Sexual Health and Relationships

The Home’s manager should ensure that children are provided with suitable, good quality, up to date information, support and advice on matters relating to sexual health and relationships. This information should supplement what is provided through the school/educational setting.

Such information and advice must be provided in a manner appropriate to children's age and understanding.

Before providing such information and advice, the manager/staff must consult the social worker and, if possible, parents or those with parental responsibility to ensure it is provided in the context of the child’s background and needs. Any specific requirements must be incorporated into the child’s Placement Plan.

Children and young people at risk of CSE will often be in high risk situations and isolated from protective, nurturing adults. They will need to be encouraged to express their wishes and feelings to make sense of their circumstances and contribute to decisions that affect them. Of relevance is the impact of those who may have groomed and conditioned children and young people, to coerce and abuse them. Children and young people may also be under very strong pressure, intimidated, afraid and/or dependent on those that have exploited them where substance misuse is a factor. Children and young people may therefore reject offers of help and support and appropriate interventions need to be designed to address this.

The Home will strive to prevent any such abuse to safeguard Children and young people before they face such situations of abuse. The Home will do this through a number of methods:

• Liaison and co-operation with any local authority which is, or may be, making child protection enquiries in relation to any child accommodated in the Home;
• Ensuring that thorough, professional and systematic recruitment practices are followed which ensure that adequate references are taken up for all care workers, and use is made of all checking procedures, particularly the Disclosure and Barring Service (DBS) disclosure process;
• Encouraging the role of the advocate for children and young people. Children and young people who have no relatives or friends to act as advocates should be encouraged to have an independent advocate who will act as spokesperson and participate in care reviews as necessary;
• Recognising the fundamental rights of children and young people to privacy, dignity, maintenance of self-esteem and fulfilment, choice, recognition of diversity, individuality and independence, together with the maintenance of their rights as citizens;
• Making relatives and advocates aware of the Home’s complaints procedure and encouraging them to comment upon the care received by children and young people and to participate in reviews of care;
• Committing to quality assurance and regular quality reviews;
• Ensuring that training is provided on the forms and prevention of abuse, together with skills to care for children who have been abused and that such training is available to all employees;
• Acting whenever there is suspicion that abuse has occurred;
• Utilising management systems which support and supervise employees in their work and facilitate good communications;
• Encouraging an atmosphere of openness and trust where employees and children feel able to discuss and therefore prevent the development of potentially abusive situations;
• Ensuring that induction procedures for employees include the prevention of abuse of children and young people;
• Giving children and young people a copy of the Home’s complaints procedure on admission and ensuring that they understand how to use the procedure.

Key agency contacts will be LSCB, Police, Social Services, DOFA, NSPCC, Health Authority, Education and Youth Services, YOT and local voluntary agencies.

The Manager of the Home has a duty to refer, promptly, to the local authority (Designated Officer for Allegations against People in a Position of Trust, DOFA) in whose area the Home is situated, any allegation of abuse or neglect affecting any child accommodated in the Home.

In addition, this duty extends to notifying the child’s placing authority and Ofsted of the instigation and outcome of any child protection enquiries involving a child accommodated in the Home. If there are identified injuries or if fraud is suspected, the police will have to be informed.

Finally,

• Any communications with outside agencies should be logged, with the date and time, and noted in the child or young person’s records;
• If the alleged abuser is a member of staff, they will be dealt with according to the Home’s disciplinary procedure;
• The abused child or young person should be offered counselling and support;
• Consideration and support should be offered to other children and young people who may have witnessed the abuse. 

Everyone employed at the Home (including junior staff, ancillary, volunteer and agency, paid, unpaid) have a duty to report any concerns about the welfare or safety of any child accommodated in the Home to one of the following persons:

• The registered manager (Inform as a first priority and they will, where appropriate, inform the authorities);
• A police officer;
• An official of Ofsted;
• An officer of the local authority in whose area the Home is situated (DOFA);
• An officer of the National Society for the Prevention of Cruelty to Children.

Contact details (Name of contact, if appropriate, job title, telephone number and postal address) for both Ofsted and the DOFA are posted in a prominent place within the Home. Where allegations or suspicions of abuse concern the Manager of the Home then staff should contact the Responsible Individual. 

Any employee who is found to have abused a child or young person in such a manner will face disciplinary action which may include dismissal and subsequent referral to the Police and/or the Disclosure and Barring Service.                                               

The Manager of the Home is the designated person responsible for managing allegations of abuse within the Home and for liaising with the Designated Officer for Allegations against People in a Position of Trust (DOFA).             

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

Staff must adopt the same approach to children who are confused about or wish to explore 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.

As necessary this must be addressed in Placement Plans.

The use of online filters can help to ensure that younger children do not accidentally access pornographic or sexual images online. See UK Safer Internet for more information.

Older young people are likely to be curious about sex and relationships and may search for online for pornographic or sexual material. It is important that staff have an open discussion with young people about pornographic images and the impact that viewing these can have on young people and their own developing relationships. The NSPCC have produced comprehensive guidance for parents and carers on how to talk to young people about online porn and healthy relationships.

For more information please see Online porn - Advice on how to talk to your child about the risks of online porn and sexually explicit material (NSPCC).

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.

The Home’s manager must be alert 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. See Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.

