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Intimate Personal Care and Contact (Scotland) Policy

The policy is written in line with the Scottish Social Services Council Code of Practice for Social Service Workers and to comply with the national health and social care standards described in My Support, My Life.

Examples from My Support, My Life are as follows.

Dignity and Respect

“1.4 If I require intimate personal care, this is carried out in a dignified way, with my privacy and personal preferences respected.”

Responsive Care and Support

“3.18 I am supported and cared for sensitively by people who anticipate issues and are aware of and plan for any known vulnerability or frailty.”

Be Included

“1.11 My views will always be sought and my choices respected, including when I have reduced capacity to fully make my own decisions.”

Wellbeing

“3.20 I am protected from harm, neglect, abuse, bullying and exploitation by people who have a clear understanding of their responsibilities.

“4.27 I experience high quality care and support because people have the necessary information and resources.”

The purpose of this policy is to provide guidance to care workers employed by any care service providing personal care to adults on the issues raised by their having to carry out activities of an intimate personal nature that could result in the person receiving the service feeling embarrassed and distressed. The care might involve physical contact and touching so the policy is intended to make clear the difference between appropriate and inappropriate contact and touching, and the procedures to be followed if inappropriate touching occurs.

Policy Statement

Personal care can be defined as help provided to a person with their:

• eating or drinking (including forms of tube feeding)
• toileting (including in relation to the process of menstruation)
• managing incontinence
• washing or bathing
• dressing
• oral care
• the care of skin, hair and nails.

Personal care includes the acts of prompting and supervision of a person in relation to any of these activities, where the person is unable to take their own decisions about them or to give their informed consent to the activities being proposed (ie where the person might lack mental capacity and the activities are carried out as best interests’ decisions).

In the carrying out of any of these activities, care staff are expected to respect the dignity of the person who is receiving their help. They must make sure that what they are doing is always in line with the person’s wishes as reflected in their plan of care and that the person has consented to anything that is proposed (or a best interests’ assessment has been made if the individual lacks mental capacity).

They will often need to obtain the person’s consent by talking with the person and constantly checking out that what they are doing is consistent with the person’s wishes and they are not causing any distress or discomfort.

Personal Contact

In providing any form of personal care, care workers must be aware that they will be in close personal contact with the person and they should also check how they might be feeling about this. Care workers should be aware of their own body position and how this might come across to the person receiving their care.

It is inevitable in the offering of personal care that some form of physical contact will be made, which each person will experience differently and not always consistently (depending on their mood, etc). Care workers must learn about how individuals feel about the personal care they are receiving from them at any time.

Care staff are made aware of any cultural factors that might account for some people’s responses in their training and supervision and briefing to carry out the tasks required.

Transgender (trans) and non-binary people have the same basic healthcare needs as all other people who use services. As with all people, trans and non-binary people should always be treated respectfully when they receive any intimate personal care.

Appropriate and Inappropriate Personal Contact

Individuals will vary in their views on what they consider to be appropriate or inappropriate personal contact by their care workers. They are encouraged to express these so that they feel comfortable and safe and care workers are also able to work safely with them.

Care workers are taught to recognise that there are some forms of personal contact that are inappropriate, because they are abusive and could result in disciplinary or even criminal actions being taken against them. These are clearly stated in the agency’s protection from abuse policy.

Inappropriate personal contact will usually refer to the touching of breasts, genitalia and bottoms, but it could also include kissing, hugging, sidling and sexually suggestive movements that could be interpreted as inappropriate or abusive. This could occur in a variety of situations, including when being moved and transferred.

Care workers are warned against any such behaviour that presents any risks of harm to the people receiving their care and indeed to their own safety and personal integrity.

Intimate Personal Care

People who require help with intimate personal care that could include dressing, washing, bathing, etc are probably most at risk of inappropriate contact and touching. {{org_field_name}} is also aware that care workers are also put at risk of accusations and allegations made against them while carrying out such tasks and that it has a duty of care to protect them as well from false allegations or misunderstandings that might arise.

Transgender individuals may have specific issues addressing continence problems due to stigma and lack of understanding. Sensitive open communication is key as to the most appropriate support. See the Continence and Urinary Tract Care topic for more information.

In general, the policy is to encourage people to do as much for themselves as possible in respect of any aspect of intimate personal care and for care workers to carry out these tasks only when the person is clearly unable to do so and after all risks to the person receiving care and staff involved have been assessed.

All intimate care activities to be carried out are clearly described in the person’s plan of care and staff are expected to comply with the instructions included there.

Care staff are expected to offer an immediate apology in the event of any accidental contact or touching that the person receiving the care (or the care staff member) might consider to be inappropriate.

If the person appears distressed or considers that the touching might have been deliberate and indicates that they are not satisfied by a simple apology, the care staff involved should suggest that the person might put in a formal complaint. They should report the matter to their line manager at the first opportunity, who might seek to address the issue as a complaint following the relevant procedures or if necessary through safeguarding from abuse procedures.

Care staff members who consider that they are subject to inappropriate physical contact by people receiving their care while carrying out personal care should also raise the matter with their line manager so that the issues can be addressed through the relevant policies designed to protect staff from abuse.

Assessing and Managing Risk

{{org_field_name}} always carries out a risk assessment in relation to people who might need intimate personal care to protect both the person from potential abuse and their carer workers from incorrectly being accused of abuse. The results will be included in the care and support plan, which will indicate if any special arrangements should be in place to control any risks.

These will depend on the individual situation but might include:

• avoiding lone working and having two people to carry out the care, which will often be needed regardless for people with intimate care needs
• arranging the care to be carried out in the presence of a “chaperone”, who could be another household member or care staff member who could discreetly observe the care being carried out; this would always require the consent of the person with any arrangement agreed taking into account the need to maintain the person’s sense of dignity and any need for privacy and confidentiality
• close supervision and monitoring of the intimate care practices so that concerns and issues can be identified and addressed promptly
• careful arranging of the immediate care environment to minimise exposure and embarrassment and to reduce the need for physical contact and the risks from it.

Training

All care staff receive training on appropriate/inappropriate personal contact and touching and the associated procedures as part of their induction and ongoing training and in supervision, when they can also express any concerns about their practice and experiences.

Managers receive training to address sensitively and professionally any concerns or complaints made by people who use services and to address issues raised by them in their day-to-day work and in formal supervision.

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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: this policy is reviewed annually (every 12 months). When needed, this policy is also updated in response to changes in legislation, regulation, best practices, or organisational changes.

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