Safeguarding Children and Adults at Risk Policy

Safeguarding Children and Adults at Risk Policy

To be read in conjunction with the West Yorkshire Consortium Inter Agency Safeguarding and Children Procedures Manual and the Safeguarding Adults West and North Yorkshire and York Multi-Agency Policy

and Procedures

Responsible
Directorate: / Quality& Safety
DateApproved: / 7th September 2017
Committee: / NHS Leeds CCG’s Partnership Safeguarding Children and Adults at Risk Committee
Version: / 5
Revision Date: / August 2019
Accountable Director: / Jo Harding
Lead Officers: / Gill Marchant, Head of SafeguardingChildren &
Adults / Designated Nurse

Contents

1.PolicyStatement ...... 4

2.Introduction ...... 5

3.ScopeofthePolicy ...... 6

4.Principles of thePolicy ...... 6

5.Definitions ...... 7

5.1Children ...... 7

5.2Safeguarding Children...... 7

5.3Adults at Risk...... 7

5.4Adult Safeguarding...... 7

6.The PreventStrategy ...... 9

7.CCG Roles and ResponsibilitiesforSafeguarding ...... 9

7.1Accountability ...... 11

7.2Designated and NamedProfessionals ...... 12

7.3Individual staffmembers...... 13

7.4Member General Practices ...... 13

7.5Governance ...... 14

8.Safeguarding Standards for Commissioned Services...... 15

9. Managing Allegations of Abuse Against Staff...... 15

10.What to do if you suspect a child is at risk of Harm...... 17

11.What to do if you are concerned if an adult is at Risk of harm………………...…..17

12.Raising concerns about Adult and Children who may be at risk of radicalization 17

13.Management of Safeguarding related incidents…………………………………….17

14.Contact Details………………………………………………………………………….18

15.Reference Documents…………………………………………………………………18

15.1Statutory Guidance……………………………………………………………… …….18

15.2Non Statutory Guidance…………………………………………………………… …19

15.3Best Practice Guidance………………………………………………………………..18

15.4Leeds Safeguarding Adult Board…………………………………………………….19

15.5Care Quality Commission…………………………………………………………… 20

15.6Disclosure and Barring Service………………………………………………………..20

15.7Social Care Institute for Excellence………………………………………………...... 20

16.0 Glossary ………………………………………………………………………….……….20

16.1 Abuse of Children...... 21

16.2 Abuse of Adults…………………………………………………………………………..21

Appendix A: Leeds CCG Procedure for raising an Adult Safeguarding Concern

Appendix B: Escalation Process: Raising a PREVENT concern

Appendix C: How we respond to the need of Children and families in Leeds

Appendix D: Front Door Safeguarding Hub: Contact Form

Appendix E: Safeguarding Standards for General Practice

Appendix F: Safeguarding Standards for Providers

1.Policy Statement

NHS Leeds Clinical Commissioning Groups Partnership (now referredtoastheCCG),aswithallotherNHSbodies,haveastatutorydutyto ensurethatitmakesarrangementstosafeguardandpromotethewelfareofchildren and youngpeople andtoprotectadultsat riskfromabuseor therisk ofabuse.

CCGshaveastatutoryresponsibilityforensuringthatorganisationsthey commissionprovidesafesystemsthatsafeguardchildrenandadultsatrisk, ensuringthatcomprehensivesingleandmulti-agencypoliciesandproceduresarein placetosafeguardandpromotethewelfareofchildrenandtoprotectadultsatrisk fromabuse or the riskofabuse.

AllNHSfundedservicesandemployeeshavearesponsibilitytoensurechildrenand adultsinvulnerablecircumstancesarekeptsafe,byearlydetectionandresponding quicklywhenproblemsareidentified.TheCCGshouldalsoensurethathealth providersarelinkedintothelocalsafeguardingchildrenandsafeguardingadult boardsand thatallhealth workers contribute to multi-agency working.

2.Introduction

NHS Leeds Clinical Commissioning Groups PartnershipaswithallotherNHSbodieshaveastatutorydutyto ensurethattheymakearrangementstosafeguardandpromotethewelfare ofchildrenandyoungpeoplethatreflecttheneedsofthechildrentheydeal with; and to protectadults at risk of abuse.

