Safeguarding Children and Young People Policy

Safeguarding Children and Young People Policy Version 1.0 Date: August 2012 Agreed by Quality Committee Approved by Nene CCG Governing Body on 22 nd August 2012 Review Date: August 2013

Document Management Title of Document Type of Document Description Safeguarding Children and Young People Policy (Commissioning) The policy outlines responsibilities for safeguarding children and young people in line with statutory guidance and policy, and supports the ethos of safeguarding children is everybody s business. The purpose of the policy is to ensure all staff, including contracted staff, are aware of their roles and responsibilities for safeguarding children and young people, and to provide a framework for accountability at all levels. Target Audience All Staff in NHS Nene Clinical Commissioning Group and NHS Corby Clinical Commissioning Group, Independent Contractors Author Department Directorate Cathy Sheehan, Designated Nurse Safeguarding Children and Looked After Children Safeguarding Quality Approved by Date of Approval Version Number 1.0 Next review date April 2013 Related documents Safeguarding Adults Superseded document 2

Internal distribution External distribution Availability Contact Details (of main contact for this document) All ratified policies, strategies, procedures and protocols are published on the Trust Intranet and Public Website Name: Cathy Sheehan Address: Francis Crick House, Summerhouse Road, Moulton Park, Northampton, NN3 6BJ Tel: 01604 651711 E-mail: cathy.sheehan@northants.nhs.uk 3

CONTENTS SECTION DESCRIPTION PAGE 1. Introduction 5 2. Scope of Policy 7 3. Definitions 7 4. Policy Statement 8 5. Roles and Responsibilities 9 6. Staff Training, Support and Professional Development 11 7. Recruitment and Personnel Processes 12 8. Prevent 12 9. Commissioning Arrangements 13 10. Clinical Governance 14 11. Serious Case Reviews 14 12. Review and Maintenance of Policy 15 References and Bibliography 16 4

1. Introduction - Context This document defines the Safeguarding Children Policy for NHS Nene Clinical Commissioning Group and NHS Corby Clinical Commissioning Group, hereafter referred to as the CCGs., This policy illustrates the statutory requirements to safeguard children, and standards for compliance with these legislative duties, and with local and national safeguarding quality assurance frameworks. It supports the ethos that safeguarding children is everybody s business. It is applicable to all staff. Northamptonshire PCT is the current statutory commissioning organisation for Northamptonshire. The PCT Cluster Chief Executive remains responsible for ensuring that the duties to safeguard children and adults within Northamptonshire are discharged effectively across the whole health economy. Under the Health and Social Care Act 2012, many of the statutory PCT duties to safeguard children will pass to the CCG s as of 1 st April 2013. The PCT and the CCGs have agreed a scheme of delegation that will allow the CCGs to assume responsibility for these safeguarding duties in the interim. Responsibility for commissioning primary care independent contractor services (general practice, NHS dentistry, and community pharmacy and orthoptic services) currently remains with the PCT, along with a duty to ensure that children are effectively safeguarded in these services. The commissioning responsibility for these services will pass to the NHS Commissioning Board as of 1 st April 2013. The PCT and CCG s have a responsibility to ensure that children are effectively safeguarded by the services they commission. All provider health organisations commissioned by the PCT and CCG s must have their own polices for safeguarding children, which must be consistent with this policy, and in line with their own statutory responsibilities and with Northamptonshire Local Safeguarding Children Board child protection procedures. This document should be read in conjunction with: Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children, HM Government, 2010. (A revision of this statutory guidance is currently being consulted on, with consultation ending on 4 th September 2012) Northamptonshire Local Safeguarding Children Board (LSCBN) Child Protection Procedures, and Integrated Working Procedures (IWP) for Practitioners and Managers 2011. 5

