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Registration Number: {{org_field_registration_no}}

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Supporting Personal and Sexual Relationships Policy

1. Purpose

This policy outlines {{org_field_name}}’s commitment to supporting the people we support in developing and maintaining personal and sexual relationships while ensuring their rights, dignity, and safety. It aligns with CQC regulations, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and Regulation 9 – Person-Centred Care. The policy ensures that all individuals are treated with respect and that their personal relationships are supported in a way that upholds their rights, promotes choice, and protects them from harm.

2. Scope

This policy applies to all employees at {{org_field_name}}, including care staff, nurses, support workers, volunteers, and management. It covers all aspects of personal and sexual relationships, including emotional relationships, intimacy, sexual expression, and marriage for individuals receiving care and support.

3. Legal and Regulatory Framework

{{org_field_name}} will comply with all applicable legislation, regulations and statutory guidance concerning personal and sexual relationships, privacy, consent, mental capacity, safeguarding and equality. This includes:

• Health and Social Care Act 2008 – provides the statutory framework for the regulation of health and adult social care services in England.
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 9 – Person-centred care – requires care and treatment to be appropriate, meet the person’s needs and reflect their preferences. People must be supported to participate as fully as possible in decisions concerning their care, support, lifestyle and relationships.
• Regulation 9A – Visiting and accompanying in care homes, hospitals and hospices – requires people living in care homes to be facilitated to receive visits unless exceptional circumstances apply and not to be discouraged from taking visits outside the care home. Any restrictions must be necessary, proportionate, individually assessed and kept under review.
• Regulation 10 – Dignity and respect – requires people to be treated with dignity and respect, including maintaining their privacy, supporting their autonomy and independence, supporting relationships that are important to them and having due regard to relevant protected characteristics under the Equality Act 2010.
• Regulation 11 – Need for consent – requires care and treatment to be provided only with the consent of the relevant person. Where a person aged 16 or over lacks capacity to consent to care or treatment, staff must act in accordance with the Mental Capacity Act 2005.
• Regulation 12 – Safe care and treatment – requires risks associated with the provision of care and treatment to be assessed and reasonably mitigated without imposing unnecessary or disproportionate restrictions on a person’s lawful choices and relationships.
• Regulation 13 – Safeguarding service users from abuse and improper treatment – requires people to be protected from abuse, including sexual abuse, exploitation, coercion, discriminatory abuse and improper treatment.
• Regulation 17 – Good governance – requires accurate, complete and contemporaneous records relating to each person’s care and treatment and effective systems for assessing, monitoring and managing risks.
• Care Quality Commission (Registration) Regulations 2009, Regulation 18 – Notification of other incidents – requires the registered person to notify CQC without delay of specified incidents, including abuse or allegations of abuse involving a person using the service and incidents reported to or investigated by the police.
• Mental Capacity Act 2005 and Code of Practice – requires capacity to be presumed unless established otherwise and assessed in relation to the specific decision at the time the decision is required. A person must be given all practicable support to make their own decision before being treated as unable to do so. Certain decisions, including consent to sexual relations and consent to marriage or civil partnership, cannot be made on another person’s behalf.
• Care Act 2014 and Care and Support Statutory Guidance – establishes adult safeguarding duties where an adult has care and support needs, is experiencing or is at risk of abuse or neglect and, because of those needs, is unable to protect themselves from the abuse or neglect or the risk of it.
• Sexual Offences Act 2003 – establishes criminal offences relating to non-consensual sexual activity, sexual activity involving people whose mental disorder impedes their ability to choose, and specific offences concerning sexual activity between certain care workers and people with a mental disorder.
• Equality Act 2010 – requires protection from unlawful discrimination, harassment and victimisation. Relevant protected characteristics include age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation.
• Human Rights Act 1998 – protects relevant Convention rights, including respect for private and family life and the right to marry, subject to lawful and proportionate restrictions.
• Data Protection Act 2018 and UK GDPR – require information concerning a person’s relationships, sexual life, sexual orientation and health to be processed lawfully, fairly, securely and only where there is an appropriate lawful basis.

