Docstoc

Child Protection

Document Sample
Child Protection Powered By Docstoc
					                           WtPCT CH 001




Child Protection Policy

CHILD PROTECTION IS EVERYONES’
RESPONSIBILITY
CONTENTS
                                                                       Page
Introduction                                                           2

Aim and Objectives of the Child Protection service                     3

Roles and Responsibilities                                             4

Consent and Confidentiality                                            5

Making a Children in Need/Child Protection referral                    6

Multi Agency Referral Form                                             7

Child Protection Conference Reports                                    11

Report for an Initial Child Protection Conference                      12

Report for a Review Child Protection Conference                        13

Procedure for the Management of Vacant Caseloads.                      14

Notification to Mangers of Children on the Child Protection Register   15

Notification to Managers of Change of Circumstances                    16

Health statement for Care Proceedings                                  17

Health report for CAFCASS                                              19

Reports requested by Police or Guardian-Ad-Litem                       20

Attendance at Court                                                    20

Transfer of Records                                                    21

Missing Children (including the Unborn Child)                          22

Local Agency Contacts                                                  23

Child Protection Supervision                                           24

Framework for the Assessment of Children in Need                       30

Definitions of Abuse: Physical Abuse                                   31
                      Sexual Abuse                                     32
                      Emotional Abuse                                  33
                      Neglect                                          34

Bibliography                                                           35


                                          1
                                   INTRODUCTION


            CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


Children are reliant on adults for protection and deserve the opportunity to achieve
their full potential. All Trust employees and staff commissioned by Walsall PCT must
be able to recognise abuse and be aware of the procedures to follow in order to
safeguard and protect children. This also applies when the adult/carer is the client as it
is recognised that sources of stress within a family can have a negative impact on
children. Sources of stress would include social isolation, domestic violence, mental
illness of a parent/carer or drug and alcohol misuse.

This document should be read in conjunction with Walsall‟s Area Child Protection
Committee (ACPC) Child Protection Procedures (September 2001) – a copy of which
is available in all clinics/health centres and departments where children receive care.


Child Protection Work requires statutory and voluntary agencies to work together
with children and their families.

“Promoting children‟s well-being and safeguarding them from significant harm
depends crucially upon effective information sharing, collaboration and understanding
between agencies and professionals”

Working Together to Safeguard Children 1999 (1.10)


These guidelines have been informed by the Children Act 1989 and Working
Together to Safeguard Children ( D.O.H. 1999). All staff employed by Walsall
Primary Care NHS Trust who encounters incidents of suspected or actual abuse must
follow them. The Trust has a duty under Section 27 of the Children Act 1989 to co-
operate with the Local Authority in the exercise of its functions. As a consequence,
the Local Authority may request the help of the Trust or Trust employee and there is
an obligation to comply.


If in doubt advice and support can be obtained from:

Elaine Hurry, Child Protection Advisor.                01922 858970
Designated Nurse for Child Protection

Dr V. Rao, Consultant Community Paediatrician.         01922 858971
Designated Doctor for Child Protection




                                            2
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY




                  AIM OF THE CHILD PROTECTION SERVICE


 To ensure children are protected and staff are supported in this work.



                                    OBJECTIVES


To provide an efficient and effective service that promotes children‟s welfare and
protects them from harm


To provide a responsive service that offers early intervention to minimise harm and
enables children to reach their full potential.


To provide a service by staff well trained in child protection procedures.


To provide a service that is pro-active and participative in inter agency work.


To provide a service that works in partnership with children and their parents/ carers
– respecting their individuality, views, culture and religion.


To ensure an effective system for the transfer of records within and between
Community Trusts.




                                           3
            CHILD PROTECTION IS EVERYONES‟ RESPONSIBILTY


                         ROLES AND RESPONSIBILITIES



All health professionals, in the NHS, private sector and other agencies, play an
essential part in ensuring children and families receive the care, support and services
they need in order to promote children‟s health and development. Because of the
universal nature of health provision, health professionals are often the first to be
aware that families are experiencing difficulties in looking after their children.



