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9.14 Bathing Children and Young People

RELEVANT CHAPTER

Cross Gender Care Policy

This chapter was added to the manual in June 2013.


Contents

  1. Policy Aim
  2. Policy
  3. Procedure


1. Policy Aim

Ensuring that health and safety is paramount when a child/young person is bathed.


2. Policy

During their stay at Breakaway each child or young person may use the bathing facilities. This may include the shower, bath, or Aquanova bath that incorporates a changing table. It is imperative that under no circumstances may a child/young person be left in the bathroom area out of visual sight of the child care officer, without the written consent of the child/young person’s parent or guardian.

The personal care needs of every child/young person will be unique and specified within their personal care plan - ‘This Is Me’. When bathing, all care workers should be aware of the child/young person’s care plan and follow guidelines within that plan. Written consent of the parents/guardian of the child/young person contained in the care plan may override the above policy requiring staff having visual sight of the child/young person in the bath. In these circumstances staff are required to stand outside the bathroom whilst the child/young person completes their bathing activity. Routines are very important to children and young people, following their care plans will reinforce familiarity and act as reassurance during their stay at Breakaway.

Privacy and Respecting Children and Young People’s Dignity

Bathing is a time for the children/young people to not only wash, but to relax and wind down. Bathing is a private time when children/young people may feel vulnerable being undressed in front of carers.

Staff should ensure that any staffing arrangements aim to meet gender needs of children/young people. Care Plans may state a preference. In the case of the child/young person being unable to communicate their needs, the child/young person’s advocate should speak on their behalf. (Refer also to Breakaway’s Cross Gender Care Policy).

It is also important to take into consideration any preference that the child/young person may have with regard to who, in particular, bathes them. They may feel more comfortable being undressed in front of particular carers.

Privacy is important as some children/young people may use bath time to explore their own bodies. Therefore, if permitted by the Care Plan, you allow the child/young person to explore their bodies, without being directly watched or looked over. This is also important for children/ young people who independently undress themselves.


3. Procedure

  • Ensure before you have entered the bathroom with the child/young person you have everything you need for the whole duration of bathing. Parents/carers are asked to send in toiletries for their child/young person and these must be used. If a child/young person hasn’t any toiletries then Breakaway’s supply should be used and a message put in the child/young person’s communication book that toiletries are required for their next stay. Please check individual consent forms in relation to this activity. If an item, unfortunately, is missed when getting everything together and is required for bathing  then you must call for a member of staff and ask them to get it for you. At no point is the child/young person to be left alone in the bathroom. A supply of Breakaway toiletries is kept in the bathroom cabinets so are easily accessible should they be required. The cabinets can remain unlocked while the carer is present in the bathroom unless the child/young person’s behaviour deems it unsafe. Must be locked after use;
  • If Breakaway’s towels and flannels are used then a fresh set should be used for each child. Under no circumstances can towels and flannels be used on more than one child/young person, until they are washed/sterilised again;
  • It is important that all females are encouraged to wash their vaginas and bottoms from front to back, thus reducing the spread of infection;
  • Each child/young person should bring in their own toothbrush. If they haven’t got their own then Breakaway staff would need to get them a new one from the supply that Breakaway hold (linen cupboard). If a toothbrush is supplied then it is not to be used by any other child/young person. Once the toothbrush has used the toothbrush it is to be clearly labelled with the child/young person’s name. When getting a toothbrush for a child/young person please check first whether there is already one labelled for the child/young person. Children/young people should bring in with them their own hairbrush/comb. If not a Breakaway hairbrush/comb (linen cupboard) may be used but should never be shared between children/young people. After each use the brush/comb must be thoroughly cleansed;
  • Children/young people with head lice should always have a  hairbrush/comb for sole use;
  • To prevent children/young people slipping when they exit the bath or care workers slipping on water on the floor, bath mats must be used on the floor to absorb excess water. If the bath mat doesn’t adequately cover the area of wet floor or the amount of space the child/young person needs, towels may be used;
  • When assisting a child/young person with undressing, talk to them and explain everything that you are doing so that they understand what is happening to them. When drying children/young people, cover the part of their body that may be exposed whilst drying the other part to maintain their dignity;
  • Some children/young people can independently undress themselves, in these circumstances they must be allowed to do this  with the care worker only giving assistance if the child/young person asks them to;
  • Always check care plans as well as individual programmes within the ‘This Is Me’ as to the level of assistance the child/young person will/may require.

Using the A-side Aquanova Bath

Care workers must feel confident and have the knowledge/training to use the Aquanova bath efficiently before they bath children/young people.

Preferably children/young people who wear pads should be bathed in the Aquanova bath as it incorporated an adjustable changing table. Always refer to individual Care Plans. Some children/young people are very able and dislike the association with the Aquanova bath as it may carry a stigma with it. In these cases where the child/young person requests not to be bathed in the Aquanova bath their preference must be acknowledged. The Aquanova bath is operated electronically and is able to raise the child out of the water quickly and with ease thus preventing the amount of time the child/young person is immersed in water limiting the risks of drowning. This is particularly important if the child/young person is susceptible to having seizures. 

The Aquanova bath can be adjusted to suit the height of the carer, thus limiting the amount of strain on the carer’s back during personal care. The temperature of the water is regulated and checked every week to ensure that the temperature is maintained. In addition to this the water temperature must be checked every time the bath is used. The Aquanova bath has a system on the tap handle where the temperature can be adjusted manually. It is therefore important to check before the bath/shower head is used.

Aquanova Additional Features

  • Shower Head - The shower head can be used to shower or rinse a child/young person while sitting/laying in the bath only. At no point should a children/young person stand or be encouraged to stand in the Aquanova bath;
  • Slip Mat - Slip mats must be used  when bathing children/young people;
  • Head Support - The Aquanova bath head support can be placed and fixed into either end of the bath. Two special metal holes at either end of the bath platform hold the head support in place. The head support isn’t always suitable for all children/young people. Please refer to individual care plans;
  • Bathroom Slings - A  bathing sling should be used for children/ young people who are unable/need assistance to walk and need to be hoisted into the bath. For some children/young people it may be necessary to leave the sling underneath them throughout the duration of their bath. The child/young person should come in for their stay at Breakaway with their own sling. Please refer to individual Care Plans and the Safe Moving of Service Users policy - to follow.

Over Head Tracking in A-side Bathroom

Care workers must be trained and feel confident to use the over head tracking efficiently before they hoist a child/young person into the bath. This is also to include how to use the over head tracking during a power failure or emergency. The over head tracking in the bathroom must be used for all children/young people who require hoisting.

B-side Bath

This bath is fixed to the floor and cannot be adjusted. Therefore this bath is more suited to children/young people who are able to carry out a certain amount of self care. Due to the bath being fixed to the floor it is unable to be raised to a required level to prevent the care worker stretching over and putting a strain on their back.

When bathing a child/young person the care worker must ensure a non-slip mat is placed in the bath before the child or young person enters the bath. The water temperature must also be checked to ensure that it is at an acceptable temperature (not exceeding 42 degrees).

It is vital that the plug  on this bath has a metal chain attaching it to the bath to enable it to be pulled out as quickly as possible in an emergency situation to  release the water down the drain i.e if a child/young person has a seizure. Also if this bath is being used by a child/young person.

If a child/young person who has Epilepsy uses this bath on that has seizures it is important to ensure there are numerous towels in the bathroom close to the bath to soak up water and cushion the child or young person should they have a seizure. Staff must use the emergency pull cord to raise the alarm should they require assistance.

B-side Shower

This shower has a shower chair fitted to the wall so it can be used for children and young people who can stand unaided and are able to balance and for some children/young people who are less mobile (refer to child/young person’s Care Plan). A non-slip mat must be placed in the shower tray before a child or young person enters the shower.

A-side and B-side Key Pads

Outside each bathroom is a key pad that when the correct numbers are keyed in, it releases the lock on the door allowing access. All care workers must ensure that they know the code to the bathrooms.  It is the responsibility of each care worker to obtain the key code during handover, if they don’t already know it. If the key pad code is changed, notification should be written in the message book informing all staff with the new number recorded for everyone to see.

The reason for using this method of access to the bathrooms is for use in emergencies. If a care worker requires access to the bathroom they should knock on the door and say who they are before being given the go ahead by the care worker inside the bathroom to enter. This is to ensure that the child/young person’s dignity and privacy is respected. Staff may also need to enter the bathroom if a child/young person has gone to use the toilet and locked the door  staff may be concerned, but again before entering they must say who they are.

End