Integrated Children’s Services
Intimate Care for Children and Young People:
Policy and Guidance
March 2009
HIGHLAND COUNCIL
Integrated Children’s Services
Intimate Care Policy and Guidance for Children and Young People
CONTENTS
1. Acknowledgements and Thanks Page 2
2. Introduction Page 3
3. Highland Council Policy. Page 4
4. Proforma Intimate Care Policy. Pages 6 -12
This policy should be adopted by individual schools and should be used where appropriate by early years and residential settings.
5. Guidance on providing specific types of Intimate Care Pages 13-23
These appendices should be included in the policy of each school, early years or residential setting.
6. Intimate Personal Care - Staff Information Summary Page 24
A single page summary which should be given to all staff who provide intimate personal care in schools, early years centres and residential settings.
7. Proforma Intimate Care Protocol Page 25
This should be used in all settings for children and young people who require assistance with intimate personal care.
8. Proforma Permission for School/Centre to provide intimate Care Page 26
This agreement for parents/careers should be used in all settings for children and young people who require assistance with intimate personal care.
9. Child Protection. Page 27
This document provides guidance in relation to Child Protection and Children with Disabilities or Additional Support Needs.
10. Intimate Personal Care for Children in Early Years Settings Page 31
This document provides guidance on changing children in Early Years settings. It can be used as a basis for policy by individual Early Years settings.
11. Manual Handling
Proforma Policy Statement for Schools and Note on Best Practice. Page 32
Manual Handling Assessment Proforma Page 33
Risk Assessment Proforma Page 36
Individual Manual Handling Plan Page 38
These documents should be used in all settings for children and young people who require assistance with movement and positioning.
1. Acknowledgements and Thanks
Acknowledgement and thanks are given to the Drummond School Intimate Care Policy Group for their work on developing policy and guidance for schools.
Acknowledgement and thanks are given to Jane Baines, Elaine Barrie, Irene Bloomfield, Sam Brogan, Neil Campbell, Liz Gordon, Andrew McTaggart, Fiona Malcolm, George Reid, Colin Stein, Andrew Stevenson and Glynne Williamson for their help in developing this documentation.
Acknowledgement and thanks are also given for the valued information/reference documents obtained from the following:
Beatlie School, Policy and Guidelines on Personal and Social Development, West Lothian Council
Capability Scotland: A Code of Conduct for Staff Working with Children & Young People, Edinburgh
Capability Scotland: Child Protection Policy, Edinburgh
Carnbooth Residential School for Deaf-Blind Children, (2000) Policy/Guidelines on Dressing, Bathing, and Toileting and Sex Education
Currie M. et al, (1999) Helping Hands: Guidelines for Staff who provide Intimate Care for People with Disabilities, Scottish Office Education and Industry Department
Dawson Park School, Intimate Care: Guidelines to Good Practice-Managers, Angus Council
National Care Standards, (2002) Early Education and Childcare up to The Age of 16, Scottish Executive, Edinburgh
NHS, Highland, (2002) Infection Control Guidance for the Pre-School Setting
Pinewood School, (2001) Policy Document on 'Intimate Care', West Lothian Council
2. INTRODUCTION
This Policy and relevant sections of the Guidance must be followed by all Highland Council staff involved in the intimate care of children. These staff include those in Early Years settings, schools and residential care settings within the Highland Council area, those who are involved in school trips, out-of-school activities and outdoor pursuits, and foster carers
The documentation supports those staff who provide intimate care to Highland children and young people. It acknowledges the responsibilities and protects the rights of everyone involved.
This Policy and Guidance are based on national guidance, accepted good practice and practical experience working with children and young people requiring intimate care.
Infants may require assistance with toileting, including nappy changing because they have not yet achieved full continence.
Older children and young people may require intimate personal care because they have learning disabilities, physical, visual, hearing or speech and communication impairments.
Children and young persons who require intimate personal care will be found in all educational settings including Early Years centres, nursery classes, primary schools, secondary schools, special schools, special classes and resourced bases.
Since some Intimate Personal Care requires Moving and Handling this document includes proforma policy and guidance for Moving and Handling (see Section 12).
This Policy and Guidance should be read in conjunction with other Highland Council policies including:
· The ECS Accessibility Policy, as required by Disability Discrimination legislation
· The Highland Child Protection Policy
· The Highland Council’s Health & Safety and Moving and Handling Policies
· ECS and SWS guidance in relation to Moving and Handling
· Joint Council and NHS Policy and Guidance: Administration of Medicines in Schools (in preparation)
Throughout this Policy and Guidance the term child/children will be used to refer to children and young people. The term parent/s is used to refer to parents, carers and legal guardians. The term school includes all Early Years settings.
This Policy and Guidance will be reviewed every two years, or more frequently if required, in order to take account of feedback and in order to take account of operational changes and changes in legislation.
3. HIGHLAND COUNCIL POLICY
Definition of Intimate Care
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, additional support needs associated with learning difficulties, medical needs or needs arising from the child’s stage of development.
Intimate 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 invasive 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 specialised procedure only a person suitably trained and assessed as competent should carry out the procedure.
Staff providing Intimate Care must be aware of the need to adhere to good Child Protection practice in order to minimise the risks for both children and staff. It is important that staff are supported and trained so that they feel confident in their practice.
