Child Protection and Safeguarding Children Policy

Transcription

1 Eastbourne, Hailsham and eaford CCG Hastings and Rother CCG High Weald Lewes Havens CCG Child Protection and afeguarding Children Policy APPROVED BY: EFFECTIVE FROM: eptember 2015 REVIEW DATE: eptember 2017

2 Policy Category: Relevant to (taff Group): All staff in EH/HR/HWLH CCGs Version History: Version Date: Changes Made: No: 1 Jul 2007 Following consultation with Primary Care Trust (PCT) afeguarding trategic Group. 2 Aug 2007 Review 3 Apr 2008 Formatting and editing to comply with PCT standards 4 Dec 2009 Review V1 / V2 (NH West ussex) 5 May 2012 Review (NH ussex) 6 ept 2012 Review by shadow EH/HR/HWLH CCGs 7 Dec 2013 Review V2 8 ept 2015 Agreed by Quality and Governance Committee. Ratified by Governing Bodies. 8.1 Nov 2015 Policy updated to reflect the a change of provider for the Pan ussex Child Protection and procedures Contents 1. Purpose 5 2. cope and Principles 5 3. Responsibilities 3.1 Chief Officer (EH/HR) Chief Officer (HWLH) Chief Nurse (EH/HR) CCG Governing Body GP Lead for afeguarding Human Resources Designated Doctor and Nurse Named Doctors, General Practitioner, Nurses, 8 Midwives and Professionals 4. Requirements Accountability Procedures Commissioning afer recruitment and Allegation Management 11 2

3 4.5 Training and Development upervision Effective Inter-agency Working Monitoring References 13 Appendices 1 Equality Impact Assessment 2 CCG afeguarding tandards for Commissioned ervices 3 Contacts 4 Training trategy afeguarding Children trategy taff Quick Reference Guide afeguarding Children is a core, statutory responsibility in NH commissioning. All staff working for the Clinical Commissioning Groups (CCGs), regardless of their role or place within the organisation have a responsibility to ensure children are kept safe. ection 11 of the Children Act 2004 places a duty on CCGs to ensure that all services they commission discharge their functions with regard to the need to safeguard and promote the welfare of children. Children are defined as those who have not yet reached their eighteenth birthday. This policy outlines the responsibilities of key members of the CCG Boards, governance arrangements and accountability framework. The policy describes how safeguarding permeates all areas of CCG business including commissioning, learning and development, recruitment and inter-agency working. It describes the statutory functions and essential roles that CCGs should secure. The policy provides an overview of assurance in terms of safeguarding standards and identifies a two year strategy which includes priorities for the safeguarding team. To be read in conjunction with: ussex Child Protection and afeguarding Procedures (2011) and CCG Policies: Data Protection and Confidentiality erious Incident Assurance Records Management Information Governance Freedom of Information Risk Management trategy Policy and Procedures Managing Allegations Against People who Work with Children 3

4 Domestic Abuse Whistle Blowing Compliance with all CCG policies is a condition of employment. Breach of policy may result in disciplinary action All reasonable steps have been taken to ensure that this Policy reflects the: Equality and diversity agenda Relevant articles of the Human Rights Act 1998 Health and afety at Work Act 1974 and associated legislation Freedom of Information Act 2000 Equality Act 2010 ection 11 of the Children Act 2004 places a statutory duty on organisations and individuals, to ensure that their functions are discharged with regard to the need to safeguard and promote the welfare of children (Child Protection). This policy sets out the key arrangements for safeguarding and promoting the welfare of children for Eastbourne, Hailsham and eaford, Hastings and Rother and High Weald Lewes Havens Clinical Commissioning Groups (CCGs). All information in this policy relates to the above CCGs. 4

5 1. Purpose 1.1. This policy sets out the key arrangements for safeguarding and promoting the welfare of children in East ussex. It should be read in conjunction with and supports the multi-agency ussex Child Protection and afeguarding Procedures 2011 available on line at At all levels within the organisations, the CCGs are committed to the promotion of children s welfare and to protecting them from abuse and neglect. The purpose of this policy is to outline the structure and describe the systems that enable the promotion of children s welfare and child protection and to describe monitoring processes. taff must be aware of their role in safeguarding and protecting children. There must be a framework for the development of competence and confidence in this role and appropriate support in order to achieve this ection 11 of the Children Act 2004 places a statutory duty on organisations and individuals, to ensure that their functions are discharged with regard to the need to safeguard and promote the welfare of children. Working Together to afeguard Children (WTTC 2015) sets out how professionals should work together in multiagency teams to promote children s welfare and protect them from abuse. The three Local afeguarding Children Boards (LCBs), West ussex LCB, Brighton and Hove LCB and East ussex LCB jointly provide the procedures that guide those members of staff working across ussex (ussex Child Protection and afeguarding Procedures 2011). The CCGs, as stated above, acknowledge the importance of staff receiving adequate training and supervision The CCGs will safeguard and promote the welfare of children through: Ensuring that there is a commitment throughout the organisations, from top to bottom to safeguard children. Ensuring that the health contribution to safeguarding and promoting the welfare of children is discharged effectively and monitored appropriately across the whole local health economy through commissioning arrangements. Ensuring that there are clear lines of accountability for safeguarding and clear organisational structures to work within. upporting a culture that promotes and enables safeguarding issues to be addressed and decisions, actions and outcomes properly recorded. This policy also gives consideration to meeting the requirements of: tandard 5 - National ervice Framework for Children, Young People and Maternity ervices 2004; and Care Quality Commission outcome 7. 5