The involvement of health professionals is important at all stages of work with
children and families:

      Recognise children in need of support and/or safeguarding, and parents who
       may need extra help in bringing up their children.

      Contribute to enquiries about a child and family.

      Assess the needs of children and the capacity of parents to meet their
       children‟s needs.

      Plan and provide support to vulnerable children and families.

      Participate in child protection conferences.

      Plan support for children at risk of significant harm.

      Provide therapeutic help to abused children and parents under stress.

      Play a part, through the child protection plan, in safeguarding children from
       significant harm.

      Contribute to case reviews


Working Together to Safeguard Children 1999 ( 3.19)




                                           4
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY

                       CONSENT AND CONFIDENTIALITY

Information sharing is crucial in child protection. Often it is only when information
from a number of sources has been shared that it becomes clear a child is at risk of, or
is suffering, significant harm.

Information may be shared with other professionals if:

      there is consent from either the child(ren) or someone who has parental
       responsibility for them. Consent from someone with parental responsibility is
       required when a child or their family are referred to social services as Children
       in Need (see page 6).

      requested to do so by the court

      without the consent of either the child(ren) or someone who has parental
       responsibility for them if the public interest in sharing the information
       outweighs the duty of confidence.

For child protection referrals it is not necessary to obtain consent from either the
child(ren) or someone who has parental responsibility for them. However good
practice would be to inform the parents of any action to be taken providing in
your judgement this would not increase the risk to the child. Information should
only be shared on a „need to know‟ basis so that informed decisions can be made to
protect child(ren).

The interests of the child must take priority over the interests of their parents/carers.
If there is a choice between preserving confidentiality in respect of an adult and
passing on information to enable a child to be protected the child‟s welfare must come
first.

People with parental responsibility for a child include: the child‟s mother, the child‟s
father if married to the mother at the time of conception , birth or later; a legally
appointed guardian; the local authority if the child is subject to a care order; or a
person named in a residence order in respect of the child. Fathers who have never
been married to the child‟s mother will only have parental responsibility if they have
acquired it through a court order or parental responsibility agreement.

Anxiety about confidentiality and disclosure of information is not uncommon. Ethical
and statutory codes concerned with confidentiality, Caldicott Guardian, Human
Rights or Data Protection are not intended to prevent the exchange of information
between professionals who have a responsibility to protect children.

If in doubt about what information can be shared further advice can be obtained from
the Designated Professionals for Child Protection (see page 23 Local Agency
Contacts).




                                            5
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY

                  MAKING A CHILD PROTECTION REFERRAL

This section should be read in conjunction with Walsall Area Child Protection
Committee‟s (ACPC) Child Protection Procedures (September 2001) Section 5.

If a Health Professional suspects or has knowledge that a child (including an unborn
child) may be suffering or may be at risk of suffering significant harm then a referral
to Social Services must be made. The referral must be made on the same working
day. Advice can be sought from the Designated Professionals for Child Protection.
General Practitioners can contact Dr. Rao or Dr Carter for advice (see Local Agency
Contacts page23).

The safety and well being of children must always be of paramount importance and
will override any other considerations. This is particularly important when the adult/
carer is the client (see Appendix 2 Walsall ACPC Child Protection Procedures).

The Multi-Agency Child in Need and Child Protection Referral Form (ACPC1 see
page 7) must be completed when a child or their family is referred to Social Services.
This form can be used for Children in Need referrals (as defined by Section 17 of the
Children Act 1989) as well as Child Protection referrals (as defined by Section 47 of
the Children Act 1989).

Section 17 of the Children Act 1989 states that a child shall be taken to be in need if:

(a) he is unlikely to achieve or maintain …. a reasonable standard of health or
development without the provision of services by a local authority
(b) his health or development is likely to be impaired without the provision of
services
(c) he is disabled.

Section 47 of the Children Act 1989 states that the local authority have a duty to
investigate when they suspect that a child who lives, or is found in their area is
suffering or likely to suffer significant harm.

Referrals must be made to the duty officer for children and families at The Quest
Building. For referrals made out of office hours the Emergency Duty Team must be
contacted instead.( See Local Agency Contacts page 23 and Walsall‟s ACPC Child
Protection Procedures (September 2001).

