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5.5.2 Personal Care and Relationships

AMENDMENT

This chapter was updated in September 2017 by adding the DfE definition for Child Sexual Exploitation and a link to the DfE Child sexual exploitation: definition and guide for practitioners (2017). (See Section 10, Sexual Exploitation).


Contents

  1. Introduction
  2. Physical Contact and Getting to Know People
  3. Intimate Care and Personal Care Guidelines with Disabled Children
  4. Bathing Guidelines
  5. Bedrooms
  6. Puberty and Sexual Identity
  7. Pornography
  8. Sexual Activity in Homes and Safeguarding Children with Disabilities
  9. Contraception and Pregnancy
  10. Sexual Exploitation
  11. Sexually Transmitted Infections and Contagious Diseases
  12. Peer Group Abuse
  13. Menstruation
  14. Enuresis and Encopresis
  15. Guidance in Relation to Personal Care and Relationships
  16. Appropriate Language
  17. Friendship and Support
  18. First Aid and Medication

    Appendix 1: Policies and Guidance

    Appendix 2: 'Professional Practice Standards for Residential Child Care'


1. Introduction

The purpose of this procedure is to support and assist any member of staff working with children and young people who are Looked After.

The aim is to support staff in their role in order that they are equipped to professionally manage the issues discussed in this procedure that may arise as part of their job.

Overall this procedure will assist staff to have the knowledge and confidence to develop professional relationships with young people and to support them in ensuring that their personal care needs are met. This can also be used as a guide to protect you as a member of staff and most importantly to provide adequate care and ensure that the young person’s best interests are paramount.


2. Physical Contact

Carers/residential staff must provide a level of care, including physical contact, which is designed to demonstrate warmth, friendliness and positive regard for children and Young People.

Physical contact should be given in a manner which is safe, protective and avoids the arousal of sexual expectations, feelings or in any way which reinforces sexual stereotypes.

Whilst carers/ residential staff are actively encouraged to play with children, it is not acceptable to play fight or participate in overtly physical games or tests of strength with the children.


3. Intimate Care

Prior to providing personal care staff need to be introduced properly and get to know the young person. You need to be aware of any communication difficulties and how to understand the young person. Risk assessments indicate the support levels required for each young person in relation to personal care. As a service we aim to keep a balance between ensuring vulnerable children are not exposed to risk with respecting their rights to privacy and avoiding being over intrusive. Under no circumstances should a new member of staff undertake personal care unassisted until after indication and appropriate training has been undertaken. During the first few weeks new staff will ‘shadow’ experienced staff until the young people know them and they are confident and competent in maintaining personal care and supporting young people. Team Leaders will review children’s support needs with new staff and record this in supervision.

Children must be supported and encouraged to undertake bathing, showers and other intimate care of themselves without relying on carers/ residential staff. However additional support may need to be given to children with disabilities for example they may need additional support with personal care such as toileting and bathing.

Such arrangements must emphasise that children's dignity and their right to be consulted and involved will be protected and promoted; and, where necessary, carers/ residential staff will be provided with specialist training and support. In order to preserve dignity the following issues need to be considered:

  • Use locks on bathrooms and toilet doors and use dressing gowns and towels appropriately to preserve young people’s dignity;
  • Talk to young people throughout providing intimate care, ask their preferences, tell them what you are doing at each stage and check that they feel comfortable, e.g. ‘Was that ok for you?’;
  • Encourage young people to maintain good standards of personal hygiene;
  • Ensure that you are prepared before providing intimate care i.e. you need to ensure that materials needed are to hand;
  • As a staff member you should encourage the young person to have an image of their own body i.e. our attitude to the Young Persons Care is important, as far as appropriate with the young person’s age in mind, care should be relaxed and fun. Acknowledge each young persons sexual and physical development and where possible discuss these changes;
  • Young people should be encouraged as far as ability allows to participate in their own intimate care, attempts should be made to avoid assisting young people with tasks that they are able to perform alone. This is important for tasks such as removing undergarments and washing private parts; support the young person in doing all that they can do themselves.

