STAFF/CLIENT RELATIONSHIPS POLICY
Foreword
This policy is to be read in conjunction with the, “Gloucestershire County Council Code
of Conduct and Confidential Reporting Procedure (Whistle-Blowing) for Employees”
The County Council Code of Conduct forms the over-arching arrangements for the
matters set out below. However, due to the very nature of the work of the Social
Services Department, where relationships are formed with Clients, specific guidance is
necessary to assist employees in carrying out their duties. It is extremely important that
this policy is read, understood, applied and abided by all Social Services staff and those
who provide services on behalf of the Department. Should you need clarification on any
aspects of this document and the various contexts to which it applies, you should
address queries to your line manager in the first instance.
Introduction
Illness, disability and social circumstances can cause people to become vulnerable which
may compromise their ability to act independently raising their need to rely on others
for assistance. Some groups of people are particularly vulnerable to abuse, for example,
those who are physically frail or have mental health problems; people with a learning
disability and children all require special consideration. People who live in residential or
nursing home accommodation and those who are emotionally upset or socially isolated
are also at additional risk. It is important that all staff who work with service users are
aware of a possible power imbalance in the relationship they have with the people they
help, support and enable. This can develop into such a situation that the user or the
County Council employee can seek advantage from the relationship.
The employee should be aware that the County Council has a duty of care toward all
service users and will therefore investigate any reported incidents. This may cause
undue concern for the employee to be investigated for an allegation that may not have
occurred. It should also be noted that the County Council will not tolerate any member
of its staff breaching their responsibility by any act or omission that causes or permits
the abuse of a service user or allows improper relationships to develop. This is the only
philosophy that is consistent with protecting service users and the general public from
harm.
The County Council is also responsible for ensuring that staff can carry out their duties
in an environment that is safe and supportive.
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PURPOSE
1.
This document aims to provide advice and guidance to managers and staff with
regard to situations where personal relationships have the potential to
compromise any individual or the Department in respect of their duties and
responsibilities.
2.
The emphasis of the guidance is on safeguarding the interests of staff, service
users and the Department. This is particularly important in view of both the
vulnerability of service users to the abuse of power and the vulnerability of staff
to allegations concerning their conduct.
3.
The Department acknowledges the difficulty of distinguishing in practice
between inappropriate personal and legitimate professional relationships and
provides this guidance to assist in defining the parameters.
4.
While it is impossible to be totally prescriptive, the general guideline should be
that; if the relationship can be viewed by a third party, as potentially seeing a
member of staff in a situation where their conduct could create an impression of
conflict of interest, or corruption, in the minds of the public, then the likelihood
is that the relationship is inappropriate.
5.
Please note that there is no intention to suggest that staff may not be able to continue
to enjoy relationships with persons that are already known to them or that they come
to know during employment, where the person receives a service from the Department.
What is important is whether there may be a conflict of interests or whether the
professional accountabilities may be compromised by the relationship. Therefore in the
interests of the service user and the employee, there will be a requirement for the
employee to discuss the matter with his or her line manager. This is made clear within
this document at paragraphs 3 and 4.
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PRINCIPLES
General Conduct
The conduct of employees generally are subject to the provisions of the National
Conditions of Service and the County Council’s Code of Conduct. A breach of this
policy could lead to the instigation of the disciplinary procedure.
Staff Service User Relationships
1. The only appropriate professional relationship between a service user and a member
of staff is one that focuses upon the needs of the service user. Staff should be aware of
the potential imbalance of power in this relationship caused by the service user’s
need for care, assistance, guidance and support. It is the responsibility of each
member of staff to maintain appropriate professional boundaries within relationships
at all times. Staff are also accountable for ensuring that they promote and protect the
interests of each service user they work with irrespective of gender, age, race,
disability, sexuality, culture or religious beliefs.
2. Helping and supporting others can be rewarding, enjoyable and fun. It can also be
both physically and emotionally demanding and draining. Boundaries are therefore
required in order to allow a service user and a member of staff to engage safely in a
professional caring relationship. These boundaries should be based upon trust,
appropriate use of power and should ensure that service users and their decisions
about their own care are treated with respect. The relationship must focus upon the
needs of the service user; moving the focus away from the service user and towards
the staff member’s own needs is an unacceptable abuse of power.
3. All professional relationships contain the potential for conflicts of interest. Staff
may, on occasions, develop strong feelings for a particular service user or family.