Referrals can be made by telephone but must be confirmed in writing using the
ACPC1 form (see page 7), within one working day. At the end of the conversation
with Social Services all parties should be clear about what action (if any) will be taken
and by whom. Referrers should be notified of the outcome of any enquiries made
(Section 5.41 Walsall ACPC Child Protection Procedures).

A copy of all the Child Protection Referrals made by staff employed by Walsall
Primary Care Trust must be sent to the Child Protection Advisor at Brace Street
Health Centre.


                                            6
                                                                            ACPC 1

Multi-agency Child in Need and Child Protection Referral Form


This form is confidential. Information will only be shared with a third party if it
                  is the interest of the child concerned to do so.

THIS FORM SHOULD BE USED BY ALL AGENCIES TO SHARE INFORMATION WITH SOCIAL SEVICES
WHERE THERE ARE CONCERNS THAT A CHILD MAY BE IN NEED. WHERE THERE ARE CONCERNS
THAT A CHILD MAY BE IN NEED OF PROTECTION THE REFERRAL SHOULD BE MADE BY TELEPHONE
AND THE FORM SENT BY FAX IF NECESSARY TO CONFIRM THE DETAILS. THE FORM SHOULD BE
SENT TO THE AREA OFFICE COVERING THE CHILD’S HOME ADDRESS. REFER TOACPC CHILD
PROTECTION PROCEDURES FOR FURTHER GUIDANCE.


CHILDS DETAILS

Full name of child:………………………………Date of Birth: ……………Male  Female 

Home address (plus any previous, if known)

    1. …………………………………………………………………………….…………..

    2. …………………………………………………………………………………………………..

School/Nursery attended (if known)      …………………………………Tel
no………………………..

G.P: ……………………………………………Tel no………………………

Does the child have special needs? Yes  No 
If so, please give details:…………………………………………………

Where is the child now……………………………….



Primary language of child:                       Ethnic Origin of child

   English      Hindi         Urdu                White               Black Caribbean

   Bengali      Punjabi      Gujarat              Black African      Black other
                                                                          (please specify)
   Cantonese      British Sign Language
                                                     Indian           Bangladeshi

   Other (Please specify) ………………………              Pakistan           Chinese          Mixed

                                                     Other (specify):……………….

Primary language of carers (if different         Ethnic origin of carers (if different from
From child):                                     from child):




                                             7
FAMILY:

(Please indicate which parent/carer has parental responsibility, if known)

Mother:            …………………………… ………DoB                             .………………………………

Father;            …………………… ………………DoB……                              ……………………………….

Other Adults:      …………………………                        ……………………        ……………………………….

Other Children: (include date(s) of birth if known




School attended




_____________________________________________________________________
CONSENT



NB The referring agency should seek to obtain the family’s prior agreement and
consent to sharing information about them unless to do so would place the child at
risk of significant harm.


(a) Is the child aware of referral?  Yes                    No


(b) Is the parent(s) aware of referral?                    Yes     No


(c) Has the parent given consent to the sharing of information?               Yes
 No

 If no, please give
reasons:…………………………………………………………………

    _______________________________________________________________

Other Agencies involved (if known)




                                                      8
SUMMARY OF CONCERN FOR THE CHILD

Please be as specific as possible about the nature of your concerns. Describe any injuries
the child may have or any information the child has shared (in the child’s own words).




    Detail of actions already taken by referrer:
    Please include immediate action if child protection concerns and/or details of any support
    or intervention that has already been provided by your agency or others.




     _____________________________________________________________________
    Information about the child, family and environment. Please identify strengths as well
    as needs and concerns.

    Child’s needs – including health, education, emotional and behavioural development,
    self-care skills, identity and social presentation, family and social relationships:




                                              9
Parents’/carers’ capacities to respond to the child’s needs – including basic
care, ensuring safety, emotional warmth, stimulation, guidance and boundaries,
stability, any particular difficulties parents/carers are experiencing e.g. physical or
mental illness, substance or alcohol misuse:




Family and environmental factors which impact on the child and family such
as family history, other family members, housing or employment issues.