Statutory guidance on making arrangements to safeguard and promote the welfare of children under section 11 of the Children Act (Chapter 5, 2004) Working Together to Safeguard Children provides detailed guidance on safeguarding roles and responsibilities for organisations and some key individuals, and where these delegated responsibilities have been transferred to the CCG s, they are outlined in the relevant sections of this policy. Working Together also provides the core practice guidance on managing individual cases where there are concerns that a child may be at risk of significant harm. LSCBN child protection procedures describe Northamptonshire s local interagency arrangements for responding to concerns that a child may be at risk of significant harm. The IWP provide a framework for early intervention and support for children, young people and families with additional needs, with the aim of preventing concerns escalating to the significant harm threshold. Section 11 Duties: CCG s must comply with the duty under Section 11 of the Children Act 2004 to demonstrate that they are meeting their responsibilities to safeguard and promote the welfare of children, and must be able to provide evidence of the following: Senior management commitment to the importance of safeguarding and promoting children s welfare; A clear statement of the organisations responsibility towards children is available to all staff; A clear line of accountability within the organisation for work on safeguarding and promoting the welfare of children. That service development takes into account the need to safeguard and promote the welfare of children and is informed, where appropriate, by the views of children and families. That there is a funded safeguarding children training strategy to ensure all staff (including contracted staff) at all levels receive relevant training and have an understanding of both their roles and responsibilities, and those of other professionals and organisations. Safer, robust recruitment procedures that help prevent unsuitable people from working with children. Those who recruit staff should have the appropriate training. That the organisation supports effective inter-agency working, following national statutory guidance (Working Together to Safeguard Children 2010, and Framework for the Assessment of Children in 6

Need 2004) and local practice guidance from the Local Safeguarding Children Board. That the organisation promotes effective information sharing, supported by national and local guidance and protocols. (From Statutory Guidance on Making Arrangements to Safeguard and Promote the Welfare of Children Under Section 11 of the Children Act 2004, HM Government 2007) 2. Scope of the Policy This policy applies to all staff working within the CCG s. Each NHS Nene CCG and NHS Corby CCG member, employee or contractor has an individual responsibility for the protection and safeguarding of children and young people, in both their professional and home lives. The CCG s are required to have appropriate contract monitoring arrangements in place to ensure all providers are meeting their statutory and contractual responsibilities. All provider health organisations commissioned by the PCT and CCG s must have their own polices for safeguarding children, which must be consistent with this policy, and in line with their own statutory responsibilities and with Northamptonshire Local safeguarding Board child protection procedures. 3. Definitions Safeguarding and promoting the welfare of children is defined as: Protecting children from maltreatment Preventing impairment of children s health and development Ensuring that children are growing up in circumstances consistent with the provision of safe and effective care; and undertaking that role so as to enable those children to have optimum life chances and to enter adulthood successfully. Child Protection is a part of safeguarding and promoting the welfare of children. This is the process of protecting individual children identified as suffering, or who are likely to suffer significant harm as a result of abuse or neglect. The main forms of abuse are physical, sexual or emotional abuse, or neglect. Significant Harm is the threshold that justifies compulsory intervention in family life in the best interests of children (Children Act, 1989). There are no absolute criteria on which to rely when judging what constitutes significant harm. Sometimes, a single traumatic event may constitute 7

significant harm, but more often, significant harm is a compilation of significant events, both acute and long-standing, which interrupt, change or damage the child s physical and psychological development. Children in Need Children who are defined as being in need ; under section 17 of the Children Act 1989, 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 (section 17 (10) of the Children Act 1989), plus those children who are disabled. Child: Anyone who has not yet reached their 18 th birthday. (As defined in Working Together to Safeguard Children, 2010) 4. Policy Statement The CCG s support the view that children and young people must be valued and protected. The CCG s champion the rights of all children and young people not to be abused, neglected or exploited and have the right to be happy, healthy, safe and productive in their contribution to society. The CCGs are committed to all policy, procedures and practice which safeguards children and promotes their welfare and aims to commission safeguarding services that will ensure equal access to all children and young people, regardless of: - Race, religion, first language or ethnicity, - Gender or sexuality - Age - Health status or disability - Political or immigration status The CCGs will fulfil this commitment by: Full compliance with all statutory guidance on safeguarding children. Demonstrating compliance with with local and national safeguarding quality assurance frameworks including the LSCBN section 11 audit standards. Active partnership and full co-operation with Northamptonshire Local Safeguarding Children Board (LSCBN) and Northamptonshire Children and Young People s Partnership Board (CYPPB) aims and objectives. 8