6 2. cope 2.1. This policy applies to the three CCGs in East ussex. There is a shared management team and Chief Officer for EH/HR and a separate management team and Chief Officer for HWLH This policy applies to all staff working for the CCGs regardless of their role or place within the organisations, and must be brought to their attention and read by them. The policy is also applicable to contractors and volunteers working within the organisations. Children are defined as anyone under 18 years of age (Children Act 2004) and for the purpose of these procedures in line with ussex Child Protection and afeguarding Procedures 2011 include the unborn child. Reference is made here to the ussex afeguarding Adult policy and procedures that gives guidance in relation to vulnerable adults ection 11 of the Children Act 2004 places a duty on CCGs to ensure that all health providers with whom they have commissioning arrangements discharge their functions with regard to the need to safeguard and promote the welfare of children. CCGs must ensure providers can demonstrate their compliance of safeguarding as described in NH Commissioning Board 2013/14 NH tandard Contract, ervice Conditions (inclusive) and they are required to conform with any legal responsibilities. These will be in line with ussex Child Protection and afeguarding Procedures 2011 and be easily accessible for staff within the organisation providing services commissioned Principles Within ection 1.2 Underlying Policy, Principles and Values of the ussex Child Protection and afeguarding Procedures 2011 is the shared beliefs section, which the CCGs support and endorse. The shared beliefs state that all children have the right to be safeguarded from harm and exploitation whatever their: Race, religion, first language or ethnicity Gender or sexuality Age Health or disability Location or placement Any criminal behaviour Political or migration status 2.5. The CCGs are committed to promoting a culture where employees are able to raise concerns about safeguarding issues and will be supported in doing so. Whistle Blowing Policy is available to staff via the CCG intranets Failure to comply will leave the organisations exposed to challenge by LCB who have a statutory duty to monitor the CCGs compliance with discharging their duties under ection 11 Children Act 2004 and from other inspectorial and regulatory bodies, for example the Care Quality Commission (CQC), the National Patient afety Agency (NPA) and Monitor the independent regulator of NH Foundation Trusts. 6

7 2.7. Promoting children and young people s wellbeing and safeguarding them from significant harm is crucially dependent upon effective information sharing. All employees should follow the guidance in section 2 of the ussex Child Protection and afeguarding Procedures (2011) and the Information haring: Advice for practitioners providing safeguarding services to children, young people, parents and carers (HM Government 2015). 7

8 3. Responsibilities 3.1. Chief Officer (EH and HR) The Chief Officer has ultimate responsibility for ensuring that the health contribution to safeguarding and promoting the welfare of children is discharged effectively across the relevant part(s) of the East ussex health economy through the commissioning arrangements and to ensure the CCG(s) work with the local authority in the operation of the LCB and support the work carried out by the LCB Chief Officer (HWLH CCG) The Chief Officer, HWLH CCG has ultimate responsibility for the day to day delivery of the safeguarding arrangements and is accountable managerially for ensuring the outcomes are delivered. This includes, but is not restricted to, robust CCG arrangements to discharge safeguarding requirements, assurance of staff training and competence, effective partnership working, participation in the LCB and access to clinical expertise. They have delegated some of the responsibilities for delivering the operational functions to the CCG Head of Quality. Together they keep the CCG Governing Body fully informed, to enable the Governing Body to be assured via its governance framework Chief Nurse, (EH CCG and HR CCG) The Chief Nurse has the delegated responsibility from the Chief Officer, EH and HR CCG for the day to day delivery of the safeguarding arrangements and is accountable managerially for ensuring the outcomes are delivered. This includes, but is not restricted to, robust CCG arrangements to discharge safeguarding requirements, assurance of staff training and competence, effective partnership working, participation in the LCB and access to clinical expertise CCG Governing Body GP Lead for afeguarding The CCG Governing Body GP Lead Member for safeguarding is the Member with the day to day delegated responsibility, from the Chief Officer of the CCG, accountable for assuring that the CCG is discharging its responsibilities effectively through the safeguarding arrangements in place to meet legislative, national and local requirements and outcomes. They are responsible at Governing Body level for ensuring safeguarding is central to decision making around commissioned services and in the operation of the CCG. The designated professionals and Named GP have a reporting relationship to the Governing Body GP Lead for afeguarding to ensure access outside the line management arrangements for assurance Human Resources The three CCGs in East ussex commission Human Resource expertise from outh East Commissioning upport Unit (ECU). The relevant Chief Officers hold the responsibility for this contract. 8

