1.6.9 Sexual Health and Relationships

Contents

1. Provision of Information and Advice
2. Puberty and Sexual Identity
3. Pornography
4. Under Age Sexual Relationships
5. Sexual Activity in Homes
6. Contraception
7. Pregnancy and Termination
8. Working with Young Fathers
9. Prostitution/Commercial Sexual Exploitation
10. Sexually Transmitted Diseases
11. Masturbation
12. Peer Group Abuse

1. Provision of Information and Advice

Managers must ensure that children are provided with suitable, good quality, up to date, information and advice on matters relating to sexual health and relationships.

Such information and advice must be provided in a manner appropriate to children’s age and understanding and which is provided in a creative, child friendly manner.

Before providing such information and advice, Managers must consult Social Workers and, if possible, Parents or those with Parental Responsibility to ensure it is provided in the context of children’s backgrounds and needs; and any specific arrangements must be incorporated into the Care Programmes and Health Care Plans are key working sessions.

2. Puberty and Sexual Identity

Staff must adopt a non-judgemental attitude toward children, particularly as they mature and develop an awareness of their bodies and sexuality.

Staff must adopt the same approach to children who explore or are confused about their sexual identity or who have decided to embrace a particular lifestyle so long as it is not abusive or illegal.

Children who are confused about their sexual identity or indicate they have a preference must be afforded equal access to accurate information, education and support to enable them to move forward positively.

As necessary this must be addressed in Care Programmes.

3. Pornography

All materials published, circulated or available to children must promote and encourage healthy lifestyles and images of men and women that are positive and encouraging.

Children must be positively discouraged from obtaining material that is potentially offensive or pornographic.

If they obtain such material that is suspected to be illegal it must be confiscated and in extreme circumstances consideration must be given to reporting the matter to the Police. See The Police Procedure.

If children obtain material legally and it is considered appropriate they should be required to keep it private.

4. Underage Sexual Relationships

Children under the age of 13 are deemed to be incapable of giving consent to sexual activity. Therefore, children of this age who engage in sexual activity must be referred under safeguarding children procedures as a Child Protection Referral as potentially suffering from Significant Harm.

Managers must be alert to such relationships when considering the placement of children under 13. Children of this age who are likely to be at risk from each other (or from older children) should not be placed together.

When considering the placement (or ongoing placement) of children over the age of 13, Managers must assess the risk of sexual relationships developing and should ensure Strategies are in place to reduce or prevent these risks if they are likely to be exploitative or abusive.

Where children aged 13 - 18 are placed together with no identified risk of exploitative or abusive behaviour, Managers and Staff must monitor any developing relationships, sensitively but positively discouraging children from engaging under aged sexual relationships.

Overall, Staff should be mindful of their duty to consider the overall welfare of children and this may mean recognising that illegal activity is taking place and working to minimise risks and consequences. If there is any suspicion that a child is engaging in illegal behaviour it must be discussed with the Social Worker and consideration given to consulting the Child Protection Agencies.

Any actions taken in this respect will be subject to consultation and must be addressed in Care Programmes.

Should Staff suspect children are engaging in sexual relationships, they should:

1. Ensure the basic safety of all the children concerned.
2. Notify the Manager, who should notify/consult relevant Social Workers and the Line Manager for the home.
3. Record all events, distinguishing between fact and opinion.

Should Staff discover children engaging in sexual relationships, they should:

1. Ensure the basic safety of all children concerned (if necessary Staff may consider removal of one or more child).
2. Inform the Manager, who should notify/consult relevant Social Workers and the Line Manager for the home.
3. Record all events, distinguishing between fact and opinion.

5. Sexual Activity in Homes

This section must be read in conjunction with Section 4, Underage Sexual Relationships.

Children under the age of 13 are deemed to be incapable of giving consent to sexual activity, but it is understood that older children may develop relationships with each other that they will wish to express themselves sexually and explore their views, attitudes and behaviours.

This may be acceptable so long as their behaviour is respectful of the wishes and feelings of everyone they live with including Staff and other children. However Staff may not condone or permit unhealthy, exploitative, abusive or illegal behaviour and must take all reasonable steps to reduce or prevent it.

If Staff are seriously concerned about children’s behaviour they must draw this to the attention of the Manager who may invoke Strategies to reduce or prevent the behaviours from escalating. Such strategies must be developed in consultation with relevant Social Workers and consideration given to consulting the Child Protection Agencies.

6. Contraception

Whilst not encouraging it, it is understood that children may engage in sexual activity; some before they reach the age of consent. In such circumstances Staff must take reasonable steps to minimise risk of pregnancy or infection, including facilitating contact with relevant agencies providing contraceptive advice; such as the Brook Advisory Service, The Placing Authority’s Looked After Children Nurse or GP. Matters of concern must be discussed with the Social Worker and addressed in Care Programmes.

7. Pregnancy and Termination

If a child is suspected or known to be pregnant the Manager (or a delegated person acting on the Manager’s behalf) should talk sensitively and openly to the child with a view, if necessary, to arranging for an appropriate test and follow up advice/support.

Under normal circumstances, the child’s Social Worker and Parent(s) should be informed and should collaborate with the child in drawing up a suitable plan for the promotion of the welfare of the pregnant and unborn child.

However, a child who has reached the age of sixteen may request that Parent(s) or the Social Worker are not informed. Where a child is under the age of sixteen they may also request confidentiality if they are of an age and level of understanding to make such an informed decision.

