Safeguarding Children Policy

CITY & HACKNEY GP CONFEDERATION

______

Policy Owner City and Hackney GP Confederation

Policy Author Mary Clarke

This policy applies to: All Employees

Date of Clinical Board Approval 19th December 2014

Review Date: December 2018

Version Control Record

Description of Version Reason for Change Author Date Change(s)

Development of 1.0 First version Mary Clarke 8th December 2014 Policy Responsibilities Updated Amendment to Reference to Mental 2.0 Mary Clarke 16th December 2016 policy Capacity Act 2005 and Deprivation of Liberty Policy Added 1 Table of Contents

1 Introduction 3

2 What our commitment means 3

3 Scope and purpose of the policy 5

4 Responsibilities 6

4.1 Chief Executive Officer...... 6 4.2 Managers...... 6 4.3 Individual Staff Members...... 7

5 Safer Recruitment 8

6 Training and Development 8

7 Supervision 9

8 Effective Inter-agency Working 9

9 Confidentiality and information sharing 9

10 What to do if you are worried that a child is being abused 10

11 Categories of abuse 10

12 References and bibliography 11

13 Disciplinary Procedures 12

14 Monitoring and Review 12

Appendix 1 - Safeguarding Children Training Chart 12

Appendix 2 – Useful Safeguarding Children Contact Details 14

Appendix 3 - What to do if you are worried that a child is being abused Flow Chart16

2 1 Introduction

1.1. City and Hackney GP Confederation is committed to safeguarding and promoting the welfare of children and young people. As with all other organisations providing and subcontracting NHS services we have a statutory duty to ensure that arrangements are in place to safeguard and promote the welfare of children and young people that reflect the needs of the population.

1.2. This policy relates to service contracts awarded to the Confederation where the services are delivered via our practices, and to any services we provide directly as a GP Confederation.

1.3. In discharging these statutory duties and responsibilities the organisation must take account of:

a) Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children (HM Government, 2013)

b) London Child Protection Procedures (2014)

c) Statutory Guidance on Promoting the Health and Well-being of Looked After Children (Department of Health, 2009)

d) Intercollegiate Document: Safeguarding Children and Young People: roles and competencies for health care staff (2014)

e) The policies and procedures of City and Hackney Local Safeguarding Children Board (CHSCB).

1.4 As an organisation we are required to ensure that the organisation provides safe systems that safeguard children at risk of abuse or neglect.

1.5 This policy details the roles and responsibilities of City and Hackney GP Confederation and that of its employees.

2 What our commitment means

2.1 In developing this policy City and Hackney GP Confederation recognises that safeguarding children is a shared responsibility with the need for effective joint working between agencies and professionals that have different roles and expertise. This is crucial in protecting the most vulnerable groups in society from harm. In order to achieve effective joint working there must be constructive relationships at all levels.

a) This will be promoted and supported by City and Hackney GP Confederation by having:The commitment of the Confederation Clinical Board members, managers and staff to safeguard children.

3 b) Clear lines of accountability for safeguarding reflected in the governance arrangements.

c) Appropriate arrangements in place to co-operate with City and Hackney Local Safeguarding Children Board and the Health and Wellbeing Board.

d) Arrangements in place for interagency working and effective arrangements for information sharing.

e) Taken into account during service developments and the provision of services the need to safeguard all service users, and is informed, where appropriate, by the views of service users.

f) A plan to train staff in recognising and reporting safeguarding issues and continuing professional development so that staff have an understanding of their roles and responsibilities, and those of other professionals and organisations in relation to safeguarding children.

g) Safe working practices including recruitment and vetting procedures in place

h) Supporting a culture that promotes and enables safeguarding issues to be addressed and decisions, actions and outcomes properly recorded

3 Scope and purpose of the policy

3.1 The Safeguarding Children policy sets out City and Hackney GP Confederation’s approach to ensure that:

a) No act or omission on behalf of the organisation puts a child inadvertently at risk.

b) Rigorous systems are in place to proactively safeguard and promote the welfare of children from abuse, or the risk of abuse.

c) Support is available to staff in fulfilling their obligations.

3.2 This policy applies to all staff working for City and Hackney GP Confederation regardless of their role within the organisation. This policy must be brought to their attention and read by them.

3.3 The policy is also applicable to contractors and volunteers working within the organisation.

3.4 Children are defined as anyone under 18 years of age (Children Act 2004) and for the purpose of this policy in line with the London Child Protection and Safeguarding Procedures 2014 include the unborn child.