4. Principles of Supporting Relationships

• Choice and autonomy: People have the right to develop and maintain friendships, personal relationships, romantic relationships and other relationships of their choosing. Staff must not assume that a person lacks capacity because of their age, disability, diagnosis, appearance, behaviour or because staff consider their decision unwise.
• Consent to sexual activity: Sexual activity must always be consensual. Where there is a proper reason to doubt a person’s capacity to consent to sexual relations, capacity must be considered in accordance with the Mental Capacity Act 2005 and must relate specifically to that decision at the relevant time.
• Privacy and dignity: Staff must respect and promote people’s privacy and dignity in relation to friendships, relationships, intimacy, correspondence, telephone calls, electronic communication and visits.
• Safeguarding and protection: People must be protected from sexual abuse, exploitation, grooming, coercion, harassment, controlling behaviour and other abuse while avoiding unnecessary or disproportionate restrictions on consensual relationships.
• Person-centred support: Support must take account of each person’s wishes, preferences, communication needs, culture, religion or belief, identity, sexual orientation and other relevant individual circumstances.
• Equality and non-discrimination: Support must be provided without unlawful discrimination, harassment or victimisation. Staff must respect relevant protected characteristics under the Equality Act 2010, including sex, sexual orientation, gender reassignment, disability, age, race, religion or belief and marriage or civil partnership.
• Least restrictive practice: Risks associated with relationships must be considered individually. Restrictions must not be imposed merely because a relationship involves an element of risk. Any restriction must have a lawful basis, be necessary and proportionate, and be the least restrictive option available.

5. Supporting Individuals in Developing Personal Relationships

Encouraging Social Interaction

• Supporting individuals in building friendships and romantic relationships within and outside the care setting.
• Facilitating access to social events, dating services, and online communication where appropriate.

Providing Information and Guidance

• Educating individuals about healthy relationships, boundaries, and personal safety.
• Ensuring individuals understand their rights to consent, privacy, and safe sexual practices.

6. Sexual Expression and Intimacy

Respecting Individual Needs

• Support must recognise that sexual expression is a fundamental aspect of human well-being.
• Where appropriate, individuals should be supported in accessing sexual health services and education.

Facilitating Privacy

• Individuals must have access to private spaces for personal and intimate relationships.
• Staff should not enter private areas without permission unless there is an emergency or safeguarding concern.

Support for LGBTQ+ Individuals

• Individuals identifying as LGBTQ+ must receive equal support in expressing their relationships and identity.
• Any discrimination or prejudice from staff or other individuals will be addressed under the CH30-Equality, Diversity, and Inclusion Policy.

7. Mental Capacity and Consent in Relationships

Presumption of Capacity

Every person aged 16 or over must be presumed to have capacity to make their own decisions unless it is established, in accordance with the Mental Capacity Act 2005, that they lack capacity to make the particular decision in question.

A person must not be treated as unable to make a decision merely because they make a decision that staff, relatives or professionals consider unwise.

Before concluding that a person lacks capacity, all practicable steps must be taken to support them to make the decision themselves. This may include providing information in an accessible format, adapting communication, choosing an appropriate time and environment, using communication aids and involving an interpreter, advocate or other appropriate communication support.

Decision-specific and Time-specific Assessment

Mental capacity is decision-specific and time-specific. Staff must not make a general finding that a person “lacks capacity for relationships”.

Where there is a proper reason to doubt capacity, the specific decision requiring assessment must be identified. The assessment must determine whether, because of an impairment of or disturbance in the functioning of the mind or brain, the person is unable to:

• understand information relevant to the decision;
• retain that information for long enough to make the decision;
• use or weigh that information as part of the decision-making process; or
• communicate their decision by any means.

Capacity must be reviewed where there is reason to believe that it may have changed or may fluctuate.

Consent to Sexual Relations

Sexual activity must always be consensual. Consent must be voluntary and must remain present throughout the sexual activity. A person may refuse or withdraw consent at any time.

Where there is a proper reason to doubt a person’s capacity to consent to sexual relations, an appropriately competent person must undertake or arrange a decision-specific capacity assessment in accordance with the Mental Capacity Act 2005 and relevant current legal guidance.

No member of staff, relative, attorney, deputy, advocate, healthcare professional or other person may consent to sexual relations on behalf of a person who lacks capacity to make that decision.

A best-interests decision under the Mental Capacity Act 2005 must not be used to authorise sexual relations on behalf of a person who lacks capacity to consent to those sexual relations.

Where a person is assessed as lacking capacity to consent to sexual relations and there is a risk that sexual activity may occur, staff must take immediate, lawful and proportionate safeguarding action to protect the person. Advice must be sought from the Registered Manager and safeguarding lead and, where appropriate, the local authority adult safeguarding service, relevant healthcare professionals, legal advisers and/or the Court of Protection.

Any immediate protective action must be proportionate to the identified risk and must not extend into an unnecessary blanket restriction on the person’s social contact or relationships.