________________________________________________________________________
ACTION AGREED




Referral completed by:


Name…………………………………                            Designation…………………………….

Address and telephone no…………………………………………………………..

Signature……………………………… Date…………………………….……….




                                        10
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


                 CHILD PROTECTION CONFERENCE REPORTS

All Health Professionals invited to attend either an Initial or Review Child Protection
Conference must provide a written report using the ACPC 3 form. ( see pages 12 – 13
or Walsall‟s ACPC Child Protection Procedures). If a health professional is unable to
attend either type of conference arrangements must be made for a colleague, manager
or the Child Protection Advisor to attend in their place and present the report. There
is a requirement for conferences to be quorate and failure to attend may mean that the
conference has to be re-arranged.

The report should detail the health professional‟s involvement with the child(ren) and
their family and should follow the format laid down in the Framework for the
Assessment of Children in Need and their Families (D.O.H. 2000). (see page 30 or
Appendix 1 Walsall ACPC Child Protection Procedures)

The Framework for the Assessment of Children in Need and their Families (D.O.H.
2000) provides a systematic way of understanding, recording and analysing
information about children and their families. The three domains are:

1. Child‟s Developmental Needs:

Health professionals should provide any information they have about the child‟s
health and development. This will include emotional development as well as social
and selfcare skills.

2. Parenting Capacity:

The report should contain information about the parent/carers ability to parent their
child(ren). This will include the parent /carers ability to ensure the child‟s safety,
provide basic care, guidance and boundaries.

3. Family and Environmental Factors:

Health professionals should provide any information they have about the family‟s
income, employment, housing and extended family or support networks.

Reports should be completed using black ink or preferably typed. If hand written the
writing must be legible and clear. Advice on the content of the report can be obtained
from one of the Designated Professionals for Child Protection (see Local Agency
Contacts page 23).

A copy of the report must be retained in the child‟s records. A copy of the report
must reach The Hollies the day before the conference, to enable the Conference Chair
to read it beforehand. Sufficient copies of the report must be taken to the Child
Protection Conference for distribution. The exact number of copies can be found on
the invitation to conference. All those invited to attend will receive a copy of the
report.


                                           11
Report to Initial Child Protection Conference


                    To be held on ………………..(date)

Name of child/ren                         dob.




   Please provide details about your involvement with the child/ren and the
   parent/carers. Your report should contain information about each child’s
  health and development. Also include any information you have about the
family and environmental factors and the capacity of the parent to ensure the
                  child’s safety and promote their well-being




Name                                             Designation


Signature                                        Date


                                     12
Report to Review Child Protection Conference

                         To be held on …………(date)


Name of child/ren                         dob.




Review conference reports should summarise your involvement since the last
    conference with reference to your responsibilities outlined in the child
  protection plan if applicable. Your report should contain information about
each child’s health and development. Also include any information you have
 about the family and environmental factors and the capacity of the parent to
            ensure the child’s safety and promote their well-being




          Name                                        Designation

             Signature                                    Date




                                     13
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


Following a Child Protection Conference all health professionals must notify their
manager of the decisions made for the child(ren) on their caseload. Part A of the
Child Protection Information Form (see page15) should be completed and sent to the
manager.

Any change of circumstances, including de-registration, should be recorded on Part B
(see page 16 ) and sent to the manager.

 Any change of health personnel must be notified to the Child Protection Advisor and
the Social Services Key worker for the child.



                   MANAGEMENT OF VACANT CASELOADS


This procedure must be followed for vulnerable children, Looked After Children or
those whose name is on Walsall‟s Child Protection Register when staff have prior
knowledge of leaving an existing caseload where there is no immediate known
replacement.

Discussion must take place between the member of staff and their manager. The
manager is responsible for ensuring the child/family are allocated a named health
professional for the interim period. The manager will inform the Child Protection
Advisor of the change of personnel using Part B Child Protection Information Form
(see page 16).

Any problems in allocating vacant caseloads must be discussed with the Child
Protection Advisor.

