Safeguarding Children & Young People Policy Document History Lead/Author(s) Sue Nichols Reggie Medina-Rios Version and date 02 February 2016 Approved by BHR CCGs Quality & Safety Committee Approval / Implementation date 7 June 2016 Review date February 2019 Target audience All CCG staff Date of equality impact assessment February 2016 Policy reference number SCYPP001 Version History Date Version Author Status 2 April 2014 01 Steph Sollosi Final Sue Nichols February 2016 02 Reggie Medina-Rios Final Description of change/comments 30/06/2015 reviewed and revised in with up dated Government guidance: Working together to safeguard children. DFE 2015 Serious Incident Framework -Supporting learning to prevent recurrence. NHS England. March 2015 The London Child Protection Procedures LSCB 2015 Safeguarding Children & Young People: Roles & Competencies for Health Care Staff Intercollegiate Document. September 2014 1
Table of Content Section Page Number 1 Introduction 4 2 Application and Scope 4 3 Purpose 5 4 Definitions of harm 5 5 Accountability structure for safeguarding in CCG 6 Duties and responsibilities 6 7 Partnership working 7 8 Safeguarding children training 7 9 Information sharing 7 10 Local arrangements for addressing concerns 11 Safer Recruitment 9 12 Allegations against staff 9 13 Whistleblowing 9 14 Professional boundaries 10 15 Supervision and Support 10 16 Serious Case Reviews 10 17 Monitoring and Effectiveness 10 References 11 Equality Impact Assessment (EIA) 12 Appendices Appendix 1. Definitions of harm Appendix 2. Safeguarding Structure 5 8 13 14 2
1.0 INTRODUCTION 1.1 The safety and wellbeing of children and young people, pre-birth to 18 years. This policy sets out the statutory requirements for the CCG to discharge its appropriate accountability for safeguarding children and young people at risk of harm or abuse. This policy should be read in conjunction with the London Child Protection Procedures (2015) and Working Together to Safeguard Children (2015). 1.2 Barking & Dagenham, Havering & Redbridge Clinical Commissioning Group (BHRCCGs) is fully committed to promoting the safety and wellbeing of children and young people, pre-birth to 18 years. This policy sets out the statutory requirements for the CCG to discharge its appropriate accountability for safeguarding children and young people at risk of harm or abuse. This policy should be read in conjunction with the London Child Protection Procedures (2015) and Working Together to Safeguard Children (2015). 1.3 This policy sets out the collective and individual expectation for CCG staff to comply with legislation and codes of conduct. The policy describes the definitions of abuse for children and set out how CCG staff should report such abuse. 1.4 Key guidance, national regulations, reports and legislations that govern how safeguarding children and child protection services should be provided, managed and monitored are as follows: The Children Act 1989 and 2004 The London Child Protection Procedures (2015) Working Together to Safeguard Children (2015) The National Assessment Framework for Children in need and their Families (2000) Common Assessment Framework for Children and Families (2005) Children s NSF (2004) Statutory Guidance on Promoting the Health and Wellbeing of Looked After Children (2015) Essential standards of quality and safety: outcome 7 regulation 11 (2010) Munro Review of Child Protection: A child centred system (2011) Safeguarding Children & Young People: Roles & Competencies for Health Care Staff: Intercollegiate Document (September 2014) Information Sharing Guidance (DCSF 2015) Data Protection Act 1998 Human Rights Act 1998 Safeguarding Vulnerable People in the Reformed NHS: Accountability and Assurance Framework June 2015 3
2.0 APPLICATION AND SCOPE 2.1 This policy applies to all CCG staff including those on secondment in and out of the organisation, volunteers, students, honorary appointees, trainees, contractors, temporary workers including locum and those working on a bank or agency contracts. 2.2 For ease of reference, all staff and workers who fall under these groups will be uniformly referred to as staff in this document. 3.0 PURPOSE 3.1 This policy will describe how the CCG will meet its corporate accountability for safeguarding Children. 3.2 It will provide guidance to CCG staff to enable them to fulfil their safeguarding children responsibilities. 3.3 It will also provide guidance in our commissioning roles to drive continual improvement of services for children in terms of equity, effectiveness, safety, timeliness, efficiency and child centeredness. 4.0 DEFINITIONS OF HARM OR SIGNIFICANT RISK OF HARM 4.1 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. 4.2 Appendix 1 sets out these definitions in detail. 5.0 ACCOUNTABILITY STRUCTURE FOR SAFEGUARDING IN CCG 5.1 Barking and Dagenham, Havering and Redbridge CCGs (BHR CCGs) Chief Officer has overall accountability for safeguarding within the CCGs and these accountabilities are discharged through the delegation of responsibilities to the Governing Body Nurse Director. 5.2 The Nurse Director is the Governing Body executive lead for safeguarding and is supported by the Head of Safeguarding. The Chief Operating Officer (COO) within the CCG is the operational lead for ensuring the implementation of safeguarding functions, supported by the CCG safeguarding team. 5.3 The CCG safeguarding team consists of the designated doctor and nurse for safeguarding children, designated doctor for child deaths and designated doctor and nurse for looked after children (LAC). 4