Unless otherwise agreed, children will be given intimate care by adults of the same gender. However this is not always possible due to staff levels, systems are in place such as Risk Assessments if intimate care is to be provided by a member of staff who has a different gender to the child such as to support males providing intimate care to female service users. (For further information see Appendix 2: 'Professional Practice Standards for Residential Child Care' for the reference to Medication and Healthcare Procedure).

Intimate Personal Care Guidelines with Disabled Children

The young people we support often receive support from a number of carers over the course off the week, e.g.: parents, family support workers, school. This together with their limited understanding and/or poor communication skills makes them a very vulnerable group of children. It is important that we recognise the need to be sensitive to the feelings of the young person and to also be aware how vulnerable they must feel. Young people need to develop their understanding of social boundaries and as a staff member you may also need to support them and their parents to learn what is socially acceptable and what is not.


4. Bathing Guidelines

All young people who use our services will need supervision in running a bath. To ensure this is done in safe manner we have set out ‘Safe Bathing Guidelines’ which must be strictly observed.

  • Some young people particularly enjoy effective supervision throughout bathing. Staff should be in the bathroom at all times unless their Care Plan, risk assessment and a specific agreement has been confirmed by the Manager with the parents which indicates otherwise;
  • If a young person has a medical condition with an identified risk, they must never be left alone in a bath or shower. Staff to be present at all times;
  • Staff must ensure that the area is safe from hazards, i.e.: slipping on wet floor, chemical and/or products which the young person may misuse. Extra care will be taken in assisting a young person in and out of the bath/shower. Slip mats must be used;
  • Bathroom aids that are used must be checked daily and kept in a clean condition. Staff will also adhere to COSHH regulations in regard to cleaning materials;
  • If you as a staff member determine that a young person’s state of health has deteriorated or there are any concerns about aspects of their bathing needs that are unclear - do not bath without advice from your Line Manager;
  • Personal Profiles will identify if the young person prefers a shower to a bath or do not like having water running down their face;
  • Read and check the Care Plan to ascertain if the young person has a risk assessment of bathing needs. If there is a risk assessment in relation to bathing, all advice must be strictly adhered to;
  • Bathing or showering must only be carried out where it has been identified in the Placement Plan. In the event of an emergency situation, (i.e.: continence difficulty, vomiting and soiling) that is not covered by the Placement Plan; bathing procedures must be rigorously adhered to;
  • Ensure you have all requirements i.e.: gloves, towels, flannels, soap equipment etc before proceeding to bathe the young person;
  • Hot water taps all have safety regulators, which provide for the water to be mixed at the point of delivery. As the regulators can be subject to mechanical failure temperature record checks are made on a weekly basis or daily when the young person is bathed/showered. This must be signed for.

In Running a Bath/Shower - The Following Guidance must be Followed

Bath temperatures must be taken and recorded before the young person has a bath:

  • Cold water to be run before the hot, even if using mixing taps;
  • A bath thermometer will be used to check the temperature of the water before child/young person enters the shower or is supported into the bath. The temperature should not be above 43c;
  • Once the water has been run ensure the taps are secured to prevent any subsequent water drips;
  • Having first checked the water temperature with the bathing thermometer you should also then do so by hand to confirm the water feels comfortable;
  • When using a shower ensure that the water has been flowing for a minute before the young person enters;
  • Hot water must never be added to a bath once the young person is in the bath;
  • If a second bath is required, i.e.: if the young person has been incontinent, they must get out of the bath until fresh water has been run and the temperature has been retaken;
  • Temperatures must be recorded and signed for.


5. Bedrooms

Each child over 3 will have their own bedroom or, where this is not possible, the sharing of the bedroom will have been agreed by the placing authority and the Foster Carers’ Supervising Social Worker must have conducted a risk assessment and any arrangements must be outlined in the child’s Placement Plan.

Children should be encouraged to personalise their bedrooms, with posters, pictures and personal items of their choice.

Children of an appropriate age and level of understanding should be encouraged and supported to purchase furniture, equipment or decorations. For older children this should be part of a plan to prepare the child for independence.

Children's rooms should be kept in good structural repair and be clean and tidy. The furniture should conform to standards of flame retardant materials as advised by trading standards.

