Draft 301014

PROTECTING CHILDREN AND YOUNG PEOPLE WHO ARE AT RISK OF CHILD SEXUAL EXPLOITATION

Lead Executive Director: / Stephanie Dawe
Chief Nurse and Executive Director of Integrated Care (Essex)
Lead executive director sign off prior to the approval process:
Date of sign off by lead executive director:
Name of originator / author and job title: / Catherine Webb Associate Director Safeguarding and Looked After Children
Jen Sarsby Lead Nurse for Domestic Abuse
Approved by:
Approval date:
Implementation date:
Review date:
Date equality impact assessment carried out: / 3rd November 2014

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Draft 301014

Document Control Sheet

Policy title / Protecting children and young people who are at risk of sexual exploitation
Policy number / [leave blank]
Assurance statement / North East London NHS Foundation Trust (NELF) is committed to working with partnership agencies to achieve the national strategic vision for providing services to tackle the health and social impacts of child sexual exploitation and ensuring the safety of vulnerable families. Providing clear guidance on tackling child sexual exploitation is essential for promoting high standards of practice consistent with the local and national priorities for protecting children and young people.
Target audience (policy relevant to) / All staff/ employees in NELFT who are working closely with,and come into contact children and young people, including specialists, Mental Health Services (MHS), adults, children and universal services.
Links to other policies / NELFT 2013) Safeguarding Children Policy.
Version control / Status / Version / Approval date / Review date
V001 / Draft

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Draft 301014

Contents

SectionPage

Introduction 4

  1. Background and summary 4
  2. Aims and objectives 5
  3. Definitions 6
  4. Models of exploitation and risk factors 7
  5. Risk Factors 7
  6. Risk Category 8
  7. Roles and responsibilities 9
  8. Process 10
  9. Consent 11
  10. Implementation process 12
  11. Monitoring arrangements 12
  12. Equality statement 14
  13. External references 14
  14. Training 14
  15. Training table 15

Stakeholder form 16

Equality Impact Assessment (EqIA) 17

Approval Checklist 20

Appendix 1Levels of risk 22

Appendix 2 Responding to Concerns that a Child Might Be at Risk of 27 Sexual Exploitation

EMT approval form 28

Addendum 29

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Draft 301014

Introduction

This policy is intended to guide practice around the identification, protection and support of children and young people who are at risk of child sexual exploitation. The guidance does not affect existing safeguarding arrangements within NELFT. Instead, it complements the directions contained within existing adult and children safeguarding policies and procedures, as well as NELFT’s Domestic and Sexual Violence (CSE) (2013) strategy document. Its purpose is to provide clarity around the prevention and protection of children and young people who are affected by sexual exploitation.

The policy reflects the multi-agency efforts to tackle CSE through effective information sharing and collective response to support the health and social impact of the problem. Therefore this policy provides the framework to ensure that a robust system is in place to safeguard children and young people from sexual exploitation and it is underpinned by the Working Together to Safeguard Children DCSF (2010); Safeguarding Children from Sexual exploitation (2014) document as well as local borough guidance.

In particular, London Child Protection Procedures (2010) (currently under review) Southend Essex and Thurrock (SET) Child Protection Procedures (2013) which provide practical guidance to assist all staff working with children, young people and families. This includes all NELFT staff and those who work in the multi-agency forum to protect children and families from child sexual exploitation.

The term child in this document is taken to mean children and young people up to the age of 18years old.

The guidance for safeguarding vulnerable adults including adults with care and support needs from sexual exploitation is contained within the NELFT adult safeguarding document at

1.Background summary

1.1It is recognised that Child Sexual Exploitation (CSE) is a form of child abuse which encompasses the physical, emotional and sexual abuse of children. The problem remains particularly well hidden because of the exploitative nature of the perpetrator’s behaviour and multiple complexities that are linked to understanding the problem which is still emerging. However research suggests multi-agency actions to safeguard children and young people from sexual exploitation can greatly reduce their vulnerabilities, improve their resilience as well as disrupt the activities of perpetrators and reduce local tolerance to exploitative behaviour.However research shows that child sexual exploitation is a growing concern with damaging health and social consequences for children and young people. The report from the Children’s Commissioner into Gangs and Groups estimated that between April 2010 and March 2011 over 16,500 children were at risk of sexual exploitation. This does not include other forms of organised models of exploitations.

1.2In excess of 2,409 children were confirmed as victims of sexual exploitation in gangs and groups in England during the period from August 2010 to October 2011. It is also estimated that there are child sexual exploitation concerns for over 1 in 7 young people who are known to social services and of which 1 in 5 is deemed to be at significant risk. Moreover studies commissioned by the NSPCC and undertaken by Radford et al (2011) found that 1 in 20 children (4.8 %) have experienced contact sexual abuse. This is consistent with international studies which found that8-31% of girls and 3-17% of boys have experienced sexual abuse (Barth, et al 2012).

1.3 A consistent body of evidence points to the increased vulnerabilities of Looked After Children and care leavers whose familial and social history often increases the likelihood of sexual exploitation within this particular group. Of particular note are looked after children who are placed outside the NELFT geographic location.

