POLICY REF NO SABP/EXECUTIVE BOARD/0019 SAFEGUARDING CHILDREN POLICY NAME OF POLICY: REASON FOR THE POLICY: Safeguarding Children Policy To Provide Guidance for all staff on Safeguarding and Promoting the Welfare of Children. This policy also includes guidance around children visiting in-patient wards and units. WHAT THE POLICY WILL ACHIEVE: Provide a framework for Safeguarding Children within the Trust WHO NEEDS TO KNOW ABOUT IT: All directorates, clinical and managerial staff DATE APPROVED: 5 th May 2016 4.0 VERSION NUMBER: EXECUTIVE BOARD APPROVING COMMITTEE: DATE OF IMPLEMENTATION: 5 th May 2016 DATE OF FORMAL REVIEW: 5 th May 2019 AUTHOR/REVIEWER: DIRECTORATE RESPONSIBLE: Dr Mayvis Oddoye Consultant Nurse Safeguarding Children Quality DISTRIBUTION: All directorates and services including volunteers, clinical and managerial staff. This policy has been reviewed and is compliant with the most up to date Code of Practice and NICE Guidelines TITLE OF CODE OF PRACTICE NICE REFERENCE NUMBER Humans Rights Act 1998 Data Protection Act 1998 Children Act 1989/2004 PH50 QS116 Mental Health Act 1983 Health Act 1999 Sexual Offences Act 2003 CG89 PH28 Children and Families Act 2014 Care Act 2014 Working Together to Safeguard Children 2015 QS31 Page 1 of 62
SAFEGUARDING CHILDREN POLICY VERSION CONTROL SHEET Version Date Author Status Comment 2.0 22/05/13 Mayvis Oddoye Going to Consultation 2.0 30/08/13 Mayvis Oddoye Consultation and Impact assessment Completed Consultation period was extended at the request of the Carers Advocate Group (CAG) 3.0 06/06/14 Mayvis Oddoye Amended version to be discussed with PAG Minor additions approved through chairman s actions 3.1 02/02/16 Mayvis Oddoye Amended version to be discussed at PAG Inserted a paragraph on FGM duty and Prevent Radicalisation 4.0 05/05/2016 Mayvis Oddoye Approved at PAG 5.0 14/02/17 Mayvis Oddoye Amendment to include Looked After Children and the MASH Summary of Changes since Version (4.0) Page /Paragraph/Appendix Number (select the appropriate action) Original / New / Amendment / Deleted Statement (select the appropriate action) Page 6, Section 13 Page 15, Section 11.10 Page 17, Section 13 Page 27, Section 35 Included Looked After Children Included Domestic Abuse/Violence Included Looked After Children Inserted Named Doctor Safeguarding Adults Lead Safeguarding Children and Children Visiting In-patient wards/units Policy Content Table Section Contents Page Safeguarding Children and Children Visiting In-patient ward/units Policy Version Control 2 1 Scope of Policy 3 2 Policy Statements 3 Page 2 of 62
1. Scope of Policy and Procedure 1.1 Surrey and Borders Partnership NHS Trust (SABP) is committed to safeguarding and promoting the welfare of children. This is reflected in this policy and procedure which is intended for the use of all staff including volunteers working for the Trust. 1.2 In this policy and procedure a child is defined as anyone who has not yet reached their 18th birthday. Children therefore means children and young people throughout. For the purpose of this policy the unborn child must also be considered. 2. Policy Statements 2.1 Working Together to Safeguard Children 2013 sets out how organisations and individuals should work together to safeguard and promote the welfare of children and young people in accordance with Section 11 of the Children Act 2004. It is therefore important that all practitioners working to safeguard children and young people understand their responsibilities and duties as set out in primary legislation and associated regulations and guidance. Children Safeguarding Quick Guide There are 4 categories of abuse, these are: Neglect Physical abuse Sexual abuse Emotional abuse If you are worried a child is being abused or is at risk you must do the following: Discuss your concerns with your line manager and or other colleagues as you think is appropriate If you still have concerns: o Contact the Local Authority Children s Services to discuss your concerns and or to make a referral o If a referral is made by telephone contact, follow this up in writing within 48 hours o In an emergency contact the police via 999 If you need any advice or guidance contact the Consultant Nurse Safeguarding Children. If out of hours contact the Local Authority Emergency Duty Team Complete Trust Incident Reporting (Datix) for all referrals to children s service Ensure you also complete the Safeguarding Children Monthly Monitoring Log Page 3 of 62
2.2 It is important that any child or young person who has a significant relationship with someone who is an inpatient within Trust services is able to maintain contact during the inpatient stay. However in maintaining this contact consideration must be given to the therapeutic benefits of any visit to both the child/young person, and patient, and the suitability of the environment in which the visit is to take place. In planning these visits, the safety of the children concerned will be the paramount consideration. 2.3 The decision to allow or deny planned visits will be based on risk assessment. In general, decisions will be easy to make and will support the planned visits of children. However, in a minority of cases where risk assessment identifies concerns, detailed planning will be required, which may involve other agencies. In accordance with the Children Acts (1989 and 2004), the welfare of a child is paramount and takes primacy over the interest of any and all adults. 2.4 SABP works collaboratively with the following Local Safeguarding Children Boards (LSCB) Surrey Hounslow Hampshire Brighton To ensure that children and young people are protected from abuse, harm and their needs are met. All SABP services in Hampshire, Hounslow and Croydon must access the Local Safeguarding Children Board s Procedures in the respective areas and adhere to the procedures accordingly. 2.5 This policy and procedure will be implemented with the Think family (Whole Family Approach) philosophy in mind and therefore requires that professionals consider the impact of an individual s condition on other members of the family, the needs of young and young adult carers and where necessary signpost family members to appropriate services for support. 2.6 This policy and procedure will be implemented within the Human Rights Act 1998 legislation with specific regards to Article 8, All persons have a right for private and family life. This right is guaranteed so far as interference is in accordance with the law, public safety, the prevention of disorder or protection of health or morals or the protection of the rights and freedom of others. 2.7 This policy and procedure requires that all children and families are treated the same, with the same sensitivity regardless of the protected characteristics including race, culture, religion, disability or sexual orientation, religion, gender reassignment, pregnancy and maternity as set out in the Equality Act 2010. 2.8 It should be noted that people who use our services and are admitted into our In patient wards will be referred to as patients when describing the process to follow for children visiting in-patient wards/units. 2.9 This Policy and Procedure fully reflects our local multi-agency policy and procedures and we undertake continuous review of our local arrangements through the Local Safeguarding Boards to ensure our processes remain aligned to the agreed multi agency arrangements. Page 4 of 62
POLICY REF NO SABP/EXECUTIVE BOARD/0019 SAFEGUARDING CHILDREN PROCEDURE NAME OF PROCEDURE: REASON FOR THE PROCEDURE: WHAT THE PROCEDURE WILL ACHIEVE: WHO NEEDS TO KNOW ABOUT IT: DATE APPROVED: VERSION NUMBER: Safeguarding Children Procedure To Provide Guidance for all staff on Safeguarding and Promoting the Welfare of Children. This procedure also includes guidance for children visiting in-patient wards and units. Provide a framework for Safeguarding Children within the Trust All directorates, clinical and managerial staff 05 th May 2016 4.0 APPROVING COMMITTEE: Executive Board DATE OF IMPLEMENTATION: DATE OF FORMAL REVIEW: AUTHOR/REVIEWER: DIRECTORATE RESPONSIBLE: 05 th May 2016 05 th May 2019 Mayvis Oddoye Consultant Nurse Safeguarding Children Quality DISTRIBUTION: All directorates and services including volunteers, clinical and managerial staff Page 5 of 62
Safeguarding Children Procedures Contents Table Section Contents 1 Procedure Statements 8 2 Trust Responsibilities (Leadership and Training) 8 3 Trust Responsibilities (Leadership) 10 4 Management Responsibility 10 5 Responsibilities of SABP Staff 11 6 Confidentiality and Information Sharing 12 7 Records 12 8 Recognition of Abuse 12 9 Assessment 12 10 Action when Abuse (Sexual, Physical, Emotional or Neglect) is Suspected 13 11 Dealing with Specific Circumstances such as Children in Whom Illness is Fabricated or Induced, Female Genital Mutilation, Forced Marriage, Honour-Based Violence, 14 Radicalisation of Vulnerable People, Hate and Mate Crime and Domestic Abuse 12 Young Carers and Young Adult Carers 16 13 Looked After Children 17 14 Making a Child Protection Referral 17 15 Action for Professional Supervisor / Line Manager in relation to concerns of Suspected / Actual Abuse referred by Staff 18 16 Framework for Supervision of Staff in Relation to Safeguarding Children 19 17 Child Protection Case Conference Invitation and Attendance by Staff 19 18 Abuse of Children by Staff / Professionals / Others 19 19 Whistleblowing 20 20 Procedure for Action When Third Party / Anonymous Information Relating to the Abuse is Received 20 21 Legal Issues / Reports 21 22 Managing Individuals Who Pose a Risk of Harm to Children 21 23 Young Children / People Who May Pose a Risk to Others 21 24 Adults who have a Learning Disability / Adults who have a Mental Health Problem Who May Pose a Risk to Children 21 25 Records: Transfer Out of Families where a Child has a Protection Plan 21 26 Death of a Child 21 27 Out of Hours Support Arrangement 22 28 Learning Lessons from Serious Case Reviews 22 29 Children Admitted to Adult In-patient Units 22 30 Children Visiting In-Patient Wards / Units 23 30 Formal Patients 23 30 Informal Patients 23 30 Clinical Team Assessment 23 30 Visiting Arrangements 24 30 E-safety advice for Staff 26 32 The Multi-Agency Safeguarding Hubs 26 33 Implementation of Policy and Procedure 26 34 Monitoring and Review 27 35 Trust Named and Lead Professionals 27 Page Page 6 of 62
