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Sexual safety policy

Contents

  1. Policy summary
  2. Introduction
  3. Purpose
  4. Scope
  5. Procedures
  6. Responsibilities and safeguarding
  7. Principles
  8. Training implications
  9. Equality impact assessment screening
  10. Links to any other associated documents
  11. References
  12. Appendices

1 Policy summary

RDASH has joined NHS England’s Sexual Safety Charter to commit to a zero-tolerance approach to any unwanted, inappropriate and/or harmful sexual behaviours in the workplace.

As an organisation the Trust has a responsibility to our patients, colleagues, visitors, and volunteers to respond to any sexual safety incidents that may occur on trust premises or in patients own homes.

2 Introduction

The introduction of the Sexual Safety in Healthcare, Organisational Charter (NHS England 2023) has superseded the CQC report ‘Sexual Safety on Mental Health Wards’ (2018).

The trust is committed to the following principles and actions to achieve a zero-tolerance approach:

  1. We will actively work to eradicate sexual harassment and abuse in the workplace.
  2. We will promote a culture that fosters openness and transparency, and does not tolerate unwanted, harmful and/or inappropriate sexual behaviours.
  3. We will take an intersectional approach to the sexual safety of our workforce, recognising certain groups will experience sexual harassment and abuse at a disproportionate rate.
  4. We will provide appropriate support for those in our workforce who experience unwanted, inappropriate and/or harmful sexual behaviours.
  5. We will clearly communicate standards of behaviour. This includes expected action for those who witness inappropriate, unwanted and harmful sexual behaviour.
  6. We will ensure appropriate, specific, and clear policies are in place. They will include appropriate and timely action against alleged perpetrators.
  7. We will ensure appropriate, specific, and clear training is in place.
  8. We will ensure appropriate reporting mechanisms are in place for those experiencing these behaviours.
  9. We will take all reports seriously and appropriate and timely action will be taken in all cases.
  10. We will capture and share data on prevalence and colleagues experience transparently.

3 Purpose

The sexual safety policy is applicable to all patients, colleagues, volunteers, and visitors including people who have a different gender to the one assigned at birth; sexual orientation or identification; disability, physical health, employment, or marital status in accordance with the Equality Act (2010).

This policy will:

  • support colleagues to ensure that: sexual wellbeing is promoted and that all concerns relating to “sexual incidents” are listened to and actioned appropriately
  • consider the professional boundaries between colleagues, patients, volunteers, and visitors
  • enable colleagues to understand their responsibilities in relation to sexual activity between patients
  • support all persons who may be subject of a “sexual incident”
  • ensure those who lack the mental capacity to make decisions are protected whilst in the care of the trust
  • ensure allegations of sexual abuse are reported to the Police
  • ensure sexual incidents are reported to the safeguarding team and the Ulysses IR1 system.

3.1 Sexual Safety Charter group

The steering group is to provide a space for people to connect and be empowered to inform a safe, transparent culture in the Trust that fosters the importance of an environment that does not tolerate unwanted, harmful and/or inappropriate sexual behaviour. We hope that membership of the group will be diverse and made up of people from different areas within the Trust and people from a variety of diverse groups, as we recognise that certain groups are disproportionately impacted by sexual harassment and abuse.

4 Scope

This document applies to and is relevant across:

  • All RDASH colleagues
  • Patients
  • Visitors
  • Volunteers
  • Contractors

For further information about responsibilities, accountabilities, and duties of all employees, please see appendix A.

5 Procedure

5.1 Quick guide

5.1.1 Sexual safety incident (urgent)

  • If rape or attempted rape or non-consensual penetration of vagina, anus or mouth and non-fatal strangulation contact police on 999 and escalate to senior managers and Safeguarding team.
  • Preserve any evidence and encourage individual not to wash or change clothes.
  • Protect individual from harm and if injured to get medical treatment.

5.1.2 Sexual safety incident

  • Ensure individual is safe from harm.
  • If medical treatment is required. Ensure this is provided with information of the incident.
  • Support individual to express how they feel and what actions are required.

5.1.3 Advice

  • Out of hours contact on call manager
  • Contact safeguarding supervisor or RDASH Safeguarding team

5.1.4 Report

  • Complete IR1 incident form
  • Duty of Candour
  • Complete safeguarding adult concern form if individual is an ‘adult at risk’ as defined by Care Act 2014
  • Refer to children’s social care if a child is under 18 years of age

5.1.5 Record

  • Update electronic patient record including what actions have been taken

5.2 Definitions

5.2.1 Sexual incidents

Any behaviour of a sexual nature that is unwanted, or makes another person feel uncomfortable or afraid. Sexual incidents can involve patients, colleagues, visitors, contractors, and volunteers either as a victim or a perpetrator. Sexual incidents can be broadly defined as physical or non-physical.

5.2.1.1 Physical
  • Rape
  • Attempted rape
  • Inappropriate touching anywhere (including use of objects).
  • Non-consensual masturbation of either or both persons
  • Non-consensual sexual penetration or attempted penetration of vagina, anus or mouth with objects other than penis.
  • Non-fatal sexual strangulation or suffocating
5.2.1.2 Non-physical sexual harassment
  • Inappropriate looking
  • Sexual teasing or innuendo
  • Sexual harassment
  • Unwanted exposure of pornography
  • Witnessing sexual acts
  • Indecent exposure

5.2.2 Grooming

Is when a person builds a relationship with a child, young person or an adult so they can abuse them and manipulate them into doing things sexual, financial or other illegal acts. It can take place online or in person and can happen over a short or long period of time.

5.2.3 Sexual safety

Feeling safe from any unwanted behaviour of a sexual nature and feeling safe from sexual harm.

5.2.4 Sexual consent

Consent is defined by section 74 Sexual Offences Act 2003.

“Someone consents to vaginal, anal or oral penetration only if he or she agrees by choice to that penetration and has the freedom and capacity to make that choice”.

6 Responsibilities and safeguarding

6.1 Adults and children who experience a sexual safety incident

If rape or attempted rape or non-consensual penetration of vagina, anus or mouth and non-fatal strangulation:

  • Report immediately to the police (999) and escalate to line manager and Safeguarding team.
  • Preserve any evidence, for example bag clothing and bedding to prevent cross contamination (police will need this for forensic examination)
  • Try to prevent individual from washing.
  • If the individual requires medical treatment, then this must be prioritised, and history of injury relayed to medical team or the Emergency department to ensure preservation of evidence.
  • Provide individual privacy and support while waiting for the police.
  • If the alleged perpetrator is a patient, then provide support until police arrive.
  • If the alleged perpetrator is a member of colleagues, then police will lead investigation until RDaSH policies can be invoked.
  • If alleged perpetrator leaves the incident area, obtain a description. Do not put yourself at risk to pursue.
  • If a sexual safety incident has occurred to contact 999 or 101 depending on severity
  • Immediate action should be taken to protect the individual from further harm.
  • If the individual is an ‘adult at risk’ as defined by the Care Act 2014 then a safeguarding concern must be submitted to the local authority. For further information please refer to the safeguarding adults policy
  • If the individual is a child (under the age of 18) please refer to the safeguarding children policy
  • An IR1 must be completed for any sexual safety incident (please refer to incident management policy) and if this involves a patient, document the incident and what actions were taken on the electronic record (please refer to healthcare record-keeping policy).
  • All incidents must be reported to Safeguarding team and if out of hours to on call manager.
  • If the alleged perpetrator of a sexual incident is a member of colleagues, then the person in a position of trust policy (PiPoT) will be invoked.

Consideration must be made for patients who may not have capacity to make decisions for themselves for example patients with learning disabilities and patients detained under the Mental Health Act. For advice and support please contact RDASH Mental Capacity Act Lead or the Safeguarding team.

6.1.1 Other considerations

Further to the above consideration must be made in conjunction with the police and Consultant whether the victim requires:

  • Emergency contraception and follow-up pregnancy test.
  • Post exposure prophylaxis (PEP) for Human Immunodeficiency Virus (HIV)
  • Referral to sexual abuse referral centres (SARC)

6.1.2 Non-physical incidents (sexual harassment)

Sexual harassment is unlawful and prohibited under The Equality Act 2010. The term sexual harassment encompasses a wide range of behaviour, which may take place in person, online or over the phone. A single event or a series of events can amount to sexual harassment. This can be aimed at an individual or there may be a culture of sexual harassment which is not specifically aimed at one person.

Any such behaviours should be reported via incident report and escalated to line manager. Some people may feel more comfortable to reporting via Safeguarding team and freedom to speak up (FTSU).

