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Intimate Care Policy

Intimate Care Policy 

Approved by: Adele Clark (Headteacher)
Date: 4.03.22
Last review: March 2022
Next review: March 2024


 

Contents

Intimate Care Policy

Protocol

Guidelines for good practice


Forward

The writing of this policy was informed by the Intimate care guidance provided by Education Leeds.

It is recommended that where children require intimate care, good practice guidelines are drawn up within the establishment and disseminated to all staff.

Parents / carers and the child should also be involved in discussions and decisions in relation to how intimate care will be managed.

These guidelines should be viewed as expectations upon staff, which are designed to protect both children and staff alike. In situations where a member of staff potentially breaches these expectations, other staff should be able to question this in a constructive manner.  

Staff should be advised that if they are not comfortable with any aspect of the agreed guidelines, they should seek advice within the establishment. For example, if they do not wish to conduct intimate care on a 1:1 basis, this should be discussed, and alternative arrangements considered. For example, it may be possible to have a second member of staff in an adjoining room or nearby so that they are close to hand but do not compromise the child’s sense of privacy.    

 

Protocol

  • An Intimate Care Plan is to be completed for all KS1 and KS2 children who require support with intimate care – see appendix 1.
  • For EYFS children a care plan will be created for children who need regular changing.
  • For children who have infrequent accidents a plan will not be created unless accidents become more frequent and continue.
  • All intimate care will be recorded on the changing records Appendix 2, located in the care suite and, for EYFS, in Nursery.
  • All intimate care for KS1 & KS2 children will take place in the care suite.  
  • In EYFS, intimate care will take place in the changing room or toilet cubicle.  Where a child needs a full change of nappy or clothes this should take place in the changing room.  If a child needs assistance with, for example, wiping after using the toilet, this may occur in the toilets.
  • A record will be made and reported via CPOMS regarding any of the below (this list in not exhaustive):

○ The child seems sore or unusually tender in the genital area.  

○ The child appears to be sexually aroused by your actions.

○ The child has a very emotional reaction without apparent cause (sudden crying or shouting).  

○ If you accidentally hurt the child or the child misunderstands or misinterprets something, record this information and inform a member of SLT. If necessary seek first aid assistance. Parents are to be informed.  

 

 

Guidelines for good practice

1.0 Treat every child with dignity and respect and ensure privacy appropriate to the child’s age and the situation.  

Privacy is an important issue. Much intimate care is carried out by one staff member alone with one child.

Leeds LSCB believes this practice should be actively supported unless the task requires two people. Having people working alone does increase the opportunity for possible abuse. However, this is balanced by the loss of privacy and lack of trust implied if two people have to be present – quite apart from the practical difficulties. It should also be noted that the presence of two people does not guarantee the safety of the child or young person - organised abuse by several perpetrators can, and does, take place. Therefore, staff should be supported in carrying out the intimate care of children alone unless the task requires the presence of two people. Where possible, the member of staff carrying out intimate care should be someone chosen by the child or young person. For older children (eight years and above) it is preferable if the member of staff is the same gender as the young person. However, this is not always possible in practice. Agencies should consider the implications of using a single named member of staff for intimate care or a rota system in terms of risks of abuse.  

2.0 Involve the child as far as possible in his or her own intimate care.  

Try to avoid doing things for a child that s/he can do alone and if a child is able to help ensure that s/he is given the chance to do so. This is as important for tasks such as removing underclothes as it is for washing the private parts of a child’s body. Support children in doing all that they can themselves. If a child is fully dependent on you, talk with her or him about what you are doing and give choices where possible.

3.0 Be responsive to a child’s reactions.  

It is appropriate to “check” your practice by asking the child – particularly a child you have not previously cared for – “Is it OK to do it this way?”; “Can you wash there?; “How does mummy do that?”. If a child expresses dislike of a certain person carrying out her or his intimate care, try and find out why. Conversely, if a child has a “grudge” against you or dislikes you for some reason, ensure your line manager is aware of this.  

4.0 Make sure practice in intimate care is as “care planned” as possible.  

Line managers have a responsibility for ensuring their staff have a “care planned” approach. This means that there is a planned approach to intimate care across the agency, but which is also flexible enough to be planned to meet the specific needs (and wishes as appropriate) of individuals. It is important that approaches to intimate care are not markedly different between individuals, but also reflect individual needs and wishes.

5.0 Never do something unless you know how to do it.  

If you are not sure how to do something, ask. If you need to be shown more than once, ask again.

 

6.0 If you are concerned that during the intimate care of a child:

  • You accidentally hurt the child  
  • The child seems sore or unusually tender in the genital area  
  • The child appears to be sexually aroused by your actions  
  • The child misunderstands or misinterprets something  
  • The child has a very emotional reaction without apparent cause (sudden crying or shouting)  

Record any such incident as soon as possible as ‘a cause for concern’ on CPOMS.  This is for two reasons: first, because some of these could be cause for concern, and secondly, because the child or another adult might possibly misconstrue something you have done.  

Additionally, if you are a member of staff who has noticed that a child’s demeanour has changed directly following intimate care, e.g. sudden distress or withdrawal, this should be recorded on CPOMS and discussed with your designated person for child protection.

7.0 Encourage the child to have a positive image of her or his own body.  

Confident, assertive children who feel their body belongs to them are less vulnerable to abuse. As well as the basics like privacy, the approach you take to a child’s intimate care can convey lots of messages about what her or his body is “worth”. Your attitude to the child’s intimate care is important. As far as appropriate and keeping in mind the child’s age, routine care of a child should be enjoyable, relaxed and fun.  

 Intimate care is to some extent individually defined, and varies according to personal experience, cultural expectations and gender. Leeds LSCB recognise that children who experience intimate care may be more vulnerable to abuse:-  

  • Children with additional needs are sometimes taught to do as they are told to a greater degree than other children. This can continue into later years. Children who are dependent or over-protected may have fewer opportunities to take decisions for themselves and may have limited choices. The child may come to believe they are passive and powerless.  
  • Increased numbers of adult carers may increase the vulnerability of the child, either by increasing the possibility of a carer harming them, or by adding to their sense of lack of attachment to a trusted adult.  
  • Physical dependency in basic core needs, for example toileting, bathing, dressing, may increase the accessibility and opportunity for some carers to exploit being alone with and justify touching the child inappropriately.  
  • Repeated “invasion” of body space for physical or medical care may result in the child feeling ownership of their bodies has been taken from them.  
  • Children with additional needs can be isolated from knowledge and information about alternative sources of care and residence. This means, for example, that a child who is physically dependent on daily care may be more reluctant to disclose abuse, since they fear the loss of these needs being met. Their fear may also include who might replace their abusive carer.  


 

Appendix 1: Intimate Care Plan

Name

 

Date

 

Date of Birth

 

Assessor

 

Relevant Background

Information

 

Setting of care to be given

Hygiene Suite

Toilet

Consent given

 

Identified need – specific individual requirement e.g. cream applied

 

 

 

 

Communication

Use of symbols?

Signs?

Verbal prompts?

Object of reference etc?

Self care skills

Fully dependent/aided

Supported/independent

Mobility

Independent/steady/grab rail

Unsteady/wheelchair user

Fine motor skills

Can do – tapes/zips/buttons/taps/towels/adjust own clothing

 

Moving and handling

Assessment

Step by step guide to what happens

Tracking/mobile hoist or S, M, L or own sling in chair transfer using mobile hoist.

Walking frame/support to table/physical turntable

Facilities

Environment to provide dignity safety

Handwashing

Equipment

Gloves, wipes, aprons, waste bins foot operated

Rise and fall bed. Changing mat/moving and handling equipment.

Continence produce/nappy size/paper towels/liquid soap/spray cleaner

The disposal of soiled articles of clothing as agreed with parents/carers

Solid waste into the toilet.

Clothes sent home in tied plastic bag.

Indicate in bag or in diary contents of bag.

 

 

Frequency of procedure required

On arrival/mid morning/lunchtime/mid afternoon/ whenever necessary/on request

Review date

Whenever needs change

 

Advice Only

 

If your child needs cleaning, plain water will be used with a few drops of a sensitive baby wash liquid cleanser added to the water.

Please advise if this is not suitable for your child and send in an alternative.

 

I/we have read, understood and agree to the plan for Intimate Care

 

 

Signed ………………………………………………………………

 

 

Name ………………………………………………………………..

 

 

Relationship to child ………………………………………………

 

 

Date ……………………………


         

Appendix 2: Changing Record

W (wet), D (dry), B (bowels open), M (menstruation), U (urinated), S (soiled)

Date

Time

Child Supported

W, D

B, M

U, S

Comments/ observations

Eg – skin impairment – changed bowel or urinary pattern.  

Staff signature

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please remember – if you have any concerns, then record them on CPOMS immediately.