Safer Care Practice and Personal Care
Regulations and Standards
The Fostering Services (England) Regulations 2011
Regulation 11 - Independent fostering agencies—duty to secure welfare
Fostering Services: National Minimum Standards:
STANDARD 1 - The child's wishes and feelings and the views of those significant to them
STANDARD 6 - Promoting good health and wellbeing
Related guidance
Foster carers constantly have to balance risks in the everyday decisions they make with regard to the child or young person they support so are accountable for the day-to-day decisions they take. Some practices have to be different to safeguard everyone.
Children and young people who are looked after are often particularly vulnerable due to their previous life experiences, so foster carers need to understand and manage the particular risks with care.
Good, safer caring is about foster carers being aware of the risks involved for particular children in different situations and making well thought through decisions, in partnership with the child's social worker and the Agency. Risks around safe caring must be made in a risk sensible way not a risk averse way to support a child or young person to grow and learn.
As an Agency, safe caring practices around personal care or any type of support should be ingrained into practice and recorded on care and placement plans as well as the safe caring plan. These should be written in conjunction with the foster carers and children's social worker and reviewed frequently to reflect the changing needs of the child or young person.
Carers must provide a level of care which is designed to demonstrate warmth, respect and positive regard for children.
Children must be supported and encouraged to undertake bathing, showers and other intimate care of themselves without relying on carers.
Such arrangements must emphasise that children's dignity and their right to be consulted will be protected and promoted; and, where necessary, carers will be provided with specialist training and support.
Unless otherwise agreed, children who require personal care by adults will be given care by a foster carer/adult of the same gender.
One of the primary tasks for foster carers is to work with the children to maximise opportunities for forming and benefiting from positive relationships with adults.
Warmth and understanding are essential, but everyone needs to know and understand when a relationship is inappropriate. What is important is that carers need to be putting the children's interests first and always considering what is appropriate in any given situation with a particular child.
Where it is known that a child has been a victim of sexual abuse and it is likely he or she will behave towards carers in a sexual manner, particular rules will have to be drawn up for carers. This may involve the need to avoid being alone with the child, by always having a third person present.
Children who have suffered many unexpected losses in adult relationships are likely to be constantly fearful of being abandoned again.
Carers must have knowledge and understanding of the child and his or her background, and this awareness will enable them to offer acceptance and understanding with regards to their fear of emotional engagement.
Foster carers should be sufficiently aware of children demonstrating sexualised bahaviours towards the foster carer and be able to support the child and seek appropriate advice from other professionals.
Should a foster carer believe that a child’s behaviour towards anybody within the household is inappropriate, they should discuss this with the agency immediately and appropriate measures put in place.
Research says that if parents/carers talk to children about this subject they are more likely to delay having sex and use contraception when they do.
All children need age-appropriate communication, guidance, and information about these issues.
Discussions around relationships and sex need to be child led and appropriate for their age and level of understanding. Foster carers may want to think about:
- Starting early, carers do not need to know it all, but if the child asks a question and the carer doesn't know the answer, they should say they will get back to the child and make sure they do;
- Checking out what a child/young person knows, so if the child asks a question, ask the child what they think it means;
- Discussions could involve talking to a young person about something that has been on the television or in the news to get their views. This should also cover topics such as friendships, respect and trust;
- Finding books, leaflets or appropriate websites dependent on age for the child to look at, or look at them together;
- Find out where local services are that can help. Contact local youth services or look online for more information;
- Being open and honest and not providing confusing stories is beneficial.
Effective relationships and sex education at home and at school is essential if young people are to make responsible and well informed decisions about their lives and resist peer pressure.
Carers must adopt a non-judgemental attitude toward children, particularly as they mature and develop an awareness of their bodies and sexuality.
Carers must adopt the same approach to children who explore their sexual identity or who have decided to embrace a particular lifestyle so long as it is not abusive or illegal.
Children who are exploring their sexual identity or indicate they have a preference must be afforded equal access to accurate information, education and support to enable them to move forward positively.
As necessary this must be addressed in each child's Placement Plan.
All materials published, circulated or available to children (including the internet) must promote and encourage healthy lifestyles and images of men and women that are positive and encouraging.
Children must be discouraged from obtaining material that is potentially offensive or pornographic.
If they obtain such material that is suspected to be illegal it must be confiscated. This should be discussed with the child's social worker and if there are concerns that the child has been exposed to extreme pornography, the concerns should be shared with the fostering manager about what support the child may need and whether it is deemed a safeguarding issue (depending on where and who is supplying the pornography).
Children under the age of 13 are deemed to be incapable of giving consent to sexual activity. Therefore, children of this age who engage in sexual activity must be referred to the local authority's Children's Social Care Services under the Multi-Agency Safeguarding Children Procedures as potentially suffering from Significant Harm.
Staff must be alert to such relationships when considering the placement of children under 13. Children of this age who are likely to be at risk from each other (or from older children) should not be placed together.