6.1.2.1 Impact of sexual harassment

The negative impact on people who have been victims of this behaviour can be presented in different ways and we should be mindful of this. Some symptoms are:

  • Post traumatic stress disorder
  • Anger
  • Guilt self blame
  • Lack of trust especially if professional boundaries have been breached.
6.1.2.2 Reducing the risk and keeping safe
  • Be vigilant and take action if any observations are made regarding sexual incidents.
  • Single gender corridors and bathrooms
  • Identify risks and support with the devising of protection plans.
  • Ensure that any historical abuse is documented, and care plans devised.
  • Colleagues will listen and respond to any sexual safety incidents.
  • Colleagues will be trained on managing professional boundaries and maintaining professional standards.
  • Utilise Oxevision and CCTV
  • Seek advice and support from the safeguarding team and/or patient safety team.
6.1.2.3 Colleague as a victim
  • Support colleagues to report to police.
  • Undertake actions as previously stated within this policy.
  • Offer support via RDASH Health and Wellbeing Team
  • Support from FTSU
6.1.2.4 Colleague as perpetrator
  • Report to police.
  • Instigate person in a position of trust (PiPoT) procedures if the victim is an adult.
  • Instigate Local Authority designated officer (LADO) procedures, if it is a child or if the perpetrator works with children.
  • Sign post to respect phone line.
  • Refer to Health and Wellbeing team.
  • Ensure that the victim and alleged perpetrator do not have any contact.
6.1.2.5 Patient as a Victim and as a perpetrator

If any incidents of a sexual nature take place on inpatient wards between patients, this is a safeguarding incident regardless of consent/capacity at the time. Decisions made by someone who is unwell, lacks capacity and vulnerable, can impact not only on their lives but family too. As a trust we have a duty to ensure their safety and to put measures in place to minimise the risk. This would include putting immediate safeguards in place, discussions with the individuals involved and capacity assessment regarding decision-making. Support can be sought from the Safeguarding team and the Patient Safety team.

6.1.2.6 Malicious allegations

If it is identified that a colleague has made malicious allegations against another colleague, then this should be treated as a serious disciplinary procedure and action will be taken.

7 Principles

The fundamental actions point of this policy and procedural guidance are:

  • That all colleagues are aware of their responsibilities in relation to any sexual safety incidents that may have occurred within RDaSH services.
  • That any sexual incident will be appropriately actioned whether the individual is a victim or perpetrator.

8 Training implications

Training for use of this policy will be included in safeguarding training delivered by the RDASH safeguarding team.

Additional, bespoke training may be accessed via the RDaSH Safeguarding team. However, it is not mandatory.

All colleagues need to be aware of the policy and this can be via:

  • All user emails for urgent messages
  • RDASH app
  • Safeguarding intranet
  • Group supervision
  • One to one supervision
  • Continuous professional development
  • Team meetings
  • Posters

9 Equality impact assessment screening

To access the equality impact assessment for this policy, please email rdash.equalityanddiversity@nhs.net to request the document.

9.1 Privacy, dignity and respect

The NHS Constitution states that all patients should feel that their privacy and dignity are respected while they are in hospital. High Quality Care for All (2008), Lord Darzi’s review of the NHS, identifies the need to organise care around the individual, ‘not just clinically but in terms of dignity and respect’.

Consequently, the trust is required to articulate its intent to deliver care with privacy and dignity that treats all service users with respect. Therefore, all procedural documents will be considered, if relevant, to reflect the requirement to treat everyone with privacy, dignity, and respect, (when appropriate this should also include how same sex accommodation is provided).

9.1.1 Indicate how this will be met

No issues have been identified in relation to this policy.

9.2 Mental capacity act (2005)

Central to any aspect of care delivered to adults and young people aged 16 years or over will be the consideration of the individual’s capacity to participate in the decision-making process. Consequently, no intervention should be carried out without either the individual’s informed consent, or the powers included in a legal framework, or by order of the court.

Therefore, the trust is required to make sure that all colleagues working with individuals who use our service are familiar with the provisions within the Mental Capacity Act (2005). For this reason, all procedural documents will be considered, if relevant to reflect the provisions of the Mental Capacity Act (2005)to ensure that the rights of individual are protected, and they are supported to make their own decisions where possible and that any decisions made on their behalf when they lack capacity are made in their best interests and least restrictive of their rights and freedoms.

9.2.1 Indicate how this will be achieved

All individuals involved in the implementation of this policy should do so in accordance with the guiding principles of the Mental Capacity Act 2005 (section 1).