These feelings in themselves are neither abnormal nor wrong. They only
compromise the relationship if they are acted upon improperly. Where personal or
business relationships exist, the staff members will report this to their line manager
who may offer guidance and assistance. It is the individual responsibility of each
worker to maintain each relationship within its own appropriate boundary.
4. There will be situations where the ‘appearance’ of a possible relationship between a
member of Staff and a service user is open to being misconstrued. Staff who find
themselves in a difficult situation, which may be open to being misconstrued, must
report the matter to their line Manager. Line Managers will ensure that this
information is recorded and guidance given to the member of Staff.
5. Physical contact is integral to the provision of personal care. Supportive physical
gestures can also be essential in providing help and reassurance.
In no
circumstances can the physical abuse and/or striking of a service user be acceptable,
and will be treated as a gross misconduct.
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Definitions
6. Abuse within the staff-service user relationship is the result of the misuse of power
or a betrayal of trust, respect or intimacy between the practitioner and the service
user, which the staff member should know could cause physical or emotional harm
to the service user. Abuse takes many different forms and may be physical,
psychological, verbal, sexual, financial/material or based upon neglect.
7. Abuse may be identified or suspected by a number of different people, including the
abused person themselves, their carers, family members, advocates and members of
the social care or health team.
8. All staff have a responsibility to protect service users from all forms of abuse.
Physical abuse
9. Physical abuse is any physical contact that harms a service user or is likely to cause
them unnecessary and avoidable pain or distress. Examples include handling the
service user in a rough manner, giving medication inappropriately, poor application
of manual handling techniques or unreasonable physical restraint. Physical abuse
may also cause psychological harm.
Psychological abuse
10. Psychological abuse is any verbal or non-verbal behaviour that demonstrates
disrespect and which could be emotionally or psychologically damaging. Examples
include mocking, ignoring, coercing, and threatening to cause physical harm or
denying privacy.
Verbal abuse
11. Verbal abuse is any remark which may reasonably be perceived to be demeaning,
disrespectful, humiliating, intimidating, racist, sexist, homophobic, ageist or
blasphemous. Examples include making sarcastic remarks, using a condescending
tone of voice or using excessive and unwanted familiarity.
Sexual abuse
12. Sexual abuse is forcing, inducing or attempting to induce to engage in any form of
sexual activity. This encompasses both physical behaviour and remarks of a sexual
nature made towards the service user. Examples include touching a service user
inappropriately or engaging in sexual discussions which have no relevance to the
service user’s care.
Financial/material abuse
13. Financial/material abuse involves not only illegal acts such as stealing a service
user’s money or property but also the inappropriate use of funds, property or
resources. Examples include borrowing property or money, inappropriate
withholding of money or possessions and the inappropriate handling of, or
accounting for, money or possessions.
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Neglect
14. Neglect is the refusal or failure on the part of a member of staff to meet the essential
care needs of a service user. Examples include failure to attend to the personal
hygiene of a service user, failure to communicate adequately and the inappropriate
withholding of food, fluids, clothing, medication, medical aids, assistance or
equipment.
No tolerance of abuse
15. If it is suspected that abuse has occurred or is occurring, then this must always be
immediately reported. Reports of abuse must always be treated seriously and
properly, promptly and thoroughly investigated. Where the allegation appears to
implicate a member of staff the Authority’s disciplinary procedures will be invoked
and the allegation investigated without delay and in accordance with the
procedure’s requirements. Failure to report suspected abuse will be regarded as a
disciplinary matter.
Preventative Measures
16. Breaches of the boundary of the professional relationship between the staff member
and service user increase when potentially abusive situations are not detected. If the
proper professional boundaries are to be maintained, it is of paramount importance
that the potential for abuse is openly acknowledged by all concerned.
17. Emotions aroused in the course of a caring relationship on the part of either the
practitioner or the service user do not necessarily disappear as soon as the service
user is discharged from care. Staff must very carefully consider whether it is ever
appropriate to continue anything other than a purely professional relationship with
a service user or a former service user. The Authority will still regard the staff
member as accountable for maintaining correct boundaries when professional
relationships do continue as personal relationships with a service user outside of
work.
18. When practitioners and service users engage in a close therapeutic relationship, the
potential and opportunity for the relationship to develop in an improper manner
increases. In order to maximise the safety of both the service user and the
practitioner, special consideration should be given to those staff who work in
isolation or in largely unsupervised situations. Line Managers will ensure that Staff
have access to appropriate supervision and support.
