Learning disability personal and sexual relationships policy and guidance

This guidance has been developed by the Learning disability strategy’s Big Plan working group Relationships, Friendships and Feeling Safe. 

This group consists of members from Brighton & Hove City Council, Sussex Partnership NHS Foundation Trust, Learning Disability Provider services within the city and people with a learning disability. 

The purpose of which is to uphold the rights of people with a learning disability to develop personal and sexual relationships that are safe, legal, and fulfilling. 

Relationships, love, and intimacy are an essential part of human wellbeing. People with a learning disability have the same rights (subject to being a capacitated consenting adult) as everyone else to explore, express, and enjoy personal relationships, including sexual relationships, in ways that are meaningful to them. 

People with a learning disability told us: 

“We need staff to be confident talking to us about personal relationships and sexuality”. 

“We need a choice of staff members to talk to about personal relationships and sexuality, we may not feel comfortable talking to all staff members”. 

“I would like staff to talk to me about my sexuality. I don’t really have people that I can talk to about my sexuality and the judgment I have experienced from family and the past harassment and abuse I have experienced because of my sexuality”. 

“When we are in a relationship, we would like staff to support us to explore choices: what we want from the relationship and to explore sexuality, pleasure things you enjoy and like. We would also like support to have this conversation with our partner so we can discuss consent, what we would like, don’t like and what our boundaries are”. 

“Our partner should also have the opportunity to have the conversation separately from us before we are supported to have the conversation together”. “We need help to explore and discuss relationships when things are not working”. 

This document sets out the principles, legal frameworks, and practical guidance to ensure that all adults with a learning disability are supported in line with human rights, equality legislation, and safeguarding responsibilities. It promotes a positive, person-centred, and rights-based approach that balances individual choice and autonomy with the need for safety and protection from abuse. 

The guidance is intended for all staff and professionals working in adult social care, health, commissioned services, and the wider community sector who support people with a learning disability. It should be read alongside the Mental Capacity Act 2005, the Care Act 2014, the Sexual Offences Act 2003, and the Brighton & Hove Safeguarding Adults Board (SAB) multi-agency policy and procedures.

This policy and guidelines adhere to values that are firmly rooted within the United Nations Declaration of Human Rights: 

We are committed to support relationships, love, and sexuality as essential to wellbeing. 

Everyone is valued and supported in exploring relationships and intimacy in a way that works for them. 

We respect diverse sexual orientations, gender identities, and cultural backgrounds.

Policy 

Everyone has the same rights regardless of disability, mental ill-health or background.

The law says that everyone has the same capacity to consent and make decisions about their intimate lives, and the right to enjoy their private lives freely (including personal relationships, romantic, sexual, or otherwise) without restriction unless proven otherwise through a formal capacity assessment or legal restriction. 

We support being positive about managing risk, this does not mean trying to eliminate risk. It means managing risks to maximise people’s choice and control over their lives. 

We support the ‘Sexuality and My Rights Charter’ produced by Tizard University of Kent, NDTi, My Life My Choice and Supported Loving. 

In Summary We support legal and mutually consenting relationships. 

Law 

Mental Capacity Act - The Right to Decide The 5 principles in the Mental Capacity Act (2005) must be followed in any decision-making with adults with learning disability. 

These are: 

1. Every adult must be presumed to have capacity unless it is assessed that they lack capacity for the specific decision in the Act. 
2. A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success. 
3. An unwise decision does not mean a person lacks capacity. 
4. Any decision or action taken on behalf of a person lacking capacity must be in their best interests. 
5. Any decision or action taken on behalf of a person lacking capacity should aim to be the least restrictive option available. 

These principles are decision-specific and apply equally to each decision that a person makes with regard to their sexuality, as to other decisions about their life. Practitioners must be able to evidence their compliance with these principles when applying this policy to their practice. 

Human Rights Act 

The Human Rights Act 1998 was enacted to ensure public authorities act compatibly with the European Convention on Human Rights The United Nations Convention on the Rights of Persons with Disabilities(CRPD)means in practice that, services must: 

• support people with relationships, not just manage risk
• balance safeguarding with the persons Article 8 Rights 
• provide sex and relationships education in accessible formats 
• ensure policies on intimacy are lawful, rights based and person centred. 

The UN Convention on the Rights of Persons with Disabilities.

Guidelines 

What rights people have

The rights of people with a learning disability to:

• enjoy and express their sexuality
• practise their sexuality and have their sexuality recognised by others

These rights include support for: 

• information 
• privacy 
• intimacy 
• specialised contraceptive services (UNCRPD- Article 25)
• parenthood 
• marriage and civil partnerships 
• sexual preference 

These rights can sometimes be complicated. 

For example: 

• a person may require assistance to access a particular right
• the rights of a person may conflict with the views of a parent
• the rights of an individual may conflict with the rights of the wider group
• the rights of a person may conflict with the rights of member/s of staff
• a person may have some legal restrictions placed upon them by the courts

In such circumstances, it may be necessary to take the following steps to: 

• consult fully with all those involved, including a line manager
• consider whether there are any legal implications
• make the decision with sensitivity, focusing on the intentions of the policy

Responsibilities and rights – staff and providers 

Providers are responsible for ensuring staff are well supported and equipped with the skills and resources to support people with relationships and sexual expression and considering the individual preferences for support. 

Boundaries between staff and the person should be consistent and professional and all staff should be aware of the agreed boundaries based on the individual support needs of the person. 

Staff have a responsibility to seek advice and support if they have concerns about a person’s wellbeing. • Any safeguarding concerns must always be addressed. 

Staff should act as champions of inclusion by demonstrating cultural sensitivity and awareness and using positive and inclusive language. 

Top tips - do’s and don’ts 

Do:

• create an open, shame-free culture where the individual’s wishes are the starting point
• listen to each individual to be able to guide them to the resources and information they may need to explore and express their needs, wants and wishes
• acknowledge that the individual’s wishes are as important as yours and everyone else's
• share the Brighton & Hove Sexuality and Relationships My Rights Charter with people

Don't:

• make decisions for individuals - allow them to make decisions by giving non-judgmental information (unless the individual is assessed as lacking mental capacity to make the decision for themselves and you have the legal authority to make the decision for them) 
• remove all risks

Ask: 

• what does the individual want to achieve? 
• how can staff support them to achieve this? 

Remember:

• everyone has the same rights
• not all decisions have to result in a ‘positive’ outcome
• a ‘positive’ for somebody being supported may not be the same as their staff’s perspective
• positive risk-taking is safeguarding the individual
• restricting people increases risk! 

Resource links 

Guidance: Supported loving toolkit: 

You are a Sexual Citizen: Gillian Leno: You are a sexual citizen.

Legislation 

This policy supports adults with a learning disability’s right to love, intimacy and relationships, and sets out how we will uphold those rights in practice. 

It is grounded in the Equality Act 2010, which protects people from discrimination, particularly on the grounds of disability, sex, sexual orientation and gender reassignment and in the Human Rights Act 1998, which embeds the right to private and family life (Article 8) and requires any limits on that right to be lawful, necessary and proportionate. 

Together, these laws require us, as a public authority and as care providers, to actively remove barriers to equality of opportunity, foster inclusion, and ensure that people with a learning disability and autistic people can access information, support and environments that enable safe, consensual relationships on an equal basis with others. At the same time, this policy explains our safeguarding and capacity responsibilities. 

The Mental Capacity Act 2005 presumes capacity and requires tailored support to aid individuals to make informed decisions for themselves. The Act makes clear that no one (including the Court of Protection) can consent to sexual activity on another person’s behalf where they lack capacity to engage in sexual relations meaning sexual activity cannot lawfully occur. 

The Sexual Offences Act 2003 defines consent as a free and capacitated choice and creates specific offences to protect people in caring relationships or those who lack capacity; staff and volunteers must never engage in sexual activity with people they support. 

Under the Care Act 2014, we promote wellbeing, including people’s rights to relationships and we prevent and respond to abuse through proportionate, person‑centred safeguarding. 

The sections that follow set out the practical standards, decision‑making guidance and staff training required to balance human rights, choice and independence with safety, lawfulness and protection from harm. 

Guidelines 

Purpose and scope 

This section outlines the key legal framework for supporting people with a learning disability in Brighton & Hove regarding personal and sexual relationships. It provides staff with an overview of relevant statutory provisions, practice principles, and safeguarding duties. • This framework does not replace the need for legal advice in complex cases. Where there is uncertainty, managers must seek legal advice and follow Brighton & Hove Safeguarding Adults Board (SAB) procedures. 

Summary:

• Adults with a learning disability have the same rights to relationships, marriage, and parenthood as others, subject to capacity and consent. • The Mental Capacity Act 2005 provides the framework for assessing capacity. 
• The Sexual Offences Act 2003 creates offences to protect against exploitation and clarifies the definition of consent. • Best interests decisions cannot be made about sexual relations. 
• Where capacity is in doubt, legal advice and an application to the Court of Protection may be required. 
• Safeguarding concerns must always be reported immediately. 

Overarching legal principles 

When working with people with a learning disability, the following statutory principles apply: 

• Presumption of capacity – every adult is presumed to have capacity unless it is established that they lack capacity for the specific decision in question. 
• Support to make decisions – before concluding someone lacks capacity, all practicable steps must be taken to help them decide (for example, accessible formats, communication aids, advocacy, familiar environments, additional time). 
• Decision- and time-specific – capacity is assessed for the specific decision at the time it needs to be made
• Unwise decisions – making an unwise decision does not in itself mean a person lacks capacity. 
• Best interests and least restrictive option – where someone lacks capacity for decisions other than consenting to sexual relations, any act taken must be in their best interests and be the least restrictive option available.
• No substitute decisions for sexual consent – the law does not permit anyone to consent to sexual relations on behalf of another person.
• Practice note: for autistic people, consider sensory processing, communication style, and social understanding when applying the Mental Capacity Act principles and making reasonable adjustments where required. 

Consent 

The Sexual Offences Act 2003 defines consent as: “A person consents if he or she agrees by choice and has the freedom and capacity to make that choice.” 

Implications

Consent must be informed, voluntary, and can be withdrawn at any time. 

A lack of capacity to consent means sexual activity with another person cannot lawfully take place. 

Consent is act-specific, person-specific and time specific; consent to one activity does not imply consent to another even with the same person. 

No person (including professionals, carers, or the Court) can consent to sexual activity on behalf of another adult. 

Staff must not: arrange, book, or negotiate with a sex worker or agency; transport a person for the purpose of purchasing sexual services; handle money or facilitate payment; act as an intermediary or communicate with a sex worker on behalf of the person. Any such actions may expose staff and organisations to criminal liability. 

Sexual Offences Act 2003 

The Act creates specific offences to protect people with a learning disability from sexual exploitation and abuse. 

All suspected offences or unlawful activity must be reported immediately through Brighton & Hove Safeguarding Adults procedures and to the police. 

Capacity to engage in sexual relations legal position 

Capacity to engage in sexual relations must be assessed under the Mental Capacity Act 2005. 

The assessment is decision-specific (for example, consenting to penetrative sex) and time-specific. 

An individual cannot consent on behalf of another person.

When assessing if a person has capacity to engage in sexual relations the bar should not be set too high. 

It is important acknowledge the legal test as to whether P (the person) is:

• unable to make a decision for themselves in relation to the matter and 
• whether that inability is because of an impairment of or a disturbance in the functioning of mind or brain 

The functional test to determine if the person is able to make the decision for themselves is below: 

The Four-Part Functional Test A person must be able to:

• understand the nature of the sexual activity, who it involves. The relevant information to assess this understanding is established by case law as: 
  • (1) the sexual nature and character of the act of sexual intercourse, including the mechanics of the act; 
  • (2) the fact that the other person must have the capacity to consent to the sexual activity and must in fact consent before and throughout the sexual activity; 
  • (3) the fact that P can say yes or no to having sexual relations and is able to decide whether to give or withhold consent; 
  • (4) that a reasonably foreseeable consequence of sexual intercourse between a man and woman is that the woman will become pregnant; 
  • (5) that there are health risks involved, particularly the acquisition of sexually transmitted and transmissible infections, and that the risk of sexually transmitted infection can be reduced by the taking of precautions such as the use of a condom
• retain that information long enough to decide
• use or weigh the information to make the decision
• communicate their decision by any means

Additional considerations

A person may have capacity for some sexual decisions but not others. 

Assessments should always consider communication and processing differences in autistic people. 

A person may not have capacity to engage in sexual relations but the possibility of them gaining or regaining capacity must be explored without delay - for example through educative work. 

A person may lack capacity to make decisions to have contact with others but have capacity to engage in sexual relations – they are different decisions 

Assessment and escalation

Assessments must be undertaken by professionals with the requisite skills and experience (for example, psychologist, psychiatrist, or other specialist assessor). 

If there are concerns that a person may lack capacity, legal advice must be sought on whether an assessment is required and whether an application to the Court of Protection is necessary. 

Best interest decisions cannot be made to authorise sexual relations for someone who lacks capacity. 

Marriage and civil partnerships 

People with a learning disability/autism have the same rights to marry or live together as anyone else, provided they have the capacity to understand what marriage means. 

Case law has established that understanding what marriage (also applies to Civil Partnership) involves:

• (a) marriage is status specific not person specific
• (b) the wisdom of the marriage is irrelevant
• (c) P must understand the broad nature of the marriage contract
• (d) P must understand the duties and responsibilities that normally attach to marriage, including that there may be financial consequences and that spouses have a particular status and connection with regard to each other
• (e) The essence of marriage is for two people to live together and to love one another
• (f) P must not lack capacity to enter into sexual relations

The minimum age of marriage and civil partnership is 18.

Forced marriage is prohibited under the Forced Marriage Act 2007 and is a criminal offence under the Anti-Social Behaviour, Crime and Policing Act 2014.

