STANDARDS OF PROFICIENCY

STANDARDS

GUIDANCE

A1

Act in the best   interests of your clients

Members must maintain the high standards of   professional conduct appropriate to membership of the SMTO in which the   interests and welfare of the client are deemed to be paramount.

Do not allow your views about clients’ gender,   age, colour, race, disability, sexuality, social or economic status,   lifestyle, culture or religious beliefs to affect the way you treat them or   the professional advice you give.

Be sensitive to clients in regard to modesty and   special needs, e.g. language difficulties, disability or if they wish a   companion to be present.

Be personally responsible for making sure that   you promote and protect the best interests of the people you care for.

Respect the client’s autonomy and allow them a   choice; never take advantage of the power that exists in, or exploit the   therapist/client relationship; this would constitute abuse.

Members must act to protect the interests of   clients, carers and other members of the public at all times.

Members should provide the best possible care,   either alone or as part of a team, with other insured and experienced practitioners,   in health/social care professions.

Members must not do anything, or allow anything   to be done that they have reason to believe will put the health or safety of   a client in danger; this includes both their own actions and those of others.

Members must remain accountable for their   professional conduct, any care or professional advice they provide, any failure   to act and any tasks they may delegate, both within and outwith the treatment   session; this includes when working individually or as part of a team.

Members   must protect clients if they believe that the client is actually, or   potentially, at risk from a colleague’s conduct, performance or health. The   safety of clients must come before any personal and professional loyalties at   all times. As soon as they become aware of any situation that puts a client at   risk, Members should discuss the matter with a senior professional colleague   or the SMTO

STANDARDS OF   PROFICIENCY

STANDARDS

GUIDANCE

A2

Respect the   confidentiality of your clients

Respect the therapist/client relationship, in   particular the confidentiality of the client, endeavouring to foster and   maintain trust at all times.

Treat   information about clients as confidential and use it only for the purpose for   which it was given; only   use information about a client:

Never   knowingly release or discuss any personal or confidential information to   anyone who is not legally entitled to it. Provide information (if requested)   to other health professionals ONLY with the client’s written consent.

Keep to the conditions of any relevant Data Protection   legislation and follow best practice for handling confidential information   relating to individuals at all times; best practice is likely to change over   time it is the Member’s responsibility to stay up-to-date. When records are   stored on a computer, registration with database authorities is required.

Be particularly careful not to reveal,   deliberately or accidentally, confidential information that is stored on   computers.

Confidentiality can be a particular challenge   when treating minors. In most circumstances it would be most appropriate to   have an adult present at the consultation but the issue of confidentiality   would need to be carefully considered and decisions made depending upon   individual circumstances.

A3

Maintain high   standards of personal conduct

Members must keep high standards of personal conduct,   as well as professional conduct; they must not do anything that may affect   someone’s treatment by, or confidence, in them.

Members   must inform the SMTO, immediately, if they are convicted of a criminal   offence or have accepted a police caution. Each case will be considered   individually and a decision made in the light of the circumstances of the   case. Membership may be at risk if they are convicted of a criminal offence   that involves, for example, one of the following types of behaviour:

STANDARDS OF   PROFICIENCY

STANDARDS

GUIDANCE

A4

Provide to the   SMTO, on request, any relevant information about your conduct, competence or   health

Members   should inform the SMTO (and other relevant regulators and professional   bodies) if they have any relevant information about their own conduct or   competence, or about other professionals they work with. In particular, Members   must inform the SMTO straight away if they are:

Members must co-operate with any SMTO investigation   or formal inquiry into their professional conduct, competence or health, or   the conduct of any other healthcare provider, or the treatment of a client,   where appropriate. Relevant information in connection with their conduct or   competence should be supplied to any legitimate enquirer.

Members must provide information about the   conduct or competence of other healthcare providers if someone who is   entitled to know asks them for it. This relates to their duty to act in the   best interests of their clients and users. A complaint about a colleague   should be referred to the SMTO for advice. Please note, Members must refrain   from criticising fellow practitioners and must not attempt to entice clients away   from another therapist.