Specific Guidelines
To assist all parties in defining appropriate professional boundaries the following
guidance is relevant:
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Private Work for Service Users
19. A member of staff should not work privately for a service user of the Department.
Nor should they arrange for private work to be undertaken by a third party. Staff
will inform their line manager if this is contemplated to seek advice and guidance on
how to proceed.
Buying or selling articles/goods to Service Users.
20. On no account is it considered appropriate for a member of staff to buy or sell
articles/goods to service users of the Department during the course of their work.
The utmost care should be taken regarding any such arrangements made outside of
work and such arrangements should be subject to the prior approval of the Line
Manager. Situations where it would be unintentional and difficult to avoid as in the
case of a classified advertisement or car boot sale are excepted. If the service user is
known to the staff member then it would be advisable to let the manager know
subsequently.
Cashing cheques for Service Users
21. Arrangements for cashing cheques for service users by members of staff can only be
authorised by the Line Manager. In no circumstances will a member of staff allow a
third party to carry out such an arrangement unless authorised by the Line Manager.
Contact with Service Users outside work time
22. Use of Member of Staff’s Homes
No member of staff must take a service user to their home or any other private or
unauthorised residence. Only in highly exceptional circumstances, where it is
believed that a service user may receive particular benefit may a member of the
DMT authorise the arrangement.
Staff should not offer accommodation or other services to a service user in their own
home. However, it is recognised that a member of staff’s spouse/partner may seek
to provide day services (i.e. as a child minder) in the member of staff’s own home,
that may also be available to service user’s. In this case, the member of staff should
notify their manager and seek guidance.
The policy ‘Employees who wish to become foster carers for children or substitute
carers for adults’ should be applied in relation to staff who wish to become foster
carers for children or substitute carers for adults. It should be noted that the
Department is obligated to review these arrangements if the member of staff is being
investigated or is undergoing disciplinary proceedings.
23. Friendship with Service Users
There may be circumstances where a member of staff has a friend who becomes a
service user, or becomes friends with a service user, or becomes friends with
previous service users. In these circumstances the member of staff must discuss this
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with their line manager who will advise on any conflicts of interest or potentially
adverse consequences, and ensure the confidentiality of service user records. It
should be noted that intimate, sexual friendships between members of staff and
current service users are not allowed on any account where there is a work
relationship. In the event that the relationship is with a previous service user, the
member of staff needs to be aware that the Department may have a legitimate cause
to conduct an investigation to establish whether the relationship began to develop
when the individual was a service user.
Members of staff may be asked to help out friends on a professional basis i.e. by
advising them on child or adult care arrangements. Staff should have regard to any
relevant code of practice/guidance, and should make it clear that any advice given
is in a purely private capacity. If the individual receiving the advice, or their
spouse/partner subsequently becomes a service user, the member of staff must
advise their line manager.
Use of Service Users Homes
24. Members of staff will not hold service user’s keys unless authorised to do so by the
Line Manager. Members of staff will not enter Service User’s unoccupied homes
unless authorised by the Line Manager and are accompanied by another employee
of the Authority.
Gifts, Loans and Bequests
25. Members of staff must not receive gifts, loans or bequests (property or money), from
Service Users other than those of a trivial nature, as set out in the County Council
Code of Conduct. (calenders, diaries etc) Any offering of these by a service user
must be reported to the Line Manager.
Responsibility of Members of Staff
26. It is the responsibility of all members of staff to safeguard the interests of the service
users. Members of staff should bring to the attention of their line management;
relationships involving a member of staff and a service user, which they feel, are
inappropriate. This is to ensure that the situation can be fully explained and the
necessary arrangements put in place to ensure the safeguard of service users and
members of staff. There may be circumstances where a member of staff considers
that the Raising Concerns procedure is more appropriate.
Reporting
27. Line Managers should ensure that if an employee notifies them of any issues in
relation to this policy then the Line Manager should record the information and
place it on the employee’s personnel file. In the event that the Line Manager
considers that the information provided is not routine and has more consequences,
they should seek advice from their Line Manager and or Social Services Personnel at
Shire Hall.
Policies and Procedures
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28. The following Policies and Procedures, are particularly applicable to this document,
and should be refereed to for further guidance:




County Council’s Code of Conduct and Confidential Reporting Procedure (WhistleBlowing) for Employees County Council’s Disciplinary Procedure
Social Services Raising Concerns Policy.
Home Care Duties and Conditions of Service.
Guidelines for Employees who wish to become foster carers for Children or
substitute carers for adults.
Social Services Department
Staff/Client Relationships Policy
Appendix.
