WAMCCG-Safeguarding-Policy-January-2013 by dandanhuanghuang

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									  Windsor and Maidenhead
Clinical Commissioning Group
  Safeguarding Children and
   Vulnerable Adults Policy



                           Version 1.2
            Date: 26th November 2012
            Agreed by Governing Body
              Review Date: April 2014




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Document      Management   Title   of Safeguarding Children and Vulnerable
Document                              Adults Policy (Commissioning)


Description                           The policy outlines responsibilities for
                                      safeguarding children and vulnerable
                                      adults in line with statutory guidance
                                      and policy, and supports the ethos of
                                      “safeguarding is everybody’s business.‟
                                      The purpose of the policy is to ensure all
                                      staff, including contracted staff, are
                                      aware of their roles and responsibilities
                                      for safeguarding children and vulnerable
                                      adults, and to provide a framework for
                                      accountability at all levels.

Target Audience                       All Staff in Windsor and Maidenhead
                                      Clinical Commissioning Group




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CONTENTS SECTION   DESCRIPTION                                                 PAGE

1.                 Introduction

2.                 Scope of Policy

3.                 Definitions

4.                 Policy Statement

5.                 Roles and Responsibilities

6.                 Staff Training, Support and Professional Development

7.                 Recruitment and Personnel Processes

8.                 Prevent

9.                 Commissioning Arrangements

10.                Clinical Governance

11.                Serious Case Reviews

12.                Review and Maintenance of Policy

                   References and Bibliography




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1. Introduction - Context

This document defines the Safeguarding Children and Vulnerable Adults Policy for
Windsor and Maidenhead Clinical Commissioning Group hereafter referred to as the
CCG.,

This policy illustrates the statutory requirements to safeguard children and vulnerable
adults; and standards for compliance with these legislative duties, and with local and
national safeguarding quality assurance frameworks. It supports the ethos that
‘safeguarding children and vulnerable adults is everybody’s business’. It is
applicable to all staff.

Berkshire PCT Cluster is the current statutory commissioning organisation for Berkshire.
The PCT Cluster Chief Executive remains accountable for ensuring that the duties to
safeguard children and adults within Berkshire are discharged effectively across the
whole health economy until this responsibility is transferred to the CCG on 1st April 2013

In discharging these statutory duties/responsibilities account must be taken of:

   Statutory guidance on making arrangements to safeguard and promote the welfare of
    children under section 11 of the Children Act 2004 (HM Government 2007)
   Working Together to Safeguard Children (HM Government 2010)
   Statutory Guidance on promoting the Health and well-being of Looked After Children
    (DH2009)
   No Secrets (DH and Home Office 2000)
   Mental Capacity Act 2005: Code of Practice (Department for Constitutional Affairs
    2007)
   The policies and procedures of the Berkshire Local Safeguarding Children Boards
    (LSCBs) and the Windsor and Maidenhead Safeguarding Adults Partnership Board
    (SAPB).
   The Care and Support Bill includes sections on adult safeguarding.
   Safeguarding Adults: The Role of the Health Service March 2011
   Deprivation of Liberty Safeguards : Care Home Safeguards
   The Policies and Procedures of the Well Being Boards

Responsibility for commissioning primary care independent contractor services (general
practice, NHS dentistry, and community pharmacy and orthoptic services) currently
remains with the PCT, along with a duty to ensure that children and vulnerable adults are
effectively safeguarded in these services. The commissioning responsibility for these
services will pass to the NHS Commissioning Board as of 1st April 2013.

The PCT and CCG have a responsibility to ensure that children and vulnerable adults
are effectively safeguarded by the services they commission. The CCG is required to
ensure that all health providers from whom they commission services (both public,
independent, voluntary, community and faith sector) have comprehensive single and
multi-agency policies and procedures in place to safeguard and promote the welfare of
children and to protect vulnerable adults from abuse or the risk of abuse; that health
providers are linked into the LSCB and SAPB and that health workers contribute to multi-
agency working.

