Child Protection Policy

CLIN006v2

DOCUMENT CONTROL

Reference Number
CLIN 006 / Version
2 / Status
Final / Sponsor(s)/Author(s)
Eileen Welch
Designated Nurse for Safeguarding Children
Amendments / Date / By whom
Policy updated / Mar 2009 / Safeguarding children’s team
Amendments following consultation / Mar 2009 / Gene Kelly
Amendments following comments made by members of the PCT Clinical Policies and Guidelines Group / April 2009 / Gwyneth Jones
Intended Recipients:
All PCT staff
Independent contractors / Group/Persons Consulted:
PCT Clinical Governance committee Professional advisors
GP practices
PBC GP leads
Sandwell Community Healthcare Services
Public Health and Joint Policy Unit
Operational Performance Team (for onward dissemination to all members of staff)
Monitoring Arrangements and Indicators:
  • PCT Learning and development will monitor compliance with training as part of this policy and report findings to the Heads of departments.
  • Reports to clinical governance and integrated governance committees
  • Monitoring in GP practices and other independent contractors will be via clinical governance visits
  • Monitoring of this policy by Sandwell Community Healthcare Services will be according to their own processes and procedures

Training/Resource Implications:Included in mandatory training
PCT Value: / Put the needs of our communities first
Achieve through partnership
People experience respect and dignity
Value staff and the contribution they make
Approving Body:
Clinical Policies and Guidelines Group
Integrated Governance Committee / Date Approved:
26 March, 2009
2 April, 2009
Date of Issue / 1 April, 2009
Review Date / April 2011
Contact for Review / Safeguarding children’s team
Policy Location: / PCT Extranet & Clinical Policy Folder
Summary
The aim of this policy is toensure that all health professionals are aware of their responsibilities to safeguard/protect children and the procedure to follow if child abuse is suspected.
Key issues to be covered include :
  • Roles and responsibilities for all staff
  • Procedures to be followed in the event of suspected child abuse
  • Procedures to be followed in the event of a child death
This policy should be read in conjunction with the following local and national polices and guidance:-
  • Sandwell Local Safeguarding Children Board Inter Agency Safeguarding Children Procedures.
  • What To Do If You’re Worried A Child Is Being Abused – Department of Health (2006) (
  • Working Together to Safeguard Children (2006) (
  • Children Act 1989 &2004
  • Sandwell PCT Safeguarding Children Strategy 2009

PART B
Pharmacist Approval –please consult and obtain authorisation from PCT Assistant Director of Medicines Management- Kingston House, if medication is included. NOT APPLICABLE
Name of PCT Pharmacist- Print
Signature ______
Date ______
PART C
Pathology Approval for completion if normal values for investigative testing are included NOT APPLICABLE
To be signed by Pathology Head of Dept. once the values are checked and approved
Name of Pathology Rep. Print ______
Signature ______
Date ______
PART D
Equalities Legislation Requirements: An Equality Impact Assessment /Sandwell Impact Assessment Tool has been undertaken to ensure the policy/guideline meets the requirements of Equalities Legislation.
Signed _

Date 31 March, 2009

Contents
Number / Section / Page No.
1 / Introduction and abbreviations / 5
2 / Purpose / 6
3 / Definitions / 7
4 / Roles and Responsibilities / 8
5 / Procedure / 10
6 / Training (see also Appendix 10) / 15
7 / Audit and Monitoring the Compliance and Effectiveness of this Policy / 15
8 / Policy Implementation Plan (see also Appendix 11) / 16
9 / Contacts / 16
10 / References / 16
11 / Appendices
Appendix 1 / Multi-Agency Notification Form / 16-2
Appendix 2 / Guidelines for completion of Multi-Agency Notification Form / 23
Appendix 3 / PCT Child Death procedures / 24
Appendix 4 / Guidelines for Children Found at Home Alone / 25
Appendix 5 / Guidelines for Children Attending a Child Protection Conference / 26
Appendix 6 / Guidelines for Staff on Report Writing / 27
Appendix 7 / Guidelines and Proforma for Health Professionals When Writing a Legal Statement For Care Proceedings / 28
Appendix 8 / Proforma for Health Professionals When Writing a Legal Statement For Care Proceedings / 30
Appendix 9 / Guidelines for Reports Requested by Police or Children’s Guardian / 33
Appendix 10 / Standards for Child Protection Training / 34
App 11 / Policy Implementation Plan / 36