Children's privacy should be respected. Unless there are exceptional circumstances, carers/ residential staff should knock on the door before entering children's bedrooms; and then only enter with their permission. The exceptional circumstances where carers/ residential staff may have to enter a child's bedroom without asking permission include:

  • To take necessary action, including forcing entry, to protect the child or others from injury or to prevent likely damage to property. NB The taking of such action is a form of Physical Intervention;
  • This will be very different when caring for children with a disability for example the child may have additional and complex needs which impact on the level of care they receive. If a child has severe needs although the Residential Worker will knock on the bedroom door, they may need to complete regular checks on this child and they would not necessarily wait for permission to enter the bedroom;
  • To wake a heavy sleeper, undertake cleaning, return clean or remove soiled clothing; though, in these circumstances, the child should have been told/warned that this may be necessary.


6. Puberty and Sexual Identity

Carers/residential staff must adopt a non-judgemental attitude toward children, particularly as they mature and develop an awareness of their bodies and sexuality.

Carers/residential staff must adopt the same approach to children who explore or are confused about their sexual identity or who have decided to embrace a particular lifestyle so long as it is not abusive or illegal.

Children who are confused about their sexual identity or indicate they have a preference must be afforded equal access to accurate information, education and support to enable them to move forward positively. As necessary this must be addressed in Placement Plans.


7. Pornography

All materials published, circulated or available to children (including the internet) must promote and encourage healthy lifestyles and images of men and women that are positive and encouraging.

Children must be positively discouraged from obtaining material that is potentially offensive or pornographic.

If they obtain such material that is suspected to be illegal it must be confiscated. This should be discussed by the carers/residential staff with the child’s Social Worker and their manager/supervision Social Worker. If there are concerns that the child has been exposed to extreme pornography, the concerns should be shared by the carers/residential staff with the child’s Social Worker and their manager/supervision Social Worker. Who will consider with their managers what additional action is required.

If children obtain material legally they should be required to keep it private; this will depend on the age and level of understanding of the child.


8. Sexual Activity in Homes

Children under the age of 13 are deemed to be incapable of giving consent to sexual activity. Therefore, children of this age who engage in sexual activity must be referred under Safeguarding Children Procedures (as a Child Protection Referral) as potentially suffering from Significant Harm.

In accordance with ‘The Sexual Offences Act 2003’ and the age of consent; the legal age for young people to consent to have sex is still 16, whether they are straight, gay or bisexual. The aim of the law is to protect the rights and interests of young people, and make it easier to prosecute people who pressure or force others into having sex they don't want.

For the purposes of the under 13 offences, whether the child consented to the relevant risk is irrelevant. A child under 13 does not, under any circumstances, have the legal capacity to consent to any form of sexual activity.

Although the age of consent remains at 16, the law is not intended to prosecute mutually agreed teenage sexual activity between two young people of a similar age, unless it involves abuse or exploitation. Young people, including those under 13, will continue to have the right to confidential advice on contraception, condoms, pregnancy and abortion.

Children’s Social Workers, placement officers and care providers must be alerted to such relationships when considering the placement of children under 13. Children of this age who are likely to be at risk from each other (or from older children) should not be placed together.

When considering the placement (or ongoing placement) of children over the age of 13, managers must assess the risk of sexual relationships developing and should ensure strategies are in place to reduce or prevent these risks if they are likely to be exploitative or abusive.

Where children aged 13 - 18 are placed together with no identified risk of exploitative or abusive behaviour, carers/ residential staff must monitor any developing relationships, sensitively but positively discouraging children from engaging in under-aged sexual relationships

When staff are suspicious or aware that children may be engaging in sexual relationships, they need to consider the following issues:

  • The age of the young person - sexual activity at a young age is a very strong indicator of risks to the welfare of the young person (boy or girl) and, possibly, others;
  • Whether the young person is competent to understand and consent to the sexual activity in which he or she is involved; this links in with protecting people with a mental disorder.