36 Enquiries and Links 27 36 Links to the Safeguarding Children Boards, related policies and other services /organisations as referenced throughout this document can be accessed via the appropriate link below 27 37 Related References and Policies, Procedures and National Guidance Documents 29 38 Multi-Agency Safeguarding Hub (MASH) Contact Details 30 Appendices Appendix I Appendix II Appendix III Appendix IV Appendix V What to do if you are worried a child is being abused Flow chart with contact details for Surrey, Hampshire and Croydon 31 What to do if you are worried a child is being abused Flow chart with contact details for Hounslow 32 Safeguarding Children Standards to be adhered to by all Managers Surrey Safeguarding Children Board format for Professionals Report for Initial/Pre-birth/ Transfer / Review Child Protection Conference 37 Guidance Regarding Provision of Agency Report to Initial Child protection Conferences 33 39 Appendix VI Assessment Framework Triangle 42 Appendix VII Appendix VIII Appendix VIIII Appendix X Guidance for Mental Health Professionals for Submitting reports to Child protection Conferences 43 Children Visiting Mental health In-Patient Services Clinical Team Assessment Checklist 46 Visiting Arrangements Documentation 45 47 Appendix XI E-Safety Advice for Staff 48 Appendix XII Appendix XIII Appendix XIV Appendix XV Working Together to Safeguard Children and Young People Training (Awareness) Exceptions 52 Children s Details Form Safeguarding Children Monthly Monitoring Log 56 Young Carers, Mental Health Services and Safeguarding Extracts from the Triangle of Care (Young Carers) 58 55 Page 7 of 62
SAFEGUARDING CHILDREN AND CHILDREN VISITING IN-PATIENT WARDS/UNITS PROCEDURE 1. PROCEDURE 1.1 This Procedure should be read in conjunction with the Surrey, 4 LSCB s and London Safeguarding Children Board Procedures. 2 Trust Responsibilities (Leadership and Training) 2.1 The Trust has a Consultant Nurse (Named Nurse), a Named Doctor and an Executive Director for Safeguarding Children. 2.2 All staff who, in the course of their work, are likely to come into contact with children and/or families with children will have access to appropriate training and clinical supervision of their practice in relation to safeguarding / child protection. 2.3 Safeguarding training will be based on competencies which enable staff to effectively safeguard, protect and promote the welfare of children and young people. Different staff groups will therefore require different levels of competencies depending on their role and degree of contact with children, young people and their families, nature of work and level of responsibility. 2.4 The Trust competency training is based on the Intercollegiate Document 2014. This document gives further information on the contents of the training and can be accessed via the Trust Safeguarding Children website. Staff should also refer to SABP Education Department Course Guide for more information on training available. Levels 1& 2 Level 3 Induction Awareness Training for all staff employed by SABP (What to do if you re worried a child is being abused) This equates to the Intercollegiate Levels 1 & 2 competencies Multi-Agency Training For clinical /practice staff working with children, young people and or their parents/carers and who could potentially contribute to assessing, planning, intervening and evaluating the needs of a child or young person and parenting capacity where there are safeguarding/ child with protection plan concerns Must have attended the in-house awareness (What to do if you have concerns a child is being abuse) training before accessing this. This training is provided by all the Safeguarding Children Boards and SABP staff can access the training in their local work area, i.e. Surrey, Hampshire, Hounslow and Brighton. This equates to the Intercollegiate Level 3 Competencies Page 8 of 62
Level 4 Specialist Roles This included Named Professionals Please refer to the Intercollegiate Level 4 competencies Trust Refresher / Update Training In addition to the above all staff will receive a refresher /update training every three years Corporate staff can access the refresher training via ESR e-learning Clinical /practice staff must attend the 3 yearly face to face updates In addition all clinical/practice staff can also access other Safeguarding Children Board s training programs such as Adult Substance Misuse and its Impact on Children etc. The Safeguarding Children Board s training brochures / programs can be accessed via the Trust Safeguarding Children s website or via the links in Section 36 of this document. 2.5. All staff will complete the Level 1&2 Awareness training within 3 months of appointment. 2.6. All staff working in CYPS and Community Mental Health and Recovery Teams will complete the Level 3 training within 2 years of appointment. 2.7 All staff working with children and young people or their parents/carers must complete the Working Together to Safeguard Children and Young People training as described above. The ONLY exception is for those professionals who can demonstrate competency and therefore do not need to undertake Working Together to Safeguard Children and Young People (Awareness Training). The manager must provide evidence (see appendix XII) to the Consultant Nurse Safeguarding Children (to countersign) indicating that the professional has demonstrated safeguarding children competency at levels 1&2. 2.8 Meticulous training records will be maintained by Education Department and the respective Service Managers on individuals ESR. 2.9 Trust will adhere to the National Disclosure and Barring Process as required and all staff will have a Disclosure and Barring check before commencing employment. Further details about employment checks are outlined in the Trust Recruitment, Selection and Employment Checks Policy. 2.10 Trust will comply with Statutory, Care Quality Commission and Monitor and CCG s standards and guidelines. 2.11 Safeguarding Children responsibility will be incorporated within job descriptions of all SABP staff. This will state that all staff will have a sound awareness of Safeguarding issues and Page 9 of 62
Be clear about their respective roles and responsibilities to prevent, report and share information in relation to Safeguarding Adults, Safeguarding Children, Domestic Abuse and Public Protection including the Prevent agenda. 3. Trust Responsibilities (Leadership) 3.1 The named professionals will be responsible and accountable within the managerial framework of the Trust. 3.2 The named professionals will have responsibilities as specified within the Surrey/ Hounslow/ 4LSCB s / London Safeguarding Children Procedures, Working Together to Safeguard Children 2013 and the Roles and Competencies, Intercollegiate Document 2014. 3.3 Links will be maintained with the Surrey, Hounslow, 4LSCB s and Croydon (London) Safeguarding Children Boards through meetings and the designated professionals. 3.4 Consultant Nurse/Named Doctor for Safeguarding Children will be responsible for auditing and monitoring Safeguarding Children arrangements within the Trust.(See Child Protection Standards attached, Appendix III) 3.5 Trust has a Designated Senior Manager who will lead and work collaboratively with the Local Authority Designated Officer (LADO) on all allegations against staff. 4. Management Responsibility 4.1 All new members of staff must receive instruction on Safeguarding Children policy and procedure as part of their induction. 4.2. All managers will ensure that staff adheres to the training requirement standards set out in 2.4 of this procedure. 4.3. Monthly managerial support and clinical supervision must be provided for staff who are working with children and young people with protections plans and or families where there are children in need concerns. 4.4. Bank/Agency staff will only be allocated families who have children with protection plans if the member of staff is on a long term contract within the Trust. 4.5. Line Managers will ensure that the Consultant Nurse - Safeguarding Children, FGM and Prevent is informed of all children who have protection plans or children in need by completing the Trust Safeguarding Children Monitoring Log. 4.6. CYPS Line Managers will have processes in place for monitoring and following up children who miss out-patients appointments. 4.7. Each team will identify a Link Person for Safeguarding Children who will provide front-line support for the team on all issues relating to safeguarding children. 5. Responsibilities of SABP Staff Safeguarding Children is Everyone s Responsibility Page 10 of 62
