Document type: / Policy
Version 5
What does this policy replace? / Update of previous policy
Staff group to whom it applies: / All staff within the Trust
Distribution: / The whole of the Trust
How to access: / Intranet
Issue date: / July 2016
Next review: / July 2018
Approved by: / EMT
Developed by: / Carol Morgan Specialist Advisor Safeguarding Adults
Director leads: / Director of Nursing, Governance and Safety
Contact for advice: / Specialist Adviser for Safeguarding Adults
Contents Page
Topic / Page NumberIntroduction / 3
Purpose and scope / 4
Definitions / 5
Duties / 6
Principles / 8
Equality Impact Assessment / 8, Appendix page 29
Dissemination and implementation arrangements (including training) / 8
Process for compliance and effectiveness / 9
Review and revision arrangements (including archiving) / 9
References / 9
Associated documents / 11
Appendices A / · Introduction
· Equality Act
· Human Rights Act
· Marriage
· Autonomy
· Carers and Best Interest
· Mental Capacity Act (2005) and Best Interests
· Domestic Violence
· Controlling
· Coercion
· Forced Marriage
· Arranged Marriage
· Human Trafficking
· Female Genital Mutilation
· Care programme Approach
· Allowing / prohibiting relationships
· Legal
· Processionals and Service users
· Child Sexual Exploitation
· Children and persons in position of trust
· Sexual offences Act (2003)
· Age of Consent
· Confidentiality
· Historical sexual abuse
· HIV Reckless transmission
Appendix B / Page 28
Appendix C / Page 34
Appendix D / Page 36
Sexual Relationships Policy
1. Introduction
The rationale for the review and implementation of the sexual relationships policy is to support SWYPFT staff where there are concerns regarding sexual relationships that may impact upon the Trust and its employees reputation, professionalism and care. The policy covers a broad spectrum of possible sexual relationships including between two service users, persons in positions of Trust and service users, including: consideration of age, capacity, and other related concerns and provides further guidance in the appendix to support staff.
Most people, due to the media coverage, will be aware of Jimmy Saville and his extensive sexual abuse of vulnerable individuals in our society, children and adults. The lessons that have been learnt from the inquiries regarding the sexual abuse and that most of the incidents are only being acknowledged in retrospect, historically and the recommendations are referred to in the guidance.
The independent external inquiry in to Leeds NHS teaching hospital (2014) found that 64 people came forward to share accounts of abuse or inappropriate encounters at the hands of Saville. Sixty of these accounts concerned abuse.
Of the victims from the Leeds Teaching Hospitals NHS Trust or its predecessor bodies, ages ranged from five years to 75 years. 19 children and 14 adults were patients at the time of their abuse. In addition, 19 members of staff reported abusive or inappropriate encounters with Saville.
As part of the Leeds inquiry the recommendations included a commitment to ‘lead and safeguard patients on a 24 hours, seven days a week basis’. Similar findings and recommendations were echoed in the Broadmoor Inquiry (2014) which identified that procedures to safeguard vulnerable patients were poorly developed during Saville’s active involvement with Broadmoor, including the reporting and proper investigation of complaints. It is believed that safeguarding has been greatly improved and that procedures are appropriate and effective, Both inquiries highlighted issues with leadership, culture, training and policies regarding safer staffing, visiting procedures, and safeguarding.
SWYPFT staff also need to be aware of the recommendations that other inquiries such as the Jay Report (2014) and the Goddard inquiry (initiated 2015) have provided.
The Independent Inquiry into Child Sexual Exploitation in Rotherham
1997 - 2013 Alexis Jay OBE (2014) included recommendation that ‘all services should recognise that once a child is affected by Child Sexual Exploitation (CSE), he or she is likely to require support and therapeutic intervention for an extended period of time. Children should not be offered short-term intervention only, and cases should not be closed prematurely’. Further guidance for staff is provided in the appendix and on the safeguarding children intranet page. http://nww.swyt.nhs.uk/safeguarding-children/Pages/default.aspx
As a result of numerous enquiries into child abuse across a number of statutory and non-statutory organisations, on the 4th February 2015, the Home Secretary, Theresa May, announced that a new, statutory, inquiry would take place into child sexual abuse. An Inquiry Panel would be formed to be led by the New Zealand Judge, Lowell Goddard. As a result SWYPFT is asked to retain any and all documents; correspondence; notes; emails and all other information –however-held- which contain or may contain content pertaining directly or indirectly to the sexual abuse of children or to child protection and care. For the purposes of this, the word “children” relates to any person under the age of 18.
