Child Health Promotion May 2014 Safeguarding Children

2. Child Health PromotionMay 2014 Safeguarding Children Allison WaddellWorkforce Development OfficerCalderdale Safeguarding Children Board Julie Warburton Named Nurse- Safeguarding Calderdale and Huddersfield Foundation Trust

3. The Legal Framework Children’s Act 1989/2004 – Duty to safeguard and promote the welfare of children The welfare of the child is the paramount consideration Parents never lose parental responsibility for their child (unless their child is adopted) The child’s wishes should be taken into consideration (Gillick principle-Fraser competency) Every Child Matter Agenda states that all children deserve the opportunity to achieve their potential Private Fostering arrangements

4. Sarah’s story

5. Aims of safeguarding Ensuring that children grow up in an environment which provides safe and effective care to give them the best chance of entering adulthood successfully (Working Together 2013)

6. What's Acceptable?

7. Facts & figures Live with known domestic abuse in the home Children killed every year as a result of abuse Parents have problematic drug use 11 million childrenin England Parents have mental health problems Live with parents thought to misuse alcohol

8. Continuum of Need and Response in Calderdale

9. The Common Assessment Framework • Eileen Munroe (Working Together 2013) – Early Help – providing help as soon as a problem emerges • Relies on local agencies to work together to: • identify children and families who would benefit from early help; • undertake an assessment of the need for early help; • provide targeted services to address needs of child and family which focuses on activity to significantly improve the outcomes for the child

10. The Common Assessment Framework • Requires parental consent to refer. • Intended to support families so that problems don’t escalate.

11. Concept of Child in Need ( S17. Children Act 1989) • “he is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by a local authority. • Or • “his health or development is likely to be significantly impaired, or further impaired without the provision for him of such services. • Or • A disabled child

12. Significant Harm • Significant Harm is any Physical, Sexual, or Emotional Abuse, Neglect, accident or injury that is sufficiently serious to adversely affect progress and enjoyment of life. Harm is defined as the ill treatment or impairment of health and development. • There are no absolute criteria on which to rely when judging what constitutes significant harm. Sometimes a single violent episode may constitute significant harm but more often it is an accumulation of significant events, both acute and longstanding, which interrupt, damage or change the child’s development. (CSCB procedures)

13. Significant harm - consider • The nature of harm in terms of maltreatment or failure to provide adequate care • The impact on the child’s health & development • The child’s development within the context of their family & wider environment

14. Significant harm - consider • Any special needs such as medical condition, communication impairment or disability, that may affect the child's development & care within the family • The capacity of parents to meet adequately the child’s needs; and • The wider & environmental family context

15. Toxic trio Substance misuse, mental ill health and domestic violence may co-exist agencies should understand that this may increase the risk of harm to children.

16. Child Protection ProvisionsPart 5 of Children Act 1989 • Section 47 Local Authority Duty To Investigate • Grounds: Local Authority has reasonable cause to suspect that a child who lives in area is suffering or likely to suffer from significant harm. • Duty: The Authority shall make, or cause to be made, such enquiries as they consider necessary to enable them to decide whether they should take any action to safeguard or promote the child’s welfare.

17. Characteristics of the Child • 36% < 1 year old, 29% 1-5 years old • 65% < 5 years old • Adolescents -15% suicide • Health needs i.e. prematurity, disability • Invisible i.e. large family, assumption that they were being seen by someone else • Emotionally rejected

18. Characteristics of the Family • Hard to help, chaotic, overwhelmed • Frequent moves • Isolated • Domestic abuse 63% • Mental health problems 58% • Substance misuse 42% • All three ‘Toxic trio’ 22%

19. Continued • Young parents • Parental learning disability • Poor living conditions • Presence/role of men in households • Disguised compliance

20. Characteristics of the Professionals • Lack of ‘respectful uncertainty’, or ‘healthy scepticism’ Fixed views • Low expectations/accommodation • Start again syndrome • Men ‘off the radar’/focus on mum • Lack of child focus • Poor communication/ joint working • Threshold wrangles

21. What to do if you’re not sure • Observe and record your findings • Check against your NICE guidelines, information booklet • Contact your local NHS Safeguarding team for advice. • Contact your local Children’s Social Care team to discuss the referral.

22. 4 key principles for making assessments Focus on the child Recognise that the adult’s management of their own life is a good indicator of their ability to look after a child The best predictor of future behaviour is past behaviour Information from more than one source is better than information from one. (Forrester 2004)

23. What to do if you believe a child has been abused • Observe and record your findings • Contact your local Children’s Social Care team • Advise the parents of your actions unless safety or a criminal investigation would be jeapordised • Out of hours contact EDT • In an emergency contact the Police

24. Information Sharing • Welfare of the child is paramount • Children’s Act 1989 (section 1.1) • Crime and Disorder Act 1998 (section 115) gives public and statutory bodies the power to disclose information to prevent crime and disorder • HM government (2008)Information sharing guidance for practitioners & managers

25. 7 golden rules for information sharing • Remember that Data Protection Act is not a barrier to sharing information • Be open & honest from the outset re why, what & with whom sharing • Seek advice if in doubt • Share with consent where appropriate • Consider safety & well being • Necessary, proportionate, relevant, accurate, timely & secure • Keep a record of decision & rationale for sharing

26. Serious Case Reviews When a child dies and abuse or neglect is known or suspected a SCR will be undertaken SCR’s will also be considered if: a child suffers serious injury through suspected abuse or neglect a child has been subject to serious sexual abuse a child has been killed by a parent with a mental illness the case gives rise to concerns about interagency working The purpose of the review is to identify lessons to be learned. It is not an inquiry into how the child died or who is responsible, that remains a matter for the Coroners and criminal courts.

27. Updating Assessments Effective Information Sharing Effective Inter-agencyCollaboration Understanding roles & responsibilities

28. LSCB KSCB www.kirklees.gov.uk/safeguardingchildren CSCB www.calderdale-scb.org.uk Responsibilities Policies/Procedures Planning services Monitoring effectiveness of safeguarding Training SCR’s Child death review panels Safety and welfare of children who are privately fostered

29. Key Messages • The welfare of the child is paramount • Safeguarding the welfare of all children is a collaborative, multi agency activity • It’s everybody’s responsibility • If you are concerned, and unsure how to proceed, ASK!! • Ensure that you know where to go for advice

30. Never ever do Nothing Remember: Your information may only be part of the puzzle, but it may be crucial to completing the whole picture GP Education Midwife Police Mental Health The Public Health Visitor School Nurse CHILD Housing Voluntary sector Police Family Acute Health Staff Health Education Social Care Care Services Your Information Housing Public