There are additional policies and procedures that interlink with this policy:

11 References

12 Appendices

12.1 Appendix A Responsibilities, accountabilities and duties

12.1.1 Executive Management team

The Executive Management team is responsible for approving the sexual safety policy and for its approval, dissemination, and implementation.

12.1.2 The chief nurse

The chief nurse will, on behalf of trust board, ensure that this policy is implemented and that documents are controlled in accordance with non-clinical records management requirements.

12.1.3 The deputy director of nursing

The deputy director of nursing will, on behalf of trust board, ensure that this policy is implemented and that documents are controlled in accordance with non-clinical records management requirements.

12.1.4 The nurse consultant for safeguarding

The nurse consultant for safeguarding will have oversight of the policy and act as a point of escalation for matters requiring this and seek to achieve resolution.

12.1.5 Specialist staff

The lead professionals for safeguarding adults and the named professionals for safeguarding children have a frontline role in supporting the nurse consultant and associated directors in developing and implementing this policy. The Safeguarding team are responsible for giving advice to clinical teams regarding sexual safety incidents from a safeguarding perspective.

The Safeguarding team will liaise directly with members of staff throughout the trust regarding any matters requiring specialist support, advice and guidance.

12.1.6 All trust staff

All trust colleagues must be aware of the Sexual Safety policy and how it impacts on practice. Colleagues have a responsibility to seek advice if a sexual safety incident has occurred. Colleagues must ensure that all incidents relating to sexual safety are reported using the Ulysees IR1 reporting system to ensure the Trust has a robust mechanism for monitoring incidents of a sexual nature.

12.2 Appendix B Monitoring arrangements

12.2.1 Incidents of a sexual safety nature

  • How: Collation of IR1 forms.
  • Who by: Safeguarding team and Patient Safety team.
  • Reported to: Ulysses.
  • Frequency: Yearly.

12.2.2 Themes of discussions with practitioners and supervision

  • How: Analysis of themes of safeguarding contacts.
  • Who by: Safeguarding team.
  • Reported to: Safeguarding team.
  • Frequency: Yearly.

12.3 Appendix C standards

Everyone has the right to feel safe from sexual harm. We do not want anyone to feel uncomfortable, frightened, or intimidated in a sexual way. We will work to promote everyone’s sexual safety by meeting the following standards.

  • Standard 1: I respect myself.
  • Standard 2: I treat others with respect and dignity.
  • Standard 3: I understand that sexual activity with another person should be for mutual pleasure and never used for punishment or through coercion.
  • Standard 4: I do not try to talk someone else into engaging in sexual activity or harass another person sexually.
  • Standard 5: I try to be aware of how my behaviour makes others feel, and will change my behaviour if someone tells me it makes them uncomfortable, or I will ask for help with this if I need to.
  • Standard 6: I understand that fulfilling my own sexual needs through masturbation must be conducted privately and discreetly.
  • Standard 7: I will speak up if I have been hurt, harassed, or assaulted sexually.
  • Standard 8: I will speak up if I see or hear about someone else being hurt, harassed, or assaulted sexually.

12.4 Appendix D sexual safety incident identified

  1. Sexual safety incident identified.
  2. Ensure safety of victim, access medical services (emergency department and SARC), all practical steps to safeguard victim to be taken.
  3. Preservation of evidence and report to the police as soon as practicable, if this has happened on an inpatient ward then seal off rooms or restrict access, prevent showering if at all possible of victim or perpetrator.
  4. If this occurs in hours, liaise with unit or service managers or if this occurs out-of-hours, liaise with on call managers for further support and advise.
  5. Consider safeguarding:
    • safeguarding concern?
    • safeguarding protection plan (for both victim and alleged source of harm)
  6. In hours seek additional support, advice and guidance from the Safeguarding team, out-of-ours notify the Safeguarding team by email (this will be actioned the next working day).
  7. Complete contemporaneous documentation, incident report to be completed under the category of sexual safety.

Document control

  • Version: 2.
  • Unique reference number: 597.
  • Approved by: Clinical policy review and approval group.
  • Date approved: 6 August 2024.
  • Name of originator or author: Safeguarding adults lead professional.
  • Name of responsible individual: Chief Nurse.
  • Date issued: 27 August 2024.
  • Review date: August 2027.
  • Target audience: All trust colleagues.
  • Description of change: Inclusion of NHS England sexual safety charter.

Page last reviewed: December 11, 2024
Next review due: December 11, 2025

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