1. Safeguarding Team Rachel Larkin Child Sexual Exploitation Nurse

2. Safeguarding Team Jenny Donnelly Child Sexual Exploitation Nurse

3. Objectives igneneral awareness of CSE amongst health staff. Raise general awareness of CSE amongst health staff. Recognise the signs of grooming and identifying risks Recognise factors that make children vulnerable to CSE Recognise the signs of sexual exploitation and make appropriate referrals to specialist services/other agenciess of sexual exploitation and make appropriate referrals to specialist services/other agencies. al exploitation and make appropriate referrals to specialist services/other agencies. Safeguarding Team

4. Partnership Safeguarding Team

5. Definition Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities. Child sexual exploitation can occur through use of technology without the child’s immediate recognition, for example the persuasion to post sexual images on the internet/mobile phones with no immediate payment or gain. In all cases those exploiting the child/young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Safeguarding Children and Young People from Sexual) Exploitation (2009 )

6. Child Sexual Exploitation Quiz

7. Warning Signs Rapid change in behaviour Poor attendance at school Self harm Low self esteem Repeat STI testing Repeat pregnancy Drug and alcohol misuse Unexplained injuries Delay in presentation or untreated injuries

8. Vulnerabilities Parental Mental health Criminality Substance Use Learrning Disability Missing from Home Recent loss/ bereavement Child Looked After Sexual Orientation Low confidence/ Self esteem Domestic Abuse History of Abuse

9. Grooming Line Activity

10. Grooming Line

11. Grooming Types Boyfriend/ Girlfriend PartyLone OffenderPeer Organised/Group Offender Internet/ Social Media

12. Ryan’s Story

13. Health Role of the school nurse The Department of Health 2014 have released a pathway helping school nurses to tackle CSE. School nursing teams have a role in raising awareness and supporting children at risk of sexual exploitation. School nursing teams must offer a quality service which improves the health outcomes for children at risk of sexual exploitation. School nursing teams have a role in leading, coordinating and contributing to supportive partnerships with other agencies.

14. Impact of CSE on Health Emotional Health Self-Harm Poor or Deteriorating Mental Health Eating Disorders Post Traumatic Stress Disorder (PTSD) or Flashbacks Suicide Effect on families Safeguarding Team Physical Health Physical Injuries Unexplained Medical Symptoms Sleep Disorders Alcohol and Substance Misuse Change in Physical Appearance

15. Impact of CSE on Health Others factors which can impact on Health Running away / Missing From Home Bullying through the Internet or Social Media Becoming Alienated from Family Members Criminal/ Offending Behaviours Poor or Non Attendance at School, resulting in exclusion Safeguarding Team Sexual Health Repeated Sexually Transmitted Infections (STI’s) Unwanted or Unplanned Pregnancies Repeated Terminations Long term complications Reluctance to Access Sexual Health Services

16. Case Study

17. Drivers for Change Anne Coffey report-Serious case reviews @ Real Voice (MP greater Manchester)2014 Department of Health – Health Working Group on CSE 2014 Office of the Children’s Commissioner 2014 See Me, Hear Me Framework National Working Group – If you shine a light you will probably find it - Dr Kirtley - 2014

18. Sexual Offences Act 2003 The law says it is an offence to… Sexually touch or penetrate a person of any age without their consent Sexually touch or penetrate a child under 16, even with their consent Cause or incite a child under 16 to engage in a sexual act Meet a child following sexual grooming Cause or incite a person under 18 to be involved in pornography or prostitution Cause or incite a child to watch a sexual act (live or recorded) Engage in a sexual act in the presence of a child under 16

19. Things to know…… Offences against children under 13 years- the offender cannot claim the defence of having believed the person to be 16 or over (statutory rape) Sexual offences can be committed by males or females. The law applies to homosexual and heterosexual acts Although a 16 or 17 year can consent to sexual activity, prostitution and pornography are illegal. This includes the distribution of indecent images of young people via mobile phones and internet!

20. Things to remember…. Although sexual activity under 16yrs is illegal, the law is not intended to be used to prosecute willing sexual activity between people of a similar age Professionals who are aware of sexual activity with 13-15 year olds will consider whether the relationship is exploitative before taking the matter further…but it is illegal! If a professional becomes aware of any sexual activity involving a child less that 13 years they will report it as a child protection issue and it will be investigated

21. Role of the CSE Nurse The role of the CSE nurse is to ensure that the physical, emotional and sexual health needs of young people experiencing (or at significant risk of) exploitation are being met. Comprehensive Health Assessments Providing Packages of Care Emotional Health Support and Advocacy Confidence and Resilience Building Health Screening Crisis Management Health and Lifestyle Advice and Guidance Support through Investigations/Assessments Liaison with Other Health Services Safeguarding and Confidentiality Safeguarding Team

22. CSE Divisional Teams Deter Team - Preston, Chorley and South Ribble and West Lancs. 01772 209122/01695 566117 Awaken Team - Blackpool Fylde and Wyre and Lancaster- 01253 477349 Engage Team- Blackburn with Darwen, Hyndburn Ribble Valley, Burnley, Pendle and Rossendale. 01254 353589/353651. Safeguarding Team

23. Referral Pathway Speak to Engage for advice on 01254 353589/353651. Speak to E Speak to Engage for advice on 01254 353589/353651 ngage for advice on 01254 353589/353651. Deter Team - Preston, Chorley and South Ribble and West Lancs. 01772 209122/01695 566117 Awaken Team - Blackpool Fylde and Wyre and Lancaster- 01253 477349 Engage Team- Blackburn with Darwen, Hyndburn Ribble Valley, Burnley, Pendle and Rossendale. 353589/353651. Lancashire cases email: engage@lancashire.pnn.police.uk BwD cases refer into the MASH team: cypreferrals@blackburn.gcsx.gov.uk RRo your relevant Safeguarding Te Rachel Larkin : 07939982249 Speak to your relevant Safeguarding Team