If there is concern that a person may lack capacity to marry/enter a civil partnership or could be the subject of a forced marriage, then legal advice should be sought. If the person is to marry imminently the Registrar’s office should be contacted urgently. 

Parenthood, contraception and reproductive rights 

There is no legal barrier to parenthood for people with a learning disability.

Parenting pathway protocol for adults with a cognitive impairment should be referred to ensure reasonable adjustments are being made as part of the assessment for adults who are becoming parents are offered appropriate reasonable adjustments to support the maintaining of the family unit. 

The Children Act 1989 requires the welfare of the child to be paramount. Local authorities have a duty to safeguard and promote the welfare of children. 

Contraception may be provided where the individual has mental capacity to decide whether and what form of contraception to use. For under-16s, who are assessed as Gillick competent it may be provided without parental consent if deemed in their best interests. Any assessment and decision is for the prescribing clinician. 

Sterilisation - where consent is not possible, it can only proceed following legal authorisation (usually the Court of Protection). Any assessment and applications to the court will be undertaken by relevant clinicians and health authority. 

Termination of pregnancy must comply with the Abortion Act 1967. If capacity is in doubt, legal advice and potentially a Court of Protection application will be required. Any assessment and applications to the court will be undertaken by relevant clinicians and health authority. 

Safeguarding and protection 

All adults have the right to be protected from abuse and exploitation.

Sexual activity without valid consent is sexual assault or rape. 

Any concerns or disclosures of abuse must be reported immediately via Brighton & Hove SAB procedures. 

Staff must never pursue or engage in sexual activity and relationships with people who they support in a professional capacity. 

Staff duties and good practice 

All staff must be trained in: 

• The Mental Capacity Act 2005 and Code of Practice
• safeguarding adults procedures
• The Sexual Offences Act 2003 and offences relating to care settings
• supporting autistic people in communication and decision-making. 

Additional requirements

All decisions, conversations, and assessments must be clearly documented. 

Managers must ensure access to specialist assessors and legal advice where required. 

Note: This section provides a Brighton & Hove-specific legal framework for policy. Staff must always refer to the Brighton & Hove Safeguarding Adults Board multi agency policy and procedures and seek legal advice in complex cases. 

Do’s and Don’ts 

Do:

• educate yourself on what people’s rights are regarding sexuality and relationships
• make sure people are aware of their own rights and receive education if needed
• respect people’s right to make decisions in this area, even if you don’t agree
• provide training for staff to confidently support people’s sexuality and relationship rights (for example, legal knowledge and practical skills)

Don't: 

• see rights in this area as different to any other area – they are important human rights
• over-emphasise safeguarding at the expense of human rights
• allow human rights breaches to go unexamined – you must raise concerns if you feel this is happening without there being a reason prescribed in law. 

Top tips 

Make sure human rights are respected and reflected throughout your organisation. This is not an ‘add on.’ 

Think about how someone's environment may limit their relationships, for example, only having a single bed or single chairs. 

If, due to capacity or other issues, people’s rights need to be restricted, how can we make the most of what they are able to do? For example, if a person has been declared by the court to lack capacity to engage in sexual relations, how do we still support their relationship to continue in other ways? 

Resource links 

Guidance: Equality and human rights commission guidance.

World Health Organisation's (WHO) working definition on sexual and reproductive rights.

Supported Loving Toolkit

Easy read 

Sexuality and Relationships – My Rights Charter.  

British Institute for Human Rights

Human Rights Card Game.

Policy 

The right to relationships and intimacy 

People with a learning disability and autistic people have a right to relationships. Relationships in this policy refers to platonic, familial, intimate or sexual relationships with others. People with a learning disability and should be supported to engage in mutual, consenting and legal expressions of physical and emotional intimacy as they choose. Expressions of physical intimacy may range from physical touch to sexual activity. For example, this could include touching, kissing and sexual intercourse. 

The diversity of relationships should be respected. People with a learning disability have a right to make decisions about their relationships, dating, living with partners, marriage or civil partnership, sexuality and sex life in accordance with the Mental Capacity Act. Where there are concerns about someone’s capacity to make decisions in relation to relationships they should be provided with support and accessible information to make this decision before commencing a Mental Capacity Assessment. 

Relationships, physical intimacy and sexual expression should be considered to be a core aspect of people with a learning disability’s identity and wellbeing. Choice, consent and legal frameworks should underpin how people are supported to express these needs. (Like the general population, some people with a learning disability may be on the asexual or aromantic spectrum. Asexual, or ‘Ace’, is a sexual orientation where people experience little to no sexual attraction to others. Aromantic is a romantic orientation where people experience little to no romantic attraction to others. 

People with a learning disability should not be assumed to be asexual or aromantic but if they decide not to explore romantic relationships and sexual expression this should also be respected). 

The right to information and support about relationships 

People with a learning disability should be supported to express the range of human emotions (including pleasure, anger, happiness, loss, joy, love, desire, intimacy) and not discouraged to express sadness in regard to relationships. 

People with a learning disability should be supported to make and enact decisions about maintaining and building new relationships in accordance with the Mental Capacity Act. This is particularly important for people who have lived in multiple social care settings throughout their lives and may have lost touch with old friends. 

People with a learning disability should be supported to explore what a good relationship means for them depending on their identity, cultural background and experiences. This is likely to include considering expectations, desired level of physical intimacy, and their own boundaries. People with a learning disability should be supported to understand and respect the concept of enthusiastic consent. 

People with a learning disability may use the internet for developing platonic, romantic and sexual relationships. Online relationships should be considered as valid and important as offline relationships and people with a learning disability should be supported to understand the potential risks associated with meeting people online. Staff should follow safeguarding policies and the mental capacity act where there are concerns regarding online relationships. Policies and practices may need to be updated as technology (and associated risks and benefits from online relationships) change. 

Identity 

The identity of people with a learning disability should be respected. Relationships may look different - depending on someone with a learning disability’s religion, cultural background, gender identity and/or expression, sexual orientation, personal experiences, preferences and values – and this diversity should be respected. Similarly, staff should affirm and validate the diverse range of sexual expression (as long as they are consensual and legal) and understand how this may range from physical touch, masturbation, the use of sex toys, polyamory, the use of porn, BDSM practices and LGBTQIA+ definitions of sex which may differ from heteronormative concepts. 

People with a learning disability may want to develop relationships with people similar to themselves - whether this is people with similar interests, from a similar cultural or religious background, sexual orientation or gender identity. People with a learning disability should be supported to engage with communities they align with as they choose. 

Social care providers should develop LGBTQIA+ inclusive environments so LGBTQIA+ people with a learning disability feel safe to express their identity. Staff should affirm and validate the sexual and gender identities of people with a learning disability and consider how this impacts the support they need. 

Staff should respect the privacy of people with a learning disability in relation to coming out as LGBTQIA+ and respect choice and boundaries as the people they support may want to come out to different people at different times as outing someone without their consent can be dangerous and harm relationships. 

If people with a learning disability would like to explore gender affirming healthcare, then they should be supported to access this similar to any other healthcare need in accordance with the Mental Capacity Act. Not all trans people need or want to access gender affirming healthcare and this does not make them any less trans. LGBTQIA+ people with a learning disability should be supported to engage with the wider LGBTQIA+ community as they choose as this can lead to significant potential benefits associated with their health and wellbeing. 

People with a learning disability who are intersex may face unique challenges related to healthcare, social inclusion and advocacy. Staff should avoid gendered assumptions not assuming someone’s gender, pronouns, or body parts, if unsure, staff should ask, “What words do you use to describe your body?” or “How would you like to be supported?”

Do not assume someone’s sexual or romantic orientation based on their learning disability. Asexuality (or “ace”) a lack of sexual attraction to others, and aromanticism (or “aro”) a lack of romantic attraction exists on a spectrum, everyone’s identity is unique. 

Do not pressure someone into romantic or sexual relationships, even if you believe it’s “normal” or “healthy” for them. 

Consent and personal agency are key. Ask individuals how they identify and what terms they use (for example, asexual, aromantic, or other identities like gray-asexual or demisexual). 

Respect their choices and avoid making assumptions. 

Staff should be aware of the potential risks of discrimination, hate crime and discriminatory abuse experienced by people with a learning disability who have intersecting marginalised identities (such as LGBTQIA+ people with a learning disability). Staff should be aware how to support people experiencing discrimination, hate crime and discriminatory abuse and know when to raise safeguarding concerns as appropriate. Staff should follow a positive risk-taking approach, following the Mental Capacity Act and safeguarding policy and legislation, when supporting people with a learning disability who are at risk of experiencing hate crime and discrimination. 

This approach involves promoting the choice of people with a learning disability, considering potential risks in partnership with them, giving them support to make their own decisions (following the Mental Capacity Act) and recognising that discouraging or invalidating LGBTQIA+ identity and/or expression is likely to be harmful and may amount to conversion therapy. 

Staff should have equality and diversity training that includes LGBTQIA+ identities and experiences, hate crime and discriminatory abuse. 

Trauma informed approach 

Staff should follow a trauma informed approach which seeks to avoid re traumatisation and address the barriers that people who have experienced trauma may face when accessing services. 

Abuse and conflict 

People with a learning disability should be supported to understand what abuse is in the context of relationships, how to recognise the potential signs of abuse and how to access support if they are experiencing abuse. 

Family members of people with a learning disability may discourage, or be uncomfortable with, them engaging in romantic or sexual relationships and expressing their gender or sexual identity. Staff may be particularly uncomfortable when family members views are related to a religious or cultural belief. Staff should treat religious or cultural beliefs with respect and should not prioritise family’s views above the views, wishes and needs of people with a learning disability or following this policy, the Mental Capacity Act and safeguarding policy and legislation. Where there is conflict, staff should sensitively explain the Mental Capacity Act and access additional support from Specialist Community Disability Service (see page 89) if there are concerns regarding discriminatory abuse and/or this conflict is having a significant impact on the wellbeing of the person with a learning disability. 

Guidelines 

Creating a LGBTQIA+ inclusive space

People with a learning disability are often assumed to be cisgender (they identify with the gender they were assigned at birth) or heterosexual, but there is a large community of LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer / Questioning, Intersex, Asexual / Aromantic) people with a learning disability. 

Research suggests that people with a learning disability are hesitant to come out as LGBTQIA+ as they do not know if it is safe to disclose this with staff and they are often dismissed when they do so. 

Social care providers can create a space that aims to be safe and inclusive of LGBTQIA+ people through: 

• considering the use of gender neutral language and not making assumptions about the sexual or gender identity of people you support for example, asking “would you like a romantic partner?” instead of “would like a boyfriend?” 
• normalising displaying and asking of pronouns when you first meet with someone
• celebrating LGBTQIA+ history and events such as Pride and Trans Pride
• displaying clear policies regarding gender and sexual expression and explicitly saying that you are LGBTQIA+ inclusive in posters, leaflets and websites. 

Trauma informed approach 

Trauma informed approaches aim to enable people to develop culturally sensitive, safe and trusting relationships with staff who partner with them to make choices about their health and wellbeing. 

Principles include: 

• promoting psychological, emotional and physical safety
• trustworthiness and transparency
• choice
• collaboration
• empowerment
• cultural consideration

Positive risk-taking approach

As part of a positive risk-taking approach, decision-making should be: 

• focused on promoting choice and autonomy of the person with a learning disability in accordance with the mental capacity act
• collaborative in terms of working with the person with a learning disability, their support network (where appropriate) and other agencies in order to identify and explore potential risks, solutions and available resources - the final decision should be made by the person with a learning disability or the lead decision maker where they have been assessed as lacking capacity to make that decision
• balanced, considering potential emotional, psychological, social and physical benefits - as well as harms - of a particular decision
• defensible not defensive - defensible decisions are well-founded, legally justifiable and proportionately recorded. Defensive decisions are primarily motivated by the need to protect professionals and agencies leading to less effective and less risky decisions. 

Supporting people whose sexual behaviours pose risks or cause harm to others requires a compassionate, structured, and person-centred approach. 

This involves balancing the individual’s rights, dignity, and autonomy with the need to ensure safety for everyone involved. Below is a structured guide to understanding, addressing, and supporting such situations effectively. 

Key considerations 

Understanding the behaviour 

Many behaviours are not intentional or malicious: Some behaviours may stem from a lack of understanding, impulse control, or unmet emotional or sensory needs. 

Ensure you accurately record any incidents: Record the nature, frequency and duration of the incidents, for example, who was the sexual behaviour in relation to - staff, self or another individual with a learning disability. Be specific about what has happened and any relevant factors e.g. the person's mood, any triggers for their behaviour, what led the behaviour to stop. 

Underlying causes: Consider factors that might be contributing like boredom, loneliness, lack of education about boundaries, sensory needs, mental health conditions, or trauma.

Ask for help sooner rather than later - especially if the sexual act has involved force, was prolonged or intrusive, or if it involved coercion or manipulation. Consider both psychological and physical harm. 

Legal and ethical frameworks 

Human rights: Everyone has the right to dignity, privacy, and autonomy, but these must be balanced with the safety of others. 

Level of understanding or capacity to make decisions about sexual and intimate relationships: Assess whether the individual can understand what they are doing and the consequences of their actions.

Safeguarding: Report all concerns to the local safeguarding team and (where necessary the police) following an incident of sexually harmful behaviour. 

Support strategies 

Education and training: Ensure rules and boundaries are clear. Use social stories and visual aids. Provide regular reminders about what is ok/ not ok, for example, private or public spaces. Where appropriate, provide tailored sex education that includes boundaries, consent, and social norms. Use accessible language and visual aids. Explain what behaviours are unacceptable and why. Teach and reinforce safer, socially appropriate alternatives. 

Positive behaviour support (PBS): Focus on reinforcing positive behaviours and addressing unmet needs that may trigger risky behaviours. Structure the individual’s day to reduce opportunities for risky behaviours. 

