Culture of openness on sexual needs required in social care

Adult social care leaders must create a culture of openness where people using services feel empowered and supported to be open about sexuality and relationships.

That is according to the Care Quality Commission, whose latest research into supporting people in adult social care to have safe sexual relationships highlighted the need to allow people the basic human right to express their sexuality, and an open culture where people feel able to raise concerns around safety where necessary.

The 661 statutory notifications of sexual incidents that were reported to CQC between March and May 2018 detail 899 sexual incidents or incidents of alleged sexual abuse that took place in adult social care services, such as residential and nursing homes. This reflects three per cent of all the abuse notifications received by inspectorate during this period.

Almost half of the incidents were categorised as allegations of sexual assault, whilst the second most common type of incident (11 per cent) was that of indecent exposure and nudity. The CQC also reports that 16 per cent of all notifications made allegations against employed staff or visiting workers and five per cent of reported instances were detailing cases of consensual sex.

Following engagement with people who use adult social care, the CQC has highlighted a number of recommendations, including co-produced guidance for care managers and staff that focuses on how to protect people using adult social care from sexual abuse and how to support them to develop and maintain relationships and express their sexuality. It says that providers and leaders across adult social care should develop a culture that encourages people and staff to talk about sexuality and raise concerns around safety.

Kate Terroni, Chief Inspector of Adult Social Care, said: "Supporting people as individuals means considering all aspects of a person's needs, including sexuality and relationships. We know that an open culture, where staff feel they can share concerns without fear of reprisal, where people and families are empowered to speak about their wants and needs in a sensitive way, and where managers and providers proactively enable conversations about sexuality to take place are the conditions that lead to people being empowered to stay safe and supported.

"However, our report also shows all too starkly the other side of this - the times when people are harmed in the very place they should be kept safe. This is utterly devastating, both for the people directly affected and their loved ones.  While we are aware that sexual incidents in services are not common, we know from speaking to those affected that the impact and consequences can be life-changing. Their message to us is that more needs to be done to prevent sexual abuse happening.

"It is not good enough to put this issue in a 'too difficult to discuss' box. It is particularly because these topics are sensitive and complex that they should not be ignored. We are clear that abuse in any form can never be accepted and we must act on the findings of this report to help providers and care staff protect people from sexual harm, while enabling people to continue or develop intimate relationships. We are confident that with the right commitments across the sector we can achieve both."