Safeguarding 2016 Level 2 Children Navigation Toolbar

Safeguarding Children A child is defined as anyone up to their 18th birthday and may also include the unborn The Legal Framework for Safeguarding Children is the Children Act 1989 This introduces two key areas 1. Section 17 - Safeguarding a child in need of additional help and support 2. Section 47- Protecting a child where significant harm or abuse is suspected Navigation Toolbar

Examples of Early Help include It is important that if you identify an emerging problem or a potential unmet need you do NOT wait for Section 17 or section 47 thresholds to be met (as described in the next slides) but act early in identifying what support is required. Examples of Early Help include Family circumstances presenting challenges i.e. parental substance misuse, adult mental health issues, domestic abuse or neglect Young carer Disabled or specific additional needs ACT EARLY Consider undertaking an Early Help Assessment (previously a CAF) to identify the advice, support or targeted services the child and family require. REMEMBER Partnership working is vital in providing consistent and effective support. Navigation Toolbar

The Children Act 1989 (Section 17) The Children Act 1989 (section 17) defines a child in need; as children or young people who because of their vulnerability, will need the provision of services in order to reach or maintain a satisfactory level of health or development Where a child in need is identified, practitioners working with the child will complete either: a Early Help Assessment (EHA) or A specific Local Authority Request for Support Form for a co-ordinated response and delivery of services to the child/young person and their family. The assessment triangle is a tool for staff to use when making a holistic assessment of the child and family. Consent from the parent and/or young person is central to this process. Navigation Toolbar

Assessment Framework Triangle Health Education Identity Family & Social Relationships Social Presentation Emotional & Behavioural Development Self-care Skills Basic Care Ensuring Safety Emotional Warmth Stimulation Guidance & Boundaries Stability Child and Development Needs Parenting Capacity CHILD Safeguarding & Promoting Welfare Family and Environmental Factors Family History & Functioning, Wider Family, Housing, Employment, Income, Family’s Social, Integration, Social Resources Navigation Toolbar

The Children Act 1989 (Section 47) The Children Act 1989 (section 47) introduced the concept of significant harm as a definition of abuse; harm means ill treatment or the impairment of health or development including impairment from seeing or hearing the ill treatment of another. Significant relates to the child’s health and development and the comparison with that which could reasonably be expected of a similar child. Where a child or young person has been identified as at risk of significant harm the Local Authority (Social Care) has a legal duty to make enquiries and take appropriate action to ensure the safety of the child/young person. Consent for these enquiries is not obligatory, but agencies will always seek to work with parents where this does not place the child or young person at increased risk. Navigation Toolbar

Who Abuses Children? By an Adult(s) By a child/young person Abuse can occur within the family, an institution or community setting.  Abuse can occur in all social groups regardless of age, gender, race, religion, culture, social class or financial position. Children may be abused by Someone the child knows well or more rarely a stranger.  By an Adult(s) By a child/young person All staff who work with children or adults, from any service have a responsibility in safeguarding children when they become aware of or identify a child at risk of harm. This includes considering the implications for children of parents behaviours and the impact these may have on their parenting capacity. Navigation Toolbar

Which Legal Framework is used for Safeguarding Children? Question Which Legal Framework is used for Safeguarding Children? The Children’s Act 1988 The Safeguarding Act 1985 The Safeguarding Act 1987 The Children’s Act 1989 Navigation Toolbar

Signs that could indicate physical abuse include: Four Categories of Child Abuse Physical Abuse, sexual abuse, emotional abuse & Neglect Physical abuse involves a range of physical injuries including hitting, shaking, throwing, poisoning, burning, scalding, drowning or suffocating and also includes fabricated and/or induced illness and Female Genital Mutilation. Signs that could indicate physical abuse include: Bruising is more likely to be non accidental : On a non-mobile baby or child On any fleshy, non-bony part of the body,(face, neck, buttocks or back ) Multiple bruising or clusters e.g. finger prints Bruises with a defined outline Fabricated or Induced Illness is classed as a physical abuse where a parent/carer fabricates or deliberately induces illness Navigation Toolbar

Burns & Scalds Burns include scalds from hot liquids, contact burns from hot objects (such as an iron) or caused by flames, chemical and electrical. Burns with a clear outline or uniform depth for example may be more indicative of non accidental injury. A recent UK study estimates that of the children admitted to burns units, 10% had sustained burns that were the result of abuse Any injury which the child, parent, carer tries to hide or give several different or unlikely explanations, should raise concerns. In these circumstances advice should always be sought. Bites Bites can leave a clear impression and abuse should be considered as a possibility especially when it is thought unlikely to have been caused by a young child. An animal bite on a child may indicate neglect for example: inadequate supervision of the child or failure to protect from danger. Navigation Toolbar

