Supporting relationships and sexuality in social care

Emotional and romantic wellbeing is a key part of person-centred support. We hear from Paula Harrison, Learning Partner at North West health and social care charity Alternative Futures Group, about the training she delivers to frontline colleagues on sexuality and relationships.

At AFG, we support people across the North West with a learning disability to live full and independent lives, which includes supporting their emotional and romantic wellbeing.

As part of AFG’s learning and development team, I’m responsible for running regular specialist training sessions to our frontline colleagues on sexuality and relationships. These sessions cover everything from:

• LGBTQIA+ identity
• The law and capacity to consent
• Recognising manipulation, coercion or abuse
• Supporting people to form and maintain relationships

Here we provide a safe space for colleagues to open up, ask questions and gain confidence talking about topics that can sometimes feel awkward.

Although colleagues can be shy when they first join the session, the group often relax quickly once they start chatting. If someone feels uncomfortable, that is okay. We encourage colleagues to understand the importance of supporting people to form and maintain relationships. It’s incredibly important, regardless of who they are or what stage of life they are at.

“How do I know if someone can consent to a relationship?”

This is one of the most common questions I get asked. The answer is that the individual must have the capacity to consent to a relationship and intimacy.

People with a learning disability can have capacity to make decisions about relationships and intimacy, but it depends on the individual and the decision.

Some people may have capacity over their finances whereas others may not, for example.

We will always follow the five principles of the mental capacity act 2005 We use the CURB method to determine capacity:

• C – Can they Communicate their decision?
• U – Can they Understand the information?
• R – Can they Retain that information long enough to decide?
• B – Can they Balance the pros and cons?

It’s important to remember:

• We must always assume someone has capacity unless shown otherwise.
• Having capacity means people have the right to make unwise decisions, just like everyone does. We cannot make that decision for them.
• If someone doesn’t have capacity but is showing interest in sex or relationships, don’t ignore it. This might be a safeguarding concern. Our role is to explore why they’re asking and what support they need.

“Am I crossing a boundary?”

There are some legalities around providing support around sex and relationships which are important to know – for example, if someone we are supporting would like to purchase an item or resource related to sex, you can support them to do this, but you cannot do it yourself – even if they have asked you to. It is of course very important that our frontline colleagues are aware of this distinction.

Supporting families through sensitive conversations

Families may worry about their loved one’s ability to make decisions around sex and relationships – it is natural for there to be some anxiety around this topic, especially if it’s never been explored before. It’s important to remind them that just because their family member needs support with aspects of their life, that does not mean they do not or should not have romantic feelings or form relationships. We use the BETTER model to help reassure and guide those conversations.

• Bring – Bring up the topic or issue
• Explain – that sexuality, relationships and sexual intercourse is a part of live and gives people a better quality of life (with consent)
• Tell – the family if they are having concerns or worries, we can find the appropriate resource and meet with other professionals.
• Time – give them time, this can be very upsetting for a family member. They may not be ready have the discussions. We could arrange to meet another day
• Educate – assist the family with finding the right information, research, leaflets or other health professionals.
• Record – record the information, this would need to be facts and not what you believe or think.

LGBTQIA+ and Learning Disabilities: The Missing Stats

There are an estimated 1.5 million people in the UK who identify as lesbian, gay or bisexual, which is around 3.2% of the population. This number has doubled over the past decade, which is likely due to growing openness and societal acceptance.

But how many people within supported living or who have learning disabilities identify as LGBTQIA+? The truth is: we don’t know.

There is currently no official research on this – which is exactly why these conversations are so important. For some of the people we support, this may be the first time they’ve ever spoken about their sexuality or expressed an interest in forming a romantic relationship. That’s why it’s so powerful to see individuals attending their first-ever Pride events. These conversations can make a life-changing difference.

Our top tips for talking about relationships and sex

Supporting someone in this area doesn’t have to be scary. Here are some of our key messages from training:

• Be open. Don’t shy away from the topic – a supportive, non-judgmental chat can mean the world.
• Ask, don’t assume. Let the person lead the conversation where they want it to go.
• Support safely. Understand the legal and ethical boundaries and know when to ask for help.
• Celebrate identity. Everyone deserves to feel proud of who they are.

Everyone deserves to feel seen and heard and this is all about providing truly person-centred support, recognising the importance of emotions, relationships and identity.

Find out more about supporting personal relationships.

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