SABP staff will: Ensure that the interest of the child is paramount and their rights protected at all times. Have a working knowledge of Surrey, Hounslow, Hampshire and Brighton. Procedures which can be accessed via link page. Have a working knowledge of the SABP Safeguarding Children and Children Visiting In- patient wards/units Policy and Procedure. Have a working knowledge of the NICE guidance on When to Suspect Child Maltreatment. This guidance can be accessed via the link page. Adhere to the SABP CPA and Risk Assessment policy when assessing the needs of people who use services to ensure that any dependents such as children, caring responsibilities and actual or potential risks are identified and managed appropriately. This policy can be accessed via the link page. Ensure that all aspects of practice are up to date and written records are in line with the SABP Records Management Policy and Procedure Identify training needs with the help of Line Manager Contact Line Manager whenever there are concerns relating to children and make enquiries of the child protection plan where appropriate through the Local Authority Child and Family Services. All incidents must be reported through SABP datix incident reporting system. All safeguarding children concerns reported to the Local Authority Children s Social Care services and or other agencies must also be reported on SABP datix incident reporting system. All staff must ensure that all cases where there is a child with protection plans or a child in need is reported on the 30 th of each month via the Trust Monitoring Log. The Children in Care services will report the numbers of children in the service to the Trust Consultant Nurse at the end of each month. This incident reporting policy can be accessed via the link page. Be responsible for referring concerns to the Local Authority Child and Family Services appropriate to area of work. Be conversant with the Domestic Abuse and Safeguarding Adult at Risk Policies. Before discharging, ensure that where there are concerns about the safety and welfare of a child and/or young person, they are assured that there is an agreed plan in place that will safeguard the child and/or young person s welfare by the appropriate agency. Have access to an interpreter / translators when and as the need arises and to Page 11 of 62
access any guidance available via Trust web or the link page. 6. Confidentiality and Information Sharing 6.1 All staff must also adhere to SABP Information Sharing policy/protocol which can be accessed on the Trust website or via the link page. 6.2 All staff must also refer to the (appropriate Local Safeguarding Children Board s) Surrey, 4 LSCB/ Hounslow and Croydon procedures to familiarise themselves with the Human Rights Act 1989, Confidentiality and Data Protection Act and Information Sharing and adhere to the procedures and protocols. Accesses to the procedures/protocols are via the link pages. 7. Records 7.1 All staff must keep meticulous records and with due regard for confidentiality. All professionals must refer to the Surrey / LSCB /London Safeguarding Children Board Procedures and local guidance on issues of confidentiality. SABP procedures can be accessed via the link page. 7.2 All Safeguarding Children conference/ core group minutes and or other related documents will be uploaded onto the Safeguarding Children Section in SystmOne with a cover note stating that the information should not be shared without the consent of the author. 7.3 Random audit of records and record keeping will occur as part of the SABP s auditing process. 7.4 All documentation will be in line with the SABP Records Management Policy which can be accessed via the link page. 8. Recognition of Abuse 8.1 There are 4 categories of abuse, these are: Neglect ( including child trafficking and Female Genital Mutilation- FGM) Physical abuse ( including fabricated and induced illness) Sexual abuse ( including sexual exploitation) Emotional abuse (including domestic abuse, ) (See the Safeguarding Children Board Procedures) 9. Assessment 9.1 The assessment of risk to children is complex and must always be based on the fullest possible information and research findings. All staff must refer to the Safeguarding Children Board s Early Help Multi Agency Levels of Need Guidance when assessing children/families with children. 9.2 At each initial clinical assessment professionals must try and establish if the individual has contact with children, the ages of the children, the school they attend if appropriate and whether other agencies/professionals are involved with the family. Page 12 of 62
9.3 Professionals must also establish who has parental responsibility for the child / children, establish if the parental responsibility is shared by both parents and/or whether other members of the family such as grand-parents have identified / established responsibilities. 9.4 It should also be established if a parent who may not live with the child/children has parental responsibility. This will enable the involvement of those agencies /professionals and individuals when discussing and agreeing appropriate services/support for the children and family as a whole. Appendix XIII can be used when discussing the need to collect data on children/ parents/carers and information should be loaded on SystmOne and form part of the CPA. 9.5 All staff must adhere to the SABP CPA and Risk Assessment policy and procedure when assessing people with Mental Health and Learning Disabilities during admission, at CPA reviews and discharge planning to ensure that any actual or potential risk to children including delusional belief about the children and compliance with treatment are identified and appropriate interventions implemented. 9.6 A Consultant Psychiatrist should be directly involved in all clinical decision-making for people with mental health or learning disability who may pose a risk to children. 10. Action when Abuse (Sexual, Physical, Emotional or Neglect) is Suspected 10.1 All staff who in the course of their duty become concerned that abuse has occurred or may be taking place or a child is at risk should take the following action: Discuss the situation with Line Manager as soon as possible and then refer concerns to Surrey/Hampshire Local Authority Children and Family Services as appropriate. In urgent cases where managers are not immediately available, referral can be made to Local Authority Children s Services and then discussed with the Line Manager. A referral must be made to Local Authority Children s Services if a person who uses services expresses delusional beliefs involving their child and/or might harm their child as part of a suicidal plan. Do not attempt to deal with the situation on your own. If necessary seek advice from the Named Doctor/Consultant Nurse/Link Professional for Child Protection. All verbal referrals to Surrey/Hampshire/London Local Authority Children and Family Services must be followed up in writing within 48 hours. Referrals to Local Authority Children s Services must be followed up in writing if Children s Services have not responded to the initial referral within 3 working days. Where domestic abuse is suspected staff must adhere to the Domestic Abuse Policy. All concerns, conversations must be documented in case notes within 24 hours. Where appropriate, inform other colleagues who are involved in providing care for the child and or family, i.e. GP. All managers must monitor referrals to Children s Services and where there are Page 13 of 62
concerns about responses from Children s Services the manager must ensure that this is communicated to the Consultant Nurse, Safeguarding Children, FGM and Prevent. 11. Dealing with Specific Circumstances 11.1 Children in whom Illness is Fabricated or Induced 11.2 A practitioner, who becomes aware of a child s frequent presentations of symptoms that cannot be readily explained, should discuss this with their Line Manager and/or Named Doctor Child Protection. Where there are concerns the practitioner must adhere to the Surrey/4LSCB/Croydon/Hounslow Safeguarding Children Board Procedures as appropriate. These can be accessed via the links below. 11.3 The Sexual Exploitation of Children is described as involving exploitative situations, contexts and relationships where young people (or a third person or persons) receive something (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of their performing, and/or another or others performing on them, sexual activities. 11.4 Forced Marriage is a marriage in which one or both spouses do not consent to the marriage but are coerced into it. 11.5 Honour-Based Violence or izzat embrace a variety of crimes of violence (mainly but not exclusively against women) including assault, imprisonment and murder where the person is being punished by the family or their community for actual or allegedly undermining what the family or community believes to be the correct code of behavior. 11.6 Radicalisation is the process by which people come to support terrorism and violent extremism and, in some cases, to then participate in terrorist groups. Professionals who have concerns that a vulnerable person has been radicalized or is at risk of being radicalised must: in the first instance discuss their concerns with the Trust lead for preventing radicalisation and then refer concerns to the police via the police101 number. 11.7 Mandatory Reporting of Female Genital Mutilation (FGM) Female genital mutilation comprises all procedures involving the partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons. FGM is considered child abuse in the UK and a grave violation of the human rights of girls and women. Mandatory reporting duty for individuals professionals came into force on the 31 st October 2015. Regulated professionals are required to report any concerns that a child may have had or is at risk of having FGM. Please click below to see reporting flow chart FGM Mandatory reporting duty In all other cases, professionals should follow normal safeguarding processes. For further information, please refer to the recent published Home Office statutory guidance Mandatory Reporting of Female Genital Mutilation and note Annex A FGM mandatory reporting process map 11.8 In addition to consulting the Consultant Nurse Safeguarding Children, FGM and Prevent, all staff must refer to the Safeguarding Children Board s Procedures for definitions, indicators Page 14 of 62