UK Female Genital Mutilation Act 2003 The Act covers all UK Citizens and residents in the UK and overseas. This illegal and life-threatening initiation ritual can leave young victims in agony and with physical and psychological problems that can continue into adulthood. Carried out in secret and often without anaesthetic it involves the partial or total removal of the external female genital organs for cultural or other non-therapeutic reasons’ (Department of Health, 2011). I The number of women and girls living with FGM in the UK is likely to be around 170,000 The World Health Organization (WHO) defines FGM as ‘procedures that intentionally alter or cause injury to the female genital organs for nonmedical reasons’ (WHO, 2013). I Victims are usually aged between four and ten, but some are babies. If you know someone who has been a victim, encourage them to speak to their GP or the FGM helpline on 0800 028 3550 for more help. Navigation Toolbar

Sexual Abuse Trust staff must report any known cases to their line manager and the Trust Safeguarding Team and a referral made to Children’s Social Care. It may also be appropriate to contact the Police if the situation is urgent, although social care will always liaise with police. Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including sexual exploitation whether or not the child is aware of what is happening. This may involve sexual physical contact or non-contact activities including coercing or grooming children by the use of pornographic material or watching sexual activities including those via the internet, webcams, cameras, mobile phones, or encouraging children to behave in sexually inappropriate ways. However, abuse within the family is still far more common. I It is important to recognise that children & young people can be sexually abused by adult males, females and other children & young people I In 2012/13, 1,061 young people specifically talked about online sexual abuse, with girls and 15 year olds being the most affected. Often young people talked to ChildLine about being made to post sexually provocative images online, or share them via a mobile phone at the request of someone they had met online (often referred to as sexting). ChildLine review 2012/13 Navigation Toolbar

(The Sexual Offences Act 2003) A child under 13 years is not legally capable of consenting to sexual activity (The Sexual Offences Act 2003) Sexual activity with a child under 16 years is also an offence, however where it is consensual it may be considered less serious, although there may still be serious consequences for the welfare of the child/young person and consideration about whether there is a need to share information with other agencies in order to protect the child/young person should be given in every case. If you are aware of a child that has contact with an adult with prior allegations or convictions of sexual abuse you must seek advice from the Safeguarding team and your line manager with a view to making a child protection referral. Navigation Toolbar

What is child Sexual Exploitation (CSE)? Young people under 18 who are encouraged into a sexual relationship or situation by an adult. No child can legally consent to their own abuse, even if they are 16 or 17 yrs. Sometimes young people do not realise or accept they are a victim or at risk of CSE It involves young people receiving ‘something’ as a result of performing, and /or others performing on them, sexual activities EG money, food, alcohol, drugs or affection I Safeguarding Children e-Academy and Parents Against Child sexual Exploitation are offering a free online course. Register at: keepthemsafe.safeguardingchildrenea.co.uk/ See any SEPT training bulletin for details CSE is a complex crime, those exploiting the child/young person have power over them by virtue of age, gender, physical strength, economic or other resources. CSE is not limited to any particular geography, ethnicity, gender or social background. Evidence shows this is a widespread problem Navigation Toolbar

Signs which could indicate sexual abuse include: Changes in behaviour such as withdrawn, or aggressive, risk taking such as running away or substance misuse Sexually transmitted disease Wetting and/or soiling especially where a child has been previously toilet trained Child/Young person has money or gifts that they cannot account for Children displaying inappropriate sexualised behaviour or language for their age and stage of development Sexually inappropriate relationships, such as discrepancy of age or position of power of trust Pregnancy or concealed pregnancy in a young person Self Harming behaviour, including eating disorders and hair pulling Navigation Toolbar

Question What age is a child not legally capable of consenting to sexual activity (The Sexual Offences Act 2003)? 18 16 13 15 Navigation Toolbar

Emotional Abuse Persistent emotional maltreatment which causes severe and persistent effects on the child or young persons’ emotional development.  This can occur where there is persistent emotional unavailability and unresponsiveness from the parent or carer towards a child and in particular towards a baby. Being emotionally unavailable to the child because of adult behaviours or factors including parental substance misuse, mental ill health or domestic abuse. Using the child for the fulfilment of the adult’s needs (for example, children being use in marital disputes). Where there is domestic abuse within the family. I Imposing age or developmentally inappropriate expectations on a child/young person. I Conveying to a child they are worthless or unloved and may include not giving a child the opportunity to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate. Allowing a child to see or hear the ill treatment of another, including pets. “Mum and Dad split up. Since then I feel like they’ve used me as a go-between in their arguments. Mum and Dad don’t speak to each other and I am expected to pass messages.” Girl, aged 16 NSPCC. Rejecting or scapegoating a child or young person. I Navigation Toolbar