(Creegan, 2005; Scott and Skidmore, 2006; Coy, 2008; Pearce 2009, Barnardos,

2010; The Children’s Commissioner, 2012: Pearce and Pitts,2011, Brodie et al,

2011).

1.4The sexual exploitation of children and young people can have a devastating physical, psychological and social impact upon the lives of the victim. Whilst some may recover, others will suffer longer-term psychological trauma (possible suicide) and other debilitating conditions which might prevent the child or young person from reaching their full potential as adults.

2.Aims and objectives

2.1 This policy outlines NELFT’s objectives and course of action in relation to the prevention, identification and management of CSE. The policy is underpinned by multi-agency strategic objectives and local guidance. It sets out the activities to improve the resilience of vulnerable children and young people who are affected by or at risk of sexual exploitation. The policy therefore sets out actions that will:

  • Raise awareness and provide preventative education for the welfare of children, young people and the wider community who are being sexually exploited.
  • Identify children and young people who are at risk of being sexually exploited.
  • Improve the information sharing and multi-agency practices and apply a proactive approach to risk assessment in relation to child sexual exploitation.
  • Work collaboratively with partner agencies to prevent sexual exploitation by disrupting perpetrators’ behaviour.
  • Reduce the harm caused by sexual exploitation through early identification and effective intervention to safeguard those vulnerable to sexual exploitation.
  • Deliver high standards of care that will be child centred and reflect dignity, compassion and respect for children and young people.

2.2The measures contained in this policy are designed to tackle the patterns of sexual abuse and child sexual exploitation that affect children and young people. Although it is acknowledged that the overwhelming majority of victims are girls, it is recognised that boys also experience this type of exploitation. Therefore, the policy outlines guidance to support all victims regardless of gender, race or sexuality or dis/ability.

2.3TheTrustacknowledges thesignificance ofNational Health &Clinical Excellence (NICE)guidance.TheTruststrives toprovide highquality carethat consistently improves bytaking account ofbest practice.In ordertoachieve this, National Health &Clinical Excellence (NICE) Guidancemustbedisseminated, reviewed and whereappropriate, implementedwithin theTrust. TheTrust is thereforecommittedto ensuring National HealthClinical Excellence (NICE) Guidance is disseminated, reviewed and where appropriate implemented within the Trust.

3. Definitions

3.1The sexual exploitation of children and young people describes a set of harmful and exploitative practices. The Working Together to Safeguarding Children from Sexual Exploitation (2010) document defines sexual abuse as follows:

3.2“Forcing or enticing a child or young people to take part in sexual activities, including prostitution, whether or not a child is aware of what it is happening. The activities may involve physical contact including penetration (e.g. rape, buggery or oral sex) or non-penetrative acts. This may include non-contact activities such as involving children or looking at, or in the production of sexual online images watches sexual activities or encouraging children to behave in a sexually inappropriate way”. This policy also adopts the following description of child sexual exploitation: Sexual exploitation of children young people under 18 involves exploitative situations, context and relationships where children (or person or third persons) receives something (e.g. food accommodation or drugs, alcohol, cigarette, affection gifts, money) as a result of them performing and/or another or others performing on them sexual activities.

3.3Child sexual exploitation can occur through the use of technology and without the child’s immediate recognition; for example being persuaded to post images on the internet/mobile phones without immediate payment or gain. In all cases those exploiting the child or young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Violence coercion and intimidation are common involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social/economic or emotional vulnerability.

3.4Anyone can be a perpetrator; however, the majority of exploitative behaviour is carried out by men.Perpetrators may be acting as individuals or as part of a group targeting and sexually exploiting children and young people or as part of a gang. In gang scenarios, sexual exploitation might be a by-product of code or values held within the gang such as part of initiation to the gang or as establishing discipline within the gang.

4. Models of Exploitation

There are different ways in which sexual exploitation can take place such as:

  • Inappropriate relationships frequently characterised by a significant age difference where the perpetrator exercises power over the young person through giving them something they need in exchange for sexual activity.
  • The boyfriend model- where the young person is groomed to view the person as their boyfriend but is then forced into performing sexual acts for others. Grooming may be opportunistic or targeted.
  • Peer on peer exploitation- the young person is drawn into sexual activities by their peer e.g. as part of the ritual of belonging to a gang. Peer on peer exploitation might take place within some schools where the behaviour is normalised amongst the groups.
  • Modern Day Slavery or Trafficking children and young people from abroad or within the UK is a common practice of selling children and young people for sexually exploitative situations. These groups of children are particularly difficult to detect because the child or young person is usually hidden from services but may access sexual health services and walk-in centres.

5.Risk factors

Research suggests that Looked After Children and care leavers’ familial and social history often increases the likelihood of sexual exploitation within this vulnerable group. (Creegan, 2005; Scott and Skidmore, 2006; Coy, 2008; Pearce 2009, Barnardos, 2010; The Children’s Commissioner, 2012: Pearce and Pitts,2011, Brodie et al, 2011). Furthermore, the evidence from serious case reviews indicates a growing body of evidence which suggests that the risk for looked after children might be significantly underestimated.