5.4 Leadership and management for commissioning and quality assuring safeguarding responsibilities and functions are provided at a senior level through the designated professionals. 5.5 Appendix 2 shows the BHR CCGs safeguarding structure 6.0 DUTIES AND RESPONSIBILITIES 6.1 Designated professionals 6.1.1 The designated doctor and nurse take a strategic and professional lead on safeguarding children across the borough. 6.1.2 The designated nurse for safeguarding children works closely with the provider trusts named doctors and nurses to develop and improve safeguarding practice in line with Working Together 2015. 6.1.3 The designated professionals for children offer safeguarding supervision to the named doctors and nurses. 6.1.4 The designated doctors and nurses will access training and supervision commensurate with their roles. 6.2 Commissioning and Contract Managers 6.2.1 Commissioning and contract managers will ensure that service specifications of all health providers from whom services are commissioned include clear service standards for safeguarding and promoting the welfare of children. 6.2.2 The requirement to work in accordance with the Data Protection Act and Caldicott Principles; to secure information in transmission when sharing information within and between organisations; and to comply with CCG Information Governance policies. 6.2.3 To ensure all services commissioned or provided are delivered in a nondiscriminatory manner, respect the individuality and rights of the child, and are child-centred. 6.3 CCG staff 6.3.1 It is the responsibility of all staff to safeguard children. They should be able to recognise indicators of abuse and know how to act upon concerns. The depth of knowledge should be commensurate with their roles and responsibilities. 6.3.2 Staff must be up to date with the appropriate level of safeguarding children training as set out in the intercollegiate document (2014) and human resource mandatory training guidance. 5
6.3.3 Staff should recognise that sharing information is vital to ensure that children are protected from abuse and neglect and that the safeguarding of children is paramount and can override any duty of confidentiality. Staff should be familiar with the government information sharing guidance 6.3.5 Staff have a responsibility to uphold safe working practice by acting on concerns relating to the conduct of colleagues, particularly in relation to children at risk. Staff should seek advice from their line manager or another senior manager. Staff should also refer to the CCG Managing safeguarding allegations against staff policy. The safeguarding team are also available for advice and support. 6.4 LINE MANAGERS 6.4.1 Line managers have a responsibility to comply with the safeguarding policies and the commitment of the CCG to ensure all staff are supported to maintain training, staff competency and supervision as appropriate to role. 7.0 PARTNERSHIP WORKING 7.1 The CCG shares a responsibility to work with its partners to safeguard and promote the welfare of children. This is achieved in the following ways; 7.2 Designated professionals for safeguarding children work across the borough with healthcare service providers and local authority services by providing expert safeguarding advice, support, supervision, and seeking assurance of their safeguarding arrangements 7.3 The CCG is represented on the Local Safeguarding Children Board (LSCB) by the nurse director, head of safeguarding and designated professionals. The designated professionals participate in LSCB sub-groups or committees and other relevant safeguarding meetings. 8.0 SAFEGUARDING CHILDREN TRAINING. 8.1 In order to safeguard and promote the welfare of children and young people all staff who work in a healthcare setting must have the knowledge and skills to carry out their roles and responsibilities. The CCG is committed to have arrangements in place to ensure effective training for all staff. 8.2 The CCG expects all staff to be trained in children safeguarding at Level 1. Further levels of training will be determined by their roles and responsibilities as set out in job descriptions. Staff should refer to the CCG Training Strategy for Safeguarding and Looked After Children to determine the required competency, skills and knowledge commensurate to their role. 6
9.0 INFORMATION SHARING 9.1 Promoting young people s well-being and safeguarding them from harm depends upon effective information sharing, collaboration and understanding. Often, it is only when information from a number of sources has been shared and pulled together that it becomes clear that there are concerns or that a child is in need of protection or services. 9.2 It is important, of course, to keep a balance between the need to maintain confidentiality and the need to share information to protect others. Decisions to share information must always be based on professional judgement about the safety and well-being of the individual and in accordance with legal, ethical and professional obligations. 