3.9.5 Sexual Health and Relationships |
Contents
- Policy Statement
- Introduction
- Definition
- Legal and National Policy Context
- Need
- Royal Borough's Quality Standards
- References
- Acknowledgements
Appendix 1
Appendix 2 - Information Sharing, Privacy and Confidentiality
Appendix 3 - Definitions
Footnotes
1. Policy Statement
In Kensington and Chelsea we take seriously our responsibility to provide accurate, age and developmentally appropriate Sex and Relationship Education (SRE) to promote responsible behaviour for looked after children and young people (footnote 1) and prepare them for adulthood. We acknowledge that they are a particularly vulnerable group who require additional help to access the support and guidance available to make positive, safe and healthy choices about sex, relationships, pregnancy and parenthood. The SRE policy applies to all the Royal Borough’s looked after children and includes young people who are placed outside the authority (see Standards Section below). As with school SRE programmes, the Royal Borough’s looked after children policy is based on learning about relationships and applies to school age children, but also includes young people leaving care.
The Looked After Children’s SRE policy is also an important component of the Royal Borough’s Corporate Parenting and Safeguarding responsibilities for young people in the Council’s care. The provision of appropriate SRE advice, information and support safeguards children and young people against the dangers of sexually transmitted infections, sexual exploitation, bullying and violent relationships.
The Royal Borough is committed to promoting health and healthy outcomes for young people. Providing accessible sex and relationship education for looked after children builds on the Royal Borough’s undertaking to, ‘improving access to sexual health services’ in the Children and Young Person’s Plan 2006. Additionally, improving outcomes for vulnerable looked after children by developing a clear SRE policy is an objective of the Royal Borough’s Teenage Pregnancy Strategy Action Plan (2006/07).
The policy places an emphasis on the significance of a moral framework, and the contribution made by religion, culture, beliefs and values. Equally, SRE must be provided in the context of equal opportunities, diversity and non-discriminatory practice as guided by professional codes of practice, without making unwarranted assumptions.
Looked after young people often have fractured and disrupted relationships with their birth parents and as a result need additional support in many areas including sex and relationships education. It is a priority for all staff and carers to promote and facilitate access to confidential, non-judgemental and accessible SRE information, advice and health services. This assumes that time is invested in getting to know children, building trust in order to provide clear guidance and support, so they are in turn, able to make informed decisions about sex and relationships.
Furthermore, children’s right to privacy, self-determination and personal choice must be respected and the way they wish to access SRE should be fully taken into account. Children have told us clearly that to make SRE relevant, they want to be involved in its planning and delivery.
“All the young people felt their involvement and participation is crucial in ensuring that the aims and objectives of the policy are implemented and to make a real improvement to the quality of SRE for LAC” (footnote 2).
We also believe in the important role played by parents and carers and the Looked After Children’s SRE policy has been developed within the context of Royal Borough’s vision of strong families at the heart of strong communities. Schools, youth services, health agencies and voluntary groups, private providers all play a significant role in providing SRE and placing it in the context of the wider community children are part of.
The priorities for providing SRE to looked after children will be reflected in Family and Children’s Services business planning and has been developed in line with the Royal Borough’s safeguarding responsibilities.
This policy is inclusive and aims to address the SRE needs of all looked after children, whilst also acknowledging that some looked after children such as children with disabilities, may need to seek specialist SRE advice and support.
An SRE Action Plan will be drawn up to implement the quality standards laid out below (Section 6, Royal Borough's Quality Standards). The plan will be monitored and reviewed by the Performance, Audit and Review service and progress reported to the Royal Borough’s Corporate Parent Panel.
2. Introduction
The policy sets out the shared vision and principles for improving SRE provision to Royal Borough Looked After Children, which has been developed in consultation with young people, their carers and a range of local services (see Section 8, Acknowledgements).
The scope of the policy has been limited to addressing the overarching LAC SRE issues; in accordance with current guidance, (see Section 7, References). More detailed guidance is available in existing ‘LAC sexual health and relationship’ procedures and these will be updated, as part of the implementation of this policy. This will include ensuring access to specialist SRE advice where this is appropriate for the young person. A list of issues covered in separate staff guidance is provided in Appendix 1 for reference.
The principles for information sharing, confidentiality and privacy are set out in Appendix 2 - Information Sharing, Privacy and Confidentiality. The DfE has issued specific guidance for residential staff, foster carers and social work practitioners, on looked after children’s entitlement to sex and relationship education, to minimise barriers for accessing sexual health and relationship information or advice.
The policy contains the following three key areas:
Section 7, References provides Internet links to all the documents referred to throughout the policy.
World Health Organisation definitions for ‘sexuality’, ‘sexual health’ and ‘sexual rights’ are provided in Appendix 3 - Definitions.
Appendix 4 summarises comments from Royal Borough looked after children who have reviewed the SRE standards (see Section 6, Royal Borough's Quality Standards below).
3. Definition
SRE has been described as: ‘lifelong learning about sex, sexuality, emotions, relationships and sexual health. Through SRE children and young people acquire accurate information, develop skills and develop positive values which will guide their decision-making, judgements, relationships and behaviour throughout their life. Sex and relationship education should be an entitlement for all children, young people and adults and should meet the needs of boys as well as girls; those who are heterosexual, those who are lesbian, gay or bisexual; those with physical, learning or emotional difficulties; and those with a religious or faith tradition.’ (National Children’s Bureau - Sex Education Forum 2004)
SRE has three key elements:
-
Attitudes and Values
- learning the importance of values and individual conscience and moral considerations;
- learning the value of family life, marriage, and stable and loving relationships for the nurture of children;
- learning the value of respect, love and care;
- exploring, considering and understanding moral dilemmas;
- developing critical thinking as part of decision-making: and
- respect and understanding of people’s different methods of communication
-
Personal and Social Skills
- learning to manage emotions and relationships confidently and sensitively;
- developing self-respect and empathy for others;
- learning to make choices based on an understanding of difference and with an absence of prejudice;
- developing an appreciation of the consequences of choices made;
- managing conflict; and
- learning how to avoid conflict and abuse;
- learning how to manage risky behaviour for themselves and others .
-
Knowledge and Understanding
- learning and understanding physical development at appropriate stages;
- understanding human sexuality, reproduction, sexual health, emotions and relationships;
- learning at appropriate stages, about contraception and the range of local and national sexual health advice, contraception and support services;
- learning the reasons for delaying sexual activity, and the benefits to be gained from such delay; and
- the avoidance of unplanned pregnancy.
See Appendix 3 - Definitions for further definitions (World Health Organisation) about SRE and other related areas.
4. Legal and National Policy Context
The overarching principle of the Children Act 1989 is that ‘children’s welfare is paramount” and Section 22 imposes an obligation on the Local Authority to ‘safeguard and promote the welfare’ of young people who are looked after. The Children (Leaving Care) Act 2000 includes a specific duty on local authorities to provide SRE. This is accompanied by guidance, informed by research, which demonstrates that looked after children consistently achieve poorer outcomes than their peers. ‘The Children Act (Miscellaneous Amendments) Regulations 2002 New Guidance on Promoting the Health of Looked After Children’, contains regulation relating to the health and health care of looked after children.
The Sexual Offences Act 2003, Working Together to Safeguard Children and the London Child Protection procedures, provide guidance on the disclosure of sexual abuse, non-consensual sexual relationships, sexual exploitation, female genital mutilation (FGM) and the risk of significant harm to children. Where safeguarding issues arise in the context of SRE, child protection procedures should be followed.
The Equality Act 2006 sets out a duty to promote equal opportunities to ensure that every individual has the chance to achieve their potential, free from prejudice and discrimination. It refers specifically to respecting sexual orientation and provides new powers to protect the lesbian, gay and bi-sexual population from sexual discrimination and harassment.
The recently issued Green Paper ‘Care Matters: Transforming the Lives of Children and Young People in Care’ sets out proposals for improving the health and support to pregnant young women and teenage parents.
The Policy is linked with the Royal Borough’s Teenage Pregnancy Strategy and its priorities.