Ensuring that children are valued and their safety and welfare is considered at all stages of commissioning, including contracting arrangements and performance management frameworks. 5. Roles and Responsibilities Accountable Officer Responsible for ensuring that the health contribution to safeguarding children and promoting their welfare is discharged effectively across the range of services commissioned by the CCG Responsibilities of the Governing Body To ensure that a board executive lead for safeguarding children is identified to take responsibility for the organisation s safeguarding strategy and governance. To ensure that a senior paediatrician and senior nurse are identified to undertake the role of designated professionals for safeguarding children across the health economy. To ensure that the CCG s cooperate with the local authority in the establishment and operation of Local Safeguarding Children Board (LSCBN) and that the CCG s as LSCBN partners, share responsibility for the effective discharge of its functions in safeguarding and promoting the welfare of children. To receive information relating to serious case reviews and other case reviews, including notification that a review has commenced, and updates on identified learning, recommendations and action plans, and progress towards publication where relevant. To receive governance reports and any other reports requiring board approval or decision. Board Executive Safeguarding Lead Execute all safeguarding children responsibilities on the behalf of the Accountable Officer and Governing Body. Represent NHS Nene CCG and NHS Corby CCG on the Northamptonshire Local Safeguarding Children Board.(LSCBN) Ensure effective engagement in MAPPA (Multiagency Public Protection Arrangements, a partnership arrangement to manage risks posed by violent and sexual offenders in the community) and MARAC (Multiagency Risk Assessment Conference, a victim- focussed multiagency meeting to share information and manage the highest risk domestic abuse cases) 9

Commission and sign off internal management reviews for serious case reviews where necessary. Report any appropriate safeguarding children risks and/or achievements to the Accountable Officer and the Governing Body through the Quality Committee. Be overall accountable for the reporting of serious incidents regarding safeguarding children. Designated professionals Provide advice to ensure the range of services commissioned by the CCGs takes account of the need to safeguard and promote the welfare of children, and on the monitoring of the safeguarding aspects of provider contracts Provide professional advice on matters relating to safeguarding children to the Local Authority Adult and Children s Services (ACS), the Northamptonshire Local Safeguarding Children Board, and other partner organisations. Provide advice, support and clinical supervision to the named professionals in each provider organisation across the county. Promote, influence and develop training on a single and inter-agency basis- to ensure the training needs of all staff are addressed. Provide skilled professional advice or involvement in individual child safeguarding cases, where requested by named professionals or team/service managers in ACS, and/or in line with LSCBN procedures. Participate in serious case reviews and other case reviews and audits, to ensure an overview evaluation of how health professionals and providers work together across the health economy to safeguard children, and to take a strategic lead in embedding learning from such reviews. The Designated Nurse for Children s Safeguarding and looked after children will be responsible for the implementation and maintenance of the MCFA (East Midlands Missing Children and Families Alert System, May 2011) system through an administrative officer. The purpose of the Missing Children and Family Alert (MCFA) process is to locate children who have disappeared from view following an undisclosed change of address and for whom there may be concerns about child welfare in respect of unmet need, vulnerability or abuse. Health staff across the health economy are required to comply with the MCFA guidance in making appropriate responses where they have concerns that a family is missing. 10

