Care homes told to meet people's sexual desires or risk failing inspections

Care homes across the country must ask residents if they are sexually active, gay or cross dress and work on meeting their sexual needs if they want to pass inspections, according to guidelines issued by the Care Quality Commission.

The care regulator has said questions should be asked by care staff about whether a care home resident is sexually active and what their sexual tastes and practices are.

Like preferences for eating, drinking and sleeping, the guidelines mean care inspectors will check to see if ‘person-centred care’ is being carried out for sexual needs by all adult social care providers including care homes.

"We know that the best care is person-centred and in supporting relationships and sexuality there can be no one approach that fits all” said Debbie Westhead, acting chief inspector of adult social care.

"Supporting people to build and maintain relationships in the way they want to is incredibly important, regardless of who they are or what stage of life they are at. This guidance aims to ensure providers are supporting people to form and maintain sexual relationships that meet their needs, while also helping them to understand risks."

Helping care home residents date

The guidance ‘Relationships and sexuality in adult social care services’ is the first of its kind issued by the CQC in relation to sexual needs.

Overnight guests are encouraged at care homes and the guidance covers how care workers can help residents access specialist dating services.

The CQC especially aims to make care homes more accommodating for people with physical and learning disabilities and LGBT+ residents.

Questions CQC inspectors can now ask care providers include whether a care provider has a relationship and sexuality policy and in what way does the care home encourage and support people to develop relationships.

Controversy has historically surrounded sexual desire in care homes, with care workers often concerned about crossing a line when it comes to allowing someone to be intimate, while protecting them from sexual abuse.

The care watchdog advises staff to support those with ‘sexual disinhibition’.

Damage to the brain can cause increases or decreases in sexual desire and can result in a person no longer being aware that their behaviour is socially unacceptable.

The CQC has said staff caring for people with a neurological impairment like dementia, must understand the brain’s influence on sexual behaviour.

For example, a care home resident who has had a traumatic brain injury, who is being helped to undress by a care worker, might misinterpret personal care as a sexual advance. Someone with dementia may accidentally climb into bed with another care home resident mistaking them for their missing partner.

The guidance says sexual disinhibition could be a sign that someone is struggling to meet their sexuality needs. The CQC recommends care homes ensure ‘a person’s capacity to consent to sex is reviewed regularly’.

The guidance, available on the CQC website, was developed with care providers and organisations like Supported Loving Campaign and U-Night Group.

Claire Bates of the Supported Loving campaign and Sue Sharples of U-Night Group said: "This is a long-awaited document that will give providers clarity and direction in relation to a sensitive and complex area of need.

"It affirms the link between supporting opportunities for sexual expression and personal wellbeing, within a framework of care services' regulatory responsibilities.

"Our organisations were pleased to be consulted in the development phase of the guidance, including gaining the perspective of members with a learning disability."

Questions CQC inspectors can now ask care providers

• Does the organisation have a relationship and sexuality policy, including an easy read version?

• Does the organisation recognise people have different ways of experiencing and expressing sexuality?

• Are staff trained to support people with their personal relationship needs?

• Are there examples that demonstrate positive support for relationships?

• Is there accessible information about, and links with, sexual health services?

• What is the policy for allowing people to have guests staying over for the night?

• How does the setting accommodate people who are in existing relationships?

• How are people encouraged and supported to develop relationships?

• Are people given information and support about relationships and sexual health?

• Can people be signposted to a local organisation that provides this service?

• Are staff aware of what action to take if they have concerns that someone is at risk of harm or abuse?