5. Need
At any one time there are between 250-270 (footnote 3) children looked after by the Royal Borough. Approximately 140 children are of statutory school age, with 40 attending primary schools and 100 at secondary school. 110-130 young people are between 16-20 years old.
A significant proportion of looked after young people, (21%) have a Statement of Special Educational Needs (SEN) and a small group (8%) are disabled. The majority of placements for children (70%) are outside of the Royal Borough, which has consequences for providing supplementary or additional SRE for those attending out-of Borough schools.
Research has estimated that it is twice as common for looked after young people to want a baby by the age of 20, compared with those living with their families. They are also more likely than others to be against abortion and carry on with their pregnancy (footnote 4).
Teenagers who become parents are known to experience greater educational, health, social and economic difficulties than young people who are not parents. Looked after children and young people are at greater risk of early pregnancy and social disadvantage than other groups.
In 2004-2005 nationally, 2.4% of all female looked after children (aged 12 to 18 years) were young mothers. The corresponding figure for the same period for Royal Borough looked after children was 7.8%. It should be noted however that this relates to only five young people, as numbers overall are small. For 2005-2006, the percentage of female looked after young people (aged 12 to 18 years) who are mothers has halved to 3.7%, which represents two young mothers.
Reliable information is not available on the number of looked after young people who have become fathers. Three male care leavers are known to be parents and are receiving support. Ensuring that the SRE needs of young men and young fathers are squarely addressed is an important objective of this policy.
As of September 2005, 8 care leavers (3.1%) had recently given birth and from the total population of Royal Borough care leavers (footnote 5), 20 (7.8%) were parents with children living with them.
Access to good quality sex and relationship education has been demonstrated to reduce levels of teenage pregnancy and looked after children and young people are known to have less access to good quality, consistent sources of sex and relationship education and advice than other children and young people.
The incidence of sexually transmitted disease has been rising in the United Kingdom in recent years, particularly among young people. Between 1991 and 2001, the number of new episodes of sexually transmitted infections (STIs) seen in Genito-Urinary Medicine (GUM) clinics in England, Wales and Northern Ireland doubled from 669,291 to 1,332,910. Young people, in particular young women under the age of 20, bear the burden of sexually transmitted infections (National Statistical Office).
Chlamydia is the most common sexually transmitted infection. The number of cases has risen steadily since the mid 1990s and more than tripled from 30,794 cases diagnosed in 1995 to 109,958 in 2005 with highest rates being found in London (National Statistical Office).
Providing vulnerable looked after children and young people with access to appropriate and timely SRE advice and support can make a crucial difference to combating the transmission of infection and promoting sexual health and well being, on an individual and also collective basis.
There is increased awareness in schools about the prevalence of homophobic bullying of pupils, which may include vulnerable looked after young people. A survey of secondary schools found respectively that 82% and 26% of teachers were aware of either verbal or physical homophobic incidents (footnote 6). Currently there is no national or local data relating to looked after young people and sexual orientation.
Furthermore, whilst the majority of young people can look forward to safe and loving sexual relationships, sexual abuse, exploitation and violence in relationships can pose real risks for some. Looked after children and young people, with their mixed experiences of positive family life and role models can be particularly vulnerable to these dangers.
6. Royal Borough's Quality Standards
The principles for ensuring looked after children’s entitlement to SRE are embedded in the following 12 standards. These are further developed in the action plan and contain a commentary from young people with care experience (see Standard 4 ). The action plan will be subject to regular reviews and updated to reflect new priorities as these develop.
Implementation of these standards is applicable to looked after children of both genders and particular emphasis will be placed on ensuring boys and young men, as well as girls and young women, have access to SRE.
The SRE standards are also applicable irrespective of the location of the young person’s placement. As a significant majority of the Royal Borough looked after young people are placed outside of the authority, compliance with these standards will be monitored by the LAC Nurse and Independent Review Officers (see Standard 4 below).
Standard 1 – Every looked after child is supported to identify an adult (footnote 7) who will agree to become responsible for ensuring access to SRE, which is relevant to them and sensitive to their needs, gender and sexual orientation.