Environmental adjustments: Modify living or social environments to reduce opportunities for risky behaviours (e.g. specific seating on transport, supervised access to certain areas). 

Therapeutic interventions: Work with the Specialist Community Disability Service to address underlying issues like impulse control, trauma, or emotional regulation.

Planning 

Assess the risk: Is the behaviour harmful, illegal, or just socially inappropriate? How often is it happening? What is the psychological or physical impact? Are you able to impact the person's behaviour by offering education, changing how the person is supported or modifying the environment? 

Seek professional advice as soon as you are concerned: Consult a learning disability nurse, social worker, or clinical psychologist for a tailored plan.

Involve the individual: Where possible, include them in discussions about their behaviour and how to manage it.

Access training: Equip yourself and caregivers with skills in positive behaviour support and safeguarding. 

Review regularly: Monitor progress and adjust the support plan as needed. 

What is abuse 

Abuse is when someone mistreats or neglects another person in a way that causes that person to experience significant emotional, physical, sexual or psychological harm and violates individual’s rights. Abuse may not always be intentional or consciously done. 

Abuse may involve:

• physical (for example, unnecessary use of physical force or restraint)
• emotional or psychological (threats of punishment, humiliation, isolating someone from friends or family, attempts to inappropriately influence or coerce decisions)
• sexual (non-consensual sexual activity)
• financial (coercing someone into giving away their money or possessions) 
• domestic abuse, or domestic violence, (defined as any incident of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members, regardless of their gender or sexuality)
• discriminatory abuse (unfair treatment, abuse or harassment related to the protected characteristics of the equality act, for example:
  • age
  • disability
  • gender reassignment
  • marriage and civil partnership
  • pregnancy and maternity
  • race, religion and belief
  • sex
  • sexual orientation). 

Under the UK Serious Crime Act 2015, coercive or controlling behaviour in an intimate or family relationship is a criminal offence. 

The law applies if: 

• the behaviour causes the victim to fear violence on at least 2 occasions, or  
• it causes serious alarm or distress that has a substantial impact on their daily life 

A conviction can lead to up to 5 years in prison, a fine, or both. What is a healthy relationship Whilst abuse is legally defined under the Care Act, an individual’s definition of a healthy relationship may differ depending on their preferences, life experiences and identity. 

However, some overarching principles of what makes a healthy relationship include: 

• rust 
• communicating honestly and respectfully 
• patience 
• empathy 
• affection and interest 
• flexibility and collaborative decision making that takes into account both individual’s wishes and needs 
• appreciation and gratitude 
• respect 
• reciprocity 
• healthy conflict resolution 
• individuality and boundaries – there are commonalities that keep the individuals connected and each respect and value differences in friendships, values, goals and interests. 

Resource links 

Guidance 

Working definition of trauma-informed practice.

Choice Support - Supporting LGBTQIA+ People.

Health Education England – How to be an intersex ally.  

Brook - what does it mean to be asexual or aromantic?.

Easy Read 

Identity Booklet: This booklet talks about all the different identities that LGBTQIA+I+ people have, including being gay, bisexual, lesbian or pansexual. It also talks about gender identities, including being transgender or non-binary. 

Free Outspoken Wellbeing Activity Booklet: This wellbeing activity booklet has pages that you can fill in when doing some of the activities. They include a weekly self-care planner and an exercise about energy levels. 

Transgender an Easy Read Guide.

LGBTQIA+ - An Easy Read Guide. 

Being LGBTQIA+IA+.

You Being You film: You being you: Your gender and sexuality - YouTube about identity, gender and sexuality. You being you: Your gender and sexuality.

Film Guide.

Pronouns.

Easy read leaflets, images and picture banks

A Cup of Tea and Consent. This video used by the Thames Valley Police breaks down the concept of consent.

How to support people to express their sexuality and engage in sexual relationships. 

This section covers areas such as masturbation, pornography, pregnancy, social media, and intimate care. 

Intimate and personal care

Policy 

People with a learning disability should always be encouraged and given opportunity to carry out those aspects of personal care that they can do for themselves, following the principle of least intervention. 

Intimate care requires a high degree of sensitivity and respect for the individual's privacy and personal boundaries. 

Wherever possible, intimate personal care should be carried out by member of staff whose gender was chosen by the person with a learning disability. 

Law

Any sexual touching in the context of personal care is illegal. But touching of sexual body parts as part of authorised personal care and hygiene would be considered acceptable. 

Guidelines 

People with a learning disability and/ or autism should always be encouraged and given opportunity to carry out those aspects of personal care that they can do for themselves, following the principle of least intervention. 

When providing intimate or personal care, staff must make every reasonable effort to make sure that they respect people's preferences about who delivers their care and treatment. When people receive care and treatment, all staff must treat them with dignity and respect at all times. 

The care plan should state how this is to be done. The persons sexual preferences should also be respected, although their wishes may not necessarily be for a carer of the same or different gender. There may be reasons why a person would prefer one staff member rather than another that have nothing to do with their sexuality. 

The emotional and physical safety of people with a learning disability should be considered by staff at all times, for example, paying strict attention to health and safety matters, like using safe manual handling techniques. A risk assessment should be carried out to ensure both the emotional and physical safety of staff and people with a learning disability, paying close attention to workplace policies and health and safety matters. 

Addressing trauma in personal and intimate care

Individuals with a history of trauma may find personal and intimate care particularly challenging. It is essential to approach care with heightened sensitivity: 

Trauma-informed care

Understand the principles of trauma-informed care, which include safety, trustworthiness, choice, collaboration, and empowerment. This approach helps in creating a supportive environment. 

Triggers and responses

Be aware of potential triggers and how they might manifest. Gentle and respectful communication, along with predictable routines, can help minimise triggering traumatic memories. 

Empowerment

Empower individuals by involving them in their care decisions. Providing choices and respecting their autonomy can help them feel more in control and safe. 

Do’s and don’ts 

The dignity of people must be upheld by staff at all times. Considerations should include the following.

Do: 

• approach personal care tasks with the utmost respect for the individual's dignity - this includes seeking consent, explaining procedures, and ensuring the person feels comfortable and valued. Providers may be required to implement best interest decisions for individuals that lack capacity, with due consideration of the persons wishes and feelings and their customs
• carry out intimate care in private
• ensure intimate care is undertaken ideally by workers whom the person is familiar with and trusts - this should be considered in the recruitment of workers and the planning of work and rotas
• engage with the individual, listen to their preferences, and encourage their participation in decision-making regarding their care
• ensure the environment is safe and comfortable - this includes proper hygiene practices, using appropriate equipment
• be mindful of any special needs or preferences the individual may have, including awareness of religious and cultural beliefs and practices 
• be aware that people may become aroused during personal care, seek support from management if it occurs
• ensure staff are well-trained and competent in delivering personal and intimate care

Don’t:

• make negative comments and show disapproval through word or body language, this is always unacceptable practice

Resource links 

Guidance

How to help someone you care for keep clean.

Easy read

Puberty and sexual development.

Personal hygiene.

Personal hygiene check list.

Keep yourself clean for men. 

Masturbation 

Policy 

It is normal behaviour to masturbate for people of all genders. It is a safe way to explore one’s own sexuality. Reprimanding people for masturbating is not appropriate. People with learning disability should be helped to understand that masturbation should take place in private. 

Law 

It is not illegal to teach someone about masturbation, but it is good practice to make sure this is an agreed part of the establishment’s sex and relationships education (SRE) policy; and to maintain notes with clear details about the programme. 

Any physical touching involved in teaching about masturbation would be considered as sexual assault. (Sexual Offences Act 2003). Where people need physical help to understand masturbation, or to masturbate effectively, the decision would have to be taken by a court after a formal case conference, if the person is assessed as lacking mental capacity to consent to such arrangements. 

It is always necessary to refer to the Mental Capacity Act 2005 Code of Practice to guide decision-making in cases where a person’s ability to consent is in question. 

Guidelines 

Self-stimulation or masturbation is a normal physical sexual activity and can be a valid outlet of sexual feelings for everyone. For some people it may be the only way they can achieve orgasm. The knowledge of and familiarity and comfort of our body is an important part of positive self-esteem. Masturbation can relieve frustration and tension, provide pleasure and relaxation. 

People touch their genitalia for different reasons: it can be a comfort, sensory reason or sexual. We need to understand this in the context of the person’s presentation. It is important that people we work with are supported and not prevented from experiencing or made to feel guilty about masturbation. 

Residential providers should ensure that they identify appropriate ‘time and space’ so that everyone has some acceptable opportunity to masturbate, if they so wish. Staff may need to teach a person that there are places where it would be inappropriate to masturbate. 

For some people, masturbation can give physical pleasure, release tension and relieve boredom. Others may become very frustrated by being unable to masturbate. It is rare, but constant masturbation may bring about minor physical harm. If there is a concern about masturbation this should be discussed with care management. If it is felt necessary, the provider or care management should set up a meeting of relevant professionals, (and the individual and carer if appropriate) to discuss the issues and develop an appropriate plan. The meeting should consider the needs of the person and how these may be best addressed. Specialist advice may be necessary. 

If a person needs support in masturbating effectively, action may only be taken after a meeting of relevant professionals, including the persons family. The person should be consulted, affirming the principle of putting them at the centre of any decisions. 

Potential problems with masturbation:

• lack of understanding of the process
• physical difficulties – there may be a practical issue if a person is not able to remove clothing or continence products
• psychological issues
• some people can find it difficult to have erections and ejaculate
• some known side effects of anti-convulsant and psychotropic drugs can cause problems with erections and ejaculation. Some prescription medicines can also lower sex drive especially depression medicines called selective serotonin reuptake inhibitors (SSRIs)
• health conditions, such as diabetes, heart disease, and prostate conditions can lead to erection problems. Another possible cause is the prescription medications used to treat those conditions. 

Many health conditions can also affect sex drive. 

These include:

• cancer
• diabetes
• high blood pressure
• coronary artery disease 
• neurological diseases

Other things to consider: 

• is the person:
  • bored and in need of alternative stimulation/activities? 
  • able to masturbate effectively? 
• is an appropriate private environment available?
• are there relationship issues? 
• is there a concern about abuse? 
• are there any health-related issues? 

What happens if we choose to ignore these issues? 

• potential for physical and emotional distress demonstrated through behaviour
• sexually inappropriate behaviour in public
• stigma and isolation
• potential for frequency and intensity of issues to further develop becoming a major management problem

What may people with a learning disability need? 

• assessment of sexual behaviour(s) taking into account cognition, processing of information and communication needs
• accessible information, such as, visual sequencing strip, social story or easy read booklet on: 
  • what is masturbation 
  • how to masturbate 
  • what happens to them when they masturbate 
  • what is public and private and what may be offensive to others 
  • health and hygiene relating to masturbation 
  • sensitive empathic carers who can promote: 
    • positive sexual expression and sexual health 
    • access to GP and/or specialist services if required.

Staff need an awareness of: 

• sexual health policy and guidance
• how to be responsible – increasing knowledge, skills and confidence
• how to access training and support.
• how to complete a risk assessment, developing a multi-professional/multi agency shared care plan identifying issues, supports and positive interventions required and by whom. 

Workers are strictly forbidden to perform any sexual relief or sexual acts with a person with a learning disability. Any contravention of this would be a disciplinary matter and in addition workers could be charged with a criminal offence. 

Do’s and don’ts 

Do:

• recognise how the views of services and staff may impact upon the individual regarding their right to masturbate
• explore whether the individual understands the concepts involved with appropriate and safe masturbation, and their rights to engage in the activity - this should not be too intrusive. Services may need to understand the individual’s masturbatory methods, including stimulatory methods, and whether climax is reached
• develop appropriate policies and procedures to protect both individuals and staff - there should be a comprehensive and proactive sex and relationships programme that includes the issue of masturbation

Don't:

• ignore the issues, especially if an individual is masturbating in an inappropriate manner or place - by ignoring the issue and not providing support, you are potentially putting the individual at risk
• assume that the individual is fully aware that they can masturbate - some individuals may be under the impression that it is ‘dirty,’ or that they need permission from those around them to engage in masturbation
• make assumptions regarding the cause of inappropriate masturbation - this can be an indicator of sexual abuse that has happened or is still occurring
• ignore the importance of emotions linked with masturbation, which can be experienced by the individual - these will need to be considered as they may override the individual’s control in engaging in the activity appropriately

Resource links 

Guidance

Supported loving toolkit. 

Masturbation, autism and learning disabilities - A guide for parents and professionals:

Easy read

Things Ellie Likes - a book about sexuality and masturbation for girls and young women with autism and related conditions.

Things Tom Likes - a book about sexuality and masturbation for boys and young men with autism and related conditions.

Aids and equipment

Policy 

People have a right to support around their sexuality, which includes finding appropriate equipment and aids to facilitate sexual activities. 

Guidelines 

If a person you support wants to buy a sex toy and has the capacity to choose the equipment, you can help them to do this. Sources of information on which pieces of equipment might be suitable, are not always presented in an accessible way, for example:

• British Sign Language (BSL)
• Easy read 
• audio versions

If someone you support wants to access a sex shop (for example, Ann Summers), or some practical help with using a computer to access an online sex shop (for example, The Pleasure Garden or Lovehoney) support staff can provide that support. Shop staff are very knowledgeable and virtually shock-proof and can help select a suitable device. 

Some people may not understand how to look after their sex toy and keep it hygienic. Explain that if sex toys are used, they must be cleaned as per the instructions that came with the toy. You may need to provide accessible information on how to do this. 

As a result of their disability, some disabled people can’t reach their genitals without an aid. If a person wants to use a sex toy, but cannot use it independently, you can position the sex toy and then leave them to use it privately. There are sex toys that can be used ‘hands-free’. Bondage tape can be used to adapt a wide range of sex toys for hands-free use. It can be used to firmly fix toys in place to a pillow, bed or chair, without leaving any sticky residue. 