4 4 Responsibilities

4.1 Chief Executive Officer

The Chief Executive Officer has ultimate responsibility for ensuring that the health contribution to safeguarding and promoting the welfare of children is discharged effectively and to ensure City and Hackney GP Confederation works with the two relevant local authorities in the operation of the Local Safeguarding Children Board The Chief Executive Officer is also responsible for: a) Ensuring that the health contribution to safeguarding and promoting the welfare of children is discharged effectively across all the organisation

b) Ensuring that all staff within the organisation have safeguarding children training at the required level as defined in the Safeguarding Children and Young People: Roles and competences for health care staff Intercollegiate Document (2014) and in line with the City and Hackney Local Safeguarding Children Board standards.

c) Ensuring that a n y contract specification or sub-contract drawn up by City and Hackney GP Confederation includes clear service standards for safeguarding children.

4.2 Safeguarding Children Clinical Lead

The Safeguarding Children Clinical Lead is responsible for:

 Providing support and guidance to the GP Confederation Clinical Board on safeguarding children;  Promoting good professional practice within Primary Care relating to the safeguarding of children;  Working closely with the Chief Executive Officer and other clinicians to support all activities necessary to ensure that the GP Confederation meets all its responsibilities in relation to Safeguarding Children;  Developing and promoting communication across primary care in City and Hackney for the dissemination and sharing of information in relation to safeguarding children;  Advising on the implementation of policies and procedures in primary care in relation to Safeguarding Children;  Contributing, with others, towards improving skills and knowledge within Primary Care for disseminating good practice in raising alerts for children who are suffering, or at risk of suffering harm from abuse or neglect;  Ensuring that knowledge is kept up to date in respect of internal policies and procedures, and national policy guidance relating to safeguarding children.

4.3 The Safeguarding Children Management Lead

5 The Safeguarding Children Management Lead is responsible for:

 Working closely with the Safeguarding Children Clinical Lead and other clinicians to support all activities necessary to ensure that the GP Confederation meets all its responsibilities in relation to Safeguarding Children;  Being the strategic lead on safeguarding children matters;  Ensuring safeguarding children work and policies and decisions are fully integrated within the organisation;  Providing expert professional advice to managers, staff, on specific safeguarding children matters;  Being responsible and accountable for initiating, developing, implementing and monitoring policy and practice related to safeguarding children;  Ensuring that knowledge is kept up to date in respect of internal policies and procedures, and national policy guidance relating to safeguarding children.

4.4 Managers

Managers are responsible for:

a) Ensuring staff can access safeguarding children procedures, policies and guidance.

b) Ensuring staff are aware of their responsibilities under this policy, and that it is fully implemented within their area of responsibility.

c) Providing leadership and support to staff.

d) Ensuring that staff work effectively with professionals from other agencies

e) Ensuring operational implementation of this policy into practice and taking appropriate action should any breach of this policy take place.

f) Ensuring that service plans / specifications / contracts include reference to the standards expected for safeguarding children.

g) Ensuring that recruitment and selection process guidance is followed during recruitment of staff working with children, or handling information on children, including that references are always verified, a full employment history is always available with satisfactory explanations for any gaps in employment history, that qualifications are checked and that Disclosure and Barring Checks are undertaken in line with national and local guidance.

h) Ensuring staff attend safeguarding children training at the appropriate 6 level according to their responsibilities, to safeguard and promote the welfare of children

i) Ensuring that safeguarding children training is discussed with staff during annual Performance Development Reviews and included in individual staff development plans.

j) Ensuring staff are released from their work area to attend single and interagency safeguarding children training according to staff roles and responsibilities.

k) Ensuring safeguarding responsibilities are reflected in all job descriptions

4.5 Individual Staff Members

Individual staff members are responsible for:

d) Being alert to the potential indicators of abuse or neglect in children and know how to act on those concerns in line with local guidance.

e) Taking part in training, including attending regular updates so that they maintain their skills and are familiar with procedures aimed at safeguarding children.

f) Understanding the principles of confidentiality and information sharing in line with local and government guidance.

g) Contributing to, when requested, the multi-agency meetings established to safeguard and protect children.

h) Discussing with their line manager when they are aware of circumstances, difficulties or problems in their working life which may adversely affect their working relationships and ability to safeguard children. This should be discussed with their line manager so that appropriate support can be provided.

