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Intimate Care Policy 2023

Intimate Care Policy

Policy details

Academy: Co-op Academy Princeville

Policy owner: Asma Majid

Date of Policy Creation: March 2023

Date shared with staff: March 2023

Date shared with governors: March 2023

Date of next Policy Review: March 2024

Contents

Policy details

Policy details

Rationale

Purpose

Health and safety

Staff and facilities

Responsibilities

Safeguarding

Appendix 1 – Intimate care risk assessment

Appendix 2 - Record of intimate care intervention

Appendix 3 - Toilet management plan

Appendix 4 - Agreement between child and personal assistant

Appendix 5 - Permission for school to provide intimate care

Rationale

The rationale behind this policy is to provide guidance and support for the safeguarding of staff and pupils when fulfilling duties which require close contact.

Purpose

The purpose of the policy at Co-op Academy Princeville is to:

  • uphold pupils’ rights to privacy and dignity
  • identify situations which have elements of close personal/intimate contact
  • recognise the responsibilities of adults involved
  • safeguard pupils and adults from any misinterpretation of action
  • ensure consistency of action whilst being sensitive to individual need
  • encourage independence and choice for pupils
  • maximise learning opportunities

  1. Definitions and examples

  1. Intimate care is defined as any care which involves washing, touching or carrying out an invasive procedure that most children and young people carry out for themselves, but which some are unable to do.
  2. Intimate care tasks are associated with bodily functions, body products and personal hygiene that demand direct or indirect contact with, or exposure of, the genitals.
  3. Examples of intimate care include support with dressing and undressing (underwear), changing incontinence pads and nappies, menstrual hygiene, helping someone use the toilet or washing intimate parts of the body.
  4. Children may be unable to meet their own care needs for a variety of reasons and will require regular support.
  1. Health and safety

  1. Our full Health and Safety Policy lays out specific requirements for cleaning and hygiene including how to deal with spillages, vomit and other bodily fluids.
  2. Staff will wear fresh PPE (aprons, disposable gloves and masks) while assisting a child in the toilet or while changing a nappy/incontinence pad.
  3. Soiled nappies/incontinence pads will be securely wrapped and disposed of appropriately in the designated bin.
  4. The changing area/toilet will be cleaned and wiped with an antibacterial wipe and, where necessary, the caretaker/cleaning staff will be informed.
  5. Hot water and antibacterial soap are available to wash hands.
  6. Paper towels are available to dry hands.

  1. Staff and facilities

  1. Staff members who provide intimate care are trained to do so and are fully aware of best practice. Suitable equipment and facilities will be provided to assist children who need special arrangements following assessment from a physiotherapist/occupational therapist. This may include:
  • Adjustable bed.
  • Changing mat.
  • Non-slip step.
  • Cupboard.
  • Adapted toilet seat or commode seat.
  • Hoist.
  • Disposable gloves/aprons.
  • Nappies/pads.
  • Tissue roll (for changing mat/cleansing) and supply of hot water.
  • Soap, antiseptic cleanser for staff, barrier creams.
  • Antiseptic cleanser for the changing bed/mat.
  • Clinical waste bag.
  • Spillage kit.
  1. Mobile children will be changed standing up, other children will follow their individual plan.
  2. Children who are not mobile will be changed on purpose-built changing facilities.
  3. Staff will be supported to adapt their practice in relation to the needs of individual children, taking into account developmental changes such as the onset of puberty or menstruation.
  1. Responsibilities

  1. The school will:
  1. Arrange a multi-agency meeting to discuss the personal care needs of any pupil prior to them attending the school.
  2. Involve the child who requires intimate care in planning for their own healthcare needs wherever possible.
  3. Create, in liaison with the child and parents/carers, an Individual Healthcare Plan to ensure that reasonable adjustments are made for any child with a health condition or disability.
  4. Regularly consult with all parents and pupils regarding toilet facilities.
  5. Maintain the privacy and dignity of any pupil who requires intimate care.
  6. Change the child, or assist them in changing themselves if they become wet, or soil themselves.
  7. Never leave a child in wet or soiled clothing.
  8. React to accidents in a calm and sympathetic manner.
  9. Keep accurate records of times, staff and any other details of incidents of intimate care.
  10. Agree how often the child should be routinely changed if the child is in school for a full day, and designate a member of staff to change them.
  11. Agree to a minimum number of changes.
  12. Agree to encourage the child’s participation in toileting procedures wherever possible.
  13. Discuss and take the appropriate action to respect the cultural practices of the family.
  14. Where possible, only allow same-sex intimate care.
  15. Contact parents/carers if the child refuses to be changed, or becomes distressed during the process.
  16. Maintain excellent standards of hygiene when carrying out intimate care.
  1. Parents/carers should:
  1. Change their child, or assist them in going to the toilet at the latest possible time before coming to school.
  2. Provide spare nappies/incontinence pads, wet wipes and a change of clothes in case of accidents.
  3. Read and sign this policy to ensure they understand the policies and procedures around intimate care.
  4. Inform the school should their child have any marks/rashes.
  5. Discuss with the school how often their child will need to be changed, and who will do the changing.
  1. Safeguarding