    (See Procedure for Working with Young People Engaged in Sexual Activity, Appendix 1: Policies and Guidance);
  • The nature of the relationship between those involved, particularly if there are age or power imbalances;
  • Whether overt aggression, coercion or bribery was involved including misuse of substances/alcohol as an inhibitor;
  • Whether the young person's own behaviour, for example, through misuse of substances, including alcohol, places them in a position where they are unable to make an informed choice about the activity;
  • Any attempts to secure secrecy by the sexual partner beyond what would be considered usual in a teenage relationship;
  • Whether there have been concerns about the sexual partner, including his/her relationships with other young people;
  • Whether the young person denies, minimises or accepts concerns;
  • Whether methods used to secure compliance and/or secrecy by the sexual partner are consistent with behaviours considered to be 'grooming'
  • Whether sex has been used to gain favours e.g. exchanging sex for cigarettes, clothes, alcohol, drugs, mobile phones, etc;
  • Whether the young person has unreasonable amounts of money or other valuables that cannot be accounted for.

Overall, carers/ residential staff should be mindful of their duty to consider the overall welfare of children and this may mean recognising that illegal activity is taking place and working to minimise risks and consequences. If there is any suspicion that a child is engaging in illegal behaviour it must be discussed with the child’s Social Worker who will consider what further action is required under the Safeguarding Children Procedures.

Any actions taken in this respect will be subject to consultation and must be addressed in Placement Plans.

Should carers/ residential staff suspect children are engaging in sexual relationships, they should:

  1. Ensure the basic safety of all the children concerned;
  2. Inform the child’s Social Worker and their manager/supervision Social Worker.

Safeguarding Children with Disabilities

It is important to recognise that we are supporting young people who are very vulnerable to abuse and that as a staff member attending to their personal care needs that you could be vulnerable to allegations of abuse. If any of the following incidents occur, report them as soon as possible to a Line Manager and record it on the young person’s file. This is both to register any potential concerns and also to avoid and misunderstanding;

  • You accidentally hurt the young person;
  • The young person is sore and unusually tender in a particular (genital) area;
  • The young person appears sexually aroused by your actions;
  • The young person misunderstands or misinterprets something;
  • The young person has a very emotional reaction without apparent cause (sudden crying or shouting).


9. Contraception and Pregnancy

Access to contraceptives will not be conditional on children giving information about their lifestyles and contraception will never be withdrawn as a punitive measure.

Whilst not encouraging it, it is understood that children may engage in sexual activity; some before they reach the age of consent.

In such circumstances the carers' Supervising Social Worker/residential manager should consult the Social Worker to agree what reasonable steps can be taken to minimise risk of pregnancy or infection, including facilitating contact with relevant agencies providing contraceptive advice; such as the Brook Advisory Service.

If a child is suspected or known to be pregnant the carers/residential staff should notify their managers and the child's Social Worker to decide on the actions that should be taken.


10. Sexual Exploitation


Definition of Child Sexual Exploitation from DfE Child sexual exploitation: definition and guide for practitioners (2017)

Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.

See DfE Child sexual exploitation: definition and guide for practitioners (2017).

Children may have previously exchanged sex for rewards, gifts, drugs, accommodation and money. Some maintain this lifestyle whilst continuing to be accommodated by the authority. Such situations must be reported by the carers/residential staff to their managers and the child's Social Worker to decide on the actions that should be taken.

Carer/residential staffs must be alert to such behaviours and should do all they can to create an environment which encourages children to be open about their past or present attitudes and behaviours and which demonstrates they will be supported to guide them away from such lifestyles.

Where there is any suspicion that a child is engaged in such behaviour it should be addressed in the child's Placement Plan together with strategies to be adopted to help the child find alternative lifestyles need to be identified.

In addressing these behaviours consideration must be given to the extent to which the child is suffering Significant Harm and whether it is necessary to refer the child under Safeguarding Children Procedures in the area where the child is living.

If there is any suspicion that a child is involved in Child Sexual Exploitation, Ofsted must be notified.


11. Sexually Transmitted Infections and Contagious Diseases

If it is known or suspected that a child has a sexually transmitted infection (including HIV and AIDS), carers/residential staff must notify their managers and the child's Social Worker, who will decide what measures to take.