Explain that using lube for masturbation can help avoid friction damage. There are some disabilities and health conditions that can cause vaginal dryness, making lube an essential part of a sex toolkit. Introducing a good quality lubricant can help reduce discomfort and increase pleasure during sex. The main types of lubricant are water or silicone based. Water-based lubes are generally cheaper and can be used with all types of sex toys. Silicone lube is thicker and lasts longer but is sometimes incompatible with silicone sex toys. 

It should also be explained that sharing sex toys with a partner can pass on Sexually Transmitted Infections (STIs) such as chlamydia, syphilis and herpes. There is also an increased risk of bacterial vaginosis in women who have sex with women. The transmission of STIs can be prevented by covering sex toys with a new condom each time it is used to have sex with a partner (especially between different partners) and using a water-based lubricant. The condom should also be changed between vaginal and anal penetration to avoid the transfer of germs between body parts. 

If someone you support has not expressed a desire to purchase a sex toy or lacks the capacity to do so, but there are concerns regarding use of inappropriate objects or issues relating to poor technique, introducing one may reduce harm. Providing education about sex toys will be the first step, so that the person you support can access information about an item they may have never realised was available to them. However, any introduction of equipment for a harm reduction reason, without the informed consent of the person you are supporting, needs to be approached carefully, within a Multi-disciplinary Team (MDT) approach and as part of a best interest decision. 

Top tips 

Remember that the human body was built for pleasure, and pleasure should be available to everybody, no matter what their level of physical ability. 

People with disabilities should have the best possible opportunities to sexually express themselves. 

Resource links 

Guidance 

Choice Support website.

Easy read 

Kinks and fetishes - people have a right to support around their sexual preferences. This includes support around different kinks and fetishes.  

Pornography and the sex industry 

Policy 

People with a learning disability have the same right as others to obtain and enjoy publicly available pornography (for example, ‘top shelf’ magazines). No pornographic material should be openly displayed in any public parts of the building. Each establishment will set out clear guidelines to avoid people accessing illegal pornography via the internet. See also - Section 8. Staying Safe.

Law 

Legal pornography 

It is legal to purchase or own pornography showing people over 18 and if the purchaser is over 18 (Sexual Offences Act 2003). Legal pornography includes any materials that may be legally sold in the UK in a newsagent, a licensed sex shop, films certified by the British Board of Film Censors (BBFC), or material legally downloaded from the internet. 

It is not illegal to physically assist a person to buy legal pornography, where the person is unable to purchase pornography. For example, a wheelchair user who cannot reach the material on a ‘top shelf’. Any member of staff in this situation should consult with a manager. The use of explicit material to teach sex and relationships education (SRE) is not illegal. 

Illegal pornography 

Illegal pornography includes indecent photographs of children and possession of ‘extreme pornographic images, including sexual engagement with animals. 

Sexual images showing children 17 and under are always illegal. This includes images downloaded from the internet. Any material containing sexual images of children must be reported to the police. 

Extreme images are those depicting rape or non-consensual penetrative activity or act likely to result in a person’s severe injury. 

Where materials are being accessed that are thought to be illegal, staff should immediately seek advice from their line manager, who may report the matter to the police. 

It is also necessary to refer to the Mental Capacity Act 2005 Code of Practice to guide decision making in cases where a person’s ability to consent is in question. 

Guidelines 

Pornography 

Pornography is a controversial subject. Pornography is regarded by some people as offensive and degrading. However, some pornographic material is publicly available and people with a learning disability cannot readily be denied something that is available to others; it is their choice if they wish to use it. 

Pornography can sometimes help people, to achieve some sexual satisfaction which they might otherwise be unable to attain. People with a learning disability who use pornographic materials must be helped to understand that: 

• most people do not behave as the people in the magazine or videos
• it must be kept and used in private and not brought into public spaces as people may have different views about pornography - a bedroom is usually considered the most appropriate place to use or display pornography

However, for some people there may be concerns about pornography leading to unhealthy sexual expression or increasing the potential for sexual offending. Staff may need to discuss this with the wider multi-disciplinary team, in order to decide whether staff should assist with this in any way. Others will have restrictions imposed on them because they are in hospital settings where hospital policies, individual care plans and legislative restrictions may apply, or they may be in a community setting but still subject to legislative restrictions. 

Staff should not bring pornographic material into their work settings, nor should they buy pornographic material on behalf of a service user. The one exception to this is where a person is unable to purchase pornography and the reasons, what was purchased, how and when should be clearly recorded. For example, a wheelchair user who cannot reach the material on a ‘top shelf’. Any member of staff in this situation should consult with a manager. Assurance will be needed that the person is making a clear choice (It is always necessary to refer to the Mental Capacity Act 2005 Code of Practice to guide decision-making in cases were a person’s ability to consent is in question.). 

It should be made clear that pornographic material should be used in private, should not be shared with other people and should not be displayed when staff are with the person. The storage and the visibility of such material may need to be discussed depending on the persons living situation, where the rights of co residents may also need to be considered. 

Internet pornography 

People may be able to access pornography online via the internet. In law, any online extreme pornography is considered illegal. This includes images (still or moving) that portray life-threatening acts, serious injury to a person's genitals, anus or breasts, sexual activity involving violence, coercion or lack of consent, sexual acts involving a corpse, or sexual acts involving animals (bestiality). It also includes any sexual images involving children, which are always illegal. Dealing with this requires each establishment to agree clear guidelines about what is acceptable and what is not; a clear policy on what must be reported to police; and who is responsible for this. It is possible to restrict access to the internet so that illegal pornographic sites cannot be visited. 

The guidelines will need to balance the rights of the individual, the requirements of the law, and any potential damage to the person or others. When these issues arise, staff must inform their line manager. 

In commissioned care settings, access to legal pornography on the internet will not be permissible on the organisations computers and this will be covered by organisational policy. 

However, many people with a learning disability will have their own computers, or other technologies which give internet access, with no filtering or blocking. Staff may be required to support with age verification processes, support people with identification and/ or facial recognition for confirmation of age, in accordance with the Online Safety Act. This is to support safe internet use and therefore staff would also be expected to ensure that the site obtaining the information appears to be legitimate. 

Mobile technology 

Many people with a learning disability will also have remote internet access on them wherever they may be. The same guidelines apply to that of a static computer (see also social media) with regard to accessing social media and pornographic material. Staff should ensure people with a learning disability are aware and understand that they should not access pornography in public places. An additional concern may include that ‘roaming’ data downloads may be much more expensive than a Wi-Fi connection, leading to increased bills. 

Some adults with a learning disability may be at risk of entering sites with more hardcore or illegal material without necessarily understanding the consequences and can be vulnerable to being victimised, online radicalisation and misogyny. Staff may wish to support people with their consent to find certain material as part of an agreed risk assessed plan, to avoid the risk of inappropriate or illegal sites being searched

The sex industry

Commercial sex venues 

A person with a learning disability may seek support to access, for example, a strip club. Strip clubs are legal and a part of normal sexual experience for some people, thought felt by others to be exploitative and degrading. Requests for assistance to visit such a venue should be considered in the same way as pornography, the person should have capacity, their wish should be acknowledged, and there should be discussion with the line manager, or where there are more serious concerns, the wider multidisciplinary team. A risk assessment should be undertaken to ensure that all involved are not negatively impacted, whether the person themselves, the staff member, the other patrons in the venue, or indeed those working in the venue. All decisions should be recorded in care and support plans. 

Sex workers 

A person with a learning disability may choose to seek the services of a sex worker and may request assistance from staff to do so. Staff cannot suggest accessing sex workers as an option but can respond to requests to assist, meaning, staff may assist in maximising a person’s general ability to communicate independently, for example, accessing assistive technology, but staff should not make direct arrangements with a sex worker or agency. 

While prostitution itself (the exchange of sexual services for money) is not illegal in England, there are a number of potential crimes around it, and any contact with a sex worker, either on the street or in a brothel or sauna, could leave staff open to a variety of allegations and potential criminal charges. 

Staff must not arrange, book, or negotiate with a sex worker or agency. Transport a person for the purpose of purchasing sexual services. Handle money or facilitate payment. Act as an intermediary or communicate with a sex worker on behalf of the person. Any such actions may expose staff and organisations to criminal liability. 

The person must be able to consent and understand that using a sex worker is a financial transaction. If the person has capacity their wish should be acknowledged but staff should point out the potential legal, emotional or financial implications of accessing sex workers. There are also potential impacts around loss of reputation, sexual health and experience of stigma. These should all be made clear to the person, so they have as clear as possible an understanding of the potential risks. 

Risk assessment 

Where a person expresses interest in accessing sex work, a risk assessment must be completed. 

Discussion must include: 

• physical safety
• exploitation risks
• sexual health risks
• emotional impact

Decisions must be clearly recorded, defensible and proportionate. 

Decision making

Support the person with decision making, what to expect and how to how to communicate what they would like to happen, boundaries and preferences. 

Keeping safe 

Discuss privacy and confidentiality who will know about this and how to keep it safe. Talk about meeting in safe, public or controlled environments if possible. Encourage sharing plans with a trusted person for safety. Make sure they know how to say no or stop at any time. Discuss safe sex practices and the importance of protection to prevent STIs. 

Emotional support 

Be patient and non-judgmental, discuss potential feelings before and after, including emotional support options. 

Professional support

Organisations such as the TLC Trust  support people with a disability to more safely access sex workers and navigate the legal system. 

Supporting people with a learning disability who are sex workers 

Any adult engaging in sex work must have the mental capacity to consent to the activity. This means they must understand what sex work involves, the risks, and be able to make voluntary, informed decisions without coercion. People with a learning disability in sex work can be at higher risk of abuse, exploitation, and barriers to accessing support. 

Legal and advocacy support

People with a learning disability who are sex workers should be referred to the Specialist Community Disability Service. If the person is deemed to lack capacity, working as a sex worker raises serious legal and safeguarding concerns. Authorities and support services have a duty to protect vulnerable people from exploitation or abuse. 

Support 

Avoid stigma related to sex work and focus on the person’s safety and well-being. Ensure communication is accessible and that individuals understand their options and rights. Discuss boundaries and recognising abuse. 

Safety planning

Help the person to develop personalised safety plans addressing risks related to sex work. Identify safe contacts and emergency resources. Facilitate access to mental health support and trauma-informed care and support access to sexual health services. 

Top tips 

Explore your own views about pornography and the sex industry and think about how these views affect your practice delivery. 

Talk about pornography and the sex industry. Have conversations that encourage people to become critical viewers and be prepared to answer questions about pornography and the sex industry. 

Respect other peoples’ rights to view legal pornography, access commercial sex venues and the services of a sex worker. 

Do's and don'ts

Do:

• ensure that relationships and sex education and using the internet safely are included when supporting someone to exercise their choice
• consider where someone may view pornography. Unless they are living independently, they will need to agree how they can access internet content privately without affecting housemates, especially if they are using shared devices. It may not be appropriate to share devices if there are under 18s or other vulnerable people or people lacking mental capacity to decide to view pornography within the household. 
• recommend if someone wants to view pornography that they have a device for their sole use and know how to close website pages they have looked at
• establish a supportive environment where questions and concerns about online experiences can be discussed openly and without judgment. 

Don't:

• suggest someone accesses pornography or the sex industry if they have not expressed this themselves - as staff our role is to provide balanced, neutral support
• supply someone with pornography or make direct arrangements with a sex worker or agency - if a person wants to access pornography, they must access this themselves online or choose and purchase a DVD or magazine themselves. If a person struggles to type into a device online, to access pornography or to make arrangements with a sex worker or agency explore things such as voice activated searches so they can search independently
• ignore when people are viewing pornography in shared spaces, impact on the other people who use them - viewing pornography is a private sexual activity

Resource links

Guidance 

Supported Loving Toolkit.

Planet Porn Teaching Pack As well as talking about porn, the pack covers: 

• self-esteem
• body image
• boundaries
• pleasure
• consent
• communication
• safer sex
• sexual safety
• the law
• emotions
• relationships
• gender 
• sexual diversity and oppression

Practical resources addressing online pornography .

Australian Pod Cast: Why Sex Worker Services Matter For People With Disability 

Easy read

Online Pornography and illegal content - Achieve Together.

Parenthood

Policy 

People with a learning disability have the same rights as others to be a parent. It should not be assumed that people with a learning disability and autistic people are excluded from parenthood. The welfare of the child is paramount and will prevail over the interests of the parents (Children Act 1989). Note: The Brighton & Hove Parenting Pathway is currently being updated, a link to the pathway and its value statements will be added when update complete. 

Law 

People with a learning disability have the same rights as others to be a parent. A single person similarly has the right to choose whether or not to have children. The Children Act 1989 imposes duties on the local authority to meet the needs of and safeguard children in their area. It is crucial to ensure referral to and co-working with Children’s Services where there are concerns a parent to be or a parent may experience difficulty in meeting the needs of their child. Regardless of the needs of the parent any safeguarding concerns about a child must be reported to Children’s Services. 

Guidelines 

Staff should provide support, information and resources to people with a learning disability who wish to be parents, addressing the persons expectations and responsibilities as a parent. The Specialist Community Disability Service (SCDS) clinical team, occupational therapists, speech and language therapist and psychology take it in turns to join monthly pre-birth assessment consultation slots, run by Brighton & Hove City Council Partners in Change, where Child Social Workers discuss their assessments of pregnant / prospective parents. 

This ensures that any parents who may have a learning disability can have their needs identified and, if necessary, assessed (daily living skills, communication, cognitive ability) in a timely way to ensure that any reasonable adjustments are identified and put in place when assessing their parenting skills. 

