Confidentiality Guidelines Regarding Personal Relationships and Sexual Health of Looked After Children

Confidentiality is an issue that causes great anxiety for children, staff and foster carers alike. It is essential that the boundaries of confidentiality is clearly understood by all staff, carers and children. It is important that children understand that confidentiality might have to be broken, in certain circumstances, rather than break a promise that cannot be kept.

Many Looked After children are hesitant to approach members of staff or foster cares for fear of personal information being discussed widely with other professionals without their consent.

Personal information regarding sex, sexuality and personal relationships should be recorded but should not be shared by staff and foster carers except in specific circumstances - see Section 3, Recording Confidential Issues.

Routine information sharing is not acceptable, such information should be treated as strictly confidential and only made available to those who need to know in order to authorise or provide a service, to promote the health or welfare of the individual concerned to protect other individuals.

The best interests of the child are paramount and generally confidentiality boundaries should be agreed, which ensure that the child feels safe and is confident about asking for support. Information relating to sex, sexuality and personal relationships can often be very sensitive so staff and foster carers should not share such information without prior knowledge and preferably the consent of the child involved.

Staff and carers do not have a duty to inform parents of evidence or suspicion of sexual activity, but the Children Act 1989 makes it clear that they should work in partnership whenever possible or appropriate.

See also London Safeguarding Children Procedures, Sexually Active Children Procedure.

If a child feels unable to talk to their parents/carers about their sexuality and sexual health, their confidentiality should be respected unless a worker believes them to be at risk of Significant Harm, or of harming someone else. In these exceptional circumstances, the steps set out in Safeguarding Sexually Active Children should be followed, in which case, the child should be informed of why and how their confidentiality should be broken and supported through the process. The duty of confidentiality is the same towards young lesbians and gay men as it is towards heterosexual young people.

Personal information should only be shared on a 'need to know' basis. Children should be informed, if and how any information they choose to indulge will be recorded, who will have access to it, and whether it will need to be passed on to other people. Recorded information should be stored securely so that unauthorised people do not have access to it - see Section 3, Recording Confidential Issues.

Where a Looked After Child divulges personal information of a significant nature, but the threshold for Significant Harm is not met (perhaps because no exploitation was involved), e.g. sexually transmitted infection, pregnancy, the worker or foster carer receiving that information must inform the child that they will need to seek advice from their line manager or supervising social worker on a need to know basis, so that appropriate help can be offered.

In these circumstances the line manager or supervising social worker will need to decide who (if anyone) should be informed in making this decision the following will be considered:

• The age and understanding of the child;
• The nature of the information;
• The degree of seriousness of the information;
• Whether risk is increasing or decreasing;
• The legal status of the child;
• The views of the child;
• The consequences of informing or not for the longer term care of the child;
• The child's best interests.

The decision will be shared with the child and the reasons recorded on their file.

Whilst information of a personal nature may therefore be held by individual staff/carers with whom the child has confided, great care must be taken to avoid collusive or secretive relationships with children whilst maintaining this level of professional confidentiality. That is why these guidelines requires that another senior professional within the agency be informed of this personal information to enable the highest standards of care to be provided and the interests of the child to be safeguarded.

Generally, it is not appropriate for staff and carers to disclose personal details to a child in order to illustrate a point about sex and relationships.

In the limited circumstances in which a child shares information which should not be available to all staff, the staff/carer receiving the information must fully record it and consult their manager/supervising social worker as to where the record should be kept.

If the manager/supervising social worker decide that the information should not be placed on the child's file, s/he will endorse the record to this effect and store the record safely in his or her office. It is essential, however, that sufficient information should placed in the child's record to give an outline of what may be a very significant current issue for the child.