Personal Relationships and Sexuality Guideline

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Introduction

The majority of people with a disability do not need support to create initiate and maintain rewarding relationships. However, some people with a disability have encountered obstacles in their attempts to develop relationships, explore and express their sexuality, and access sexual health information and services.

The Personal Relationships and Sexuality Guideline has been formulated to assist service providers and disability support workers to develop a sensitive and consistent approach to the support of people with disability in the areas of personal relationships and sexuality.

The Personal Relationships and Sexuality Guideline is designed to provide accessible, relevant information for staff who are directly involved with supporting people with disability.

The information contained in this Guideline will assist service providers and disability support workers to explore and enhance opportunities for people with disability in the areas of sexuality and personal relationships while exercising their duty of care to avoid harm. The information focuses on ensuring the person with disability is as fully informed as possible before making or being assisted to make their choice/s.

The Personal Relationships and Sexuality Guideline must be read in conjunction with the Department Personal Relationships and Sexuality Policy P2010/1101-001.

Key Definitions

Personal Relationships

Personal relationships cover the spectrum of relationships from casual acquaintances to colleagues, friends, family and partners. These personal relationships develop and change over a lifespan. They can provide support, love, joy, intimacy, sex and opportunities for giving and receiving. They can enhance our self-esteem and give us a sense of belonging. They are fundamental to our sense of wellbeing.

Personal relationships are often based on shared interests. They are usually reciprocal but may go through stages where one person puts in more effort. Personal relationships can provide us with challenges that may be difficult, but they can also help us grow and mature as individuals. People generally learn how to have respectful relationships through education, experience and experimentation. However, many people with or without a disability need, or benefit from, specific support in developing skills that enhance relationships.

Sexuality

Sexuality refers to our desires, practices and identity. It has psychological, biological and social aspects and involves values and attitudes. Sexuality develops throughout childhood and adolescence. Our sexuality is a key feature of our identity and so it affects the way we present ourselves in the world. The way each individual understands and interprets their sexuality varies enormously and often changes over time.

Positive sexuality is facilitated by open communication, values, factual information, and respect for self and others. Relevant, adequate, accurate, regular and timely information and support are crucial for us to understand our sexuality and ensure that the sexual rights of all persons are respected.

Dignity of Risk provides balance between over protecting and under protecting a client by enabling the client to make a decision which involves making a change. This decision may have a risk or questionable consequences for the client.

People with Disability

Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others.

Source: Conventions on the Rights of Persons with Disabilities (CRPD)

Guideline

The guidelines provide a wide range of information and advice that is designed to help support providers and workers put the policy principles into practice and create optimal conditions for people with a disability to experience positive relationships

People with disability are to be supported to:

• learn new skills
• make friends and meet new people
• have their relationships treated with respect and confidentiality
• have privacy and to respect the privacy of others
• have opportunities to socialise, through organising and attending outings to see friends and family and social events
• maintain relationships and contact with family and friends
• manage situations when family members don’t like their friends
• Engage in any form of relationship that is legal and non-exploitative in order to support requirements outlined above, people with disability, their families and carers must have access to relevant and accurate information in the areas of personal relationships and sexuality.
• Formal education courses must be made available to people with disability to enable them to develop the skills and knowledge they need in the areas as outlined above.
• Opportunities must be made available for people with disability to meet and make new relationships and to maintain existing friendships.
• Staff are to develop an awareness of community services and resources in the areas of personal relationships and sexuality
• Practical support such as transport to venues, assistance with telephoning friends or organising social events must be made available whenever possible.
• All information and education for people with disability, their families and carers must be presented in a format that takes into consideration a range of communication needs and abilities.

