Policy No: OP75c Version: 1.0 Name of Policy: Safeguarding Unborn Babies Policy Effective From: 03/12/2012 Date Ratified 16/11/2012 Ratified Integrated Safeguarding Committee Review Date 01/11/2014 Sponsor Director of Nursing, Midwifery and Quality Expiry Date 15/11/2015 Withdrawn Date This policy supersedes all previous issues. Safeguarding Unborn Babies Policy v1
Version Control Version Release Author/Reviewer Ratified by/authorised by 1.0 03/12/2012 K. McCluskey G. Thompson Integrated Safeguarding Committee Date Changes (Please identify page no.) 16/11/2012 Reviewed and updated in respect of changes to LSCB policy Safeguarding Unborn Babies Policy v1 2
Contents Section Page 1 Introduction... 4 2 Policy scope... 4 3 Aim of policy... 5 4 Duties (Roles and responsibilities)... 5 5 Definitions... 6 6 Safeguarding unborn babies... 8 6.1 Safeguarding Documentation in the Maternity Dept... 8 6.2 Referral to Children s Social Care... 9 6.3 Resolving Professional Disagreements... 10 6.4 Attendance at Multi-agency meetings... 11 6.5 Concealed Pregnancy and Birth... 11 6.6 Gateshead women with an AN2 who choose to deliver in another hospital... 12 6.7 Support and Supervision in relation to Safeguarding Issues... 12 6.8 Caring for pregnant substance users... 12 6.9 Peri-natal Mental Health... 13 6.10 Missing antenatal women... 13 7 Training... 13 8 Equality and diversity... 14 9 Monitoring compliance with the policy... 14 10 Consultation and review... 14 11 Implementation of policy (including raising awareness)... 15 12 References... 15 13 Associated documentation (policies)... 15 Appendices Page 1 AN1 form... 16-18 2 AN2 form... 19 3 Referral form to Children s Social Care... 20 4 Guidance for Midwifery Child Protection Report... 22-26 5 Contact Numbers... 27 Safeguarding Unborn Babies Policy v1 3
Safeguarding Unborn Babies Policy 1.0 Introduction This policy sets out the national and local expectations in relation to safeguarding children and young people that pertain to all individuals in Gateshead Health Foundation Trust. This policy and the associated procedures need to be used in conjunction with the interagency procedures of the Gateshead Safeguarding Children Board which are very detailed and can be accessed using the link below: www.gateshead.gov.uk/lscb All children deserve the opportunity to achieve their full potential and in order to do this they need to feel loved, valued, supported and protected. The Children Acts of 1989 and 2004 and the statutory guidance Working Together to Safeguard Children 2010 have set out the principles for safeguarding and promoting the welfare of children and have moved the emphasis from protecting children from abuse to a much more holistic philosophy of safeguarding children in all aspects of their lives including reducing accidents and bullying. Safeguarding Children and Young People therefore means: 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 The Children Act 2004 emphasises that we all share a responsibility to safeguard children and young people and provide for their welfare and that all members of the community can help to do this. The important message is therefore that safeguarding is everybody s business. Midwives are the primary health professionals likely to be working with and supporting women and their families throughout pregnancy. The close relationship they foster with their clients provides an opportunity to observe attitudes towards the developing baby and identify potential problems during pregnancy, birth and the child s early care. (Working Together to Safeguard Children, 2010). 2.0 Policy scope The policy is applicable to all staff that come into contact with children and their families, including managers, nurses, midwives, medical staff, allied health professionals and support staff in all divisions. Safeguarding should be seen as an integral part of patient care. Risks of neglect, harm or abuse will be reduced where there is strong leadership. All staff have a role in safeguarding children and notifying the safeguarding team if abuse is suspected, disclosed or discovered. This can be done using the Cause for Concern form. Safeguarding Unborn Babies Policy v1 4
3.0 Aim of policy The policy is used to assist staff working in Gateshead NHS Foundation Trust to identify children and young people who may be at risk and to respond appropriately; to carry out their roles and responsibilities in accordance with Trust and multiagency policies. 