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Intimate care FAQs

What if we have nowhere to change children?

The key concern here must be the safety and dignity of the child/young person and member of staff providing intimate care. If changing in the pupil’s toilet is the only remaining option, then extra consideration needs to be made to safeguard and protect the dignity, health and safety of the child/young person. Most children can be changed in a standing position and can be changed in a cubicle. A ‘do not enter’ sign (visually illustrated) can be placed on the toilet door to ensure that privacy and dignity are maintained during the time taken to change the child.

Won’t it mean that adults will be taken away from the classroom or setting?

Depending on the accessibility and convenience of a setting’s facilities, it could take ten minutes or more to change an individual child. This is not dissimilar to the amount of time that might be allocated to work with a child on an individual learning target, and of course, the time spent changing the child can be a positive learning time.

It is OK to leave a child until parents arrive to change them?

No. Asking parents to come and change a child is likely to be a direct contravention of the Equality Act 2010, and leaving a child in wet or soiled clothing for any length of time pending the return of the parent is inappropriate and may be determined as a form of abuse.

Who is responsible for providing nappies/continence wear?

Parents are responsible for providing nappies and continence wear. Schools should provide gloves, other disposable clothing and personal protective equipment.

How do we dispose of nappies?

Check with your refuse collection service provider. For occasional use you may single wrap wet and double wrap soiled nappies and use ordinary waste bins.

What if no one will take responsibility to change nappies?

Consider your provision of intimate care procedures for when a child accidentally wets or soils, the same procedures could be used for this. Staff cannot be required to change nappies unless the task is clearly stated in the job description of an intimate care provider and the intimate care provider has agreed to undertake the role. It is good practice for a familiar adult to undertake this task who has undergone intimate care training.

I am worried about lifting

Risk assessments must be undertaken for each child, where manual handling in the form of support is required staff should receive advice or training. Children must not be physically lifted if over the weight of 16kg, but encouraged to get on/off any changing beds themselves, many are height adjustable. Suitable equipment, such as hoists should always be used for children who are unable to help themselves, this will reduce the risk of injury to both the child and staff – training will be required. Hoists should be serviced regularly and staff should be trained on the equipment that they will be using.

How can I help a child to communicate when they need to use the toilet?

Children with communication difficulties may need tools to help them communicate. Picture symbols and signs can be used to reinforce spoken words. For children who are learning English as an additional language, it is helpful to learn how to say the appropriate words in their home language.

Parents won’t bother to toilet train their child will they?

Most parents are as anxious as you for their child to be out of nappies. You will need to make it clear that your expectation is that all children of statutory school age will be out of nappies, but that you will support children and families through any difficulties. For school based early years settings it is not appropriate that your expectation is that all children will be out of nappies prior to starting nursery.

Is it true that men can’t provide intimate care because of child protection issues?

No, there are many men in childcare/ education who provide intimate care on a daily basis. DBS checks are carried out to screen for any known risks. Safe and appropriate practice is determined by good training and supervision and not according to gender.  DBS is the Disclosure and Baring Service (previously CRB checks). Staff providing intimate care tasks will be required to have an enhanced DBS check; this will normally be arranged by the employer.

What if a child reacts defensively to intimate care?

Is the child otherwise anxious about adults? Is it new or changed behaviour? Is this behaviour occurring in other areas of school life? Ask the parent/carer whether anything has happened which may have led to the child being anxious or upset about being changed. Has there been a change in the household/school? If you are still concerned, consider whether there may be any safeguarding issues and follow the school child protection policy.

What if a member of staff refuses to change a child/young person who has soiled?

The Equality Act 2010 is clear that children should be protected from discrimination, and therefore a child who has soiled should be attended to in order to return to the classroom/setting without delay. The issue should not arise if designated support staff have been appointment on the basis that the provision of intimate care will form part of their job role. Members of staff where the provision of intimate care does not form part of their job role may volunteer but cannot be required to do so if they refuse. This emphasises the need for serious consideration being given to the inclusion of intimate care within job roles.