Responsibilities of all staff All health professionals have an individual duty to safeguard children, and it is imperative that all staff (including contracted staff, and nonclinical staff) are able to: recognise and understand what constitutes abuse or neglect, be aware of LSCBN safeguarding policy and procedures, and those of their own organisation know where to access support and advice, by knowing the contact details of named and designated professionals know how to record the details of any concerns and action taken understand the principles of information sharing when children are in need, or at risk of abuse or neglect Where appropriate to their role, health professionals must be able to refer to the appropriate agency within appropriate timescales, and contribute effectively to subsequent multi-agency working to protect children in need of a protection plan. 6. Staff training, support and professional development In order to ensure that CCG staff can meet their organisational and individual professional responsibilities to safeguard children, the CCG s will ensure that all staff access training, support and professional development appropriate to their role. All safeguarding training will be consistent with: The Common Core of Skills and Knowledge, Children s Workforce Development Council (CWDC), Roles and Competencies for Health care Staff, the Intercollegiate Document, Royal College of Paediatrics and Child Health (RCPCH, 2010) Working Together to Safeguard Children, 2010 Any CCG staff whose role involves individual case work with vulnerable children (for examples, commissioning services for individual children with highly complex needs arising from disability or mental health) will access advice and supervision in relation to any safeguarding concerns via the designated professionals. The CCG s will ensure that the designated professionals and others with senior safeguarding roles, including the executive lead for safeguarding, will have access to any training, supervision and support identified as needed through professional development processes. 11

7. Recruitment and Personnel Processes The organisation has a duty to introduce safer working practices, in line with statutory guidance in Working Together to Safeguard Children 2010. This includes recruitment processes that filter out people who are not suitable or safe to work with children, and ensure appropriate regard to the need to safeguard children by a sound process of: Training staff involved in recruitment, Ensuring all references are taken up prior to starting work Stringent and appropriate Criminal Records Bureau disclosure, based on assessment of risk to children Appropriate management of allegations against staff. Clinical Commissioning Groups have a statutory duty to ensure that appropriate action is taken, if an allegation is made, or suspicion or concern arises, about harm to a child by an employee. The same process must also apply to students and volunteers. The CCG s will apply an allegations management procedure consistent with statutory guidance and LSCBN procedures. Statutory guidance and LSCBN procedures on allegations management require that organisations have a Named Officer accountable for ensuring that this process is functioning effectively and fairly. Currently, the Named Officers for Allegations are: i. PCT Cluster - Director of Nursing ii. NHS Nene CCG - Director of Quality iii. NHS Corby CCG - Chief Commissioning Officer 8. Prevent Prevent is part of a national strategy led by the Home Office, which focuses on working with individuals and communities who may be vulnerable to the threat of violent extremism and terrorism. Supporting vulnerable individuals and reducing the threat from violent extremism in local communities is a priority for the health service and its partners. The healthcare sector is a key strategic partner in Prevent and this was endorsed by the publication of the Prevent Strategy (2011) with the following objectives: Challenge the ideology that support terrorism and those who promote it Prevent vulnerable individuals from being drawn into terrorism and ensure that they are given appropriate advice and support Work with sectors and institutions where there are risks of radicalization 12

Healthcare workers may have contact with vulnerable adults or young people (including children under the age of 18) who could become victims of radicalisation. There is no obvious profile of a person likely to become involved in terrorist-related activity, or single indicator of when a person might move to support extremism. Vulnerable individuals who may be susceptible to radicalisation can be patients or staff. Prevent ensures that those who are at risk will receive help and support from partners best placed to meet these needs. The CCG s will ensure that there are robust Prevent arrangements in place across the health economy. This will be monitored through safeguarding assurance processes and form part of quality contracting monitoring. CCG staff will receive Prevent awareness training via Level One Safeguarding Children Awareness. For raising concerns, the CCG staff will contact the safeguarding designated professionals in the first instance, who will provide advice and identify local referral pathways if necessary. 9. Commissioning Arrangements The CCG s are responsible for improving the health and wellbeing of their local population, including children and young people. To achieve this, they are under a legal duty to work with the local authority to assess what kind of health services people need and this is facilitated through the Joint Strategic Needs Assessment (JSNA). Commissioning organisations are responsible for ensuring that all provider organisations and contracted staff are carrying out their safeguarding roles and responsibilities through the commissioning, contracting and quality assurance framework. They must therefore ensure that service specifications for commissioned and contracted services include clear service standards and monitoring arrangements for safeguarding children and young people and that all health providers from whom services are commissioned have comprehensive single and multi-agency policies and procedures to safeguard and promote the welfare of children, linked to those of the Northamptonshire Local Safeguarding Children Board. The following are examples of particular service provision and policy requirements: All providers have a policy to inform the Local Authority if a child is resident in hospital or hospice care for 12 weeks or more, a requirement under Section 85/86 of the Children Act 1989. 13