The allocated health professional can seek professional advice and support about the
case from the Child Protection Advisor. The allocated health professional must also
inform the Social Services Key worker for the family about the change of personnel.

In the event of sudden staff absence it is the manager‟s responsibility to ensure a
named health professional provides continuity of care. Any problems in allocating
vacant caseloads must be discussed with the Child Protection Advisor.

Health Professionals must arrange for their caseloads to be covered whilst on Annual
Leave. School Nurses must inform their manager of who will provide cover during
the holidays. The manager will provide the Child Protection Advisor with this
information.




                                          14
                                                                PART A

                    WALSALL PRIMARY CARE TRUST

                   CHILD PROTECTION INFORMATION


NOTIFICATION OF CHILD(REN) ON THE CHILD PROTECTION REGISTER


NAME:                                        A.K.A.

D.O.B.

ADDRESS:                                     H.V./S.N.



SCHOOL (IF APPLICABLE)

DATE OF REGISTRATION:

IF NOT ON WASLALL‟S – PLEASE STATE WHICH AREAS.

LEGAL STATUS OF CHILD(REN) (PLEASE TICK)

1.       E.P.O.
2.       I.C.O.
3.       C.O.

KEYWORKER: NAME:
                   TEL. NO:
                   AREA OFFICE:

OTHER HEALTH PROFESSIONALS INVOLVED WITH FAMILY



DATE OF THIS CONFERENCE:

DATE OF NEXT CONFERENCE:

DECISION (INCLUDING CATEGORIES OF REGISTRATION)




RECOMMENDATIONS (ONLY IF RELEVANT TO HEALTH NEEDS




SIGNATURE:                  PRINT NAME                   DATE




                                    15
                                                           PART B

                    WALSALL PRIMARY CARE TRUST

                    CHILD PROTECTION INFORMATION


             DE-REGISTRATION / CHANGE OF CIRCUMSTANCES
                       (Please complete as applicable)



NAME:


D.O.B.


DE-REGISTRATION DATE:




CHANGE OF H.V./S.N. FROM:                   TO:          DATE:




MOVED OUT OF AREA    DATE:                  TO: AREA




RECORDS FORWARDED TO:                                    DATE:




SIGNATURE:                            PRINT NAME:        DATE:




                                 16
            CHILD PROTECTION IS EVERYONES‟ RESPONSIBILTY


          HEALTH REPORTS FOR CARE PROCEEDINGS UNDER THE

                                 CHILDREN ACT 1989



Any requests to provide statements for Care Proceedings must be referred to the Child
Protection Advisor for authorisation. The Child Protection Advisor will also provide
assistance with the content of the report and arrange for independent legal advise
before the report is submitted to court.

Under no circumstances must any health professional divulge health information
or copies of records or letters without the consent of their manager or Child
Protection Advisor.

Once approval has been granted the health professional must complete a statement for
court within the allotted timescale. Failure to do so could incur a financial penalty for
the health professional, from the courts. The statement must be factual, accurate,
unambiguous and based on evidence from the records. The Child Protection Advisor
will arrange for the statement to be typed.

The Child Protection Advisor will seek independent legal advice before any statement
is submitted to court. The final statement must be checked thoroughly by the health
professional before signing to ensure that it is factually correct. The Child Protection
Advisor will send the statement to the legal department. Two photocopies will be
made. The health professional and the Child Protection Advisor each retain a copy.

This statement will be made available to the court, its officers and all parties prior to
the hearing.



The following format is used for all statements:




                                            17
                                 WALSALL PRIMARY CARE TRUST

                                                 Statement

In the matter of ….(child/rens name)

Statement of…..(Health Professionals name)

Filed on behalf of Walsall Primary Care Trust for ….(Local Authority making the request to court)

My name is:

I am employed by Walsall Primary Care Trust as a ……….and am based at…(full address of base). I
have held this post since …….

My professional qualifications are:
(It is important to include all registered qualifications as this informs the court of your expertise and the
year they were gained).

1. Family Composition:

Subject(s):                                    date of birth:
Mother:
Father:
Home address:

I have known this family since ………….