and actions to take if there are any concerns about a young person or child who may be at risk of any of the special circumstances described above and other circumstances as indicated in the Safeguarding Children Board s procedures. 11.9 What is Hate Crime and Mate Crime? Disability Hate Crime is: Any criminal offence that is motivated by hostility or prejudice based upon a person s disability. If you believe someone is being picked on because of their disability then it is a Hate Crime. Hate Crime is serious and needs reporting to the police when it happens. Mate Crime happens when someone pretends to be your friend and then uses you instead of being a good friend. A mate may be a friend, family member, supporter, paid staff or another person with a disability. Mate Crime is done by someone known to the individual. If you have concerns that a person who uses our service is suffering a Hate or Mate crime this needs to be reported to the police. 11.10 Domestic Abuse/Violence o o o The term domestic abuse is used to acknowledge that physical violence may be only one aspect of abuse. Abuse may be threatened abuse or actual abuse. Domestic abuse affects all sectors of society and although it is predominantly perpetrated by men on women there is growing awareness of abuse perpetrated by women on men and within same sex partnerships. The Government definition of domestic violence and abuse is: Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass, but is not limited to, the following types of abuse: psychological physical sexual financial emotional o o o Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour. Coercive behaviour is: an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten the victim. The Government definition includes 'honour based violence, female genital mutilation (FGM), forced marriage, violence by family members as well as between adults who are or were intimate. Family members are: mother, father, son, daughter, brother, Page 15 of 62
sister & grandparents; directly-related, in-laws or step-family. o Trust staff who have concerns about domestic abuse/violence in a household and or amongst young people from the ages of 16 onwards must refer the family to Children s Social Care in the local area where the family live. 11.11 All staff must also refer to the Trust Safeguarding Adults Policy and Local Safeguarding Children Boards procedures for further guidance on managing domestic abuse/violence. 12. Young Carers and Young Adult Carers 12.1 A young carer is someone under 18 who helps look after someone in their family, or a friend, who is ill, disabled or misuses drugs or alcohol. Older young carers are often described as young adult carers so there is often cross over in terminology. (see appendix XV) 12.2 Young adult carers are young people aged 16-25 who care, unpaid, for a family or friend with an illness or disability, mental health condition or an addiction. 12.3 All professionals should consider the needs of young and young adult carers during the assessment process in their own right. The young carers assessment will determine what the young carer or young adult carers circumstances are and their need for support. Support can be provided directly to the young carer or young adult carer to meet these needs, and some support needs can be met by providing services for the person they care for. This should be included in a care plan for the person who uses our service and their carers. (Please refer to The Triangle of Care for Young Carers and Young Adult Carers appendix XV and the memorandum of Understanding appendix XVI) 12.4 The extent and effect of their caring responsibilities may satisfy the criteria for Children in Need (particularly where a child is unlikely to achieve or maintain a reasonable standard of health or development or in need or additional support because of their caring responsibilities). 12.5 If any professional is concerned that a young carer is at risk of neglect, abuse or harm, this must be referred to Children's Social Care Services (see Contacts and Referrals Procedure.) 12.6 Unless there is reason to believe that it would put the child at risk, young carers should be informed if there is a need to make a referral, in order that their trust in a worker is retained. 12.7 If possible, the young carers consent should be sought through a discussion of why the referral must be made and the possible outcomes. 12.8 In those situations where the child does not give consent, but it is still considered necessary to involve children s services they should be kept informed of all decisions made, and offered support throughout. 12.9 The above is not exhaustive therefore please refer to the Safeguarding Children Board s Procedures and the Triangle of Care for Young Carers and Young Adult Carers (2015) for information on other circumstances not described in this policy. Page 16 of 62
13. Looked After Children 13.1 The term Looked After Children (LAC) refers to all children and young people aged under 18 years who are either: In care as a result of a court order under Part IV of the Children Act - the local authority has legal parental responsibility along with the parent (Interim Care Order), or sole parental responsibility. (Full Care Order Section 31) Accommodated under Part III of the Children Act the local authority does not have legal parental responsibility. (Section 20) 13.2 These children and young people live both in and out of Surrey and are looked after by Surrey County Council. There are also children and young people in Surrey who are looked after by other local authorities. 13.3 Looked After Children generally have greater health needs than their peers yet they may have more difficulty accessing adequate health care. They have statutory yearly health assessments (twice yearly if aged under five). The first health assessment should be carried out in time for the child's first review, which is held on the day 28 following being taken into care. 13.4 It is expected that staff working within the Looked After Children s service will contribute to these assessment and provide consultation and guidance to other colleagues as appropriate. 13.5 We will identify a Named Specialist Nurse and Doctor who will work closely with the Trust Lead Professionals for Safeguarding Children to ensure that the needs of Looked After Children are met. 13.6 It is expected that SABP staff will work collaboratively with the Designated Nurse and Doctor and other Specialist Nurses and Local authority Professionals for Looked After Children across the county. 13.7 The Named Specialist Nurse and Doctor will ensure that health assessments are completed when required and carried out in a timely manner. 13.8 We continue to offer specialist pathways for mental health care in addition to placement stability for Surrey Looked After Children. Contact One-Stop Mindsight Surrey CAMHS (0300 222 5755) or Children In Care for more information if required. (Tel: 01372 203096). 14. Making a Child Protection Referral a. A referral can be made by any member of staff working in a hospital/home or in the community who has concerns about a family or a child. Page 17 of 62
b. For all new referrals/concerns and Early Help contact the MASH (Multi-Agency Safeguarding Hub) in your local area - Surrey, Hampshire Hounslow and Brighton. c. For existing referrals or to contact the allocated social Worker or Family Support Worker direct, call the appropriate Local Children s Service Contact Centers. d. The name of the person to whom the information is given should be noted and the time and date of the conversation. e. In exceptional circumstances, a referral can be made to MARAC for victims under the age of 18 who are experiencing high risk domestic abuse or where the perpetrator is a young person abusing family members or their parents. See link below for information f. The referrer must discuss the referral with the MARAC Coordinator prior to formal referral to ensure appropriate referrals are made and appropriate agencies are informed. Professionals must also ensure they adhere to the Surrey / Hampshire/London Safeguarding Children Procedures. g. Managers must ensure that the Consultant Nurse for Safeguarding Children is informed of actions taken by completing the Trust Safeguarding Children Log. 15. Action for Professional Supervisor / Line Manager in relation to concerns of Suspected / Actual Abuse referred by Staff a. Line Manager/Professional Supervisor should ensure that member of staff reporting a case of suspected abuse follow the correct procedure as outlined in the Surrey /4LSCB/Croydon and Hounslow Safeguarding Children Board Procedures (if unsure contact Consultant Nurse Safeguarding Children for advice). b. Complex cases or those likely to require legal proceedings should be discussed with the Consultant Nurse Safeguarding Children who will seek appropriate legal advice for the professional involved. c. In cases where professionals believe that their concerns have not been considered appropriately by other agencies/organisations and or services within the Trust, must escalate the concerns to their Line Manager. d. Line Managers must discuss the case with the professional who raised the concerns in the first instance. If the line manager agrees with the concerns raised, the line manager must then discuss the case with their colleague (line manager) in the other agency/organisation/service and agree a way forward. e. If the two managers are unable to agree a way forward and the line manager/professional still has concerns, these should be discussed with the Consultant Nurse Safeguarding Children. f. Where appropriate the Consultant Nurse Safeguarding Children will then discuss the case and concerns raised with the appropriate agency/organisation /service and agree a way forward. g. If the Consultant Nurse Safeguarding Children is unable to resolve the issues / concerns raised, this will then be referred to the Lead Director Page 18 of 62
Safeguarding who will then discuss the case/concerns with senior colleagues at the appropriate agency / organisation / service and agree a way forward. 16. Framework for Supervision of Staff in Relation to Safeguarding Children a. Team Managers are responsible for overseeing the whole caseload of their Teams and for ensuring that all staff receives adequate monitoring, supervision, support and advice on safeguarding children issues. Team members include all professional staff. b. Professionals remain responsible for their own supervision when working with children and families in which there may be concerns about the safeguarding of children. Professionals must notify their Team Manager of any child protection concerns and cases being worked with or supported and by being co-operative with the Multi-Disciplinary Team (MDT) arrangements described in 14.3 and 14.4 below. c. Team Managers are responsible for ensuring that all Child Safeguarding cases have arranged designated MDT group supervisions at a frequency determined by risk but not less than 6-8 weekly. This should include all members of the MDT who are specifically working with the child / family. d. Team Managers must identify senior competent staff within their Team to oversee/ supervise the group MDT process and ensure appropriate records are kept. Individual supervision processes will be expected to be carried out as per the Trusts Supervision policy. e. Medical staff supervision arrangements will be enhanced by the expectation of one supervision per year to be inclusive of consideration of child safeguarding issues in line with the current guidance for medical supervision activities. f. In the scenario where the child and family members are known to more than one Team within Surrey and Borders Partnership NHS Foundation Trust, then consideration should be given by the Team Managers of each Team of liaison with each other, as to whether it would be beneficial for there to be one MDT supervision arrangement for all staff working with the child and family rather than separate supervision arrangements. g. Team / individual supervision process must include enabling the professional to reflective on their practice / day to day work with the family / child / other agencies and professionals. 17. Child Protection Case Conference Invitation and Attendance by Staff a. All staff with professional responsibility for providing care to the family must, on receipt of invitation, give priority to attending the conference called on the family. b. For further details on requirements and compiling of case conference reports, please refer to Surrey / 4LSCB / London Safeguarding Children Board Procedures and look under appropriate section (see appendix IV and V). Page 19 of 62
18. Abuse of Children by Staff / Professionals /Others a. There is increasing recognition that children can be abused or neglected by those working in a child care professional capacity. This may include children who are living in residential schools, children s homes, foster homes, being child minded, attending nursery/school or in-patient on hospital ward. b. SABP staff that has any concerns or allegations that a member of staff may have abused a child has an overriding responsibility to bring that concern to the attention of their line manager and or senior management. c. The Line manager / Senior manager must inform SABP Designated Senior Manager for all allegations against staff. d. SABP Designated Senior Manager will lead on all safeguarding children allegations and work collaboratively with the Local Authority Designated Officer (LADO). e. The SABP Designated Senior Manager will adhere to the Trust Disciplinary Procedures when dealing with allegations of abuse by a member of staff. f. The SABP Designated Senior Manager will also adhere to the Surrey, Hampshire and London Safeguarding Children Board procedures as appropriate, when dealing with such allegations by accessing the procedure via the links below. g. Serious allegations against staff may involve publicity. The Designated Senior Manager must inform the Communications Office. 19. Whistleblowing a. Usually staff concerns about workplace practices can be addressed through supervision and team meetings. However, when the concern is about risk to people who use services / carers, professional misconduct and competence it may be difficult to know what to do. b. SABP Whistleblowing procedure is intended to reassure staff that it is safe to speak up and raise any concerns appropriately and timely. SABP welcomes genuine concerns and is committed to dealing with them professionally as it ensures the safe delivery of services and protects the interest of people who use our services, staff, volunteers, trainees and the organisation. c. SABP employees can access the Whistleblowing procedure via links page 20. Procedure for Action When Third Party / Anonymous Information Relating to the Abuse is Received a. If members of the public contact Trust staff it must be explained to the informant that their concerns will be divulged to the appropriate agencies and advise them to contact Children s Services or NSPCC direct and: i. Inform Children s Services and confirm in writing within 48 hours. ii. In all cases, all action must be recorded in full, precise and factual detail, Page 20 of 62
21. Legal Issues / Reports including telephone calls, name of worker referral made to, date and time. a. All reports or statements should be discussed with Professional Supervisor/Line Manager. The staff member should retain a copy of the statement. b. Any sensitive or third party information may need to be discussed with the Trust s solicitors via the Trust legal department before the report is sent to other agencies. 22. Managing Individuals Who Pose a Risk of Harm to Children. a. These are people who have been identified as presenting a risk, or potential risk, of harm to children. b. Occasionally a parent, carer or relative may present a risk not only to their child but also to others in the home. c. Professionals must contact Child and Family Services to discuss concerns and ask for advice. 23. Young Children / People Who May Pose a Risk to Others a. If children, who are known to have committed offences or to have behaved in a harmful way towards another child, are admitted to your area of work, the person in charge must inform the Line Manager. b. A risk assessment and management plan must be made for supervising the child or young person during their admission and stay on the ward or attendance at outpatient s clinic following consultation with Children s Services. 24. Adults who have a Learning Disability / Adults who have a Mental Health Problem who may pose a Risk to Children a. A risk assessment must be completed, followed by a plan of care which will include supervising the person either as an in-patient or in the community. b. When parents of children under five are admitted to a psychiatric in-patient ward, Health Visitors must be informed as part of the risk assessment and where appropriate invited to CPA meetings to participate in the care planning process. 25. Records: Transfer Out of Families where a Child has a Protection Plan a. The transfer of records must follow the SABP transfer of case records policy. This policy can be accessed via the link page. b. All transfer of records to other organisations must be timely to ensure that the receiving organisation is able to provide appropriate and effective care. 26. Death of a Child Page 21 of 62