4.0 Duties - Roles and responsibilities Chief Executive To ensure that Gateshead NHS Foundation Trust has policies and procedures in place which protect children from abuse. To support and comply with the LSCB multi-agency procedures for safeguarding children and for ongoing compliance with Regulation 11 of the Care Quality Commission registration standards (outcome 7). Director of Nursing, Midwifery and Quality To be the Link Director for Safeguarding Children To be the represent the Trust on Local Safeguarding Children Board To ensure the Trust is represented on LSCB sub-groups To chair the Trust Integrated Safeguarding Committee Head of Corporate Risk Responsible for enduring compliance with and ensuring that all investigations adhere to the Trust s Incident Reporting Policy (RM04) To ensure that external reports are made as appropriate Named Professionals To be the Operational leads within the Trust for safeguarding children To support the Executive Director in maintaining links with Gateshead Safeguarding Children Board To be accessible to frontline staff for advice and guidance To develop and update policies and procedures related to safeguarding children, and to ensure compliance with these To be the central points of contact within the Trust for all safeguarding children enquiries Divisional Directors, Service Managers, Senior Nurses, Ward and Department Managers To adhere to and implement the policy and procedure for safeguarding children, ensuring that all concerns are raised, shared appropriately and documented in a timely way. To support members of staff who are involved in any issues or incidents pertaining to safeguarding children To refer to Children s Social Care if necessary Personnel Managers To advise managers on the investigation of allegations against staff relating to safeguarding children. To ensure staff are checked by the Criminal Records Bureau in accordance with the Trust policy and are registered with the Independent Safegaurding Authority as part of the vetting and barring system Safeguarding Unborn Babies Policy v1 5
All staff To familiarise themselves with the definitions and application of child protection measures and to ensure these are applied in their practice To recognise and report suspected or witnessed abuse To attend Safegaurding children training as part of the Trust s corporate induction programme and mandatory training in accordance with requirements in the Trust s training needs analysis To treat all allegations of abuse seriously, regardless of the source of information. It is important for staff to share information or concerns immediately to their line manager and the safeguarding children team. To follow the guidance within this policy To comply with the Trust Incident Reporting and Investigation policy (RM04) and Being Open policy (RM49) To cooperate with instructions and advice given by the Safeguarding team To document all actions in the patient s notes To attend child protection meetings if required 5.0 Definition of terms 5.1 Child Anyone who has not yet reached their 18 th birthday. Children therefore means children and young people throughout. The fact that a child has reached 16 years of age, is living independently or is in further education, is a member of the armed forces, is in hospital or custody in the secure estate for children and young people, does not change his or her status or entitlement to services or protection under the Children Act 1989. 5.2 Safeguarding and promoting welfare and child protection Protecting children from maltreatment; Preventing impairment of children s health or development; Ensuring that children are growing up in circumstances consistent with the provision of safe and effective care; Child protection is a part of safeguarding and promoting welfare. This refers to the activity that is undertaken to protect specific children who are suffering or likely to suffer, significant harm. 5.3 Significant Harm The Children Act 1989 introduced the concept of significant harm as the threshold that justifies compulsory intervention in family life in the best interests of children, and gives local authorities a duty to make enquiries to decide whether they should take action to safeguard or promote the welfare of a child who is suffering or likely to suffer, significant harm. Harm means ill-treatment or the impairment of health or development. Safeguarding Unborn Babies Policy v1 6
Where the question of whether harm suffered by a child is significant turns on the child s health and development, his health or development shall be compared with that which could reasonably be expected of a similar child. To understand and identify significant harm, it is necessary to consider: The nature of harm, in terms of maltreatment or failure to provide adequate care; The impact on the child s health and development; The child s development within the context of their family and wider environment; Any special needs, such as a medical condition, communication impairment or disability, that may affect the child s development and care within the family; The capacity of parents to meet adequately the child s needs; and The wider and environmental family context. 5.4 Abuse and Neglect Abuse and neglect are forms of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by failing to act to prevent harm. Children may be abused in a family or in an institutional or community setting, by those known to them or, more rarely, by a stranger for example, via the internet. They may be abused by an adult or adults, or another child or children. 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 or carer fabricates the symptoms of, or deliberately induces, illness in a child. Emotional Abuse is the persistent emotional maltreatment of a child such as to cause sever and persistent adverse effects on the child s emotional development. It may involve conveying to children that they are worthless or unloved, inadequate or valued insofar as they meet the needs of another person. Sexual Abuse involves 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 assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in a sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet). Neglect is 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 or development. Neglect may occur during pregnancy as a result of maternal substance abuse. Once a child is born, neglect may involve a parent or carer failing to: Provide adequate food, clothing and shelter; Safeguarding Unborn Babies Policy v1 7
Protect a child from physical and emotional harm or danger; Ensure adequate supervision; Ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child s basic emotional needs. 6.0 Safeguarding Unborn Babies Policy 6.1 Safeguarding Documentation in the Maternity Department In Gateshead all women in early pregnancy should be booked by a midwife. During the first contact appointment a full obstetric, medical and social history is taken, including completion of an AN1 assessment form (Appendix 1). The purpose of the AN1 form is to identify potential areas of wider health need and to highlight any past or present social problems. It is a risk assessment. The midwife must give consideration to the woman s wellbeing and safety whilst eliciting this information; for instance it is inappropriate and sometimes extremely dangerous to ask a woman about domestic abuse issues in the presence of other people; this includes the woman s partner and other family members. It may be that some areas of the assessment need to be revisited at a more appropriate time. With women whose first language is not English, it may be necessary to obtain the services of an independent interpreter, as it often not appropriate to use family members or partners as this may place the women at risk. Following the completion of this documentation:- A copy will be retained by the community midwife A copy should be filed in the hospital notes A copy should be sent to the health visitor If the midwife identifies any problems or areas of need whilst completing the AN1 form then an AN2 form must be completed (Appendix 2). The information in the AN2 form should provide further details concerning the problem or need, and it is also an opportunity for the midwife to formulate an action plan in partnership with the woman. It is essential for the midwife to explain the information sharing process and for the woman to then read and sign the completed AN1 form. However, in cases where there are barriers to written communication, i.e. language or literacy issues, then the midwife must ensure that other strategies are employed in order to facilitate full understanding. A copy of this information is then distributed to relevant professionals. A copy will be retained by the community midwife A copy of the AN1/AN2 should be filed in the hospital notes, in a red plastic wallet under the Correspondence section. A copy should be sent to the Named Nurse for Safeguarding Children, which will then be scanned onto the Safeguarding Children Database A copy should be sent to the Safeguarding Children Admin Officer, who will then forward it to the appropriate Safecare Lead in the community to be allocated to a health visitor. Safeguarding Unborn Babies Policy v1 8
The Named Nurse for Safeguarding Children will liaise and share information as necessary with the Gateshead Community Safeguarding Children Team. When it is identified that a woman or a family has an area of wider health need, the midwife should share this information with the Named Nurse for Safeguarding Children via the AN1/AN2 forms. The midwife is responsible for ensuring that there is a robust and definitive action plan documented within the AN2, and for contacting the most appropriate professional to receive an update on the situation as required. Contact details for these professionals should be documented within the hospital records within the red safeguarding wallet. All discussions (including telephone and face to face) regarding the family should be fully documented within the hospital records within the red safeguarding wallet. If staff become aware of a change in the family circumstances during pregnancy (such as a relationship breakdown or a new partner), then a new AN1 form must be completed so that the new information is documented and a risk assessment of the new circumstances is undertaken. This should then be forwarded to the professionals stipulated on the previous page. It is the responsibility of the midwife to ensure that hospital records are regularly updated with progress made against the action plan as documented on the AN2 form. This should include details/minutes of any meetings that have been held in respect of the family. A robust birth plan should be included where necessary, and it is the responsibility of the community midwife to liaise with relevant agencies to ensure that this information is in place in a timely manner. Once the baby is born, the red safeguarding wallet and all documentation filed within should be transferred from the mother s hospital records into those of the baby. This will then act as a further safeguard should the baby attend hospital in the future. 