Contagious Diseases

During your work you may be exposed to infections, illnesses or diseases which are contagious. You should always report any such occurrences to your Manager, who will in turn notify everyone required. They will have access to the ‘Control of Infectious Diseases Procedures’, and will talk to the Health & Safety Officer for advice. When you attend your G. P you should make clear to him/her the nature of your work, so that they can notify the Community Physician if required. If the situation is serious the Doctor may place you on sick leave until they determine the risk to others is past.


12. Peer Group Abuse

The possibility of peer abuse will always be taken seriously but we recognise it is equally important not to label or stigmatise normal sexual exploration and experimentation between children.

Behaviour is not a cause for concern unless it is compulsive, coercive, age-inappropriate or between children of significantly different ages, maturity or mental abilities.

If at any time carers/residential staff suspect children are engaged in abusive sexual relationships as perpetrators and/or victims, they must immediately inform their managers and the child's Social Worker and make a referral under the Safeguarding Children Procedures.


13. Menstruation

Young women should be supported and encouraged to keep their own supply of sanitary protection without having to request it from carers.

There should also be adequate provision for the private disposal of used sanitary protection.


14. Enuresis and Encopresis

If it is known or suspected that a child is likely to experience enuresis, encopresis or may be prone to smearing it should be discussed openly, with the child if possible, and strategies adopted for managing it; these strategies should be outlined in the child's Placement Plan.

Carers/residential staff, their managers and the child's Social Worker should consider the reasons for enuresis and encopresis there may be a variety of reasons but it is likely that such behaviour is symptomatic of anxiety and worries about previous experiences including abuse and neglect.

It may be appropriate to consult a Continence Nurse or other specialist, who may advise on the most appropriate strategy to adopt. In the absence of such advice, the following should be adopted:

  1. Talk to the child in private, openly but sympathetically;
  2. Do not treat it as the fault of the child, or apply any form of sanction;
  3. Do not require the child to clear up; arrange for the child to be cleaned and remove then wash any soiled bedding and clothes;
  4. Keep a record, either on a dedicated form or in the child's Daily Record with detail, if necessary, in a Detailed Record;
  5. Consider making arrangements for the child to have any supper in good time before retiring, and arranging for the child to use the toilet before retiring; also consider arranging for the child to be woken to use the toilet during the night;
  6. Consider using mattresses or bedding that can withstand being soiled or wetted e.g. mattress protectors.

Note: There may be other reasons for this behaviour for example a child may suffer from a severe disability which results in incontinence; if this is the case then this will be included in the Child’s Placement Plan and specialist care will be given.

Continence and Using the Toilet

When supporting young people with continence problems you may need to prompt them to use the toilet, or provide them with total assistance if they use incontinence pads. Incontinence aids must only be used where the young person has been assessed by an incontinence nurse as requiring them. You should anticipate that people might need to use the toilet somewhere between 6 and 8 times typically in any 24 hour period. Leaving young people who are unable to directly ask you for this support unattended is not acceptable, given that they may feel distressed and extremely uncomfortable.

Personal hygiene should dictate that where young people are incontinent that you should always wash soiled areas properly, this is essential not only for personal comfort but also to impede sores and limit the potential for urinary infection. Disposable wipes and gloves are available for use and these must always be worn during personal care.

Gloves, wipes, aprons etc must be kept locked away from the young people.

Staff must check Profiles for indications of allergic reactions of wipes, creams or soaps. Staff in summer will need to help young people to apply sun cream, wear clothing and hats and avoid undue exposure to the sun; especially when young people are prescribed medication that heightens skin sensitivity.

During outings it may be necessary for female staff to support a young man who wishes to use the toilet and this can present problems; where possible disabled toilets should be used. If this facility is not available assistance should be sought from venue staff to enable staff to support the young person in as dignified a manner as possible.

Personal Profiles should identify the level of support required with continence. Staff should encourage the young person to do as much as they are capable for themselves and build on skills to enable the young person to attend to their own needs independently, e.g.: wiping themselves, urinating standing up etc


15. Guidance in Relation to Personal Care and Relationships

The term 'Touch' is used throughout this manual in two different contexts.

'Touch' as a form of physical intervention designed to prevent a child or others from being injured or to protect property from being damaged; and the use of 'Touch' to enable carers/residential staff to demonstrate affection, acceptance and reassurance.

This section provides guidance relating to the demonstration of affection, acceptance and reassurance.

