7. Intimate & personal care: Support Practices

Encourage a young person or adult’s independence, where possible within their intimate or personal care. Where the individual is dependent on a carer for their care provision, the individual must be involved in discussions about this provision, what is required and any choices where possible. Discussions with the young person or adult who receive care should occur regularly to ensure the care provided is satisfactory. This should occur away from the Designated Carer or Nominated Person and within the code of conduct (Yellow Card).

Part of ensuring the young person is fully involved in their intimate personal care is ensuring they consent to their care. Just because the Individual Support Plan is written doesn’t mean any individual should assume consent to every step, every time. If the young person does not consent the care should stop in accordance with our Safeguarding Policy. This might mean explaining a step in clearer language or giving them time and returning to care later. It should also be recorded and discussed with all those involved. This does not mean anyone has done anything wrong, but might indicate a young person is ready to take more ownership of their own personal care.

In all cases where the Nominated Person is supplying the care, there must always be two adult volunteers present. The Nominated Person should undertake the care, the other adult is present to ensure the safety of the young person. Where the care requires two people for the greater comfort or safety of the individual, this will need to be discussed and wherever possible, accommodated. Intimate or personal care is individually defined and varies according to personal experience, cultural expectations and gender so it is important to explore the individuals expectations at the assessment stage and that of their parent/carer. A Designated Carer, such as a parent or professional carer will need to discuss and agree how they provide the appropriate care safely.

When facilitating care provision check that your practice is appropriate by asking the individual if the care you are providing is suitable. If the individual expresses dislike of the care provided or against the person carrying out their intimate or personal care, where suitable this should be discussed with the individual and if appropriate their parent/carer. This should also be reported to the appropriate volunteer line manager for review and recorded on the care log (appendix 4). All safeguarding concerns should be reported to the safeguarding team and advice sought regarding informing parents.

Effective communication between the individual, parents/carers or agencies involved ensures practice is consistent. Any changes should be recorded on the care log (appendix 4) and when appropriate the Individual Support Plan.

Volunteers should only facilitate care that they feel competent and confident to carry out and that they understand.  All volunteers carrying out intimate or personal care must have received an external nationally recognised training for the provision of intimate and/or personal care.  No volunteer should carry out any care that they are not comfortable with or trained to complete. Care should stop immediately, should the volunteer or person receiving the care feels uncomfortable.

Confident, self-assured young people or adults, who feel their body belongs to them, are less vulnerable to sexual abuse.  Therefore the approach the Nominated Person or Designated Carer take towards the intimate or personal care can convey positive messages about body worth. All communication should be age appropriate, treat everyone with dignity and respect and use an age appropriate approach, ensuring that the care can be delivered in a relaxed and considerate environment. 

If during any care provided a volunteer observes any unusual markings, discolorations or swelling of intimate areas including the genitalia, report immediately to the safeguarding team. If there is an immediate risk to the individual, the Police should be contacted immediately. If during the provision of personal or intimate care the individual is hurt, misunderstands or misinterprets the care provision, reassurance should be offered. Ensure that the individual is safe and report the incident immediately to the volunteer line manager and recorded in the care log. It is important also to report and record any unusual emotional or behavioural response to the care provision. A written record of any concerns must be made and kept in the individual’s care log. Contact the safeguarding team if you are unsure on how to proceed with a concern.

Any adult present to act as a Designated Carer, is solely present to attend to the young person or adults needs. They are NOT to be included in ratios or to participate in any volunteer roles. For any adult acting as the Nominated Person a decision must be made during the assessment period whether their role in facilitating care will prevent them also being included in ratios when acting in this position. Any decision must be recorded on the Individual Support Plan and shared as noted above.

During the assessment period consideration must be taken in regard to an appropriate location where care can be delivered, if additional equipment is required and how this will be acquired.