FMH10 Make and maintain personal and professional boundaries with individuals in a secure setting

Overview

This standard covers the need for staff who have to work closely with individuals for long periods of time to develop a proper relationship that does not run the risk of exploiting power or yielding inappropriate power to the individual. From time to time this has been problematic in residential settings and can give rise to individuals developing even more difficulties within their own personal patterns of behaviour, for example, sex offenders and those with learning difficulties or personality disorder. It is national policy that staff working with individuals with complex needs must access reflective practice/supervision to enable them to manage the demands made on them by forensic work. It is also very important that all staff within the multidisciplinary team agree and actively support the policy where they work to achieve clarity and consistency of treatment of the individuals. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. Mental health disorders
2. Self-harming behaviours, including ligation
3. Offending behaviours, especially violent behaviour not related to mental illness
4. Drug, alcohol or substance misuse
5. Psychopathy and personality disorder
6. Inquiry reports on forensic mental health settings, including recommendations and analysis of practice in maintaining boundaries
7. Your own responses and feelings
8. Processes of reflective practice
9. How to use clinical supervision and other opportunities for reflection in and on practice
10. The history of problems faced by staff and individuals in secure care
11. Local admission criteria
12. Current mental health legislation and regulations (eg with respect to relationships and sanctions)
13. Codes of professional conduct, ethics, HR legislation
14. A range of communication styles and methods, including those of interviewing
15. Negotiation skills
16. Communication protocols between establishments
17. Theory and practice of managing aggression
18. Role modelling relationships, demonstrating integrity
19. The religious beliefs of different cultures
20. The effects of culture and religious beliefs on individual communication styles
21. The different features services must have to meet people’s gender, culture, language or other needs
22. The effects of different cultures and religions on care management
23. The principle of confidentiality and what information may be given to whom
24. How information obtained from individuals should be recorded and stored

Performance Criteria

You must be able to do the following:

1. explain clearly to individuals, carers and other staff:
1. your role and responsibilities
2. how your role fits with the roles and responsibilities of other team members
3. what confidentiality is and its limits
4. the importance of personal and professional boundaries
5. the boundaries that come with developing a therapeutic relationship with an individual
2. help the individual understand that the therapeutic relationship is a joint pursuit, initiated and maintained by you, and how and when the individual can expect the therapeutic relationship to terminate
3. avoid disclosure of personal information about yourself and others and when necessary explain why you are doing this
4. use supervision to explore and evaluate your personal and professional boundaries
5. recognise the nature and challenges of the personal and professional relationship in your specific workplace (eg as a practitioner in a long-term residential care setting)
6. recognise when individuals arouse either strongly positive or negative feelings in you, check that these do not determine your actions and discuss this in supervision
7. ensure that structures are in place to provide support on a regular, on-going basis (eg reflective practice sessions, clinical supervision) and use these
8. use the reporting mechanism for yourself and others when you believe that personal and professional boundaries have been exceeded within the multidisciplinary team
9. debrief with a member of the multidisciplinary team without delay if you think you might have behaved in a way that has exceeded personal and/or professional boundaries

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: Core 5 Quality