In dischargingthese statutoryduties/responsibilities accountmust be taken of:

Safeguarding Vulnerable People in the NHS – Accountability and Assurance Framework (NHS England 2015)
Statutory guidance onmaking arrangements tosafeguard and promotethe welfare of children under section 11 of the Children Act 2004 (HM

Government 2007)

Working TogethertoSafeguard Children(HMGovernment2015)
StatutoryGuidanceonpromotingtheHealthandwell-beingofLooked After Children(DH 2009)
The Children Act 1989 Guidance and Regulations: Volume 2, Care Planning,placement and Case Review(HMGovernment 2010)
No Secrets(DH and Home Office2000)
MentalCapacityAct2005:CodeofPractice(Department forConstitutional Affairs 2007)
SafeguardingAdults: The Roleof HealthServices(DH 2011)
ThepoliciesandproceduresoftheLocalSafeguardingChildrenBoard (LSCB) andthe Local SafeguardingAdults Board(LSAB).
Safeguarding children and young people: roles and competences for health care staff Intercollegiate DocumentThird edition: March2014
Care Act 2014

3.Scope of the Policy

ThispolicyaimstoensurethatnoactoromissionbytheCCG as a commissioningorganisation,orviatheservicestheycommission,putsa serviceuseratrisk;andthatrobustsystemsareinplacetosafeguardand promotethewelfare of children,andtoprotectadultsat risk of harm.

WheretheCCGisidentifiedasthecoordinatingcommissioner,theCCGwillnotifyassociatecommissionersofaprovider’snon-compliancewiththe standardscontainedinthispolicyorofanyserioussafeguardingincidentthat havecompromisedthesafetyandwelfareofachild/adultatriskresident within theirpopulation.

Safeguardingchildren,youngpeopleandadultsatriskiseveryone’s responsibilityandisdefinedas:

Prevention of harmand abusethroughhigh qualitycare
Effectiveresponsetoallegationsofharmandabusethatareinlinewith multi-agencyprocedures
Usinglearningto improve service to patients.

4.Principles of the Policy

Indevelopingthispolicy,theCCGrecognisesthatsafeguardingchildrenand adultsatriskofabuseisasharedresponsibilitywiththeneedforeffective jointworkingbetweenagenciesandprofessionalsthathavedifferentroles andexpertiseifthosevulnerablegroupsinsocietyaretobeprotectedfrom harm.Inordertoachieveeffectivejointworkingtheremustbeconstructive relationships atalllevels, promoted and supportedby:

acommitmentofseniormanagersandGoverningBodymemberstoseek continuousimprovementwithregardstosafeguardingbothwithinthework ofthe CCGand within those services commissioned
clear lines of accountabilitywithin theCCG for safeguarding;
servicedevelopmentsthattakeaccountoftheneedtosafeguardall serviceusers,andisinformed,whereappropriate,bytheviewsofservice users
stafftrainingandcontinuingprofessionaldevelopmentsothatstaffhave anunderstandingoftheirrolesandresponsibilitiesinregardsto safeguardingchildren,adultsatrisk,childrenlookedafterandtheMentalCapacityAct andPrevent
safe workingpracticesincludingrecruitment and vettingprocedures
effective interagencyworking, including effective information sharing
restorative practice:

Definitions

5.1 Children

Inthispolicy,asintheChildrenAct1989and2004,achildisanyonewhohasnot yetreachedtheireighteenthbirthday.‘Children’thereforemeanschildrenandyoung people throughout.

5.2Safeguarding Children

Working together to SafeguardingChildren (HM Government 2015) defines safeguarding andpromoting the welfare of children and youngpeople as:

protectingchildrenfrommaltreatment;
preventingimpairment ofchildren’s healthordevelopment;
ensuringthatchildrenaregrowingupincircumstancesconsistentwiththe provision ofsafeand effective care;and
Undertakingthatrolesoastoenablethosechildren(thoseundertheageof

18) tohave optimumlife chancesandtoenteradulthood successfully.

5.3Adults at Risk

An adultat risk is defined asapersonaged 18 or over who is at risk of abuse or neglect. This is usually an adult who has care and support needs, and who is unable to protect themselves from abuse or neglect because of their care and support needs. In a small number of cases, it may include an adult with support needs, such as an unpaid carer of someone with care and support needs.

An adultat risk maythereforebea person who,for example:

Isanolderpersonwhoisfrailduetoillhealthphysicaldisabilityorcognitive impairment
has alearningdisability,has aphysical disabilityand/or a sensoryimpairment
hasmental health needs including dementiaor a personalitydisorder
has along-term illness/condition
misuses substances oralcohol
isacarersuchasafamilymember/friendwhoprovidespersonalassistance and care to adultsandis subjecttoabuse
lacksthementalcapacitytomakeparticulardecisionsandisinneedofcare and support

This list isnotexhaustive.

5.4Adult Safeguarding

The Care Act (2014) came into force in April 2015. This supersedes the guidance

document‘No Secrets’ (2000). The introduction of the Care Act means that

safeguarding duties now have a legal effect in relation to organisations other than

the Local Authority. The Act has placed requirements upon statutory organisations

which prior to its introduction were best practice.

