered with regard to individual teaching and care plans for each student. As with all arrangements for intimate care needs, agreements between the student, parents/carers and the school should be easily understood and recorded. Regardless of age and ability, the views and/or emotional responses of students with special needs should be actively sought (with advocacy arrangements made for those who can't) in regular reviews of these arrangements.

Physical Contact

All staff engaged in the care and education of students need to exercise caution in the use of physical contact.

The expectation is that staff will work in ‘limited touch’ cultures and that when physical contact is made with students this will be in response to the student’s needs at the time, will be of limited duration and will be appropriate given their age, stage of development and background.

Staff should be aware that even well intentioned physical contact might be misconstrued directly by the student, an observer or by anyone the action is described to. Staff must therefore always be prepared to justify actions and accept that all physical contact be open to scrutiny.

Physical contact which is repeated with an individual student is likely to raise questions unless the justification for this is formally agreed by the student, the school and those with parental responsibility.

Students with special needs may require more physical contact to assist their everyday learning. The general culture of ‘limited touch’ will be adapted where appropriate to the individual requirements of each student. The arrangements must be understood and agreed by all concerned, justified in terms of the student’s needs, consistently applied and open to scrutiny. Wherever possible, consultation with colleagues should take place where any deviation from the arrangements is anticipated. Any deviation and the justification for it should be documented and reported.

Extra caution may be required where a student has suffered previous abuse or neglect. In the student’s view, physical contact might be associated with such experiences and lead to staff vulnerable to allegations of abuse. Additionally, many such students are extremely needy and seek out inappropriate physical contact. In such circumstances staff should deter the student without causing them a negative experience. Ensuring that a witness is present will help to protect staff from such allegations.

Restraint

There may be occasions where it is necessary for staff to restrain students physically to prevent them from inflicting damage on either themselves, others or property and to prevent them engaging in behaviour prejudicial to maintaining good order and discipline at the school.

In such cases only the minimum force necessary should be used for the minimum length of time required for the child to regain self- control.

In all cases of restraint the incident must be documented and reported. Staff must be fully aware of the school’s guidance on the ‘Use of Reasonable Force’ by reading the ‘Positive Handling Policy’.

Under no circumstances is it permissible to use physical force as a form of punishment, to modify behaviour, or to make a student comply with an instruction. Physical force of this nature can, and is likely to, constitute a criminal offence.

Students in distress

There may be occasions when a distressed student needs comfort and reassurance that may include physical touch such as a caring parent would give. Staff must remain self-aware at all times to ensure that their contact is not threatening or intrusive and not subject to misinterpretation.

Judgement will need to take account of the circumstances of a student’s distress, their age, the extent and cause of the distress. Unless the student needs an immediate response, staff should consider whether they are the most appropriate person to respond. It may be more suitable to involve the child’s relative or the collegl counsellor.

Particular care must be taken in instances which involve the same student over a period of time.

First Aid and intimate care

Staff who administer first aid should ensure wherever possible that another adult or other student are present. The student’s dignity must always be considered and where contact of a more intimate nature is required (e.g. assisting with toileting or the removal of wet/soiled clothing), another member of staff should be in the vicinity and should be made aware of the task being undertaken.

Regular requirements of an intimate nature should be planned for. Agreements between the school, parents/carers and the student concerned should be documented and easily understood. The necessity for such requirements should be reviewed regularly. The student’s views must also be actively sought and, in particular, any discomfort with the arrangements addressed,

Physical Education and other skills coaching

Some staff are likely to come into physical contact with students from time to time in the course of their duties when participating in games, demonstrating an exercise or the use of equipment.

Staff should be aware of the limits within which such contact should properly take place and of the possibility of misinterpretation.

Where it is anticipated that a student might be prone to misinterpret any such contact, alternatives should be considered, perhaps involving another member of staff or a less vulnerable student in the demonstration.

Showers/changing clothes

Young people are entitled to respect and privacy when changing clothes or taking a shower.

However, there must be the required level of supervision to safeguard young people with regard to health and safety considerations and to ensure that bullying or teasing does not occur. This means that adults should announce their intention of entering changing rooms, avoid remaining in changing rooms unless students’ needs require it, avoid any physical contact when students are in a state of undress and avoid any visually intrusive behaviour.

Given the vulnerabilities of the situation, it is strongly recommended that when supervising students in a state of undress, another member of staff is present. However, this may not always be possible and therefore staff need to be vigilant about their own conduct, e.g. adults must not change in the same place as students or shower with students.

Out of school trips, clubs etc.

Staff should take particular care when supervising students in the less formal atmosphere of a residential setting or after-school activity. Although more informal relationships in such circumstances tend to be usual, the standard of behaviour expected of staff will be no different from the behaviour expected within school. Staff involved in such activities should also be familiar with the school’s policy and all local authority guidance regarding out of school activities.

To ensure student’s safety, increased vigilance may be required when monitoring their behaviour on field trips, holidays etc. It is important to exercise caution so that a student is not compromised and the member of staff does not attract allegations of overly intrusive or abusive behaviour.