6.2 Referral to Children s Social Care Any safeguarding concerns should be discussed with the Named Nurse for Safeguarding Children and if necessary, referrals to be made to the appropriate services. In the case of a referral to the Referral and Assessment Team of Children s Social Care, this must be a faxed written referral, a copy of which should be added to the red safeguarding wallet within the hospital records and a copy forwarded to the Named Nurse for Safeguarding Children (See Appendix 3) Referrals to Children s Social Care should be made as soon the concern is recognised; ideally by 12 weeks gestation and no later than 24 weeks gestation in order to facilitate planning as early as possible. The referral must clearly state the nature of concerns, e.g. parental substance misuse, domestic abuse etc. The referrer must give their views on how the parental behaviour is likely to impact on the baby and what risks are predicted. Safeguarding Unborn Babies Policy v1 9
Concerns should be shared with the prospective parent/s and consent obtained to refer to Children s Social Care unless this action in itself may place the unborn baby at risk, e.g. if there are concerns that the parents may move to avoid contact with services. In respect of an unborn baby, a referral to Children s Social Care should be made whenever any of the following factors exist: There has been a previous unexplained death of a child whilst in the care of either parent; A parent or other adult in the household poses a risk to children; A sibling in the household is subject to a Child Protection Plan; A sibling has previously been removed from the household either temporarily or by Court Order: Domestic abuse is known to have occurred and there are concerns that the level and frequency are likely to have a negative effect on the child; The degree of parental substance misuse is likely to significantly impact on the baby s wellbeing; The degree of parental learning difficulty is likely to impact on the baby s wellbeing; There are concerns about parenting ability to self care and/or to care for the child, e.g. unsupported young mother; Any other concern exists that the baby may be at risk of significant harm including a parent previously suspected of fabricating or inducing illness in a child. This is not an exhaustive list. If unsure whether a referral is necessary, staff should discuss with the Named Nurse/Midwife or the duty social worker from the Referral and Assessment Team on 0191 4332349 or 0191 4332410, who will be able to provide advice. 6.3 Resolving Professional Disagreements In the event that a professional does not agree with the response and decisions about the referral by Children s Social Care, the member of staff should discuss their concerns directly with the line manager of the social worker in the first instance, to seek resolution. If the professionals are unable to resolve differences through discussion; their disagreement must be addressed by more experienced or more senior staff. With respect to most day to day issues, this will require a social work team manager or assistant team manager and input from the Named Professionals. At this point a meeting should be convened to discuss the situation involving all parties. Records of discussions must be maintained by all agencies involved. The outcome of discussions and agreed actions should also be documented. Safeguarding Unborn Babies Policy v1 10
6.4 Attendance at Multi-Agency Meetings Midwives can provide vital information in terms of assessing and managing potential risk to the mother and/or the unborn baby. Attendance at Multiagency meetings should be a priority for the midwife who has knowledge of the family. When preparing for an Initial Child Protection Conference, which will usually be held no later than 24 weeks gestation, the community midwife should compile and submit a written report, with support from the Named Nurse for Safeguarding Children if required. (see Appendix 4 for guidance). Following their attendance at multi-agency meetings or child protection conferences, the midwife must document decisions and outcomes e.g. a child protection plan, planned legal proceedings, and plans for visiting whilst in hospital if appropriate, in the hospital notes accordingly. 