9 3.6. Designated Doctor and Nurse Each CCG has a statutory duty to identify a senior paediatrician and senior nurse to undertake the roles of designated professionals for safeguarding children, to take a strategic and professional lead on all aspects of the health service contribution to safeguarding children across the health economy (ection 11 Children Act 2004). Designated professionals may be employed by a Provider ervice and their functions discharged through a ervice Level Agreement (LA). In the case of the designated doctor this will be obligatory as the designated doctor has to be a senior paediatrician employed by an organisation delivering services to children. afeguarding roles and responsibilities should be clearly identified within job descriptions with reference to the competencies identified in the intercollegiate document (2014). The designated professionals are responsible for ensuring that this policy is implemented and that all staff are fully conversant and compliant with the requirement of any other policies, procedures and guidance relating to the protection of children. The designated professionals are also responsible for ensuring that ussex Child Protection and afeguarding Procedures are kept up to date Named Doctors, General Practitioner, Nurses, Midwives and Professionals The CCGs will support health providers with their responsibilities for identifying named doctors, nurses and other health professionals required for their organisation who will take a professional lead within their own organisation on safeguarding children matters (ection 11 Children Act 2004). afeguarding roles and responsibilities should be clearly identified within job descriptions with reference to competencies identified in the Intercollegiate Document (2014). Named professionals will be supported and supervised by the designated doctor and designated nurse. A named GP will support independent contractors in their safeguarding role. Other professionals such as a named dentist could be identified to support dentists in their specialist roles. 9

10 4. Requirements The CCGs are required through ection 11 Children Act to ensure that the following systems are in place. * HWLH CCG Governing Body and GP Lead afeguarding * EH CCG Governing Body and GP Lead afeguarding * HR CCG Governing Body and GP Lead afeguarding ***Lead member Chief Officer HWLH Chief Officer EH/HR Head of Quality HWLH Chief Nurse (EH/HR) Designated Nurse Child afeguarding Designated Paediatrician Child afeguarding Named GP Child afeguarding Lead East ussex Reporting relationship only * - Designated professionals have a reporting relationship to the Governing Body GP Leads for afeguarding 10

11 4.1. Accountability The CCGs have clear lines of accountability within the organisations for work on safeguarding and promoting the welfare of children. Reports will be submitted to the Boards as requested, but at least annually by the Chief Nurse. Reports will provide information on the overall picture of safeguarding children across East ussex, including what is working well and action plans for what needs to be improved. The Governing Bodies delegate to their committees responsibility for monitoring the implementation of this policy. The CCGs are monitored in fulfilling their functions by NH England, CQC, NH Litigation Authority and the LCB. Appendix 1 identifies the safeguarding standards and toolkit that will be used to seek assurance for the CCGs that those providers, services, organisations and independent contractors whose services are commissioned by the CCGs meet these benchmarks. It is a requirement of Working Together (HM Government 2015) that designated professionals will be performance managed in relation to their designated functions by a Board Level Director who has executive responsibility for safeguarding children as part of their portfolio of responsibilities. Where this person is not the Board level lead for Clinical Governance and Clinical Professional Leadership, the designated professionals will also need to work closely with this lead person Procedures The CCGs will ensure that internal procedures are in place to direct staff in meeting the requirements of this policy and that these procedures support and are in line with the ussex Child Protection and afeguarding Procedures, 2011, of the three relevant LCBs. Internal and Pan ussex Procedures will be easily accessible for staff at all levels within the organisation. Internal procedures are available on the Intranet sites: The CCGs will expect that all health providers from whom they commission services both public and independent sector have comprehensive single and multi-agency policies and procedures to safeguard and promote the welfare of children which are in line and informed by the multi-agency LCB procedures, and are easily accessible for staff at all levels within each organisation. This includes specific guidance for staff relating to the action that must be taken following missed health appointments (Reference: CQC 2009 Report following the death of Baby P). Additionally, procedures and training will incorporate the key messages from the counter-terrorism strategy Building Partnerships, taying afe, the health sector contribution to HM Government s Prevent trategy: Guidance for healthcare organisations (DH 2011) and Prevent statutory guidance (2015). 11

