This Hygiene and Close Personal Contact Policy has been developed to safeguard children and staff. It applies to everyone involved in the intimate care of children. It aims to provide guidance and support for the safeguarding of staff and pupils when fulfilling duties which require close contact.

Purpose

The purpose of the policy at Co-op Academy Brierley is to:

uphold pupils’ rights to privacy and dignity
identify situations which have elements of close personal/intimate contact
recognise the responsibilities of adults involved
safeguard pupils and adults from any misinterpretation of action
ensure consistency of action whilst being sensitive to individual need
encourage independence and choice for pupils
maximise learning opportunities

Safeguarding and Professionalism

This policy should be read in conjunction with these policies:

Child Protection and Safeguarding Policy
Staff code of conduct and guidance on safer working practice
Special Educational Needs & Disability policy
Policy for supporting students with medical conditions
RSE Policy

There is an expectation that staff employed by the Co-op Academy Brierley will be prepared to provide intimate care to students. Co-op Academy Brierley is committed to ensuring that all staff responsible for the intimate care of students will undertake their duties in a professional manner at all times. It is acknowledged that these adults are in a position of great trust.

We recognise that there is a need to treat all students, whatever their age, gender, disability, religion, ethnicity or sexual orientation with respect and dignity when intimate care is given. The child’s welfare is of paramount importance and their experience of intimate and personal care should be a positive one. It is essential that every student is treated as an individual and that care is given gently and sensitively: no student should ever be attended to in a way that causes distress, or pain.

Staff will work in close partnership with parent/carers and other professionals to share information and provide continuity of care.

Staff deliver a full personal safety curriculum, as part of Personal, Social and Health Education (PSHE) curriculum to all children and young people as appropriate to their developmental level and degree of understanding. This work is shared with parents who are encouraged to reinforce the personal safety messages within the home.

All students will be supported to achieve the highest level of autonomy that is possible given their age and abilities. Staff will encourage each individual student to do as much for his/herself as possible.

Staff who provide intimate care receive appropriate induction to ensure the skills necessary to provide appropriate care are understood (e.g. health and hygiene, moving and handling and communication strategies) according to the needs of the student. Staff should be fully aware of best practice regarding infection control, including the requirement to wear disposable gloves and aprons where appropriate.

Relevant equipment is in place following a risk assessment from the moving and handling key trainers at Co-op Academy Brierley and/or from assessments from physiotherapist/occupational therapist as required.

Staff will be supported to adapt their practice in relation to the needs of individual students taking into account developmental changes such as the onset of puberty and menstruation.

There must be careful communication with each student who needs help with intimate care in line with their preferred means of communication (verbal, symbolic, etc.) to discuss what support they require as part of the personal care process. Where the student is of an appropriate age and level of understanding permission should be sought before starting an intimate procedure.

Staff who provide intimate care should speak to the student personally by name, explain what they are doing and communicate with all students, using the preferred mode of communication for the student.

Every child's right to privacy and modesty will be respected. Careful consideration will be given to each student’s situation to determine who and how many carers might need to be present when they need help with intimate care. Best practice suggests that reducing the numbers of staff involved goes some way to preserving the child’s privacy and dignity. Wherever possible, the student’s wishes and feelings should be sought and taken into account.

Whilst safer working practice is important, such as in relation to staff caring for a student of the same gender, there is research which suggests there may be missed opportunities for children and young people due to over anxiety about risk factors; ideally, every student should have a choice regarding the member of staff. There might also be occasions when the member of staff has good reason not to work alone with a student. It is important that the process is transparent so that all issues stated above can be respected; this can best be achieved through a meeting with all parties, as described above, to agree what actions will be taken, where and by whom.

All staff should be aware of the Trust confidentiality policy, which can be found on the Trust’s website. Sensitive information will be shared only with those who need to know.

An individual member of staff should inform another appropriate adult when they are going alone to assist a student with intimate care.

Supply staff may assist with intimate care as the second person once they have completed the Manual Handling induction training and are aware of the safeguarding reporting procedure.

Safeguarding Procedures

Safeguarding Procedures are supported by rigorous selection and recruitment procedures including DBS checks. No staff member will be permitted to work alone with a child until they have undergone a Disclosure and Barring Service (DBS) check.

If a staff member notices any unexplained marks during close contact or have any safeguarding concerns these must be reported to the Designated Safeguarding Lead or one of the Designated Safeguarding Deputies, who can be identified via the poster displayed around school. These concerns should be reported without delay. This must also be reported on CPOMS by the person noticing the marks on the same day. A body chart must be completed.

Staff that don't have access to CPOMS (supply staff) must complete a pupil concern form provided in the classroom and hand the completed form the a DSL.

No member of staff will use a mobile phone, camera or similar device whilst providing intimate care or when changing students for swimming. School iPads only may be used to record Evidence for Learning whilst students are in the pool.

Close contact at Co-op Academy Brierley

Physical contact with children and young people is essential to support their emotional development. Co-op Academy Brierley recognises this and in order to clarify and support the work of all staff in school, this policy will outline where forms of physical contact are likely to occur. Any form of physical contact in this school is respectful and dignified. Physical contact to support pupils’ behaviour is addressed separately in the Care and Control policy. Staff also understand that pupils for whom physical contact is perceived to be invasive, for example some pupils with an Autistic Spectrum Condition (ASC).