The Specialist Community Disability Service (SCDS) Psychology Team provides therapy for anyone with a learning disability who has a need for therapy, is motivated to work on therapeutic goals and can't get this via mainstream services. Under the parenting protocol, all interventions for people who are about to become parents, are prioritised, so they have time to work through their need for therapy before becoming parents. Where someone isn't eligible for therapy with SCDS, they would be signposted to another appropriate service. 

Pregnant people with a learning disability who have significant current or recent mental health issues may also be referred to the perinatal mental health team to access more intensive support during pregnancy and during the first year of parenting. This referral usually is made by their midwife or GP. 

Resource links 

Easy read 

Are you ready for pregnancy.

A guide to pregnancy.

Ready Steady Baby - briefing for health professionals and easy read resources.

Policy

Adults with a learning disability have the same right as others to have a healthy sexual life. Sexual health issues are just as important for people with learning a disability as for anyone else. 

Adults with a learning disability have the right to:

• choose or refuse sexual health care
• be made aware of all choices
• confidentiality

Brighton & Hove promotes the rights of adults with a learning disability to have sexual relationships, supported by services like Brighton & Hove Sexual Health and Contraception Service (SHAC) . 

All staff have a responsibility for the health and wellbeing of people with a learning disability with whom they work. 

They have a responsibility to promote good sexual health. People should be given support to protect their own and any partner’s sexual health. 

Sexually Transmitted Infections (STIs) and HIV screening and testing should be encouraged for all. Information should be provided on STIs, and this should include HIV and, where appropriate, Hepatitis B vaccination. 

Education should be provided to help people understand and practice safer sex. 

When a person with a learning disability complains of symptoms associated with an STI, workers should agree a plan of action with the person, which would include seeking medical advice and treatment as appropriate. 

The medical background and matters relating to the sexual health of people with a learning disability is strictly confidential. Information on Sexually Transmitted Infections (STIs) should be restricted to essential (need to know) persons only. Leaflets on a range of STIs are available from sexual health services and GP practices. 

Guidelines 

GP practices and Sexual Health and Contraception Clinics are available for contraception and safer sex education. It is important that adults with a learning disability can understand what they are doing and are not being abused or forced into a relationship, ensuring they are able to give consent and receive information about their bodies and relationships. 

People with a learning disability should have access to a range of information about local sexual health screening and testing services, STI’s, HIV and contraception. 

Staff should ensure that they are aware of these key sexual health issues and able to provide support to people who require assistance in understanding information and services. Staff should be aware of and be able to facilitate access to services relating to sexual health and contraception as detailed in the following paragraphs. 

Contraception

People with a learning disability have the same right to information and help with contraception as non-disabled people; this should be discussed sensitively as part of the overall care plan (but may not necessarily be discussed at a review meeting). 

In making their own decisions about contraception methods, people should be supported through referral to the mainstream sexual health and contraception services. This must include considerations of the person's cultural and religious values, which may forbid the use of some forms of contraception. 

Bear in mind that consenting or otherwise to using contraception is separate from consenting or otherwise to sexual activity. 

Contraception should be seen in terms of the needs of the person rather than in terms of relieving the anxieties of workers and relatives. 

In line with the Mental Capacity Act, every effort must be made to ensure that the person understands any contraceptive method advised and the person's wish to inform relatives or not must be respected, unless there are concerns about the individual’s capacity to make this decision. 

Where an assessment of mental capacity is indicated, support can be accessed from local clinical services such as Sexual Health and Contraception Service, and the local Specialist Community Disability Service. 

Where a person with a learning disability is unable to understand and take responsibility for contraception, involved parties, including carers, should meet to address issues around the apparent need for contraception and to establish programmes for future work in support of that person. It may be necessary to consider the Mental Capacity Act and the ‘best interests’ of the person and whether a person’s lack of capacity to make decisions about contraception indicates the need for an assessment of capacity to engage in sexual relations. Strict attention should be given to limit the number of involved people to absolute minimum, such as, essential parties only, people who need to know. 

Workers must be clear that their role is to identify the need, ensure the person has all the necessary information and then to refer on to the relevant services. 

Contraceptive services 

The Brighton & Hove Sexual Health and Contraception Services (SHAC)  and most GP practices offer a full range of contraceptive options, including short acting contraception: pill, patch and ring that people need to remember to use or take regularly, and longer lasting methods including the contraceptive implant, injection and intrauterine contraceptive device (IUCD). 

Condoms

The use of condoms as a barrier to the transmission of STIs and HIV is to be encouraged. People should also be supported to understand the use of contraception methods other than condoms to prevent unintended pregnancy. 

Ideally, condoms and femidoms / vaginal condoms / internal condoms should be made available in centres and residential establishments. Where this is not possible, staff should facilitate the purchase of condoms. 

The condom distribution scheme in Brighton & Hove for young people under 25 is the C-Card Scheme, which provides free condoms, femidoms / internal condoms, and lubricant.

People aged 16 and over can download the Brighton & Hove C-Card app, complete educational materials, and use the app to collect packs at designated locations. Young people can also register for a paper C-Card, as an alternative to the app, at SHAC clinics. Young people visiting a C-Card collection site will always be able to access free condoms, even if they are not registered with the C-Card scheme yet. 

Short acting contraception 

Short acting contraception is a very effective method of contraception but only if used correctly. Effectiveness rates for typical use are less than effectiveness rates for long-acting contraception methods because it can be very easy to forget to take pills or change patches and rings. 

Short-acting contraceptives include the :

• combined oral contraception pill 
• progestogen only pill (the mini pill) 
• contraceptive patch 
• contraceptive ring (nuvaring) 

Remember, while these forms of contraception are effective at preventing pregnancy they will not protect against sexually transmitted infections (STIs). It may be advisable to use condoms or femidoms as well. 

Longer lasting contraception 

Longer lasting contraception (sometimes referred to as long acting and reversible contraception or LARC). Contraception is an individual choice, and it may change from time to time dependent on people’s lifestyles. LLC is contraception that lasts a long time where the person doesn’t need to remember or think about it every day. 

Longer lasting contraception starts working very quickly but stops within days after it is removed and won’t affect future fertility. It is very safe and most people can use it up to the menopause. As with any contraceptive, occasionally there are some side effects. 

The 3 main types of longer lasting contraception include the:

• intrauterine device (IUD) (lasts 5 to 10 years)
• intrauterine system (IUS) (lasts up to 5 years) 
• implant (can last for 5 years)

A medical professional will discuss the range of methods available to help the person decide. All forms of LLC are suitable for any age, irrespective of whether or not the person has had a child. It is important to note that, as with other forms of contraception, LLC only provides protection from pregnancy and does not protect against STIs, unless used with condoms. 

Emergency contraception 

Remember: if someone has not used contraception or the contraception has failed, for example, they have had a burst condom, they can access free emergency contraception from a GP, a pharmacy or a sexual health service. 

There are 2 types of emergency oral pills (sometimes known as the ‘morning after pill’) available from doctors, community pharmacies and sexual health services. Or an intrauterine device (IUD) a small, plastic and copper device that can be fitted into the womb. It can be fitted up to 5 days after having unprotected sex. Both types of emergency contraception (pill or IUD) offer no protection against sexually transmitted infections. 

Information on the methods of contraception is available from a number of online sources in easy read versions and other leaflets are available free from sexual health services. 

Workers must be clear that their role is to identify the need, ensure the person has all the necessary information and then to refer on to the relevant services. 

Sexual health

People with a learning disability who are sexually active are just as likely as other people to come into contact with Sexually Transmitted Infections (STIs). 

All people have the right to access timely and appropriate sexual health screening and testing services. Part of a sexual health relationship and wellbeing education programme could involve visits to sexual health services to assist in removing the anxiety about accessing them when required.

People who are sexuality active should be encouraged to have regular full sexual health tests at least every 12 months. For people that may have engaged in higher risk behaviours (for example, unprotected penetrative sexual intercourse), or who have more than one sexual partner, it is considered good personal practice to have a sexual health check-up more often. 

A full sexual health test is one which will test for all the most common Sexually Transmitted Infections (STIs), including HIV. These are available in Brighton & Hove from the Sexual Health and Contraception Service (SHAC). Some GP practices will also provide sexual health screening or testing and contraception services. 

People who understand the risk and significance of acquiring STIs, including HIV, have the same rights as any person to engage in high-risk activity. Where a person with a learning disability lacks capacity to consent to testing, screening, and vaccinations there is a need for the treating clinician to either make a best interests decision or apply to the Court of Protection. 

Sexually transmitted infections (STIs) and HIV guidelines 

STI is the term used to cover sexually transmitted infections. 

The most common ones include: 

• Chlamydia
• Genital herpes 
• Genital warts 
• Gonorrhoea 
• Pubic lice (crabs)* 
• Hepatitis B* 
• HIV and AIDS* 
• NSU (non specific urethritis) 
• Syphilis 

* These infections can also be transmitted in other ways. 

Several STIs are increasing in prevalence in the general population but may be particularly noticeable in specific sub-populations such as under 25s. Examples of STIs which have increased in prevalence are chlamydia, syphilis and HIV. Some difficulties have been experienced with STIs such as gonorrhoea displaying resistance to common treatments. 

STIs are a significant health risk for all parts of society. If left undiagnosed, they can result in pain, ill health, infertility and/or death. 

People with a learning disability need to know: 

• how an STI is passed on
• the general signs and symptoms of STIs, and that some people often don't have symptoms 
• where to go for diagnosis, testing and treatment 
• how to access services (like bus routes and opening times) 
• who to talk to for advice and confidentiality 
• how to avoid getting an STI 

Symptoms associated with STI include: 

• itchiness around the genitals 
• rashes or blisters
• lower abdominal pain
• pain during sex 
• unusual vaginal bleeding 
• blisters, sores or lumps, spots in or around the genitals 
• unusual or smelly discharge from the penis or vagina
• pain when urinating (peeing) 
• bloody urine or stools 
• flu like symptoms 

It is also important to know that some STIs may have no symptoms and screening is very important. The best way to reduce the risk of getting an STI or passing one on is through safer sex and condom use. Most STIs are easily treated with a simple administration or course of antibiotics. Left untreated, an STI can have serious health consequences such as causing infertility. STIs such as syphilis and hepatitis if left untreated over a long period will have more serious negative health outcomes which can include mortality. Support and assistance in relation to sexual health is to be encouraged. 

Staff should know how to access their local services and facilitate access for people with a learning disability.  

Other infections 

Thrush, Cystitis and BV (Bacterial Vaginosis) are other infections that have some of the symptoms of STIs but are not necessarily sexually transmitted. They are very common and easily treated. Symptoms can be similar to those of STIs and include strange discharge and smell, itchiness, soreness when urinating (peeing) can be signs of these infections. 

HIV 

As with other STIs, HIV poses a health risk to people with a learning disability, they are as likely to encounter HIV as people without a learning disability. People with a learning disability should be offered education around HIV and how it can be transmitted and where to get tested, in a way which is accessible to them, including: 

• what are HIV and AIDS? 
• how people get HIV and how to prevent getting it or transmitting it 
• how and where to test for it 
• how it is treated 
• medical and social implications of being HIV positive 
• rights to confidentiality 

It is important to distinguish the difference between HIV and AIDS, as often it is used interchangeably but they are not the same thing. HIV is a virus that attacks the immune system and makes it difficult to fight off other illnesses. 

AIDS stands for Acquired Immune Deficiency Syndrome. It’s the name given to a collection of infections and diseases, such as tuberculosis, pneumonia and some cancers that when present indicate that the HIV virus has severely weakened someone’s immune system. 

You cannot catch AIDS. HIV causes AIDS. It is only HIV that can be passed on. There is no cure for HIV but there are drugs that can slow the progress of the condition. With recent developments in the treatment for HIV, people can expect to live a normal, healthy life. 

There should be provision of resources for people with a learning disability, who are HIV positive, in a format that is accessible to them. 

Find more information about HIV.

Easy read

HIV and AIDS in easy read.

PrEP (HIV Pre Exposure Prophylaxis) 

A pill taken by HIV-negative people before and after sex that reduces the risk of getting HIV. PrEP is a medication that protects people from HIV. It is a course of tablets that are taken before and after sex. There are different ways to take PrEP depending on the type of sex people are having, but if taken correctly it is 100% effective. Taking PrEP means people can feel in control of reducing their risk of HIV. PrEP is suitable for people who are: HIV negative; have anal, vaginal or frontal sex in a variety of situations where condoms are not easily or always used; want to protect themselves from HIV. 

In Brighton & Hove PrEP is accessible through all of the clinics at the Sexual Health and Contraception Service. Go to the website to book an appointment. 

Easy read

What is PrEP? Easy read guide 

PEP (post-exposure prophylaxis for HIV) 

Staff should be familiar with Post Exposure Prophylaxis for HIV, including what PEP is and how to access it? PEP (sometimes called PEPSE) is a treatment that can stop an HIV infection after the virus has entered a person’s body. It must be taken as soon as possible after exposure but within 72 hours. 

PEP is a combination of HIV drugs that can stop the virus taking hold. It can be used after the event for people at risk of HIV transmission. To work, PEP must be taken within 72 hours (three days), and should be taken as soon as possible, ideally within 24 hours. 

PEP is available on the NHS for free but is only given to people who meet guidelines about its use. The best place to get PEP in Brighton & Hove is at the Sexual Health and Contraception Service.  

Chlamydia screening for under 25s 

Sexually active people under the age of 25 should be supported to access a routine chlamydia screening test annually or after each new sexual partner. In Brighton & Hove people can order a free and confidential home postal kit or pick up a self-testing kit for free from a C-Card site or SHAC clinic. 

Find details of C-Card sites on the C-Card app or online. 

Go to the SHAC website to read about Chlamydia - test, symptoms and treatment.

