Guidelines for Staff who provide Intimate Care for Children and Young People with Disabilities

7. STAFF DEVELOPMENT

For staff involved in intimate care it can be difficult to achieve a balance between ensuring the child's privacy on the one hand, and his/her safety and protection on the other. There are concerns that actions, no matter how well intentioned, might be misrepresented in a damaging way. It is clearly important that managers and employers provide appropriate guidance and training for staff working in this sensitive area.

The following questions could be used for awareness raising and discussion in staff development and training to promote the protection of children from abuse or staff from allegations of abuse.

Questions related to requirements for good practice

• Are parents informed and consulted about arrangements for intimate care?
• Are staff familiar with child protection guidelines and procedures?
• Do staff know who to turn to for advice if they feel unsure or uncomfortable about a particular situation?
• Are any allegations which a child may make left unchallenged or unrecorded?
• Is inappropriate touching of any kind by staff or children allowed in games eg "horseplay", and tickling?
• Are there guidelines as to the tasks which qualified and unqualified staff should undertake?
• Are students or volunteers involved in intimate care and, if so, are they supervised by qualified staff?

Questions involving more flexible approaches

There are common situations and dilemmas facing establishments where children receive intimate care some of which are referred to below. There are often no 'right' answers since circumstances will vary.

What is important is the opportunity for staff to be able to discuss such issues with managers and to reach decisions based on skilled professional judgement calling a specialist advice where necessary, good communication with parents and, most importantly, the best interests of the child.

• How are decisions about the gender of the carer for a particular child reached?

Whilst it is considered preferable, especially for older, and more physically mature children to receive intimate care from a member of staff of the same gender, there are usually more female than male staff employed for these tasks. Boys are therefore likely to receive intimate care from a woman and this is usually acceptable to parents, although not in some cultures. Parents should be consulted where male members of staff might be required to provide intimate care for girls eg bathing and changing. Members of staff themselves may have reservations about carrying out aspects of intimate care with older children of the opposite gender.

• Should a member of staff be alone with a child when intimate care is being given?

It is not usually practicable from the point of view of staffing resources, for there to be two members of staff involved with a child for intimate care unless for health and safety reasons eg with a child who is ill or difficult to move or handle. The best interests of the child need to be considered in making such decisions on staffing. Whilst the presence of two people may be seen as providing protection against a possible allegation of abuse against a member of staff, it further erodes the privacy of the child. Ensuring that members of staff make their intention and purpose known to others before commencing intimate care with a child is a sensible precaution. Managers can also make arrangements to ensure that there is always another member nearby when intimate care is being undertaken on a one to one basis. Additionally, in some establishments, signed and dated records of intimate care are kept. Appendix 12 gives an example of a format for recording such details