STANDARDS OF   PROFICIENCY

STANDARDS

GUIDANCE

B1

Members must keep   their professional knowledge, skills and performance up-to-date and relevant   to their field(s) of practice

Members must meet the Standards of Proficiency   that relate to Massage Therapy, as defined by the SMTO, in conjunction with the   National Occupational Standards (NOS) for Massage, and the CNHC. Members are   required to meet these standards, whether they are in practice or not. The   Standards of Proficiency describe minimum standards of clinical practice. Members   must stay up-to-date with any changes to the Standards of Proficiency that   the SMTO, the National Occupational Standards for Massage and the CNHC may   make for each of their disciplines as knowledge and techniques develop.

Members should ensure, by means of continuous   update of information and training, a level of competence consistent with the   highest standards of the profession.

Members must maintain a portfolio of Continuing   Professional Development.

B2

Members must act   always within the limits of their knowledge, skills and experience and, if   necessary, refer on to another Member or healthcare professional

Members must always observe the highest degree of   integrity and responsibility in regard to the practice of Massage Therapy,   working within their professional competences.

Member should keep within their scope of   practice; this means that they should only practise in those fields in which they   have appropriate education, training, qualification and experience.

The duty of care to a client includes the   obligation to refer them for further professional advice or treatment if it   becomes clear that what they need is beyond the Member’s own scope of   practice. If Members accept a referral from another healthcare or social care   professional, they must make sure that they fully understand the request. They   should only provide the treatment or advice if they believe this is   appropriate. If this is not the case, they must discuss the matter with the   practitioner who has made the referral, and also the client, before they begin   any treatment.

Members must seek appropriate medical advice in   any situation in which they may lack the necessary competence or experience   to administer treatment. Members should not knowingly treat anyone with a   serious medical condition without prior approval by their doctor, unless the   client signs a disclaimer giving written permission to the Member.

STANDARDS OF   PROFICIENCY

STANDARDS

GUIDANCE

B3

Maintain   appropriate and effective communication with clients, carers and other   Members and professionals

Members must take all reasonable steps to make   sure that they can communicate properly and effectively with their clients,   and their client’s carers and family (when the client’s permission is given).  

Members should, where possible, co-operate, and   share their knowledge and expertise with professional colleagues for the   benefit of clients. This is of particular importance when entering into   multiple relationships involving the same client; please note: written   permission must be sought from the client before any personal information can   be discussed or shared.

It is essential that every client understands   what is required of him/her and why. Clients should not be left in the room   during a Massage Therapy session without being advised, nor should they be   confused as to the actions of the Member in the room. Members must at all   times, communicate clearly and check that the client has understood the   request, instruction or explanation. This is essential for safe practice.   Members should always ask for permission to proceed. Clients should feel   comfortable, safe and in control throughout any treatment session and fully understand   all procedures with regard to the consultation, the assessment, the removal   of clothes, getting onto the treatment table, any techniques being used, in   particular those that may be uncomfortable, and reassessment. Clients should   also be advised that they are entitled to have a chaperone present.

B4

Members must   effectively supervise tasks they have delegated

People who consult or receive treatment or   services from Members are entitled to assume that a person who has the   knowledge and skill to practise their profession will carry out their   treatment. Whenever Members give tasks to another person to carry out on their   behalf, they must be sure that they have the knowledge, skills and experience   to carry out the task safely and effectively. If they are not suitably   qualified healthcare professionals, Members must not ask them to do the work   of healthcare professionals. If they are healthcare professionals, Members   must not ask them to do work that is outside their scope of practice. If they   are training to be healthcare professionals, Members should be sure that they   are capable of carrying out the task safely and effectively.

Whoever Members ask to carry out a task, they   must always continue to give adequate and appropriate supervision and remain   accountable for the outcome. If someone tells them that they are unwilling to   carry out a task because they do not think they are capable of doing so   safely and effectively, Members must not put pressure on them to carry out   the task. If their refusal raises a disciplinary or training issue, they must   deal with that separately, without endangering the safety of the client.

STANDARDS OF   PROFICIENCY

STANDARDS

GUIDANCE

B5

Obtain informed   consent to give treatment (except in an emergency)

Members must maintain good communication at   all times thus ensuring the client understands and has given consent to all   procedures. Where a client is unable to consent, then consent must be   obtained from someone who can give it on the client’s behalf.