An emotionally abused child or young person may present with: Indicators. An emotionally abused child or young person may present with: Changes in behaviour, clingy, fearful, withdrawn, attention seeking, constantly seeking to please Increased risk taking behaviour Depression Self harming behaviours including eating disorders Low self esteem Some level of emotional abuse is involved in all types of maltreatment of a child or young person, although it may also occur alone Navigation Toolbar

Neglect I A neglected child/young person may present with: Neglect is the persistent failure to meet the child’s basic physical and or psychological needs, likely to result in the serious impairment of the child or young person’s health and/or development. Neglect may occur during pregnancy as a result of maternal substance misuse. Neglect has harmful physical, emotional and social consequences for children and young people and can ultimately be fatal. A neglected child/young person may present with: I Delayed Development Significant untreated childhood conditions such as head lice infestations, eczema Significant dental caries Persistently hungry. May steal food from other children at school Missing significant amounts of school, including children and young people that are caring for others in the home and are unable to access education and social activity. Frequently have ingrained dirt on clothing and body, may smell of urine, faeces or body odour Missing routine health appointments Significantly under or over weight Navigation Toolbar

Neglect may involve a parent or carer failing to: Provide adequate food, clothing and shelter (including exclusion from home or abandonment) and a clean safe environment Ensure appropriate access to medicate care or treatment, including attending health appointments Ensure adequate supervision including the use of inadequate care givers, or leaving young children home alone Protect a child/young person from physical and emotional harm or danger, including domestic abuse Ensure children and young people have access to appropriate education These categories overlap and an abused child frequently suffers more than a single type of abuse. Navigation Toolbar

What type of abuse is this? Question “My mum and dad are hitting me – it's happening quite often and is really painful. I cry all the time. Maybe it's my fault they hit me” Girl aged 10 (NSPCC) What type of abuse is this? Sexual Emotional Physical Neglect Navigation Toolbar

What type of abuse is this? Question “I’m 16 and I recently sent pictures of me in my underwear and topless to someone I thought was a girl. It turns out it was actually a guy and he threatened to upload all my photos and show the photos to my family and friends unless I showed myself to him via live video messaging. I am so scared right now, I don’t know what to do – is what he is doing illegal?” Boy aged 16 What type of abuse is this? Physical Sexual Emotional Neglect Navigation Toolbar

What factors may increase risk to children? Factors that may affect parenting capacity and impact on a child/young person’s safety and welfare include, domestic abuse, parental mental ill health and parental substance misuse. The risk to the child when these factors co-exist is significantly increased and a referral to Children’s Social Care MUST take place. Ways in which the factors can impact on parenting capacity include … Children may be expected to fend for themselves and care for the parent and/or younger siblings A parent may be unpredictable, inconsistent and ineffective with their children Neglect of physical needs Neglect of emotional needs by being emotionally unavailable Navigation Toolbar

Domestic Abuse Domestic abuse is any incident of threatening behaviour, violence or abuse between adults who are or who have been intimate partners or family members, regardless of gender or sexuality This includes issues of honour based violence, female genital mutilation (FMG) and forced marriage Facts about domestic abuse: Research indicates a strong link between domestic abuse and other forms of child abuse and also animal cruelty UK evidence suggest domestic abuse is a known issue in 1 in 3 child protection cases Children can be at risk of physical injury including harm to the unborn child either by direct injury or from attempting to protect the non abusing parent Prolonged and/or regular exposure to domestic abuse can have a serious long term impact on a child’s health, development and emotional wellbeing Domestic abuse often starts or escalates when a woman is pregnant Navigation Toolbar

What type of abuse is this? Question “I am really scared my parents are going to split up. They argue all the time over the smallest little things. When they argue I just go up to my room and sit on my own. Sometimes I just cry because I am so upset to hear them shouting at each other. I don't think they understand how they are affecting me when they argue.” Girl aged 12 (NSPCC) What type of abuse is this? Physical Neglect Sexual Emotional Navigation Toolbar