This document should be read in conjunction with:




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   Working Together to Safeguard Children: A guide to inter-agency working to
    safeguard and promote the welfare of children, HM Government, 2010. (A revision
    of this statutory guidance is due in January 2013)
   Berkshire Local Safeguarding Children Board (LSCB) Child Protection Procedures.
   Statutory guidance on making arrangements to safeguard and promote the welfare of
    children under section 11 of the Children Act

Working Together to Safeguard Children provides detailed guidance on safeguarding
roles and responsibilities for organisations and some key individuals, and where these
delegated responsibilities have been transferred to the CCG they are outlined in the
relevant sections of this policy.

Berkshire LSCB Child Protection Procedures describe Windsor and Maidenhead’s
local interagency arrangements for responding to concerns that a child may be at risk of
significant harm.

Section 11 Duties: The CCG must comply with its duty under Section 11 of the Children
Act 2004 to demonstrate that they are meeting their responsibilities to safeguard and
promote the welfare of children, and must be able to provide evidence of the following:

   Senior management commitment to the importance of safeguarding and promoting
    children’s welfare;

   A clear statement of the CCG’s responsibility towards children is available to all CCG
    staff and the services the CCG commissions.

   A clear line of accountability within the CCG for work on safeguarding and promoting
    the welfare of children.

   That service development takes into account the need to safeguard and promote the
    welfare of children and is informed, where appropriate, by the views of children and
    families.

   That there is a funded safeguarding children and vulnerable adult training strategy to
    ensure all staff (including contracted staff) at all levels receive relevant training and
    have an understanding of both their roles and responsibilities, and those of other
    professionals and organisations

   Safer, robust recruitment procedures that help prevent unsuitable people from
    working with children. Those who recruit staff should have the appropriate training.

   That the organisation supports effective inter-agency working, following national
    statutory guidance (Working Together to Safeguard Children 2010, and Framework
    for the Assessment of Children in Need 2004) and local practice guidance from the
    Local Safeguarding Children Board.

   That the organisation promotes effective information sharing, supported by national
    and local guidance and protocols.

(From Statutory Guidance on Making Arrangements to Safeguard and Promote the
Welfare of Children Under Section 11 of the Children Act 2004, HM Government 2007)




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2. Scope of the Policy

    This policy applies to all staff working within the CCG.

    Each Windsor and Maidenhead CCG member, employee or contractor has an individual
    responsibility for the protection and safeguarding of children and young people, in both
    their professional and home lives.

    The CCG is required to have appropriate contract monitoring arrangements in place to
    ensure all providers are meeting their statutory and contractual responsibilities. All
    provider health organisations commissioned by the PCT and CCG must have their own
    polices for safeguarding children, which must be consistent with this policy, and in line
    with their own statutory responsibilities and with Berkshire Local Safeguarding Board
    child protection procedures.


3. Definitions

   Safeguarding and promoting the welfare of children is defined as:

      Protecting children from maltreatment
      Preventing impairment of a child’s health and development
      Ensuring that children are growing up in circumstances consistent with the provision
       of safe and effective care; and
      undertaking that role so as to enable those children to have optimum life chances
       and to enter adulthood successfully.

   Child Protection is a part of safeguarding and promoting the welfare of children. This is
   the process of protecting individual children identified as suffering, or who are likely to
   suffer significant harm as a result of abuse or neglect. The main categories of abuse
   are physical, sexual, emotional abuse, or neglect.

   Significant Harm is the threshold that justifies compulsory intervention in family life in
   the best interests of children (Children Act, 1989). There are no absolute criteria on
   which to rely when judging what constitutes significant harm. Sometimes, a single
   traumatic event may constitute significant harm, but more often, significant harm is a
   compilation of significant events, both acute and long-standing, which interrupt, change
   or damage the child’s physical and psychological development.

   Children in Need - Children who are defined as being “in need‟; under section 17 of the
   Children Act 1989, are those whose vulnerability is such that they are unlikely to reach or
   maintain a satisfactory level of health or development, or their health and development
   will be significantly impaired, without the provision of services (section 17 (10) of the
   Children Act 1989), plus those children who are disabled.

