‘A Healthier Dorset’ Safeguarding Children Primary Care Update September 22 nd 2011 Safeguarding Children: the role of Dentists

‘A Healthier Dorset’

Safeguarding Children Primary Care Update

September 22nd 2011

Safeguarding Children: the role of Dentists


Aims of the session

• Dental staff will understand what is meant by safeguarding and promoting the welfare of children

• Dental staff will understand their responsibilities to safeguard and promote the welfare of children

• Dental staff will understand the arrangements they need to have in place within their Practice to ensure children are protected

• Dental staff will be compliant with CQC standard 7.


CGC Essential Standards of Quality and Safety March 2010

Outcome 7: Safeguarding people who use services from abuse

11.—(1) The registered person must make suitable arrangements to ensure that service users are safeguarded against the risk of abuse by

• taking reasonable steps to identify the possibility of abuse and prevent it before it occurs and

• responding appropriately to any allegation of abuse.



Abuse means:• Sexual abuse• Physical or psychological ill treatment• Theft, misuse or misappropriation of money or

property• Neglect or acts of omission which cause harm or

place at risk of harm(Regulation 11 of the Health and Social Care Act 2008)



Where any form of control or restraint is used in the carrying on of

the regulated activity, the registered person must have suitable

arrangements in place to protect service users against the risk of such

control or restraint being either

• unlawful or

• otherwise excessive.


Outcome 7: Safeguarding people who use our services from abuse: how do we do this?

A clear practice Safeguarding Children policy to identify• the Practice lead (and deputy) for safeguarding children and how to

get advice

• what abuse and neglect is

• what to do if concerns arise

• Where to get advice locally, (Safeguarding Children Teams, the child’s GP, the relevant Children’s Social care)


Outcome 7: Safeguarding people who use services from abuse: how do we do this?

• Local and government safeguarding children advice will be available to staff in your practice

• A system to monitor and review incidents, concerns and complaints which may become an abuse or safeguarding issue (eg Significant Event meetings)

• Report alleged abuse to the appropriate authority ( this also applies to managing allegations against staff)



• Act immediately to ensure abuse is stopped or suspected abuse is addressed

• Ensure that people using the service know how to raise concerns about abuse

• Review the person’s care plan to ensure they are properly supported following an alleged abuse incident


Outcome 7: Safeguarding people who use services from abuse: how do we do this?

• Use the information from safeguarding concerns to identify non compliance or risk of non compliance with the regulations

• Identify what will be done to return to a state of compliance


Outcome 7 Safeguarding people who use services from

abuse: How?• Staff will know how to recognise signs of abuse and

neglect – Training to the appropriate level for their role

• Staff will know how to report/ seek advice within the Practice and be confident to act – Induction programme includes safeguarding / Practice policy

• The practice lead will know how to seek advice from

specialist safeguarding named/ designated professionals


Outcome 7 Safeguarding people who use services from

abuse: The Outcome

• People using your services are protected from abuse/ the risk of abuse

• Their Human Rights are upheld and respected

• Children are human too!

• The needs of the child are paramount and over ride the duty of confidentiality owed to the parent/ carer


The role of the dentist: Working Together to Safeguard Children 2010 (2.119)

• Dental staff may see vulnerable children

• Dental staff are in a position to identify injuries to the head, neck, throat, face, mouth and teeth

• Dental staff may identify other child welfare concerns

• Child Protection and the Dental Team provides guidance and learning including dental neglect/ general neglect

www.cpdt.org.uk



• Dental staff need access to the Safeguarding Children Board Inter Agency Safeguarding Children procedures

http://www.dorsetlscb.co.uk/site/advice-for-people-working-with-children/local-inter-agency-procedures/



• The dental team must have the knowledge and skills to identify child welfare concerns

• They should know how to refer to Children’s Social care

• They should know how to get advice, including local named and designated professionals


• Dr Julie Doherty, Designated Doctor for Safeguarding Children, Consultant Paediatrician Dorset County Hospital

via switchboard: 01305 251150 and Pager 07699 736867

• Janet Bowen Designated Nurse for Safeguarding Children NHS Dorset and NHS Bournemouth and Poole

Mobile 07824 835669 Pager: 07699 712385

Contact Details Safeguarding Children Advice


Contact Details Safeguarding Children Advice

• Liz Chapman lead for safeguarding children Dorset Healthcare University Foundation Trust (DHUFT)