There are a number of signs and vulnerability factors that can indicate that a child or young person is at risk of being groomed for sexual exploitation. This following list is not exhaustive but includes:

  • Living in a chaotic or dysfunctional household which may include parental misuse of drugs and alcohol, mental illnesses, domestic violence and parental criminalities.
  • History of abuse or living in household where an adult is known to be a perpetrator.
  • Child or young person might be subjected to household with familial violence such as (forced marriage and honour-based related crimes).
  • Recent bereavement or loss.
  • Young carers.
  • Missing from care or repeatedly running away from care/home.
  • Children who live in households or associate with other children who are being exploited also face increased risk.
  • Gang association through relative peers, intimate relationships or memberships or living in areas of known gang activities.
  • Learning disabilities and concerns such as mental illnesses.
  • Homelessness including hostels, bed and breakfast, foster or living in householdswith multi-occupancy where perpetrators may also reside.
  • Isolation or lacking friends of similar age group.
  • Care-leaver with particular vulnerabilities such as isolation, homelessness.

Children and young people who are sexually exploited can present across a range of health settings in variety ways: poor self-care, injuries, sexually transmitted infections, contraception requirements, unplanned pregnancies, terminations (including multiple pregnancies/terminations), drug and alcohol problems, medically unexplained symptoms and self-harming behaviour. The child or young person might become withdrawn, with behavioural problems including nightmares. (see risk assessment tool appendix1 of this document).

  1. Risk category

The following flowchart illustrates the categories of vulnerabilities that are linked to the risk assessment and response flowchart (see appendix 1 and 2) as well as further guidance at:

CAT 1 (at risk) A vulnerable child who is at risk of being targeted for Sexual Exploitation - but at this stage no evidence of any sexual offences. Monitoring and support is required

CAT 2 (High risk) Evidence a child is being targeted for opportunistic abuse through the exchange of sex for- E.G.: attention, accommodation, food, gifts and drugs. Requires referral through local CSE reporting and or MASH

CAT 3 (Immediate risk) Evidence a child is being sexually exploited where coercion/control is implicit. See also appendix 1 and 2. Immediate section 47 referral is required as well as local CSE reporting. See CSE procedure document for all reporting procedures.

Principles for responding to CSE

Sexually exploited children should be treated as victims of abuse, not offenders. This means fostering a compassionate approach which does not seek to blame victims for their situation.

Sexual exploitation includes sexual, physical and emotional abuse and in some cases neglect.

Children do not make informed choices to enter or remain in sexual exploitation but do so from coercion, enticement, manipulation or desperation.

Young people who are, or at risk of being sexually exploited will have varying levels of needs. They may also have multiple vulnerabilities and therefore an appropriate multi-agency response and good coordination is essential.

Sexually exploited children are children should have access to services and immediate protection using the principles embedded within the NELFT safeguarding strategy and multiagency policy.

Supporting victims and their families must be based upon a multi-disciplinary assessment of their circumstances. However evidence has shown how important families are in helping young people in their recovery. Therefore interventions should be based on the need and strength of the family.

7. Roles and responsibilities

7.1Chief executive

The Chief executive has accountability for ensuring the provision of high quality, safe

and effective services to tackle child sexual exploitation within the Trust.

7.2 The Chief Nurse is the Executive Trust Board Lead for Safeguarding and holds delegated responsibility for ensuring that the Trust executes it’s duties in relation to safeguarding children and young people from sexual exploitation.

7.3Executive Directors

Executive Management Team (EMT) are responsible for ratifying all policies and

strategies.

7.4Trust Secretary

Is responsible for ensuring the executive lead signs off all policies after AD approval before presentation to EMT for ratification (note: procedures/guidelines and protocols do NOT require EMT approval).

7.5Senior Leadership Team (SLT)

Responsible for the approval of all procedures/guidelines/protocols.

7.6 Directors

All directors are responsible for the implementation of this policy into practice within their service areas and taking appropriate action should any breach of this policy arise.

7.7Assistant Directors

All assistant directors have a delegated responsibility for ensuring that this policy is known to all staff and that its requirements are followed by all staff within their area.

7.8Operational leads

Responsible for:

•bringing to the attention of their staff the publication of this document

•providing evidence that the document has been cascaded within their team or

department.

•ensuring this policy is effectively implemented

•ensuring that staff have the knowledge and skills to implement the policy and provide training where gaps are identified

7.9Staff

Responsible for:

•Adherence to this policy

•ensuring any training required is attended and kept up to date

•ensuring that any competencies required are maintained

•co-operating with the development and implementation of policies as part of

their normal duties and responsibilities

•identifying the need for a change in policy as a result of becoming aware of changes in practice, changes to statutory requirements, revised professional or clinical standards and local/national directives, and advising their line manager accordingly

•identifying training needs in respect of policies.

7.10 Authors

Responsible for writing the policy, sending out for consultation and making all amendments prior to final sign off.