   Child: Anyone who has not yet reached their 18th birthday.

   (As defined in Working Together to Safeguard Children, 2010)

   Vulnerable Adult: Whilst there is no formal definition of vulnerability within health care,
   some people receiving health care may be at greater risk from harm than others,
   sometimes as a complication of their presenting condition and their individual
   circumstances. The risks that increase a person’s vulnerability should be appropriately


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   assessed and identified by the health care professional/VCFS provider at the first contact
   and continue throughout the care pathway (DH 2010).

   In 2000 'No Secrets' (Department of Health and Home Office), was published for use by
   all health and social care organisations and the police. It defined abuse as 'a violation of
   an individual's human and civil rights by any other person or persons'. 'No Secrets' was
   based on the premise that some groups of adults experience a higher incidence of abuse
   than the general population and that they are not easily able to access services to lead
   safer lives; work undertaken since the publication of 'No Secrets' has confirmed this to
   be the case.

   Under Section 59 of the Supporting Vulnerable Groups Act (2006) a person aged 18
   years or over is also defined as a vulnerable adult where they are ‘receiving any form of
   health care’ and ‘who needs to be able to trust the people caring for them, supporting
   them and/or providing them with services’. A vulnerable adult is a person aged 18 years
   or over who may be unable to take care of themselves, or protect themselves from harm
   or from being exploited. This may be because they have a mental health problem, a
   disability, a sensory impairment, are old and frail, or have some form of illness.

Adult at risk: a person aged 18 or over and who:
   is eligible for or receives any adult social care service (including carers’ services)
       provided or
   arranged by a local authority; or
   receives direct payments in lieu of adult social care services; or
   funds their own care and has social care needs; or
   otherwise has social care needs that are low, moderate, substantial or critical;
   or falls within any other categories prescribed by the Secretary of State

   and

   is at risk of significant harm, where harm is defined as ill-treatment or the impairment of
   health or development or unlawful conduct which appropriates or adversely affects
   property, rights or interests (for example theft, fraud, embezzlement or extortion).


4. Policy Statement

    The CCG asserts that children and vulnerable adults must be valued and protected. The
    CCG champions the rights of all children and vulnerable adults not to be abused,
    neglected or exploited and have the right to be happy, healthy, safe and productive in
    their contribution to society.

   The CCG is committed to all policy, procedures and practice which safeguards children
   and protects vulnerable adults and promotes their welfare. The CCG aims to commission
   safeguarding services that will ensure equal access to all children and vulnerable adults,
   regardless of:

       age;
       disability;
       gender reassignment;
       pregnancy and maternity;
       race;
       religion or belief;

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     sex;
     sexual orientation.
     marriage and civil partnership

   The CCGs will fulfil this commitment by:

      Full compliance with all statutory guidance on safeguarding children.

      Demonstrating compliance with local and national safeguarding quality assurance
       frameworks including the Berkshire LSCBs section 11 audit standards.

      Active partnership and full co-operation with Windsor and Maidenhead Local
       Safeguarding Children Board (LSCB) and Windsor and Maidenhead Children and
       Young People’s Partnership Board (CYPPB) aims and objectives.

      Active partnership and full co-operation with Windsor and Maidenhead Safeguarding
       Adults Partnership Board aims and objectives.

      Ensuring that children and vulnerable adults are valued and their safety and welfare
       is considered at all stages of commissioning, including contracting arrangements and
       performance management frameworks.

      Ensuring all service developments take account of the need to safeguard all service
       users, and is informed, where appropriate, by the views of service users.

      Supporting safe working practices including recruitment and vetting procedures.

      Promoting effective interagency working, including effective information sharing.


5. Roles and Responsibilities

    Accountable Officer
    Responsible for ensuring that the health contribution to safeguarding children and
    vulnerable adults and promoting their welfare is discharged effectively across the range
    of services commissioned by the CCG

   Responsibilities of the Governing Body
    To ensure that a board executive lead for safeguarding children and vulnerable
      adults is identified to take responsibility for the organisation’s safeguarding strategy
      and governance.