5.4.1 The currently used definition within Safeguarding Adults work remains that abuse if a violation of an individual’s human and civil rights by any other person or persons:

•Abuse may consist of a single act or repeated acts.

•It may be physical, verbal or psychological.

•It may be an act of neglect or an omission to act, or it may occur when a vulnerable person is persuaded to enter into a financial or sexual transaction to which they have not consented or cannot consent.

•Abuse can occur in any relationship and may result in significant harm to, or exploitation of, the person subjected to it.

5.4.2Safeguarding adults is underpinned by multi-agency working, with the Local Authorities taking the lead. The CCG works in partnership with partner agencies on the Leeds Safeguarding Adults Board (LSAB)

5.4.3The CCG’s policy is to actively promote the health and wellbeing of vulnerable adults and to prevent harm wherever possible through the promotion of a good understanding of safeguarding adults procedures amongst all staff, effective risk assessment and risk managements, routine incident report and review, staff training and supervision processes.

5.4.4This policy applies to all individuals, including those who have been assessed as lacking Capacity. Actions taken on behalf of these people should be done so in their best interest, in accordance with the Mental Capacity Action (2005).

6.The Prevent Strategy

TheGovernment’scounterterrorismstrategyisknownasCONTEST.Preventispart ofCONTESTanditsaimistostoppeoplebecomingterroristsorsupporting terrorism.

CONTEST has four keyprinciples:

Pursue–stopterrorist attacks
Prevent–to stoppeople becomingterrorists or supportingterrorism
Prepare–where we cannot stopan attack,mitigateits impact
Protect–strengthenoverallprotectionagainst terrorismattack.

TheHealthServiceisakeypartnerinPreventandencompassesallpartsofthe NHS,charitableorganisationsandprivatesectorbodieswhichdeliverhealth services toNHS patients.

Three national objectives have beenidentifiedfor thePrevent strategy:

Objective1:Respondtotheideologicalchallengeofterrorismandthethreat we facefromthose who promote it.
Objective2:Preventpeoplefrombeingdrawnintoterrorismandensurethat theyare given appropriateadvice andsupport.
Objective 3:Work with sectorsand institutions where there are risks of radicalisationwhich weneed to address.

Prevent focusses onworkingwithadults atriskwhomay be atriskofbeingexploited byradicalisersandsubsequentlydrawnintoterrorismrelatedactivity.Consequently the strategyis managed aspart of the safeguardingagenda.

CCGsarerequiredtohavePreventimplementationstrategiesinplacetoinclude leadership;policiesandproceduresandtrainingacrosstheworkforcesothatallstaff areable toidentifyandmake referral.

Furtheradvicecanbeobtainedviathe:Preventstrategy(HMGovernment,2011)

7.CCG Roles and Responsibilities for Safeguarding

TheultimateaccountabilityforsafeguardingsitswiththeChiefOfficerofthe CCG.Anyfailuretohavesystemsandprocessesinplacetoprotectchildrenand adultsatriskinthecommissioningprocess,orbyprovidersofhealthcarethatthe CCGcommissions,wouldresultinfailuretomeetstatutoryandnon-statutory constitutionaland governance requirements.The CCGmust:

Demonstraterobustarrangementsareinplacetodemonstratecompliance withsafeguardingresponsibilities.NHSEnglandwillmonitorcompliancewithsafeguardingasrequired.
Establishandmaintaingoodconstitutional and governance arrangements withcapacity andcapability todeliversafeguardingduties andresponsibilities, aswellaseffectivelycommissionservicesensuringthatallserviceusersare protectedfromabuseandneglect
Establishclearlinesofaccountabilityforsafeguarding,reflectedin governance arrangements
Co-operatewiththelocalauthorityintheoperationofthelocalsafeguarding children,and safeguardingadultboards
Participate in DomesticHomicide Reviews
SecuretheexpertiseofaDesignatedDoctorandNurseforsafeguarding children;aDesignatedDoctorandNurseandforchildrenlookedafter(CLA); a DesignatedPaediatricianforchilddeaths(SUDIC);aDesignated SafeguardingAdultNurseand aMental CapacityAct Lead.
Gainassurancethatallproviderswithwhomtherearecommissioning arrangements have in place comprehensive and effective policies and

procedurestosafeguardchildrenandadultsatriskinlinewiththoseofthe Leeds Safeguarding Children Board (LSACB /LSAB (Appendix E)

Gainassurancewithineachoftheorganisationsandservicescommissioned thatplansareinplacetotrainallstafftotheappropriate level for theirroleandresponsibilities tosafeguard children andadults at risk.
Ensurethatappropriatesystemsandprocessesareinplacetofulfilspecific dutiesofcooperationandpartnershipandtheabilitytodemonstratethattheCCGmeetsthebestpracticeinrespectofsafeguardingchildrenand adultsat risk and children looked after.
Ensurethatsafeguardingisattheforefrontofserviceplanningandaregular agenda itemofeach ofthe CCG’sgoverningbodybusiness.
Ensurethatalldecisionsinrespectofadultcareplacementsarebasedon knowledge ofstandards ofcareand safeguardingconcerns.

