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SAFEGUARDING CHILDREN & ADULTS (NON-CLINICAL STAFF) SEPT - MANDATORY TRAINING

On completion of the Level 1 course, you will have a basic understanding of: The Trust Safeguarding arrangements for children and adults; Your professional responsibility in relation to safeguarding children and adults; The definition of child/adult abuse and categories Know what to do if you are concerned for a child or adults welfare; Know how to access further information On completion of the Level 1 course, you will have a basic understanding of: The Trust Safeguarding arrangements for children and adults; Your professional responsibility in relation to safeguarding children and adults; The definition of child/adult abuse and categories Know what to do if you are concerned for a child or adults welfare; Know how to access further information Safeguarding Course LEVEL1 This Safeguarding Children and Adult LEVEL 1 course is for ALL non clinical staff Definition of abuse (children) The fact that we have all been children means that we will often have different opinions of what constitutes abuse. However the Government Policy document Working Together to Safeguarding Children 2010, refers to a 'child' as those up to their eighteenth (18th) birthday and defines abuse as: "A child who may suffer or be at risk of significant harm, including impairment suffered from seeing or hearing the ill-treatment of another", for example Domestic Abuse.

SEPT - MANDATORY TRAINING Abuse can occur within the family, an institution or community setting. Abuse can occur in all social groups regardless of religion, culture, social class or financial position. Children may be abused by those known to them or more rarely a stranger. They may be abused by an adult(s) or another child(ren). Working Together to Safeguarding Children 2010 states that: Mental Health Services, including those providing general adult and community, forensic, psychotherapy, alcohol and substance misuse and learning disability services, have a responsibility in safeguarding children when they become aware of or identify a child at risk of harm. This may be as a result of service’s direct work with those who may be mentally ill, a parent, a parent-to-be, or a non-related abuser, or in response to a request for the assessment of an adult perceived to represent a potential or actual risk to a child or young person’ Safeguarding children is everyone's responsibility. All staff have a statutory duty to report concerns regarding a child's welfare to their Line Manager or the Safeguarding Team. Staff must record all details and actions taken following a concern or allegation as per Trust Safeguarding Children policy

SEPT - MANDATORY TRAINING Categories of abuse (children) Child abuse can take many forms, but is usually divided into four categories. Physical Abuse The following is not a comprehensive or definitive list but provides a guide to the more common non- accidental injuries. Any injury which the child, parent, carer tries to hide or give several diffferent or unlikely explanations, should raise concerns. In these circumstances advice should always be sought. Physical abuse involves, hitting, shaking, throwing, poisoning, burning, scalding or suffocating. Bruising on uncommon sites for example, buttocks, mouth, cheeks, under the arm, genital area or neck may etc. may indicate physical abuse. Indicators that should also cause concern are bruises; On a non-mobile child Multiple bruises or bruises in clusters On any non-bony part of the body or face including the eyes, ears and buttocks On the neck i.e.attempted strangulation, or ankles and wrists that resemble ligature marks Bites can leave a clear impression and abuse should be considered as a possibility especially one that is thought unlikely to have been caused by a young child. An animal bite on a child may indicate inadequate supervision of the child or neglect. Physical abuse may occur where a parent fabricates or deliberately induces illness in a child (Fabricated or Induced Illness). Sexual Abuse Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including sexual exploitation (used for prostitution) whether or not the child is aware of what is happening.

SEPT - MANDATORY TRAINING The activities 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 thosed via the internet, webcams, cameras, mobile phones, or encouraging children to behave in sexually inappropriate ways. Signs which could indicate sexual abuse including: Children displaying sexualised behaviour or language Wetting/Soiling/Self Harm Withdrawn behaviour Running away Child/Young person that has money or gifts that they cannot account for or want to discuss Staff who are aware of a child that has contact with an adult with prior allegations or convictions of sexual abuse should be reported to the line manager or Safeguarding team Pregnancy in a young person or a concealed pregnancy may also raise concerns of sexual abuse. Emotional Abuse Persistent emotional ill treatment which causes severe and persistent effects on the child’s 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. Indicators include: Conveying to children they are worthless or unloved Causing children to feel frightened or in danger, e.g. witnessing domestic violence. Negativity or hostility towards a child or young person Rejection or scapegoating of a child or young person. Using the child for the fulfilment of the adult’s needs (for example, children being used in marital disputes).

SEPT - MANDATORY TRAINING Neglect Involves the persistent failure to meet the child’s basic physical and or psychological needs, likely to result in impairment of health and development. For example, During pregnancy as a result of maternal substance misuse Repeated failure to attend health appointments or school Failure to provide food, warmth and clothing Child persistently dirty and smelly Poor supervision- young children left alone These categories overlap and an abused child frequently suffers more than a single type of abuse Risk Factors (children) Staff should be aware of factors affecting parents that may also have an impact on a child/rens welfare, such as: Domestic abuse / violence This can have a serious impact on a child’s development and emotional well being. Children can be at risk of physical injury including harm to the unborn child. Research indicates a strong link between domestic violence and other forms of abuse. Parental drug and alcohol misuse Misuse of drugs (prescribed or illegal) and or alcohol is strongly associated with significant harm to children (and the unborn during pregnancy) especially when combined with other features such as domestic violence, mental illness.

