1. Working with the people of Camden to achieve the best health for all
Level 1 Safeguarding Children Training
For Practice Managers & Admin Staff
Jackie Dyer -Designated Nurse
July 2015
Working with the people of Camden to achieve the best health for all

2. Working with the people of Camden to achieve the best health for all
Aim of the session
To develop an awareness of and the ability to act on concerns about the safety and the welfare of children & young people
Working with the people of Camden to achieve the best health for all

3. Working with the people of Camden to achieve the best health for all
Scope of session
Recognise signs & potential indicators of child maltreatment
Understand impact of parent/carer physical and mental health on the well-being and development of a child & young person
What to do if they have concerns about children , in order to safeguard and promote the welfare of children, including those who are suffering or at risk of suffering significant harm
Knowledge of the relevant legislation Children Acts 1989 , 2004 & Sexual Offences Act 2003
Working with the people of Camden to achieve the best health for all

4. Definition of Safeguarding
The process of protecting children from abuse, neglect, preventing impairment of their health and development, and ensuring they are growing up in circumstances consistent with the provision of safe and effective care which is undertaken so as to enable children to have optimum life chances and enter adulthood successfully.
(Working Together to Safeguard Children 2015)
Working with the people of Camden to achieve the best health for all

5. Safeguarding Children
A duty to protect children from maltreatment
A duty to prevent impairment
Working with the people of Camden to achieve the best health for all

6. Definition of Child Protection
Child protection is the process of protecting children who have been identified as either suffering, or likely to suffer significant harm as a result of abuse.
The categories of abuse are;
Neglect
Physical
Emotional
Sexual
Working with the people of Camden to achieve the best health for all

7. Definition of Physical Abuse
may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child.
Physical harm may also be caused when a parent fabricates the symptoms of, or deliberately induces illness in a child
Working with the people of Camden to achieve the best health for all

8. Definition of Emotional Abuse
is the persistent emotional maltreatment of a child such as to cause severe and persistent effects on the child's emotional development, and may involve:
Conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person;
Imposing age or developmentally inappropriate expectations on children. These may include interactions that are beyond the child's developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction;
Working with the people of Camden to achieve the best health for all

9. Definition of Emotional Abuse
Seeing or hearing the ill-treatment of another e.g. where there is domestic violence and abuse;
Serious bullying, causing children frequently to feel frightened or in danger;
Exploiting and corrupting children.
Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone
Working with the people of Camden to achieve the best health for all

10. Working with the people of Camden to achieve the best health for all
Definition of Neglect
The persistent failure to meet a child’s basic physical and /or psychological needs, likely to result in the serious impairment of the child’s health and development, such as failing to provide adequate food, shelter and clothing, failing to protect a child from physical harm or danger, or the failure to ensure access to appropriate medical care or treatment.
It may also include neglect of or unresponsiveness to a child’s basic emotional needs.
Working with the people of Camden to achieve the best health for all

11. Definition of Sexual Abuse
Forcing or enticing a child or young person to take part in sexual activities, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (e.g. rape or buggery) or non-penetrative acts.
They may include non-contact activities, such as involving children in looking at pornographic material or watching sexual activities, or encouraging children to behave in sexually inappropriate ways.
Working with the people of Camden to achieve the best health for all

12. Signs of Child Maltreatment
Child Sexual Exploitation (CSE)
FGM
Trafficking
Exploitation by radicalization
Fabricated Illness
Potential Signs
Understanding potential impact of parents/carers mental health,
Domestic Abuse
Risks associated with Intranet & Social Media
Working with the people of Camden to achieve the best health for all

13. What is Child Sexual Exploitation CSE
FGM
Trafficking
Exploitation by radicalization
Fabricated Illness
Potential Signs
Understanding potential impact of parents/carers mental health,
Domestic Abuse
Risks associated with Intranet & Social Media
Working with the people of Camden to achieve the best health for all

14. Trends in Child Sexual Exploitation CSE
Trends in CSE
Trafficked
Online
Opportunistic
Familial
Sexual
Bullying
Older
‘boyfriend’
Gangs &
groups
Child Sexual
Exploitation
Working with the people of Camden to achieve the best health for all

15. Definition of Domestic Abuse
Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass but is not limited to the following types of abuse:
psychological
physical
sexual
financial
emotional
Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.
Coercive behaviour is: an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.”*
*This definition includes so called ‘honour’ based violence, female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group.“ ( Home Office 2013 )
Working with the people of Camden to achieve the best health for all

16. Definition of Domestic Abuse
1in 4 women will experience abuse
12.9 million incidents recorded by British Crime Survey against women, 2.5 million against men
1 call a minute to police
Children living DV represent 2/3 cases CP conference
2 women are killed UK each week
DV is a feature of most CP cases worst outcomes.
Feature in 56% of SCR’s in London
Feature in 62% of child sexual abuse referrals included DV Hester and
Pearson 1998
30% of DV starts or escalates during pregnancy, women are at
greater risk after they have given birth
Working with the people of Camden to achieve the best health for all