Currentlytheeffectivenessofthechildrenandyoungpeople’ssafeguardingsystem isassuredandregulatedinanumberofways.Forchildrenandyoungpeople,these include:

Via the LSCB throughSection11audits
Via external joint inspections with CQC led byOfsted
Providing assuranceto the CCG’sQualityand Performance Committee

Foradultsatrisk,theeffectivenessofthesafeguardingsystemis assuredand regulatedbythefollowing:

ViatheLSABwithappropriatearrangementstoworkcloselywithlocal authorities inallmattersrelatedto safeguardingadultsat risk
Clearlinesofaccountabilityforsafeguardingareproperlyreflectedinthe governance arrangementsacross organisations.
Havinginplaceclinicalleads forsafeguardingadultsandtheMentalCapacity Act. 10
Providing assurance to CCG’s Quality and Performance Committee.

7.1Accountability

AccountabilityforsafeguardingsitswiththeChiefOfficer of theCCG,with delegatedresponsibilitytotheDirectorofNursingandQuality. TheHeadofSafeguardingisresponsibleforthe deliveryofthe CCG’s safeguardingdutiesfor children andadultsatrisk.

The safeguardingarrangements inplaceforthe CCGwill:

Ensurethatthehealthcontributiontosafeguardingandpromotingthewelfare ofchildrenandadultsatriskofabuseisdischargedeffectivelyacrossthe wholelocalhealtheconomythroughtheorganisation’scommissioning arrangements
Ensurethattheorganisationnotonlycommissionsspecificclinicalservices butexercisesapublichealthresponsibilityinensuringthatallservicesusers are safeguardedfromabuse or the risk of abuse
Ensurethatsafeguardingisidentifiedasakeypriorityareainallstrategic planningprocesses.
Ensurethatsafeguardingisintegraltoclinicalgovernanceandaudit arrangements
Ensurethatallhealthprovidersfromwhomservicesarecommissionedhave comprehensivesingleandmulti-agencypoliciesandproceduresfor safeguardingwhichareinlinewiththelocalsafeguardingchildrenandadult boardprocedures,andare easilyaccessiblefor staff atalllevels
Ensurethat allcontractsforthe deliveryofhealthcareincludeclear standards forsafeguarding;thesestandardsaremonitoredtherebyprovidingassurance

thatservice users are effectivelysafeguarded

Ensurethattheirstaffandthoseinservicescontractedbythe CCGare trainedandcompetenttobealerttopotentialindicatorsofabuseorneglectin childrenandadultsatriskandknowhowtoactontheirconcernsandfulfil theirresponsibilities inline with LSCB andLSAB policiesandprocedures.
Ensurethe CCGco-operateswiththelocalauthorityintheoperationofthe LSCBand LSAB
Ensurethatallhealthorganisationsthat the CCGhascommissioning arrangements withhavelinkswiththeirLSCBandLSAB;thatthereisappropriate representationatanappropriatelevelofseniority;andthathealthworkers contribute tomulti-agency working
Ensurethatanysystemandprocessesthatincludedecisionmakingaboutan individualpatient(e.g.fundingpanels)takesaccountoftherequirementsof

theMentalCapacityAct2005;thisincludesensuringthatactionsand decisionsaredocumentedinawaythatdemonstratescompliancewiththe Act.

Recognisetheimportanceofchildren/familiesinvolvementinthefeedback processesusingexistingmechanismswhicharealreadyinplacein SafeguardingAdultsandChildren’sBoardsandotherhealthcareproviders.

7.2 Designated and NamedProfessionals

TheLeedsCCG’sSafeguardingChildrenandAdultTeamprovidesupportandexpertadviceto the CCG and its staff.Inmeetingitsstatutoryarrangements,TheSafeguarding teamincludesaHeadofSafeguarding/DesignatedNurseforChildrenand Adults,aDeputy DesignatedNursefor SafeguardingChildren and Adults/LeadforMentalCapacityAct/DeprivationofLibertysafeguards, 2 Named Nurses andaNamedGPforChildren,whoprovideexpertadviceandsupporttostaffwithin the CCGandacross the healtheconomy.

TheCCGhascommissioningarrangementsthroughLeedsCommunity HealthcareTrustfortheservicesofaDesignatedDoctorforSafeguardingChildren, inadditiontotheDesignatedDoctorforSuddenUnexpectedDeathsinChildhood (SUDIC) and the Designated Doctor and Nursefor Children LookedAfter(CLA).

TheDesignatedProfessionals(DesignatedDoctorsforsafeguardingchildren have specific responsibilities for childrenand notadults.)are requiredto:

Providestrategicguidanceonallaspectsofthehealthservicecontributionto protectingchildrenandsafeguardingadultswithinthe CCGandLeeds LSCB andLSABarea
Provideprofessionaladviceonsafeguardingissuestothemulti-agency network
BeanadvisortotheLSCB,LSABandrelevantsub-groupsasrequired, delegatingtoother health professionals asappropriate
BeinvolvedintheappointmentofNamedProfessionals,providingsupportas appropriate
ProvideprofessionalsafeguardingsupervisionandleadershiptoNamed Professionalswithinproviderorganisations.Supportthestrategicoverviewof safeguardingarrangementsacrosseachCCG,theLeedsLocalAuthorityareaand assistinthedevelopmentofsystems,monitoring,evaluatingandreviewingthe health service contribution to the protection ofchildrenandsafeguardingadults.
CollaboratewiththeLSCB,LSAB,the DirectorofNursingandQuality, The Deputy Director of Nursing and Quality,theCCG’sHeadofQualitySafety,andNamedProfessionalsin ProviderTrustsinreviewingtheinvolvementofhealthservicesinserious incidentswhich meet the criteriafor serious case reviews
Adviseonappropriatetrainingforhealthpersonnelandparticipatewhere appropriateinits provision
Adviseonpracticepolicyandguidanceensuringhealthcomponentsare updated

Ensureexpertadviceisavailableinrelationtosafeguardingpolicies, proceduresandthedaytodaymanagementofsafeguardingchildrenand adultsat risk
Liaisewithotherdesignatedandleadprofessionalsforsafeguardingchildren, lookedafterchildrenandsafeguardingadultsacrosstheYorkshire and Humber regionandbeyond as required to doso
Attend relevantlocal, regional and nationalforums
Participate in theirownindividual annualappraisal process.

7.3Individual staff members.

All staff must;

Bealerttothepotentialindicatorsofabuseorneglectforchildrenandadults and knowhowto act on those concernsin line with local guidance.
Listen to childrenandadults andensure theconcernsexpressed are recorded andtakeappropriateactioninlinewithsafeguardingpoliciesandguidanceto

addressconcerns.

ReportconcernstoaseniormanagerorviatheWhistleblowingPolicywheretheyfeelunabletoreporttotheirline manager or remain concerned that theadult(s)is/are still at risk.
ReportconcernsdirectlytotheCQCorLeedsAdultSocialCare(andthepoliceiftheybelieveacrimehasbeencommitted)when theyfeelunabletoraiseconcernswithintheorganisationorbelievethattheir concernhasnotbeenactedupon.
Undertaketraininginaccordancewiththeirrolesandresponsibilitiesas outlinedbythetrainingframeworksoftheRoyalCollegePaediatricsand

Child Healthsafeguardingcompetences (RCPCH2014),WorkingTogether toSafeguardChildren(2015),theLSCBandLSABandtheCCGTraining

StrategyforSafeguarding,sothattheymaintaintheirskillsandarefamiliar with proceduresaimedat safeguardingchildren andadultsat risk

Understandtheprinciplesofconfidentiality andinformationsharinginlinewith local and government guidance
Contribute,whenrequestedtodoso,tothemulti-agency meetings established to safeguard childrenandadultsat risk

7.4Member General Practices

The CCGwill support allmember practices to:

Meet theirduties and responsibilities to safeguard children andadults at risk
ImplementPractice level policies andprocedures
Work with andtotheWest Yorkshire Consortium Inter Agency Safeguarding and Children Procedures Manual and the Safeguarding Adults West and North Yorkshire and York Multi-Agency Policy

and Procedures.

Guidanceastowhatactionneedstobetakenwherethereareconcernsthatachild oranadultatriskisbeingabused;isavailableviatheCCGIntranet:

GP member practices will take account of the safeguarding standards as detailed in

Appendix E. Compliance with the standards will be subject to audit and scrutiny by the CCG Safeguarding Team on an annual basis.

7.5 Governance

NHSEngland’sSafeguardingVulnerablePeopleintheReformedNHS– AccountabilityandAssuranceFramework(2015)setsouttheclearresponsibilitiesof each ofthe keyplayers in safeguardingwithin the NHS.

NHSEnglandregionalandlocalareateamseachhaveaDirectorofNursingwhois responsibleforsupportingandprovidingassuranceonthesafeguardingofchildren andadultsatrisk ofabuse orneglect.

NHS England,through the leadership oftheChiefNursing Officer (CNO):

Ensures thattheBoard meetsitsspecificsafeguardingdutiesin relationtothe services that it directly commissions (e.g. primarycare, specialisedservices)
ActsasthepolicyleadforNHSsafeguarding,includingleadinganddefining improvement insafeguardingpracticeandoutcomes
Leads,inconjunctionwithregionalDirectorsofNursing,assuranceandpeer reviewprocessesforbothCCGsanddirectlycommissioned services
Providesspecialistsafeguardingadvicetothe NHS
Leads asystemwhere there is a culture that supports staffin raisingconcerns regardingsafeguardingissues
LeadsjointworkwithCQCandMonitoronajointinformationsharingprotocol and MemorandumofUnderstanding(MoU)for areas of concern.

The CCGwillworkcloselywithNHSEngland,and,inturn,willworkclosely withtheLocalAuthority,LSCBand LSAB,toensurethereareeffectiveNHS Safeguardingarrangements acrosseach local authorityhealth community.

StatutorymembershipofLSCBsissetoutinWorkingTogethertoSafeguard Children(2015).BoardpartnerswhichmustbeincludedintheLSCBincludeNHS England,CCGs,andNHSTrustsandNHSFoundationTrustswhosehospitals, establishmentsandfacilities are situatedin the localauthorityarea.

WorkingTogethertoSafeguardChildren(2015)reinforcesthecentralroleofLSCBs, strengtheningtheirindependenceandtheirroleinholdingotherbodiestoaccount. AllNHSandNHSfundedorganisationsareexpectedtoparticipatefullywiththeir LSCB(s),includingprovidingpracticalsupportandresourcesorresourcesinkind whereappropriate.NHScommissionersshouldusecontractualmechanismsto reinforceandmonitor these requirements.

The CCGandNHSEnglandareworkingtogethertoensurethatrobust processesareinplacetolearnlessonsfromcaseswherechildrenoradultsdieor areseriouslyharmedandabuseorneglectissuspected.Thiswillinclude contributingfullytoSerious CaseReviews(SCRs)whichare commissionedby the LSCB/LSABandalso,whereappropriate,conductingindividualmanagement reviews.

InadditiontothedistinctresponsibilitiesthatNHSEnglandhaveasa co-commissioner ofprimarycareandspecialist health services,itisalsoresponsibleforensuringthatthehealth commissioningsystemasawholeisworkingeffectivelytosafeguardandimprove theoutcomesforchildrenandadultsatriskandtheirfamilies,andthuspromotes theirwelfare.Itprovidesoversightandassuranceof the CCG’ssafeguarding arrangementsandsupports the CCGinmeetingitsresponsibilities.Thisincludes workingwiththeCareQualityCommission(CQC),professionalregulatorybodies andother national partners.

Safeguardingincidents,performanceanddeliveryofstatutorydutiesaremonitored throughtheCCGSafeguardingCommittee.TheSafeguarding Committeewillformallyconsiderincidents,actionsandlearningfromthe LSCB andLSAB,actionandlearningfromOfsted/CQCinspectionsandSeriousCase Reviews, Serious Adult Reviews and Domestic Homicide reviews, pluscommissionedservicescompliancewithsafeguardingquality indicators.The CCGwillreceivetheminutesfromtheSafeguarding Committeeviathe Quality and Performance Committee.

8.0Safeguarding Standards for Commissioned Services

Providers of services commissioned by the CCG are required to meet the minimum standards contained in Appendix F. These standards are not comprehensive and may be in addition to those standards required by legislation, national guidance or other stakeholders, including regulators and professional bodies. The standards are based on the Section 11 Audit Template Guidance document produced by the LSCB and regionally agreed commissioning standards for safeguarding adults. Providers will complete the audit tool in Appendix F on an annual basis to provide the CCG with assurance that they are compliant or working toward compliance with the standards.

9.0Managing Allegationsof AbuseAgainst Staff

WithintherecruitmentprocessallCCGemployeeswillbevettedwithregardtothe suitabilityoftheiremploymentandhaveaDisclosureandBarringService(DBS) checkasperHRpolicies.Allallegationsofabuseagainststaffmustbemanaged accordingtoWYConsortiumPolicyandProcedures(Children)andWY SafeguardingAdultsProcedures.

All allegations concerning abuse of children by those who work with children must be taken seriously. Allegations against people who work with children, whether in a paid or unpaid capacity, can cover a wide range of circumstances. The West Yorkshire Consortium Safeguarding Procedure; Allegations Against Persons who Work with Children should be applied in all situations where it is alleged that a

person who works with children has:

behaved in a way that has harmed a child, or may have harmed a child;
possibly committed a criminal offence against or related to a child; or
behaved towards a child or children in a way that indicates they may pose a risk of harm to children.

Whereacomplaintisreceivedagainstanemployeeandthatcomplainthasachild protection/childconcerncomponent,the designated senior manager; the HeadofSafeguarding / Designated Nursemustbenotifiedand involvedinreviewingthecaseandinthereportingtotheLocalAuthorityDesignated Officer(LADO).In the absence of the designated senior manager or where that person is the subject of the allegation or concern, the Deputy Designated Nurse must be notified. Complaintsarisingfromlegalproceedingswillonlybeprocessedif raisedbyajudgeormagistrate.Aparallelprocesswillbefollowedregardingadults at risk.

10.0 What to do If You Suspect a Child is At Risk of Harm

Allstaffshouldknowwhattodoiftheysuspectachildisatriskofharmorisbeing abused (Appendix D) Thefollowingstepsmust befollowed:

Discuss with your line manager, your child protection supervisor ifappropriate, or amemberofthe safeguardingteamas soon aspossible

Record your observations and discussions in detail according to record keepingpolicyand practice guidance, retain alloriginal notes as these maybe

disclosed infutureat court proceedings

Youmaydecideorareaskedtomakeareferraltochildren’ssocialwork services.YoumustinitiallytelephonetheDutyandAdviceTeamon0113 3760336duringofficehoursor0113 3760469outofoursandthenfollowthis upinwritingwithin24hoursusingtheRecord of ContactForm if requested to do so (Appendix D) ensuring a copy is kept in the child’s records were appropriate.. The form can be accessed here:

Youmaybeaskedbychildrensocialworkservicestoparticipateinfurther discussionsinordertoassesstherisksandtoprotectthechild.Itisimportant thatyouparticipateandcontributetothechildprotectionprocessinorderto protectthechild.

11.0 What to do if you are concerned an adult is at risk of harm

Ifyouareworriedaboutthewelfareorsafetyofanadultatriskpleasefollowthe Leeds CCGs Procedurefor RaisinganAdult SafeguardingConcern (AppendixB)

ThisprocedureshouldbereadinconjunctionwiththeWestYorkshireMulti-Agency SafeguardingAdultsPolicyand Procedures

Raising Concerns about Adults and Children who may be at risk of Radicalisation

AllCCGshouldcompleteaDATIXincident report,refertotheflowchartinAppendixB.Concernsthatanindividualmaybe vulnerabletoradicalisationdoesnotmeanthatyouthinkthepersonisaterrorist,it meansthatyouareconcernedtheyarepronetobeingexploitedbyothers,andso the concernis asafeguardingconcern.

Ifamemberofstafffeelsthattheyhaveaconcernthatsomeoneisbeing radicalised,thenwhere appropriate theyshoulddiscusstheirconcernswiththeirmanagerand/or relevant safeguardingprofessional.

Ifanyonehasimmediateconcernsthatanindividualispresentinganimmediate terroristrisktothemselves,othersorproperty,thentheyshouldcontacttheNational Counter-TerrorismHotlineon 0800789 321, or the police on 999.

13.0Management of Safeguarding Related Incidents

13.1Allserioussafeguardingchildrenandadult’sincidentsmustbereportedin accordancewiththeLeedsCCG’sSeriousIncidentPolicyandGuidance,as wellasbeingmanagedandreportedfollowingthelocalmulti-agency safeguardingadultspolicy.AlsoseetheLeedsSafeguardingAdults Partnership Board guidance on TheCo-ordinationofSafeguardingInvestigations with Other Investigations.

13.2AllsuspicionsoffraudinsafeguardingcaseswillbereportedtotheCCGLocalCounterFraudSpecialist,ChiefFinancialOfficer,ortheNational FraudandCorruptionLine.ThisisinaccordancewiththeLeedsCCGs Anti-FraudandCorruptionPolicy.

13.3AnyCCGmanagersdealingwithanyclaims,complaints,disciplinaryor performance issues will be responsible for seeking advice regarding anysafeguardingrisksandmakingreferralstothemulti-agencyprocedures accordingtothis policy.

14.0Contact Details

All members of the Safeguarding Team can be contacted via 0113 843 1713.