Members must explain to the client the   treatment they are intending to carry out, the risks involved and any other treatments   possible. They must make sure that they obtain informed and signed consent to any treatment they   do proceed with. Members must make a record of the client’s treatment   decisions and pass this on to all members of the healthcare or social care   team involved in their care (where the client’s permission has been given).   It is recognised that in emergencies, Members may not be able to fully   explain treatment or get informed consent at the time, but this should be   fully documented on the client’s records.

B6

Keep accurate   client records

Making and keeping records is an essential   part of care and Members must keep records for everyone they treat or who   asks for professional advice or services, in order to safeguard both   themselves and their clients. All records must be complete and legible, and Members   should sign and date all entries. Clients should sign records for consent to   treatment. Please note that records are the property of the client.

Members must maintain careful, legible and   understandable records of all clients, including a full medical history and   presenting complaint, assessment and procedures performed, up-to-date medical   records, clinical findings (to the level of competence gained), information   and advice given and any comments made, as well as details of any suggested   referral. Records should be kept for a minimum of 7 years. In the case of   children, records must be kept for a minimum of 21 years. For seriously ill,   injured or disabled clients, records should be kept indefinitely.

Members should advise clients to consult a   doctor if they are in any doubt as to the client’s health or the suitability   of the treatment; this advice, as all advises, should be recorded.

When supervising student therapists, Members   should also counter-sign any student entries in the notes. Whenever Members   review the records, they should update them and include a record of any   arrangements they have made for the continuing care of the client.

Members   must protect information in records against loss, damage or use by anyone who   is not authorised. They can use computer-based systems for keeping records,   but only if they are protected against anyone tampering with them (including   other healthcare professionals). If Members update a record, they must not   erase information that was previously there, or make that information   difficult to read; instead, they must   mark it in some way. Members must adhere to Data Protection guidelines with   regard to the handling of personal information (see A2).

STANDARDS OF PROFICIENCY

STANDARDS

GUIDANCE

B7

Be aware of, and   manage effectively and safely, the risks of infection

Members must take appropriate precautions to   protect their clients, client’s carers and families, staff and themselves   from infection.

Members must also take precautions against the   risks that they might infect someone else. This is especially important if they   suspect or know that they have an infection that could harm others,   particularly clients and they must get medical advice and act on it. This may   include the need for the Member to stop practising altogether, or to change their   practice in some way in the best interests of protecting their clients.

Members must keep to the rules of confidentiality   when dealing with people who have infections. For some infections, such as   sexually transmitted infections, these rules may be more restrictive than the   rules of confidentiality for people in other circumstances. However, Members   are duty bound to report all notifiable disease states according to applicable   laws.

B8

Members must limit   their work or stop practising if they or another person has any reason to   believe that their performance of judgment is affected by their physical,   emotional or mental health.

Members have a duty to take action if their   physical, emotional or mental health could be affecting their fitness to   practise. They should get advice from a consultant in occupational health or   another suitably qualified medical practitioner and act on that advice. This   advice should consider whether, and in what ways, they might need to change their   practice, including stopping practising, should this be deemed necessary. They   also have a duty to report any other SMTO Member if they believe they are   failing to meet this requirement.

B9

Ensure appropriate   First Aid skills and valid certification.

It is the responsibility of Members to keep their   First Aid certification up-to-date. Members must have the necessary skills to   cope in an emergency situation. Members should be prepared and competent to   administer emergency procedures as may be required by the client, and   maintain such procedures until relieved. Any incident should be recorded on   the client’s records.

STANDARDS OF   PROFICIENCY

STANDARDS

GUIDANCE

C1

Members must   conduct themselves in a professional and ethical way at all times.

Members must carry out their duties and   responsibilities in a professional and ethical way. Clients are entitled to   receive good and safe standards of practice and care, with clear instructions   given at all times. The SMTO seeks to protect the public from unprofessional   and unethical behaviour, and to make sure that Members know the standards   expected of them.

C2

Behave with   integrity and honesty

Members must ensure that they behave with   integrity and honesty and keep to high standards of personal and professional   conduct at all times. Members should act honourably towards clients and fellow   practitioners at all times. They must uphold and maintain the high standards   of the profession. They must seek good relationships and co-operate with   other healthcare professionals.