Human Papillomavirus (HPV) 

Vaccination Staff should also be aware of and facilitate access to the National Human Papillomavirus (HPV) Vaccination programme HPV vaccine. The HPV vaccine helps protect against human papillomavirus (HPV). It's recommended for young people aged 12 to 13 years old and people at higher risk from HPV. If people missed getting vaccinated when they were 12 or 13, the HPV vaccine is available for free on the NHS for people under the age of 25 and people in high risk groups up to the age of 45. 

Vaccinations are available from GP practices and from Sexual Health Clinics including the Brighton & Hove Sexual Health and Contraception Service (SHAC).

The HPV vaccine reduces peoples chances of getting human papillomavirus (HPV), a common virus that's spread through skin contact (usually when having sex). Most types of HPV are harmless. 

But some types are linked to an increased risk of certain types of cancer, including: 

• cervical cancer
• mouth cancer
• anal cancer
• penile cancer
• vulval cancer
• vaginal cancer. 

HPV can also cause genital warts. 

Cancer screening

In addition to sexual health screening and testing, staff should be aware of and facilitate access to screening programmes such as those for Cervical, Breast and Bowel Cancer. Find more information about these services . 

Supporters of individuals with a learning disability should request reasonable adjustments within screening settings. 

Testicular self examination 

Staff should be aware of best practice in relation to methods of testicular self examination and be ready to provide support to people in raising awareness of examination and encouraging people to practice this. Find more information.

Education 

A programme of sex and relationships education should be made available to people with a learning disability with the use of resources, tools easy read communication.

Local community learning disability teams can support carers, staff and adults with learning disabilities access this information and education. 

This should include elements of both looking at and understanding different types of relationships, not just sexual relationships, and understanding safer sex practices. The programme should make it clear that the use of condoms in any form of penetrative sexual activity protects against STIs including HIV. Further, the programme should make it clear that additional contraceptive methods should be used to prevent unintended pregnancy. The programme should be delivered in a way that will encourage the establishment of good interpersonal and sexual relationships, and encourage positive self-image and good self esteem. 

Do’s and don’ts 

Do:

• check out specialist services in your local area
• accompany the person to any appointments they may have if they want you to
• find some accessible information about contraception/sexual health to support their visit

Don't:

• speak for the person during appointments and don’t let clinicians ask you for information that the person can give themselves
• assume that people with a learning disability can’t make decisions about contraception and sexual health
• ignore this important area of people’s health because it is embarrassing or difficult

Resource links 

Guidance

Supported Loving Toolkit.

Brighton & Hove Sexual Health and Contraception Service.

British Association for Sexual Health and HIV.

MEDFASH (Medical Foundation for HIV & Sexual health).  

Cancer Screening.

Easy read

Supported Loving toolkit - Contraception.

Brighton & Hove Sex and Contraception Service (SHAC).

Kevin’s story going to the Brighton & Hove Sex and Contraception Service: 

Easy Read Contraception.

Easy Read Contraceptive Leaflets from NHS Forth Valley.

What is chlamydia?.  

What is PreP. 

HIV and Aids. 

HPV Vaccination.

Breast Screening.

Bowel Screening.

Cervical Screening:  

Testicular Self Examination.

Policy 

People with a learning disability should be supported to understand what abuse is in the context of relationships, how to recognise the potential signs of abuse and how to access support if they are experiencing abuse. 

All People with a learning disability have a right to be protected from abuse and exploitation. 

All members of staff have a duty to safeguarding individuals from harm whom would otherwise be unable to protect themselves. 

Abuse can never be condoned, whoever the perpetrator. 

Members of staff must have no sexual contact or sexual relationships with service users. 

Law 

Sexual Offences Act 2003.

Mental Capacity Act 2005.

Care Act 2014 - provides a clear legal framework for how local authorities must protect adults at risk of abuse or neglect.  

Safeguarding Vulnerable Groups Act 2006 - this act, along with the Protection of Freedoms Bill, created a system to prevent unsuitable people from working with children and vulnerable adults through the use of barred lists.  

The Domestic Abuse Act 2021 - defines domestic abuse as any incident of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members, regardless of their gender or sexuality. 

Guidelines 

Abuse is when someone mistreats you in a way that causes you significant emotional, physical or psychological harm and violates your rights. Abuse may not always be intentional or consciously done. All provider organisations and their staff have a duty to protect people who are vulnerable to exploitation. In cases where staff are concerned that an individual is being exploited or sexually abused, then the Sussex Safeguarding Adults policy and procedures should be implemented. 

Help for an adult at risk of abuse or neglect.

Abuse in a relationship may involve the following.

Discriminatory abuse (also known as a ‘hate crime) 

This is the ill-treatment, threats or insults related to the protected characteristics of the equality act, for example:

• age
• physical or learning disability or mental health needs
• gender reassignment
• marriage and civil partnershi
• pregnancy and maternity
• race
• religion and belief
• sex or sexual orientation

Physical 

This includes being:

• pushed
• shaken
• pinched
• hit
• held down
• locked in a room
• restrained inappropriately (for example, unnecessary use of physical force or restraint)
• knowingly giving an adult too much or not enough medication

Emotional or psychological

This includes being:

• shouted at
• ridiculed
• bullied
• threatened
• humiliated
• blamed for something they haven’t done, or controlled by intimidation or fear 

It includes:

• harassment
• verbal abuse
• cyber-bullying (bullying which takes place online or through a mobile phone) 
• isolating someone from friends or family
• attempts to inappropriately influence or coerce decisions. 

Sexual

An adult being made to take part in sexual activity when they do not, or cannot, consent to this. 

It includes:

• rape
• indecent exposure
• inappropriate looking or touching
• sexual activity where the other person is in a position of power or authority (non consensual sexual activity)

See below for more information about sexual abuse. 

Financial

Misusing or stealing an adult’s money or belongings, fraud, postal or internet scams tricking adults out of money, or pressuring an adult into making decisions about their financial affairs, including decisions involving wills and property - (coercing someone into giving away their money or possessions) 

Romance fraud

An adult receiving communication online from another, over a period in the context of financial abuse, in which they build trust with the adult, in exchange for funds. This friendship or relationship is socially engineered for fraudulent financial gain. (Source: Romance Fraud - spot the signs and report it.

Domestic abuse, or domestic violence

The Domestic Abuse Act 2021, defines domestic abuse as any incident of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members, regardless of their gender or sexuality. 

This definition extends to ‘honour’ based violence, being forced to marry or experience genital mutilation and economic abuse. 

For further information see Section 2.7. Safeguarding and domestic abuse and Domestic Abuse Statutory Guidance 

Non-fatal strangulation

The Domestic Abuse Act 2021 has also amended the Serious Crime Act 2015 to create a new criminal offence of non-fatal strangulation or suffocation. This includes an adult experiencing strangulation, suffocation and other acts which affect another person’s ability to breathe, including in the context of domestic or physical abuse. For more information, see Strangulation and suffocation on GOV.UK (2024). 

Survival sex/sexual exploitation

An adult presenting with an altered pattern of selling sex, and where there are signs of coercion and control from other women, men or partners. This form of abuse exists in the context of domestic or sexual abuse, whereby it is the only option for the adult to survive financially (Source: Beyond the Streets). 

Modern slavery

An adult being forced to work for little or no pay (including in the sex trade), being held against their will, tortured, abused, or treated badly by others. For further information please go to section 3.1. Legislation, national guidance, and toolkits. .

Coercive or controlling behaviour

Under the UK Serious Crime Act 2015, coercive or controlling behaviour in an intimate or family relationship is a criminal offence. 

The law applies if: 

• the behaviour causes the victim to fear violence on at least two occasions, or 
• it causes serious alarm or distress that has a substantial impact on their daily life 

A conviction can lead to up to 5 years in prison, a fine, or both. 

Sexual abuse 

Sexual abuse is defined as the involvement of vulnerable adults in sexual activities which: 

• they do not want to have and have not given consent to 
• they could not understand enough to give their consent 
• they may wish to withdraw from 
• are against the law

Abuse may consist of contact or non-contact abuse, or harassment. It can take place within a family, care-giving situation or other power relationships including trusted friends and neighbours or with strangers. 

‘No secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse (2000)' defines abuse as ‘a violation of an individual’s human and civil rights by any other person or persons. 

Sexual acts which might be abusive include: 

• non-contact abuse: 
  • voyeurism 
  • coercion to make or view pornography 
  • sharing people's intimate images without their consent 
  • indecent exposure 
  • harassment
  • serious teasing 
• Contact abuse: 
  • touch - for example of breasts, genitals, anus, mouth 
  • masturbation of either or both persons 
  • penetration or attempted penetration of anus, mouth, vagina with or by penis, fingers, other objects

Sexual harassment is unwanted and uninvited sexual attention, which may involve ‘jokes’, sexual comments about a person’s body, intrusive personal questions. Tthis is considered a serious matter. Service users may be abusing each other, staff may abuse service users or, in some circumstances, service users may abuse staff. 

Provider organisations need to ensure that their procedures cover all these scenarios. Most abuse is perpetrated by someone known to the service user. 

Disclosure and Barring Service (DBS) 

Staff working with vulnerable adults do so under the Safeguarding of Vulnerable Groups Act 2006 which establishes a ‘vetting and barring’ scheme managed by the Disclosure and Barring Service (DBS) which was created by the Protection of Freedoms Act 2012.

Employers, local authorities, professional regulators and other bodies have a duty to refer information to the DBS about individuals working with children or vulnerable adults where they consider them to have caused harm or pose a risk of harm. 

Supporting people with a learning disability 

Staff, have a responsibility to ensure people with a learning disability know that:

• they have the absolute right to feel safe and to be supported to learn the skills to keep themselves safe
• in a situation where they do not feel safe, if they talk to someone they trust they will be listened to
• they have the power to decide how to express their sexuality in a way that is protective of themselves and others

In practice, this means that the person with a learning disability should be taught to:

• recognise the signs of abuse and when personal safety is compromised learn strategies on how to feel safe and protect oneself
• negotiate saying ‘yes’ and saying ‘no’
• know who/where to go to for help

It is essential that:

• staff provide opportunities for people to talk about sexual health and relationships through informal chats, care plans and reviews
• staff provide the opportunity to disclose abuse through informal chats, care plans/reviews, routine enquiry
• the relevant training and support is provided so that workers know how to deal with disclosure of harm or abuse
• in the event of a person disclosing a situation of harm or abuse, the person is listened to, and the appropriate organisational policies and procedures are invoked to ensure the protection of that individual and any other people who may be at risk

Consent 

Consent is crucial in deciding whether a particular sexual relationship or act is abusive. The Sexual Offences Act 2003 contains for the first time a clear definition of consent as follows: ‘A person consents if s/he agrees by choice and has the freedom and capacity to make that choice.’ 

What needs to be decided is: 

• whether the individual had the capacity about whether or not to take part in the sexual activity at the time in question
• whether the individual was in a position to make that choice freely, not being constrained in any way

It is not permissible for a decision on consenting to have sexual relations to be made on behalf of another person. There are some people with a learning disability who would be considered as being unable to give consent and who would lack capacity (the ability to make informed choice). This is a complex decision, and workers should seek guidance from health and social care professionals. 

The Mental Capacity Act (2005) is now the most significant piece of legislation in the protection of vulnerable adults. It establishes a framework for dealing with mental capacity issues, putting the individual who lacks capacity at the heart of decision making, and placing a strong emphasis on supporting and enabling the individual to make his/her own decisions.

An assessment of capacity for the purposes of sexual relationships requires the assessment to be specifically about the adult’s abilities to understand sexual and personal relationships. Professional intervention and assessment may be necessary to identify the current level of knowledge and understanding of sexual and personal relationships in relation to their current circumstances. Evidence of mutuality should be looked for by those assessing consent, to show that the relationship is not abusive. 

This is reflected in factors such as:

• both parties seeking each other out 
• spending spare time together
• shared resources 
• shared leisure activities 
• equal power balance in choices within the relationship 

Factors which might mean someone cannot consent to sexual activity or sexual relations would include if a person: 

• does not really understand what is being asked
• does not know they have the right to refuse sex
• not know how to refuse sex
• is afraid to refuse sex
• does not know that sex is not meant to be painful or uncomfortable
• does not know that he or she is being exploited when a reward / incentive or payment for sex is used
• does not know that some relationships are illegal, such as those within families, or between workers and clients please refer to the legal test set out earlier in the policy. 

Consent can only be said to be valid if the person knows what they are consenting to, and has a real option of saying yes or no. 

There are situations where people may be engaging in activities which other people view as morally wrong or not in the best interests of the individual. Some examples are same sex relationships, not using condoms, having multiple partners, or being in a violent relationship. The individual could be very aware of what they are doing, and aware of the implications, positive or negative, and may still wish to continue to engage with this activity. Individuals who have mental capacity to consent to engage in sexual activity have the right to make unwise decisions as any other member of the public would. 

Workers are not expected to make a value judgement about the rightness of any sexual activity which is taking place. However, they are expected to be sensitive to the possibility of abuse. If workers are unsure, they must bring any observations or concerns to the attention of their line manager. 

If at any time workers become aware of a particular situation or act taking place which is, in their opinion, abusive they should take immediate action to intervene and refer to the police if a suspected criminal offence has occurred (see Safeguarding Adults policy ). The welfare and well-being of those in their care are of prime importance and not to act quickly would be to have neglected their duty of care. The local authority will undertake Section 42 Enquiries to discharge their Duties under the Care Act 2014 to protect individuals from harm. 

Do’s and don’ts 

Do:

• report it if someone you support says they are being sexually abused - explain to them that you need to share the information with another staff member (manager or safeguarding lead) and possibly the police 
• reassure the person they have done the right thing to speak out

Don't:

• ignore it or presume the person is lying/making it up
• panic - try to remain calm

Top tips

Reassure the person, they have done the right thing by speaking about the sexual abuse or violence. 

Reassure the person that it is not their fault. 

Ask the person if they want to tell the police. If it is a recent event, explain they may need to have a forensic examination. 