a. If a health professional receives notification of the death of a child who has a protection plan, the professional must immediately inform their Line Manager. If not available contact the Consultant Nurse or Doctor for Safeguarding Children, who will inform the Lead Director for Safeguarding Children. b. The death must be reported on datix as a serious incident and the Consultant Nurse Safeguarding Children informed. c. The members of staff directly involved in the case should receive professional support from the Line Manager or the most acceptable senior or professional person. d. The Line Manager will co-ordinate services to the parents as appropriate, ensuring that such intervention is not in conflict with police investigations into the case. e. Detailed contemporaneous records must be kept by all involved and must clearly differentiate between facts, hearsay and opinions. This should include sequence of events and action taken. 27. Out of Hours Support Arrangement a. All staff will adhere to SABP arrangement for out of hour s services. For all safeguarding children concerns, all staff will contact the Emergency Duty Team (Social Services) in the first instance for all child protection advice. b. If advice is needed from SABP, then the staff member will contact the Senior Manager on call via the switchboard on 0300 55 55 222. 28. Learning Lessons from Serious Case Reviews 28.1 Lessons and recommendations from Internal Management Reviews and Serious Case Review Overview Reports will be shared with Trust services via: The local service involved with the family Quality Assurance Groups (QAG s) Quality Reports E-bulletin Update training 28.2 All managers will be expected to share and discuss the lessons at the team/service clinical meetings. 28.3 Where actions are required, respective managers will be required to action the recommendation and feed back to the local QAG and the Consultant Nurse Safeguarding Children. 29. Children Admitted to Adult In-patient Units a. SABP staff will report children under the age of 18 years admitted to adult in-patient units on datix as per SABP incident reporting procedure. b. The Director of CYPS and Consultant Nurse for Safeguarding Children will be informed of all children under the age of 18 years admitted to adult in-patient units using the Children and Young People Services monitoring form. Page 22 of 62
c. Staff from CYPS will visit the adult in-patient unit and complete an assessment on the needs of the child and advise the in-patient staff on the best possible care to be provided for the child. d. A care plan will then be formulated between CYPS and the adult in-patient staff, implemented and evaluated accordingly. e. If the child is admitted under the Mental Health Act 1983, the Mental Health Act manager will be informed by phone then followed up in writing within 3 working days. f. The Director of CYPS is responsible for monitoring Children admitted to in-patient services. 30. Children Visiting In-patient wards/unit Formal Patients 30.1 In instances where a compulsory admission is being considered, the need of and arrangements for children involved with the patients must be considered by the Approved Mental Health Practitioner (AMHP) as an integral element within the assessment. This information must be recorded by the AMHP and communicated to the hospital in the event of admission. 30.2 The AMHP must provide the admission ward with information about the views of other person (s) with parental responsibility for the children of the patient, if these can be ascertained. 30.3 On admission the admitting nurse and doctor must request this information as part of the initial care plan. Informal Patients 30.4 Where an informal patient is being admitted, the admitting nurse and doctor must follow the process above and ascertain from the patient if there are any children who may visit and who has parental responsibility for the children. 30.5 This information must form part of the initial care plan. Clinical Team Assessment 30.6 When there is a possibility that a child may visit a patient on the ward, the clinical team must assess the degree of risk the patient presents to children in general and for the particular child who is the subject of the request, taking into account the patient s past history and current mental health state and any other available information relating to the child. 30.7 The team must also consider the risk that other patients on the ward may also present, should they come into contact with the child. 30.8 Where there are concerns, the team must make preliminary enquiries with Local Authority Social Services Contact Centre to establish whether the child or child s family is known and Page 23 of 62
whether there are grounds for concern. (See Surrey/Hampshire/ Hounslow Safeguarding Children Procedure for telephone numbers) 30.9 If a child has a Child Protection Plan then the named key-worker for the child (social worker) must be involved in the discussion and decision-making. The named key-worker (social worker) must agree to the visit before it can be arranged. 30.10 If the initial assessment indicates clearly that it would not be in the best interest of the child to visit the patient, the request for the visit must be refused and this clearly documented in the patient s notes. The team may consider the following to help them make a decision about the visit: i) Is the patient a person who poses risk to children, or been found not guilty by reason of insanity in respect of such an offence? ii) iii) iv) Is the patient subject to a Section 41 restriction order? Has the patient or child been previously known to Social Services Children & Family Services? Is the patient suspected of having been involved in incidents of emotional, physical or sexual abuse involving children? v) Is there a history of family violence involving the patient? vi) vii) Does the patient have an enduring mental illness resulting in significant emotional and functional defects? Is the child a close relative (i.e. son, daughter, grandchild, brother, sister, nephew, niece). 30.11 The clinical team must also refer to SABP CPA and Risk Assessment and Management policy and Procedure for further guidance. Visiting Arrangements 30.12 Staff must think about how to make the visit a positive experience. 30.13 The location of the visit must be considered carefully. In some cases it may be better for arrangements to be made for visiting away from the hospital. 30.14 In the case of detained patients this will require due consideration of the need for leave. 30.15 Appropriate and sensitive supervision must be provided. 30.16 In child protection cases, the named key-worker (social worker) will be responsible for arranging appropriate supervision for the child. 30.17 Families must pre-arrange visits to the ward if they are bringing children, so that Page 24 of 62
arrangements can be made to accommodate the visitors and to ensure the suitability of children visiting. 30.18 On arrival to the ward, visitors must report to the nurse in charge, informing him or her that children are accompanying them and check to ensure that it is still feasible to visit. 30.19 A responsible adult must accompany all children visiting. 30.20 Children visiting the ward must be restricted to the designated visiting area. Children must not be allowed to wander around other areas of the ward or be left unsupervised by the responsible adult. 30.21 The visiting adult has the responsibility for the children s behaviour. In the event that children become excessively noisy or disruptive, the nurse in charge may prematurely end the visit. If this happens, the nurse in charge must give full explanation to the visitors and record events in the patient s notes. 30.22 If the patient becomes distressed or disturbed during the visit, the accompanying responsible adult may be requested to remove the children from the ward by the nurse in charge or their nominated deputy. 30.23 The nurse in charge, following a discussion with the responsible clinician and/or the MDT, may restrict the visiting of children if it is agreed that: - There may be an element of risk to a child or that it may be detrimental to the patient. In general, the ward visited is felt to be unsafe or inappropriate for children s visits at that time; staff should endeavour to make alternative arrangements to accommodate the visits. In some circumstances nurses may supervise the visit, e.g. if the patient is on continuous observation. An explanation must be given to both patient and visitor regarding supervision. During supervised visits, nurses must remain as unobtrusive as possible and strive to promote and respect the privacy and dignity of the patient, visitor and child. Nurses must also seek to ensure the safety and security of all those concerned by following the procedure set out in this document. Any such decisions must be recorded in the patient s notes. 30.24 In the event of an incident on the ward involving a child, the nurse in-charge must inform the Line Manager immediately or Senior Manager on call during out of hours. 30.25 If a patient is unhappy about the decision to not allow children to visit, the patient must support the patient in discussing this with the consultant. If necessary nursing staff should assist the patient in obtaining an advocate s support. 30.26 A full explanation must then be given to the patient as to why he/she cannot have children visiting. 30.27 This feed-back must be clearly recorded in the patient s electronic care notes (SystmOne) Page 25 of 62