Co-op Academy Brierley encourages social interaction between pupils which may involve physical contact. Physical contact is a part of everyday life at our school and individual circumstances may need to be assessed “on the spot”. All staff should be mindful of how a situation is perceived by other staff, students and onlookers. If a staff member has concerns about something that they have observed, they should raise this immediately with the safeguarding lead/deputy or headteacher if the concern is about a member of staff, permanent/supply/volunteer.

The nature of our pupils’ needs necessitates a wide spectrum of physical contact in many different circumstances. Intimate care can be defined as any care which involves washing, touching or carrying out a procedure to intimate personal areas which most people usually carry out themselves, but some students are unable to do because of their intellectual impairment, physical disability, sensory impairments and/or medical conditions. Examples include care associated with continence and menstrual management as well as more ordinary tasks such as help with washing, toileting or dressing. It also includes supervision of students involved in intimate self-care.

The following are some of the more frequent times when close contact is required at Co-op Academy Brierley:

Moving and handling and positioning in specialist equipment including fitting slings
Rebound Sessions
Support in the swimming pool
Intimate care procedures – supporting pupils’ hygiene needs
Physical prompts and guidance
Invasive medical procedures
Medical interventions including administering oral medication
Physiotherapy exercise
Intensive interaction and Sounds of Intent as an early form of communication development
Putting splints onto hands and feet, especially where massage is essential to relax the limb
Foot spas and massage
Tac Pac
During outside visits to ensure pupil safety
Providing Full Physical Guidance during learning activities
Putting coats on and off and other times of dressing and undressing (e.g. swimming sessions)
To provide comfort when pupils are distressed or unwell
When providing first aid
When pupils initiate interaction by physically requesting close interaction
During praise and congratulations
To support learning for pupils with visual or hearing impairment (or both)
When making adjustments to wheelchair straps and clothing
During gastrostomy feeding and winding
During music and movement sessions

This list is not exhaustive but provides an indication of the range of activities where physical contact is likely to occur.

Affection from Pupils

Some students may attempt to kiss or ‘nuzzle’ staff in acknowledgement of security and happiness and this may be an important step in their development. It may also be a way for students to understand their ‘place in the world’. To not return affection at these times may have a detrimental effect upon the individual student’s well being and may cause confusion. Staff will be mindful of redirecting the students’ affection by changing the contact (for example, into a ‘side hug’) without making the child feel rejected.

Feeding/Eating

Only adults who have had dysphagia training should support pupils who require full support at feeding times.
People providing full feeding support will focus and give full attention to the child/children they are feeding.
Any concerns (such as swallowing coughing during eating) must be reported to the care team who will then report to Speech and Language Therapist (SALT) as a matter of urgency.
Account must be taken of pupils’ likes and dislikes and normal routine.
Hygiene procedures to be adhered to
Pupils' dignity will be taken into full consideration; pupils must not leave the feeding area with food on their faces. If clothes are especially dirty, they should be changed.

Physiotherapy

Postural management that requires specific guidance must be demonstrated by the physiotherapist personally, and written guidance given and updated at least annually. The physiotherapist should observe the member of staff positioning students.
Under no circumstances should school staff devise or carry out postural management without physiotherapy advice.
If a student has a physiotherapist plan this must be followed.
Staff should only use equipment provided by the physiotherapist once they have been shown how to use it.
Any concerns about postural management or any failure of equipment should be reported to the physiotherapist and a member of the senior leadership team pr the care team.

Medical Procedures

Students might require assistance with invasive or non-invasive medical procedures such as the administration of rectal medication, managing catheters or colostomy bags. These procedures will be discussed with parents/carers, documented and will only be carried out by staff who have been trained to do so and have been signed off by the school nurses as being competent..

It is particularly important that these staff should follow appropriate infection control guidelines and ensure that any medical items are disposed of correctly.(see disposal of medication procedure).

Any member of staff who administers first aid should be appropriately trained in accordance with LA guidance. If an examination of a child is required in an emergency aid situation it is advisable to have another adult present, with due regard to the child’s privacy and dignity (see first aid procedure).

Swimming

Swimming is an enjoyable and regular activity for students at Co-op Academy Brierley in order to develop physical strength, movement, relaxation and fun.

Students who require assistance with changing need to have access to facilities that provide privacy and modesty e.g. separate toileting and changing for boys and girls or at least adequate screening.

Students should be encouraged to dress/undress themselves independently whenever possible.

Toileting/changing

The following must be taken into consideration:

Dignity is paramount. This starts in the classroom. For example, rather than commenting on an odour, staff will discuss pupils’ toileting needs in a considerate, discrete manner, for example such as, ‘I am going to go and make xxxxx comfortable’

The need for privacy, whilst being aware of the need to protect staff from allegations and pupils from possible inappropriate touching or abuse.

Due to specific circumstances, some children have risk assessments in place to safeguard themselves and staff.

