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Intimate Personal Care and Contact Policy

Policy Statement

This policy is for 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.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 contain the following regulations that apply to intimate personal care.

• Regulation 9: Person-centred Care — requires service providers to ensure that the care and treatment of people using services must be appropriate, must meet their needs, and must reflect their preferences.
• Regulation 10: Dignity and Respect — requires that people using care services must be treated with dignity and respect, including being treated in a caring and compassionate manner; personal preferences, lifestyle choices and choices relating to care and treatment of people must be respected by staff at all times.
• Regulation 11: Need for Consent — requires that care and treatment — including intimate personal care — is only provided with the consent of the relevant person.

The thrust of these regulations is to give the person choice and control, to enable them receive the right care, treatment and support, and have their diversity and/or disabilities considered.

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.

Definitions

Personal care is described in terms of the 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 his or her own decisions about him or her or to give his or her informed consent to the activities being proposed (ie where the person might lack mental capacity and the activities have to be carried out in terms of the best interests).

In the carrying out of any of these activities our 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.

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.

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 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.

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 relevant Safeguarding People Using a Care Service from Abuse or Harm 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, support with continence aids, etc are probably most at risk of inappropriate contact and touching. We are also aware that our care workers are also put at risk of accusations and allegations made against them while carrying out such tasks, and that we have a duty of care to protect them as well from false allegations or misunderstandings that might arise.

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 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 using services 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 individual from potential abuse and their care 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 using services 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 training.

Managers are also enabled to address issues arising with people using services and through their own training, particularly in the use of 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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