17. Working with the people of Camden to achieve the best health for all
Definition of FGM
Female genital mutilation (FGM) form of child abuse, devastating physical & psychological consequences for girls and women.
The World Health Organisation describes it as: "procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons" (WHO, 2013).
Since 1985 it’s been a serious criminal offence under the Prohibition of Female Circumcision Act to perform FGM or to assist a girl to perform FGM on herself.
The Female Genital Mutilation Act 2003 tightened this law to criminalise FGM being carried out on UK citizens over
An estimated 66,000 women with FGM in UK
>20,000 girls under 15 yrs are potentially at risk of FGM (England and Wales)
ref: “A Statistical Study to Estimate the Prevalence of Female
Working with the people of Camden to achieve the best health for all

18. Working with the people of Camden to achieve the best health for all
Camden’s FGM Program
To raise awareness of FGM in training
Develop a process for sharing information in health (midwife/health visitor/school nurse/GP/paediatrician
Make referrals into tertiary local clinics, centralising expertise and services
Liaise with multi-agency groups Police /Social Care
Working with the people of Camden to achieve the best health for all

19. BROACHING THE TOPIC
Using the term mutilation may be upsetting to some patients
Be sensitive and use value-neutral terms
Have you been cut down there?
Were you circumcised?
Have you been closed?
Safeguarding women with FGM and girls at risk of undergoing FGM is everyone’s responsibility

20. Working with the people of Camden to achieve the best health for all
What you should do
Identify FGM in women and girls from affected communities
Give information to empower and support affected women and girls
Refer to specialist services and support organisations
Consider child protection issues – treat as child abuse and inform social services of concerns
Document information and share as appropriate
Consider getting involved in awareness campaigns
Working with the people of Camden to achieve the best health for all

21. Parental Mental Illness & Safeguarding Children
Approximately 30% of adults with mental ill health have dependent children.
The majority of parents with a history of mental ill health do not present a risk to their children.
A wide range of mental ill health can affect parents & their families.
High risk if parents illness incorporates delusional beliefs about the child or include them in suicidal planning
Review of SCR’s show where children had died or been harmed found in 2/3 of cases parents had a current or past history of mental illness
Working with the people of Camden to achieve the best health for all

23. Working with the people of Camden to achieve the best health for all
Private Fostering
Working with the people of Camden to achieve the best health for all

24. Child Protection Guidelines for General Practitioners in Camden
Is the child acutely sick, in pain, bleeding or has “medical” problems?
Yes No
Will the child be at immediate risk of abuse when he/she leaves the surgery?
Discuss with
Mon- Fri 9-5
Child Protection Team Hotline
Tel
Refer for assessment to the Safeguarding Children Clinic
Child Protection Team, Crowndale H.C
59 Crowndale Road, London NW1 1TU
Not Sure
Mon-Fri 9-5
GP Child Protection Lead
Claire Taylor
Designated Nurse for Safeguarding Children Jackie Dyer
Tel
Designated Doctor for Safeguarding Children Deborah Hodes
Duty Social Worker Team
Out of Hours
On call Paediatric Registrar at acute trust
Refer to
Mon - Fri 9 -5
Duty Social Team at MSH Multi-Agency Safeguarding Hub
9am – 5pm
Tel
Tel
Tel
Out of hours
Or dial 999 in emergency
NB. All referrals to be followed in writing within 48hrs
Contact the on-call Paediatric Registrar
University College Hospital
Tel
Whittington Hospital
Tel
Royal Free Hospital
Tel
You see a child and suspect abuse or neglect

25. Working with the people of Camden to achieve the best health for all
National context
Children Acts 1989 & 2004
London Child Protection Procedures 2011
Working Together to Safeguard Children 2015
Munro review of Child Protection 2010/11
Health & Social Care Act 2012
 NHS Commissioning Board – Safeguarding Vulnerable People in the Reformed NHS Accountability and Assurance Framework – March 2013
Working with the people of Camden to achieve the best health for all

26. Local Safeguarding Contacts
Designated Nurse Jackie Dyer
Designated Doctor Deborah Hodes
Named General Practitioner
Designated Doctor for Looked after Children (LAC)
Designated Nurse for LAC
Designated Doctor for CDOP
Camden’s MASH Team
Tel
Tel
Tel
Working with the people of Camden to achieve the best health for all

27. Working with the people of Camden to achieve the best health for all
Further Training
Camden Safeguarding Children Board
Training details can be found at:
Working with the people of Camden to achieve the best health for all