9.3 Healthcare professionals can disclose information for the purposes of safeguarding provided that the proposed disclosure meets the public interest test. This test involves weighing up; the public interest of protecting individual children or vulnerable adults who are potentially at risk of harm, against; the public interest of protecting their confidentiality and privacy, while taking account of the individual s wishes where these are known. 9.4 In making disclosures, professionals need to disclose information incrementally, starting with the minimal disclosure. The responsibility for making these disclosures rests with the senior responsible professional. Where the balance of public interests is unclear, the advice of the Caldicott Guardian should be sought. 9.5 The CCG is signed up to the LSCB Multi-Agency Information Sharing Framework. 10.0 LOCAL ARRANGEMENTS FOR ADDRESSING CONCERNS RELATING TO THE SAFETY AND WELLBEING OF CHILDREN AND YOUNG PEOPLE. 10.1 It is the responsibility of staff to make a referral to Children Social Services whenever they suspect that a child is suffering or likely to suffer from significant harm. 10.2 Staff can contact the designated professionals for advice on safeguarding children/child protection matters if discussion is needed prior to referral to Children Social Services and/or Multiagency Safeguarding Hub (MASH). It remains the responsibility of the person who has the concern to make the referral. 10.3 Staff who refer a child to children social services should confirm their referral in writing on the appropriate form within 24 hours. If the referrer has not received an acknowledgement within 3 working days, they should follow up with the appropriate local authority children social services. 7
10.4 If the referrer remains unclear regarding the outcome of their referral or if there is a difference of opinion regarding the outcome, the referrer should contact the designated professionals for further discussion. Staff should refer to the LSCB Escalation Policy if differences cannot be resolved. 10.5 All professionals have a responsibility to comply with the Female Genital Mutilation FGM mandatory reporting process introduced 31 st October 2015. See link for further guidance https://www.gov.uk/government/publications/mandatory-reporting-of-femalegenital-mutilation-procedural-information 10.6 All staff should refer to the Local Child Sexual Exploitation Strategy produced by the Local Safeguarding Children Board 10.7 Contact details and Multi-Agency Referral Forms Safeguarding Children Essential Contact Details Multi Agency Referral Form (MARF) B&D LSCB Escalation Policy Safeguarding Children Essential Contact Details Multi Agency Referral For (MARF) B&D LSCB Escalation Policy 11.0 SAFER RECRUITMENT 11.1 The CCG recruitment policy adheres to the principles of safer recruitment. Safeguarding statements are clear in job descriptions and adverts and prior to commencing employment a minimum of two references are required including the most recent employer, checking of ID, professional qualifications and employment history. 11.2 Recruiting managers shall seek guidance from Human Resources to determine the level of Disclosure and Barring Service (DBS) check required for the role. Managers shall ensure clearance is obtained before the applicant commences employment. 12.0 ALLEGATIONS AGAINST STAFF 12.1 The CCG adheres to the Local Authority Designated Officer (LADO) process for dealing with allegations relating to staff conduct towards children or other behaviour which indicates they pose a risk to children. Refer to the CCG Managing Safeguarding Allegations against Staff Policy and Procedure. 8
13.0 WHISTLEBLOWING 13.1 A culture of open practice underpins effective safeguarding within an organisation. This CCG whistleblowing policy contributes to the CCG safeguarding children arrangements by supporting a culture where issues can be raised safely and addressed by the organisation. This may be in relation to an individual s conduct and practice, illegal activity or a widespread or systemic failure in the provision or management of services to children which places them at risk. 14.0 PROFESSIONAL BOUNDARIES 14.1 Maintaining professional boundaries is central to providing safe and quality care for patients. It ensures personal and organisational reputation is maintained, professional standards are upheld and statutory requirements are met. Staff should be aware that this responsibility extends to conduct on the internet and in the use of communication devices such as mobile phones and tablets. Refer to the CCG Standards of Employment Practice. 15.0 SUPERVISION AND SUPPORT 15.1 Safeguarding children supervision is described as An accountable process which supports; assures and develops the knowledge, skills and values of an individual, group or team. 15.2 The CCG seeks assurance from all commissioned healthcare provider services that provisions are made for their staff to receive safeguarding supervision. 15.3 Designated professionals should receive regular supervision and also provide supervision to named professionals. Refer to the CCG Safeguarding Supervision Policy. 15.4 The designated professionals are available for advice and support both within the CCG and other healthcare colleagues across the borough. They are a source of expertise and advice in the management of complex and challenging cases or situations 16.0 SERIOUS CASE REVIEW (SCR) PROCESS 16.1 Refer to Working Together to Safeguard Children (2015). Chapter 4 Learning and Improvement Framework for clarification and guidance 9