The aim of the Inquiry is to conduct an overarching National review of the extent to which institutions in England and Wales have discharged their duty of care to protect children against sexual abuse.
This Sexual Relationships Policy relates to all users of South West Yorkshire Partnership (NHS) Foundation Trust who are service users irrespective of their Mental Health Status. It also affects staff / service user relationships where staff may be working with individual service users in the community or outpatients clinic as part of their treatment plan. It also affects service users who are granted Section 17 (MHA 1983 amended 2007) leave beyond hospital premises, even if that leave is not to a dwelling house, as staff need to have risk assessed sexuality issues as part of their assessment. Policies and procedural documents are designed to support staff in discharging their duties, ensuring consistent behaviour across the trust.
2. Purpose and scope of the policy
The purpose of this document is to:
· Clarify the professional boundaries between staff and service users
· Enable staff to understand what their responsibilities are in relation to sexual activity between service users
· Ensure those who lack Mental Capacity are protected whilst in the care of SWYPFT
· Ensure all allegations of sexual abuse are addressed via the Safeguarding Adults policy or the Policy and Procedures on the Protection, Safeguarding and Promoting the Welfare of Children (incorporating the Safeguarding Children Supervision Guidance).
· Ensure all allegations of sexual abuse, are discussed with the Police
· Describe arrangements for ensuring this document is regularly reviewed to reflect guidance
· Describe the process for version control to ensure people have access to are operating to the most current version
· This policy should be read in conjunction with the Policy and Procedures on the Protection, Safeguarding and Promoting the Welfare of Children (incorporating the Safeguarding Children Supervision Guidance) and safer staffing
3. Definitions
Types of relationship, in considering the scope of this policy, it was decided that it should include all different types of relationship (including marriage), which might give rise to mutual sexual activity. In this case, sexual activity refers to all intimate physical contact involving another person and not just penetrative sex.
These relationships may be heterosexual or same sex. Moreover, there might be occasions where a service user has a series of sexual partners.
Sexualised Behaviour Acts, words or behaviours designed or intended to arouse or gratify sexual impulses or desires.
Sexual Abuse any kind of unwanted or inappropriate sexual behaviour; this includes sexual intercourse, oral sex, anal sex, being touched in a sexual way and being persuaded to touch someone else. It may involve inserting objects or sexual acts with animals. Some criminal charges that can result from sexting include felony and misdemeanor offenses, such as: Child Pornography. Distributing or Possessing a Sexually Explicit Photo. Communicating with a minor with the intent of a lewd act.
Frotteurism: The non-consensual rubbing against a person to achieve sexual arousal.
Intimate physical contact: This is an extremely difficult concept to define. There is a continuum with regard to this from the simple act of holding hands through to sexual intercourse. A decision which the health care professionals must make is what reasonable behaviour is. It may well be that even the aforementioned holding of hands or touching, brushing against a person i.e. frotteurism is unreasonable, in which case it must be prohibited
Adult at Risk of abuse or Harm - is a person, who is over the age of 18 and has needs for care and support (whether or not the local authority is meeting any of those needs) and; is experiencing, or at risk of, abuse or neglect; and as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect. (Chapter 14 Page 229 Care Act (2014) Guidance replaces the Department of Health (2000) No Secrets Document) http://nww.swyt.nhs.uk/safeguarding-vulnerable-adults/Pages/default.aspx
Definition of Safeguarding Children and Child Protection- Working together to Safeguard Children 2015 states that safeguarding and promoting the welfare of children means the process of:
• protecting children from maltreatment
• preventing impairment of children’s health or development
• ensuring that children are growing up in circumstances consistent with the
provision of safe and effective care
• taking action to enable all children to have the best outcomes
The term child protection refers to the activity which is undertaken to protect specific children who are suffering, or at risk of suffering, significant harm. Child protection is part of safeguarding and promoting the welfare of all children. http://nww.swyt.nhs.uk/safeguarding-children/Pages/Policies-and-procedures.aspx
4. Duties
The following duties apply to the Sexual Relationships Policy.