Risk taking behaviour: substance misuse, running away from home Children and young people may express distress through their behaviours in different ways, for example: Be unable to concentrate on learning or play and begin to fall behind developmentally Risk taking behaviour: substance misuse, running away from home Have sleep disturbance such as nightmares or bedwetting Self Harming Become withdrawn and isolated, anxious and/or depressed Miss school because they are concerned about what is happening at home Display aggressive and bullying behaviour Navigation Toolbar

“Dad sometimes hits mum when he’s angry “Dad sometimes hits mum when he’s angry. I think it may be my fault because I can never get things right with Dad.” Natalie, 14 years old (quote from ChildLine 2007) Two women are killed each week in England and Wales by a partner or former parted, 30% of cases start during pregnancy and 90% of children are in the same or next room when violence occurs (Home Office 2007) Women living in households where there is domestic abuse are at an increased risk when pregnant. Domestic abuse can affect the unborn child through physical injury (kicks/punches to the abdomen), stress and anxiety to the mother and a failure to attend ante natal appointments Navigation Toolbar

Parental Drug and Alcohol Misuse Misuse of drugs (prescribed or illegal) and or alcohol is strongly associated with significant harm to the unborn child, children and young people. Evidence shows that when parents have problems with substance misuse this often adversely affects their ability to respond to the needs of their children. Non compliance with treatment often indicates a difficulty parents have with organising their own lives, they may neglect their own needs and in turn neglect the needs of their children. Lives are often chaotic with little regard for routines, boundaries and supervision. Navigation Toolbar

Misuse of drugs (prescribed or illegal) and/or alcohol is strongly associated with significant harm, especially when combined with other features such as domestic abuse and mental illness. Many of the children who rang ChildLine told us that physical, sexual and emotional abuse and neglect were all linked in their lives with alcohol and drug misuse. This is evidence that the emotional volatility, the reduced ability to parent responsibly and the reduction in normal inhibitors can have the most serious impact on children’s lives (NSPCC 2010) Navigation Toolbar

What type of abuse is this? Question “My dad broke my nose last year when he was drunk. My sister has left home. I feel empty and hurt” Milly 12yrs (Quote from ChildLine 2007) What type of abuse is this? Emotional Neglect Physical Sexual Navigation Toolbar

Children can experience problems outside the home as a result of parental alcohol or drug misuse these include; Children report being worried, frightened and confused by their parents’ alcohol and drug misuse Problems with concentration at school due to lack of sleep or worries over their parents or siblings. Missing school to look after their parents or siblings Being bullied at school However, for some children, school can provide respite from their problems at home, “Mum goes out drinking. She doesn't come back until the morning. I am left to babysit my little brother and little sister. I can't sleep when Mum is out as I can hear noises downstairs.” Adrian, aged 14, (quote from ChildLine 2010) Navigation Toolbar

Parental Mental ill Health It is essential that staff working with adults consider the implications of a parent/carers mental health on children's welfare and parenting capacity. The majority of parents who suffer mental illness are able to care for and safeguard their children, however nationally 25% of children who are subject to Child Protection Conferences have a parent with mental health problems. Navigation Toolbar

What type of abuse is this? Question “Mum’s always miserable. She never asks me how I am. She just sits in front of the telly all day. I could be dead for all she cares.” Wayne, 13 years old (quote from ChildLine 2007) What type of abuse is this? Emotional Physical Neglect Sexual Navigation Toolbar

Indicators The following associated risks may justify a referral to social care for an assessment if the child’s needs and must be discussed with Team managers or the Trust Safeguarding Team: Conditions affecting parenting capacity e.g. post natal depression Children witnessing parental self harming behaviour I Suicidal thoughts involving a child I Delusional beliefs which include the child This is also a wider issue which often indicates difficulty parents have with organising their own lives, they may neglect their own needs and in turn neglect the needs of their children Unsupported and/or isolated parent with mental illnesses Non compliance with treatment Navigation Toolbar

Think Family We cannot assume that someone else is talking with children and young people, and we should ensure that we communicate and work with other professionals where appropriate in order that children and young people can make sense of their parent’s illness and feel supported. Are there children in the family Other professionals that can help with this includes: Child & Adolescent Mental Health Services Health Visitors & School Nurses Children’s Social Services School Counsellors Voluntary Sector Who is looking after them How is the parent’s illness affecting the children Do the children have someone to talk to Are the children safe Navigation Toolbar

Previous history of safeguarding concerns = Where a previous child/young person has been subject to a child protecting plan (formerly known as the child protection register) Where a previous child/young person has been removed u the local authority (social care) Adults or young people known to be a Risk to a child (formerly a Schedule 1 Offender) Vulnerable Factors Age of the child, children under one year are particularly vulnerable Children and young people with any kind of disability are more vulnerable to abuse and neglect Looked after children/young people (LAC) those in private or local authority foster care or children’s homes Navigation Toolbar