Marriage and Civil Partnership

A person must have capacity to consent to their own marriage or civil partnership.

No person may consent to marriage or civil partnership on another person’s behalf, and a best-interests decision cannot be used to authorise marriage or civil partnership for a person who lacks capacity to make that decision.

Where there is doubt about capacity to marry or enter into a civil partnership, appropriate legal advice must be obtained before staff facilitate the proposed arrangements.

Relationships That Do Not Involve Sexual Activity

A person must not automatically be prevented from having friendship, companionship, emotional contact or other non-sexual relationships because they lack capacity in relation to a different decision.

Any restrictions considered necessary for safeguarding purposes must be based on the person’s individual circumstances and risks, have a lawful basis, be necessary and proportionate, and constitute the least restrictive available intervention.

Recording

Where a capacity assessment is required, the record must clearly state:

• the precise decision being assessed;
• the reason there was doubt about capacity;
• the steps taken to support the person to make the decision;
• the relevant information provided to the person;
• the assessment against the Mental Capacity Act 2005 criteria;
• the outcome and reasons for the conclusion;
• who completed or contributed to the assessment; and
• when the assessment should be reviewed, where appropriate.

Where the issue is complex, disputed or involves serious consequences, the Registered Manager must obtain appropriate professional or legal advice and consider whether an application to the Court of Protection is required.

8. Managing Safeguarding Concerns

Recognising Safeguarding Concerns

Staff must remain alert to signs or disclosures of:

• rape or sexual assault;
• sexual touching or activity without consent;
• sexual activity where a person may lack capacity to consent;
• pressure or coercion to engage in sexual activity;
• sexual harassment;
• grooming or sexual exploitation;
• controlling or coercive behaviour;
• domestic abuse;
• inappropriate sexual photography or recording;
• forced exposure to pornography or sexual acts;
• exploitation involving gifts, money, accommodation, substances or other inducements;
• stalking, intimidation or threats;
• discriminatory abuse connected with a person’s sexual orientation, sex, gender reassignment or other protected characteristic; or
• any relationship in which there are reasonable grounds to suspect abuse, exploitation, undue influence or coercion.

A consensual relationship must not be treated as a safeguarding concern solely because staff, relatives or other people disapprove of the relationship.

Immediate Action

Where a person is in immediate danger or requires urgent medical attention, staff must take immediate action to protect the person and contact the emergency services where necessary.

Staff must preserve potential evidence following an alleged sexual offence and must not undertake their own detailed investigation or repeatedly question the person where this could interfere with a police or safeguarding investigation.

Internal Reporting

Any suspected, witnessed or disclosed abuse, exploitation or coercion must be reported immediately in accordance with the CH13-Safeguarding Adults from Abuse and Improper Treatment Policy.

The Registered Manager and safeguarding lead must be informed without delay.

Referral to the Local Authority

Where the criteria for adult safeguarding are met or may be met, a safeguarding concern must be referred promptly to the relevant local authority adult safeguarding service in accordance with the Care Act 2014 and local multi-agency safeguarding procedures.

The Care Act safeguarding duties apply where an adult:

• has needs for care and support, whether or not the local authority is meeting those needs;
• is experiencing, or is at risk of, abuse or neglect; and
• because of those care and support needs is unable to protect themselves from the abuse or neglect or the risk of it.

Police Referral

Where a criminal offence is suspected, including rape, sexual assault, sexual exploitation, stalking or other sexual offences, the police must be contacted where required by the circumstances and safeguarding procedures.

Immediate police assistance must be requested where there is an immediate risk of harm or a crime is in progress.

CQC Notification

The Registered Person must ensure that the Care Quality Commission is notified without delay of abuse or an allegation of abuse in relation to a person using the service where required by Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Where an incident is reported to or investigated by the police, the Registered Person must also ensure that any applicable CQC notification requirement is met.

Making a referral to the local authority or police does not remove the separate requirement to make a statutory notification to CQC where required.

Person-centred Safeguarding

The person’s wishes, feelings, desired outcomes, communication needs and capacity must be considered throughout the safeguarding process.

Information must be provided in a form the person can understand and advocacy must be considered where required.

Where the person has capacity and does not want safeguarding action to be taken, staff must consider their wishes carefully while also considering whether information nevertheless needs to be shared because another person may be at risk, a serious crime may have occurred, coercion or undue influence is suspected, or another lawful safeguarding reason applies.

Any intervention affecting a personal or family relationship must be lawful, necessary and proportionate and must take account of the person’s rights to privacy, autonomy and family life.

9. Supporting Sexual Health and Well-being

Access to Sexual Health Services

People must be supported, where appropriate and in accordance with their wishes and assessed needs, to access relevant sexual and reproductive health services, including:

• sexual health information and advice;
• contraception;
• sexually transmitted infection testing and treatment;
• reproductive health services; and
• appropriate specialist healthcare advice.

Information and support must be provided in a format that meets the person’s communication and accessibility needs.

Confidentiality and Information Sharing

Information about a person’s sexual health, relationships, sexual life or sexual orientation must be treated sensitively and confidentially and processed in accordance with the Data Protection Act 2018, UK GDPR and the organisation’s confidentiality and information governance procedures.

Confidentiality is not absolute. Information may be shared without the person’s consent where there is a lawful basis to do so, including where this is necessary and proportionate to safeguard the person or another person, comply with a legal obligation, report a serious crime or meet another applicable statutory requirement.

Only information that is relevant and necessary for the purpose must be shared, and the reason for sharing information without consent must be recorded.

Where it is safe and appropriate to do so, the person should be informed about what information is being shared, with whom and why.

Sexual Health Awareness

Staff providing support relating to sexual health must have sufficient knowledge and competence for their role and must know when to refer the person to an appropriately qualified healthcare professional.

Staff must not provide clinical sexual health advice outside their competence.

Supporting People With Physical Disabilities

People with physical disabilities must not be discriminated against or unnecessarily restricted in expressing their sexuality or maintaining consensual intimate relationships.

Where a person requests assistance because of physical impairment, the support required must be considered on an individual basis, with appropriate assessment, consent and professional advice where necessary.

Any equipment used as part of care or support must be suitable and safe for its intended purpose.

10. Supporting Marriage, Cohabitation, Visiting and Family Life

Marriage and Civil Partnership

People have the right to marry or enter into a civil partnership provided that the legal requirements are met and they have the capacity to consent to the marriage or civil partnership.

Staff may support a person with practical arrangements where requested, but must not influence or make the decision on the person’s behalf.

Consent to marriage or civil partnership is a personal decision that cannot be made for another person under the Mental Capacity Act 2005. A best-interests decision must not be used to authorise a marriage or civil partnership where the person lacks capacity to consent to it.

Where there is a genuine concern about a person’s capacity to consent to marriage or civil partnership, the Registered Manager must obtain appropriate legal or professional advice before the service facilitates the arrangements.

Cohabitation and Partners

A person’s wish to maintain a relationship with a spouse, civil partner or other partner must be respected and supported as far as reasonably practicable.

Where decisions concerning accommodation, care arrangements or other matters require a mental capacity assessment, capacity must be assessed in relation to the specific decision concerned.

Visits to the Care Home

In accordance with Regulation 9A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, people living in the care home must be facilitated to receive visits unless exceptional circumstances make this inappropriate.

Visits must be supported in a way that:

• meets the person’s assessed needs;
• reflects the person’s preferences so far as reasonably practicable;
• protects privacy and dignity;
• takes account of the person’s care plan;
• makes reasonable adjustments where required; and
• uses necessary and proportionate precautions where an identified risk needs to be managed.

The person’s wishes about who visits them must be respected. A visitor does not have an automatic right to visit where the person with capacity does not wish to receive that visitor.

Visits Outside the Care Home

People living in the care home must not be discouraged from taking visits or social trips outside the home unless exceptional circumstances apply.

The service must not impose blanket restrictions or unreasonable administrative requirements that have the effect of discouraging visits outside the home.

Restrictions on Visiting

Restrictions on visiting must not be imposed routinely or for the convenience of the service.

Where exceptional circumstances require a restriction, the decision must:

• be based on an individual assessment;
• consider the wishes and rights of the person;
• identify the specific risk being addressed;
• consider reasonable precautions that could enable the visit to proceed;
• be necessary and proportionate;
• use the least restrictive available option;
• be documented;
• be communicated to relevant people; and
• be regularly reviewed and removed as soon as it is no longer necessary.

Where a person lacks capacity to make the relevant decision about a particular visit, any decision made on their behalf must comply with the Mental Capacity Act 2005 and must be in their best interests.

This best-interests provision concerning visiting must not be interpreted as permitting anybody to give consent on the person’s behalf to sexual relations, marriage or civil partnership.

Maintaining Family and Important Relationships

Staff must support people, in accordance with their wishes, to maintain contact with partners, family members, friends and other people who are important to them through in-person visits, telephone calls, correspondence and electronic communication.

Any restriction on contact must have a lawful basis and must be necessary, proportionate and kept under review.

11. Staff Training, Conduct and Responsibilities

Staff Competence and Training

Staff must receive training, instruction and supervision appropriate to their role so that they understand and can apply the requirements relevant to personal and sexual relationships.

Training must include, where relevant to the staff member’s role:

• dignity, privacy and person-centred care;
• consent;
• the Mental Capacity Act 2005;
• decision-specific capacity assessments;
• the distinction between decisions that may be made in a person’s best interests and decisions that cannot lawfully be made on another person’s behalf;
• recognising sexual abuse, exploitation, coercion, grooming and controlling behaviour;
• adult safeguarding and reporting procedures;
• equality, diversity and LGBTQ+ inclusion;
• confidentiality and lawful information sharing;
• professional boundaries; and
• relevant provisions of the Sexual Offences Act 2003.

Staff competence must be reviewed and additional training, supervision or support provided where gaps in knowledge or practice are identified.

Professional Boundaries

Staff must maintain clear professional boundaries with every person using the service.

Staff must not exploit, groom, coerce or use their professional position to establish an inappropriate sexual or intimate relationship with a person using the service.

Staff must understand that the Sexual Offences Act 2003 creates specific offences relating to sexual activity involving certain care workers and people with a mental disorder. Consent by the person using the service does not necessarily prevent conduct from constituting an offence where the statutory care-worker provisions apply.

Any concern about inappropriate sexual conduct, grooming, exploitation or a breach of professional boundaries by a staff member, volunteer, agency worker or other person working within the service must be reported immediately to the Registered Manager or another appropriate senior person where the concern involves the Registered Manager.

Safeguarding, disciplinary, police, Disclosure and Barring Service, professional regulator and CQC referral or notification requirements must be considered and followed where applicable.

Staff Responsibilities

Staff must:

• respect each person’s privacy, dignity, identity and lawful relationship choices;
• avoid expressing personal moral judgement about a person’s consensual relationship or sexuality;
• support people to communicate their wishes and preferences;
• recognise and respond promptly to safeguarding concerns;
• follow Mental Capacity Act requirements where capacity is genuinely in doubt;
• avoid unnecessary or disproportionate restrictions;
• maintain confidentiality subject to lawful safeguarding and information-sharing requirements;
• record relevant decisions and concerns accurately; and
• seek advice from the Registered Manager where a situation is complex, disputed or outside their competence.

12. Documentation and Record-keeping

Records relating to personal and sexual relationships must be factual, respectful, relevant and proportionate. Staff must avoid judgemental, discriminatory or unnecessarily intrusive language.

Where relevant to the person’s care and support, records must include:

• the person’s expressed wishes, preferences and support needs;
• agreed support relating to privacy, relationships, visiting or communication;
• reasonable adjustments required;
• relevant risk assessments and agreed risk-management measures;
• decision-specific mental capacity assessments where there is a proper reason to question capacity;
• safeguarding concerns, referrals, actions and outcomes;
• advice obtained from healthcare professionals, safeguarding professionals or legal advisers where relevant;
• restrictions affecting visiting or relationships, including the reason, legal basis, proportionality, least restrictive options considered and review arrangements; and
• relevant CQC, police or local authority notifications and referrals.

Information concerning a person’s relationships, sexual life, sexual orientation or sexual health must only be recorded where it is relevant and necessary for a legitimate care, safeguarding or legal purpose.

Records must be stored securely and accessed or disclosed only by people who have an appropriate lawful reason to receive the information.

Where information is shared without the person’s consent for a safeguarding or other lawful purpose, staff must record:

• what information was shared;
• with whom it was shared;
• the reason for sharing it;
• the lawful or safeguarding basis relied upon; and
• whether the person was informed, or the reason why informing them was not appropriate.

All records must comply with the Data Protection Act 2018, UK GDPR, Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and {{org_field_name}}’s information governance and record-keeping requirements.

13. Related Policies

• CH09-Person-Centred Care Policy
• CH10-Dignity and Respect Policy
• CH13-Safeguarding Adults from Abuse and Improper Treatment Policy
• CH17-Infection Prevention and Control Policy (Sexual Health Considerations)
• CH18-Risk Management and Assessment Policy
• CH30-Equality, Diversity, and Inclusion Policy

14. Policy Review

• This policy will be reviewed annually or sooner if updates in CQC regulations, safeguarding laws, or best practices arise.
• Amendments will be made to ensure continued compliance and respect for personal rights.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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