15.0Reference Documents

Indevelopingthispolicy,accounthasbeentakenofthefollowingstatutoryandnon- statutoryguidance,bestpracticeguidanceandthepoliciesandproceduresofthe LSCB and LSAB.

15.1Statutory Guidance

DepartmentforConstitutionalAffairs(2007)MentalCapacityAct2005:Code ofPractice,TSO: London
DepartmentofHealth(2000)FrameworkfortheAssessmentofChildrenin NeedandtheirFamilies, London, HMSO
DepartmentofHealth,HomeOffice(2000)NoSecrets:guidanceon developingandimplementingmulti-agencypoliciesandprocedurestoprotect vulnerableadultsfromabuse(issuedunderSection7oftheLocalAuthority

Social Services Act 1970)

Department ofHealth etal(2009)Statutoryguidanceon Promoting theHealth andwell-beingof Looked After Children, Nottingham,DCSF publications
HMGovernment(2007)Safeguardingchildrenwhomayhavebeentrafficked, DCSF publications
HMGovernment(2007)Statutoryguidanceonmakingarrangementsto safeguardandpromotethewelfareofchildrenundersection11ofthe Children Act2004, DCSF publications
HMGovernment (2008)Safeguarding Children in whomillness is fabricatedor induced, DCSF publications
HMGovernment (2009)TheRight toChoose:multi-agency statutory guidance for dealingwithForcedmarriage,Forced Marriage Unit: London
HMGovernment(2010)StatutoryGuidanceonpromoting theHealthand well- beingofLookedAfter Children(DH 2009)
HMGovernment(2015)WorkingTogethertoSafeguardChildren, Nottingham, DCSF publications.
MinistryofJustice(2008)DeprivationofLibertySafeguardsCodeofPractice tosupplement MentalCapacity Act 2005,LondonTSO
Care Act 2014
Children’s Act 1989

15.2Non-statutory Guidance

Children’sWorkforceDevelopmentCouncil(March2010)Earlyidentification, assessmentofneedsandintervention.TheCommonAssessmentFramework forChildrenand YoungPeople:Apractitioner’s guide, CWCD
DH(June2012)TheFunctionsofClinicalCommissioningGroups(updatedto reflect thefinal HealthandSocial CareAct2012)
DH(March, 2011) Adult Safeguarding:The Role of HealthServices
DH(May, 2011) Statement of Government Policyon AdultSafeguarding
HMGovernment(2006)Whattodoifyou’reworriedachildisbeingabused, DSCF publications
HMGovernment(2008)InformationSharing:Guidanceforpractitionersand managers, DCSF publications
Law Commission (May, 2011) Adult Social Care Report
Royal College Paediatrics and Child Health et al (2014) Safeguarding Children and Young people: Roles and Competences for Health Care Staff. Intercollegiate Document.

15.3Best Practice Guidance

DepartmentofHealth(2004)CoreStandard5oftheNationalService FrameworkforChildrenYoungPeopleandMaternityServicesplusthose elementsbeyondstandard5thatdealwithsafeguardingandpromotingthe welfare of children
DepartmentofHealth(2009)Respondingtodomesticabuse:ahandbookfor health professionals
DepartmentofHealth(2010)ClinicalGovernanceandadultsafeguarding:an integratedapproach, Department of Health
HMGovernment (2011) Multi-agency Practice Guidelines: Female Genital Mutilation
HMGovernment(2009)Multi-agencypracticeguidelines:Handlingcasesof Forced Marriage,Forced Marriage Unit:London
NationalInstituteforHealthandClinicalExcellence(2009)Whentosuspect child maltreatment, Nice clinical guideline 89
Department of Health (2006) Mental Capacity Act Best Practice Tool, Gatewayreference:6703

15.4Leeds Safeguarding Children Board (LSCB)

TheDirectorofChildren’sServiceshastheresponsibilitywithinthelocalauthority, undersection18oftheChildrenAct2004,forimprovingoutcomesforchildrenand youngpeople,children’ssocialcarefunctionsandlocalcooperationarrangements forchildren’sservices.TheLSCBisaccountableforcoordinationandeffectiveness. ThelocalauthorityChiefExecutive,drawingonotherBoardpartnersand,where appropriate,theLeadMemberwillholdtheLSCBChairtoaccountfortheeffective workingof theLSCB.

Policies, proceduresand practice guidance can befound at:

15.5Leeds Safeguarding Adult Board

Safeguarding Adults Boards were strengthened by the Care Act 2014 (implemented in 2015), which made them legal requirements in each area, with specific duties and responsibilities as set out in Schedule 2 of the Act. The Board must include senior