12 4.3. Commissioning In commissioning services the CCGs expect that all providers meet the standards as set out in afeguarding tandards for Commissioned ervices in Appendix 2. This includes the commissioning of public health services undertaken by the local authority which includes sexual health, school health services and from October 2015, health visiting and Family Nurse Partnership. As commissioners of these health services, local authorities should liaise with the Designated Nurse as part of their assurance process to ensure that effective safeguarding arrangements are in place within these services to safeguard children and young people. (Accountability and Assurance Framework, NH England 2015) The CCGs must ensure, through commissioning, that paediatricians with expertise in examining, identifying and assessing children and young people who may have experienced abuse or neglect are available to undertake medical examinations under child protection procedures. The fact that children will be seen in a timely manner must be a key consideration. The CCGs will work with ussex Police to develop services for children who, during the course of examination, may require the collection of forensic specimens and ensure that these examinations take place in the appropriate setting with appropriate experienced staff available and that there is expertise available for the on-going care of these young people (GU medicine, sexual health services, psychological support). Reference: Facing the Future; standards for Paediatric ervices. Dec 2010, RCPCH. From April 2015, a Paediatric exual Assault Resource Centre (ARC) in Brighton will provide a comprehensive service for ussex children up until their 14 th birthday; this will include forensic and historical examinations. All requests for a forensic examination must come from a social worker or police officer. From July 2015, all concerns regarding child sexual abuse (CA), both forensic and historic, will go centrally to the Brighton Hub. Children will then be seen in the most appropriate setting, either locally by their local paediatrician or at the Brighton CA Hub afer Recruitment The CCGs, in partnership with ECU, will ensure recruitment and Human Resource management procedures take into account the need to safeguard and promote the welfare of children and young people, including arrangements for appropriate checks on new staff and volunteers. The trust will ensure that managers have access to training in safer recruitment practices. The CCGs will work to ensure that at least one person on an interview panel recruiting for a post that involves working with children will have undertaken safer recruitment training. The CCGs have in place procedures for dealing with allegations of abuse against members of staff and volunteers who work with children, and for monitoring and evaluating the effectiveness of those procedures (available on staff Intranet). 12

13 4.5. Training and Development All staff and those services contracted by the CCGs should ensure that they are trained appropriately, are competent to be alert to potential indicators of abuse or neglect in children and know how to act on their concerns consummate to their role. This should be in line with the Intercollegiate Document Individual agencies are responsible for ensuring that all their staff are competent and confident in carrying out their responsibilities for safeguarding and promoting children s welfare (WTTC 2015). taff should also be made aware of the HM Government guidance What to do if you re worried a child is being abused- Advice for practitioners (2015) (Appendix 4) This includes: Child Protection awareness is included in the mandatory Induction programme for the CCGs and all contracted and commissioned services. There is a tiered approach to child protection training and development requirements for all staff and there is a training strategy in place to support this (as per 'WTTC 2015 and Intercollegiate document 2014). The CCG support and promote inter-agency training provided by the East ussex LCB. The CCGs will ensure there are protected resources and funding available for child protection training for designated and named staff. All staff must: Be aware of the risk factors for child abuse this includes situations where adults may pose a risk to children. Know how to recognise the different forms of abuse. Know how to act if a child s welfare or safety may be at risk. Be aware of local procedures in child protection. Know the names and contact details of named and designated professionals Ensure they have access to adequate training, relevant to fulfil the responsibilities of the post upervision All staff working for the CCGs have access to child protection supervision through the designated professionals. For those services commissioned and contracted by the CCGs, all members of staff whose work brings them into direct contact with children and families should have access to regular structured supervision. This should be clearly defined in the internal Child Protection Procedures of that organisation Effective Inter-agency Working It is the philosophy of the CCGs is to work collaboratively with other organisations to safeguard and promote the welfare of children and work within the information sharing guidance of the LCB Procedures. The CCGs are committed to supporting the work of the LCB and to ensuring that there is senior representation on the LCB Board, teering Group and LCB subgroups as appropriate. The CCGs will support the LCB with expertise from the Designated Nurse and Doctor as expert professional advisors. The CCGs will work with the Local Authority to commission and provide coordinated and, wherever possible, integrated services. 13

14 4.8. Monitoring The CCGs will ensure that safeguarding the welfare of children is integral to clinical governance and audit arrangements. This policy will be implemented and monitored through the CCG governance frameworks. This Policy, which includes standards to be monitored, will be attached to every contract pertaining to Children s ervices. The CCG policy on the erious Incident Assurance will be followed and all incidents related to safeguarding or child deaths reported appropriately and monitored through the erious Incident crutiny Group. All erious Case Reviews involving the health services across East ussex will be coordinated by the relevant Designated Professionals and NH England will be kept informed. The CCGs will require all NH Providers to give assurance that they are protecting children by following national guidance, both internally and in their working with other organisations, and can evidence that their safeguarding responsibilities are being fulfilled (see appendix 1). 5. References CM 5730 (2003) Every Child Matters. London, The tationery Office. HM Government (2015) Working Together to afeguard Children: A guide to interagency working to safeguard and promote the welfare of children. The tationery Office. HM Government (2015) Information haring: Advice for practitioners providing safeguarding services to children, young people, parents and carers. Royal College of Paediatrics and Child Health (2014) afeguarding Children and Young People: Roles and Competences for Health Care taff (Intercollegiate Document). ussex Child Protection and afeguarding Procedures (2011). ection 11, Children Act, HM Government (2015) What to do if you re worried a child is being abused- Advice for practitioners. NH Commissioning Board 2013/14 NH tandard Contract. NH England afeguarding Vulnerable People in the NH- Accountability and Assurance Framework July