30.28 All discussions, assessments, care plans and decisions made must be clearly recorded in patient s electronic care notes. (SystmOne) 30.29 Any inquiries about this policy and procedure must be addressed to the Consultant Nurse Safeguarding Children. 31. E-Safety Advice for Professionals 31.1 All practitioners must be aware of the risks and benefits of the internet while providing valuable resources to the community and how it affects children and young people. 31.2 All professional working with children and young people and their parents/carers must understand that the nature and responsibilities of their work place them in a position of trust and therefore must be aware of how technology can be used inappropriate and the impact that can have on the individual professional, parents / carers and children/young people. 31.3 Appendix eleven of this policy and procedure provides advice and guidance on e-safety for professional and therefore all staff must ensure that the read the contents. 32. The Multi-Agency Safeguarding Hubs 32.1 The Multi-Agency Safeguarding Hub (MASH) provides triage and multi-agency assessment of safeguarding concerns in respect of vulnerable children and adults. It brings together professionals from a range of agencies into an integrated multi-agency team. The MASH teams make assessments and decisions depending on statutory need, child protection or early help. Quicker response times, a co-ordinated approach and better informed decisionmaking ensures that vulnerable children and adults are protected. 31.2 If you have a concern about a child, young person or adult, please contact the local MASH via the individual websites as appropriate. 33. Implementation of Policy and Procedure 33.1 This policy and procedure will be implemented via the Trust Policy and Procedure processes. Key amendments will be included in Trust Safeguarding Children training programme. Page 26 of 62
34. Monitoring and Review Policy/Procedure Compliance Monitoring Table What will be monitored How/Method Frequency Lead Reporting to Deficiencies / gaps recommendations and actions The implementation of the Safeguarding Children Policy and Procedure Review of compliance through discussions in Safeguarding Children Steering Group Quarterly Safeguarding Lead Annually to Quality Committee. To be raised monthly through the reporting process to Quality Management Board 35. Trust Named and Lead Professionals Executive Board Lead for Safeguarding Children Jo Young (Tel: 0300 5555 222) Lead Director for Safeguarding Children Billy Hatifani (Tel: 0300 5555 222) Consultant Nurse for Safeguarding Children Named Doctor for Safeguarding Children Dr Mayvis Oddoye (Tel: 01372 205807) TBA Safeguarding Adults Lead Debra Cole (Tel: 0300 5555 222) Named Doctor Safeguarding Adults Lead Ruby Osorio (Tel: 020 8538 1150) 36. Enquiries and Links a. All enquiries about this policy and procedure should be addressed to the Consultant Nurse - Safeguarding Children on 01372 205807 / 01372 205809 or 07713 739 237. mayvis.oddoye@sabp.nhs.uk or mayvis.oddoye@nhs.net. b. Links to the Safeguarding Children Boards, related policies and other services / organisations as referenced throughout this document can be accessed via the appropriate link below Page 27 of 62
Surrey Safeguarding Children Board http://sscb.proceduresonline.com/index.html 4 Local Safeguarding Children Boards for: Hampshire, Isle of Wight, Portsmouth and Southampton http://4lscb.proceduresonline.com/ Croydon and Hounslow Safeguarding Children Board http://www.londonscb.gov.uk/procedures/ SABP Web Page http://nww.sabp.nhs.uk/quality/safeguarding/safe-guarding-children National Institute for Health and Clinical Excellence: When to Suspect Child Maltreatment- Issued July 2009, Reissued in December 2009 http://nww.sabp.nhs.uk/quality/safeguarding/safe-guarding-children/nice-guidance-when-tosuspect-child-maltreatment-cg89.pdf Care Planning and Assessment Procedure/SABP/Service Improvement/0023 http://www.sabp.nhs.uk/aboutus/policies/ac/sabp0023%20cpa%20policy%20october%2 02009.pdf/view Incident Management SABP/RISK/0002 http://www.sabp.nhs.uk/aboutus/policies/gi/sabp0002%20incident%20management%20p olicy%20v4.pdf/view SABP Policy - Domestic Abuse (Support for Staff) http://nww.sabp.nhs.uk/quality/safeguarding/domestic-abuse?searchterm=domestic SABP0012- Safeguarding Adults Policy http://www.sabp.nhs.uk/aboutus/policies/su/sabp0012%20safeguarding%20policy%20fin al%20version%20_2_.pdf/view Translation and Interpretations http://www.sabp.nhs.uk/aboutus/policies/g-i/interpreters-and-translators-sabpexecutiveboard-00018/view Integrated Paper / Electronic Health Records SABP/Service Improvement/003 http://www.sabp.nhs.uk/aboutus/policies/p- R/SABP0035%20Integrated%20Records%20Policy%20v3%200.pdf/view SABP Policy - Domestic Abuse (Support for Staff) http://nww.sabp.nhs.uk/quality/safeguarding/domestic-abuse?searchterm=domestic MARAC Referral http://www.surrey.police.uk/keeping-safe/protecting-you-and-your-family/domesticabuse/marac SABP/Workforce/003/Procedure01 http://www.sabp.nhs.uk/aboutus/policies/df/sabp%200036%20disciplinary%20policy%20 _2_.pdf/view Page 28 of 62
Whistle Blowing SABP Procedure/EXECUTIVE BOARD/0023 http://www.sabp.nhs.uk/aboutus/policies/vz/whistle_blowing_procedure_executive_board_ 0023/view Think Family tool kit https://www.education.gov.uk/publications/eorderingdownload/think-family.pdf Early Help - Multi agency levels of Need Guidance http://www.surreycc.gov.uk/ The Triangle of Care for Young Carers and Young Adult Carers A Guide for Mental Health Professionals https://professionals.carers.org/working mental health carers/triangle care mental health https://professionals.carers.org/sites/default/files/toc_ycyac proof4.pdf 37. Related References and Policies, Procedures and National Guidance Documents Care Planning and Assessment Procedure / SABP / SERVICE IMPROVEMENT / 0023 Disciplinary Procedure / SABP / WORKFORCE / 0036 / PROCEDURE01 Domestic Abuse (Support for Staff) / SABP / EXECUTIVE BOARD / 0019 Equality and Human Rights Act Policy SABP/Workforce/0016 Hampshire Safeguarding Children Board Procedures Incident Management / SABP / RISK / 0002 London Safeguarding Children Procedures Records Management Integrated Paper / Electronic Health Records / SABP / Service Improvement / 0035 SABP Translation and Interpretations Guidance Adults Policy / SABP / 0012 Safeguarding Children and Young People: Roles and Competencies for Health Care Staff: Intercollegiate Document 2010 Surrey Safeguarding Children Board Procedures Think Family Toolkit: Improving Support for Families at Risk, Strategic Overview. When to Suspect Child Maltreatment, Quick Reference Guide, NICE Clinical Guideline 89-2009 Working Together to Safeguard Children: A guide to Inter-Agency Working to Safeguard and Promote the Welfare of Children 2015 Page 29 of 62
4 Local Safeguarding Children Board s for: Hampshire, Isle of Wight, Portsmouth and Southampton Local Authority Circular LAC (99)23 Mental Health Act Code of Practice (1999) Guidance on the Visiting of Psychiatric Patients by Children. LAC HSE 1999/222/LAC (99) 32 Surrey/Hampshire/London Safeguarding Children Procedures Triangle of Care for Young Carers and Young Adult Carers: A Guide for Mental Health Professionals For all new referrals / concerns and Early Help in Surrey contact the MASH Multi- Agency Safeguarding Hub Tel: 0300 470 9100 Email: mash@surreycc.gov.uk Secure email: mash@surreycc.gcsx.gov.uk For existing referrals or to contact the allocated Social Worker or Family Support Worker direct, call the appropriate Surrey Children s Services Contact Centres SE Area covering Mole Valley, Tandridge, Banstead and Reigate Tel: 0300 123 1620 SW Area covering Guildford and Waverley Tel: 0300 123 1640 NE Area covering Epsom and Ewell, Elmbridge and Spelthorne Tel: 0300 123 1610 NW Area covering Runnymede, Woking and Surrey Heath Tel: 0300 123 1630 For other areas please contact your local MASH direct. Page 30 of 62
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Appendix III Key to RAG Status SAFEGUARDING CHILDREN STANDARDS TO BE ADHERED TO BY ALL MANAGERS This tool will be amended as appropriate for auditing practice Red Not in place or not at standard required and significant gaps/improvement identified Amber Progress being made but further work/investment required Green Provision in place and/or good progress being made against requirements Service/unit/ward Date Audited..Service Manager.. Tick as appropriate STANDARD Red Amber Green Comments General Issues (For All areas to Complete) 1. All Managers will have systems in place which enables staff at each new contact with clients to collect basic information about any child or children in the family i.e. name, address, age, school & GP as recommended by the Victoria Climbie recommendations. Page 33 of 62
