The purpose of this policy is to provide guidance to our staff who provide 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 this 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.
Fundamental Standards Compliance (from April 2015)
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 contain the following with respect to intimate personal care.
• Regulation 9: Person-Centred Care — requires service providers to ensure that the care and treatment of residents must be appropriate, must meet their needs, and must reflect their preferences
• Regulation 10: Dignity and Respect — requires that residents 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 residents 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.
This home understands that inspectors are prompted in the Key Lines of Enquiry published by the CQC to ask how residents receive personalised care that is responsive to their needs. This forms part of the five key-question test to rate how caring the service is. When looking for evidence of compliance, inspectors are prompted to ask people and/or their relatives for their views and experiences of person-centred care including the choice, with regard to gender, of who provides their personal care. This should include how much they are asked for their views, given choice and control, get the right care, treatment and support when they need it, and have their diversity and/or disabilities taken into account.
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)
• washing or bathing
• oral care
• the care of skin, hair and nails.
Personal care also include the acts of prompting and supervision of a person in relation 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 have to be carried out in terms of their 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.
In providing any form of personal care, care workers must be aware of the fact that they will be in close personal contact with the person and they should also check how he or she might be feeling about this. Care workers should be aware of their own body position and how this might come across to the service user.
It is inevitable in the offering of personal care some form of physical contact will be made, which each residnet 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 residents’ responses in their training and supervision and briefing to carry out the tasks required.
Appropriate and Inappropriate Personal Contact
Individual residents 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 in the course of the personal care work 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 considered to be abusive and could result in disciplinary or even criminal actions being taken against them. These are clearly stated in the relevant safeguarding 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 their residents and indeed to their own safety and personal integrity.
Intimate Personal Care
Residents who require help with intimate personal care that could include dressing, washing, bathing, 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 residents 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 resident 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 residents 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.
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 residents and through their own training, particularly in the use of supervision.
Policy review date: _____________________________