2. Developmental Assessment of (Child)

The content of the statement must include details of the health professional‟s first involvement with the
child/family and all subsequent professional contacts in chronological order. The date, time and
location of each contact must be recorded as well as the names of any other persons present.

The health profile of the child must contain details of general health and development including
immunisation status, percentile information, speech and language, behaviour and details of any special
health or educational needs.

3. Family Relationships

This section should include any information the health professional has about the relationship between
the parents/carers and the child(ren). Included here would be any relevant information about the
extended family.

4. Specific Areas of Concern

This section summarises any areas of concern that have been identified by the health professional in the
previous sections.

5. Conclusion

This section should include any recommendations the health professional would like to make.

I, the undersigned, declare that to the best of my knowledge and belief the contents of this my
statement are true and I understand that it may be placed before the court.

Name:                                                     Date:

Signature:


                                                     18
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


HEALTH REPORTS FOR CHILDREN AND FAMILY COURT ADVISORY AND

                         SUPPORT SERVICE (CAFCASS)



Any requests for reports from the CAFCASS service must be referred to the Child
Protection Advisor or the health professional‟s manager. Assistance can be given
with completing the report and independent legal advice can be sought if necessary.
All reports must be completed within the allotted time scales.


Under no circumstances must any health professional divulge health information
to adult parties or their legal representative without the consent of their manager
or the Child Protection Advisor.


The report should be factually correct and any opinion expressed should be based on
professional judgements. The content of the report will include how long the health
professional has known the family, a summary of general health and development and
any relevant information about the child‟s relationship with their parents/carers and
siblings. It is important to state immunisations status, percentile information, if
relevant, and any areas of concern e.g. domestic violence, drug and alcohol misuse,
mental health problems etc.

Once the health professional and their manager/Child Protection Advisor have agreed
the content the typed report can be sent to CAFCASS. Two photocopies will be made.
The health professional and the Child Protection Advisor each retain a copy.


This information will be required for private law hearings i.e contact and residency
disputes and will be made available to all parties involved prior to the hearing.




                                          19
            CHILD PROTECTION IS EVERYONES‟ RESPONSIBILTY


        REPORTS REQUESTED BY POLICE OR GUARDIAN AD LITEM


Any member of staff who is contacted by either of the above must contact their
manager or Child Protection Advisor immediately to organise a mutually convenient
date to meet with the requesting officer.

Under no circumstances must a health professional meet with either of the above
without their manager or Child Protection Advisor present.

The police will write the statement with the health professional and their manager or
Child Protection Advisor. The health professional must then read the statement and
agree the contents before signing. The health professional may request a copy of the
statement but this is not always granted.

A Guardian ad Litem is appointed by the court to represent the interests of the
child(ren). The health professional will be required to share relevant health
information about the child/family with the Guardian ad Litem who will incorporate
this within their report to court. The health professional will not be given a copy of
this.


               ATTENDANCE AT COURT - WITNESS SUMMONS

Private Law:

Health professionals will always require a witness summons if they are requested to
give evidence on behalf of the adult parties or their representative for private law
orders. Should the court direct the member of staff to give evidence on behalf of the
child there will be no requirement for a witness summons..

Public Law:

It is not necessary for a health professional to receive a witness summons to attend
court on every occasion that they are required to give evidence in Care proceedings.

However, the decision as to whether or not a witness summons is required must be
left to the professional who is required to give evidence. When a witness summons is
required, the legal representative calling the health professional must be informed in
good time for the court to prepare and serve the document.

Any health professional required to attend court should contact their manager or Child
Protection Advisor to inform them of the dates for the Hearing. Either their manager
or Child Protection Advisor will accompany staff to court. Preparation sessions can
be arranged with the Child Protection Advisor (see Local Agency Contacts page 23).




                                          20
            CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


                              TRANSFER OF RECORDS


When a child moves out of the Walsall area the Child Health Records, Family Record
Card and any confidential information must be transferred to the receiving area. The
Child Protection Advisor will transfer records for vulnerable children and those whose
names are on Walsall‟s Child Protection Register. Records for Looked After Children
must be sent to Maureen Chaudhry, Health Co-ordinator for Looked After Children
(see Local Agency Contacts page 23). All records will be forwarded by recorded
delivery.