2. All Managers will ensure that the safeguarding children monthly log is completed and returned to the Consultant Nurse Safeguarding Children. 3. All Managers will ensure that lessons from serious case reviews are cascaded and discussed with staff within the team/service and governance/quality groups. 4. All Managers will ensure that all professionals working with children/families within the team/service receive the appropriate training. (If unsure clarify with the Consultant Nurse Safeguarding Children.) 5. All Managers will ensure that all telephone referrals to Children s Services are followed up in writing within 48 hours. 6. All staff to be made aware that the responsibility to refer to other agencies is the responsibility of the person who raised the initial concerns. The responsibility therefore remains with that individual until a satisfactory response is received. (Managers must be made aware of any difficulties experienced by staff member) 7. All Managers will ensure that no case involving a vulnerable child is closed until a plan for on-going promotion and safeguarding of the child s welfare has been agreed with all other agencies involved in the child s care. 8. All Managers will ensure that any safeguarding children concerns/issues are discussed and action taken recorded at each supervision session. 9. All Managers will ensure that all staff have a clear understanding of their roles and responsibilities when they are invited to a child protection conference or to a professional core group meeting. Staff must attend all meetings as a priority. Page 34 of 62
10. All Quality Action Group Leads will ensure that Safeguarding Children is a standing agenda at QAG meetings. 11. All staff will ensure that they are aware of the Trust Consultant Nurse (Safeguarding Children) and Named Doctors (Safeguarding Children) and how to contact them. 12. All managers to confirm that all safeguarding children concerns/alerts are recorded on datix In-patients Services Only 13. Managers to ensure that there is an identified area for children visiting in-patient services 14. All staff are familiar with and adhere to the Children visiting in-patient services procedure CAMHS Only 15. CAMHS Managers will have system for monitoring children who do not engage with service and also demonstrate an adherence to Trust non engagement policy. (This will include children who miss outpatient s appointments). 16. Does assessment process include the assessment of Domestic abuse for the 16-17 year old? Page 35 of 62
Action Plan for issues identified in this Audit Issue Identified Action Implemented Lead person Completion date Page 36 of 62
Appendix IV Surrey Safeguarding Children Board Format for Professional Reports for Initial /Pre-birth/Transfer/Review Child Protection Conference Name of Service/School Base Address: Report prepared by: Designation Tel No: Email Date of Conference : Name of Child/ren Subject of Conference : Family Profile Name Relationship to child DoB Nursery/school G.P. Family Address : Child s Current Address (if different) : Chronology of involvement/significant events/background information (attach confidential information separately if necessary) N.B. Refer to The Assessment Framework for the following sections: Family & Environmental Factors: Page 37 of 62
Individual Child Profile Childs Name: Child Development : Parenting Capacity : Childs Wishes and Feelings Analysis of implications for the child s future safety, health, and development Future Plan of intervention Recommendations Date report shared with parents/carers Date report shared with child Page 38 of 62
Appendix V GUIDANCE REGARDING PROVISION OF AGENCY REPORTS TO INITIAL CHILD PROTECTION CONFERENCES The expectation is that all professionals working within surrey agencies will provide a written report for conference, whether they are able to attend the conference or not. A copy of the report should be forwarded to the Chair of the conference at least 48 hrs in advance. The author must provide copies for conference members. (A guide will be numbers of invitees) The author should share the contents of the report with the parents/carers and child where possible. It may be necessary to provide separate reports where some family members should not have access to some of the report e.g. split/ reconstituted/ reconfigured families The expectation is that all agencies will consider each of the headings on the report format, before deciding they have nothing relevant to offer. Authors should: distinguish between, observation, allegation and opinion be clear where information is provided from another source i.e. second or third hand use relevant information from current and past records Authors should check Initial case conference invitation for accuracy of family/ child details and add any missing information. Where agencies have information on the parent s/child s views of the situation and related issues it would be appropriate to include these in their reports. Chronology/background Include brief details of each contact /incident/call to address, checking dates, nature of calls, and who present. How long has the family been known to the service/school and to the author Date of enrolment in school/ date origin and reason for referral Details of Failed appointments missed contacts Specify if authors information or if taken from records Medical opinion of examining doctor if appropriate Previous concerns/enquiries/court orders Page 39 of 62
Please attach a separate sheet of relevant criminal history for each family member. Please indicate clearly with whom each sheet can be shared. Family and environmental factors Include information known about family history and functioning Information on extended family Housing, employment and finances Families social integration and community resources/support available Family lifestyle /beliefs Individual Child Profile /Development (complete separately for each child known to you) Include information if known relating to: The child s health and growth (attach centile charts stating significance of any measurements), immunisations. Include dental health and nutrition, injuries and medical treatment. For preschool children include birth history if known. Emotional and behavioural development Family and social relationships/social presentation Self-care skills including problem solving and seeking help Education (including stimulation) indicating if the child has a statement of special educational needs, has any educational needs not covered by a statement, has been referred to Educational Psychology. Details of school attendance and any referral to Education Welfare Service. Academic progress Relevant police/probation/youth offending information Any development needs not being met Parenting capacity Basic care of the child/ren and understanding of child s needs Attachment and emotional warmth Boundary setting and safety and how they use discipline Household stability Page 40 of 62
Parental physical and mental health/medication/ and effect on parenting Parental Substance misuse effecting parenting capacity Domestic abuse effecting parenting capacity Information about how parents model appropriate behaviour and or control emotions Childs views and wishes Include how the child talks about/relates to parents and significant adults Childs views of school and any services provided Analysis of implications for the child s future safety, health, and development Consider individual child s needs, risk factors, positive factors and strengths identified in the above information and comment upon the likely implications/outcome for the child if the situation remains the same Recommendation Consider and comment on whether the threshold of significant harm has been demonstrated or is likely to be demonstrated based the information above and if in your view the child is in need of a child protection plan. (Your view may alter having heard other conference participants information) Page 41 of 62
Appendix VI Page 42 of 62
Guidance for Mental Health Professionals for Submitting Reports to Child Protection Conferences Introduction Appendix VII The task for all agencies in ensuring that children are safeguarded and their needs met is a complex one. It relies on the skills and expertise of a wide range of professionals and it is important that each one can contribute to the discussion at a Child Protection Conference as effectively as possible. This guidance has been produced to help mental health professionals consider in their report the kind of information that would best inform the discussion. Areas to Consider (It is appreciated that the author of the report may not be able to answer all the questions) NB. If possible, please avoid using terms that may not be understood by others reading the report, or if you do, please provide an explanation of the term 1. What are the prevailing characteristics of your client s illness/psychiatric condition? 2. What is the prognosis for your client and are they responding to intervention? 3. Is there research evidence to support your prognosis? 4. What is the history of engagement of your client and their compliance with recommendations? 5. How long have mental health professionals been working with this client, which professionals have been involved and how has your client worked with each? 6. What (if any) is the medication prescribed to your client and what are the side-effects (if any) of this, including failure of compliance? 7. What is the client s understanding of their clinical condition and to what degree are they responding to the service being provided? 8. What interventions have you found to be most helpful with your client? 9. Can you comment on your client s ability to parent their child/ren both now and Page 43 of 62