i) Staff members employed or contracted who do not directly deliver services to individuals, in circumstances where they identify a concern around the safety and welfare of a child or young person, are expected to ensure that they act in accordance with City and Hackney Local Children Safeguarding Board policies and procedure. Please refer to section 10

5 Safer Recruitment

City and Hackney GP Confederation will ensure that recruitment and human resources management policies and procedures take into account the need to safeguard and promote the welfare of children and young people, including arrangements for appropriate checks on new staff and volunteers. 7 6 Training and Development

All staff employed by and providing service on behalf of City and Hackney GP Confederation should ensure that they are trained appropriately and are competent to be alert to potential indicators of abuse or neglect in children and know how to act on their concerns consummate to their role, this should be in line with the Safeguarding children and young people: roles and competences for health care staff: Intercollegiate Document - Third edition: March 2014 .

All staff must:

a) Be aware of the risk factors for child abuse – this includes situations where Children may pose a risk to children b) Know how to recognise the different forms of abuse c) Know how to act if a child’s welfare or safety may be at risk d) Be aware of local procedures in child protection e) Know the names and contact details of named and designated professionals

Staff will be enabled to participate in training on safeguarding and promoting the welfare of children on both a single and interagency basis. The training will be proportionate and relevant to the roles and responsibilities of each staff member, as identified by their manager. Training can be delivered in any method that meets the requirement set out Safeguarding children and young people: roles and competences for health care staff: Intercollegiate Document - Third edition: March 2014 and may be via e- learning packages or face to face sessions. Conferences may be acceptable for Safeguarding Professionals that require higher than Level 4 training. Assessments or individual supervision may be used to highlight changes in national / local legislation and guidance such as recommendations from serious case reviews. For the majority of staff training will be at the mandatory “all NHS staff” level 1 which is available both on induction for new staff members and as an e- learning package for update training. However, managers should ensure that members of staff who fall into any other category as outlined in the training framework should access the relevant single or multi-agency training. All staff must access mandatory safeguarding training as outlined in Appendix 1.

7 Supervision

All members of staff whose work brings them into direct contact with children and families will have access to regular structured supervision.

8 8 Effective Inter-agency Working

The philosophy of City and Hackney GP Confederation is to work collaboratively with other organisations to safeguard and promote the welfare of children and work within the information sharing guidance of the Local Safeguarding Children’s Board Procedures.

City and Hackney GP Confederation is committed to supporting the work of the CHSCB.

9 Confidentiality and information sharing

a. Confidential information about a child or young person should never be used casually in conversation or shared with any person other than on a “need to know basis.”

b. There are some circumstances when staff may be expected to share information about a child, for example when child abuse is alleged or suspected. In such cases individuals have a duty to pass information on without delay in line with Local Safeguarding Children Board procedures. Staff must document when, with whom and for what purpose information was shared.

c. The main restrictions within the legal framework to disclosure are:

i. Common law duty of confidence

ii. Human Rights Act 1998

iii. Data Protection Act 1998

d. Disclosure should be justified in each case and guidance should be sought from the Designated and Named Professionals for Safeguarding Children in cases of uncertainty. The Designated Professionals may seek guidance from City and Hackney Clinical Commissioning Group’s legal representatives.

e. The storing and processing of personal information about children and young people is governed by the Data Protection Act 1998. Effective information sharing underpins integrated working and is a vital element of both early intervention and safeguarding. It is important that all staff understand when, why and how they should share information. f. In some circumstances the sharing of confidential information without consent would normally be justified in the public interest. These circumstances would be: i. When there is evidence that the child suffering or is at risk of suffering significant harm.

9 ii. Where there is justifiable cause to believe that a child may be suffering or at risk of significant harm. iii. To prevent significant harm arising to children and young people including through the prevention, detection and prosecution of serious crime likely to cause significant harm to a child or young person. g. Information could also be shared without consent in the following circumstances:

i. If the child or young person is at greater risk.

ii. If you or another health care professional is at risk.

iii. If specific forensic evidence is needed.

h. Consider the likely outcome of sharing or not sharing information. At all times the safety and wellbeing of the child or young person is paramount. Reasons for decisions to share, or not share must be recorded. All decisions require professional, informed judgment. If in doubt this should be discussed with a Designated Professional for Safeguarding Children.