C3

Follow SMTO   guidance in relation to advertising your services

Any advertising Members undertake in   relation to their professional activities must be accurate. Advertisements   must not be misleading, false, unfair or exaggerated. Members must not claim   that their personal skills, equipment or facilities are better than anyone   else’s.

Members must abstain from any claim or   statement misrepresenting the therapeutic benefits of Swedish Massage,   Remedial and Sports Massage, Remedial Massage, Sports Therapy, Advanced   Remedial Massage, Manipulative Therapy, Reflexology, Clinical Aromatherapy,   On-Site Massage, or any other modality that you may be qualified in.

If Members are involved in advertising or   promoting any other product or service, they must make sure that they use their   knowledge, healthcare skills, qualifications and experience in an accurate   and professionally responsible way. They must not make or support   unjustifiable statements relating to particular products or services. Any   potential financial rewards to them should be made explicit and play no part   at all in the advice or recommendations of products and services that they   give to clients.

C4

Members must not   be involved in any behaviour or activity which is likely to damage their   profession’s reputation or undermine public confidence in their profession.

Members’ behaviour will potentially be under   scrutiny at all times by the public and they should ensure they do nothing to   bring their profession into disrepute. Appropriate professional boundaries   must be maintained between Members and their clients. Development of a   personal relationship must result in the cessation of the therapeutic   relationship.

C5

Appropriate   procedures for dealing with workplace issues.

Members   should ensure that they have appropriate procedures in place for dealing with   complaints and criticisms in the workplace, whether from clients, staff, or   other practitioners, in an efficient and professional manner.

CODE OF   PRACTICE

STANDARDS

D1

Personal. A practitioner   should at all times maintain the correct appearance, behaviour and conduct   expected of a professional person; abuse of alcohol, drugs, or good order is   deemed to be a serious offence against this code.

D2

Members shall have   respect for the religious, spiritual, political and social views of any   individual irrespective of race, colour, creed, sexual orientation or gender.  

D3

Members shall at   all times conduct themselves in an honourable and courteous manner and with   due diligence in their relations with their clients and the public. They   should seek a good relationship and shall work in a co-operative manner with   other healthcare professionals and recognise and respect their particular   contribution within the healthcare team, irrespective of whether they perform   from an allopathic or alternative/complementary base.

D4

The relationship   between a Member and her/his client is that of a professional with a client.   The client places trust in a Member's care, skill and integrity and it is the   Member's duty to act with due diligence at all times and not to abuse this   trust in any way.

D5

Proper moral conduct   must always be paramount in Members' relations with clients. They must behave   with courtesy, respect, dignity, discretion and tact. Their attitude must be   competent and sympathetic, hopeful and positive, thus encouraging an uplift   in the client's mental outlook and belief in a progression towards good   health practices.

D6

In furtherance of D5,   Members must not enter into a sexual relationship of any kind with a client,   where client means anyone who attends for therapy and the Member has client   records for. Members must be diligent in guarding against any act, suggestion   or statement that may be interpreted, mistakenly or otherwise, as having a   sexual implication.

D7

All Members must use modern information   and communication technologies (ICT), e.g. text messaging, email and social   media, in an appropriate and professional manner when connecting with clients   and other therapists. ICT should neither be used to harm or harass other   people in a deliberate, repeated and hostile manner nor be used to defame or   humiliate them. If Members are using social media (e.g. Facebook, Twitter   etc.) it is recommended that they should have a business   site for their work and a separate social one, for personal relationships. As   with all professional behaviour, boundaries must be in place to protect both   the Member from complaint or compromise as well as the all-important client.

D8

All Members   working within hospitals, hospices and any other medical establishment will   comply with the protocols and guidelines in force at such establishments.

D9

Members must never   make any written or unwritten claims to 'cure'. The possible therapeutic   benefits may be described; 'recovery' must never be guaranteed.

D10

Members should   ensure that they themselves are medically, physically and psychologically fit   to practise.

D11

Discretion must be   used for the protection of Members when carrying out private treatment with   clients who are mentally unstable, addicted to drugs or alcohol, or severely   depressed, suicidal or hallucinated. Such clients must be treated only by Members   with relevant competency. In these treatment situations, it is advised to   have a chaperone/companion present. Members must not treat a client in any   case which exceeds her/his capacity, training and competence. Where   appropriate, Members must seek referral to a more qualified person.