Any providers of mental health in-patient care have policies to inform the CCG if children under 18 are housed in the same wards as adults, and that they are transferred to more suitable accommodation within 48 hours, and policy regarding children visiting in-patients on wards. All front-line staff should have access to paediatricians trained in examining, identifying and assessing children and young people who may be experiencing abuse or neglect. CCGs should also ensure that commissioning expertise on sexual violence services, to ensure there is an effective local Sexual Abuse Referral Service (SARS) care pathway for children and young people. 10. Clinical Governance The CCGs will apply the principles of sound clinical and corporate governance in relation to safeguarding children which takes account of the corporate governance framework for commissioning. The CCGs will ensure that safeguarding and promoting the welfare of children is integral to clinical governance and audit arrangements. The CCGs will ensure that all child deaths and serious incidents in relation to children are reported and investigated according to relevant reporting policies. This will also ensure that any safeguarding concerns are identified in such cases, the interfaces between these processes and the serious case review process function clearly and effectively. The Safeguarding Children Designated Professionals and the Board Executive Safeguarding Lead will report regularly on the range of safeguarding activities, quality assurance processes, Serious Case Reviews and other serious incidents via the Quality Committee, with additional exception reporting as required. 11. Serious Case Reviews The CCG s have a statutory duty to work in partnership with the Northamptonshire Local Safeguarding Children Board, and/or any other Safeguarding Children Board across the country in conducting Serious Case Reviews, in accordance with statutory guidance. They must ensure that reviews and all actions taken following reviews are carried out according to the timescale set out by the Serious Case Review Panel. The CCG s must ensure that sufficient resources are in place to meet this requirement. This will usually mean that there must be sufficient resources and support to allow the designated professionals to fulfil the key roles of SCR panel membership and preparation of a health overview report where required. Where there are a number of 14

simultaneous reviews, or where the designated professional has had significant case involvement, the commissioning of additional capacity for these functions should be considered. This may be identified internally or externally depending on case circumstances. The CCG s will also commission IMR s on behalf of any general practices involved in a serious case review, normally undertaken by the GP named doctor. Again the CCG must ensure that sufficient capacity is available for this function, including commissioning additional capacity e.g. an external author where there are two or more ongoing reviews, or any significant conflict of interest for the named GP in relation to the case. The CCG should seek assurance that there is also sufficient capacity in provider organisations to produce Independent Management Reviews when required. The designated safeguarding professionals will inform the relevant authorities including the Care Quality Commission when a Serious Case Review is commissioned. The safeguarding executive lead for the CCG will commission and sign off health overview reports and internal management reviews for serious case reviews. The CCG governing bodies will be notified that a review has commenced and will receive updates on identified learning, recommendations and action plans, and progress towards publication where relevant. 12. Review and Maintenance of Policy This policy will be subject to annual review and, if revised, all stakeholders will be alerted to the new version. This policy is issued and maintained by the Safeguarding Directorate on behalf of all stakeholders. 15

References and Bibliography HM Government 2010, Working Together to Safeguard Children, HMSO London DH 2004, NSF for Children, Young People, and Maternity Services, HMSO London DH 2004, Every Child Matters, Change for Children Programme, HMSO London HM Government 2005, Common Core Skills and Knowledge Framework For the Children s Workforce, DfES London HM Government 2007, Statutory Guidance Under S.11 of the Children Act, Stationery Office, London DH 2005, National Standards, Local Action, HMSO London DH 2006, Our Health, Our Care, Our Say, HMSO London The Children Act 1989, HM Government The Children Act, 2004, HM Government DH 2000, The Framework for the Assessment of Children in Need, HMSO, London Intercollegiate Document 2006, Roles and Competencies for Health Care Staff, Royal College of Paediatrics and Child Health, (RCPCH) DH 2009, Statutory Guidance on Promoting the Health and Well-being of Looked After Children, HMSO 16