It is acknowledged that touch raises particular issues for those working with children. Some people have views about applying a "hands off" or "hands on" Policy with children result from scandals of child abuse, or fear of violence from children. Carers may be anxious about allegations of inappropriate physical contact with children.

However, touch is acceptable; but carers should consider the following:

The child's background and previous experiences

The child may have had particular experiences which make it difficult to accept touch from an adult; or the child's experiences may lead to a need for more touch than is acceptable.

It is therefore important for carers to obtain information about the child's background before acting, in any way not just in terms of the use of touch.

If there are particular needs that the child has or if it appears that the child may respond more or less favourably to touch, this must be reflected in the planning process.

Dependent on the age and level of understanding of the child, s/he should be involved in this assessment and planning; and should be encouraged to consent to being touched; or to place conditions on it.

The child's culture and boundaries

The culture or values of the household should be such that touch is encouraged; as a positive and safe way of communicating affection, warmth, acceptance and reassurance.

Carers/residential staff and children should be encouraged to use touch, positively and safely.

But it is important for carers and children to know if boundaries exist within the home or for individual children.

If boundaries or expectations exist for individual children they should be set out in their Care Plan and Placement Plan.

If boundaries or expectations exist for the home, they should be clear. For example, if carers are not expected to allow children to sit on their laps, or to carry children, this should be stated, preferably in writing.

In the absence of any plan or expectation, the following should be taken into consideration

  1. When thinking about who is an appropriate person to touch a child, it is vital to consider what the adult represents to the particular child. Personal likes and dislikes will play a part in any relationship;
  2. In addition, many factors influence the power in relationships between adults and children, including gender, race, disability, age, sexual identity and role status;
  3. The background of the child will also influence any decision about who represents a 'safe' adult in the eyes of the child;
  4. Children from ethnic minority backgrounds may be used to different types of touch as part of the culture;
  5. Children who have been subject to physical or sexual abuse may be suspicious or fearful of touch. This is not to say that children who have experienced abuse should not be touched, it may be beneficial for the child to know different, safer and more reliable adults who will not use touch as a form of abuse;
  6. For each child, what constitutes an intimate part of the body will vary; but generally speaking it is acceptable to touch children's hands, arms, shoulders. It may be appropriate to hug or cuddle children, or carry or give them 'piggy backs';
  7. Other parts of the body are less appropriate to be touched, by degrees. Some parts of the body are 'no go areas';
  8. Therefore, it may be appropriate to touch a child's back, ears or stroke their hair or knees - if the child indicates such touch is acceptable. To go beyond this would be unacceptable, even if the child appeared to accept it;
  9. In any case, no part of the body should be touched if it were likely to generate sexualised feelings on the part of the adult or child;
  10. Also, no part of the body should be touched in a way which appeared patronising or otherwise intrusive;
  11. Therefore, the context in which touch takes place is usually a decisive factor in determining the emotional and physical safety for both parties;
  12. What message is being sent out to the child? If the intention is to positively and safely communicate affection, warmth, acceptance and reassurance it is likely to be acceptable;
  13. A fleeting or clumsy touch may confuse a child or may feel uncomfortable or even cause distress. Carers should touch with confidence, and should verbalise their affection, reassurance and acceptance; by touching and making positive comments. For example, by touching a child's arm and saying "Well done";
  14. Where children indicate that touch is unwelcome carers should back off and apologise if necessary;
  15. Carers should talk to colleagues and record their interactions with children. If particular strategies work, or not, colleagues should be informed so they can build on or avoid making the same mistake;
  16. Touch of an equally positive and safe nature is acceptable between carers; demonstrating positive role models for children. Showing that adults can get along and use touch in non abusive or threatening ways;
  17. It is also acceptable to talk about how touch feels, about acceptable boundaries and expectations; doing so in 'house meetings' or key worker sessions;
  18. Play fighting is no alternative for this. It is unacceptable;
  19. The key is for carers to help children experience and benefit from touch, positively and safely; as a way of communicating affection, warmth, acceptance and reassurance.