This appendix offers further practical
guidance to Managers and staff
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Appendix 1
This section provides guidance to Line Managers and staff.
The prevention of abuse within a staff-service user relationship depends upon
understanding how, why and where abuse occurs. The following factors can although
not exhaustive contribute to the development of abuse within the relationship:
Staff attitudes
1. These include:
 the member of staff who seeks to control service users or colleagues
 staff who display disrespectful attitudes or behaviour towards service users
 a cultural tolerance of abuse within the care setting or relationship
 a cultural tolerance of staff-service user relationships that have inappropriately
developed beyond purely work and needs related.
Supervision
2. This includes the following issues:
 lack of effective supervision
 staff working in isolation with limited supervision
 lack of staff support by managers
 low staff morale
 staff working under undue stress.
Resources
3. These encompass:
 a lack of training for staff to work in specific areas of practice
 an inability to defuse or prevent challenging service user behaviour
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 staff shortages
 absence of risk management processes
 management processes which do not meet their intended aims
 a service design which is unduly regimented and which does not facilitate
service user choice or puts too much emphasis on staff needs
 a working environment which is not conducive to caring.
Policies and procedures
4. Managers should ensure the implementation of the following procedures aimed at
preventing abuse and increasing service user and staff safety.
Staff support and management
5. This includes:
 thorough checking of references and police records at the interview stage of
recruitment
 checking status of qualifications directly with the awarding body
 induction programmes for all staff which include the recognition of potential
problems within staff-service user relationships
 regular performance review and continuing professional development
 use of supervision and SDI
 effective managerial supervision
 intervention at an early stage when staff are seen to be experiencing emotional
difficulty or demonstrating impaired function in their service user relationships
 the appropriate use of chaperones when undertaking intimate procedures
 the development of strong professional leadership.
Management actions
6. The Management of each establishment/team should ensure staff are aware of:
 guidelines and policies which clarify the limits of the practitioner-service user
relationship, including following discharge from care
 internal complaints procedures and “whistle blowing” policy
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 disciplinary policy in relation to abuse
7. Managers should also ensure they:
 are promoting and maintaining good communication channels which maximise
feedback from service users, practitioners and managers
 have fair and equitable management processes, including effective
implementation of policies for dealing with harassment in the care setting
 have embedded the clear Departmental commitment against discrimination or
victimisation of anyone making an allegation of abuse based on reasonable
evidence
 have access to advocacy to support service users
 have a regular review of practice, including critical incident and ‘near miss’
analysis
8. Managers should ensure their teams understand the following issues:
 indicators of abuse
 the nature of the practitioner-service user relationship
 forms of address and over-familiarity
 doing favours or treating a service user with inappropriate favouritism
 exchanging gifts
 the potential for exploitation within dual relationships
 the manipulation by service users who are difficult to manage
 practitioners’ reactions to reporting colleagues who are suspected of abuse
 the role of the practitioner as a service user advocate
 standards of care
 delegation of tasks
 the need to develop and implement standards and guidelines on abuse for each
setting
 how practitioners can highlight aspects of their own behaviour which may not
be appropriate to their service users.
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Detection of abuse
9. Detecting problems within the professional relationship between the staff
member and the service user is rarely a simple process. Many incidents remain
private and undocumented. However, investigations of alleged abuse have
often identified signs of difficulties within the staff-service user relationship
which, if recognised earlier, could have led to the detection of abuse. Examples
include:
 a member of staff exhibiting a sudden change in behaviour or dress
 a staff member’s general behaviour changing towards a particular service user
 subtle changes in body language on the part of either the practitioner or the
service user
 a staff member or the service user exhibiting signs of stress
 secrecy and defensiveness, rather than confidentiality, when the practitioner
discusses service user care with colleagues
 a service user beginning to demonstrate signs of having inside knowledge of the
department, its staff or of other service users
 a service user becoming increasingly withdrawn or exhibiting signs of increasing
anxiety or loss of concentration
 a service user showing signs of physical injury, such as unexplained bruises,
grazes, swellings and bleeding
 a service user becoming fearful and showing signs of loss of self-esteem
 a service user becoming manipulative, uncooperative or aggressive.
10. Other signs include:
 discovering a lack of comprehensive records about a particular service user
 discovering actual injury to the service user
 incidents reported by the service user, a staff member, a family member or carer
 a complaint or a wish to discuss an incident
 direct observation
Notes
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To avoid too much repetition within this document the term service user should be read
to include carers as appropriate
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