6.5 Concealed Pregnancy and birth The concealment of pregnancy represents a real challenge for professionals in safeguarding the wellbeing of the unborn baby and the mother. Better outcomes can be achieved with an effective inter-agency approach, once the fact of pregnancy is established. A concealed pregnancy is when a woman knows she is pregnant but does not tell anyone or those who are told conceal the fact from agencies. It may also be where the woman appears genuinely unaware that she is pregnant. Concealment may be an active act or a form of denial where support from appropriate carers and professionals is not sought. Concealment of pregnancy may be revealed late in pregnancy, in labour or following delivery. The birth may be unassisted. For the purpose of this policy, late booking is defined as presenting for maternity services after 24 weeks gestation. Some women may present late for booking and these pregnancies need to be closely monitored to assess future engagement with midwifery services and whether or not referral to another agency is indicated. The reason for the late booking must be explored and documented. Women booking late in pregnancy should have an AN2 form completed. There are many possible reasons for a woman to conceal her pregnancy. These could include ambivalence towards the pregnancy, immature coping styles and a tendency to dissociate, all of which are likely to have a significant impact on bonding and parenting capacity. Where a concealed pregnancy is identified, the key question is why has the pregnancy been denied/concealed? Information about the concealment of a pregnancy should be shared with relevant agencies (health visitor, GP). A referral to Children s Services must always be made where there are maternal risk factors e.g. denial of pregnancy, avoidance of antental care, non compliance with treatment with potentially detrimental effects for the unborn baby. Safeguarding Unborn Babies Policy v1 11
In cases of full concealment followed by unassisted delivery, a referral must be made to Children s Services. 6.6 Gateshead women with an AN2 who choose to deliver in another hospital Women living in Gateshead who choose to deliver in another area should have their booking completed as per protocol by the Gateshead Community midwife. Booking information including AN1 and AN2 is then forwarded to the appropriate Maternity Unit. After the initial booking appointment, the community midwife will notify the Community Clerk who will request the relevant hospital notes for the pregnant woman. If there are no hospital notes then the Community Clerk will make up a set. These notes are to be held in Maternity Reception in a separate box which is clearly identified; the red safeguarding wallet should be filed within the notes and updated in accordance with this policy. After the baby is born, the Community Midwife will inform the Maternity Reception staff that the red safeguarding wallet needs to be transferred into the baby s hospital notes, which will be made up in the Paediatric Department. If there are safeguarding concerns for women delivering out of area, the Gateshead Community midwife is responsible for regular liaison with the Named Midwife/Nurse Safeguarding Children for the appropriate area. If necessary the Community Midwife should forward copies of any relevant updates, including minutes from any professional meetings. (For pregnant drug users who choose to deliver outside the area, please see Section 9). 6.7 Support and Supervision in relation to Safeguarding Issues The Named Nurse/Midwife for Safeguarding Children are available Monday to Friday 9-5pm to offer advice and support to midwives wishing to discuss safeguarding issues. Individual safeguarding children supervision is available to midwives with caseloads from the Named Nurse for Safeguarding Children, and should be accessed every four months as a minimum. 6.8 Caring for Pregnant Substance Users If at any point during the pregnancy the woman discloses previous or current drug or alcohol use, the Community Midwife should explain the role of the Pregnant Drug User Service, and with consent, referrals to this service can be made. If there is cross boundary working, there needs to be early negotiation between the Specialist Midwives from both areas regarding case responsibility. As the pregnancy progresses, regular liaison between the Specialist Midwives and/or the Community Midwife is vital. Safeguarding Unborn Babies Policy v1 12