15 Appendix 2 ussex CCG s afeguarding tandards Guidance Version: 2 Ratified by: Brighton and Hove CCG Performance and Governance, Coastal West ussex CCG Quality Committee, Crawley, Horsham and Mid ussex CCG s Quality and Clinical Governance Committee, High Weald, Lewes Havens CCG, Hastings and Rother CCG and Eastbourne, Hailsham and eaford CCG Date ratified: 26 May 2015 Name of originator/author: Name of responsible committee/individual: ussex Designated Adult and Child Nurses Brighton and Hove CCG Performance and Governance, Coastal West ussex CCG Quality Committee, Crawley, Horsham and Mid ussex CCG s Quality and Clinical Governance Committee, High Weald, Lewes and Havens CCG, Hastings and Rother CCG and Eastbourne, Hailsham and eaford CCG Date issued: May 2015 Review date: May 2017 Target audience: All Clinical Commissioning Groups across ussex Document status: Document location: Document history: Version Created by Date Main Changes/Comments 1.0 Naomi Cornford arah mith Comments by A Hempstead 2.0 Debbie Barnes arah mith June Hopkins Comments by Jerram, Ian Wilson 15

16 This document applies to commissioners and all services commissioned by the Clinical Commissioning Groups across ussex, and provides them with safeguarding standards for: trategic leadership Leading effectively to reduce the potential of abuse Responding effectively to allegations of abuse afeguarding practice and procedures taff competence afer recruitment Learning from incidents Commissioning afeguarding data requested by Department of Health The Clinical Commissioning Groups across ussex actively challenge discrimination and promote quality. We will not restrict assessment, treatment, therapy or care on the basis of race, age, disability, gender, transgender, religion or belief, or sexual orientation. We are committed to providing services that are excellent, equitable and acceptable to the local community which we serve and strive continuously to improve the patient experience, wellbeing and health outcomes for our local population. 1. Introduction 1.1. Clinical Commissioning Groups (CCGs) across ussex are committed to commissioning services that are excellent, equitable and acceptable to the local community. We strive continuously to improve the patient experience, wellbeing and health outcomes for our local population We are setting in place rigorous quality and safety systems and processes in order to achieve continuous improvement and this afeguarding tandards Guidance forms part of that system. Anyone working in, or coming into contact with, health services for which CCGs are responsible should expect to be treated in accordance with national safeguarding recommendations, and children and adults should be particularly considered and protected in all clinical activity This guidance enables commissioning staff, providers and independent contractors to identify the key benchmarks to ensure an effective, systematic, auditable approach to ensuring the safeguarding of all patients/clients, whatever their age. The document will enable organisations, services and practices to audit themselves against the benchmarks and, where necessary, put in place effective systems to ensure effective safeguarding of children and adults The document supports the national guidance and statutory regulations related to child and adult safeguarding and the requirements identified within the multi-agency ussex afeguarding Children Boards, and ussex afeguarding Adults Boards CCGs will require assurance that providers, services, organisations and independent contractors whose services we commission meet these benchmarks. 2. afeguarding Children and Adults 2.1. All children and adults have the right to be protected from harm. 16

17 2.2. Child protection has a long history within both health and social care, and there have been many notable incidents where it has been evident that organisations have not worked effectively to protect and minimise risk. The Inquiry into the death of Victoria Climbie, the oham murders and, more recently, the death of Peter Connelly (Baby P) have been tragic events that have led to new legislation and national recommendations. The Children Act (ection 11) and the revised Working Together to afeguarding Children (2013) 2 both clearly identify requirements of all agencies and go beyond the historical management of child protection to ensure holistic consideration of the safety of children and young people in the broadest sense. This also places responsibility on all practitioners to take account of the safety of children and of the CCGs, as commissioners, to ensure safe practices of all its commissioned services Adult safeguarding has been a more recent development and now has statutory requirements and guidance following the implementation of The Care Act in April The CCGs in ussex are committed to ensuring a framework for protecting both children and adults, following best practice, and this guidance will reflect that commitment. The Mental Capacity Act 2007 (MCA) 4 and the Deprivation of Liberty afeguards (DoL) 5 implemented in April 2009 have placed an increased emphasis on, and a statutory framework for, protecting adults CCGs are committed to supporting multi-agency policies, training, education and recommendations from The Care Act Adults who are susceptible or subjected to abuse or mistreatment will receive the highest priority for assessment and support. All agencies will respond to concerns with prompt, timely and appropriate action in line with agreed policies There are clearly identified processes for initiating a child protection referral or an adult safeguarding concern, and organisations must ensure that staff understands how to protect children, young people and adults at all levels across the organisation. There needs to be general awareness and understanding at all levels and a tiered level of knowledge and skills to support this afeguarding is wider than the traditional protection that clinical staff has familiarity with. This involves considering the interests and safety of all children, young people and adults in the broadest sense as well as protecting the vulnerable. This includes being aware of any circumstance which may cause harm, reflecting safeguarding within guidance such as safer recruitment guidance and learning from incidents Responsibility for protecting children, young people and adults does not lie with one individual or group, but with all staff at every level of the organisation. CCGs, service providers and independent contractors should ensure that staff have knowledge and skills to deal sensitively with the various circumstances in which the safeguarding of children, young people and adults is required. 1 Children Act Working Together to afeguard Children DOL 17

