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Safeguarding Children & Young People Safeguarding children and young 31 Recommendations were made for people action by Dec 2014 • leadership, culture and values and executive accountability; • patient-centred drivers and safeguarding; • board and ward coherence; • security and controls on the physical access to hospital premises; • policy development and implementation; and • fundraising. A presentation by Jeff Barlow [email protected] All health staff must have the competences to recognise child Definition maltreatment and to take effective action as appropriate to their role. They must also clearly understand their responsibilities, and should be supported by their employing organisation to fulfil their duties. Chief Executive officers and ‘A child is anyone under the age of 18 independent contractors such as years.’ GPs, in particular have a (Children Act 1989, 2004) responsibility to ensure that all staff across the organisation have the knowledge and skills to be able to meet this requirement 4 Main Categories of Child Abuse Neglect Physical Sexual Emotional (psychological) 1 Definition of Neglect That includes Neglect is the persistent failure to Neglect may occur meet a child’s basic physical and/or psychological needs, likely during pregnancy as a to result in the serious result of maternal impairment of the child’s health or development. substance abuse. (Working Together to Safeguard Children, 2013) (Working Together to Safeguard Children, 2013 That includes - And also Denying access to appropriate medical care or treatment Definition of Physical Abuse Physical Abuse may involve hitting, shaking, NICE GUIDELINE: consider neglect when parents or carers: throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing • fail to administer essential prescribed treatment physical harm to a child. • repeatedly fail to attend essential follow-up appointments necessary for child’s health & wellbeing • persistently fail to engage with relevant child health promotion programmes which include: • immunisation • health and development reviews • screening • have access to but persistently fail to obtain NHS treatment for child’s dental caries • fail to seek medical advice for their child to the extent that child’s health and wellbeing is compromised, including if the child is in ongoing pain Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child. Working Together to Safeguard Children, 2013 Definition of Sexual Abuse Sexual abuse involves forcing or enticing a child or young person to take part in Definition of Emotional Abuse sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. • Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe The activities may involve physical contact, including assault by penetration and persistent adverse effects on the child’s emotional development. (for example, rape or oral sex) or non- penetrative acts such as masturbation, • 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. kissing, rubbing and touching outside of clothing. • It may include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate. It may feature age or They may also include non-contact activities, such as involving developmentally inappropriate expectations being imposed on children. children in looking at, or in the production of, sexual images, watching sexual • These may include interactions that are beyond the child’s developmental capability, as well activities, encouraging children to behave in sexually inappropriate ways, or as overprotection and limitation of exploration and learning, or preventing the child grooming a child in preparation for abuse (including via the internet). participating in normal social interaction. Sexual abuse is not solely perpetrated by adult males. Women can also commit • It may involve seeing or hearing the ill-treatment of another. acts of sexual abuse, as can other children. • It may involve serious bullying (including cyberbullying), causing children frequently to feel frightened or danger, or the exploitation or corruption of children. Some level of emotional abuse involved in all types of maltreatment of a child, though it may occur alone. Working Together to Safeguard Children 2013 Working Together to Safeguard Children, 2013 2 There are four main types of FGM: Other areas of concern Type 1 – clitoridectomy – removing part or all of the clitoris. Type 2 – excision – removing part or all of the clitoris and the inner labia (lips that surround the vagina), with or without removal of the labia majora (larger outer lips). Type 3 – infibulation – narrowing of the vaginal opening by creating a seal, formed by cutting and repositioning the labia. Other harmful procedures to the female genitals, which include pricking, piercing, cutting, scraping and burning the area. Other harmful procedures to the female genitals, which include pricking, piercing, cutting, scraping and burning the area. Multi-agency Guidelines on female genital Mutilation • Does the person appear disconnected from family, friends, community organisations, or houses of worship? • Has a child stopped attending school? • Has the person had a sudden or dramatic change in behavior? • Is a child engaged in commercial sex acts? • Is the person disoriented or confused, or showing signs of mental or physical abuse? • Does the person have bruises in various stages of healing? • Is the person fearful, timid, or submissive? • Does the person show signs of having been denied food, water, sleep, or medical care? • Is the person often in the company of someone to whom he or she defers? Or someone who seems to be in control of the situation, e.g., where they go or who they talk to? Parental Well Being • Mental Health issues • Drug/Alcohol misuse • Domestic Violence 3 Legal Framework - Children at Risk • Balance between two principles 1. Parents ought to be able to bring up their children as they think best 2. The state must have adequate power to protect children at risk • Framework to enable fair and reasonable decisions to be made Section 17 & Section 47 What is a Serious Case Review? Definitions • Section 17 – A risk of significant impairment to • It’s an analysis of what happened? and the reasons health & development of the child or young why? person. • Involves each organisation who has been involved with the child or family undertaking an Individual Management Review. • Section 47 – A risk of significant harm to the • Scrutinising records and individual involvement. child or young person. • Submitting a report to SCR overview author. • Evaluated by Ofsted When is a SCR undertaken? Why do a Serious Case Review? The LSCB should conduct a Serious Case Review • Establish whether there are lessons to be learned from the (SCR) when case about the way in which local professionals and abuse or neglect of a child is known or suspected; and organisations work together to safeguard and promote the either – welfare of children (i) the child has died; or • Identify clearly what those lessons are both within and (ii) the child has been seriously harmed between agencies, how and within what timescales they will be acted on, and what is expected to change as a and there is cause for concern as to the way in which the authority, their Board partners or other relevant persons result and have worked together to safeguard the child. • Improve inter-agency working and better safeguard and Working Together to Safeguard Children, (2013) promote the welfare of children’ Working Together to Safeguard Children. (2013) 4 Victoria Climbié Findings from Biennial Analysis of SCR Died 25th February 2000 SCR 2005-07 of 189 children’s cases revealed • The highest risk of maltreatment related deaths & serious injury are in the first 5 yrs of life Working Together 2006 • 17% of children were subject to a child protection plan. The major category of concern was neglect. • A third of the 40 children studied in depth had a history of missed health Baby Peter appointments. • 45% of families were highly mobile & were living in poor conditions. Half of the parents/carers had criminal convictions . Died 3rd August 2007 • There was a failure to take into account the dearth of information about fathers and other men connected to the family. (Brandon, 2009 p 36-37) Working Together 2010 Children Act 2004 .Working Together to Safeguard Children (HM Government 2013) • Sets out new duties to ensure that child welfare is • This guidance covers the legislative requirements and highlighted in the work of all relevant agencies and in the expectations on individual services to safeguard and way they work together promote the welfare of children; and • provides a framework for Local Safeguarding Children Boards (LSCBs) to monitor the effectiveness of local • Provides a framework to improve information sharing services. (databases) • Places a duty on key agencies to co-operate Every Child Matters: Change for Children The Safeguarding Adults Framework in (DfES 2004) Leeds Five key outcomes for children and (West Yorkshire Multi-Agency Safeguarding Procedures) young people • Being healthy • Staying safe • Enjoying and achieving The Safeguarding Children’s Framework in • Making a positive contribution Leeds (West Yorkshire Consortium Procedures)
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