Real life example of balancing rights - interested in opinions

[Azureal]

I have a sister who has a severe learning disability (non-verbal, developmental age of about 15 months) and has lived very happily in a small group care home for 15+ years. Some of the staff at her home have been with her from the beginning, both male and female, and are very good with her. We as a family have never had a problem with the male staff giving her personal care and she doesn't appear to mind either. Indeed her favourite staff members are probably male.

A new person has moved into the house, also with a severe disability, and her family insist that only female staff undertake her personal care.

As a result there is a new house rule that a female staff member always has to be on overnights.

Historically it was mostly the male staff who took the overnights and many of them rely on the overtime to support their families.

The longstanding male members of staff are now thinking of leaving as they can't afford the pay drop. So the parents of the other person's right to request staff of a specific sex is negatively impacting my sister who may lose longstanding relationships with staff she is accustomed to and very close to. She is epileptic and has had 2 seizures since the change when she hadn't had any in 6 years. We are worried it's a reaction to stress as it's usually bank staff now if she wakes in the night as the female staff don't want the nights and the male staff aren't allowed.

I understand both points of view, that of the other family and of ours. But I'm worried for my sister. Would this come under sex discrimination or not? And any suggestions for resolving?

This doesn’t make sense as there should be more than one person on at night.

I agree the other resident has the right to female staff for personal care. So one member of staff needs to be female.

Unless the other resident requires all female staff for mobilising etc. I can’t see why there can’t be male staff on duty too.

I agree it might reduce the number of night shifts open to male staff but there still should be some shifts.

I doubt it would. It's a perfectly reasonable requirement that only female staff do intimate care for female residents especially if they have serious physical or mental disabilities. Tbh for safeguarding and privacy reasons no male members of staff should have been allowed to do personal care for a non verbal female resident.
I'm sorry if the residence was not properly staffed before and that the operators haven't hired a full time member of staff for overnight care but it's not sex discrimination to say a female member of staff must be on shift at all times it's literally basic safeguarding

Some care places have only one at night if there are no particular overnight needs and it's a small place - often it's a sleep in shift.l, but may be a waking one if one can manage all the clients' needs - there's no cooking/cleaning/taking out etc required overnight which needs more than one.
It's very, very sad OP - changes often set people back. It is unusual that care staff stay at one place for a long time, so I imagine this home is lovely and worked for everyone.
So I'm not sure of my answer, change will always happen, and sometimes adversely affect people, but you can't stop that just try to manage the situation as well as possible until things settle. However, such a drastic change caused by a new client is so upsetting for more folk that I think some discussion should be had prior to it happening. Was this really the right place for the new girl for instance? Sometimes people are put into the wrong place but it's needs driven - lack of spaces, care place needing cash etc. I would prefer and do think that current clients' needs are maintained but practically that will rarely happen and the bottom line is everyone is receiving required care so that's enough, if not ideal at all.
Have you discussed management of the situation? Is it long term or May the new person leave soon? I hope all settles soon.

I think this is a really good example of why rights are/should be ‘category based’ as far as possible so you can say ‘these are the rules’ and everyone understands that balances may feel a bit wrong in individual situations but should be right overall.

The real question is ‘is there a right to same sex care?’ That right could be given in law, or in the contract between the client and the service provider.

if there is, all the staff should be told, on hiring, that clients have a right to same sex care and that shifts may need to be adjusted accordingly.

Sad as it is, your sister doesn’t have the right to continuity of care because logically that is impossible to provide as staff can leave at any time.

On the other hand, maybe there isn’t a right to same sex care? (I don’t actually know whether there is or isn’t). If there isn’t, it becomes a balance of competing rights (employment rights of staff, best interests of clients etc).

In terms of the rights of staff to be given particular shifts, that will depend on their employment contract but my guess would be it would give significant flexibility to the employer.

I understand from your point of view your sister’s continuity of care is hugely important and the changes are affecting her health. But she can’t have a continuity of care ‘right’ because staff are of course free to take other jobs.

My mum received at home care - many of the carers were male, which is quite a new change to the traditional demographic but care is needed and jobs are available - anyway my mum didn't mind at all and actually preferred male company 🤷🏼‍♀️ - many ladies though definitely wouldn't have the male doing their care, so it was always a mixed couple if calls were double up and always difficult for rota management if single calls.
However, and not discussed much, some men really dislike relying on women, particularly younger women helping with their care - is there a right for them to have male care?

As someone who has needed intimate personal care I think that anyone who needs such care absolutely should be able to request same-sex care.

I don't think the argument that male members of staff have family to support and so should get the overtime, rather than a female staff member, is going to go down well, OP. This is a feminism board.

Particularly when the shift in question is usually a pretty cushy one, enabling the person concerned to sleep through most of it. I speak as someone who at one point in my life used to earn £40 a night for sleeping at a local care home because two of us were required on the premises, me and a nurse. I did it 3 nights a week for a couple of years and was rarely woken.

So previously only the men did he night shifts and the women lost out on pay?

Just to make it clear. Intimate personal care includes bathing, helping with toileting including bum wiping, and for females who are menstruating the changing of tampons/pads and cleaning.

It is also worth noting that disabled people are vulnerable to sexual abuse.

It’s clear from the OPs post that the female staff don’t want these shifts. That’s why they now have to use bank staff.

I can see your pov OP but disabled, non-verbal women are so vulnerable to sexual assault, I’m not surprised the family insist on same sex care.

Is it a mixed sex facility, ie are the patients mixed sex? Are single sex facilities available elsewhere which would be more suitable for this new resident?

So let me try to understand what rights you think are being balanced here.

On one hand, we have a severely disabled woman who's family has requested single sex care.

On the other hand we have a severely disabled woman who's family does not mind them having opposite sex care.

The above aren't in opposition. It is fine for someone (or their family) to request single sex care, it is also fine to not request it.

So is the opposite 'right' the right for the night staff to only be male? Or the 'right' for the night staff to include staff that your sister is comfortable with?

I may have misunderstoood, of course. Therefore, I would appreciate it if @Azureal clarified what rights they think are being balanced and how this would relate to sex discrimination.

On a purely safeguarding basis I would always want female carers for any woman I cared about. It's basic safeguarding sense. 96% of the people behind bars for sexual offences are male. Male predators are drawn to jobs that allow them easy access to vulnerable people, male or female. They train for jobs such as social workers (remember all the children's home scandals?), nursery workers, HCPs and care home workers where they can have intimate access and where children and the elderly are too young/ confused/ unwell to report what has happened to them.

What if this man were to join the staff at your sister's home?
www.cps.gov.uk/mersey-cheshire/news/care-worker-jailed-having-sexual-relationship-client-and-making-her-pregnant

I do not understand why they cannot have one make one female staff member on at night ?

But any woman could have changed her mind and said she did want to start doing nightshifts, and they'd still have this same situation with the men moaning.

Anyway, of course women are entitled to request same sex intimate care, that's got to be the absolute priority here.

I'm shocked that male carers have been allowed to do your sister's personal care, tbh. She has no way of communicating to you if any of them have abused her.

This.

Single sex care for vulnerable females is, without doubt, good safeguarding practice. I don't think that the family of the new resident should be made to look for a single sex facility or feel bad in any way for making a sensible and legal request.

Single sex care for females, as well as always having one male and one female carer on the premises should be best practice. The stats for abuse by male carers are horrifying.

This is not balancing of right issue.

Its not a right for men to be guaranteed the overnight shifts, its not a right to have the same members of staff.

It is a right to have same sex care.

I wonder what the facility's insurers would have to say about only males being available at night? That sounds like a massive safeguarding risk to me. Non-verbal patients, patients with extremely limited capacity?

@Pluvia - it's no longer a cushy job the night shift. A relative has just left a lovely care place (small) after about 4 years sleep in shifts - the sleep was 12 to 6 but they were normally woken once or twice and at certain times if a client was poorly no sleep at all. The rate, as it doesn't need to be NMW was £25 for the 6 hours unless you're up for over an hour when you'd get NMW for that hour. When clients start staying up all night there has to be great debate about payment as well. They also did the 4 hours before midnight and 2 after 6am so a lot of work though at least for NMW. Their facility was all male normally but they would take females as well when spaces for the client were scarce but this didn't always work well. Ultimately there's just not enough resource in care altogether sadly.

This is quite an alarming post to me.
I worked in disability services for five years and one of the reasons I moved away from that area of work was because I found it too hard to deal with the prevalence of rape of my female clients. It was 100%. I got used to asking not if they had been sexually assaulted in their lives, but when.
OP my honest advice would be to use the arrival of this new housemate in the care home to say you also want your sister to only receive same sex intimate care. And you want assurance that there will be a female carer on staff, 24/7.

I knew there were major issues with male carers committing assaults but your post is really shocking, @TheCourseOfTheRiverChanged

I agree.

In a situation where a woman receiving the care can’t communicate, surely it is best practice to assume they don’t consent to being intimately touched by a man rather than assuming they do?

Did this occur when she was a child too?