Are they safe now? Think about what you need to do to help facilitate safety. 

What local support services are available for this person? 

Do they want counselling or therapy to process some of their feelings about what has happened? 

Report it If you think that sexual abuse is taking place, tell your line manager immediately. 

Report it to your local safeguarding team. If someone is in danger, report it to the police via 999. 

Resource links 

Guidance

Sussex Safeguarding Adults policy and procedures.

Brighton & Hove - Reporting adult at risk of abuse or neglect.

Sussex Police Romance Fraud.

ASK – Assessment of Sexual Knowledge and Behaviour - an assessment tool used to assess gaps in knowledge and understanding in terms of sexual behaviour and capacity to consent.

Toolkit supporting people with a learning disability and autistic people who have experienced sexual violence.

Peer Education and Staff Training sexual exploitation and people with a learning disability.

Supported Loving Toolkit

Disclosure and Barring Service

Exploring Sexual and Social Understanding. 

PAUSE PLAY STOP is an online consent tool

Easy read

Speaking Up and Staying Safe video: 

What is sexual consent.

Sexual abuse.

Commercial sexual exploitation.

Domestic abuse: how to get help.

Support for LGBTQIA+ people who have suffered from domestic abuse and honour based violence.

Social media and online safety 

Policy 

People with a learning disability and autistic people should have the right information to decide how and when they want to engage online. 

Whether it's setting up a social media profile, joining a virtual community, or trying online dating, there are plenty of ways to use technology safely. Staff should guide people through these options in a way that feels right for them, helping them connect with others and enjoy the same opportunities as everyone else. To help people explore relationships and connections through technology, ensuring they can do so safely, positively, and in a person-centred way.

Law 

The Online Safety Act 2023.

The criminal offences introduced by the Act came into effect on 31 January 2024. 

These offences cover: 

• encouraging or assisting serious self-harm 
• cyberflashing 
• sending false information intended to cause non-trivial harm 
• threatening communications 
• intimate image abuse 
• epilepsy trolling 

These new offences apply directly to the individuals sending them, and convictions have already been made under the cyberflashing and threatening communications offences. 

Guidelines 

The internet opens up a whole world of possibilities and opportunities but there are also risks, particularly for people with a learning disability. People with a learning disability should be encouraged to use the internet safely wherever possible and those working with them should feel confident in raising issues around sexual health and relationships that relate to internet use. 

The online safety act 2023 can offer guidance to using the internet safely. The Online Safety Act 2023 is a UK law that imposes new duties on online platforms and search engines to protect users, particularly children, from illegal and harmful content. The Act requires platforms to implement systems to identify and remove illegal content, conduct risk assessments for harmful content on child-facing services, and enforce age limits for age-inappropriate content such as pornography. Governed by the independent regulator Ofcom, the Act empowers the regulator to set codes of practice, monitor compliance, and impose significant financial penalties for non-compliance. 

People may try to find love on social media, like Facebook, often accepting random friend requests from strangers or messaging people they do not know. This can result in being targeted by scammers who pretend to be someone else. Help people to recognise potential red flags, encourage them to be cautious if someone online pressures them for personal information, or if their communication feels too fast or intense, for example, telling them early, they are in love with them, asking for money and saying they are their girlfriend/boyfriend. 

Scammers often try to move conversations away from public platforms to more private channels quickly, such as via text message or phone calls. They may try to isolate people from those around them (for example, sabotaging relationships with family, friends or carers) and may use threats and blackmail to achieve compliance and control. Some are interested in the persons social networks, targeting an index victim in order to access other people who may be vulnerable. 

They may expose victims to inappropriate and illegal sexual material, or material that is offensive and traumatising for some, or subject victims to cyber sexual abuse online, for example, using webcam/audio technology to observe or exhibit sexual behaviours:

Encourage the person to only share information you would with other strangers, remember, they are all strangers until you start meeting in real life. 

Ensure they never display their full name, address, phone number, passwords, bank details or where they are going to be at a specific time. 

Support the person to understand the reality of sending explicit pictures, making them aware that they cannot control what that person does with that picture and how/where it could be shared without their consent/knowledge. 

Make them aware if they repost or share an explicit image that was sent to them privately without consent, that they are committing a criminal offence. 

Encourage people to share anything they are worried about or feel unsure about with someone they trust and that they can block people if they feel uncomfortable. 

Remind them not to click on links or download attachments from people they don't know. Phishing scams can trick people into giving out personal information or downloading harmful software. 

Reinforce the importance of consent in both online and offline interactions. Ensure they understand that any online interaction should respect both their own and others’ boundaries, and that they can say no at any time. 

Encourage check-ins where they can share their online experiences. This creates an open dialogue and helps them feel comfortable reaching out if something doesn’t feel right. 

Only share basic information about likes and dislikes, local area you live in, such as, East London, Hove. 

Do not share personal address, mobile number or email address. Get to know your privacy settings. 

If you have concerns: that despite support and education, a person is unable to keep themselves safe online, a capacity assessment might be needed to determine what the ‘relevant information a person would need to retain to have capacity regarding using the internet. 

Use of technical tools for safety 

Support people with a learning disability to get or do the following.

Ad Blockers - install ad blockers to reduce exposure to intrusive or inappropriate ads and pop-ups, such as uBlock Origin and AdGuard, which block adverts and popups on all websites, including Facebook and YouTube. 

Antivirus and Anti-Malware Programs - ensure devices have up-to-date antivirus software to protect against malware often linked to unsafe websites. This helps prevent harmful pop-ups and phishing attempts. 

Clearing Cookies and Cache - as part of a regular routine clear cookies and cache from the website browser to remove saved data that could track browsing habits or auto-fill sensitive information. This can be done in most website browsers such as Internet Explorer, Edge, Google Chrome, or Mozilla Firefox, while in the browser, press Ctrl + Shift + Delete at the same time on the keyboard to open the window, make sure to close / quit the browser and restart it after clearing the cache and cookies. 

Education and empowerment 

Support people with a learning disability to:

• understand pop-ups and scams - why they appear, and the importance of not clicking suspicious ones
• have safe browsing habits - encourage visiting trusted websites only and explain how to recognise safe versus unsafe sites
• Protect personal information - emphasise never entering credit card or personal data on unfamiliar or suspicious sites - explain risks of scams and identity theft
• discuss the importance of consent and privacy in online activities, helping individuals understand boundaries and respectful behaviour Block people - support people to block someone from their social media
• report online abuse or abusive content - support people to report online abuse directly to the platform where it occurred or use services like Report Harmful Content .

Develop critical thinking and media literacy 

Teach people about healthy relationships, respect, and gender equality in ways that resonate with people’s experiences. 

Help people to recognise biased, manipulative, or extremist content by breaking down examples step-by-step. 

Encourage questions like “Who is saying this?” and “Why might they say this?” to foster scepticism about harmful narratives. 

Encourage balanced online activity with offline social connections and hobbies to reduce isolation. 

Introduce people to inclusive, respectful online groups or influencers who promote dignity and equality. 

Meeting someone in 'real life' 

As increasing amounts of socialising takes place via chat rooms and social media networks, staff may be asked to support individuals to meet up with someone new who they have met on the internet. People should be encouraged to take someone trusted with them. Always prompt the individual to tell the person they are planning to meet that they are taking a friend along – what is their reaction? Do they still want to meet up? 

For those who have capacity and choose to meet someone without any staff present, the person should be strongly encouraged to take a friend. If the person still wishes to go unaccompanied, the following advice should be given: 

• It is best not to meet someone that they only know only from talking to online, even if they have seen some pictures of them. 
• Encourage a video call before an actual date or meet up, so the person knows they are real!
• If they make excuses as to why they cannot do this, this is a red flag. Most people these days have multiple devices that have a camera, or they could use someone else’s for a quick call. Help the person to understand this is a red flag, they are not real. 
• Before they go, they should always tell someone they trust who they are meeting, with their full name and phone number and where they are meeting.
•  You could offer to get the person they are meeting to speak to staff on the phone to check the arrangements for the date. 
• Always advise a public meeting place, never a persons house for a first meeting, especially if this has been requested. 
• Invite someone they trust to go along initially if they are happy with this. 
• Make sure they keep a fully charged mobile phone with them, perhaps you could arrange a call with them halfway through to check in. 
• Remind them that they can leave at any time if they feel uncomfortable and can call someone to help them or if they feel unsafe at any point to call 999. 
• You could help the person to think about how they might leave if they feel uncomfortable, like, excuses they could make. 

Online dating 

Staff may be asked to assist people in accessing social networking sites, dating or gaming sites or chat rooms, and increasingly people are forming relationships online. Staff and people with a learning disability should be aware of any age limits (for example, over 18 only) and costs that may apply. 

Whilst the use of such sites can have positive benefits for people, staff need to be aware of the risks to adults, as well as children, of internet grooming. 

If a person does choose to start using an online dating app or dating site: 

• one of the most difficult things to deal with in any dating situation is rejection, this can include not ‘matching’, being stood up or getting nasty remarks - this can be upsetting for anyone let alone someone new to the dating scene. Explain people can be mean online because they are hidden, support the person to learn that these people are sad and not worth their time. They do not know you personally so ignore their words
• sites with a mobile app and a website will allow the account to be used on multiple devices, so supporters could help with and monitor the activity – this would have to be with their full consent
• encourage them to use a site/app that allows them to share their ‘story’ as part of the profile and to consider being open and honest about their disability as it is part of their identity, as is what they are good at or the colour of their hair. It will help to reduce the harsh reality of rejection if other users are aware of their disability. Proper dating sites are better for this or consider a disability specific site. Some dating websites afford more opportunity to talk about your personality than others and some may be more superficial in nature
• prepare the person you are supporting to manage their expectations – it can take years for anyone to find love, even online
• most sites offer a range of privacy settings, support people to understand how to use them

Grooming 

Groomers may try to establish relationships and gather more information on their potential victims and their vulnerability, assess the risk of going further with their plans, try to isolate victims from those around them (for example, sabotaging relationships with family, friends or carers) and may use threats and blackmail to achieve compliance and control. Some are interested in the victim’s social networks, targeting an index victim in order to access other people who may be vulnerable. They may expose victims to inappropriate and illegal sexual material, or material that is offensive and traumatising for some, or subject victims to cyber sexual abuse online, for example, using webcam/audio technology to observe or exhibit sexual behaviours. 

Staff should encourage people with a learning disability to ensure they never display their full name, address, phone number, passwords, bank details or where they are going to be at a specific time. Remember that people may not always be who they say they are, and that profile pictures may not always be true representations – and it is important staff remind people about this. 

Cyberbullying 

While for the majority of people social media is a positive experience, bullying exists online just as it has the potential to do so in any setting. The impacts can be devastating. Staff should feel confident in helping people with a learning disability to become aware of how to ‘block’ or ‘unfriend’ unwelcome ‘friends’, report abuse and ensure their privacy settings allow only genuine friends to access their pages or to send them messages. 

Where a member of staff is suspicious or concerned about possible grooming or bullying, they should discuss it in the first instance with their line manager, who may consider involving the police and notifying the local authority under adult protection procedures. Education on the risks of social networking may increase awareness in people with a learning disability of the potential dangers. Just as you wouldn’t allow a stranger to walk around your bedroom and look through your things, nor should you disclose private or sensitive information online. It is important that staff remind people they work with that when communicating remotely via social media, they should treat others as they would wish to be treated themselves and if they become aware of anyone being bullied they should seek advice from a trusted person. In short, if there’s a problem, ‘tell, unfriend, remove, block, report’.

People with a learning disability should always be encouraged to think carefully before posting or commenting on anything that could be considered offensive to others. 

Photographs 

Most mobile devices have a digital camera attached. Photographs of others should only be taken and/or shared with that person’s consent; which must be given beforehand. 

Many new ‘smart’ phone apps encourage the swapping of images and staff should encourage that this happens only with known and trusted friends. The sharing of sensitive and intimate images (sometimes called ‘sexting’) with anyone other than the 2 consenting adults should be strongly discouraged as online photographs can be copied, saved, shared and very hard to remove. People should be informed that public ‘posting’ of these images without consent on social media sites is classed as Intimate Image Abuse and is a criminal offence under the Online Safety Act 2023. 

Do’s and don’ts 

Do:

• support people if they want to use the internet - if a person has capacity this is their choice
• educate people about the risks and realities of the internet, explaining not everyone is always as genuine as they seem
• help people to keep safe online by giving education and helping people to spot the red flags in online relationships

Don't:

• be afraid to raise alarms if something doesn’t feel right
• forget to remind people that there may be other options, such as a local supported dating agency, social clubs and shared hobby groups they could join
• assume people know how to use the safety functions on various sites such as privacy setting and how to block – support people to understand this. 

Resource links 

Guidance

Supported Loving Toolkit.

A guide for parents, learning disabilities, autism and Internet Safety.

Easy read

Keeping Safe Online.

Internet Dating Photo story.

Internet and Phone Bullying.

Friend or Fake easy read booklet and audio.

Staying Safe Online: Relationship Scams.

I’ve made a new friend online, but I’m worried what do I do?

Video on how to spot a variety of online scams.

Find training and resources, alongside our Learning Disability course. Ideally staff will complete training in this area before supporting adults with the resources available.

Training for staff and carers

Relationships and Sexuality for people with a learning disability 

Brighton & Hove City Council free course.

Who this course is for

This course is for Children's and Adult Services staff and carers who work with people who have a learning disability. 

How to book

Log into the our Learning Zone.

If you're a family carers or learning disability provider, you need to choose ‘Request an account (external partners, non BHCC staff). 

When prompted to provide your details, you'll need to select an organisation from the drop down list. Family carers should choose ‘Foster & Family Carers/ Shared Lives/ Personal Assistants’

Book your place on this course.

