Intimate care

Intimate or personal care is carrying out or helping someone with any task which most people can do for themselves, but which some are unable to do for any reason e.g. washing, dressing or undressing, toileting, medical treatment, changing period products, incontinence pads and nappies, or supervising someone to do any of these. 

Safeguarding is particularly important when providing intimate care because it involves an extra level of vulnerability for the person you are working with. This is because: 

• The fact that they need help with intimate or personal care means they are more vulnerable than someone who doesn’t. 
• The nature of the tasks and the circumstances in which they take place can increase the possibility of abuse. 
• Receiving intimate care can blur boundaries around physical touch. 
• The person may be reliant on the worker / carer providing intimate care so may be, or feel, less able to report concerns or abuse. 
• The way intimate care is provided by your organisation gives an important message to those receiving the care about how they are valued. 

Best practice would be for your organisation to have intimate care guidelines in place, so all workers know what is expected. People with ongoing care needs should have an agreed intimate care plan in place, outlining the type of care needed; who will provide it; and how often it will be reviewed. Reviewing the plan ensures it continues to meet the needs of the person and gives opportunity for any issues or concerns to be raised. 

Workers providing intimate care should: 

• Treat everyone with dignity and respect 
• Avoid doing things for the person if they are able to do it themselves.  
• Ensure privacy appropriate to the age of the person and the situation 
• Involve the person as far as possible in their own intimate care 
• Talk to the person about what you are doing and ask questions to check they are comfortable with what is being done 
• Be aware and responsive to the person’s reactions 
• Respect a person’s right to object, say no, or to refuse help 
• Ensure the method and delivery of care is consistent across the team delivering the care 
• Never do something unless you are sure you know how to do it 
• Report concerns and incidents with supervisors and the Safeguarding Lead as appropriate 
• Seek to encourage children to have a positive image of their bodies 

Workers should make a report to their supervisor or Safeguarding Lead if, while providing intimate care to a person, the individual: 

• Gets hurt 
• Is noticeably sore or tender in the genital area 
• Tells you about harm or abuse they are experiencing 
• Becomes sexually aroused because of your actions 
• Misunderstands something 
• Has an emotional reaction without apparent cause

Things to consider 

Privacy is important to think about when providing intimate care. Some care only needs to be provided by a single worker which does increase the risk or opportunity for possible abuse, or allegations being raised. However, this needs to be balanced by the loss of privacy and lack of trust implied if two people have to be present at all times. This is why having guidelines and regularly reviewing the care being given is important. 

Intimate medical care procedures may be carried out only by nursing or medical staff unless workers have been trained and assessed as competent to carry out these procedures.