7.12 Intimate Care Good Practice Guidelines |
All the children we work with have a right to be treated with dignity and respect, as set out in Oxfordshire Charter of Children’s Rights. These guidelines are designed to safeguard both children and staff and apply to every member of staff involved with the intimate care of children. They aim to support good practice in intimate care.
Children, particularly those with disabilities, can be very vulnerable. All staff involved with their intimate care need to be sensitive to the child’s needs and also be aware that some care tasks or treatments could be open to possible misinterpretation. False allegations of sexual abuse are extremely rare, but certain basic guidelines will safeguard both children and staff. Everyone is safe if expectations are clear and approaches are consistent as far as possible. If you cannot work within these guidelines for any reason please consult with your line manager.
Treat every child with dignity and respect and ensure privacy appropriate to the child’s age and situation.
Privacy is an important issue. Much intimate care is carried out with one staff member alone with one child. This practice is 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. So, staff are supported in carrying out the intimate care of children alone unless the task requires the presence of two people.
Involve the child as far as possible in their intimate care.
Try to avoid doing things for a child that he/she can do alone, and if a child is able to help then ensure they are given chance to do so. Support the child in doing all that they can for themselves. If the child is fully dependent upon you, talk with them about what you are doing and give them choices where possible.
Be responsive to a child’s reactions
Check your practice by asking the child, particularly a child you have not previously cared for – e.g. “is this OK to do it this way?” or “can you wash there?”, “How does mummy do this?”. If a child expresses dislike of a certain person carrying out their intimate care, try and find out why? If a child appears to have a grudge against you, ensure your line manage is aware of this.
Make sure practice in intimate care is as consistent as possible.
Line managers have a responsibility to ensure staff have a consistent approach. This does not mean that everyone has to do things in an identical fashion, but it is important that approaches are not markedly different between different staff.
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. Nursing or medical staff must only carry out certain intimate care or treatment procedures.
If you are concerned, report it.
If during intimate care of a child any of the following occur, report the incident as soon as possible to another person working with you and make a brief written note.
- you accidentally hurt them
- the child seems unusually sore or tender in the genital area
- the child appears to be sexually aroused by your actions
- the child misunderstands or misinterprets something, or has a very emotional reaction without apparent cause
Some of these could be cause for concern about the child, or alternatively the child or another adult might possibly have misunderstood what has happened.
Encourage the child to have a positive image of their own body.
Confident, assertive children, who feel their body belongs to them, are less vulnerable to sexual abuse. As well as basics such as privacy, the approach you take to a child’s intimate care can convey lots of messages to them about what their body means. Your attitude to a child’s intimate care is important. Keeping in mind the child’s age, routine care should be enjoyable, relaxed and fun.
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