17.0 MONITORING AND EFFECTIVENESS 17.1 The CCG Safeguarding Children Assurance Committee will have oversight of safeguarding arrangements and hold organisations to account when gaps and or quality issues are identified. These gaps or quality issues are identified via the Care Quality Review Meetings (CQRM), Clinical Incidents and meetings with healthcare providers. 17.2 The committee will send minutes of the monthly meetings to the Quality and Safety Committee including any exception reporting and identified safeguarding risks. 18.0 References Information sharing Advice for practitioners providing safeguarding services to children, young people, parents and carers HM Govt March 2015 Providing Effective Supervision Skills for Care and CWDC 2007 Barking and Dagenham LSCB Escalation Resolution and Policy 2015 Safeguarding children and young people: roles and competences for health care staff intercollegiate document. The Royal College of Paediatrics and Child Health (RCPCH) 3rd edition: March 2014. Safeguarding Vulnerable People in the Reformed NHS: Accountability and Assurance Framework NHS England June 2015 The London Child Protection Procedures LSCB 5 th Ed. 2015 Working Together to Safeguard Children, a guide to inter-agency working to safeguard and promote the welfare of children HM Govt 2015 Mandatory reporting of female genital mutilation: procedural information Oct 2015 https://www.gov.uk/government/publications/mandatory-reporting-offemale-genital-mutilation-procedural-information Acts Children Act 1989 and 2004 Data Protection Act 1998 10
Equality Act 2010 Health & Social Care Act 2008 & 2012. Human Rights Act 1998 11
EQUALITY IMPACT ASSESSMENT Policy author: Reggie Medina-Rios Sue Nichols Title of policy: Managing Safeguarding Allegations against Staff Equality Impact Assessment Form Date of assessment: 12/02/16 Is this a new or existing policy? A new policy 1. Is there a concern that the policy does or could have a differential impact in any of the following areas? Age Civil partnership/marriage Disability Faith or religious beliefs Gender Race Pregnancy/maternity Sexual orientation Transgender Y/N delete as appropriate 2. If the answer is no for the groups above, please sign and date the form and add this form to the end of the policy. 3. If the answer is yes for any of the groups above, please explain the reasons and complete box 4 (below). For help please contact the engagement adviser for advice (020 8926 5048). 4. Are there any additions or actions to be added to the policy which ensure the policy does not have an adverse impact on any of the protected groups? If the answer is yes, please detail below. Signed: (Policy authors) Your contact details (department; e-mail; telephone number) Date: 17/02/16 Safeguarding Team Reggie.medina-rios@onel.nhs.uk 01708 574908 Sue.nichols@onel.nhs.uk 0208 926 5259 12
Appendix 1 Definition of child abuse Physical Abuse 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 Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe 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 only insofar as they meet the needs of another person. It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child s development capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction. It may involve seeing or hearing the ill treatment of another. It may involve serious bulling, causing children frequently to feel frightened or in danger, or the exploitation or corruption of children of children. Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone. Sexual Abuse Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including prostitution, whether or not the child is aware of what is happening. The activities may involve physical contact, including penetrative (e.g. rape, buggery or oral sex) or non-penetrative acts. They may include non-contact activities, such as involving children in the looking at, or in the production of, sexual online images, watching sexual activities or encouraging children to behave in sexually inappropriate ways. Neglect Neglect is the persistent failure to meet a child s basic physical and/or psychological needs, likely to result in 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 (including exclusion from home or abandonment); Protect a child from physical and emotional harm or danger; Ensure adequate supervision (including the use of inadequate care-givers); or Ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child s basic emotional needs. Staff also need to be aware of vulnerable groups such as those with disabilities, children living away from home, asylum seekers, children and young people in hospital, children in contact with the youth justice system, victims of domestic abuse and those vulnerable due to religion, ethnicity etc. and those who may be exposed to violent extremism. 13
Appendix 2 CURRENT SAFEGUARDING TEAM STRUCTURE NURSE DIRECTOR HEAD OF SAFEGUARDING Barking & Dagenham Designated Nurse for Safeguarding Children Designated Nurse for LAC (BHR CCG) Designated Dr for Safeguarding Children Designated Dr for Child Death Havering Designated Nurse for Safeguarding Children Designated Dr for Safeguarding Children Redbridge Designated Nurse for Safeguarding Children Designated Dr for Safeguarding children Designated Dr for Child Death BHR CCG Designated Clinical Officer BHR CCG Designated Dr for Looked After Children (LAC) 14