Relationships and Identity

In order to understand the support that a person may need from the service to maintain or form relationships and to be themselves we need to talk about relationships and identity before the service begins.

Although we need to understand a person’s needs, discussions may not need to be explicit in the same way as they would be for e.g., health needs. For example, "Now we are going to talk about your relationships". Neither should they be structured against a ‘list of topics’ to talk about. It is normally better to talk about relationships and identity as part of the natural conversation already taking place.

It is important to recognise that relationships and identity are private things and people may not want to talk about them with us. This is their choice and must be respected. To force a conversation could be seen as an invasion of privacy. 

Some people may want to talk but may not feel able to because they do not yet know and trust us. Therefore, initial information may be limited and become more enriched over time. This may also require us to adapt the nature of the support being provided over time.

Talking about relationships and identity is therefore something we should do often and build into everyday conversation.

The specific things that we talk about will vary depending on what the person tells us and their individual circumstances. If something does not seem appropriate or relevant to ask don’t ask. For example, if someone is happily married, don’t ask them what their sexuality is.

Whatever a person tells us we must be non-judgmental, regardless of whether we identify or agree with their relationship or lifestyle choices. This is in line with the core principles and values of equality and diversity.

See: Equality, Diversity and Human Rights

The ways in which a person may need support will vary based on their specific needs. The following are just some examples:

Accessing a community

A community is any group of people that is important to the person and therefore part of who they are. For example, a religious community, a sporting community, LGBT community, a hobby group, or a support group.

There is a chapter of this Handbook dedicated to supporting access to community.

See: Accessing the Community

Self-expression

Self-expression covers everything a person may want to do to be true to express their identity.

Professional support with identity

Some people struggle with their identity and can need support from a health professional. For example, if someone has gender identity issues. The person’s GP will be able to signpost or refer the person to any specialist services that can support them.

Managing sexual disinhibition

Sexual disinhibition is when a person expresses themselves in ways that are inappropriate or offensive to others.

For example:

• Removing their clothing;
• Masturbating;
• Using offensive sexual language.

Sexual disinhibition is normally caused by a condition that has affected the brain’s ability to regulate behaviour. For example, a learning disability, dementia, brain damage or mental health issue.

If a person is known to be sexually disinhibited, the service will need to take steps to maintain their dignity and reduce the risk of allegations against them or even criminal prosecution.

There may be triggers for the behaviours, or the person may need some time and space to express themselves privately and safely.

If the person has the mental capacity to decide how they are going to act, no restrictive measures can be put in place (unless they become subject to restrictions under the Mental Health Act 1983). If they lack capacity, it may be possible to use restrictions, but this must be authorised under the Mental Capacity Act 2005.

See: Mental Capacity

Safe to be me, produced by Age UK in partnership with Opening Doors London, helps managers and staff understand how to support older people who are lesbian, gay, bisexual or transgender (LGBT) and helps training providers ensure courses include discussions and scenarios relating to the needs of people who are LGBT.

See: Safe to be me

Manor Community have developed a flexible learning resource to help providers supporting people of working age to improve LGBT+ inclusivity for staff members and people drawing on their care and support.

See: LGBT+ Learning Materials

This section applies when there are no concerns about the relationship or the person’s mental capacity to consent to that relationship.

Staff must give people privacy, space and time to enjoy their relationships.

People should be able to see anyone they have a relationship with whenever they want to, and not be restricted by the availability of staff support.

The following are just a few examples of the ways that people may need support:

• Support staying in touch with people, or to arrange to see them;
• Support to use online dating websites or apps safely;
• Support to arrange transport or to get somewhere in the community;
• Support to get ready - hair, make-up etc.;
• Some people may always need support to ensure their needs are met or that they are safe;
• Support with sexual health. For example, access contraceptive or STI services;
• Support to maintain dignity e.g., closing doors, drawing curtains, advice about appropriate public behaviour;
• Support to access relationship education services e.g., community nursing.

Capacity and consent to sex is a complex area of law.

If anyone is concerned that a person may be having, or about to enter into a sexual relationship that they cannot consent to, a safeguarding concern must be raised.

See: Disclosure and Raising a Concern

The local authority will be able to advise on urgent action the service can/should lawfully take to reduce risks. They can then formally assess mental capacity and make any applications to Court that are necessary.

Harmful relationships are those that have a serious effect on wellbeing. For example, abusive or neglectful relationships.

For guidance about whether a relationship may be harmful, see:

Recognising Abuse and Neglect

If staff are concerned that someone is in a harmful relationship, they must not ignore this.

Ask the person if they are OK. Do they want to talk about it, or to make a complaint to the police?

If the safeguarding duty applies, a safeguarding concern must be raised.

See: Disclosure and Raising a Concern

To enable the people we support to feel safe, secure and supported, it is important that we have a good relationship with them.

However, the nature of this relationship must only ever be a working relationship. We are in a position of trust and to have any other kind of relationship would be an abuse of this trust.

Staff must not share information about their own personal circumstances or problems with people, or ask them for advice etc.

If we bump into a person or their family when outside of work it is fine to have a short, general conversation but not to socialise.

If anyone has any concerns about the above, they should speak to a manager or the registered person.