Introduction

1.1 Every Child Matters/Change for Children DoH 2006

All children deserve the opportunity to achieve their full potential. We set this out in five outcomes that are key to children and young people’s wellbeing:

  • stay safe
  • be healthy
  • enjoy and achieve
  • make a positive contribution
  • achieve economic wellbeing

1.2Sandwell Local Safeguarding Children Board (SLSCB)

Sandwell LSCB ensures that all organisations who work with children co-operate to keep children and young people safe from harm.The LSCB agrees how local services and professionals should work together in Sandwell to safeguard and promote the welfare of children and to ensure that safeguarding is everyone's business”.

1.3 The Children’s Act 1989

The Children Act clearly states that all Health Trusts (including those working with adult clients) have a duty under Section 27 of the Children Act 1989, to co-operate with the local Authority in the exercise of their functions.

1.4 The Children’s Act 2004

Section 11 of the Children Act 2004 places a duty on all agencies to make arrangements to ensure that “their functions are discharged having regard to the need to safeguard and promote the welfare of children”.

All staff should note the main principle of the Children Act which states:-

A child’s welfare is paramount and each child is unique.

This policy is mandatory for staff employed by Sandwell PCT and should be seen as good practice for staff working in Independent Contractors (GPs, Community Pharmacists, General Dental Practices and Community Optometrists).

1.5 Abbreviations

Designation / Abbreviation
Local Safeguarding Children Board. / LSCB
Named Nurse for Safeguarding Children. / NNSGC
Named Doctor for Safeguarding Children. / NDSGC
Named Nurse for Looked after Children / NNLAC
Designated Doctor for Safeguarding Children / DDSGC
Designated Nurse for Safeguarding Children / DNSGC
Royal College of Nursing / RCN
RoyalCollege Of Paediatrics & Child Health / RCPCH
Royal Pharmaceutical Society of Great Britain / RPSGB
Nursing & Midwifery Council / NMC
General Medical Council / GMC
General Dental Council / GDC
Safeguarding Children Team / SCT
Primary Care Trust / PCT
Multi-Agency Notification Form / MANF

2.Purpose

21. Aim of the policy

The aim of this policy is toensure that all health professionals are aware of their responsibilities to safeguard/protect children and the procedure to follow if child abuse is suspected.

Child abuse may be physical or sexual, neglect or emotional harm or anycombination of these, but all staff must be aware that all abuse to children produces emotional harm. Health professionals must have a high index of suspicion where injuries are seen with a discrepant explanation from the parent or carer.

2.2 The objectives of this policy are to ensure that:

  • All staff are aware of their responsibilities relating to safeguarding children/ child protection, and take the appropriate action whenever they are suspicious or have knowledge that child abuse has taken place.
  • All staff are enabled to discuss these concerns with appropriate colleagues as needed, i.e., Designated Doctor, Designated Nurse, Named Nurse for Safeguarding Children
  • All staff know that they must maintain clinical records, recording clear concise information which is contemporaneous – dated and signed.
  • All staff are aware of good practice about sharing concerns. That is, whilst good practice would suggest that professionals should share their concerns with the family, and where possible seek their agreement prior to making a referral, obtaining consent should not jeopardise any appropriate action being taken in protecting a child.
  • All staff are aware of children who are potentially at risk. There is no check list that will accurately define those families where child protection concerns may arise but vulnerable children and young people may include:-
  • Those with special needs due to physical, mental or learning difficulties.
  • Children whose parent/carers abuse drug/alcohol.
  • Children of parents/carers with mental health problems.
  • Children where there is a history of domestic abuse in the home.
  • Children from homes where there is a history of violence to animals.
  • Children from homes frequented by individuals who present a risk to children.
  • Children who are the subject of a Child Protection Plan.
  • Children whose parent/carers have a history of self harm.
  • Looked After Children
  • Refuge and Asylum Seekers/unaccompanied minors
  • Children of teenage mothers
  • Children living in poverty and deprivation
  • Young people who misuse alcohol and drugs
  • Young people who are sexual exploited (Child Prostitution)
  • Concealed Pregnancy