10 What to do if you are worried that a child is being abused

All staff should exercise vigilance in their work to mitigate against the risk that children using services might be suffering from abuse. If any member of staff becomes concerned that a child may be suffering from abuse or neglect they must seek advice from their manager and if necessary the Safeguarding Children Designated Nurse. Staff should follow the guidance set out in the flow chart attached as appendix 3 – Please see placeholder on page 15

11 Categories of abuse

For children’s safeguarding, the definitions of abuse are taken from Working Together to Safeguard Children (HM Government, 2013). Abuse and neglect are forms of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. Children may be abused in a family or an institutional or community setting, by those known to them or, more rarely, by a stranger. They may be abused by an adult or Children, or another child or children

a) 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 fabricates the symptoms of, or deliberately induces, illness to a child.

10 b) Emotional abuse: The persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development.

c) 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 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.

d) Neglect: 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.

12 References and bibliography

In developing this policy account has been taken of the following statutory and non- statutory guidance, best practice guidance and the policies and procedures of the Local Safeguarding Children Boards.

London Child Protection Procedures: http://www.londoncp.co.uk/

City and Hackney Safeguarding Children Board (CHSCB): http://www.chscb.org.uk

Children Act 1989 www.opsi.gov.uk/acts/acts1989/ukpga_19890041_en_1

Children Act 2004 www.opsi.gov.uk/acts/acts2004/ukpga_20040031_en_1

Safeguarding children and young people: roles and competences for health care staff; INTERCOLLEGIATE DOCUMENT - Third edition: March 2014

HM Government (2006) What to do if you’re worried a child is being abused, https://www.education.gov.uk/publications/standard/publicationdetail/page1/ dfes-04320-2006

H M Government (2008) Information Sharing Guidance for practitioners and managers https://www.education.gov.uk/publications/eOrderingDownload/00807- 2008BKT-EN-March09.pdf

HM Government (2013) Working Together to Safeguard Children, http://www.education.gov.uk/aboutdfe/statutory/g00213160/working- together-to-safeguard-children

11 National Institute for Health and Clinical Excellence (2009) When to suspect child maltreatment www.nice.org.uk/nicemedia/pdf/CG89FullGuideline.pdf

NHS Commissioning Board (2013) Safeguarding Vulnerable People in the Reformed NHS Accountability and Assurance Framework. http://www.commissioningboard.nhs.uk/wp- content/uploads/2013/03/safeguarding- vulnerable-people.pdf

13 Disciplinary Procedures

All suspected breaches of this policy will be investigated and may be subject to the GP Confederation disciplinary procedures. Serious breaches may result in immediate suspension and/or termination of contract, under the GP Confederation’s Disciplinary Policy.

Any breaches of this policy will be formally reported to the GP Confederation Clinical Board

14 Monitoring and Review

This policy will be reviewed every two years and will take into consideration legislation and national guidelines. Should the need arise that the policy requires reviewing before the review timeframe this will be agreed with the policy author and the Chief Executive Officer and reported to the GP Confederation Clinical Board. This might be as a result of the need to update the policy in line with changes to employment law, regulatory body changes or good practice.

To be read with the following policies:

 Recruitment and Selection (January 2015)  Disciplinary (December 2016)  Safeguarding Vulnerable Adults (December 2016)  Mental Capacity Act 2005 & Deprivation of Liberty Policy (September 2016)

12 Appendix 1 - Safeguarding Children Training Chart

COURSE FREQUENCY STAFF KNOWLEDGE Level 1 On All City and Hackney Know about the range of child abuse. includes commencement GP Confederation Know about local policies and Corporate of employment Staff procedures. Induction Repeat every 3 Know what to do if they have Programme years for non- concerns. clinical staff Understand the importance of information Sharing and dangers of not sharing information. Know who to contact if Concerned about a child or young person. Know how to access advice and support in relation to safeguarding children

Level Two Over 3 year period All staff whose work brings As above and: Safeguarding 0.5 programmed them directly into contact Children activity with children, young people Understand which groups of children are Training (Programmed parents and carers at risk of harm or neglect. Know who to activity is inform, seek advice from and how to equivalent to 4 contact them. hours) Know what to record, how long to keep it, how to dispose of records correctly, when to follow up and to feedback. Aware of own (and others) roles and boundaries. Understand the importance of information sharing. Know how to share information. Understand next steps in relation to suspected case of child abuse

Level 3 Over 3 year period All members of staff Working together with other agencies to Seminars and refresher training 1 who work identify, assess and meet the needs of workshops 1½ programmed predominantly with children where there are safeguarding activity/sessions or 3 children, young concerns. – 4 programmed people and /or their Activity (Dependent parents/ carers and Recognising the importance of family history on role) who could potentially and functioning and working with children (Programmed contribute to and family members. activity is equivalent assessing, planning, to 4 hours) reviewing the needs of a child and a As level 2 and aware of implications of parents parenting and family members. Specialists capacity where there topics are safeguarding concerns e.g. GPs, Current research findings and Practice Nurses. implications for practice.