Young People and Self Harm Self harm is a significant event and should form part of the chronology of events in the child’s life. Indicators may include: Self mutilation e.g. cutting, hair pulling Eating disorders such as bulimia Risk taking behaviour such as substance misuse Suicide threats, although serious suicidal intent is difficult to detect, 50% of completed suicides have a history of self harm. Self harm can be a sign of a child experiencing abuse Navigation Toolbar

Recognising the Factors that may stop Children Telling Is it important for practitioners to be aware of any factors that may prevent a child or young person from making a disclosure, the following is not an exhaustive list: May not recognise that what they are experiencing is abusive Direct threat to the child or young person not to ‘tell’ Lack of appropriate vocabulary due to age or disability Fear of not being believed, particularly where an abuser has told the child they won’t be believed Feelings of guilt or shame, children often feel the abuse is somehow their fault May have been made to feel ‘special’ by the abuser Lack of opportunity to be heard Silence to protect others Fear about reprisals, what may happen if they ‘tell’ Navigation Toolbar

Recognising Factors that may stop practitioners from acting on disclosures Is it important for practitioners to be aware of any factors that may prevent an adult from making a disclosure. Child or young person’s attempt to bind them to secrecy A perception of not wanting to damage the relationship with a family Not believing that the abuser could have perpetrated the abuse, particularly if the abuser is someone close or someone they work with, or where the abuser may have also ‘groomed’ the practitioner Fear of being wrong Not believing the child Some issues are too distressing to think about, particularly if they resonate with our own experiences Uncertainty about procedure and consequences Always seek advice from your line manager or the Trust Safeguarding Children Team if you are unsure about a disclosure Navigation Toolbar

Confidentiality and Consent Staff cannot give assurance of confidentiality where there are concerns about a child as information may need to be shared in order to protect the child. Consent to share information should always be sought where possible, except when; Permission has been refused but sufficient professional concern remains to justify disclosure When gaining consent would place a child, young person or an adult at risk of significant harm Seeking permission is likely to impede a criminal investigation If you are uncertain about when to share confidential information, always seek advice from the Trust Safeguarding Team or your Line Manager Navigation Toolbar

Giving consent is a process, not a one-off event Confidentiality and Consent Giving consent is a process, not a one-off event Children, young people and consent When deciding whether a child is mature enough to make decisions, people often talk about whether a child is 'Gillick competent' or whether they meet the 'Fraser guidelines' "...whether or not a child is capable of giving the necessary consent will depend on the child’s maturity and understanding and the nature of the consent required. The child must be capable of making a reasonable assessment of the advantages and disadvantages of the treatment proposed, so the consent, if given, can be properly and fairly described as true consent.“(Lord Scarman, Lord Fraser and Lord Bridge1985) The Fraser guidelines apply specifically to contraceptive advice: A child (although under the age of 16 years of age) will need to demonstrate they fully understand the advice & implications of their decisions and cannot be persuaded to discuss with her parent, and that the health professional makes an assessment that it is the child’s best interests to provide sexual health advice and /or contraception Navigation Toolbar

Remember to complete a DATIX and attach the referral What to do if you are concerned for the welfare of a child If you are concerned about a child or young person you must seek advice from the safeguarding team and your line manager. Outside normal hours contact the manager on call via switchboard. You MUST record all information and actions clearly with your name, designation, signature and date. You may need to ensure the child or young person’s immediate safety by accessing emergency assistance Referrals to children’s social care must be made within one day of identifying the concern. Any telephone referral must be followed up with a written referral within 48 hours. If the referrer has no contact from social care then they have a responsibility to follow up the outcome of the referral within 3 working days. If you are unable to contact your line manager or the safeguarding team you should seek advice directly from the Local Authority children’s services Remember to complete a DATIX and attach the referral Navigation Toolbar

Escalation Escalate to line manager If you are not satisfied with a response from a referral or are concerned regarding professional decisions which you cannot resolve then you MUST follow the escalation process. Escalate to line manager Contact the Trust Safeguarding Team for advice If unresolved Use the Local multi agency protocol to escalate within organisations Navigation Toolbar

For more information or to download these leaflets make a note of and go to the following website: http://www.nspcc.org.uk/inform/trainingandconsultancy/learningresources/coreinfo/coreinfo_wda54369.html Navigation Toolbar

This completes the Children’s section for level 2. Please proceed to the Adults part of the course. Navigation Toolbar