3.0 Definition of Categories of Abuse:

Physical Abuse

Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer feigns the symptoms of, or deliberately induces, illness in a child.

(Working Together to Safeguard Children : DoH 2006 : 1.30)

Emotional Abuse

Emotional abuse is the persistent emotional ill-treatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development. It may involve conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction. It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying, causing children frequently to feel frightened or in danger, or the exploitation or corruption of children. Some level of emotional abuse is involved in all types of maltreatment of a child, thought it may occur alone.

(Working Together to Safeguard Children : DoH 2006 : 1.31)

Sexual Abuse

Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including prostitution, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (e.g. rape, buggery or oral sex) or non-penetrative acts. They may include non-contact activities, such as involving children in looking at, or in the production of, sexual online images, watching sexual activities, or encouraging children to behave in sexually inappropriate ways.

(Working Together to Safeguard Children : DoH 2006 : 1.32)

Neglect

Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to:

  • provide adequate food, clothing and shelter (including exclusion from home or abandonment)
  • protect a child from physical and emotional harm or danger
  • ensure adequate supervision (including the use of inadequate care-givers)
  • ensure access to appropriate medical care or treatment.

It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.

(Working Together to Safeguard Children: DoH 2006: 1.33)

4.0Roles & Responsibilities

4.1 It is the responsibility of the Primary Care Trust Board

  • To explicitly state the PCT’s commitment to the safeguarding and welfare of children and young people by demonstrating through clear involvement of children and young people in planning services
  • To ensure the PCT develops and implements clear policies and procedures
  • To ensure inclusion of safeguarding children responsibilitiesin executive job descriptions
  • To ensure support for ongoing child protection training and other essential resources
  • To ensure that in discharging its functions there is due regard to the need to safeguard and promote the welfare of children
  • To ensure the protection of children by following national child protection guidance within the activities of the PCT and in dealings with other organisations
  • To have a Named PCT Trust Board Executive Director who will be the PCTBoard lead for Safeguarding and will be responsible for providing assurance to the Board on the adequacy and effectiveness of safeguarding arrangements.
  • To have a named PCT Trust Board Non executive “Children’s Champion”
  • To receive regular reports from the PCT Safeguarding Lead and Designated Safeguarding Professionals

4.2 Designated Doctor (DDSGC) and (DNSGC) Designated Nurse for Safeguarding Children

It is the responsibility of the DDSGC and DNSGC

  • To act as the PCT Safeguarding leads to take a strategic, professional steer on all aspects of the health service contribution to safeguarding children across the PCT area, which includes all providers
  • To advise the Chief Executive and the PCT Board Safeguarding Executive about planning and strategy with regard to safeguarding children with emphasis on training monitoring and policies
  • Provide skilled professional involvement in the child safeguarding processes including advice and support
  • To represent the PCT on the LSCB
  • To be responsible for health advice to other agencies
  • To supervise named health professionals
  • To work closely with other designated and named health professionals

4.3 Named doctor for Safeguarding (NDSGC)

It is the responsibility of the NDSGC who is a GP to lead, advise and support other professionals on all child protection and safeguarding issues within the PCT.

4.4Named Nurse for Safeguarding Children (NNSGC)

It is the responsibility of a senior nurse to lead, advise and support other professionals on all child protection and safeguarding issues within the Trust.