      To ensure that a senior paediatrician and senior nurse are identified to undertake the
       role of designated professionals for safeguarding children across the health
       economy.

      To ensure that the CCG cooperates with the local authority in the establishment and
       operation of Windsor and Maidenhead Local Safeguarding Children Board (LSCB)
       and that the CCG as LSCB partners, share responsibility for the effective discharge
       of its functions in safeguarding and promoting the welfare of children.

      To ensure that the CCG cooperates with the local authority in the establishment and
       operation of Windsor and Maidenhead Safeguarding Adults Partnership Board

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    (SAPB) and that the CCG as SAPB partners, share responsibility for the effective
    discharge of its functions in safeguarding and promoting the welfare of vulnerable
    adults.

   To receive information relating to serious case reviews and other case reviews,
    including notification that a review has commenced, and updates on identified
    learning, recommendations and action plans, and progress towards publication
    where relevant.

   To receive governance reports and any other reports requiring board approval or
    decision.

Board Executive Safeguarding Lead – Nurse Director Post

   Execute all children and vulnerable adults safeguarding responsibilities on behalf of
    the Accountable Officer and Governing Body.

   Represent Windsor and Maidenhead CCG on the Windsor and Maidenhead Local
    Safeguarding Children Board (LSCB) and Windsor and Maidenhead Safeguarding
    Adults Partnership Board (SAPB).

   Ensure effective engagement in MAPPA (Multiagency Public Protection
    Arrangements) a partnership arrangement to manage risks posed by violent and
    sexual offenders in the community) and MARAC (Multiagency Risk Assessment
    Conference) a victim- focussed multiagency meeting to share information and
    manage the highest risk domestic abuse cases. This might require attendance at
    MAPPA & MARAC as appropriate or when invited to do so.

   Commission and sign off internal management reviews for serious case reviews
    where necessary.

   Report any appropriate safeguarding children risks and/or achievements to the
    Accountable Officer and the Governing Body through the Quality Committee.

   Be overall accountable for the reporting of serious incidents regarding safeguarding
    children and vulnerable adults.

Designated professionals

Designated professionals have specific roles and responsibilities for safeguarding
children. As commissioners, the CCG must have a designated doctor and nurse to take
a strategic, professional lead on all aspects of the health service contribution to
safeguarding children across Windsor and Maidenhead, which includes all providers.

Designated professionals will:
 Provide advice to ensure the range of services commissioned by the CCG take
   account of the need to safeguard and promote the welfare of children.

   Provide advice on the monitoring of the safeguarding aspects of CCG contracts.

   Provide advice, support and clinical supervision to the named professionals in each
    provider organisation.

   Provide skilled advice to the LSCBs on health issues.

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      Promote and influence the development of relevant training to ensure the training
       needs of health staff are addressed

      Provide skilled professional involvement in child safeguarding processes in line with
       LSCB procedures

      Participate in serious case reviews and other case reviews and audits, to ensure an
       overview evaluation of how health professionals work together across the health
       economy to safeguard children, and to take a strategic lead in embedding learning
       from such reviews.


   Responsibilities of all staff

   All health professionals have an individual duty to safeguard children, and it is imperative
   that all staff (including contracted staff, and non-clinical staff) are able to:

      recognise and understand what constitutes abuse or neglect,
      be familiar with the Berkshire LSCB and SAPB safeguarding policy and procedures,
       and those of their own organisation
      know where to access support and advice, by knowing the contact details of named
       and designated professionals
      know how to record the details of any concerns and action taken
      understand the principles of information sharing when children or vulnerable adults
       are in need, or at risk of abuse or neglect

   Where appropriate to their role, health professionals must be able to refer to the
   appropriate agency within appropriate timescales, and contribute effectively to
   subsequent multi-agency working to protect children or vulnerable adults in need of a
   protection plan.


6. Staff training, support and professional development

    In order to ensure that CCG staff can meet their organisational and individual
    professional responsibilities to safeguard children and vulnerable adults, the CCG will
    ensure that all staff access training, support and professional development appropriate
    to their role.