D12

The aim of SMTO   membership is to offer a service to clients as well as a service and   therapeutic modalities to, and with, the medical profession. Members must   recognise that where a client is delegated to them by a registered medical   practitioner, that person remains clinically accountable for their patient and   for the care offered by Members.

D13

Referrals. Members   should be aware when it is appropriate and in the client’s best interests to   refer them to another health professional.

CODE OF   PRACTICE (cont)

STANDARDS

D14

Members must guard   against the danger that a client without previously consulting a doctor may   come for therapy for a known disorder and subsequently be found, too late, to   be suffering from another serious disorder. To this end new clients must be   asked what medical advice they have received. If they have not seen a doctor,   they must be advised to do so. Since it is legal to refuse medical treatment,   no client can be forced to consult a doctor. The advice must be recorded for   the Member's protection. It is not a breach of ethics to treat a client who   gives informed consent to receive a therapy, but Members may not knowingly   apply massage therapy to a person who is already receiving medical treatment   for a condition without the respective practitioner’s consent.

D15

Members must not   countermand instructions or prescriptions given by a doctor.

D16

Members must not   advise a particular course of medical treatment, such as to undergo an   operation or to take specific drugs. It must be left to the client to make her/his   own decision in the light of medical advice.

D17

Members must never   give a medical diagnosis to a client in any circumstances, unless medically   qualified to do so; this is the responsibility of a registered medical   practitioner. However, Members practising therapies, for example Reflexology,   may, during the course of their treatment, discover imbalances in physical,   emotional, mental and spiritual aspects. In these cases Members may make   mention of any imbalances which they may have discovered, and advise the   client to see his/her doctor for a medical diagnosis. This action should be recorded   on the client’s records.

D18

Members must not   use titles or descriptions to give the impression of medical or other   qualifications unless they possess them and must make it clear to their   clients that they are not medical doctors and do not purport to have their   knowledge or skills. Members may also not address or refer to an assistant as   ‘nurse’ unless the person referred to holds a nursing qualification in the   country in which the practitioner is operating a clinic.

D19

Members are   forbidden to diagnose, perform tests on or treat animals in any way, unless   specifically qualified, or given express permission, following diagnosis, by   a registered veterinary surgeon; they must not countermand her/his   instructions.

D20

Members must not   attend women in childbirth or treat them for ten days thereafter unless they   hold an appropriate qualification in midwifery or one approved by the SMTO.   This does not preclude treatment given with the permission of the client’s   midwife, doctor or medical team.

D21

Members must not   practise dentistry unless they hold an appropriate qualification.

D22

Members must not   treat any venereal disease as defined in the 1917 Act.

D23

Clients suffering   from AIDS may be treated at the discretion of the Member.

D24

Members must not   use manipulation or vigorous massage unless they possess an appropriate   professional qualification.

D25

Members must not   prescribe or administer remedies, herbs, supplements, essential oils or other   products unless their training and qualifications entitle them to do so.

D26

At the present   time, no alternative or complementary therapy is approved as ‘medical aid’   under the law. It is a criminal offence for a parent or guardian not to seek   ‘medical aid’ for a child under the age of 16. The Member should secure a   signed statement from a parent or guardian who refuses to seek medical aid as   defined under the law in the following format: “I have been warned by (enter   name of Member) that according to law I should consult a doctor concerning   the health of my child (enter name of the child) Signed (signed by parent or   guardian) Signed (by person witnessing the parent’s or guardian’s signature).

D27

Members should display   their certificate of membership of the SMTO in their normal place of work.   Members working in several locations and/or offering visiting services will   have available at all times a copy of their current annual membership   certificate, issued by the SMTO.

CODE OF   PRACTICE (cont)

STANDARDS

D28

Before treatment Members   must explain fully, either in writing or verbally, all the procedures   involved in the treatment including such matters as the completion of a   consultation form, the likely content and length of the consultation, the   possibility that follow-up treatments may be required, the cost of treatment etc.   Members must ensure that they have the client’s informed consent in writing to perform any treatment. Where   a client has an existing medical condition consent should be provided by the   client’s medical practitioner. Alternatively, the client must sign a   disclaimer giving written permission for the treatment.