6.9 Peri-natal Mental Health There is significant evidence to show that unaddressed mental health issues during pregnancy and the postnatal period can have serious consequences for the mother, her infant and other family members. It has been estimated that as many as 1 in seven women experience a mental health disorder in the antenatal or postnatal period (NICE guidelines, 2007). If at any point during the pregnancy the midwife becomes aware that a woman is experiencing mental health issues, consideration should be given to referring her to the most relevant health professional or service. In all cases, the GP should be informed, even if no further assessment or referral is made. 6.10 Missing Antenatal Women 7.0 Training Notifications regarding missing Antenatal Women are received by the Named Nurse for Safeguarding Children via the Community Safeguarding Children Team. These notifications will then be added to the Missing Persons File held on Maternity Reception. Otherwise notifications are received from Maternity Units and Social Services Departments throughout Britain or via the Local Supervising Authority Midwife Officer (LSA). If a pregnant woman transfers into the Gateshead area and the midwives are alerted to the situation, they will access the missing mothers file to cross reference information and to eliminate the possibility that the woman is a missing person. If the woman is located in the Gateshead area and identified as missing, the midwife must notify the Duty Social Worker from Referral and Assessment Team, who is based at Gateshead Civic Centre, or the out of hours emergency duty team. They will inform the Children s Services Department and the Health Service that sent the initial notification. Information in the missing persons file is retained for a period of 6 months after the mother s expected date of delivery or until the woman has been traced. After this period it will be destroyed. The Trust is committed to ensuring that all staff receive the appropriate safeguarding children training for their role. Records of attendance at Corporate Induction and Mandatory training (Levels 1&2) will be collected and held by the OD & Training Department. The Named Nurse will monitor staff attendance at level 3 safeguarding children training. The safeguarding children training programme within the Trust is derived from and incorporates the competencies outlined in the Intercollegiate Document Safeguarding Children and Young People: A guide to roles and competencies for healthcare staff published in 2010 by the Royal College of Paediatrics and Child Health. It also follows the recommendations from Working Together to safeguard children and young people published in 2010. For further information on Safeguarding Children Staff Requirement Matrix, please see page 22 of the Trust s Training Needs Analysis. Safeguarding Unborn Babies Policy v1 13
8.0 Equality and diversity The Trust is committed to ensuring that, as far as reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds in accordance with the Equality Act 2010. This policy has been appropriately assessed. 9.0 Monitoring compliance with the policy Standard / process / issue Monitoring will include an audit of compliance with the Trust policy to be followed in the event of an AN1/AN2 form being completed Monitoring and audit Method By Committee Frequency Audit of Named Integrated Bi- annually Safeguarding Nurse and Safeguarding documentation Named Committee in Maternity Midwife records Monitoring will be a component of the joint Safeguarding Annual Report Report Named Nurse for Safeguarding Children Integrated Safeguarding Children Annually Monitoring will be a component of the LSCB Performance Management subgroup. Audit of referrals to Children s Social Care, attendance of midwives at multi-agency meetings, and whether child protection reports were submitted LSCB subgroup members LSCB Performance Management subgroup Quarterly Monitoring of safeguarding process of pregnant Gateshead women booked at RVI Audit to ensure that RVI receive AN1/2, and completed referral form and documented outcome of referral for pregnant Named Midwife from RVI and Kate McCluskey Integrated Safeguarding Children Bi-annually 10.0 Consultation and review This policy has been reviewed by the Named Nurse for Safeguarding Children in discussion with the other Named professionals and the Equality and Diversity Officer. It has also been reviewed by the Integrated Safeguarding Committee. Safeguarding Unborn Babies Policy v1 14
11.0 Implementation of policy (including awareness raising) This policy will be implemented within the Trust in compliance with the Policy for the development, management and authorisation of policies. Staff will be notified of the re-launch of the policies via the Trust weekly briefing. 12.0 References The Children Act (1989), The Children Act (2004) Care Quality Commission: Guidance about compliance Essential standards of Quality and Safety (2009) Working Together to Safeguard Children (2010), Department of Children, School and Families Intercollegiate Document (2010), Royal College of Paediatrics and Child Health 13.0 Associated documentation Safeguarding Adults Policy Safegaurding Children Policy Safeguarding Children Supervision Policy Mandatory Training Policy Safeguarding Unborn Babies Policy v1 15
