Personal Care and Physical Contact with Children

At Autonomy Plus we believe that positive physical contact is desirable as it promotes the young peoples social and emotional development and can also form a part of non verbal communication.

Positive physical contact can be used to

• Give comfort;
• Keep a young person safe and remove from danger;
• Provide reassurance;
• Show acceptance;
• Provide sensory stimulation;
• To divert aggression;
• Improves self-confidence and self-awareness;
• Improves social skills;
• Increases feeling of safety;
• Decreasing stress levels;
• Deliver personal care routines;
• Provide therapy programs.

Young people will not learn what the difference is between appropriate positive physical contact and inappropriate physical contact. They will miss out on all of the benefits of positive physical contact such as; nurturing, reassuring, healing, sense of safety, and comforting.

Members of staff recognise that positive physical contact is an important part of the young persons development. They recognise that physical contact can be communication and respond appropriately. Touch will always be given in a developmentally appropriate way and should the young person reject touch their wishes will be honoured.

The home understands that physical contact (which is consensual, appropriate, and consistent with the developmental age of the child) is an essential ingredient in developing and maintaining excellent standards of care and protection for all of its young people. Touch, however, can be misconstrued and in acknowledging this fact this policy has been developed, so as to:

• Clarify the home’s expectations about the use of physical touch;
• Provide guidance about the use of physical touch;
• Protect the interests and wellbeing of children for whom staff and volunteers have a shared responsibility;
• Support children who have social, emotional and behavioural difficulties within an ethos of mutual respect, care and safety;
• Protect staff and volunteers in the fulfilment of their responsibilities to children.

This policy should be read in conjunction with a number of other policies which relate to the safeguarding of children, including:

• Behaviour that is Challenging and Physical Restraint Policy;
• West Midlands Child Protection and Safeguarding Procedures, Safeguarding Policy.

Staff within the home may naturally fear, in today’s social climate, that their actions, in relation to physical touch, may be misconstrued. Staff need to understand therefore, that the home will always support those who follow the guidance within this policy/procedure statement. Those who do not may not be supported and may also face disciplinary action.

The first principle is that touch, in all circumstances must always be appropriate and consensual, unless the circumstances giving rise to touch are extreme, and relate, for example to the home’s Behaviour that is Challenging and Physical Restraint Policy.

Staff are required to seek consent beforehand, and to respect the child’s wishes at all times. Children must understand what staff members are doing and why.

Physical contact is generally considered to be appropriate in the following circumstances:

• To prevent imminent slip, fall or injury;
• To manage behaviour the is challenging;
• To prevent serious damage to property;
• To provide personal care, including therapeutic treatments;
• To encourage or assist;
• To offer physical support and guidance – for example help with mobility, and moving and handling, techniques training in PE/Games etc.;
• To offer reassurance and emotional support, particularly for those children who are distressed;
• To aid and develop communication – for example physical prompts, and to make social interactions;
• Giving rewards such as “high fives” or a “pat on the back”;
• In giving first aid.

The above list is not meant to be exhaustive. Touch may be appropriate in many other circumstances, within the general guidelines of consensus and appropriateness.
All staff must understand that touch in any circumstances may be questioned, either by the children themselves, or by their parents, advocates or any significant others involved in their care. Touch must always be undertaken in a professional manner, avoiding any possible perception of inappropriate behaviour or even abuse.

Children who have reached puberty
Staff need to be vigilant and aware that children who have reached puberty may become sexually aroused by physical contact. Staff need to be mindful of this and alternative methods of contact identified.

If the child seems to be sexually aroused during personal care routines, for example, it is important that this is recorded and that the home undertakes a review of alternative approaches.

Children who touch staff inappropriately
Some children may be indiscriminate in their affections to others and may engage in physical contact that staff find inappropriate. Staff should withdraw from these situations as soon as possible and these should be discussed with a more senior member of staff. If this is a regular occurrence, the methods for managing this behaviour should be highlighted on the child’s placement plan.

Inappropriate Touch
As a general rule, the hands and arms are considered ‘neutral’, and it is sensible and good practice if you never touch a child in the area which would normally be covered by a bathing suit. This of course does not apply to first aid, or intimate care practices. In these circumstances staff should try and ensure that there is more than one person present. Staff should be sensitive to signals (non-verbal and verbal) that indicate that a child dislikes touch. For example, a child may pull away or make negative facial expressions.

