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
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
'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
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.