Personal Care and Physical Contact with Children

The Home should provide a nurturing environment that is welcoming and supportive and provides appropriate boundaries. This environment should support a child’s physical, mental and emotional health, in line with the approach set out in the Home’s Statement of Purpose.

The Home must also meet children’s basic day to day needs and physical necessities. Staff should seek to meet the child’s basic needs in the way that a good parent would, recognising that many children in residential care have experienced environments where their needs have not been consistently met – doing so is an important aspect of demonstrating that the staff care for the child and value them as an individual.

Suitable arrangements should be in place 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 identity, 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.

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

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

Where a staff member’s 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. This should be recorded on the child’s daily record and the Homes central log, so staff are aware of each other’s whereabouts and interactions taking place with children.

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.

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.

Homes staff should inform the child’s placing Social Worker of any accidents involving children and actions taken by the Home.

Homes staff should consider if it is necessary to complete an incident report to accompany the accident record.

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

Any first aid administered to a child should be recorded on the child’s daily record that should identify why the child required first aid, who provided first aid and what was required.

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

See Whistleblowing or Raising Concerns at Work Procedure.

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.

Where concerns relate to the homes manager, staff should report concerns to the Responsible Individual or Service Development Manager who will notify the child’s placing Social Worker and relevant professionals.

Any allegations, suspicions and/or disclosures of abuse should be reported as per Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.

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

The Home should ensure children have what they require to tend to their personal care.

Children’s preferences regarding sanitary products should be considered and provided to them.

Children will be provided with finances to purchase sanitary products that Homes staff should support children to purchase as and when needed.

If a child needs help with intimate care, arrangements must emphasise the child's dignity. Where necessary staff will be provided with specialist training and support.

Where a child requires help with intimate care arrangements will be set out in the child’s care & support plan that Homes staff should observe in their care of the child.

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.

Homes will be equipped with sanitary disposal facilities that will be maintained and serviced by a professional supplier.

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 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 sanction;
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.

Homes mangers should ensure staff are provided with a care plan that should be developed with the child and relevant professionals in order to meet the child’s needs. Homes managers should ensure staff receive additional training, guidance and support, so they are competent providing care and support to the child.

Homes staff should report any difficulties they may have in meeting the needs of the child to the manager, who should consider alternative arrangements to support both the child and homes staff.

Homes manager should ensure the child and staff have the required resources to provide care and support in line with the child’s needs.