13 14 Agency Name Position Telephone E-Mail Addresses Number Children's Social Care Sarah Wright Head of Service 020 8356 6824 [email protected] Safeguarding, Corporate Parenting and Learning

City of London Ade Adetosoye Director of Community and 020 7332 1650 [email protected] Children's Services Chris Pelham Assistant Director, People 020 7332 1636 [email protected]

Drug & Alcohol Action Laurence Wrenne Support Service Manager 020 8356 2285 [email protected] Team

Clinical Commissioning Nick Lessof Designated Doctor 020 7405 [email protected] Group 9200x 1293 Mary Lee Designated Nurse 0207 683 2701 [email protected] Safeguarding Children and Young People Ruth Hallgarten Named GP 020 8986 5613 [email protected]

East London Professor Jonathon Director of Nursing 020 7655 4000 [email protected] Foundation Trust Warren (switchboard) Sarah Wilson Director for Specialist 020 7655 4242 [email protected] Services, East London NHS Foundation Trust Jan Pearson Associate Director for 020 7655 4136 [email protected]

Safeguarding Children

Hackney Homes Wayne Hylton Estate Safety Manager 020 8356 6778 [email protected]

Homerton Hospital Sheila Adam Chief Nurse and Director of 020 8510 7215 [email protected] Governance Reggie Marriage Named Nurse for 020 8510 5750 [email protected]

Safeguarding Marcia Smikle Head of Nursing 0207 683 [email protected] 4314 0208 510 7938 Irene Willie Named Nurse Child 020 7683 4317 [email protected]

Protection Jane Kennedy Consultant Midwife-Public 020 8510 7715 [email protected] health, Named Midwife for

Safeguarding & Supervisor of Midwives Dr Sanjay Wazir Consultant Community 020 8510 5274 [email protected] Paediatrician and Named

Doctor for Safeguarding Children Dr Jasr Kawkby Consultant Community 020 7683 7041 [email protected] Paediatrician and Named

Doctor for Safeguarding Children

Metropolitan Police Simon Laurence Borough Commander 020 7275 3101 [email protected]

Safeguarding Children Martin Sexton Safeguarding Lead 020 8356 6212 [email protected]

15 Appendix 2 – Useful Safeguarding Children Contact Details

16 Appendix 3 - What to do if you are worried that a child is being abused Flow Chart

Hackney First Response MEMBER of STAFF HAS CONCERNS ABOUT CHILD’S WELFARE For advice please call the Named and Designated Team, Children’s Social Professionals: Care: 020 8356 5500 Member of staff discusses with manager and/or other Dr Nick Lessof [email protected] senior colleagues as they think appropriate Designated Doctor Safeguarding Children 20 7405 9200x 1293 Secure email: [email protected] [email protected] .cjsm.net Mary Lees City of London Children’s Still has concerns Still has concerns Designated Nurse Safeguarding Services team Children 0207 683 2701 Tel: 020 7332 1224/3621 Refer to social services, No further child protection Email: following up in writing within 24 action, although may need to act Dr Ruth Hallgarten social.services@cityoflondon hours to ensure services provided Named GP .gov.uk/ CCSDutyF&YPTeam 020 8986 5613 @cityoflondon.gov.uk Social worker and manager Out of Hours Contact the NSPCC Child Protection Feedback to referrer on next Consultant Paediatrician on call acknowledge receipt of referral helpline to discuss your course of action 020 8510 5555 concerns, or ask for advice and decide on next course of action within one working day Emergency Duty Teams No further social services Advice can also be sought from the involvement at this stage, Children’s Social Care Team For out of hours (5pm-9am) Initial assessment required although may be service, please contact the 020 83564844 City and Hackney Multi-Agency Referral Form and Emergency Duty Team on Concerns about child’s immediate Contact social care in 48 hours information about the City and 020 8356 2710. safety contact the Children’s Social if no feedback is received hackney Safeguarding Children’s Board can be accessed via this link City of London care Team for the appropriate borough or the Emergency Duty http://www.chscb.org.uk DCCSDutyF&YPTeam@cityo Team if out of hours flondon.gov.uk If you think a child is at risk of immediate harm, please contact the police by dialling 999.