  1. Safeguarding Procedures are supported by rigorous selection and recruitment procedures including DBS checks. No staff member will be permitted to work alone with a child until they have undergone a Disclosure and Barring Service (DBS) check.

  1. Wherever possible, staff involved in intimate care will not be involved in the delivery of sex education to the children in their care as an extra safeguard to both staff and children involved.
  2. Individual intimate care plans will be drawn up for children as appropriate to suit the circumstances of the child.
  3. Each child’s right to privacy will be respected. Careful consideration will be given to each child’s situation. Much intimate care is carried out by one staff member alone with one child unless the task requires two people (for example lifting or moving), however, the need for a chaperone should be considered, and offered, on a case by case basis. Intimate examinations should adhere to the medical agencies chaperone policy.  
  4. If any member of staff has concerns about physical changes to a child’s presentation, such as marks or bruises, they will immediately report the concerns to the  Designated Safeguarding Lead or Deputy Designated Safeguarding Lead.

7. Close Contact at Co-op Academy Princeville

7.1. Physical contact with children and young people is essential to support their emotional development. Co-op Academy Princeville recognises this and in order to clarify and support the work of all staff in school, this policy will outline where forms of physical contact are likely to occur. Professionals in this school cannot sacrifice their judgment and common sense about how best to support teaching and learning by abdicating these responsibilities.

7.2. Any form of physical contact in this school is respectful and dignified. Physical contact to support pupils’ behaviour is addressed separately in the Care and Control policy. 

7.3. Staff also understand that pupils for whom physical contact is perceived to be invasive, for example some pupils with an Autistic Spectrum Condition (ASC).

7.4. Co-op Academy Princeville encourages social interaction between pupils which may involve physical contact. Physical contact is a part of everyday life of our School that individual circumstances may need to be assessed “on the spot”. All staff should be mindful of how a situation is perceived by other staff, students and onlookers. If a staff member has concerns about something that they have observed, they should raise this immediately with the D/DSL. If the concern is about a member of staff, permanent/supply/volunteer  if necessary the whistle blowing policy must be followed.

7.5. The nature of our pupils’ needs may necessitates a wide spectrum of physical contact in many different circumstances. Intimate care/assistance and activities requiring close personal contact can be identified as any personal care/assistance that involves an individual’s personal space. The following are some of the more frequent times when close contact is required at Co-op Academy Princeville:

  • Moving and handling and positioning in specialist equipment including fitting slings
  • Support in the swimming pool
  • Intimate care procedures – supporting pupils’ hygiene needs
  • Physical prompts and guidance
  • Physiotherapy exercise
  • Intensive interaction and Sounds of Intent as an early form of communication development
  • Putting splints onto hands and feet, especially where massage is essential to relax the limb
  • During outside visits to ensure pupil safety
  • Providing Full Physical Guidance during learning activities
  • Putting coats on and off and other times of dressing and undressing (e.g. swimming sessions)
  • To provide comfort when pupils are distressed or unwell
  • When providing first aid
  • When pupils initiate interaction by physically requesting close interaction
  • During praise and congratulations
  • To support learning for pupils with visual or hearing impairment (or both)
  • When making adjustments to wheelchair straps and clothing
  • During gastrostomy feeding and winding
  • During music and movement sessions

This list is not exhaustive but provides an indication of the range of activities where physical contact is likely to occur.

8. Affection from pupil

Some pupils may attempt to kiss or ‘nuzzle’ staff in acknowledgement of security and happiness and this may be an important step in their development. It may also be a way for students to understand their ‘place in the world’. To not return affection at these times may have a detrimental effect  upon the individual student’s well being and may cause confusion. Staff will be mindful of redirecting the pupils’ affection by changing the contact (for example, into a ‘side hug’) without making the child feel rejected.

Appendix 1 – Intimate care risk assessment

Hazard

Risks

Risk level (H.M.L)

Precautions Needed

Risk Level Achieved (H.M.L)

Additional Action Needed

Trips, slips, falls

Major or minor risk to staff and children.

M

Toileting protocol in place and owned by all staff. Spillages of urine or faeces dealt with promptly.

L

Protocol followed. Spillage equipment available.

Health risks

Health risks to pupils and staff e.g. infection, diarrhoea, vomiting.

M

Protocol in place and owned by all staff. All staff trained in good hygiene practice. Staff aware of infection/health risks.

L

Protocol reviewed regularly and all staff receive refresher training.

Manual Handling

Major or minor risk of injury to staff and pupils.

M

Risk assessment in place. Staff training undertaken.

L

Staff members attend refresher training at regular intervals.

Inadequate changing facilities

Health and safety risk to staff and pupils.

M

Headteacher has an action point written into the Accessibility Plan for the school/setting. Protocol in place. Good hygiene practice, regular disinfecting of area. Privacy and dignity of pupil maintained.

L

Action plan prioritised.

Child protection (CP)

Injury to pupil or allegations against staff.

L

All staff members receive CP training and aware of best practice. All staff DBS checked. Protocol in place.

L

Staff members attend refresher training at regular intervals.

Equipment failure

Injury to pupil or staff.

L

Regular equipment maintenance by a competent adult. Regular staff checks. Faults reported.

 

Fire

Injury or death.

M

H&S policy in place. Advice from Fire Service about safe practices and refuge areas.

L

Regular fire drills. All staff and pupils aware of fire safety procedures.

Appendix 2 - Record of intimate care intervention

Child’s Name: ____________________________ Class/ Year Group: _______

Name of Support Staff Involved: ____________________________________

Date

Time

Procedure

Staff signature

Second signature


Appendix 3 - Toilet management plan

Child’s Name _____________________________ Class/Year Group ________

Name of Support Staff Involved ____________________________________

Date of Record ________________                 Review Date ____________________

Area of Need:

Equipment required:

Location of suitable toilet facilities:

Support required:

Frequency of support:

Working towards Independence

Child will try to

Personal Assistant will

Target achieved (date)

Signed _____________________ Parents/Carers

Signed _____________________ Member of Staff

Signed _____________________ Second Member of Staff

Signed _____________________ Child (if appropriate)


Appendix 4 - Agreement between child and personal assistant

Child’s Name _____________________________ Class/Year Group ________

Name of Support Staff Involved ____________________________________

Date________________                  Review Date ___________________

Support Staff

As the personal assistant helping you in the toilet you can expect me to do the following:

  • When I am the identified person I will stop what I am doing to help you in the toilet. I will avoid all unnecessary delays.
  • When you use our agreed emergency signal, I will stop what I am doing and come and help.
  • I will treat you with respect and ensure privacy and dignity at all times.
  • I will ask permission before touching you or your clothing.
  • I will check that you are as comfortable as possible, both physically and emotionally.
  • If I am working with a colleague to help you, I will ensure that we talk in a way that does not embarrass you.
  • I will look and listen carefully if there is something you would like to change about your Toilet Management Plan.

Child

As the child who requires help in the toilet you can expect me to do the following:

  • I will try, whenever possible, to let you know a few minutes in advance, that I am going to need the toilet so that you can make yourself available and be prepared to help me.
  • I will try to use the toilet at break time or at the agreed times.
  • I will only use the agreed emergency signal for real emergencies.
  • I will tell you if I want you to stay in the room or stay with me in the toilet.
  • I will tell you straight away if you are doing anything that makes me feel uncomfortable or embarrassed.
  • I may talk to other trusted people about how you help me. They too will let you know what I would like to change.

Signed _____________________ Member of Staff

Signed _____________________ Child (if appropriate)

Appendix 5 - Permission for school to provide intimate care

Child’s Full Name

Male/Female

Date of Birth

Parent/Carer’s Full Name

Address

I understand that;

I give permission to the school to provide appropriate intimate care support to my child e.g. changing soiled clothing, washing and toileting.

I will advise the headteacher of any medical complaint my child may have which affects issues of intimate care.

Signed ___________________________________________

Full Name _________________________________________

Relationship to Child _________________________________

Date ______________________________________________