18 3. Terminology 3.1. Children A child is anyone who has not yet reached their 18 th birthday, regardless of race, religion, first language, culture, gender, sexuality, health or disability, location or placement, involvement in criminal behaviour, political or immigration status. afeguarding and promoting the welfare of children is defined under the Children Acts 1989 and afeguarding and promoting the welfare of children The process is defined as protecting children from abuse or 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 that enables children to have optimum life chances and enter adulthood successfully Child in Need of Protection The process of protecting individual children identified as either suffering, or likely to suffer, significant harm as a result of abuse or neglect (Working Together, 2015) Children in Need Children who are defined as being in need are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health and development will be significantly impaired without the provision of services, plus those who are disabled Adult safeguarding The Care Act 2014 outlines the scope of adult safeguarding to an individual of 18 years or over who; (a) has needs for care and support (whether or not the local authority is meeting any of those needs) and; (b) is experiencing, or at risk of, abuse or neglect and; (c) as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect afeguarding adults within health care settings Many patients receiving healthcare may fall into the scope of adult safeguarding within the definition in 3.5, whether or not they are already in receipt of social care services. Levels of independence and wellbeing may be affected by health related conditions. A patient s health need may reduce the choice and control they have, their ability to make decisions and to protect themselves from harm. They may be highly dependent upon the health care service for the care they receive. Their personal circumstances and the nature of their treatment may reduce their ability to protect themselves from harm ignificant Harm There are no absolute criteria on which to rely when judging what constitutes significant harm. Working together to afeguard Children (2015) provides guidance and areas of consideration which may include the degree and the extent of physical harm, the duration and frequency of abuse and neglect, the extent of premeditation, and the presence or degree of threat, coercion, sadism and bizarre or unusual 4 Working Together to afeguard Children

19 elements. ignificant harm may occur through a single event or a collection of events Abuse and Neglect These are forms of maltreatment and may be due to inflicting harm or failing to act to prevent harm. Abuse may occur in a family, institution or community setting by those known to individuals or by a stranger. Types of abuse can include physical, sexual, emotional, financial/material and discriminatory. If there are repeated occurrences in a health care setting, this could be considered as institutional or organisational abuse Mental Capacity Act (MCA) The Mental Capacity Act is the statutory framework to protect people who do not have the ability to make decisions for themselves, and for those who have capacity and wish to make plans for the future Deprivation of Liberty afeguards (DoL) The safeguards are designed to protect the interests of an extremely vulnerable group of service users and to: Ensure people can be given the care they needs in the least restrictive regimes. Prevent arbitrary decisions that deprive vulnerable people of their liberty. Provide safeguards for vulnerable people. Provide them with rights of challenge against unlawful detention. Avoid unnecessary bureaucracy PREVENT ection 21 of the Counter-Terrorism and ecurity Act 2015 (Before Parliament ) places a duty on certain bodies, listed in chedule 3 to the Act, to have due regard to the need to prevent people from being drawn into terrorism. PREVENT focuses on all forms of terrorism and operates in a pre-criminal space, providing support and redirection to vulnerable individuals at risk of being groomed in to terrorist activity before crimes are committed. Radicalisation is comparable to other forms of exploitation; it is therefore a safeguarding issue that staff working in the health sector must be aware of. 4. Aims of the Guidance 4.1. The guidance draws on national requirements, statutory guidance and standards to ensure patients/clients of all ages are safeguarded effectively. The standards in this guidance apply to all services commissioned by CCGs, to directly provided services and to independent contractors. It is recognised that there will be different degrees of application dependent on the service provided and the environment in use tatutory/legislative requirements and links afeguarding adults at risk: ussex afeguarding Adult Boards; ussex afeguarding Adults multi-agency policies and procedures: afeguarding children: ussex afeguarding Children Boards; Pan ussex multiagency policies and procedures: Care Quality Commission: Essential tandards of Quality and afety: CQC Essential tandards 19