Standard 2 - Looked after children are entitled to confidentiality and privacy when discussing sex and relationship issues. Staff and carers have access to DfE guidance in this area.
Standard 3 – To promote good health and making healthy choices, looked after children are offered the opportunity to discuss SRE related issues with the LAC nurse or other health professional, either through their health assessment, or as a result of contact initiated by the young person, parent, carer or social worker.
Standard 4 – Looked after children are encouraged to attend and participate in school based SRE. The LAC nurse, independent review officers, carers and school nurses will identify young people who have for any reason (e.g. placement change) been unable to attend school based SRE or alternative provision in other education or youth service settings. This includes identifying children who have significant gaps in their education e.g. unaccompanied minors and ensuring that children placed outside of the Royal Borough have equality of access to SRE.
Standard 5 - Looked after children are provided with a child friendly, accessible SRE information pack, appropriate to their age, gender, understanding and development, which explains how to access confidential advice, health and support services.
Standard 6 – Looked after young men and women (and where appropriate boys and girls) will be involved in designing and drawing up the SRE information pack and any other associated materials.
Standard 7 – Parents, foster carers and residential staff are provided with information about the provision of SRE including; a summary of this policy, relevant DfE guidance and clarity on their respective roles in ensuring that young people receive consistent, high quality SRE support and information.
Standard 8 – SRE information, guidance and training is mandatory, in accordance with this policy, for all staff and carers working with looked after children.
Standard 9 – Looked after children are involved in planning and evaluating formal SRE sessions to ensure their needs are met and any preferences about the approach is fully taken into account.
Standard 10 – Access to specialist SRE and advice is provided to Children with Disabilities, their parents and carers with appropriate training provided for staff.
Standard 11 – Looked after children who wish to seek SRE advice based on religion, culture or meeting their linguistic needs are provided with information and helped to access appropriate sources of assistance.
Standard 12 – Looked after children who become pregnant or teenage parents are a high priority and will be supported to access services that are specifically targeted to this group. This includes health services, parenting, family support, play and childcare services, and Education, Employment and Training programmes.
7. References
- Sex and Relationship Education Guidance – Headteachers, Teachers & School Governors. (DfES 2000).
- Enabling Young People to Access Contraceptive and Sexual Health Information and Advice: Legal and Policy Framework for Social Workers, Residential Social Workers, Foster Carers and other Social Care Practitioners. (DfES, Teenage Pregnancy Unit 2004).
- Best practice guidance for doctors and health professionals on the provision of advice and treatment to young people under 16 on contraception, sexual and reproductive health. (Department of Health July 2004)
- What to do if you are worried a child is being abused Children’s Services Guidance (Joint publication from the Department of Health, Home Office, Office of the Deputy Prime Minister, Lord Chancellor, Department of Education and Skills).
- Guide for field social workers, residential social workers and foster carers on providing information and referring young people to contraceptive and sexual health services (quality protects) - to follow
- Care Matters: Transforming the Lives of Children and Young people in care
- Sex and relationship education guidance (excellence in schools)
- Stand up for us: Challenging homophobia in schools
Further Information Available From
- Teenage Pregnancy Unit
- Brook
- Sex Education Forum
- Department for Children, Schools and Families
- Department of Health
- Home Office
- Stonewall
- Terence Higgins Trust
8. Acknowledgements
The following people and services have contributed to the development of the policy:
- Young People at St. Marks Resource Centre
- LAC Review and Support team/LAC nurse
- Royal Borough Foster Carers
- St. Marks Children’s Resource Centre
- Whistlers Walk Children’s Home
- Family Placement team
- Adoption and Permanency team
- Children with Disabilities team
- Full of Life
- Locality Social work teams
- Unaccompanied Minors Team
- Independence Support team
- Youth Support and Development health/drugs education
- School nurses, PCT
- Brook Advisory Educational Outreach team
- Space KC
Appendix 1
These areas are covered in Family and Children’s staff guidance and procedures for staff and carers in contact with looked after children, and available on the Family and Children’s Services Intranet.