D29

No third party,   including assistants and members of the client’s family, may be present   during the course of a consultation with an adult without the client’s   express consent, which should be recorded. However, clients should be   informed that they are entitled to have a chaperone present.

D30

Members may not   undertake any physical examination or treatment on any child under 16 except   in the presence of the parent, guardian or authorised person, who will have   given written consent.

D31

Members must act   with consideration concerning fees and justification for treatment. Members   should not be judgmental and they should recognise the client’s right to   refuse treatment or ignore advice. It is the client’s prerogative to make   their own choice(s) with regard to their health, lifestyle and finances.

D32

Members may not   carry out any treatment of a client who has already received similar   treatment for the same condition from another therapist unless the client   has, of his/her own volition, decided to discontinue the original therapist’s   treatment.

D33

Records. Members   must ensure they keep clear, accurate and comprehensive records of client   details and their treatments including the dates, advice given and all   consent forms. This is especially   important for the defence of any negligence actions, as well as for efficient   and careful practice. All records should be kept for a minimum of 7 years. In   the case of children records must be kept for a minimum of 21 years. For   seriously ill, injured or disabled clients, records should be kept   indefinitely.

D34

Members are accountable   for their treatment choices, as an explanation from them in regard to their   treatment may be necessary at a future date e.g. in the case of an   investigation. In determining whether or not any record of the nature of any   treatment administered is reasonable, Members must be able to provide client   records that demonstrate what treatment was undertaken, the reasons for this   treatment choice, that the client consented to the treatment, and whether   that treatment was competently and reasonably undertaken.

D35

Confidentiality.   Members, their assistants and receptionists have an implicit duty to keep   attendances, all information, records and views formed about clients entirely   confidential. No disclosure may be made to any third party, including any member   of the client’s own family, without the client’s consent unless it is   required by due process of the law, whether that be by Statute, Statutory   instrument, order of any court of competent jurisdiction or howsoever   otherwise.

D36

Security. Members   must ensure that their client’s confidential records are kept in a secure   place, properly safeguarded and not accessible to third parties. Client’s   belongings should also be kept in a safe place, with the client advised of   where they are, at all times.

D37

Members must   ensure that they comply with the Data Protection Act.

D38

Insurance. All Members   must hold adequate insurance cover to practise. Normally this will be through   the SMTO policy, but private insurance is permitted, and if adopted, Members   must provide evidence of this to the SMTO. The insurance policy must state   provision for public liability and indemnity as well as the provision for   professional treatments.

D39

Premises. All Members   shall ensure that their working conditions are suitable for the practice of   their therapy. Treatment areas must be hygienic, appropriate and equipped to   minimal health and safety standards and must comply with local health and   safety regulations. Staff facilities and public areas (waiting rooms,   hallways, stairs, toilet facilities etc.) must also comply with current   health and safety regulations. When the client is treated in their own home,   all reasonable efforts to ensure the client’s safety must be made.

CODE OF   PRACTICE (cont)

STANDARDS

D40

Advertising and   professional leaflets must be dignified in tone and shall not contain named   testimonials or claim to cure any disease etc. Members shall be free to   advertise their services and practices as they see fit, but it is recommended   that all advertising shall be confined to promoting the therapy/therapies   available, the expected effects of the therapy and/or any research in support   of the therapy. The qualifications of the Member should be displayed and   offer a general service together with any necessary details, e.g. means of   contact.

All advertisements MUST adhere to the following   guidelines:

D41

Stationery and   other productions. Professional letterheads should be of good quality and   print. A full Member may use the SMTO logo on business stationery only, but   in other circumstances at the discretion of the Committee.

D42

Publications.   Nothing may be published in the name of the Scottish Massage Therapists   Organisation without the prior agreement of the Committee, or sub-committee   or Member acting with the full authority of the Committee.

D43

Discipline.   Members will follow and abide by decisions made under the disciplinary,   complaints and appeals procedures appended to this Code. Members must   understand that by signing the application and annual renewal forms that they   are agreeing to abide by the SMTO Practice Standards: Code of Conduct, Performance   and Ethics and it is in the remit   of the SMTO to sanction Members who do not uphold the standards and obey the   contents of this document, as laid out in the SMTO Disciplinary &   Complaints Policy.