20 ADA afeguarding Adults: A National Framework of tandards for good practice and outcomes in adult protection work: adass Working Together to afeguarding Children: A guide to inter-agency working to safeguard and promote the welfare of children (2013): Working Together with particular reference to Chapter 2. Pan ussex Multi-agency Procedures to upport People who elf-neglect: elf-neglect Mental Capacity Act and Deprivation of Liberty afeguards: MCA and DoL The Care Act Care Act 2014 Disclosure and Barring / afer Recruitment vetting and barring afeguarding Children and Young People: roles and competencies for health care staff (2014): afeguarding Children and Young People: Roles and Competencies for Health Care taff Department of Health guidance: afeguarding Adults: The role of health services DH afeguarding Adults : the role of health services NH England PREVENT Training and Competencies Framework (2015) 4.3. This benchmarking guidance should be read in conjunction with CCG policies and procedures related to: Quality and patient safety Information governance erious incident management Patient experience 4.4. Each of the standards in Appendix 1 will be identified as statutory, essential or developmental as denoted by, E or D in the right hand column. These can be described as: tatutory: Based on legislation and statutory guidance. Examples might include Mental Capacity Act, Human Rights Act, or Working Together to afeguard Children statutory guidance. Providers cannot operate unless these standards can be met. Essential: Guidelines and best practice (not statutory) and agreed policies and procedures (e.g. multi-agency). Examples might include National Institute for Health and Care Excellence (NICE) guidelines, agreed clinical pathways, training policies etc. Providers should not operate unless these objectives can be met, and if these cannot be met then there should be clear action plans with agreed timeframes on how and when they will be met. Developmental: Locally agreed best practice, research/evidence based. Providers should be working towards these objectives with the support of commissioners and/other agencies. 20

21 5. Benchmarks and expected best practice tandard 1: trategic leadership tandard 2: Lead effectively to reduce the potential of abuse tandard 3: Responding effectively to allegations of abuse tandard 4: afeguarding practice and procedures tandard 5: taff competence tandard 6: afer recruitment tandard 7: Learning from incidents tandard 8: Commissioning tandard 9: afeguarding data requested by Department of Health 21

22 tandard 1: trategic Leadership Benchmark of expected best practice: The strategic lead for safeguarding must ensure that responsibilities to safeguard children and adults are understood and implemented throughout the organisation. To demonstrate standards of best practice for tandard 1, the CCGs, organisations, service providers and independent contractors should ensure that: Number tandard /E/D Method of Gaining Evidence Frequency 1.1 Accountability for, and ownership of, safeguarding is recognised and evidenced by each organisation s executive body 1.2 Clear safeguarding policy is adopted at senior level with the organisation and disseminated to staff at all levels The organisation has an identified strategic lead with clearly defined responsibilities to ensure that their organisations functions are discharged with regard to the need to safeguard and promote the welfare of children and adults The Organisation has an identified PREVENT lead who acts as a single point of contact for the health regional Prevent co-ordinators, and is responsible for implementing Prevent within their organisation. The organisation works collaboratively with other services, teams, individuals and agencies in relation to all safeguarding matters and has safeguarding policies that link with multi-agency policies 1.6 Organisations ensure that safeguarding is included in training strategies and/or training plans 1.7 Organisations ensure that there are an adequate number of sufficiently trained, experienced people in the organisation to work safely and effectively to protect children and adults, and improve outcomes KPI contract monitoring Bi-monthly 22

23 The organisation has a lead operational role for child safeguarding, and lead operational role for adult safeguarding with clearly defined responsibilities E The organisation through the operational lead will establish links with the local and regional safeguarding networks and committees E Organisations will have a clear structure and dissemination process to ensure that all personnel understand their place in the organisation and how they receive supervision and guidance in their work with children and/or adults Organisations must ensure that they have effective systems in place to highlight and respond to shortfalls in capacity which have an impact on their ability to meet their safeguarding responsibilities E E Organisations must notify commissioners of any CQC inspection related to safeguarding and the outcome E Each organisation cross-references its safeguarding plans with its core business plans and includes standards and targets relating to safeguarding in them D Bi-monthly report ite Visit Bi-monthly Each organisation produces an annual safeguarding report which is signed off at Board level E 1.15 Each organisation is required to have a safeguarding audit plan that included information on the audit process, involvement of managers and staff and how the findings from audit will be disseminated E = tatutory, E = Essential, D = Developmental 23

24 tandard 2: Lead effectively to reduce the potential of abuse Benchmark of expected best practice: Organisations must ensure that people who use services are protected from abuse, or the risk of abuse, by taking reasonable steps to identify the possibility of abuse and prevent it before it occurs. To demonstrate standards of best practice for tandard 2, the CCG, organisations, service providers and independent contractors should ensure that: Number 2.1 tandard Organisations have processes and procedures in place to enable staff to confidentially report any concerns they have about another individual s practice or behaviour, and/or organisational practice in relation to children and adults, which may place them at risk of harm ( whistleblowing policy) /E/D Method of Gaining Evidence Frequency There are policies in place to ensure that organisations meet their obligations under the Equality Act 2010, and staff understand the implications of the policies in contributing to improved outcomes for children and adults ite Visit Each organisation has a clear, well-publicised policy of zero tolerance of abuse within the organisation E 2.4 afeguarding information, updates, newsletters and learning from erious Case Reviews, Learning Reviews and Domestic Homicide Reviews are disseminated through a clear process within the organisation E ite Visit Audit programme 6 monthly 2.5 taff understand how diversity, beliefs and values of people who use services may influence the identification, prevention and response to safeguarding concerns E ite Visit Audit Programme 6 monthly 2.6 Each partner organisation has clear, accessible and well-publicised complaints procedures. This includes information about how to complain to external bodies such as regulators and service commissioners, and is cross-referenced E ite Visit 24