When considering the placement (or ongoing placement) of children over the age of 13, managers must assess the risk of sexual relationships developing and should ensure strategies are in place to reduce or prevent these risks if they are likely to be exploitative or abusive.
Where children aged 13 - 18 are placed together with no identified risk of exploitative or abusive behaviour, carers must monitor any developing relationships, sensitively but discouraging children from engaging in under-aged sexual relationships.
Overall, carers should be mindful of their duty to consider the overall welfare of children and this may mean recognising that illegal activity is taking place and working to minimise risks and consequences. If there is any suspicion that a child is engaging in illegal behaviour it must be discussed with the Supervising Social Worker, who should consult the child's social worker and consideration should be given to consulting the Child Protection Agencies. The agency must be alert to the possibility that the child may be being sexually exploited and if there are concerns of this nature, the Registered Manager should be informed (see Section 9, Sexual Exploitation).
Any actions taken in this respect will be subject to consultation and must be addressed in Placement Plans.
Access to contraceptives will not be conditional on children giving information about their lifestyles and contraception will never be withdrawn as a punitive measure.
Whilst not encouraging it, it is understood that children may engage in sexual activity; some before they reach the age of consent. In such circumstances the Supervising Social Worker should consult the child's social worker to agree what reasonable steps can be taken to minimise risk of pregnancy or infection, including facilitating contact with relevant agencies providing contraceptive advice. Foster carers should not give advice on contraceptive choices.
If a child is suspected or known to be pregnant the carers should notify the Supervising Social Worker, who should consult the child's social worker to decide on the actions that should be taken.
See also: Safeguarding Children and Young People from Sexual Exploitation Procedure.
Children may have previously exchanged sex for rewards, gifts, drugs, accommodation and money. Some maintain this lifestyle whilst continuing to be accommodated by the authority. Such situations must be reported to the Registered Manager.
The Supervising Social Worker and foster carers must be alert to such behaviours and should do all they can to create an environment which encourages children to be open about their past or present attitudes and behaviours and which demonstrates they will be supported to guide them away from such lifestyles.
Where there is any suspicion that a child is engaged in such behaviour it should be addressed in the child's Placement Plan, and strategies to be adopted to help the child find alternative lifestyles need to be identified.
In addressing these behaviours consideration must be given to the extent to which the child is suffering or likely to suffer Significant Harm - and whether it is necessary to refer the child to the local authority's Children's Social Care Services in the area where the child is living under the Multi-Agency Safeguarding Children Procedures.
If there is any suspicion that a child is involved in sexual exploitation, the Regulatory Authority must be notified.
If it is known or suspected that a child has a sexually transmitted infection (including HIV), the Supervising Social Worker and child's social worker must be informed so that they along with the foster carer can decide what action needs to be taken.
Where appropriate, the issue should be discussed and any questions answered as openly and honestly as possible. This may require obtaining factual information, and contacting the Sexual Health clinic.
Each child over 3 will have their own bedroom or, where this is not possible, the sharing of the bedroom will have been agreed by the Placing Authority. The Supervising Social Worker must have conducted a risk assessment and any arrangements must be outlined in the child's Placement Plan.
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 rooms 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.
Children's privacy should be respected. Unless there are exceptional circumstances, carers should knock on the door before entering children's bedrooms.
The exceptional circumstances where carers may have to enter a child's bedroom without asking permission include:
- To care for a baby/young child;
- To wake a heavy sleeper;
- When the young person is not in their bedroom, to undertake cleaning, return clean or remove soiled clothing; This should be carried out after collaborative discussion with the young person;
- To take necessary action, to protect a child or others from injury;
- Where there is a risk to the child, i.e. self-harming, foster carers can enter the bedroom to conduct a search for specific items of concern.
See also: Countering Bullying Procedure.
The possibility of child-on-child abuse will always be taken seriously but we recognise it is equally important not to label or stigmatise normal sexual exploration and experimentation between children.
Behaviour is not a cause for concern unless it is compulsive, coercive, age-inappropriate or between children of significantly different ages, maturity or mental abilities.
If at any time carers suspect children are engaged in abusive sexual relationships as perpetrators and/or victims, they must immediately inform the Supervising Social Worker, who must consult the Registered Manager and the child's social worker, who will make a referral to the local authority's Children's Social Care Services in the area where the child is living under the Multi-Agency Safeguarding Children Procedures.
Young women should be supported and encouraged to keep their own supply of sanitary protection without having to request it from carers.
There should also be adequate provision for the private disposal of used sanitary protection.
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 and strategies adopted for supporting the child to manage this; these strategies should be outlined in the child's Placement Plan.
Foster carers and Supervising Social Workers, together with the social workers for the children concerned, should consider the possible reasons for enuresis and encopresis. There may be a variety of reasons for these behaviours which may be related to their past lived experiences including abuse and neglect.
It may be appropriate to consult a Continence Nurse or other specialist, who may advise on the most appropriate strategy to adopt. To support the child:
- Offer acceptance and empathy for the child’s experience;
- Do not treat it as the fault of the child, or apply any form of consequence;
- Do not require the child to clear up. Support the child to clean themselves and ensure that any soiled bedding and clothes are removed and cleaned;
- Keep details of frequency in the child’s daily recordings;
- Consider using mattresses or protective bedding.
