Primary Care

UK ltd / POLICY
No: 392 / Version 3i / Page 1 / Last Up-dated: 24th August 2010
Authorised: / Date: ______ / © GMP Systems, Year 2002
Same Gender Support for Personal Care Policy & Purpose

Purpose

This policy applies in all social care settings where service users may be supported with their personal care. This includes day services and also to care given in service users own homes and in community settings.

Policy Statement

All service users should be treated with respect and dignity and be offered services that are appropriate to both their age and to their social and cultural norms. They should have choice and be able to exercise control over the care they receive. Therefore where a client has expressed a strong preference that they receive personal care from a worker of either the same sex as themselves or the opposite sex, then as far as possible this should be honored.

Scope of Policy

This policy applies in all social care settings where service users may be supported with their personal care. This includes day services and also to care given in service users own homes and in community settings. Cross Gender care is care given by males to females or by females to males. Same gender care is care given by males to males or by females to females. Effective monitoring of professional standards will apply equally to male and female staff.

Personal Care is defined as intimate or personal tasks undertaken with a service user, which relate to their physical, emotional, and social well being. Examples include bathing, bed changing, dressing, hairdressing, hair washing, lifting, nail clipping, toiletting, undressing, and first aid. Staff will not undertake invasive tasks such as changing internal sanitary towels.

The policy also applies to supporting service users to take part in recreational activities such as swimming, dance, and other sports, transporting service users and individual work such as one to one counseling, life story work and interviews. These are examples and not an exhaustive list

Statutory Duties and Powers

Sex Discrimination Act 1975.

Human Rights Act 1998

Cross Reference to other Primary Care UK Policies

Equal Opportunities Statement. Child Protection Procedures. Safeguarding of Vulnerable Adults Policy.

Practice Guidance

Requests for same or cross gender care

The issue of cross gender care should be talked through with potential service users during the assessment process. It should be explained that there may be male and female carers supporting them and at this stage they should be given the opportunity to express a preference. Where a strong preference is expressed for either ‘same-gender’ or ‘cross-gender’ personal care discussion should take place between the service user, their advocate/carer/ relative/ as appropriate, and the care manager and Primary Care. As far as it is possible, the service user's request should be integrated into the support plan. However it should be made clear that although every effort will be made to respect their preferences there may be occasions where this is not possible. The discussions and decisions must be recorded.

Informed Choice

The competency of individual service-users to make informed decisions and to convey such views is a matter of legal and professional interpretation, which should be discussed with service-users, their advocates, carers/relatives (if appropriate) and care managers as an integral part of the Support Planning process.

Where a service user is unable to make an informed choice their advocate or representative should speak on their behalf and their preferences be recorded and incorporated into the care plan.

Primary Care

UK ltd / POLICY
No: 392 / Version 3i / Page 2 / Last Up-dated: 24th August 2010
Authorised: / Date: ______ / © GMP Systems, Year 2002
Same Gender Support for Personal Care Policy & Purpose

Staff recruitment and selection

It may be appropriate to recruit specifically either male or female staff in order get a balance within a staff team which enables the service to offer a meaningful choice to service users regarding the provision of personal care.

Staff training

Providing service-users with their preferred gender personal care should not exclude staff who are being trained or are on induction programs when such training cannot practically be offered elsewhere and is necessary for the maintenance of the support plan or service function. However the service user should always be consulted and should not be coerced into accepting a situation with which they are uncomfortable.

Staff shortages

There will be occasions when preferred gender care cannot be offered due to unexpected staff absences or other unplanned changes in circumstances. The service-user should be informed of this immediately and involved in deciding what action should be taken to limit the negative effects of a change in the service offered. These decisions and subsequent actions should be recorded.

If the inability to provide preferred gender-care is likely to be a long-term feature, further discussion should take place between the service user, their advocate/carer/ relative/ as appropriate, the care manager and service provider in order to agree an acceptable solution.

Risk Assessment

It is important to acknowledge the element of risk inherent in undertaking intimate personal care tasks for vulnerable service users.

·  There is a potential risk to the service user who may not be able to protect themselves from abusive or exploitative situations.

·  There is a potential risk to care staff from unfounded or malicious allegations.

·  There is the risk that public and professional confidence in the Primary Care services will be damaged.

·  To address and minimise these risks and to ensure effective monitoring of professional standards each support plan should list personal care tasks to be carried out and an assessment of each of them with reference to risk to individual service users and staff members and securing public and professional confidence.

·  Plans should then be agreed between the service user and provider which address the service users needs and preferences and minimise the risk to all involved.

These risk assessments should address the following

·  the type of care needed

·  the environment where the care is given

·  the individual receiving care, their preferences, their social and cultural background and their history.

If staff ever feel uncomfortable in providing same or cross gender care to any service user they should discuss this with their manager.

Primary Care

UK ltd / POLICY
No: 392 / Version 3i / Page 3 / Last Up-dated: 24th August 2010
Authorised: / Date: ______ / © GMP Systems, Year 2002
Same Gender Support for Personal Care Policy & Purpose

Same / Cross gender care needs/risk assessment

Example format

Below are generic examples of a same/cross gender care risk assessment. Similar assessments should be undertaken for each personal care task. For example, bathing, toileting, continence care, one to one work, etc:

e.g.: 1 managing menstruation.

Day services

service user would prefer this always to be done by a female staff member.

·  Make every effort to ensure there is a female staff member on each shift. If necessary call on female unit manager or assistant unit manager.

·  When using agency support request a female carer to ensure the service users needs can be met.

·  If the service user is able to manage her care with instruction and help she should be supported to do this in privacy.

·  If there is no female staff member on a shift the service user should be made as comfortable as possible eg washed and a fresh super absorbent sanitary pad put in place immediately before the end of the previous shift. This should be an exception, not the norm.

·  Very rarely it may become essential to change a pad and or clothing or bedding during a shift when there are no female staff. Other staff on duty (on call or office) should be informed of what action is taken and where you will be.

·  The service user should be told exactly what will be done throughout the process and encouraged to do as much as she is able herself. She should be kept covered as much as possible and every effort made to respect her privacy and dignity.

·  If this occurs it should be recorded and the Coordinator informed and given an explanation of the circumstances and what action was taken to protect their daughters privacy and dignity.

E.g.: 2 supporting a male service user to go swimming

Day services

Service user would prefer a male staff member to assist.

Action Plan

·  If the service user needs to be dressed and undressed it may be appropriate to change into his trunks under his clothes either at home or at the day centre where the space facilities may be better and more private.

·  If changing at the pool the service user should be given the choice of using a communal or larger family changing room.

·  The service user should be encouraged to manage dressing and undressing himself and to specify what assistance he needs if able.

·  Wait outside the changing room until your assistance is required.

·  Let the service user dry himself and particularly his genitals himself if able.

In some more complex situations these will need to be individual rather than generic to reflect a specific service users personal needs and preferences.

Name of service user

Service users preferences regarding personal care and parents/guardians or carer, advocate's preference where appropriate.

Those involved in discussion.

Date.

List of personal care tasks undertaken.

Location.

Action taken to accommodate service users preferences and minimise risk.