Mobile: 0766801125

• DHUFT Safeguarding Team 01305 361469

Referral Flow ChartPRACTITIONER HAS CONCERNS ABOUT

CHILD’S WELFARE

Practitioner discusses with manager and/or other senior

colleagues as they think appropriate

No longer has concerns

No further child protection action,although may need to act to ensure

services provided

Feedback to referrer on nextcourse of action

No further LA children’s social careinvolvement at this stage, although

other action may be necessary,e.g. onward referral

See flow chart 2 oninitial assessment

Still has concerns

Practitioner refers to LA children’ssocial care, following up in writing

within 48 hours

Social worker and manageracknowledge receipt of referraland decide on next course ofaction within one working day

Initial assessment required

Concerns about child’simmediate safety

See flow chart 3 onemergency action

https://www.dorsetlscb.co.uk/site/wp-content/uploads/2009/12/Chapter-3.1-Guidance-on-Consent-Confidentiality-and-Information-Sharing.pdf




Dental Flow Chart

What to do if you are worried about the welfare of a child attending your practice.

Draft for consultation


Member of staff has concerns about a child

Do you have concerns about possible neglect or the parent

child interactions?

Consider if you need to call 999 now to alert the Police and protect the

childIs there a concern about an immediate risk of harm

Or an identified injury which could be non accidental? Discuss with your

Safeguarding Children lead immediately

Do you need more information?

Refer to Children’s Social Care by phone and follow up in writing

within 3 working days

Contact the child’s GPs to share your concerns

and seek more information

Yes

YesNo

Discuss with your safeguarding children lead

Concerns increased?Record clearly in the child’s record and save a copy of the referral form/letter

Yes

No

Explain your concerns to the GP and ask for them to be recorded in the child’s

main record

Inform the child’s GP of the referral

Yes police involvement needed now

Call 999 at once and explain concerns

Consider contacting the Safeguarding Children

Professional for additional advice or information


QUESTIONS and DILEMMAS• A child repeatedly needs many restorations due to poor diet or oral

hygiene measures

• When would this would signal "dental neglect“

• When would we need to make a referral to child services• How we would approach this

• Being in essence a business we may get a ‘bad reputation’ for being a practice that is always referring children to child services because they have bad teeth and scaring children even more about going to the dentist.......................


QUESTIONS and DILEMMAS

• if we are concerned is there a way of contacting children’s social care/ children’s services about a family or child to see if they are already considered at risk without the family knowing you have made the enquiry about them?


QUESTIONS and DILEMMAS

• GDPs are not really trained in how to deal with this sensitive issue. Would it be better to train the dental community dept specifically in how to address the link between dental neglect and child neglect and they can assess whether the child needs a referral to child services

• We as GDPs could then somehow highlight how the dental condition is not improving and the possible lack of motivation of the parents to care for them in general, to the community dept, and to see if they agree and then as professional trained they can take the appropriate measures.......................................


TO CHECK IF A CHILD HAS A CHILD PROTECTION PLAN

OR IS KNOWN TO CHILDREN’S SOCIAL CARE

• If a professional has a concern about the welfare of a child and wants to know if the child is known to children’s services or has a child protection plan, they should contact the Designated Manager’ of the list of children with child protection plans.

• Each call is logged

• Two contacts to the manager generates an automatic referral to the local office where an assessment of actions needed is made.


TO CHECK IF A CHILD HAS A CHILD PROTECTION PLAN

OR IS KNOWN TO CHILDREN’S SOCIAL CARE

The numbers for Dorset , Bournemouth and Poole are to be found below

• Dorset: 01305 224314

• Bournemouth: 01202 456890

• Poole: 01202 714747


Useful Links

• https://www.dorsetlscb.co.uk/site/advice-for-people-working-with-children/local-inter-agency-procedures/INTERAGENCY PROCEDURES

• https://www.dorsetlscb.co.uk/site/advice-for-people-working-with-children/what-to-do-if-you-are-worried-about-a-child/

• https://www.dorsetlscb.co.uk/site/wp-content/uploads/2010/05/DSCB-Safeguarding-Standards-2011.pdf (includes information to develop safeguarding children policy)


More useful links

• http://www.cqc.org.uk/aboutcqc/howwedoit/workinginpartnership/maternity,childrenandyoungpeoplesservices/safeguarding.cfm

• http://www.cqc.org.uk/guidanceforprofessionals/primarydentalcare/howwilltheprocesswork/criminalrecordchecks.cfm

Documents

‘A Healthier Dorset’ Safeguarding Children Primary Care Update September 22 nd 2011 Safeguarding Children: the role of Dentists