Exam Pass Notes

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Key Takeaways

• Sexual safety in care homes means supporting lawful intimacy while preventing sexual harm.
• Moving into a care home does not end a person's sexuality, privacy needs, or right to relationships.
• Homes should have an open, respectful culture so staff can discuss sexuality, consent, risk, and safeguarding without embarrassment or avoidance.
• Resident safety, clear staff boundaries, accurate documentation, and timely escalation matter for safe practice.

Rights, Privacy, and Relationships

• People are still adults with intimate lives: avoid infantilising residents because of age, disability, dementia, or care needs.
• Support privacy and dignity: knock before entering, follow stated preferences, and avoid unnecessary interruption or judgement.
• Treat relationships with respect: this includes spouses, long-term partners, same-sex partners, and newer companions.
• Family do not automatically decide: relatives may have views, but they do not replace lawful consent or person-centred care.

Consent and Capacity

• Residents may engage in sexual activity if they have capacity to consent: this is a core NICE care-home point.
• Capacity is decision-specific: do not assume incapacity from a diagnosis or from support needs alone.
• Support the person's decision-making where possible: use clear communication, privacy, time, and calm discussion to help them decide.
• Best interests cannot decide sexual consent: in England and Wales, no one can make a best-interests decision on behalf of someone else about consenting to sexual relations.

Recognising Harm and Responding Safely

• Watch for warning signs: sexualised language, fear, withdrawal, unexplained bruising or pain, bodily fluids, secrecy, and overfamiliar staff behaviour.
• Staff-resident intimacy is a major red flag: NICE states this should be treated as suspected sexual abuse.
• Resident-to-resident situations need judgement: do not assume everything is consensual or everything is abusive; assess capacity and context.
• Disinhibited behaviour still requires action: protect the person, seek medical review if needed, and update care planning rather than laughing it off or shaming the resident.
• Use the right routes: serious incidents may require safeguarding referrals, police involvement, medical review, CQC notification, as well as internal action.