Carers must provide a level of care, including physical contact, which is designed to demonstrate warmth, friendliness and acceptance for children and young people.
Physical contact should be given in a manner which is safe, protective, and appropriate to the child's age and emotional understanding and is given in a way that takes into consideration their past lived experiences.
The term 'Touch' is used throughout this manual in two different contexts.
'Touch' as a form of physical intervention designed to prevent a child or others from being injured; and the use of 'touch' to enable carers to demonstrate affection, acceptance and reassurance.
However, touch is acceptable and can help a child or young person belong but carers should consider the following:
The child may have had particular experiences which make it difficult to accept touch from an adult; or the child's experiences may lead to a need for more touch.
It is therefore important for carers to attempt to obtain information about the child's background as soon as possible, with the support of their Supervising Social Worker and remain mindful that touch should always be child led.
If there are particular needs that the child has or if it appears that the child may respond more or less favourably to touch, this must be shared with the foster carers during the placement planning process.
Dependent on the age and level of understanding of the child, s/he should be involved in this assessment and planning; and should be encouraged to consent to being touched; or to place conditions on it.
The culture or values of the household should be such that touch is encouraged; as a positive and safe way of communicating affection, warmth, acceptance and reassurance.
Carers and children should be encouraged to use touch, positively and safely. But it is important for carers and children to know if boundaries exist for individual children within the foster home.
If boundaries or expectations exist for individual children, they should be set out clearly in their Placement Plan, for example, if carers are not expected to allow children to sit on their laps, or to carry children, this should be stated in writing.
In the absence of any plan or expectation, the following should be taking into consideration:
- When thinking about who is an appropriate person to touch a child, it is vital to consider what the adult represents to the particular child. Personal likes and dislikes will play a part in any relationship;
- In addition, many factors influence the power relationship between adult and child, including gender, race, disability, age, sexual identity and role status;
- The background of the child will also influence any decision about who represents a 'safe' adult in the eyes of the child;
- Cultural awareness should be maintained at all times and adapted accordingly;
- Children who have been subject to physical or sexual abuse may be suspicious or fearful of touch. This is not to say that children who have experienced abuse should not be touched, it may be beneficial for the child to know different, safer and more reliable adults who will not use touch as a form of abuse;
- For each child, what constitutes an intimate part of the body will vary; but generally speaking it is acceptable to touch children's hands, arms, shoulders. It may be appropriate to hug or cuddle children, or carry or give them 'piggy backs';
- Other parts of the body are less appropriate to be touched, by degrees. Some parts of the body are 'no go areas', therefore, it may be appropriate to touch a child's back, ears or stroke their hair - if the child indicates such touch is acceptable. To go beyond this would be unacceptable, even if the child appeared to accept it;
- No part of the body should be touched if it were likely to generate sexualised feelings on the part of the adult or child;
- No part of the body should be touched in a way which appeared patronising or otherwise intrusive;
- The context in which touch takes place is usually a decisive factor in determining the emotional and physical safety for both parties;
- A fleeting or clumsy touch may confuse a child or may feel uncomfortable or even cause distress. Carers should touch with confidence, reassurance and acceptance;
- Where children indicate that touch is unwelcome carers should back off and repair the relationship if necessary;
- Carers should talk to their Supervising Social Worker and record their interactions with children. To reflect upon whether particular strategies work, or not, so they can build on or avoid making the same mistake;
- Foster carers can model positive touch between family members, demonstrating positive role models for children and showing that adults can get along and use touch in non-abusive or non- threatening ways;
- It is also acceptable to talk with children about how touch feels, about acceptable boundaries and expectations;
- Play fighting is no alternative for this. It is unacceptable;
- The key is for carers to help children experience and benefit from touch, positively and safely; as a way of communicating affection, warmth, acceptance and reassurance.
It is essential that all carers are aware that the use of foul and abusive language directed towards and in front of children is totally inappropriate and unnecessary. This may have the effect of demeaning children, have a negative effect on the child/carer relationship and could lead to an escalation of disruptive and challenging behaviour.
All carers need to be aware that any complaints relating to foul and abusive language will be treated seriously and may lead to disciplinary measures.
The Agency will have safer caring plans in place.
A family safer caring plan is a general plan which is written during the fostering assessment process which details the house rules for living safety together once a foster child is placed. This should include details around the foster carer's own children, the foster carers, other members of their family network and other people who share the foster carers' lives. This could include information such as what is appropriate to wear, how privacy will be maintained and how the household will deal with any bullying incidents.
A child specific safer caring plan is an additional plan which complements the family safer caring plan. This takes into account the child's needs and the potential issues which could be an issue. The Agency should complete this plan when a child is placed and then regularly review this plan when things change to support and protect everyone, in particular foster carers, from allegations.
Last Updated: July 25, 2024
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