6.1.21 Providing Personalised Care

1. Principles

• Foster and residential carers need to ensure that they place the well-being of individual children at the centre of their practice. All children's achievements should be celebrated and appropriately rewarded;
• Children's day-to-day needs must be met, such as routine, privacy, personal space and nutritious meals. Children must be treated with dignity and respect;
• Children should experience care that is sensitive and responsive to their identity and family history, including age, disability, ethnicity, faith or belief, gender, gender identity, language, race and sexual orientation;
• Any specific type or model of care delivered or commissioned should be provided by staff or carers who are suitably trained, experienced, qualified and supervised;
• Specialist help should be made available according to the individual needs of children. This help should be available as soon as it is needed, at the intensity required and for as long as it is required;
• All necessary adaptions and equipment should be provided;
• Children must be protected, and helped to keep themselves safe, from bullying, homophobic behaviour, racism, sexism, radicalisation and other forms of discrimination. Any discriminatory behaviours must be challenged and help and support given to children about how to treat others with respect.

2. Personalising Care for Children and Young People

Foster carers/residential staff are required to provide personalised care to meet the needs of individual children. A child's needs will be identified in their Care Plan, Placement Plan, Education, Health and Care Plan (if they have one) and any other relevant plans.

Personalised care is:

Care which meets each child's needs and promotes their welfare, taking into account the child's gender, religion, ethnicity, cultural and linguistic background, sexual identity, mental health, any disability, their assessed needs, previous experiences and any relevant plans.

The child's plans will form the basis of all care provided by the foster carers and other professionals. The child's plans must take account of all information available on gender identity, ethnic origin, religion and cultural and linguistic background, sexual identity, health including mental health and disability, and these issues should be considered again each time the child's Care Plan is reviewed. See also: Care Planning Procedure.

3. Inclusion for Children and Young People

The care provided should be welcoming to all children and young people and others significant to their care and wellbeing. Services provided should recognise and build on the strengths of individual children and young people. Maintaining links with the child's home and community will be an important part of meeting individual need.

All staff and foster carers should complete Equality and Diversity training and are expected to challenge attitudes, behaviour and language that are non-inclusive and discriminatory.

4. Promoting Diversity and Positive Identity when Caring for Children and Young People

Foster carers/residential staff should promote a positive identity, potential and valuing diversity. The desired outcome is to ensure that children have a positive self view, emotional resilience and knowledge and understanding of their background. This should be done by:

• Children being provided with personalised care that meets their needs and promotes all aspects of their individual identity;
• Foster carers/residential staff being supported to promote children's social and emotional development, and to enable children to develop emotional resilience and positive self-esteem;
• Children exercising choice in the food that they eat, and being able to prepare their own meals and snacks, within the context and limits that a responsible parent would set;
• Children exercising choice and independence in the clothes and personal requisites that they buy within the reasonable limits that a responsible parent would set;
• Children developing skills and emotional resilience that will prepare them for independent living;
• Children receiving a personal allowance appropriate to their age and understanding, that is consistent with their placement plan.

5. Ethnicity, Culture and Religion

Culture is part of a child's/young person's identity and heritage. All foster carers/residential staff should respect and value a child's cultural heritage. Culture describes the way people live their lives. Culture is based on many different factors, memories, common experience, background, language, racial identity, class, religion and family attitudes etc.

Foster carers/residential staff should take practical steps to ensure that they provide care which supports the ethnic, cultural, religious and language needs of children. These include the need for multicultural resources, reading and display materials (e.g. pictures) in order to:

• Provide an environment in which all children feel comfortable;
• Promote positive black and minority ethnic images and role models;
• Provide visual illustrations which promote discussion of issues of difference, ethnicity, culture, religion and language;
• Assist in discussion of issues concerning identity;
• Wherever possible, books used in direct work should include black and minority as well as white characters.

Assessments and on-going work with children should explore their natural and extended family, their ethnic and cultural origins, any experience of racism and the role of religion in their lives. The child's view of their own identity and any identity confusion should also be explored.

Other ways that carers can support children with their cultural and ethnic background include:

Choice of diet - having access to familiar food assists with continuity and will demonstrate that their culture and religion are valued. Carers should discuss with the child and/or their social worker what food they like and be familiar with and find ways of accommodating the child's preferences.

Personal care - Choice of clothing and toiletries for skin and hair care - children should be provided with the opportunity to buy clothes appropriate to their cultural backgrounds.

A range of toiletries should be purchased which meet the needs of black and minority ethnic children. For example, African and Caribbean children may specialist hair products.

Language - Language is an important part of a child's identity and culture. Every effort should be made to preserve a child's linguistic and communication skills; otherwise they may lose a large part of their culture. If a foster carer/residential care worker needs more information or advice about a child's cultural and linguistic needs they should be supported to contact the child's social worker.

Religion - The religious upbringing of a child is very important. The right to determine the child's religion is one of the rights all birth parents retain.

6. Gender Identity

Some young people may identify as transgender (i.e. as a different gender from their birth gender) or as non-binary (they may not identify as either male or female). Girls, boys and transgender/non-binary young people should receive equal opportunities and encouragement to pursue their talents, interests and hobbies. Sexist stereotypes of behaviour must not be imposed or condoned, for example there should be equal expectations that boys and girls will participate in domestic tasks.

Young people who are experiencing gender identity issues should, in general, be given space and support to develop their own gender identity, However it is important that they are protected from adverse effects such as bullying and discrimination.

In particular foster carers/residential staff may need to support young people with the following:

• How to respond to young people sharing their issues;
• Recording a change of name and gender;
• Bullying;
• Inclusion in sport; and
• Access to toilets.

Children and young people experiencing gender identity issues may be subject to prejudice, discrimination and misunderstanding, all of which can have a detrimental effect upon quality of life, and physical and mental health. If carers have any concerns about the emotional wellbeing of young people living the home, specialist mental health support may be required.

7. Children with Disabilities and Long Term Health Conditions

Facilities must be made available to allow carers to work with children with physical, sensory and learning impairments, communication difficulties or for whom English is not their first language. Oral and written communications must be made available in a format which is appropriate to the physical, sensory and learning impairments, communication difficulties and language of the individual. This includes arrangements for reading, translating, Makaton, pictures, tape recording and explaining documents to those people who are unable to understand the document.

8. Further Information

Culturally Appropriate Care (Skills for Care) – a range of resources to support embedding culturally appropriate care in everyday good practice.