Where a child under sixteen makes such a request, the Manager should seek the advice of the Line Manager, who may seek legal advice before agreeing. Also see Consents Guidance.

In all circumstances, should there be suspicions that the pregnant child or the unborn child are at risk of Significant Harm, the Manager must discuss it with the child’s Social Worker with a view to making a child protection referral.

Any decision to terminate a pregnancy should be reached by the pregnant child. Advice, counselling and support in making the decision must only be given by suitably qualified independent counsellors.

If the pregnant child decides to terminate the pregnancy, the Manager must ensure that adequate support is given throughout and afterwards to ensure the child’s privacy is protected and any physical or emotional needs are addressed sensitively.

8. Working with Young Fathers

This can be a difficult area of work because the choice and responsibility in decisions relating to the baby lies with the mother. Regardless of how the mother views the situation, young fathers still need to be supported. The following points should be addressed:

• What does the young man want his role to be?
• Does this conflict with what the young woman wants? If so, how will this be managed?
• How will you support him to deal with his thoughts, feelings, hopes and fears?
• How can he play an active role in the child’s life?
• Is the young man clear about his legal rights, choices and responsibilities in relation to his child?

9. Prostitution/Commercial Sexual Exploitation

The following should be read in conjunction with relevant Local Safeguarding Children Board (LSCB) procedures on commercial sexual exploitation. Any suspicions or allegations that a young person is engaged, or may become involved, in prostitution or sexual exploitation must be reported as set out in Child/Adult Protection Procedure.

Also, the Registration Authority, Placing Authority and Police must be informed.

Children may have previously exchanged sex for rewards, gifts, drugs, accommodation and money. Some maintain this lifestyle whilst continuing to be accommodated by the authority.

The Manager and Staff must be alert to such behaviours and should do all they can to create an environment which encourages children to be open about their

past or present attitudes and behaviours and which demonstrates they will be supported to guide them away from such lifestyles.

Where there is any suspicion that a child is engaged in such behaviour it should be addressed in the child’s Care Programme together with Strategies to be adopted to help the child find alternative lifestyles.

10. Sexually Transmitted Diseases

Also see HIV/AIDS (Guidance).

It is the absolute right of children to have information and advice on safer sex, HIV, AIDS, hepatitis and other sexually transmitted infections. HIV and Chlamydia are currently on the increase.

In providing such advice and guidance to children, it is important that they are made aware that there are many safer and pleasurable alternatives to penetrative sex, for example, stroking, exploration of erogenous zones, sucking, kissing, licking, or mutual masturbation.

Children should be encouraged and supported to take responsibility for their own sexual well being, acknowledging cultural diversity. The opportunity to discuss this with Carers and a variety of health professionals should be available.

With regard to sexually transmitted infections including HIV, children should be advised of clinics where anonymity and appropriate pre and post testing counselling are available. They should be made aware that, if they are tested by their GP then the results of this will be recorded in their medical notes and these may be available to prospective employers, mortgage companies etc. in the future. There is, however, complete confidentiality at Genito-urinary Medicine (G.U.M.) clinics.

If it is known or suspected that a child has a sexually transmitted disease (other than HIV and AIDS, which is dealt with in HIV/AIDS Procedure), the Manager and Social Worker must be informed and decide what measures to take.

On principle, the child should be referred, with the Parents consent if possible, to the local Genito-urinary Medicine Clinic, who will provide the child and Carer with advice, counselling, testing and other support.

Only those immediate Carers of the child who need to know will be informed of any suspicion or the outcome of any tests and strategies or measures to be adopted.

Other children in the home should only be informed if there is a direct risk to them; for example if the infected child deliberately attempts to infect them.

The only other individuals who will be told are the child’s GP and Health Visitor.

Before disclosing to any other agency or individual, the following criteria must be satisfied

• The child (where appropriate) and the Parents have given their written consent to the disclosure
• The disclosure would be in the best interests of the child
• Those receiving the information are aware of its confidential nature

Consent to testing

The permission of the child aged 16 or over must be given before testing. If a child under 16 has sufficient age and understanding, his or her permission must be given before testing.

Wherever possible, the Consent of the Parents should be obtained. In order for Parents to be able to participate in decision-making, they must be provided with adequate information and given appropriate support including access to counselling both before the test and in the event of a positive diagnosis.

Where Parental consent is not forthcoming but there is a clear medical recommendation that testing is in the child’s best interests, legal advice should be obtained as to whether the test can proceed.

11. Masturbation

It is accepted that masturbation is part of normal sexual behaviour but children must be positively encouraged to undertake such activities in private and in a manner which is not harmful to themselves or other people.

12. Peer Group Abuse

Also see Section 4, Under Aged Sexual Relationships and in conjunction with relevant Local Safeguarding Children Board (LSCB) procedures.

The possibility of peer abuse will always be taken seriously but we recognise it is equally important not to label or stigmatise normal sexual exploration and experimentation between children.

Behaviour is not a cause for concern unless it is compulsive, coercive, age- inappropriate or between children of significantly different ages, maturity or mental abilities.

If at any time Staff suspect children are engaged in abusive sexual relationships as perpetrators and/or victims, they must immediately inform the Manager, who must consult the Social Worker with a view to developing a strategy to reduce or prevent it; consideration must also be given to making a child protection referral in respect of the alleged victim and perpetrator; see Child/Adult Protection Procedure.

End