GATESHEAD HEALTH NHS FOUNDATION TRUST MATERNITY LIAISON QUEEN ELIZABETH HOSPITAL (AN1) Appendix 1 NHS Number: Mother s Name: Any previous names: Date of birth: Address: Father s Name: Date of birth: Address if different: If information not provided, reason for this: Postcode: Length of time at current address: Frequency of house moves in the last 2 years: Telephone No: Occupation: Parity & EDD: General Practitioner: Hospital Booked at: Midwife: Health Visitor: General Practitioner: Occupation: Is the father aware of pregnancy?: Is there are ongoing relationship with the father of the baby? Copy of form to: Copy of NNCP if AN2 completed Community Midwife Health Visitor Maternity Record 1 Late booking over 16 weeks If yes, what is the reason for this? Yes No 2 Do you have any support? From whom? 3 Previous significant antenatal history 4 Previous significant postnatal history 5 Frequent pregnancies/ 3 children under 5 years old? 6 Are you and your partner pleased about the pregnancy? 7 Are there are any factors preventing you from attending antenatal appointments? 8 Is there current or previous history of anxiety, depression, mood swings, mental health problems or eating disorders with either parent or in extended family? 9 Is there current or previous history of drug or alcohol misuse with either parent or in extended family? 10 Does either parent have any learning/communication/ literacy difficulties? 11 Have either parent had current/previous involvement with police or probation? Safeguarding Unborn Babies Policy v1 16
12 Any problems with current home conditions? 13 Are there any significant issues in either parent s childhood, e.g. bereavement, abuse etc? 14 Have you ever experienced any form of abuse from a partner? (i.e. physical, emotional, sexual or financial) 15 Are you or your partner experiencing any financial difficulties? AN2 Form completed (please circle response) YES/NO Are there or have there been any service or agencies involved with your family or with yourself? Is there current or previous involvement from Children s Services? If yes, what is the reason for the involvement and who is the social worker? CHILD(REN S) NAMES (Mother) DATE OF BIRTH ADDRESS If children live at different address, what is their carer s name, the reason for them living there and current contact arrangements? CHILD(REN S) NAMES (Partner) DATE OF BIRTH ADDRESS Safeguarding Unborn Babies Policy v1 17
If children live at different address, what is their carer s name, the reason for them living there and current contact arrangements? Mother s signature: Completed by : I am aware this information will be shared with the health visitor / support agencies Status and signature: Date: Safeguarding Unborn Babies Policy v1 18
GATESHEAD HEALTH NHS FOUNDATION TRUST MATERNITY LIAISON QUEEN ELIZABETH HOSPITAL (AN2) Mother s Name: Mother s date of birth: Address: E.D.D: Midwife s summary and analysis of concerns from AN1: Parent s views of what action is required to reduce concerns: Action plan required to reduce concerns: Action to be taken By whom By when Date Completed Completed by: Signature: Designation/Team: Date: Safeguarding Unborn Babies Policy v1 19
Appendix 3 Child protection/ child in need/ child care concern referral form Date of referral: Time of referral: Name of duty social worker (if applicable): Name of referrer: Job title: Agency: Contact details: Child s details: Surname: Forename(s): Home address: Current address (if different): Telephone number: School/nursery Ethnicity: Is the child affected by a disability? YES/NO? DOB: Gender: GP: Religion: If yes, give details: Siblings: Name(s) (insert address if different) D.O.B. School Tick if also subject of the referral Relevant Adults: Full Name(s) DOB Address (if different) Relationship to Subject Safeguarding Unborn Babies Policy v1 20
Has parental consent to this referral been obtained? Yes No By consenting to this, are parents aware information will Yes No be shared and stored? If parental consent has not been obtained, is the parent Yes No aware of the referral? Do parents want help and support from social care? Yes No If NO state the reason: (Please note you do not need consent to make a child protection referral) Other professionals/agencies known to be involved with the child/ family: Name Agency Role Reason for referral: (this must include information regarding the nature of the current concerns including the impact upon the child s health and welfare. It should also address parenting capacity, family strengths and support. Additional information including whether there is a Team Around the Family (TAF) and whether a CAF assessment has been undertaken should also be included) Please send this referral form to Gateshead Referral and Assessment Team electronically to R&ADuty@gateshead.gov.uk or R&ADuty@gateshead.gov.uk.cjsm.net or the inbox CBS R&ADuty (from within Gateshead Council). A second copy should be sent to the named person for child protection in your own agency and a third copy should be kept within your own records for the child. Safeguarding Unborn Babies Policy v1 21