It is the responsibility of the health professional to ensure that the records are sent to
the Child Protection Advisor for forwarding. Information about the new address and
Health Visitor or School Nurse must accompany the records. The health professional
must complete the Child Health Amendment Form and send to the relevant Child
Health department.

It is the responsibility of the health professional to notify the receiving Health
Visitor/School Nurse of the details concerning the child(ren)/family. The Child
Protection Advisor will liase with the receiving Trust‟s Child Protection Unit to share
relevant information and inform them that the records are in the process of being
transferred.

There will be occasions when a child moves outside of Walsall on a temporary basis.
Health professionals should seek advice as to whether it is appropriate to transfer the
records or not – this will need to be considered in the light of the concerns about the
child(ren); the temporary address and likely duration of stay. If a decision is made not
to transfer the records immediately it is essential that liaison between all health
professional involved occurs.

When a child moves within the Trust the health professional must arrange the transfer
of records for vulnerable children, Looked After Children or those whose names are
on Walsall‟s Child Protection Register. The health professional must arrange to meet
with the new Health Visitor/School Nurse to discuss any health concerns, proposed
interventions and the health professional‟s role within the core group. If for any
reason it is not possible to arrange to meet the new health professional then a
telephone discussion must take place. However, this should be the exception and the
reason for doing this clearly recorded in the health records. The health professional
must complete the Child Health Amendment Form and send to the relevant Child
Health department and inform the Child Protection Advisor of the change of
personnel using Part B Child Protection Information form (page16).

All Child Health Records that are to be transferred must be placed in a well sealed
envelope, clearly addressed and labelled “Confidential”. If the addressee is absent
from work then a colleague should open the envelope on their behalf and take any
appropriate action



                                            21
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


           MISSING CHILDREN (INCLUDING THE UNBORN CHILD)


If a health professional becomes aware that a vulnerable child or one whose name is
on Walsall‟s Child Protection Register is missing it is the responsibility of that person
to notify the Social Services Key worker for the child(ren)/family. The health
professional must also inform the Child Protection Advisor, their manager, the child‟s
G.P. and any other professionals involved with the family. This information must be
confirmed in writing to the Key worker, Child Protection Advisor and manager

The health professional must try to ascertain the whereabouts of the child(ren)/family,
by contacting any other agencies (e.g. housing, G.P. registrations, education etc)
involved with the family or extended family if known.

When a child whose name is on Walsall‟s Child Protection Register is missing Social
Services will consider what action to take. The Custodian of the Register will be
notified (see Walsall ACPC Child Protection Procedures) and if all efforts fail to
locate the child(ren)/family the following will occur:

      Refer to the police as a missing person

      Consider legal action

      Contact the family G.P. to inform them of the situation

      Contact the DSS

      Circulate information about the child(ren)/family to neighbouring areas

      Circulate information about the child(ren)/family nationally via the Custodians
       of the Register.

      Inform Walsall‟s Emergency Duty Team


When a vulnerable child/family are missing any of the above action can be instigated.
It is essential that the health professional discuss the situation with the Child
Protection Advisor so that the most appropriate course of action can be taken.

If the health professional determines the whereabouts of a missing child/family they
must inform the Key worker, Child Protection Advisor and their manager. Every
action and contact by the health professional must be recorded in the child‟s records
with the date, time, name and discipline of other professionals contacted.




                                           22
             CHILD PROTECTION IS EVERYONES‟ RESPONSIBILTY

                           LOCAL AGENCY CONTACTS


                             Walsall Primary Care Trust.