   All safeguarding training will be consistent with:
    Roles and Competencies for Health care Staff, the Intercollegiate Document, Royal
       College of Paediatrics and Child Health (RCPCH, 2010)
    Working Together to Safeguard Children, 2010
    The Safeguarding Vulnerable Groups Act 2006
    Health and Social Care Act 2008 (Regulated Activities) Regulations 2010
    The Equality Act 2010
    Civil Law - Duty of Care
    Deprivation of Liberty Safeguards

   Any CCG staff whose role involves individual case work with vulnerable children (for
   examples, commissioning services for individual children with highly complex needs


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   arising from disability or mental health) will access advice and supervision in relation to
   any safeguarding concerns via the designated professionals.

   The CCG will ensure that the designated professionals and others with senior
   safeguarding roles, including the executive lead for safeguarding, will have access to any
   training, supervision and support identified as needed through professional development
   processes.


7. Recruitment and Personnel Processes

   The organisation has a duty to introduce safer working practices, in line with statutory
   guidance in Working Together to Safeguard Children 2010.

   This includes recruitment processes that filter out people who are not suitable or safe to
   work with children, and ensure appropriate regard to the need to safeguard children by a
   sound process of:

      Training staff involved in recruitment,
      Ensuring all references are taken up prior to starting work
      Stringent and appropriate Criminal Records Bureau disclosure, based on
       assessment of risk to children
      Appropriate management of allegations against staff.

   Clinical Commissioning Groups have a statutory duty to ensure that appropriate action is
   taken, if an allegation is made, or suspicion or concern arises, about harm to a child by
   an employee. The same process must also apply to students and volunteers. The CCG
   will apply an allegations management procedure consistent with statutory guidance and
   Berkshire LSCB procedures.

   Statutory guidance and Berkshire LSCB procedures on allegations management require
   that organisations have a Named Officer accountable for ensuring that this process is
   functioning effectively and fairly. Currently, the Named Officers for Allegations are:

    i. PCT Cluster - Director of Joint Commissioning
    ii. Windsor and Maidenhead CCG – Accountable Officer. This responsibility will be
    transferred to the Nurse Director once in post.


8. Prevent

    Prevent is part of a national strategy led by the Home Office, which focuses on working
    with individuals and communities who may be vulnerable to the threat of violent
    extremism and terrorism. Supporting vulnerable individuals and reducing the threat
    from violent extremism in local communities is a priority for the health service and its
    partners.

   The healthcare sector is a key strategic partner in Prevent and this was endorsed by the
   publication of the Prevent Strategy (2011) with the following objectives:

      Challenge the ideology that support terrorism and those who promote it




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      Prevent vulnerable individuals from being drawn into terrorism and ensure that they
       are given appropriate advice and support

      Work with sectors and institutions where there are risks of radicalization

   Healthcare workers may have contact with vulnerable adults or young people (including
   children under the age of 18) who could become victims of radicalisation. There is no
   obvious profile of a person likely to become involved in terrorist-related activity, or single
   indicator of when a person might move to support extremism. Vulnerable individuals who
   may be susceptible to radicalisation can be patients or staff. Prevent ensures that those
   who are at risk will receive help and support from partners best placed to meet these
   needs.

   The CCG will ensure that there are robust Prevent arrangements in place across the
   health economy. This will be monitored through safeguarding assurance processes and
   form part of quality contracting monitoring.

   CCG staff will receive Prevent awareness training via Level One Safeguarding Children
   Awareness. For raising concerns, the CCG staff will contact the safeguarding designated
   professionals in the first instance, who will provide advice and identify local referral
   pathways if necessary.

9. Commissioning Arrangements

   The CCG in partnership with other agencies is responsible for improving the health and
   wellbeing of their local population, including children and vulnerable adults. To achieve
   this, they are under a legal duty to work with the local authority to assess what kind of
   health services people need and this is facilitated through the Joint Strategic Needs
   Assessment (JSNA).

   Commissioning organisations are responsible for ensuring that all provider organisations
   and contracted staff are carrying out their safeguarding roles and responsibilities
   through the commissioning, contracting and quality assurance framework.

