Swansea Local Authority Policy & Rationale

It is our intention to develop independence in each child, however there will be occasions when help is required. Our intimate care policy has been developed to safeguard children and staff. The principles and procedures apply to everyone involved in the intimate care of children.

There shall be a high awareness of child protection issues throughout the use of intimate care. Staff behaviour must be open to scrutiny and staff must work in partnership with parents/carers to provide continuity of care to children/young people wherever possible.

School staff are working within local authority insurance cover; provided that the Intimate Care Policy in conjunction with the pupil’s Health Care Plan/Intimate Care Plan are agreed and recorded by the parents, education and health (where required).

Children are generally more vulnerable than adults; and staff involved with any aspect of pastoral care need to be sensitive to their individual needs.

Intimate care is any care which involves washing, touching or carrying out an invasive procedure (such as cleaning up a pupil after they have soiled themselves) to intimate personal areas. In most cases such care will involve cleaning for hygiene purposes as part of a staff member’s duty of care.

Intimate care can be defined as any activity that is required to meet the personal needs of an individual child on a regular basis or during a one-off incident. Such activities can include:

• feeding
• oral care
• washing
• changing clothes
• toileting
• physiotherapy, in conjunction with the physiotherapy plan provided by the physiotherapist
• first aid and medical assistance, in conjunction with the relevant Health Care Plan
• supervision of a child involved in intimate self-care

Parents have a responsibility to advise the school of any known intimate care needs relating to their child.

Principles of Good Practice in Intimate Care

The following are the fundamental principles of intimate care upon which our policy guidelines are based:

All children have an educational entitlement irrespective of their difficulties with toileting.

• every child has the right to be safe
• every child has the right to personal privacy
• every child has the right to be valued as an individual
• every child has the right to be treated with dignity and respect
• all children have the right to be involved and consulted in their own intimate care to the best of their abilities
• all children have the right to express their views on their own intimate care and to have such views taken into account; and
• every child has the right to have levels of intimate care that are appropriate and consistent.

LPS will work in partnership with parents and carers in planning for children’s intimate care needs and effective toilet training, acknowledging that continence and independent toileting may not be achieved by some children.

School Responsibilities

All staff working with children will be subject to the usual safer recruitment procedures. This includes students on work placement and volunteers. Vetting includes DBS checks at an enhanced level and two written references.

Only those members of staff who are familiar with the intimate care policy and other pastoral care policies of the school are to be involved in the intimate care of children.

Where anticipated; intimate care arrangements are agreed between the school and parents and if appropriate, by the child. Intimate care agreements are signed by the parent and stored in the child’s file. Only in an emergency would staff undertake any aspect of intimate care that has not been agreed by parents and school. Parents would then be contacted immediately.

Intimate care arrangements should be reviewed at least six monthly. The views of all relevant parties should be sought and considered to inform future arrangements.

If a staff member has concerns about a colleague’s intimate care practice he or she must report this to the designated teacher for child protection.

Guidelines for Good Practice

The school will identify a suitable changing area for pupils, to enable the privacy of pupils to be maintained and to provide sufficient staff to safeguard the pupil.  Within our school, intimate care is delivered by xxx members of staff.

Within our school, children will be changed in the Early Years toilet labelled, 'Designated Changing Area'.  Children where possible, should be encouraged to be changed whilst standing up, however if they are required to lay down, a mat on the floor in a toileting area is acceptable as a short term measure.

In planning stage: Development of an adequate changing space for pupil and staff member(s) to move and support safely with a changing bed, toilet and sink.

All children have the right to be safe and to be treated with dignity and respect. These guidelines are designed to safeguard children and staff. They apply to every member of staff involved with the intimate care of children.

Young children and children with additional learning needs can be especially vulnerable. Staff involved with their intimate care need to be particularly sensitive to their individual needs.

Staff also need to be aware that some adults may use intimate care, as an opportunity to abuse children. It is important to bear in mind that some forms of assistance can be open to misinterpretation. Adhering to the following guidelines of good practice should safeguard children and staff.

1. Involve the child in the intimate care

The child will be supported to achieve the highest level of autonomy that is possible given their age and abilities. Staff will encourage each child to do as much for him/herself as he/she can. This may mean, for example, giving the child the responsibility for washing themselves. Individual intimate care plans will be drawn up for children as appropriate to suit the circumstances.

Where a situation renders a child fully dependent; talk about what is going to be done and provide choices where possible. Check your practice by asking the child or parent about any preferences while carrying out the intimate care.

2. Treat every child with dignity and respect and ensure privacy appropriate to the child’s age and situation.

As per this policy, intimate care can be delivered by one member of staff if specified within their individual intimate care/health care plan. They should inform a colleague of when and where they are going to carry out this support

As per this policy, intimate care should always be delivered by two staff members.

3. Make sure practice in intimate care is consistent.

As a child may have multiple assistants, a consistent approach to care is essential. Effective communication between all parties ensures that practice is consistent. Issues regarding complex areas would need to be explicit within the pupil’s intimate care/ healthcare plan, which must be referred to.

