3.9 Privacy, Intimate and Personal Care

Children's Bedrooms
Privacy (General Guidance)
Photographs and Videos
Physical Contact
Intimate Care/Bathing
Invasive Procedures
Menstruation
Enuresis and Encopresis

1. Children's Bedrooms

1.1 Bedroom Size, Furniture and Layout

Each child should have an individual bedroom of adequate size. Bedrooms should not open onto communal space e.g. living rooms and should be large enough for the young person to store any extra quantity of possessions they should accumulate over time. There should be a suitable bed and bedding, seating and storage for clothes, safe storage for personal possessions, a window with curtains (or other window covering), appropriate ventilation, lighting sufficient to read, carpet or other appropriate floor covering, and heating. Their bedroom should be pleasantly furnished, equipped and decorated in a manner appropriate to their individual needs, interests and choices.

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 beds should be well sprung and in good condition with adequate clean bedding. The furniture, bedding and furnishings (including curtains and floor coverings) emphasise comfort and informality and avoid an institutional appearance.

Children's room 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.

Where a child's bedroom window is large enough for a child to climb out of, a risk assessment should be carried out as to the likelihood of the child putting themselves at risk by climbing out of the window. If a risk is identified, stays of an unobtrusive kind should be fitted to the window to dissuade the child from climbing out. The bedroom layout should take into account the possibility of the child bouncing on the bed and falling out of the window.

1.2 Staff Presence in Bedrooms

Children's privacy should be respected.

Unless there are exceptional circumstances, Staff should knock the door before entering children's bedrooms; and then only enter with their permission.

The exceptional circumstances where Staff may have to enter a child's bedroom without the child's permission are as follow:

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
To take necessary action, including forcing entry, to protect the child or others from injury or to prevent likely damage to property. The taking of such action is a form of Physical Intervention

1.3 Visiting and Sharing Rooms

Children may not share bedrooms or receive visits into their rooms unless it is part of a clear plan e.g. for siblings or where the Manager and Social Worker have conducted a risk assessment.

Any arrangements must be outlined in relevant Placement Plans.

1.4 Electronic Devices

Where electronic devices are used for the monitoring of children's bedrooms, the Statement of Purpose for the Home and relevant Placement Plan will state the arrangements for the use of such devices. Care will be taken to explain to children why such devices are necessary and all reasonable measures will be taken to protect children's privacy.

2. Privacy (General Guidance)

Children and other service users rights to privacy can easily be eroded, therefore it is critical that Staff do all they can to protect these rights, for example, by:

Being familiar with children's Placement Plans, therefore minimising unnecessary intrusion or disruption if it could have been avoided
Challenging other Staff practice if any erosion of a child's or user's privacy takes place
Being familiar with policies and procedures in this manual (e.g. relating to Confidentiality and Searching)
Providing children/users with information concerning their rights to privacy and to making complaints if they are dissatisfied
Managers are responsible for ensuring Staff are properly informed of arrangements for the delivery of services to children/users, and for updating Staff when these arrangements change
Being fully aware of a child's personal care arrangements and routines
Ensuring that confidential discussions are kept confidential - in keeping with relevant procedures in this manual
Using practices that do not unnecessarily draw attention to children/users and which respect their dignity and privacy
Managers are responsible for ensuring that accommodation and facilities are of a high standard and that there is an area for children and users to receive family, visitors in private
That children have access to make and receive telephone calls in private (see Telephone and Correspondence Procedure)
That children/users need time to be alone, time to "chill out", time to think away from unnecessary Staff intrusion and or interruption - assuming there is no risk

3. Photographs and Videos

The use of cameras, including camera facilities on mobile 'phones, or other equipment for creating images of children such as video recorders may only be used with the authority of the Manager and Social Worker.

The Manager should be satisfied that images taken respect the privacy of children.

Staff may not retain photographic images of children without the authorisation of the Manager.

4. Physical Contact

Staff must provide a level of care, including physical contact, which is designed to demonstrate warmth, friendliness and positive regard for children.

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 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.

5. Intimate Care/Bathing

Detailed guidance is provided in Relationships and Intimate Care (Guidance) - to follow

If possible, children should be supported and encouraged to undertake bathing, showers and other intimate care of themselves without relying on Staff. If children are too young or are unable to bathe, use the toilet or undertake other hygiene routines, arrangements should be made for Staff to assist or support them.

Such arrangements must be set out in the Placement Plan, and must emphasise that children's dignity and their right to be consulted and involved will be protected and promoted; and, where necessary, Staff will be provided with specialist training and support.

Unless otherwise agreed, children will be given intimate care by adults of the same gender.

6. Invasive Procedures

Invasive procedures include the following:

Catheter care
Oxygen therapy
Providing assistance with rectal medication such as diazepam
The inserting of suppositories or pessaries
Injections
Feeding through naso-gastric or gastrostomy tubes
Supporting physiotherapy programmes and the management of prostheses
Tube feeding

Invasive procedures may only be applied by competent Staff, either trained or appropriately supported and on the following conditions:

With the written authority of a prescribing doctor or responsible nurse; who must provide the information and support outlined below
With the consent of a Parent or person with Parental Responsibility

The consent of the child should also be obtained. To undertake such procedures without the child's consent may be an assault but, in certain circumstances, the child's consent may be over ridden; so long as the written authority of a medical practitioner and the consent of the Parent/person with Parental Responsibility have been obtained.

The doctor or nurse giving authorisation should stipulate, preferably in writing, the following:

The arrangements/procedures to be followed
Whether the child requires any assistance, and who should give it
Whether any person providing assistance has agreed and requires training or guidance
How the procedures will be recorded

Because of the contentious nature of the treatment, it is imperative that full records are kept of who undertook the procedure, when it occurred, any concerns the child had and outcome.

7. Menstruation

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.

8. 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.

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:

Talk to the child in private, openly but sympathetically
Do not treat it as the fault of the child, or apply any form of Sanction
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, in the Health log
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 wetted

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