4.5The Safeguarding Children Team

This includes the DDSGC, DNSGC, NDSGC, NNSGC, NNLAC, who work as an integrated team with other Health Specialists in Safeguarding based in Sandwell to:-

  • To facilitate adherence to the PCT Child Protection and Safeguarding Policies.
  • To ensure that Safeguarding policies and the management of suspected or definite child abuse complies to the policies of Sandwell LSCB
  • To monitor the management of children reported by PCT staff as suspected or confirmed abuse victims
  • To provide advice to any member of staff on the management of suspected or confirmed child abuse
  • To attend child protection conferences and associated meetings
  • To provide training on safeguarding including domestic abuse for PCT staff who work with children or come into contact with families.

4.6Clinical Staff

All clinical staff must ensure they meet professional standards set by their own professional bodies such as NMC, GMC, GDC, RCPCH and RPSGBsuch as safeguarding children, code of confidentiality etc.

4.7All staff

All staff are responsible for making sure that they are aware of and follow the PCT arrangements for Safeguarding Children. They must ensure that they have undertaken any necessary training and complied with any check required for their role. Any staff member who suspects a child has been or might be abused must take action in line with PCT and LSCB policies and procedures.

5.Procedures

These procedures adhere to the Sandwell Local Safeguarding Children Board Interagency Safeguarding Children Policy and Procedures 2007.

5.1 Safeguarding children is the responsibility of everyone.

  • Identification of abuse and neglect is defined in Working Together to Safeguard Children (DoH 2006).
  • All staff need to ascertain whether a Common Assessment (CAF)has beenundertaken.
  • .All staff who identify a child who is suffering or is likely to suffer significant harm should make a referral to one of the statutory agencies who have a duty to make enquiries, i.e., Assessment & Referral Team and/or Police (Child Abuse Investigation Unit).
  • Staff should ascertain if informed consent has been sought from the parent/carerwith parental responsibility or whether such consent seeking would place the child at further risk.
  • .Following making a referral, staff should complete the Multi-Agency Notification Form (appendices 1 and 2) within48 hours.
  • .If Assessment & Referral Team receive a referral, they have a duty to make enquiries if they have reason to suspect that a child may be suffering significant harm. Staff will need to share the relevant information to enable the Assessment & Referral Team to make an informed decision if the child is in need of protection. This information will be given on a strictly controlled basis, so that informed decisions relating to the child’s welfare can be considered.
  • Staff whoreceive a request for information must decide whether to maintain confidentiality or whether they have just reason to breach confidentiality pertaining to the circumstances of a particular case. Health Professionals will need to consider guidance issued by their professional Bodies, e.g. GMC, NMC, RPSGB etc.
  • .All pre-school children who are the subject of a Child Protection Plan, or who are identified as a child in need, will have a Health Visitor assigned to them.
  • All school-age children who are the subject of a Child Protection Plan, or who are identified as a child in need and attending school will have a school health nurse assigned to them. The health needs of excluded children should be discussed with the relevant School Health Nurse Co-ordinators.

All staff will have access to the Designated Nurse /Named Nurse forSafeguarding Children for advice and support.

5.2Medical Examinations.

If a child needs to be examined for suspected abuse, Children & Young People’s Service and/or the Police will arrange for this using the rota of experienced Paediatricians. Children should not be sent to Accident & Emergency unless they require emergency treatment.Staff who need to discuss a case with a Paediatrician should ring the on-call Consultant Paediatrician via Sandwell & West Birmingham switchboard. All discussions should be recorded in the patient notes. GP’s should not be asked to examine children where there are suspicions of abuse.

5.3Information Sharing.

  • To safeguard and promote the welfare of children it is important to share information between health professionals when there are potential or identified concerns with an adult client who has dependant child/ren. Staff should complete a Health Multiagency Liaison form (currently in draft format).
  • Where the child is clearly at risk of significant harm, the consent of parents/carers to disclose personal information is not required and neither is there a requirement to inform them of any action that is to be taken.
  • Where risk of significant harm may apply, good practice requires that a parent/carer is informed of intended actions by staff, including the disclosure of personal information.
  • Where the need to safeguard children does not arise, permission from the parent/carer should be sought to disclose personal information between agencies.

The key points are: