Bruising in Children who are Not Independently Mobile (NIM) Policy & Procedure

Aim:

As part of Safeguarding Children mandatory legislation, it is now our legal duty as Early Years Professionals to notify cases of bruising in children who are not independently mobile to children’s services.

Definitions

Not Independently Mobile (NIM)

A child who is not yet crawling, bottom shuffling, pulling to stand, cruising or walking independently. This includes all children under the age of 6 months or children with significant disabilities resulting in immobility.

Bruising

Extravasations of blood in the soft tissues, producing a temporary, non-blanching discolouration of skin however faint or small with or without other skin abrasions or marks. Colouring may vary from yellow through green to brown or purple. This includes petechiae, which are red or purple blanching spots, less than two millimetres in diameter and often in clusters.

Why is bruising such a concern?

Research has shown that it is difficult to cause bruising in children that are not independently mobile, during normal day-to-day activities such as feeding, nappy changing and normal handling and as a result bruising can be related to health conditions such as a blood disease, or an infection. It is therefore important for professional to make further enquiries necessary to rule out or diagnose the more serious conditions.

All professionals working with children are expected as part of their duties to make enquiries in order to ensure that children are kept safe from harm and although upsetting, it is vital that every case is investigated in order to identify the occasional serious case.

A bruise must always be assessed in the context of medical and social history, development stage and explanation given and where bruising is non-accidental immediate steps will be taken to protect the child from further harm.

Procedure

Where bruising in non-independently mobile children is observed by, or brought to the attention of Pre-School staff the matter will be treated as a cause for enquiry and concern and a record will be made of the characteristics, position and explanation given for the bruise.

Any injury, bruising or mark that may be bruising in a child of any age that comes to the attention of Pre-School staff will be treated as a matter for concern. Injuries/bruising in a non-mobile child should raise suspicion and will result in an immediate referral to Children’s Social Care.

In such an event the following procedure will be put in place:-

·  The presence of bruising of any size, in any area will initiate a referral to Children’s Services by the member of staff who first observed or learnt of the bruising.

·  The decision to refer will be undertaken jointly with the Designated Safeguarding Lead/management.

·  The referral will be made by telephone to Surrey Children’s Services or if outside of normal working hours to the Emergency Duty Team (EDT) by Pre-School staff.

North West Safeguarding Hub - 0300 123 1630

Emergency Duty Team (out of hours) – 01483 517898

·  The telephone referral will be followed up by the Designated Childcare Protection Officer/ management within 48 hours with a written referral. This will be fully documented using the Multi-Agency Referral Form (MARF).

·  As far as possible parents/carers will be included in the decision-making process unless to do so would pose a further risk to the child.

·  If a parent/carer is un-co-operative this will be reported immediately to Children’s Services.

The Bruising in Children who are Not Independently Mobile (NIM) Policy & Procedure will be reviewed annually by the Committee. Changes can only be made with the full agreement of the Committee and Pre-School management Team.

Signed: Dated: