Personal care – How to provide it safely in Early Years

Taken to the extreme, safeguarding when it comes to personal care can actually end up being detrimental to children’s wellbeing, explains Natalie Thompson…

Right now there’s an undisputed need to reassess how we care for children in response to historical allegations of sexual abuse. These have highlighted society’s failure to protect the most vulnerable. However, extreme safeguarding can actually be detrimental to children’s safety.

Eagerness to protect ourselves from allegations may mean we overlook the reason why safeguarding exists. It may lead us to forget that the child should be at the centre of any safeguarding approach.

Personal care

One area in which safeguarding can be taken to the extreme is intimate or personal care. Through my work with ERIC, the children’s bowel and bladder charity, I’ve heard first-hand from parents whose child’s school is no longer willing to change them when they’ve had a wetting or soiling accident. This is regardless of any underlying condition or disability.

This is often because the school has introduced a new policy that two members of staff must be present for personal care. Sometimes there aren’t enough staff to carry out this duty. Schools invariably say this policy change is ‘because of safeguarding’.

In December, I received a call from a distraught mum. Her son’s school had been very good at caring for her son, who has chronic constipation and additional needs. They’d recently introduced a two-person personal care policy.

The school was no longer able to help change her son when he soiled. This was because one of the teaching assistants didn’t want to assist with personal care.

The school has a duty to respect the wishes of its employees. However, this shouldn’t stop it from upholding its duty to safeguard the health and wellbeing of the child.

In my opinion, leaving a child in soiled clothing until their parent arrives is maltreatment. It’s the opposite of why safeguarding exists.

Frightening repercussions

A colleague recently recounted a conversation she’d had with a school that had a two-person policy. Staff would grab any passing member of staff in order to change a child.

While aiming to uphold their safeguarding duties, the school was effectively teaching the child that it is OK for any adult to help with their personal care. The potential repercussions are frightening.

Of course, schools must ensure that children who need help with personal care aren’t at risk of abuse. However, they also have a duty to support those with medical needs, including bowel and bladder difficulties.

We should deliver support in a child-centred way, taking into consideration the individual needs of the child.

In practice

In order to strike a balance between protecting staff and maintaining the privacy, dignity and security of the child, schools need to carefully consider how many members of staff should be present for personal care. The number of staff required will depend on each child’s situation and their unique needs.

Some personal care procedures may require two members of staff for health and safety reasons, such as manual handling.

Whatever number of staff you require, you should state their names and roles in the child’s healthcare plan.

The only requirements in law with regard to staffing levels for personal care are that the member of staff helping the child must notify another member of staff when they are going alone to assist a pupil. They must ensure another member of staff is in the vicinity and visible or audible.

To further protect the privacy and dignity of the child, staff should notify others discreetly that they are taking the child for personal care.

If a situation arises that causes concern to staff helping with personal care, they should call the second member of staff if necessary. They should also report and record the incident.

Record any concerns about the way in which the child behaves during a personal care procedure or any comments they’ve made. Discuss these with senior staff immediately.

Eric is the UK’s leading charity supporting children with a bowel or bladder problem. It has been delivering training for health and education professionals for over 20 years. Find out more about its training programmes.