4. Be aware of your own limitations

Only carry out activities you understand and feel competent with. If in doubt, ASK. Some procedures must only be carried out by members of staff who have been formally trained and assessed.

5. Promote positive self-esteem and body image.

Confident, self-assured children who feel their body belongs to them are less vulnerable to sexual abuse. The approach you take to intimate care can convey lots of messages to a child about their body worth. Your attitude to a child’s intimate care is important. Keeping in mind the child’s age, routine care can be both efficient and relaxed.

6. If you have any concerns you must report them.

If you observe any unusual markings, discolouration or swelling report it immediately to the designated teacher for child protection and record in the relevant observation log.

If a child is accidentally hurt during the intimate care or misunderstands or misinterprets something, reassure the child, ensure their safety and report the incident immediately to the designated teacher for child protection. Report and record any unusual emotional or behavioural response from the child. A written record of concerns must be made available to parents and kept in the child’s personal file.

If a child becomes distressed or unhappy about being cared for by a particular member of staff, the matter will be looked into and outcomes recorded. Parents/carers will be contacted at the earliest opportunity as part of this process in order to reach a resolution. Staffing schedules will be altered until the issue(s) are resolved so that the child’s needs are paramount. Further advice will be taken from outside agencies if necessary.

If a child or parent/carer makes an allegation against a member of staff, all necessary child protection procedures must be followed and the designated teacher must be informed immediately; as will the LA’s Child & Vulnerable Adult Safeguarding Officer. (See Child Protection Policy).

Working With Children of the Opposite Sex

There is positive value in both male and female staff being involved with children.

The intimate care of boys and girls can be carried out by a member of staff of the opposite sex with the following provisions:

• When intimate care is being carried out, all children have the right to dignity and privacy, i.e. they should be appropriately covered, the door closed or screens/curtains put in place.

• If the child appears distressed or uncomfortable when personal tasks are being carried out, the care should stop immediately. Try to ascertain why the child is distressed and provide reassurance.

• Report any concerns to the designated teacher for child protection and make a written record; and

• Parents must be informed about any concerns.

Communication with Children

It is the responsibility of all staff caring for a child to ensure that they are aware of the child’s method and level of communication. Depending on their maturity and levels of stress children may communicate using different methods - words, signs, symbols, body movements, eye pointing, etc. To ensure effective communication:

• make eye contact at the child’s level;
• use simple language and repeat if necessary;
• wait for response;
• continue to explain to the child what is happening even if there is no response; and
• treat the child as an individual with dignity and respect

Equipment Provision

Parents should provide clean change of clothing, nappies/ pull ups/ pads, wipes, etc. and parents must be made aware of this responsibility. Schools are responsible for providing gloves, plastic aprons, a bin and liners to dispose of waste. The school will aim to stock additional resources in case of emergency.

Health and Safety

The following procedures are in place for dealing with spillages of bodily fluids for staff to follow when a child wets or soils himself, or is sick while on the premises. This includes:

• Staff to wear fresh aprons and disposable gloves while supporting a pupil.
• Soiled nappies securely wrapped and disposed of appropriately.
• Changing area to be left clean. Caretaking/cleaning staff to be informed.
• Hot water and soap available to wash hands as soon as toileting/supporting with intimate care is finished.
• Paper towels to be available to dry hands

Staff should always wear appropriate PPE (e.g. a disposable apron and disposable gloves) when supporting any child with intimate care.  Any nappies, pull ups or pads should be placed along with used PPE within a biohazard bin, which has a lid. 

Recording the use of Intimate Care:

Where it is agreed that intimate care might be required for a child an agreement between parents and the school will be completed. This agreement will detail what care is to be provided and by whom. (appendix 1).

Alongside this parents and the school will work together to complete an individual intimate care plan for the child (appendix 2).

Where possible, the child will contribute towards the intimate care plan and be involved with the write up of the learner/staff agreement (appendix 3).

Where there are particular issues which might indicate a need for the intimate care to be delivered by two members of staff; a risk assessment must be completed and retained on the child’s record eg: manual handling, safeguarding issues.

For each use of intimate care staff will record using the personal care intervention log (appendix 4).

School staff may be asked to undertake a physiotherapy regime (such as assisting children with exercises). School staff must only do this once the technique has been demonstrated by a physiotherapist and the physiotherapist has signed the schools training record (appendix 5) to agree that the staff member trained is competent to carry out this task within school. The physiotherapist will observe the member of staff undertaking the exercises before signing the staff member as competent. These will be recorded in the pupil’s physiotherapy plan and reviewed regularly.

Any concerns about the regime or any failure in equipment will be reported to the physiotherapist.  School staff will not devise or carry out their own exercises or physiotherapy programmes

Policy Review 

This policy document will be evaluated and reviewed as and when appropriate as part of the school’s self-evaluation process.

Date Approved by the Governing Body: April 2022

Date of Next Review:  When required