Providing Personal Care to People from other Cultures

In order to meet the needs of a client from any culture it is important to assess their individual needs. There are an enormous variety of individual practices and variations in local traditions across the world. Please see: Providing Personal Care to People from Other Cultures Procedure referenced in Appendix 1: Policies and Guidance; this will provide some broad guidelines covering the world’s major religions and generally accepted practices and beliefs, which will have an impact upon the provision of care you provide.


16. Appropriate Language

It is essential that all carers/residential staff are aware, that the use of foul and abusive language directed towards children is totally inappropriate and unnecessary. This will only have the effect of demeaning children, have a negative effect on child/carer relationship and lead to an escalation of disruptive and challenging behaviour.

All carers/residential staff need to be aware that any complaints relating to foul and abusive language will be treated seriously and may lead to disciplinary measures.


17. Friendship and Support

Confidence in and good rapport with particular adults is a fundamental element in good care practices. Whilst children are in foster or Residential Care a variety of problems will arise, at times of stress or crisis every child needs an adult to turn to.

Warmth and understanding are essential, but everyone needs to know and understand when a relationship is inappropriate. The fine line between what is "proper" warmth and understanding and what is regarded as "improper" is likely to vary depending on the needs and experiences of the individual child.

Where it is known that a child has been a victim of sexual abuse and it is likely he or she will behave towards carers in a sexual manner, particular rules will have to be drawn up for carers/residential staff. This may involve the need to avoid being alone with the child, by always having a third person present.

What is important is that carers and residential staff need to be putting the children's interests first and always considering what is appropriate in any given situation with a particular child.

Interaction on a One To One Basis

Carers/residential staff must have knowledge and understanding of the child and his or her background, and be able to recognise and respect any emotional 'barriers' the child has 'erected'.

Carers/residential staff should be sufficiently aware of their own feelings, so that they can recognise the dangers of a relationship with a child becoming sexualised and stop to consider what is happening and what they are doing.

Other people's feelings and views, of both adults and children, need to be taken into account. If there is any indication that a relationship could be viewed as inappropriate, the carers/residential staff should discuss the issues with their managers/supervisors and the child's Social Worker.

It is not a matter of carers never becoming involved in close one to one relationships with a child, it is a vital part of the 'caring' task, however, carers must be aware of the dangers, which this type of work can bring and be clear where the boundaries in such relationships lie.


18. First Aid and Medication

First Aid

A First Aid box is provided in each unit, there is a designated person who is delegated to ensure it is kept stocked. The delegated first aid person will undertake a 5 day training course. It is the responsibility of staff members to render treatment as required to any person who is staying in the unit, member of staff, or other person(s) visiting. All other staff will complete their training in basic life saving techniques. The soundest first aid advice is to call the experts, the emergency services.

Medication

  • If a child takes any form of medication this must be administered following the MP3 Risk Assessment;
  • If you are designated as Meds 1 you must have taken part in an accredited training course;
  • All the children have on their files an MP1 and MP3 and MAR sheets to record administered medication;
  • Take time out to look at these forms and understand them.


Appendix 1: Policies and Guidance

Policies and Guidance:

After reading this procedure you also need to ensure that you read through:

Additional Support

  • Consideration should be given to the need for each child to have an Advocate or Independent Visitor - see Independent Visitors Procedure. Appropriate support must be provided to all children including those who are refugees or asylum seekers, and those who are disabled children and with communication difficulties;
  • When working with children from different ethnic and cultural backgrounds it is essential that we try to understand their beliefs and practices as this will impact upon the provision of care that we provide, Please refer to this Procedure for further information: Providing Personal Care to People from other Cultures - To Follow;
  • For further information on personal care with disabled children please refer to the following Procedure: Medication and Healthcare Procedures; parts of this procedure have been included.


Appendix 2: 'Professional Practice Standards for Residential Child Care'

‘Professional Practice Standards for Residential Child Care’

  • Standard 1: Fulfil your role as a residential child care worker;
  • Standard 2: Promote health and safety, and healthy care;
  • Standard 3: Communicate effectively and promote children and young people’s communication;
  • Standard 4: Promote the development of children and young people;
  • Standard 5: Safeguard children and young people;
  • Standard 6: Develop yourself.

For Further information on the above standards please see DfE website.

End