Relationships and Physical Contact with Children

Contents

1. General
2. Physical Contact
3. One to one Time Alone With Children
4. Intimate Care
5. Menstruation
6. Enuresis (involuntary Urination) and Encopresis (Soiling)
7. Key Points for Good Practice

1. General

Suitable arrangements should be in place in all homes for matters relating to physical contact, intimate care, menstruation, enuresis, encopresis and other aspects of children's personal care. These arrangements should take into account the child’s gender, religion, ethnicity, cultural and linguistic background, sexual identity, mental health, any disability, their assessed needs, previous experiences and any relevant plans e.g. Placement Plan and Care Plan.

Suitable arrangements should be in place in all homes for matters relating to physical contact, intimate care (including menstruation, enuresis, encopresis) and other aspects of children's personal care.

All staff working in Derbyshire County Council children’s homes must read, discuss and follow the Safer Working Practice Guidance: Safe Touch/Safe Care as part of their Staff Induction and during Formal Supervision.

2. Physical Contact

Staff must provide a level of care, including physical contact, which is designed to demonstrate warmth, friendliness, and positive regard for children.

Physical contact should be given in a manner that is safe and protective and promotes positive relationships with adults.

Whilst staff are actively encouraged to play with children, it is not acceptable to play fight or participate in overtly physical games children.

3. One to One Time Alone With Children

Also see Lone Working Procedure.

Where a staff members daily work brings them into a one to one situation they should inform other staff why this is necessary and where this will be taking place.

Where one to one work is delivered as part of a specialist service or direct work programme this should be identified in the Placement Plan.

Managers will, where it is deemed necessary, ensure a risk assessment is carried out for the delivery of any piece of work that is consistent with the Placement Plan.

Staff should always try to keep doors open unless this constitutes a breach of privacy for the child. In these instances it may be necessary to undertake a risk assessment of the situation.

No volunteer working in the home should ever be in a one to one situation with a child. Where a member of staff has to work in isolation or on duty on their own a risk assessment must be carried out.

If an accident happens whilst in this situation as with any other situation make sure an accident report form is filled in and signed by all parties.

If anything significant happens that is not care planned/ risk assessed, complete the appropriate forms and pass to a manager for response.

Giving first aid or personal care (where deemed necessary on the Placement Plan), should be recorded on the relevant format.

If any member of staff is uneasy about the behaviour of others who are putting himself or herself or the child at risk they must inform the manager of the home.

Where a member of staff feels that the unease is centred on the registered manager they must report this to a manager outside of the line management of the home, or to the child's social worker.

Any allegations, suspicions and/or disclosures of abuse should be reported as per Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure. Any allegations made against a member of staff or volunteer should be responded to in line with the Allegations Against Staff Procedure.

4. Intimate Care

Children must be supported and encouraged to undertake bathing, showers and other intimate care of themselves without relying on staff.

If a child need helps with intimate care, arrangements must emphasise the child’s dignity and their right to be consulted. Where necessary staff will be provided with specialist training and support.

Unless otherwise agreed, children will be given intimate care by adults of the same gender.

5. Menstruation

Young women should be supported and encouraged to keep their own supply of sanitary protection without having to request it from staff.

There should also be adequate provision for the private disposal of used sanitary protection.

6. Enuresis (involuntary Urination) and Encopresis (Soiling)

If it is known or suspected that a child is likely to experience enuresis (involuntary urination) and/or, encopresis (soiling) or may be prone to smearing it should be discussed openly, with the child if possible, and strategies adopted for managing it. These strategies should be outlined in the child's Placement Plan.

It is important to remember when working with children and young people with disabilities, especially those with Autism and Learning Difficulties, that soiling and smearing can be sensory (enjoy the feel of their faeces), learnt behaviour, or as a result constipation or the fear of using toilets and not being able to wipe themselves properly.

It may be appropriate to consult a Continence Nurse or other specialist, who will provide advice on the most appropriate strategy to adopt. In the absence of such advice, the following should be adopted:

1. Talk to the child in private, openly but sympathetically;
2. Do not treat it as the fault of the child, or apply any form of Additional Measure;
3. Do not require the child to clear up; arrange for the child to be cleaned and remove then wash any soiled bedding and clothes;
4. Keep a record, either on a dedicated form or in the child's Daily Record;
5. Consider making arrangements for the child to have any supper in good time before retiring, and arranging for the child to use the toilet before retiring; also consider arranging for the child to be woken to use the toilet during the night;
6. Consider using mattresses or bedding that can withstand being soiled or wet.

7. Key Points for Good Practice

• Discussion pre and on admission should take place with the young person in relation to how they prefer to be supported. This will include a discussion around touch. The outcome of these discussions must be recorded in the young person’s Individual Placement Care Plan and their Safe Care Plan;
• Physical contact should not respond to or lead to expectations or anxieties of any form and should not become habitual. Specific consideration should be given to the needs of a child within the home who has or may have been subjected to abuse and/or neglect;
• Although staff should not always respond automatically to any child asking for physical contact, a child should not be rejected without explanation;
• There should be no general expectations of privacy for the physical expression of affection or giving of comfort in any circumstance. Staff must endeavour not to be alone with a child in such situations, except in exceptional circumstances, such as a bereavement or other traumatic event. In such circumstances the staff member should inform others on duty what they are doing in order to ensure safeguards are in place,(i.e. a member of staff within ear/eye shot) and make a record of their actions;
• Residential children’s workers need to be aware of the reaction of the child to touch and modify their behaviour accordingly;
• Staff should ensure that their touch is non-abusive, with no intention to cause pain or injury, that it is in the best interest of the child and others, be clear of the reason and take account of a range of diversity issues, such as, gender and disability;
• Both staff and managers need to be alert to the problems of sexual attraction between staff and children in their care. This is an important consideration for the induction of staff;
• Any concerns should always be addressed and recorded in supervision;
• REMEMBER - In all circumstances where there is physical contact with a child it must an appropriate response to meet their needs and not those of the staff member.