Aims
The aims of the policy and associated guidance are:
· To safeguard the dignity, rights and well being of children and young people
· To ensure that children and young people are treated consistently when they experience intimate personal care in two or more settings
· To provide guidance and reassurance to staff
· To ensure that parents are involved in planning the intimate care of their child and are confident that their concerns and the individual needs of their child are taken into account
· To reassure parents that staff are knowledgeable about intimate care
Principles
The policy and guidance embrace the principles 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 information and support that will enable him or her to make informed and appropriate choices
• Every child has the right to be accepted for who they are, without regard to age, gender, ability, race, culture or beliefs
• Every child has the right to information and procedures for any complaint or queries he or she may have regarding intimate care
Partnership and participation
Much of the information required to make the process of intimate care as comfortable as possible for the child is available from parents and/or carers. They must be closely involved in the preparation of intimate care protocols. The importance of regular consultation and information sharing with parents/carers and professionals working with the child is emphasised throughout the policy and guidance.
Using the Policy and Guidance in Schools, Early Years Centres and Residential Care Establishments
Where any school, Early Years or residential setting provides intimate care to one or more pupils the Head Teacher or Centre Manager must ensure that:
1. The proforma Intimate Care policy is adopted as policy, Section 4.
2. All staff are given copies of the single page summary, Section 6.
3. Staff involved in providing Intimate Care are provided with training both in relation to the specific care being provided and in relation to child protection, and that they receive copies of the relevant parts of the appendices containing specific guidance, Section 5.
Insurance and Liability
The Highland Council has public liability insurance and, provided the Council’s documented procedures are followed, the Council will indemnify staff who undertake intimate personal care with children and young people. The Council will also indemnify any member of staff acting in good faith for the benefit of a pupil in an emergency situation. Head teachers and managers should let staff know about the provision for indemnity against legal liability made for all staff who undertake intimate personal care, and can ask the Council to provide written confirmation of insurance cover for staff who provide specific intimate personal care support.
4. INTIMATE PERSONAL CARE POLICY FOR SCHOOLS, EARLY YEARS CENTRES AND RESIDENTIAL SETTINGS (Proforma)
(NAME OF SCHOOL OR CENTRE)
Contents
Part 1 Mission Statement and Rationale
Part 2 Definition of Intimate Care and Aims
Part 3 Approach to Best Practice
Part 4 Communication regarding Intimate Care
Part 5 Responsibilities
Part 6 Policy Team members
Proforma Intimate Personal Care Policy – Part 1
Our Mission Statement
[Name of school or centre] is committed to ensuring that all staff responsible for the intimate care of children* and young people in [Name of school or centre] will undertake their duties in a professional manner at all times. [Name of school or centre] recognises that there is a need to treat all children with respect when intimate care is given. No child* should be attended to in a way that causes distress or pain. The child’s welfare and dignity is of paramount importance. Every child’s right to privacy will be respected.
Parents /Carers views will be sought and listened to with regard to every part of this policy.
Rationale
The purpose of these guidelines is to set out procedures that safeguard children and young people and staff by providing a consistent approach within a framework, and that recognise the rights and responsibilities of all those involved in providing intimate care for children and young people.
We believe that all children and young people should be able to participate in all aspects of community life so that intimate care procedures will be carried out in various settings. It is therefore important that appropriate facilities and equipment are available wherever possible.
We recognise that intimate care raises complex issues. Whilst it may not be possible to eliminate all risks the balance should be on the side of dignity, privacy, parental (and where appropriate pupil) choice and safety.
In accordance with the Highland Council Health and Safety Policy, all employees, regardless of position, are legally obliged to take reasonable care for the health and safety of themselves and others, and to co-operate with the employer or other authorised persons in achieving this worthwhile aim. It is the duty of both employer and employee to translate this safety policy into a course of effective action, Highland Council, Health and Safety Manual, (2002).
Proforma Intimate Personal Care Policy – Part 2
Definition of Intimate Care
Intimate care involves helping pupils at [Name of school or centre] with aspects of personal care which they are not able to undertake for themselves, either because of their age and maturity or because of developmental delay or disability. Children and young people with disabilities may require help with moving and handling, eating and drinking and all aspects of care including:
· Washing
· Dressing and undressing (including swimming)
· Supported Eating (including tube feeding)
· Administering medication (e.g. rectal diazepam )
· Toileting & Menstruation
· Physiotherapy Exercise Programme/Manual handling
· Massage/Intensive interaction
· Dental Hygiene
· Care of Tracheostomy
· Applying topical medicines (e.g. sun creams, eczema creams)
AIMS
· Safeguard the rights and well being of children and young people with regard to dignity, privacy, choice and safety.
· To ensure that children and young people are treated consistently when they experience intimate personal care in two or more settings.
· Assure parent/carers that all staff are knowledgeable about intimate care and that individual concerns are taken into account and when possible are acted upon.
· Parent/carers to be involved in any decision about the Intimate Care of their children.
· To provide appropriate guidance, training, supervision and reassurance to staff, and to ensure safe practice.
· To ensure that parents/carers and children and young people [where appropriate] are actively involved in the development of agreed Intimate Care protocols.
· The school/centre will ensure that details of an agreed individual Intimate Care protocol [see Part 7] are shared with other agencies that support the pupil.
· The child or young person’s choices will be taken into consideration in developing an individual Intimate Care protocol with parent / carer agreement.
· Provide staff with information and appropriate training in Intimate Care.
Proforma Intimate Personal Care Policy – Part 3
Approach to Best Practice
The management of all children and young people with intimate care needs to be carefully planned. All staff who provide intimate care need to be trained in Child Protection. Staff working with older children and young people and with those with disabilities will require training in Moving & Handling]. There need to be facilities and equipment for intimate care to take place in a manner that is fully compliant with Highland Council Policies and with our Mission Statement [see Part 1] and our aims [see Part 2].