• Not all touch is negative;
• Ensure that physical touch takes place appropriately, always in areas where they may be observed by others, and sometimes with a verbal explanation, e.g. “you look upset do you need a cuddle?” Remember that some children, particularly those with special needs, may request and benefit greatly from increased physical contact, such as “hugs”, for example;
• It is never acceptable to, kiss or fondle children. Never let a child kiss you on the lips;
• Staff should never allow a child to stand between their legs when seated;
• Holding school age and older children on your lap is not appropriate. Holding a pre- schooler or toddler on your lap is appropriate for short time spans when comfort is needed;
• All activities and practices should be scheduled, where possible, so that all children are within view of more than one member of staff at any one time;
• Staff are discouraged from taking a single child to an area where they may not be observed by others;
• Staff need to be aware that for children/young people who have suffered abuse, physical contact may have upsetting connotations and result in a negative reaction;
• Approach distressed children from the side by offering to sit with them or by offering to hold their hand or putting an arm around them. If anything happens that you believe may put you at risk of accusation by anyone, please do not keep this a secret! It is easier for the manager, Safeguarding Lead or assistant manager to support you if they are aware of what is happening.

Remember not everyone is the same

• Use of physical touch should be discussed openly and regularly. Staff should not feel embarrassed or ashamed of the use of touch and regular discussions should take place between staff teams;
• Children with physical disabilities need support to touch and interact in ways that happen naturally with their peers;
• Staff also need to consider the influences of race, gender, age, sexual identity, religion and disability;
• A child’s personal history may distort the understanding of a ‘safe’ adult;
• Children from ethnic minority backgrounds may be used to different types of touch;
• Children with multi-sensory impairments may be startled by touch;

It is important for staff to familiarise themselves with the needs of different children and to ask advice if they are unsure. Senior staff should ensure that their staff are aware of any child who finds physical touch unwelcome. This information should be recorded on the child’s placement plan.

If any member of staff is in any doubt about any issues concerning appropriate touch, or they observe any practice that causes concern, they should discuss this with the Manager of the home. All staff have a responsibility to ensure safe and appropriate practice at all times.

Where a staff member’s daily work brings them into a one to one situation they should inform other staff why this is necessary and where this will be taking place.

Where one to one work is delivered as part of a specialist service or direct work programme this should be identified in the Placement Plan.

Managers will, where it is deemed necessary, ensure a risk assessment is carried out for the delivery of any piece of work that is consistent with the Placement Plan.

Staff should always try to keep doors open unless this constitutes a breach of privacy for the child. In these instances it may be necessary to undertake a risk assessment of the situation.

If an accident happens whilst in this situation as with any other situation make sure an accident report form is filled in and signed by all parties.

Giving first aid or personal care (where deemed necessary on the Placement Plan), should be recorded on the relevant format.

If any member of staff is uneasy about the behaviour of others who are putting themselves or the child at risk they must inform the manager of the Home.

Where a member of staff feels that the unease is centred on the registered manager they must report this to a manager outside of the line management of the Home, or to the child's social worker.

Any allegations, suspicions and/or disclosures of abuse should be reported as per Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.

Children must be supported and encouraged to undertake bathing, showers and other intimate care of themselves without relying on staff where appropriate.

If a child needs help with intimate care, arrangements must emphasise the child's dignity and will be documented in the young person’s placement plan. Where necessary staff will be provided with specialist training and support.

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

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

If it is known or suspected that a child is likely to experience incontinence 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.

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

• Talk to the child in private, openly but sympathetically;
• Do not treat it as the fault of the child, or apply any form of punishment;
• Do not require the child to clear up; arrange for the child to be cleaned and remove then wash any soiled bedding and clothes;
• Keep a record, either on a dedicated form or in the child's Daily Record;
• 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;
• Consider using mattresses or bedding that can withstand being soiled or wet.

Responsibility For Policy Implementation 

All staff are responsible for the implementation of this policy with overall and final responsibility being that of the Registered Manager.

Consequences for Breach of Policy

If someone is to be found in breach of this policy depending on the severity of the breach disciplinary procedures might be taken which depending on the outcome could lead to dismissal and referral to the Disclosure and Barring Services.

Policy Review

This and all related policy’s will be reviewed and revised as necessary or as a minimum annually and our staff will be notified of any changes.