Relationships & Sexuality Workshop

1. Relationships & Sexuality Workshop Catherine Bowers Support Planning Manager Sarah Wade-Rathbone Training Manager

2. Learning Outcomes At the end of this session you will understand: • How to implement the CQC guidance on relationships and sexuality • How this fits with the Effective Key Line of Enquiry (KLOE) • How this fits with other regional and national initiatives • What is the difference between sex, gender, sexuality and sexual orientation? • How can you put it into practice?

3. What do they say? CQC recommend that when providers assess people’s needs, they should ask about their sexuality needs. This includes the following: • previous and current relationships • sexual orientation • understanding of sexual health • personal dress preferences • gender identity. Is it compulsory? No one has to share sensitive personal information about their sexuality and relationships. If they choose to do so, they can be supported to develop and maintain the sexual identity they want and create opportunities for a range of different types of relationships.

4. What is Sexuality? Sexuality encompasses a person’s gender identity, body image and sexual desires and experiences. This means people can have needs relating to their sexuality, regardless of their age, mental capacity or personal history. The definition of sexuality for the purposes of this guidance is deliberately broad. It is important to recognise that sexuality can mean different things to different groups of people. This guidance relates to:- sex, masturbation, sensuality, physical intimacy, romance and physical attraction- gender identity – the sense that we are male or female or not aligned with either gender- sexual orientation, including heterosexual, homosexual and bisexual - personal dress, body image, personal grooming and sexual expression. What is sexual orientation and gender identity? Sexual orientation describes a person's physical, romantic, and/or emotional attraction to another person (for example:straight, gay, lesbian, bisexual). Gender identity describes a person’s internal, personal sense of being a man or a woman (or someone who does not identify themselves as a man or woman). Simply put, sexual orientation is about who you are attracted to, and gender identity is about your own sense of self.

5. Key lines of enquiry, prompts and ratings characteristics for adult social care services Table extract from Kirklees RMN Master Audit E1 . .

7. If we don’t support people to have the relationships they want, we leave them at risk of loneliness The Office for National Statistics (ONS) has recently undertaken research on loneliness. The definition of loneliness they used is aligned to the definition used by the Jo Cox Commission and in the Loneliness Strategy, https://www.gov.uk/government/publications/a-connected-society-a-strategy-for-tackling-loneliness which is based on the following definition: “A subjective, unwelcome feeling of lack or loss of companionship. It happens when we have a mismatch between the quantity and quality of social relationships that we have, and those that we want.”

8. Why do we need to ask people about their sexuality and relationships? Isn’t it just their own private business?

9. Kirklees Involvement Network Kirklees Involvement Network (KIN) undertook a Happy Healthy Relationships Project, which found that people with a learning disability were particularly vulnerable to sexual exploitation, partly due to not being able to understand how to manage risks. Opening up a conversation about relationships and sexuality can provide an avenue for all people to develop self-awareness and keep themselves safe. KIN have developed a film and workbook which are available and free to use. https://www.youtube.com/watch?v=MljBd1uHkwA Watch the first video clip to see how not talking about sexuality and relationships made someone more vulnerable to sexual exploitation

10. In October 2017, the School for Social Care Research and Stonewall produced the LGBTQI+ Disabled People and self-directed social care support and found that: • More than half of those surveyed said that they never or only sometimes disclosed their sexual orientation or gender identity to their PAs who they paid to support them. Less than one third said that they were 'very comfortable' talking about their support needs pertaining to being LGBTQI+ with their PAs. • There was a full range of being out to PAs: not out, out to some and out to all. Some that were out or out to all talked about how pleasurable and important it was to be open about their sexuality or being trans. Some interviewees said that they were not immediately out to PAs but adopted a 'wait and see' policy. • Several people said they were unhappily resolved to not being fully out because they were worried about the reaction of the PA and because they needed the support more than having a totally free reign on being out.

11. Key messages • LGBTQI+ Disabled People have the right to be treated • with respect, and without discrimination. • LGBTQI+ Disabled People who use self-directed social care enjoy having choice and control over their support. • Supporting any disabled person means working with the whole person. • Many LGBTQI+ Disabled People would like to be out about their sexual orientation or gender identity to the person supporting them. • Not everyone will want to talk about their sexual orientation or gender identity. • It is important to work with each person as an individual and find out how they want to work with you. • It is essential to treat the person with respect and build a relationship based on trust.

12. The Royal College of Nursing (RCN) has produced guidance on supporting older people in care homes on sex, sexuality and intimate relationships - https://www.rcn.org.uk/professional-development/publications/pub-007126 • This summarises that all care should: • be person-centred • focus on the perspectives of individuals within the context of their unique lives and experiences • be open to learning about the person’s significant experiences and relationships • promote and support human rights, dignity, privacy, choice and control • promote clear boundaries which protect and support residents and staff.

13. Activity Time! In order to be able to support people to talk about relationships and sexuality we need to understand some key terms Meet the Genderbread person on the next page

15. Using your glossary of terms, work in groups to place word cards on the area of the Genderbread person you think they best fit

16. I am what I am… ..not what you might want me to be!

17. Now think about how you might support someone in your service in the areas you identified

18. Looking at this extract from the Good and Outstanding Care Guide from Skills for Care, you can see how participating in this workshop has put you in an excellent position to take the necessary steps to become or remain an Outstanding provider!

19. Next steps – adapted from Jenny-Anne Bishop’s guide to inclusivity for LGBTQI+ people Ask people for their preferred pronoun Ask about sexual orientation and gender identity as part of normal assessments Display LGBTQI+ posters and rainbow flags in communal areas Display LGBTQI+ posters with helpline numbers for support groups Be mindful with gender-segregated areas Have a zero tolerance approach to discrimination Use diversity training to set out your approach Use the training to challenge the status quo Be aware that trans people can have different needs especially with health screening Make sure the person’s Care Plan is truly personal and includes everyone important to them Make contact with LGBTQI+-friendly religious organisations if appropriate Facilitate a Staff LGBTQI+ Network / Collaborating with local Trans and LGBTQI+ Groups.

20. Here is a suggested Relationship & Sexuality Assessment You do not have to answer any of these questions, but if you choose to, we will be able to provide support that is more person-centred to meet your requirements in the important areas of sexual identity and relationships . * Thanks to Lydia Pignataro from Barnardo’s for helping improve this form

21. Now you have all the information, confidence and ideas to take your organisations forward now you know: • How to implement the CQC guidance on relationships and sexuality • How this fits with the Effective Key Line of Enquiry (KLOE) • How this fits with other regional and national initiatives • What the differences are between sex, gender, sexuality and sexual orientation • How you can you put it into practice

22. Thank you!