3.13.3 Physical Contact and Intimate Care

SCOPE OF THIS CHAPTER

This procedure applies to children placed in foster and residential care managed by the authority, but the principles apply to the placement of every Child in Care. Therefore, where a Child in Care is placed with parents, relatives or friends or in placements not managed by the authority, the social worker must ensure these or other adequate procedures are applied.

1. General

Suitable arrangements should exist in all foster homes and children's homes for matters relating to physical contact, intimate care, menstruation, enuresis, encopresis and other aspects of children's personal care.

These arrangements should be set out in the home's Statement of Purpose, Foster Care Agreement or Placement Plan/Placement Information Record for individual children.

In the absence of such arrangements, the following sections must be adhered to:

2. Physical Contact

Staff/carers 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 way that is safe, protective and avoids the arousal of sexual expectations, feelings or the reinforcing of sexual stereotypes.

Whilst staff/carers are actively encouraged to play with children, it is not acceptable to play fight or participate in overtly physical games or tests of strength with the children.

3. Intimate Care

Children must be supported and encouraged, depending on their age, to undertake bathing, showers and other intimate care of themselves wherever possible without relying on carers.

Such arrangements must protect and promote the child's dignity and right to be consulted and involved. Where necessary, staff/carers will be provided with training and support during their induction.

Unless otherwise agreed with the child/parent/carer, where a child requires intimate care, consideration should be given to providing staff/carers of the same gender as the child. This should be included in the child's Placement Plan/Placement Information Record.

Individual care plans for children with disabilities should provide detailed instruction regarding any intimate care provided by staff/carers.

Consideration will also need to be given to issues regarding race, religion, culture, sexuality of the young person and should be detailed with the young persons care plan.

4. Menstruation

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

However it should be recognised that some young women will not know how to deal with menstruation and they will need guidance and support to manage their periods appropriately. This should be provided by female staff or carers in a positive manner.

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

5. Enuresis and Encopresis

If it is known or suspected that a child is likely to experience enuresis, encopresis 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/Placement Information Record/Risk Assessment.

Staff and carers who care for children who show this sort of behaviour must recognise that it may be the outward sign of deeper difficulties/abuse or that it may be a sign of a medical problem. In either case, a punitive approach will make the behaviour worse.

It may be appropriate to consult a Continence Nurse or other specialist, who may advise 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 Sanction;
  3. Do not require the child to clear up; arrange for the child to be cleaned and then remove and wash any soiled bedding and clothes. This will be subject to the level of age and understanding of the young person involved;
  4. Keep a record, either on a dedicated form or in the child's Daily Record with detail, if necessary, in a Detail Record;
  5. Consider making arrangements for the child to have any supper in good time before retiring, and arrange 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 made wet.