25 with the safeguarding procedures. Relevant advocacy and advisory services are well publicised. 2.7 People who use services understand the aspects of the safeguarding processes that are relevant to them D ite Visit Audit Programme 6 monthly = tatutory, E = Essential, D = Developmental 25

26 tandard 3: Responding effectively to allegations of abuse Benchmark of expected best practice: The organisation must make suitable arrangements to ensure that service users are safeguarded by responding appropriately to any allegation of abuse. To demonstrate standards of best practice for tandard 3, the CCGs, organisations, service providers and independent contractors must ensure that: Number tandard taff respond immediately to ensure that children and adults are protected from further harm where abuse is suspected or identified Immediate consideration is given as to whether a criminal offence has taken place and this is reported to the police. taff seek advice from the police where there is any uncertainty. The organisation has a process for identifying any safeguarding incidents for children or adults and reviewing their practice in line with pan-ussex multiagency policies and procedures There is a written procedure in place for managing allegations and complaints made against staff who work with children or adults which is compliant with the pan-ussex multi-agency safeguarding procedures /E/D Method of Gaining Evidence ite Visit Audit programme ite Visit Audit Programme Exception report of incidents raised Frequency 6 monthly 6 monthly Bi-monthly All serious incidents/grievances involving staff, where there are child protection or adult safeguarding concerns, are discussed with and, where appropriate, formally reported to the local authority The organisation must have systems in place to respond to adult and child safeguarding investigations, serious incident investigations, serious case reviews, safeguarding adult reviews and domestic homicide reviews as Exception report ite Visit Audit Programme Exception report Bi-monthly 6 monthly Bi-monthly 26

27 required. taff co-operate and work collaboratively, and in a timely fashion, with all relevant services, teams and agencies during any investigative process 3.7 There is a nominated person in the organisation trained to handle complaints and allegations against staff E 3.8 taff should have access to specialist advice and support when part of a safeguarding investigation or enquiry and, where appropriate, staff and staff groups should be provided with debriefing/supervision E KPI contract monitoring Bi-monthly 3.9 People who use services that have been abused (or are suspected of being abused) are supported by the service to take part in the safeguarding process to the extent to which they want or are able to, or to which the process allows. They are kept informed of progress. E Audit programme Audit programme = tatutory, E = Essential, D Developmental 27

28 tandard 4: afeguarding practice and procedures Benchmark of expected best practice: National and regional safeguarding procedures are followed at all times. To demonstrate standards of best practice for tandard 4, the CCGs, organisations, service providers and independent contractors should ensure that: Number tandard Method of Gaining Frequency /E/D Evidence There are clear safeguarding procedures that are followed in practice, 4.1 monitored and reviewed ite visit Audit Programme The Organisation must have policies that include the principles of the Prevent 4.2 NH guidance and toolkit, which are set out in Building Partnerships, taying afe: guidance for healthcare organisations 4.3 Health organisations are required to submit the number of PREVENT referrals made by their organisation to the CCG E KPI Contract Monitoring Bi - Monthly 4.4 Agencies must demonstrate in their assessments that the young persons or adults wishes and feelings are effectively heard in accordance with guidance Audit Programme ite Visit 6 monthly 4.5 There is written policy readily available to staff on record keeping, information sharing and information governance compatible with multi-agency guidance and procedure and statutory guidance 4.6 Where any form of control or restraint is used the organisation must have suitable arrangements in place to protect service users against the risk of such control or restraint being unlawful or otherwise excessive 4.7 All organisations are required to understand their legal responsibilities under the Mental Capacity Act. Policies on consent to examination or treatment must include compliance with the Act and CQC standards KPI Contract Monitoring 6 monthly 28

29 All organisations must ensure that people that they care for in care homes and hospitals who lack capacity are not unlawfully deprived of their liberty (see Deprivation of Liberty afeguards link on page 5 for criteria) Up-to-date Pan-ussex afeguarding Multi-agency procedures are available and easily accessible to all staff working with patients (or patient records) at all levels within the organisation E KPI Contract Monitoring Audit Programme ite Visit ite Visit 6 monthly 4.10 Each organisation has a set of internal guidelines, consistent with the local multi-agency safeguarding policy and procedures for children and adults, which set out the responsibilities of all workers to operate within it. This includes clear up-to-date local information on who/how to contact for advice and support E 4.11 A dissemination process for all policy and procedure is in place across the organisation, including updates and reviews, and there is clear evidence of staff being accountable for receiving and understanding the procedures E ite Visit Action plans are developed to address any areas of risk or non-compliance with safeguarding requirements Organisations will have a process in place to ensure that risks to children and adults are appropriately documented, as well as any actions taken or advice given to mitigate against that risk E E Exception reporting of risks Audit Programme ite Visit Bi-monthly 6 monthly = tatutory, E = Essential, D = Developmental 29