Appendix 4 Quick Reference for Midwives confidential reports. CONFIDENTIAL REPORT Information Not to be Disclosed Without Author/Agency Consent Report for Child Protection Conference to be held on (Date, Time, Venue) From Date Family Name Children d.o.b M/F Mother Father Address Additional Information (Extended family/carer/different addresses) Other Agencies Involved (e.g. Drug and Alcohol) Health Visitor Social Worker General Practitioner Paediatrician Safeguarding Unborn Babies Policy v1 22
REASON FOR CHILD PROTECTION CONFERENCE (Documented in letter of invitation or liaison with Social Worker. Is it an Initial Case Conference or Review? When was the date of registration if appropriate, if known) BACKGROUND INFORMATION / INTRODUCTION (History of family and circumstances. Describe events leading up to conference. A brief synopsis of your involvement. How long have you known the family, what were the reasons for contact, was contact more/less than normal? Any difficulties. Significant past involvement by other professionals. Prepare a chronology of significant events especially in cases of neglect. (Do not replicate records visit by visit). Document legal status of child if known. Do you know of any care orders? List previous registrations and category. Safeguarding Unborn Babies Policy v1 23
FAMILY HISTORY AND ENVIRONMENTAL FACTORS (Family history and functioning, house size and conditions, shops and amenities, who is living in household and how are they related to the child, significant changes, wider family and level of support, employment / income, social interaction, view and wishes of parents/care givers.) ANTENATAL CARE (Gestation at booking. Has the recommended plan for antenatal care been followed? Antenatal clinic appointments Scan appointments Documents any DNA s or contact difficulties.) PARENTING CAPACITY (Receptive or difficult to engage, Attendance at parent craft classes. Have preparations been made for the birth, and subsequent care? Do you have past information on capacity to provide basic care, ensuring safety, emotional warmth, guidance and boundaries?) MOTHER S HEALTH (Do not include medical information if it is not relevant to conference. Relevant obstetric and medical history. Note general health, emotional and mental well being and substance misuse.) Safeguarding Unborn Babies Policy v1 24
DETAILS OF FATHER (ANYTHING OF SIGNIFICANCE) (As above) ADDITIONAL INFORMATION (Information from other sources, school, previous records, anything else you need / want to document.) Safeguarding Unborn Babies Policy v1 25
CONCLUSION AND PROFESSIONAL OPINION (Outline a summary of your concerns including any positive as well as negative aspects, bullet points are helpful. (Include carer s view of known. Evaluate your information and formulate a view on risk or potential risks of significant harm. If you are unsure about recommendation for registration or category, state you will consider registration after information sharing by other agencies at conference.) FUTURE OBJECTIVES (List future health needs you wish to address within the family, e.g. attending for Ante natal care, Parent Craft, Family Support Services, Children s Centres etc.) Has the family seen the report? Yes No (please circle) Signature : Date : Print Name : Safeguarding Unborn Babies Policy v1 26
Appendix 5 Contact details for Hospital Safeguarding Children Team Named Doctor Dr Helen Palmer (9-5pm) 0191 2834561 Named Nurse Kate McCluskey (9-5pm) 0191 4452049 (bleep 3071) Named Midwife Gill Thompson (9-5pm) 0191 4453075 Safeguarding Admin Debbie Bryant (9-5pm) 0191 4452248 During out of hours contact On Call Paediatrician via hospital switchboard Gateshead Community Safeguarding Children Team Named GP Dr Alexander Liddle 01207 542136 Lead Nurse Judith Corrigan 0191 2831134 Safeguarding Nurse Advisor Melanie Finlay 0191 2831513 Safeguarding Nurse Advisor Carolyn Batcheler 0191 2831512 Safeguarding Secretary Maria Kelly 0191 2831148 Child Protection Plan Enquiries Gateshead (9-5pm) 0191 4338031 (out of hours) 0191 4770844 Newcastle (9-5pm) 0191 277500 (out of hours) 0191 2328520 Northumberland 01670 593634 Sunderland 0191 5651612 Durham 0191 3836146 South Tyneside 0300 011 4560 Other important Contacts Gateshead Referral and Assessment Team (Civic Centre) 0191 4332349/4332410 Paediatric Forensic Network (Acute Sexual Assault) 0191 2824753 Specialist Midwife Drug and Alcohol (Gateshead) Sonia Bailey 0191 4452140 Specialist Midwife Drug and Alcohol (Newcastle) Rachel Towell/ Val Colgan 0191 2820336 Emergency Duty Team (out of hours) 0191 4770844 Police (Child Protection Team) 03456 043 043 ext 64346 Newcastle Interpreting Service (9-5pm) 0191 2563210 Out of Hours through Newcastle Hospital s Switchboard 0191 2336161 Northern Sign- 0191 4419669/ 07710988738 Named Midwife Child Protection (Newcastle) Caroline Ruddick 0191 2829759 Named Midwife Child Protection (South Tyneside) Ann Hill 08448113030 Safeguarding Unborn Babies Policy v1 27