When considering the placement (or ongoing placement) of children over the age of 13, the manager 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, the manager and staff must monitor any developing relationships, and sensitively but positively discourage children from engaging in under-aged sexual relationships.

Overall, staff should be mindful of their duty to consider the overall welfare of children and this includes working to minimise risks and consequences of any sexual activity between young people living in the Home. If there is any suspicion that a child is engaging in illegal behaviour it must be discussed with the social worker.

When staff suspect children are engaging in sexual relationships, they should:

1. Ensure the basic safety of all the children concerned;
2. Notify the Home’s manager, who should notify/consult relevant social workers and consider reviewing the child's Placement Plan;
3. Record all events in the Daily Log, relevant child's Daily Record. If required an incident report should be completed.

Should staff discover children engaging in sexual relationships, they should:

1. Ensure the basic safety of all children concerned (if necessary staff may consider removal of one or more child);
2. Inform the Home’s manager, who should notify/consult relevant social workers and consider reviewing the child's Placement Plan;
3. Record all events in the Daily Log, relevant child's Daily Record. If required an Incident Report should be completed.

If the incident is serious or persistent, the Home's manager should be notified and consideration given to whether the incident is a Notifiable Event, see Notification of Serious Events Procedure.

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

If children in the Home are engaging in sexual activity staff must take reasonable steps to minimise the risk of pregnancy or infection. This could include facilitating contact with relevant agencies providing contraceptive advice; such as the Brook Advisory Service or local Sexual Health Services.

Matters of concern must be discussed with the social worker and addressed in Placement Plans.

If a child is suspected or known to be pregnant the manager should talk to the child about who should be informed and what support the child may require to promote their own and the unborn baby's welfare.

The child's social worker and parent(s) should be informed and should collaborate with the child in drawing up a suitable plan for the promotion of the welfare of the parent to be and the unborn child. However, a child may request that parent(s) are not informed.

In all cases where there are any concerns that the pregnant child or the unborn child is suffering or likely to suffer Significant Harm, the manager must discuss it with the child's social worker with a view to making a Child Protection referral. In these circumstances it must be explained to the child why her request for confidentiality cannot be agreed. See Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.

In cases where there are no Child Protection concerns, the child should be encouraged to inform their social worker and parents. Where the child is sixteen, however, a request to keep the pregnancy confidential from their parents may be respected. Where a child under the age of sixteen requests confidentiality, it may be possible to agree this if the child is of an age and level of understanding to make such an informed decision.

See Consents and Delegated Authority Procedure.

Where a child wishes to terminate a pregnancy, the social worker must be notified/consulted with a view to providing advice, counselling and support by suitably qualified independent counsellors.

If the termination goes ahead, the manager must ensure that the child's privacy is protected and any physical or emotional needs are addressed sensitively.

The following should be read in conjunction with relevant Safeguarding Children Procedures.

Children who are placed in residential units may have previously experienced sexual exploitation (whereby sex / sexual activity is exchanged sex for rewards, gifts, drugs / alcohol, accommodation and / or money). Some children may continue to be exploited even when they are accommodated by the authority. 

The manager and all staff must be alert signs of sexual exploitation, and should do all they can to create an environment which encourages children to be open about their experiences and which offers them support.

Where there is any suspicion that a child is being sexually exploited, it should be addressed in the child's Placement Plan.

Where children living the Home are being sexually exploited, their social worker must be notified, and the Home's manager must make a notification to Ofsted and the police. See Notification of Serious Events Procedure.

See also: Safeguarding Children and Young People from Sexual Exploitation Procedure.

Also see: Blood Borne Viruses (BBVs) Procedure.

If it is known or suspected that a child has a sexually transmitted infection the Home’s manager and social worker must be informed and decide what measures to take.

The child should be referred, with the parents’ consent if possible, to the local Sexual Health Clinic, who will provide the child and staff with advice, counselling, testing and other support.

Only those immediate carers of the child who need to know will be informed of any suspicion or the outcome of any tests and the strategies or measures to be adopted.

Other children in the Home should only be informed if there is a direct risk to them; for example if the infected child deliberately attempts to infect them.

The only other individuals who will be told are the child's GP and Health Visitor.

Before disclosing to any other agency or individual, the following criteria must be satisfied

• The child (where appropriate) and the parents have given their written consent to the disclosure;
• The disclosure would be in the best interests of the child;
• Those receiving the information are aware of its confidential nature.

It is accepted that masturbation is part of normal sexual behaviour but children must be positively encouraged to undertake such activities in private and in a manner which is not harmful to themselves or other people.

The following should be read in conjunction with relevant Safeguarding Children Procedures for the area in which the Home is located.

The possibility of peer abuse should always be taken seriously. However, it is important not to label or stigmatise normal sexual exploration and experimentation between children.

Sexual behaviour is not necessarily 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 staff suspect children are engaged in abusive sexual relationships as perpetrators and/or victims, they must immediately inform the Home’s manager, who must consult the social worker and make a referral under the Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.

Consideration should be given by the Home’s manager as to whether a Notifiable Event has occurred, see Notification of Serious Events Procedure.

Legislation, Statutory Guidance and Government Non-Statutory Guidance

Promoting the Health and Well-being of Looked-after Children: Statutory Guidance for Local Authorities, Clinical Commissioning Groups and NHS England

Useful Websites

NHS website – Sexual Health

Family Lives – Teenagers and Sex