Roles and Responsibilities/Delegations

All staff

Formal and Informal Education

• All staff must ensure support is given to people with disability to identify their needs, develop appropriate options and responses and to assist them to achieve their goals.
• All staff are to develop appropriate information about universal services and resources in the areas of personal relationships and sexuality to assist people with disability, their families and carers in this area.
• Staff must be made aware of consent and confidentiality issues and follow the decision-making processes of their organisation.
• Social and sexual development of people with disability should be supported by staff, for example, people with disability may need support in accessing appropriate information and resources from relevant training or community agencies (e.g. formal sex education, counselling).
• Staff are to assist wherever possible with day-to-day education. Examples of informal education include respecting a person’s privacy by knocking before entering a room, treating people in an age appropriate manner and modelling appropriate behaviour.

Values, Attitudes and Beliefs

• All staff must ensure that they do not impose their own values, attitudes and beliefs of personal relationships and sexuality on the people they support.
• If a staff member is of the opinion that they do not have the skills, knowledge or are unable to give an unbiased view of all the options relating to areas such as gay relationships or accessing a sex worker, they should seek support immediately from a senior staff member.

Dignity of Risk and Duty of Care

• All staff must take reasonable care for the safety and well-being of people to whom they provide a service.
• All staff are to be aware that failure to take reasonable care which subsequently results in injury, loss or damage may give rise to a claim of negligence.
• All staff must have responsibility to consider their duty of care in conjunction with people with disability and their dignity of risk.
• Staff members are to minimise the risk of breaching their duty of care by:
  • providing knowledge and experiences which will empower people with disability to make their own decisions and to be personally responsible as possible
  • supporting people with disability to take informed risks consulting with senior staff and significant others for advice and support if unsure
  • documenting decisions and reasons for actions

Consent

• All service providers must seek consent from the person with disability before they commence or implement any planned activity relating to the person with disability.
• In order for a person to provide informed consent, staff must give the person with disability accurate information about the matter or procedure and ensure the person can fully understand it.
• All consent must be freely given and must not be obtained by force, threat, deception or undue influence.
• All service providers must ensure that where a person with disability is not capable of consenting, their ‘responsible person’ is informed of the proposed action and given an appropriate opportunity to provide informed consent or otherwise.
• Where there is any conflict about a proposed course of action which cannot be resolved, the matter should be referred to the Guardianship and Administration Board (GAB). The Guardianship and Administration Board (GAB) can be contacted on 1300 799 625.

Privacy

• Staff members who are given information in confidence by people with disability must not disclose this information to others. Note that this does not include information about situations where staff members are obliged to disclose information to others in accordance with their organisations and policies.
• At all times staff are to recognise and respect the needs and rights of adults to physical and emotional privacy.
• Staff are to respect the rights of people with disability to undertake sexual activity in private.

Diversity

• Staff members must take in to account linguistic, cultural and religious factors when addressing issues of personal relationships and sexuality with people with disability and their families.
• Staff are to ensure people with disability have opportunity to mix with people of both the same and opposite sex to experience a wide range of relationships

Responding to Sexual Behaviour

• Staff must ensure people with disability, their families and carers receive clear and consistent information about sexual behaviour.
• Staff must reach common agreement about what is considered to be appropriate sexual behaviour and develop and put in to place strategies for use when sexual behaviour becomes inappropriate. Staff are to consider the following questions which may clarify whether or not a particular behaviour is sexually inappropriate:
  • Does the behaviour make it difficult for the person to be accepted in the community?
  • Will it make the person vulnerable to ridicule?
  • Will it place the person at risk?
  • Is the behaviour hurting another person?
  • Will it make the person vulnerable to assault?
  • Will the behaviour make the person vulnerable to exploitation?
  • Staff must be aware of situations that are deemed as ‘inappropriate sexual behaviours’ and underlying medical and/or psychiatric causes are explored/excluded and that referrals are made for behavioural support and educational programs where appropriate.

Sexual Health

Staff are to provide people with disability access to appropriate sexual health information and education from Family Planning Tasmania (http://www.fpt.asn.au/ ), or Department of Health's Sexual Health Services –(https://www.dhhs.tas.gov.au/sexualhealth/sexual_health_service_tasmania ). Staff must be aware that any proposal to use sterilisation as a method of contraception (male or female) or for menstruation management is to be referred immediately to the Guardianship and Administration Board on: 1300 799 625.

