clinical case n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Clinical Case PowerPoint Presentation
Download Presentation
Clinical Case

Loading in 2 Seconds...

play fullscreen
1 / 20

Clinical Case - PowerPoint PPT Presentation


  • 76 Views
  • Uploaded on

Clinical Case. By Paul Wright Named Doctor Safeguarding Virgin Care. Introduction. Child BA Referred in May 2010 – Aged 13 years 6 months BA had disclosed to a teacher that she had been beaten over a long period at home School referred to Social Care and Police

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Clinical Case' - kenley


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
clinical case

Clinical Case

By Paul Wright

Named Doctor Safeguarding Virgin Care

Private and confidential

introduction
Introduction
  • Child BA
  • Referred in May 2010 – Aged 13 years 6 months
  • BA had disclosed to a teacher that she had been beaten over a long period at home
  • School referred to Social Care and Police
  • They visited her but although had been happening for over a year – no acute injuries
  • 2 days later was kicked in the morning and medical requested

Private and confidential

history of presenting problem
History of Presenting Problem
  • BA recalls many incidents of physical beating and injury
  • 2 years previously she had been hit with a metal mop which had caused her to break the middle finger of right hand
  • Present Carers have hit her many times
  • Sometimes has to kneel on the floor with her hands above her head; if they drop she is beaten

Private and confidential

history of presenting problem1
History of Presenting Problem
  • She has to do a lot of chores at home including looking after the other 2 children (they are natural children of the carers)
  • She runs their baths, sweeps the floor, does the food shopping and cooking for the family
  • She has to eat different food from the rest of the family

Private and confidential

history of presenting problem2
History of Presenting Problem
  • On the previous evening she had had little sleep and had not got up to do her chores
  • Carer had woken her up and kicked repeatedly on her legs

Private and confidential

past history
Past History
  • Born and spent early childhood in Nigeria
  • Family ethnically Yoruba
  • Father was Muslim and Mother Christian
  • Father died when BA 3 years of age, and Mother died when BA 8 years of age
  • BA told that father had died in a car accident, and mother following robbery and rape
  • However both died of AIDS related illnesses

Private and confidential

past history1
Past History
  • BA has two older siblings in Nigeria
  • When her Mother died all went to live with different relatives
  • BA’s current carers are her Paternal Grandfather’s Brother’s son and his wife
  • Mr SA (adoptive father) was granted temporary residence in UK under the Highly Skilled Migration Programme

Private and confidential

past history2
Past History
  • In March 2009 BA arrived in the UK with her adoptive parents and their 2 children
  • Papers prepared for immigration state BA born in 1997, whereas BA stated she was born in 1996
  • As part of adoption BA’s name was completely changed
  • September 1999 started at Secondary School

Private and confidential

medical history in uk
Medical History in UK
  • Taken to see GP within 2 weeks of arriving in the UK
  • History of bedwetting every night
  • 2 older siblings described as “bedwetters”
  • Referred to Enuresis Clinic
  • No appointments were kept

Private and confidential

school progress
School Progress
  • Adoptive parents refer to major behaviour problems
  • These are not substantiated by her school
  • Form tutor states BA an exemplary student, her only problem being her persistent late arrival
  • Academic progress has been excellent but adoptive mother has never congratulated her, and has hidden her good reports from adoptive father

Private and confidential

school progress1
School Progress
  • April 2010 – Adoptive Father contacted School Pastoral Care Coordinator about comments BA had been writing in her diary
  • He said he would punish her with a cane
  • Told that an inappropriate method of punishment and reported to Social Care
  • BA later disclosed to Social worker that had been punched on back, legs and arms

Private and confidential

school progress2
School Progress
  • May 2010 – BA disclosed to school that she was being punished at home and do housework in the mornings
  • Had been hit across back with a stick and had to hold her hands up to protect her head
  • Disclosed that she was adopted and fearful of reprisals
  • School contacted Social Care

Private and confidential

school progress3
School Progress
  • Next Day – Interviewed by Social Worker and Police
  • 2 Days Later – BA arrived at school very distressed as mother had reportedly kicked her 7 times that morning
  • BA kicked on thighs and legs and noted to be unable to sit down comfortably
  • Social Care informed and Medical arranged

Private and confidential

medical
Medical
  • Numerous old scars noted
    • Back at least 6
    • Right leg at least 12 including a large one which was reported to be a burn from a motorbike accident
    • Left leg at least 5
    • Left Elbow 2
  • All injuries consistent with being hit by a hard object over a prolonged period of time
  • 2 injuries consistent with accidental burns

Private and confidential

follow up from medical
Follow up from Medical
  • Following Medical, Police took out an Police Protection Order and BA placed in Foster Care
  • Following day – Meeting between Foster Mother and Social Care
  • Foster Mother informed that LA seeking to take out an Emergency Protection Order in respect of BA
  • Section 47 Investigation to be conducted into 2 other children

Private and confidential

follow up from medical1
Follow up from Medical
  • EPO obtained that day
  • 3 days later Home Visit – Foster Mother very distressed and pleading that BA returned to her care
  • 2 days later – Final strategy discussion and decision that an Initial Child Protection Conference be convened on 2 younger children
  • LA obtained an Interim Care Order

Private and confidential

abe interview
ABE Interview
  • Domestic Chores worse when adoptive father away
  • Persistently verbally denigrated by adoptive mother to visitors to house and to family in Nigeria
  • Beaten by cane anywhere on her body
  • Palms a common site as did not show marks
  • Hand beaten by a metal mop by adoptive father which had led to a fracture and resultant trigger finger

Private and confidential

investigation into 2 other children
Investigation into 2 other Children
  • No concerns raised re physical abuse other than emotional impact of what they had witnessed
  • Both made subject to CP Plans under Emotional Abuse

Private and confidential

further history
Further History
  • BA remains in Foster Care
  • BA made an allegation that she was raped aged 9 years in Nigeria
  • HIV and STD screening negative
  • Seen in Enuresis clinic – Secondary Enuresis following Mother’s Death
  • On Desmopressin for a year – Now stopped

Private and confidential

points
Points
  • Cultural Differences – Safeguarding follows UK law and is Culturally blind
  • Falsification of Age
  • Children brought to UK by “Family Members” and placed in servitude

Private and confidential