   They must therefore ensure that service specifications for commissioned and contracted
   services include clear service standards and monitoring arrangements for safeguarding
   children and vulnerable adults and that all health providers from whom services are
   commissioned have comprehensive single and multi-agency policies and procedures to
   safeguard and promote their welfare.

   The following are examples of particular service provision and policy requirements:

      All providers have a policy to inform the Local Authority if a child is resident in
       hospital or hospice care for 12 weeks or more, a requirement under Section 85/86 of
       the Children Act 1989.

      Any providers of mental health in-patient care have policies to inform the CCG if
       children under 18 are housed in the same wards as adults, and that they are
       transferred to more suitable accommodation within 48 hours, and policy regarding
       children visiting in-patients on wards.

      All front-line staff should have access to paediatricians trained in examining,
       identifying and assessing children and young people who may be experiencing
       abuse or neglect.

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      The CCG should also ensure that commissioning expertise on sexual violence
       services, to ensure there is an effective local Sexual Abuse Referral Service (SARS)
       care pathway for children and young people.

      Strategic Commissioning for Independence and Choice initiative


10. Clinical Governance

   The CCG will apply the principles of sound clinical and corporate governance in relation
   to safeguarding children and vulnerable adults which takes account of the corporate
   governance framework for commissioning.

   The CCG will ensure that safeguarding and promoting the welfare of children and
   vulnerable adults is integral to clinical governance and audit arrangements.

   The CCG will ensure that all child deaths and serious incidents in relation to children are
   reported and investigated according to relevant reporting policies. This will also ensure
   that any safeguarding concerns are identified in such cases, the interfaces between
   these processes and the serious case review process function clearly and effectively.
   This is a function of the Child Death Overview Panel

   The Safeguarding Children Designated Professionals and the Board Executive
   Safeguarding Lead will report monthly to the CCG Governing Body on the range of
   safeguarding activities, quality assurance processes, Serious Case Reviews and other
   serious incidents via the Quality Committee, with additional exception reporting as
   required.


11. Serious Case Reviews

   The CCG has a statutory duty to work in partnership with the Windsor and Maidenhead
   Local Safeguarding Children Board, and/or any other Safeguarding Children Board and
   Adult Safeguarding Boards across the country in conducting Serious Case Reviews, in
   accordance with statutory guidance. They must ensure that reviews and all actions
   taken following reviews are carried out according to the timescale set out by the Serious
   Case Review Panel.

   The CCG must ensure that sufficient resources are in place to meet this requirement.
   This will usually mean that there must be sufficient resources and support to allow the
   designated professionals to fulfil the key roles of SCR panel membership and
   preparation of a health overview report where required. Where there are a number of
   simultaneous reviews, or where the designated professional has had significant case
   involvement, the commissioning of additional capacity for these functions must be
   considered. This may be identified internally or externally depending on case
   circumstances.

   The CCG will also commission Independent Management Reviews (IMRs) on behalf of
   any general practices involved in a serious case review, normally undertaken by the GP
   named doctor. Again the CCG must ensure that sufficient capacity is available for this
   function, including commissioning additional capacity e.g. an external author where
   there are two or more ongoing reviews, or any significant conflict of interest for the
   named GP in relation to the case.

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    The CCG should seek assurance that there is also sufficient capacity in provider
    organisations to produce Independent Management Reviews when required.

    The designated safeguarding professionals will inform the relevant authorities including
    the Care Quality Commission when a Serious Case Review is commissioned.

    The Safeguarding Executive Lead for the CCG will commission and sign off health
    overview reports and internal management reviews for serious case reviews.

    The CCG Governing Body will be notified that a review has commenced and will receive
    updates on identified learning, recommendations and action plans, and progress
    towards publication where relevant.


12. Review and Maintenance of Policy

This policy will be subject to a review in April 2013 and, if revised, all stakeholders will be
alerted to the new version.

This policy is issued and maintained by the XXXXXXXX on behalf of all stakeholders.




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References and Bibliography

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




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