The use of medication to prevent pregnancy (without informed consent of the person) is a form of chemical restraint and will need to be reported to the NDIS Q&S Commission. It would be important to provide education around sexual relationships and safe sex as a first step.

Access to a Sex Worker

• Staff should consider access to a sex worker as one of the number of options when supporting people with disability to make decisions about their sexual needs.
• Senior Staff must ensure that staff who provide physical assistance to enable people with disability to access the services of a sex worker are aware that they are not in any breach of law in Tasmania.
• All staff are to only deal with a self-employed sex worker (i.e. a sex worker who with not more than one other person owns and operates a sexual services business).
• The Sex Industry Offences Act 2005 Tasmania must be complied with to gain a clear understanding of what sorts of sexual services can be legally provided in Tasmania.
• Staff must refer all requests for the services of a sex worker to their supervisor in a respectful manner.
• Following consultation by the staff member with their supervisor, the staff member has the option to decline any involvement in supporting the person’s request. In this case the supervisor must refer the matter to another staff member.

Sexual Abuse

• All staff must receive training in the identification and prevention of physical, sexual or emotional abuse.
• All allegations of sexual abuse must be reported immediately to senior staff.
• All allegations of sexual abuse must be reported to Tasmania Police immediately as instructed in the Preventing and Responding to Abuse in Services Policy P2010/1102-001 and the Preventing and Responding to Abuse in Services Procedure P2012/0177-014.

Working with Families

• Staff are to ensure people with disability are consulted about the sort of relationship they want (if any) with their various family members.
• Staff are to support people with disability with a range of activities as required such as:
  • dialling a telephone number
  • arranging a quiet place for personal calls or visits
  • recording important dates and assisting people with disability to purchase gifts or cards at their request
  • planning family visits
  • transporting people with disability to family events
  • assistance to host a morning or afternoon tea at home
  • providing support if their family member is sick or dies.
• Staff should know that intimate relationships are very personal and private.
• Staff must respect the choices made by the person with disability on whether or not they choose to discuss or share with family members details of their intimate relationships.
• In circumstances where people with disability are unable to indicate their preferences, a collaborative approach must be taken that focuses on the person. This approach must assist the person with disability to make decisions about their personal and sexual development.
• Contributions by family members should be valued and respected.
• All staff must remember that, whilst always maintaining a positive working relationship with family members, their main focus is the person with disability.
• If any issue of sexuality is confronting to the family, staff must seek independent advice from either Family Planning Tasmania http://www.fpt.asn.au/ ), or Department of Health's Sexual Health Services –(https://www.dhhs.tas.gov.au/sexualhealth/sexual_health_service_tasmania )..
• If a person with disability does not have the capacity to make a decision and there is a dispute between family members and others about a particular course of action, staff must involve an independent advocate for the person with disability.
• If a dispute remains unresolved, the Guardianship and Administration Board are to be contacted for advice on: 1300 799 625.

Related Documents/Legislation

• Tasmanian Disability Services Act 2011
• Personal Relationships and Sexuality Policy, Disability and Community Services, Tasmanian Government  P2010/1101-001
• Consent by Clients Policy P2010/1089-001 Disability and Community Services, Tasmanian Government
• Consent by Clients ProcedureP2012/0177-015 Disability and Community Services, Tasmanian Government
• National Safety and Quality Health Service Standards and Tasmania Accreditation Framework
• Consent for Medical Treatment Factsheet Guardian and Administration Board Tasmania
• Personal Information Protection Act 2004 Tasmania Government

Attachments

Nil

This Procedure may be varied, withdrawn or replaced at any time. Compliance with this directive is mandatory for the Department.  Please Destroy Printed Copies. The electronic version of this Procedure is the approved and current version and is located on the Department's Strategic Document Management System. Any printed version is uncontrolled and therefore not current.