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Child ProtectionLevel 2
For health staff who have any contact with children, young people and parents
2014
• To develop participants’ awareness of the key aspects of child abuse and maltreatment.
Aim
By the end of the course participants will be able to:
• Understand what constitutes child maltreatment.• Identify the key Safeguarding Children guidance and legislation.• Know how and when to refer to Social Care. • Demonstrate an understanding of the potential impact of parental physical
and mental health on the wellbeing of a child.• Understand the importance of acting as an advocate for the child.• Identify your professional role in a multidisciplinary team. • Document appropriate safeguarding/child protection concerns.• Be aware of the risks of Female Genital Mutilation (FGM) radicalisation
trafficking, sexual exploitation and Prevent agenda.
Learning Outcomes
Treat everyone with equal value and respect
Don’t be afraid to ask questions – avoid side discussions
Sensitivity – feelings, issues and experience
Have respect for diversity – identity, culture and role
Confidentiality - personally & professionally
Listen to each other – one voice at a time
Time Keeping – joint responsibility
Certificates will only be given for a full attendance
Participants are requested not to use mobile devices during the session
Learning Agreement
• Working Together to Safeguard Children (HM GOV 2013)
• What to do if you’re worried a child is being abused (dfes 2006)
• Children Act (1989 and 2004)
• Nice Guideline CG89. When to suspect maltreatment.
• UN Convention on the Rights of a Child (2006)
• Human Rights Act (1989)
Useful Documents
Voice of the child
• It is important to look at and listen to children.
• It is important to understand the child's journey.
• It is important to ensure the feelings of children and young people are taken into consideration, represented and recorded.
Pause For Thought
Daniel Pelka - born15.07.2007 died 03.03.2012 (RIP)
Serious Case Review –
“In this case, professionals needed to “think the unthinkable” and to believe and act upon what they saw in front of them, rather than accept parental versions of what was happening at home without robust challenge.
Much of the detail which emerged from later witness statements and the criminal trial about the level of abuse which Daniel suffered was completely unknown to the professionals who were in contact with the family at the time.”
Missed Opportunities
In Daniel’s case missed opportunities in health settings were:
• His broken arm was too readily accepted by professionals as having been caused accidentally.
• Daniel’s weight loss was not recognised, and child abuse was not considered as a diagnosis.
• Daniel appeared to have been "invisible" as a needy child against the backdrop of his mother's controlling behaviour.
• His poor language skills and isolated situation meant that there was often a lack of a child focus to interventions by professionals.
Everyone’s responsibility
A shared responsibility
An individual staff member responsibility
Protecting children from abuse and neglect is:
Abuse and Neglect are forms of maltreatment of a child.
Somebody may abuse or neglect a child by inflicting harm or failing to act to
prevent harm.
Children may be abused in the family, institutions or in community settings, by
those known or more rarely by those unknown to them eg. Via the internet.
Abuse can include radicalisation, child trafficking or sexual exploitation , Female
Genital Mutilation (FGM) and you need to consider the PREVENT agenda.
See SCB website for further details: www.safechildren-cios.co.uk
What is Child Abuse?
In your groups consider:
1.What are the signs and symptoms of abuse?
2.How these will impact on the child?
3. What would stop professionals identifying risk and reporting abuse?
Exercise 1
There are four broad categories of child abuse used:
Physical Abuse - e.g. hitting, shaking, poisoning, burning, suffocating, fabricated/induced illness etc
Sexual Abuse - e.g. forcing/enticing a child to take part in sexual activities (including non contact activities). Sexual Exploitation issues.
Neglect - e.g. failure to provide adequate food, shelter, clothing, protection from harm, access to medical care etc
Emotional Abuse - e.g. conveying to children they are worthless, unloved or inadequate, exploiting/corrupting children, causing children to feel frightened or in danger e.g. witnessing domestic violence
Four Categories of Child Abuse
• Think what would be developmentally normal for that child.
• Is the behaviour of someone else impacting on the child?
• How is this being reflected in the child’s presentation?
When considering abuse:
Factors which can increase the likelihoodof child abuse:
The Toxic Trio:
• Domestic abuse• Parental mental health• Parental substance misuse
Some other factors include teenage parents, children with complex needs, prematurity, poor housing, poverty.
Common sites for accidental injury
Common sites for non-accidental injury
Parenting
Infants’ brain
Emotional regulation via attachment
Learning
Empathy
Relationships
EmotionalRegulation
Behaviour
Self-esteem Smoking/drugs
Promiscuity
School Failure
Delinquency
Eating Disorders and ObesityJane Barlow
University of Warwick
Parenting and later outcomes
uGuidance and
Bounds
Ensuring Safety
Emotional Warmth
Stimulation
Basic Care
Stability
Family & Environmental Factors
Health
Education
Emotional & Behavioural Development
Identity
Family & relationships
Social Presentation
Selfcare Skills
CHILDSafeguarding &
Promotingwelfare
Chi
ld’s
Dev
elop
men
t Nee
ds Parenting C
apacity
Comm
unity
Resou
rces
Hou
sing
Fam
ily ‘s
Soc
ial
inte
grat
ion
Inco
me
Empl
oym
ent
Wid
er F
amily
Fam
ily H
isto
ry
& F
unct
ioni
ng
Assessment Framework
VEL1
LEVEL 2LEVEL 3
LEVEL 4
Cornwall Multi Agency Thresholds of Need
Places a general duty on the Local Authority to investigate a child’s welfare where there is a reasonable cause to suspect that a child is suffering or likely to suffer significant harm.
It also places a duty on the Local Authority, Education, Health or the NSPCC (unless it would be unreasonable to do so) to assist these enquiries e.g. by providing relevant information and advice.
CHILDREN ACT 1989: Section 47
It is the duty of every local authority to:
“”safeguard and promote the welfare of children within their area who are in need; and so far as is consistent with that duty, to promote the upbringing of such children by their families, by providing a range and level of services appropriate to those children's needs.”
CHILDREN ACT 1989: Section 17
Where possible and safe, share concerns with family.
Always need consent to share information in Common Assessment Framework (CAF) process (Section 17).
We have a duty to and do not need consent to share information in child protection (Section 47).
Confidentiality
Look at the case studies in your group.
Discuss what the impact is for the child.
What would be your action?
Looking at the threshold:• What threshold level would this case meet?• What process would you follow? • What would the likely outcome be?
Group work
• Record your concerns as soon as possible (in accordance with professional guidelines on record keeping).
• Be as factual and accurate as possible. Begin by putting all the facts down; what you saw , what was said, physical evidence – for example,’the mother said this’, ‘the bruise was here’ and so on.
• Add your opinions and interpretations separately. For example; ‘I thought this might be because…’, or ‘it seemed to me that the child was frightened’ or ‘in my opinion the child…’
• Use Body maps where appropriate.• Note any other witnesses/colleagues with whom you shared information
or who can corroborate any part of your record.• Date, time and sign the record.
Recording keeping
Record Keeping is:
• An important part of professional accountability.
• Identified in National and local enquiries as essential to good practice. • A legal and professional requirement.
• Essential to working effectively across agency and professional boundaries.
• A process that provides a chronology of involvement in a case.
• An essential source of evidence for investigations and inquiries.
• Records may be requested as part of court proceedings.
Documentation
• Telephone 0300 123 1116
• Follow up in writing within 48 hours using the multi-agency referral form. http://intra.cornwall.nhs.uk/Intranet/AZServices/C/ChildProtection/ChildProtection.aspx
• Be prepared to give information about:
Child’s name, age, address
Your concerns identifying the risk to the child
Your name and details
Other children in the family
When a referral is made to Children’s Social Care:
Children's Social Care has a duty to investigate allegations of abuse.
The referrer should be informed of this course of action within 48 hours.
Health has a duty to cooperate with any investigations made by Children's Social Care.
Children’s Social Care Response
If you do not agree with the advice you are given and feel that a child remains at risk it is your responsibility to take further action.
You can contact:
• The Safeguarding Children’s team.
• Use the Safeguarding Children Board escalation policy for guidance www.safechildren-cios.co.uk
• If you have concerns about a professional a Local Authority Designated Officer is in place to deal with issues, a policy is in place and you should contact HR or you manager.
Professional Differences
• Multi-agency meeting with all those involved with the child to consider the welfare of the child.
• Signs of safety format is used.
• Always inform manager or supervisor, if you are asked to attend.
• Inform and seek help from Named Professionals.
• If your agency is invited a written report will be required and must be shared with the family.
• The report should be completed on the approved case conference template.
Child Protection Conference
Learning lessons
• Datix/Safeguard
• Serious Incident
• Child Death Review
• Internal Management Reviews
• Serious Case Reviews
Looked After Children
• Looked After Children are particularly vulnerable.
• All Looked After Children will have a social worker
• If a Looked After Child is accessing treatment, it needs to be clear who has parental consent.
• Contact details for the Children in Care team and information regarding consent issues can be found on the intranet: http://intra.cornwall.nhs.uk/Intranet/AZServices/C/ChildreninCare.aspx
Key points:
• Listen to children
• Share information
• Challenge yourself, your colleagues and other professionals
• Don’t delay passing on information
• Communicate with each other
• Impact of parental mental and physical health
• Be confident where to go for additional advice
RCHT
Named Nurse: Alison O’Neill 01872 252596 or via switchboard
Named Midwife: Teresa Phillips via switchboard
Named Doctor: Dr Chris Williams via switchboard
Cornwall Foundation Trust
Named Nurse: Elizabeth Cox 01208 834777 mobile 07500975537
Named Doctor: Dr Ellen Wilkinson via switchboard
Peninsula Community Health
Named Nurse: Dee Hore 07771981189
Named Doctor: Dr Janine Glazier via switchboard
Countywide
Designated Nurse: Judith Parsons 01872 254552
Designated Doctor: Dr Roger Jenkins 01872 254552
Contact Numbers for NHS Organisations
Our aim…
Conclusion