- confidentiality
- anti-discriminatory practice
- relationships
- ages of consent
- puberty and personal hygiene
- sexual orientation
- sexual relationships in the placement
- safe sex
- contraception including emergency contraception
- sexually transmitted infections
- Aids and HIV
- Pregnancy
- parenthood
- referral for termination of pregnancy
- pornography
- sexual exploitation and prostitution
- masturbation
- cross dressing
- effects of alcohol and drugs
- sexualised and/or promiscuous behaviour
Additionally, signposts are provided to the National Children’s Bureau Sex Education Forum which has a wealth of informative and up to date advice and information.
DfES have issued specific guidance for social workers, residential social workers, foster carers and other social care practitioners on ‘Enabling young people to access contraceptive and sexual health information and advice’.
Appendix 2 - Information Sharing, Privacy and Confidentiality
Looked after children are entitled to confidentiality when discussing sex and relationship issues. They need to know that there are adults that they can turn to for information, guidance and advice that will remain confidential. This might involve explaining to the young person that professionals are bound by different codes of practice in terms of the exceptional circumstances when confidentiality could be breached. At the same time information should be provided about organisations that they could turn to and remain anonymous. Examples of codes of practice for health and social care practitioners are provided below whilst acknowledging that looked after children are in contact with a range of other professionals.
Health professionals have a duty not to disclose information about an individual patient, whatever their age, except in the most exceptional situations, where the health, safety or welfare of the individual, or others, is at risk. These exceptions to the overriding right to confidentiality, relate to the degree of actual or potential harm, rather the age of the individual concerned.
Social workers and their employers adhere to statutory codes of practice, which set out the standards of conduct workers and their employers should meet. These include that social workers must:
- Protect the rights and promote the interests of service users and carers;
- Strive to establish and maintain the trust and confidence of service users and carers;
- Promote the independence of service users while protecting them as far as possible from danger or harm;
- Respect the rights of service users whilst seeking to ensure that their behaviour does not harm themselves or other people;
Under the Data Protection Act 1998 organisations must keep information accurate and up to date, only keep it for as long as they need it for a specified purpose and secure. Personal data consisting of information relating to a person’s sexual life is classed as ‘sensitive personal data’ and is governed by more stringent rules in terms of secure data storage. The Information Commissioner’s Office is the UK’s independent authority to protect personal information and can be contacted for further information.
A Children’s Information Sharing Protocol is in place between the Royal Borough of Kensington and Chelsea and health partners. This covers areas such as: obtaining consent for information sharing, capacity to make an informed decision, recording and checking for consent and disclosing information without consent.
Appendix 3 - Definitions
The World Health Organisation offers the following definitions (footnote 8):
- Sexuality - a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors
- Sexual health - is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity’. It encompasses HIV and Sexually Transmitted Infections (STIs), unintended pregnancy and abortion, infertility and cancer resulting from STIs, and sexual dysfunction. Sexual health can also be influenced by mental health, acute and chronic illnesses, and violence.
- Sexual rights - for all persons to be free of coercion, discrimination and violence to:
- achieve the highest attainable standard of sexual health,
- including access to sexual and reproductive health care services;
- seek, receive and impart information related to sexuality;
- have access to sex education;
- respect for bodily integrity;
- choose their partner;
- decide to be sexually active or not;
- consensual sexual relations;
- consensual marriage;
- decide whether or not, and when, to have children; and
- pursue a satisfying, safe and pleasurable sexual life.
The responsible exercise of human rights requires that all persons respect the rights of others.
Footnotes
- Reference is made to ‘children’ throughout the document but this extends to young people, including care leavers up to the age of 21 years and sometimes beyond.
- Consultation with young people at St Mark’s Resource Centre 2006
- Children and Young Person’s Plan
- The Teenage Pregnancy Report (1999) underpinning the Government’s Teenage Pregnancy Strategy, Social Exclusion Unit.
- Note – this is a different cohort of young people to those cited in Section 5, Sixth Paragraph as the time frame and definitions are not the same
- Healthy Schools website
- parent, carer, relative or friend, LAC nurse, school or health staff, or social worker
- World Health Organistion website
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