Overview

This course will build staff’s confidence and competence in addressing and responding to issues arising in a practical way, covering topics such as: 

• physical changes 
• sexual health, sexuality and gender identity 
• role of a parent and carers 
• positive relationships and boundaries 
• bodily autonomy, consent and protection from harm 
• public and private behaviours 
• appropriate touching and masturbation 
• managing emotions 
• issues relating to pornography and online safety

Skills for Care 

Free training resource for social care staff supporting personal relationships.

Everyone has the right to have personal relationships, including the full breadth of people who draw on care and support services, regardless of the type of support they access. The adult social care workforce needs to have the right values, skills and knowledge to support people they care for to have positive personal relationships. We've produced a range of resources to help employers think about what workers need to know so they can create a development programme for their organisation. 

Read about supporting personal relationships.

Talking about sex and relationships 

Toolkits and training packs for supporters of people with a learning disability

Let’s Talk About Relationships and Sex.

The resource is suitable for adults aged 18 and over. The training resource is made up of 8 different sessions covering: 

• rights •
• consent 
• privacy and boundaries 
• sexual acts • Sexuality, gender and safe sex •
• relationships 
• online safety and self esteem 

The training package is designed to be facilitated by those who purchase the resource, such as a care provider, a local authority, support group or a parent or carer, who will use the resource to deliver 8 sessions covering all aspects of relationships and sex. 

'You, Your Body, Growing Up, Relationships and Sex’ 

You, Your Body, Growing Up, Relationships and Sex – Life Support Productions

A comprehensive resource for children and young people with a learning disability and special educational needs. Videos and lesson plans cover: 

• growing up and looking after yourself growing up and body changes
  • keeping clean
  • periods
  • self examination
  • loneliness and feelings
  • menopause and gender and identity. 
• consent and relationships:
  • relationships
  • love and affection
  • consent and saying no
  • loneliness and feelings
  • consent yes and no
  • online and social media
  • first dates 
  • separation and divorce
• relationships and sex masturbation
  • contraception
  • consent and no
  • attitudes
  • yes and no
  • safer sex
  • gay relationships and sex
  • pregnancy and birth

SoSAFE

The SoSAFE! Tools (together with SoSAFE! User Training) provide teachers, trainers and counsellors with skills and simple visual tools to enhance the social, social-sexual and social safety training of people with moderate to severe intellectual disability. SoSAFE! uses a standardised framework of symbols, visual teaching tools and concepts to teach strategies for moving into intimate relationships in a safe and measured manner, and provides visual communication tools for reporting physical or sexual abuse.  

All about us

All about us DVD-ROM and lesson plans All About Us is designed to help people with a learning disability learn about growing up, sex and relationships.

Workshop pack for family members

Y talk about relationships and sex? Lancashire based, the U-Night Group, has produced a workshop pack, in consultant with parents of learning disabled adults. 

Social-sexual education for people with developmental disabilities 

American Curriculum that is designed to teach people with a mild learning disability how to develop healthy and safe relationships while also giving them information about sexual abuse and coercion. 

Planet Porn Teaching Pack 

As well as talking about porn this download resource pack enables conversations around self-esteem, body image, boundaries, pleasure, consent, communication, safer sex, sexual safety, the law, emotions, relationships, gender and sexual diversity and oppression. 

Planet Porn Teaching Pack.

Keeping safe resource pack 

This is a pack to support you to have conversations with individuals or groups of people with additional needs to understand about safeguarding and how to keep themselves safe. This pack is a flexible resource to help you facilitate a safeguarding training session with people who have support needs. It means that that family members, care providers, friends and anyone can support someone with additional needs to understand safeguarding and what it means to them as well as what to do if they are worried. 

Keeping-Safe-Toolkit.

ASK - Assessment of Sexual Knowledge and Behaviour 

An assessment tool used to assess gaps in knowledge and understanding in terms of sexual behaviour and capacity to consent. Updated in 2024 to include different types of relationships and more questions about online activities. The download includes a series of line drawings and questions relating to those drawing as well as a pre assessment questionnaire for families / carers of the person being assessed. 

Sexual knowledge and Behaviour Assessment Tool.

Supported Loving toolkit 

The Supported Loving network has produced a series of guides to help support people with issues surrounding sexuality and relationships. 

Sexual Wellbeing Image Library 

A tool for professionals to support the development of accessible sexual health and wellbeing information. The images are free to use for educational purposes, but not for commercial gain. 

SWIRL – Sexual Wellbeing Image Resource Library.

Supported Loving - Toolkit - a useful online guide with links to easy read resources and suggestions for support workers and carers about how to support people with a learning disability. A lot of the resource links are free but for some there is a charge.   

Sexual Wellbeing Image Library - free - a tool for professionals to support the development of accessible sexual health and wellbeing information. The images are free to use for educational purposes, but not for commercial gain. 

Mencap - Mencap have gathered a handy list of recommended resources.

Rights

Sexuality and Relationships – My Rights Charter.

British Institute for Human Rights.

Human Rights Card Game. 

Identity gender and sexuality 

Identity Booklet - this booklet talks about the different identities that LGBTQIA+I+ people have, including being gay, bisexual, lesbian or pansexual. It also talks about gender identities, including being transgender or non binary. 

Free Wellbeing Activity Booklet - this booklet has pages you can fill in. They include a weekly self-care planner and an exercise about energy levels. 

Transgender an Easy Read Guide. 

LGBTQIA+ - An Easy Read Guide. 

Being LGBTQIA+ia.

You Being You - identity, gender and sexuality:

• You being you: Your gender and sexuality - YouTube Film 
• You being You video guide 
• Pronouns and their meanings 

Easy read leaflets, images and picture banks.

Circles of support - can be used to identify how close different people are within someone’s life and explore the difference between support workers and friends. 

A Cup of Tea and Consent - this video used by the Thames Valley Police breaks down the concept of consent.

Intimate and personal care 

Personal Hygiene.

Personal Hygiene Check List.

Keep yourself clean for men.

Consent 

My Life My Choice easy read resources: 

• Me and my body 
• My body, my choice 
• Let's talk about sex! 

What is Sexual Consent - a helpful resource from Somerset and Avon.

A Cup of Tea and Consent - this video used by the Thames Valley Police breaks down the concept of consent. 

Masturbation 

Things Ellie Likes - a book about sexuality and masturbation for girls and young women with autism and related conditions. 

Things Tom Likes - a book about sexuality and masturbation for boys and young men with autism and related conditions.

Pornography 

Online Pornography and illegal content – Achieve Together. 

Sex and relationships 

LoveLife Project Easy Read Guide to Words About Sex - it is a list of hard words that have something to do with sex. Each word has been explained in easy read. 

Love, sex and you  - information about relationships, sex, being safe and your body. 

What is Sex - easy read guide for people age 13 or older.

Sex and relationships.

Kinks and Fetishes People have a right to support around their sexual preferences.

Erick and Frasers Photo Story - Eric doesn't fancy women.  Fraser asks him to the football..... is this a date?:

• Photo Story for Erick and Frasers story   
• Guidance Notes for Erick and Frasers story

Anna and Bob Photo Story  - Anna and Bob fall in love! How far will they go?

• Photo story for Anna and Bob story
• Guidance Note for Anna and Bob storey

Denise and Callum’s Photo Story - Denise always wanted to be someone's girlfriend......  so why does being with Callum make her feel so bad?  

• Photo story for Callum and Denises story
• Guidance notes for Denise and Callum’s story 

Books Beyond Words – Relationships Set - A collection of word-free books covering relationships, love and friendship, that enable readers to tell their own stories using their own method of communication. The books can be purchased individual or as a set.

Parenthood 

Are you ready for pregnancy.

A guide to pregnancy.

Ready Steady Baby - Briefing for Health Professionals.

Contraception and sexual health 

Supported Loving toolkit - Contraception. 

Brighton & Hove Sex and Contraception Service (SHAC).

Brighton & Hove Sex and Contraception Service (SHAC).

Kevin's story going to the Brighton & Hove Sex and Contraception Service.

Easy Read Contraceptive Leaflets .  

What is chlamydia?.

What is PreP.

HIV and Aids.

HPV Vaccination.

Breast Screening:

• Breast screening: easy guide by GOV.UK.
• Breast care and screening by Macmillan

Bowel Screening.

Cervical Screening:

• Cervical screening: an easy guide by GOV.UK
• Cervical screening by Macmillon

Testicular self examination.

Keeping safe 

Speaking Up and Staying Safe - video.

What is sexual consent. 

Sexual Abuse. 

Commercial sexual exploitation  - Easy Read booklet, which can be used by anyone looking to understand and/or share information about commercial sexual exploitation and where to get support.  

Domestic abuse: how to get help.

Support for LGBTQIA+ people who have suffered from domestic abuse and honour-based violence  - this is an easy-read document with pictures and descriptions for LGBT+ who are hurt or treated badly by someone in their life.  

UK Government - forced marriage resource pack  - the resource pack highlights examples of best practice to help ensure that victims of forced marriage can access effective support services. 

Online Pornography and illegal content an easy read guide - this easy read guide is about online pornography and illegal content, and the issues you or someone you know may experience when looking at pornography online. The guide looks at what is legal and illegal, how to keep safe, and the types of online abuse you can experience. 

Keeping Safe Online  - a guide about different types of online abuse, how to keep safe online, warning signs, and what to do if you feel you are unsafe. Produced with Care Management group.  

Internet Photo Story - Gina looks for love on the internet...... but is Harry really the perfect boyfriend?  

• Photo story for Internet Photo Story  
• Guidance notes for Internet Photo Story

Internet and Phone Bullying.

Friend or Fake easy read booklet and audio 

Staying Safe Online: Relationship Scams. 

I’ve made a new friend online, but I’m worried what do I do.

Video on how to spot a variety of online scams.

Local services 

GPs (Doctors) 

A GP can provide sexual health and contraception advice and services. Check your practice web site for more information on the range of services they have available. 

Brighton & Hove Sexual Health and Contraception Service (SHAC) - clinics, outreach support and easy read information if you have a learning disability. Talk to a health advisor about deciding to have sex or want more information on contraception, sexual health, pleasure, relationships and consent.

Terence Higgins Trust - Brighton & Hove UK’s leading HIV/AIDS charity. 

Specialist Community Disability Service - Community Learning Disability Nurses can offer advice support to access mainstream sexual health services. They can also offer sexual health and relationship education on a one to one or couple basis. The psychology team can assist with assessments of capacity and sexual awareness work. 

Brighton & Hove Adult Safeguarding - help for an adult at risk of abuse or neglect.

Reporting a safeguarding concern form. 

Sussex Safeguarding Policy and Procedures. 

Brighton & Hove learning disability activities and social events map. 

Health Promotion Library - has various resources on sexual health and well being.

Allsorts youth project - Allsorts Youth Project listens to, supports and connects children and young people under 26 who are lesbian, gay, bisexual, trans (LGBT+) or exploring their sexual orientation and/or gender identity.

The Clare project - supporting trans, non-binary and intersex (TNBI) adults in Brighton & Hove. We run social drop-ins online and in person, monthly social meals, monthly workshops, a neurodivergent group and 1:1 support options.  

Speak Out LGBTQIA+ Group Do you identify as LGBTQIA+, have a learning disability and are aged 18 or older? Come along to Speak Out’s LGBTQIA+ Group to meet people in a safe space and talk about things that matter to you. The group is a great place for people to explore their identity together and think about that affect LGBTQIA+ people. It is a non judgmental and confidential space, where you can be yourself. 

Stay Up Late Gig Buddies - supporting people with a learning disability and autistic people to go out to gigs and events with a volunteer who shares the same interests through our Gig Buddies and Sports Buddies projects. 

Wild Rainbows The Wild Rainbows are a group of people with a learning disability who are part of our Gig Buddies project and advise on our work through their experiences as part of the LGBTQIA+ community. They are always looking for ways to celebrate who they are and be proud of their identity as people with a learning disability who are part of the LGBTQIA+ community. 

Brighton Lesbian and Gay Switchboard - Switchboard is a charity for LGBTQIA+ people looking for a sense of community, support or information.  We connect people and support them directly through specially developed Switchboard services or link them other specialist organisations. 

MindOut - LGBTQ+ Mental Health Service - MindOut is a mental health service run by and for lesbian, gay, bisexual, trans, and queer (LGBTQ) people.

The Ledward Centre - LGBTQIA+ community and cultural centre. 

Change Grow Live - We offer recovery-focused drug and alcohol support in Brighton & Hove. 

The Saturn Centre - sexual assault referral centre - offer free, confidential healthcare and compassionate support to people of all ages in Sussex that have experienced sexual assault including rape in their lifetime. The service is available 24 hours a day, every day of the year. 

National organisations 

Supported Loving - Toolkit - a useful online guide with links to easy read resources and suggestions for support workers and carers about how to support people with a learning disability. A lot of the resource links are free but for some there is a charge.   

Respond - provides counselling and therapy for people with a learning disability who have been sexually abused and may be abusers themselves. 

Trans in the City - free Trans Inclusion e-learning course, developed by Trans in the City, Cool2BTrans and Global Butterflies, includes the information you need to understand the fundamentals of trans awareness, explained by trans and non-binary role models and allies. 

Beyond the Streets - UK charity working to see a world where women are not compelled into selling sex. 

Your feedback

This resource is subject to ongoing feed-back and update. Tell us if you have any suggestions. Send an email to the Health Facilitator in the SCDS team.

Information and resources 

The information contained in this policy and guidance does not constitute a recommendation or endorsement of any organisation, resource or website listed. 

A vast range of easy read leaflets, apps and information are available nationally, aimed at supporting people with a learning disability to understand their health needs. 

The useful web sites listed in this document will signpost you to some of the information that you can access. Please be mindful that not all resources will be suitable for the individuals that you are supporting, and while many leaflets have been developed at a national level and are of a high quality, this may not always be the case.

Version

Version 1: June 2026

Review: June 2028