Encourage as much independence as possible using the progression of skills:

opportunity
dependence
co-operation
participation
supervised independent action
independence

Regulations for Hygiene Rooms

All staff adhere to hand washing procedures and the use of protective clothing (PPE).
All Hygiene rooms to be fully stocked with aprons, gloves, wipes, body cleansing foam, for staff and pupil safety.(care team will replenish when required).
All Hygiene rooms to be kept in a clean and safe manner. This is the responsibility of all staff.
All Hygiene rooms have surface spray and whiteroll. (care team will replenish when required)
All staff to be responsible for wiping the bed and surfaces, including the toilet bowl, with the surface spray and white roll to prevent/reduce the risk of cross contamination/infection.
Wet, soiled pads, sanitary pads or any white roll that has been used for personal care should be placed in a clear hygiene personal waste bag provided and disposed of in the clinical waste bins which has a yellow bin liner.
Paper towels, unsoiled gloves and aprons can be disposed of in the blacklined waste bins.
All resources needed, should be collected before attending to the pupil and returned to the cupboard and locked after use.
Resources e.g pads should be stored in closed cupboards or boxes with lids on to prevent infection and not stored on changing beds.
Resources in boxes and cupboards should be named/labelled.
If staff require more resources e.g.aprons, gloves, wipes, body cleansing foam , they can collect from the stock cupboard on the ground floor and sign out each item in the sign out stock sheet.

Procedures to ensure pupils receive the highest level of care

Give sufficient time for the pupil to achieve, to be aware of expectations and be familiar with the type and frequency of prompts
Ensure females (and males who catheterise) are cleaned front to back
Creams, etc only to be used with written permission from parents
Male and female members of staff are trained and within policy, are able to change any pupils. The school will consider the appropriateness of male/female assistance with boy/girl pupils, taking into account the wishes of the pupil, parents and staff
Changing rooms should only be occupied by the same gender at the same time
Generally any staff, once trained can assist and attend to any child
When referencing genitalia, use the accurate terms, for example ‘penis’

In the event of an accident due to incontinence or medical emergency

If there is urine/faeces/vomit/blood on the floor, staff are to contact Nightingale school reception and request an urgent clean up in the main building. Other students should be prevented from tracking through the substance.

If there is urine/faeces on the bed, sink, toilet, or other part of a hygiene suite staff are to use the surface spray and white roll to clean this area, staff must leave the area in a safe and clean manner ready for the next pupil to use.

Staff must wear protective clothing gloves, aprons for the cleaning of faeces and urine at all times.

If staff come into contact with blood, they should be mindful of the risks. Gloves and aprons must be worn and the disposable clothes should be used to clean up. All items used must be put into a secured bag and put into the yellow lined bin.

If a pupil requires showering

If a student requires showering in school as part of a hygiene programme or at the request of a social worker/ parent a permission form must be completed for this. The original copy must be given to the care team to retain in the students records. students must not be showered without parental permission.

If a pupil has an accident staff are to wear gloves, aprons and clean the pupil with skin cleansing foam/wet wipes. If a student requires a shower in an emergency situation e.g soiled themselves staff should notify the care team and proceed to shower the student. parents must be informed.

Staff to ensure dignity, privacy and respect are maintained at all times, in accordance with this policy.

Staff to encourage the pupil to assist as much as possible where appropriate.

Staff must make sure the shower is left clean and tidy and there is a wet floor sign at the door to prevent injury to others.

Washing Soiled Clothing

If there are soiled clothing items, staff are to sluice them first, then place them in a plastic bag to be sent home with the student.

Training and Presentation of Staff

Staff should not be involved with Medical Support or Intimate Care procedures, feeding or toileting, until relevant training has been undertaken, e.g. Moving and Handling medical training. If staff have no experience of providing assistance with personal hygiene and intimate care, they will be supported and coached with this by class teams.Class teacher to arrange for new staff to be supported by an experienced member of staff until the new staff member feels confident.

Basic hygiene and hand washing

In order to ensure the highest standards of care, hygiene and safeguarding for children and staff, we adhere to the NHS principle of ‘Bare Below the Elbow’.

Staff must not wear protruding, sharp or dangerous jewellery and other items, when undertaking intimate care, feeding and drinking or any close physical activity.

Hands should be clean and washed. Staff trained in medical procedures, including enteral feeds, must keep their fingernails short, clean and smooth. False or long nails and nail varnish must not be worn. Staff should wear clean, comfortable clothes and take care that when they bend or stretch all appropriate body areas remain covered up e.g. cleavages and bottoms.

The role of students/volunteer helpers

Students/volunteer helpers/parents (except with their own child)

Should not assist with toileting pupils; (unless part of an agreed, supervised, training programme)
May assist in helping pupils change for PE if supervised by a member of school staff;
Must not assist with any feeding requiring medical training to give food or respond to an emergency situation;
May assist at the dining table in general situations;
Must be supervised and not put in a situation where they are alone with pupils (except in extreme/emergency circumstances or with their own child).

LIVE - Hygiene and Close Personal Contact Policy (incorporating Intimate Care)