SEPT - MANDATORY TRAINING Parental mental health 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. Associated risks include Delusional beliefs which include the child Children witnessing parental self harming behaviour Suicidal ideation involving a child Conditions affecting parenting capacity-e.g post natal depression Previous Risks This applies to those parents or carers where it is known that there have been previous Safeguarding children concerns, for example; Those known to be a Risk to a Child (formerly a Schedule 1 Offender) Previous children subject to a Safeguarding Plan ( Child Protection Register )

SEPT - MANDATORY TRAINING Safeguarding Adults LEVEL 1 Safeguarding Adults : Definition Safeguarding Adults refers to any person aged 18 or over who: "...is or may be in need of community care services by reason of mental, physical or learning disability, age or illness and who is or may be unable to take care of himself or unable to protect himself against significant harm or serious exploitation which may be occasioned by actions or inactions of other people." Abuse is defined as ;'a violation of an individual's human and civil rights by any other person or persons. It may involve a single or repeated act or omission, occurring within a personal or close relationship where there is an expectation of trust, which causes harm to a vulnerable adult see Trust Safeguarding Policy & Procedures and Department of Health No Secrets 2000) Categories of Abuse (Adults) Categories of abuse are similar to those of children but include, Financial, Institutional and Discriminatory Abuse. Physical Many of the descriptors for children also apply to adults such as hitting,shaking, kicking, biting. The following may also apply to adult abuse

SEPT - MANDATORY TRAINING Misuse of medication Restraint or inappropriate handling Bruising not consistent with explanation given Unexplained injuries such as fractures. Repeated falls Pressure sores Discriminatory Racist or sexist remarks or abuse related to the persons age, illness, disability or culture, are all indicators of discriminatory abuse. Indicators may include: Forced marriage Incitement of others to commit abuse based on difference Lack of equal access to healthcare, etc. Sexual Including rape, sexual assault and sexual acts to which the person has not consented to or where pressure was applied to secure their consent. This may include the promise of,money, rewards or gifts in return for sex Sexual abuse also includes inappropriate touching and coercion of the person to look at sexual acts or images via the internet, photographs etc Psychological / Emotional Including verbal abuse, deprivation of contact, intimidation, isolation and withdrawal of services. Emotional Abuse also includes threats of

SEPT - MANDATORY TRAINING Abandonment Institutional Care Deprivation or control of access to room, phone, post, visitors Financial / Material Including theft, fraud, exploitation and pressure in connection with wills, property, bank accounts, inheritance or benefits. Financial abuse also includes deception and the threat of deprivation in order to obtain money or material gain Institutional Institutional abuse includes a rigid and fixed regime, the inappropriate use of medical or nursing procedures to make clients easier to manage rather than for their health needs. Examples of institutional abuse can include the use of : catheterisation sleeping tablets unauthorised use of control or restraint oppressive atmosphere lack of dignity and privacy dirty, unsafe environment Complaints made by ex-staff, visitors and or residents of a home or institution may be indicative of institutional abuse and should be reported to your line manager or the Trust Safeguarding Team Neglect Failure to protectant from harm or abuse Failure to give access to services such as health, social services, police etc. Withholding access to toilet, keep warm clean and comfortable. Withholding or inadequate provision of ‘necessaries’, e.g. nutrition, heating, medication, healthcare, social stimulation.

SEPT - MANDATORY TRAINING Message from Research (Adults) Victims Those most vulnerable to abuse include: People dependant on others for assistance, especially with finances and personal care Those with mental incapacity or fluctuating capacity Those with communication difficulties and or decreased mobility Those living in isolation or in a home, residence but without visitors Those subject to hate crime Perpetrators Research on abuse to adults, suggests that the following people can abuse others; Adult children Carers Husband/wife/partner Doctor/Nurse Social Worker/Carer Other professionals or people with access to the vulnerable person Friends/Neighbours Messages from Research The findings from the research carried out by Action on Elder Abuse (Hidden Voices) in 2005 demonstrated that 1 in 10 over 65 experience abuse; 1 in 5 with a disability experience abuse; Only 1 in 8 situations are reported; 99% of vulnerable adults reporting abuse know the abuser;

SEPT - MANDATORY TRAINING What to do if concerned Professional Responsibilities for Safeguarding All staff have a duty to report any concerns for the welfare of a child or adult to their line manager or the Safeguarding team. Staff should be aware of how to access the Trust Whistleblowing policy Consent and Confidentiality Staff cannot give assurance of confidentiality where there are concerns about abuse or the risk of significant harm. Consent to share information should always be sought where possible, but may not be required for the following circumstances; Where seeking permission is likely to increase risk Permission has been refused but sufficient professional concern remains to justify disclosure Seeking permission is likely to impede a criminal investigation Where failure to disclose information may expose others to risk of death or serious harm What to do if you are concerned for the welfare of a child or adult: Ensure client's immediate safety. Access emergency assistance if necessary. Inform your Line Manager or the Trust Safeguarding Team. For outside normal working hours contact the Manager on call via switchboard. Record all information and actions clearly with your name, designation, signature and date. Complete the appropriate referral form for your area if required Access to further information Information can be accessed via the Safeguarding site on the Trust Intranet via the 'Library' link. This includes National, Local and Trust polices and referral forms.

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