4.1 Trust Board
Trust Board is responsible for approving the sexual relationships policy and for its approval, dissemination and implementation.
4.2 Director of Nursing Clinical Governance and Safety
The Director of Nursing Clinical Governance and Safety will, on behalf of Trust Board, ensure that this Policy is implemented and that documents are controlled in accordance with non-clinical records management requirements.
4.3 Business Delivery Units (BDUs) and Trust Action Groups (TAGs)
The Director of Nursing Clinical Governance and Safety will engage BDUs and TAGs in developing and implementing the sexual relationships policy.
4.4 Specialist Staff
The Specialist Advisor for Safeguarding Adults and the Named Nurse for Safeguarding Children have a role in developing and implementing this policy. The Specialist Advisers are responsible for giving advice to clinical teams.
4.7 The Trios
The Trios, Clinical Lead, General Managers and Practice Governance Coaches have a role implementing the sexual relationships policy.
4.8 Staff
All staff must be aware of the sexual relationships policy and how it impacts on their practice. Staff have an individual responsibility to ensure they are working within legal and ethical boundaries. It is each member of staff’s responsibility to seek out contemporary guidance and seek help in implementing this guidance where they have difficulty. All new policies approved by Trust Board, its Committees and/or EMT are communicated through the weekly summary via the intranet. Staff have an individual responsibility to seek out this information.
Stakeholder involvement
Consultation with relevant stakeholders secures ‘buy in’ and provides an opportunity to identify and eliminate potential barriers to implementation.
The lead director is responsible for ensuring relevant stakeholders have been consulted during the development of the policy. The following identifies some of the individuals or groups who might be consulted with. This is not an exhaustive list.
Trust Board / Approval /Director of Nursing Clinical Governance and Safety / Initiation, lead, development, receipt, circulation
Deputy Director Nursing Clinical Governance and Safety / Consultation,
Business Delivery Groups
Service line meetings / Consultation, dissemination, implementation, monitoring
Specialist Adviser
Safeguarding Adults
Named Nurse Safeguarding Children / Development, consultation, dissemination, implementation
Service user and carers / Consultation
SWYPFT legal Services / Consultation
Health & Safety Trust Action Group
Management of Aggression and Violence Trust Action Group
Safeguarding Adults Trust Action Group / Development, consultation, dissemination and implementation
Local Authorities Safeguarding Adults Lead Managers / Development, consultation
Policies and Procedures Group / Dissemination, Consultation, development
5. Principles
The fundamental actions points of the policy and procedural guidance are:
· That staff are aware of their responsibilities in relation to possible sexual abuse, whether this is from another service user or a staff member or other person in a position of Trust
· Staff need to understand what may be a possible criminal and / or therapeutic relationship boundary concern
· That actions are proportionate with the service user being at the heart of the decision making
· That concerns that are both safeguarding and disciplinary actions are managed with least duplication and consideration of information sharing agreements
6. Equality Impact Assessments
The Trust aims to ensure its policies and procedures promote equality both as a provider of services and as an employer. All new policies and procedures should be subject to an Equality Impact Assessment. A tool to support this process is included at appendix B to this document.
If any negative impact is identified, the policy should be amended or (if this is not possible) an action plan to mitigate the negative impact must be included.
7. Dissemination and implementation arrangements (including training)
Staff are informed of this policy via weekly Communications through the Trusts Intranet system
Training relating to this policy is included within the Safeguarding Adults Level Two and Safeguarding Adults Refresher training course. It is essential for all staff who have contact with services users to agree with their line managers the need for attending this training as identified through the Training Matrix for their role.
Support is available to assist implementation of this policy from the Specialist Adviser for Safeguarding Adults and / or the Named Nurse for Safeguarding Children.
8. Process for monitoring compliance and effectiveness
The monitoring of the compliance and effectiveness of the policy will be achieved through the receipt and analysis of the Safeguarding Datixweb incidents and identification of themes. The Datixweb identifies sexual abuse as a type of abuse.