The inclusion of children and young people who require personal care
The right to inclusion
If your child requires personal care as a result of a health condition or a disability, he or she has the same right to use services and take part in activities as other children and young people. The law says that your child should not be discriminated against or treated less favourably by services because of their health needs or disabilities. Services have to take 'reasonable steps' to make sure your child is included and if there is an element of risk involved, they may do this through a process of 'risk management'. This means that services have to assess risk, then either eliminate it or minimise it by making 'reasonable adjustments' to the activities or by arranging additional support for your child. Risk assessments should not be used as an excuse for excluding your child but should be used to find a way to safely include your child wherever possible. If there is no element of risk, the service needs to make changes or offer additional support in order to include your child.
What do we mean by personal care?
Some children and young people require help with going to the toilet or need changing on a regular basis because they cannot use the toilet. Some disabled girls will need help to manage during their periods. There may be other tasks that they will require that are personal or 'intimate'. We all have a different view of what we regard as personal or intimate, but it usually involves a part of the body that is not routinely shown to other people. There are some children and young people who require catheterisation, an 'irrigation' procedure through their bowel or regular enemas - these types of 'clinical procedures' are discussed in leaflet 'The inclusion of children and young people with complex health needs who require invasive clinical procedures'.
What are the reasons given to exclude children who require personal care?
'We don't have sufficient staff to be taking children to the toilet' - some services may state that they do not have enough staff to undertake tasks on a one-to-one basis, such as taking children and young people to the toilet or changing those who are not continent.
'The staff do not have changing nappies in their job descriptions' - this may be used as an excuse, but it should not be necessary to have this in a job description as there will be many things that staff do that are not specified in their job description but which form part of offering activities to a range of children and young people.
'There are safeguarding issues so we cannot take your child to the toilet or change them' - providers of services and activities should consider the issues of providing intimate care to any child or young person who uses a service, as they may need to provide this type of care to any of the children or young people if they become ill or injure themselves. Guidelines for providing intimate care should be part of all safeguarding training and guidelines. Services always need to weigh up issues of dignity and privacy with using more than one staff member to provide intimate care.
'All children who use this service have to be toilet trained' - This type of decision is a 'blanket rule' rather than one based on getting to know your child or making an individual assessment of your child's care and support needs.
What supports my child's rights to be included in services and activities?
There are three things that support your childs right to be included in services and activities.
- The law
- Good practice
You will find links to these sections on the menu on the left hand side of this page.