Elaine Hurry, Child Protection Advisor. Brace St Health Centre   01922 858970

Dr Vidya Rao, Consultant Community Paediatrician.                01922 858971
              Brace St Health Centre

Dr Paul Carter, Consultant Community Paediatrician               01922 858144
               Sycamore House

Maureen Chaudhry, Health Co-ordinator for Looked After Children 01922 858956
            Brace St Health Centre


                           Walsall Social Services Offices:

Initial Response Service     The Quest Building                  01922 658170

Assessment, Inclusion and Family Support Service
Bloxwich Office                                                  01922 710001
Shelfield Office                                                 01922 685811

Looked After Children
Willenhall Office                                                01922 710533
Darlaston Office                                                 0121 563 6611


Out of Hours Emergency Duty Team                                 01922 653555

Review, Performance and Child Protection, Civic Centre           01922 652727

                           Police Family Protection Units

Green Lane                                                       01922 439210
Darlaston                                                        01922 439136

                                     CAFCASS

Midland Road, Walsall                                            01922 720665

                           Local Authority Legal Services

Civic Centre                                                     01922 650000


                                         23
                     CHILD PROTECTION SUPERVISION



Introduction

“The principle of clinical supervision is now an accepted part of the development of
the nursing, midwifery and health visiting professions. Clinical supervision is a term
used to describe a formal process of professional support and learning which enables
individual practitioners to develop knowledge and competence, assume responsibility
for their own practice and enhance patient/client protection and safety of care in
complex clinical situations. It is central to the process of learning and to the
expansion of the scope of practice and should be seen as a means of encouraging self-
assessment and analytical and reflective skills.”

(D.O.H. Child Protection – Guidance for Senior Nurses, Health Visitors and
Midwives and their Managers (1997))

Rationale

1.     To provide support to Health Visitors/School Nurses, recognising the stressful
       nature of their work with vulnerable children/families.

2.     To provide an opportunity for Health Visitors/School Nurses to discuss
       families causing concern with the Child Protection Advisor/Trained
       Supervisor on a systematic basis and reflect on their practice.

3.     To provide an opportunity for the Child Protection Advisor/Trained
       Supervisor to be updated and apprised of changes in circumstances of families
       causing concern and verify that Area Child Protection Procedures (ACPC) and
       Trust Policies and Procedures are being adhered to.

4.     To enable the Health Visitor/School Nurse to examine his/her caseload and
       consider individual family needs.

5.     To provide a formal opportunity for advice to be offered on case management,
       to highlight any deteriorating situations and positive changes and evaluate
       previous intervention.

6.     To highlight areas of concern with regard to any extra workload Health
       Visitors/School Nurses have as a result of child protection work.

7.     To specifically review work with families with children on the Child
       Protection register.

8.     To identify specific training needs of Health Visitors/School Nurses and their
       supervisors.




                                          24
9.    Child Protection supervision should assist Health Visitors/School Nurses to
      reflect on their practice and have a clear understanding of the issues involved
      in any particular case. It should also enable practitioners to be clear about the
      health needs of children and their parents/carers.

10.   Child Protection supervision provides an opportunity to look at evidence from
      research and how this may affect the children/families being discussed. It will
      also enable a more thorough understanding of the legislative process and how
      this will impact on the welfare of children.

Process

1.    The Child Protection Advisor/Trained Supervisor will contact the member of
      staff to arrange a mutually convenient time for supervision. Supervision
      should take place every six months.

2.    The member of staff will be required to identify the families to be discussed
      with the Child Protection Advisor/Trained Supervisor. A Child Protection
      Supervision form will be completed by the member of staff for each family to
      be discussed and sent to the Supervisor before the meeting

3.    Supervision should be conducted at the Health Visitors/School Nurses office
      base so that the appropriate records are available. If for any reason this is not
      possible alternative arrangements will need to be made.

4.    A written agreement between the supervisor and supervisee should be drawn
      up based on a common format and will be agreed and signed by both. A copy
      of this agreement will be kept by the Health Visitor/School Nurse and
      included in the child‟s records. The original will be kept in the records
      maintained by the Child Protection Advisor.

5.    During supervision the Health Visitor/School Nurse will discuss those
      children included on Walsall‟s Child Protection Register, Looked After
      Children and children/families causing concern. The Child Protection
      Advisor/Trained Supervisor will update the supervision record of any changes
      in circumstances since the last supervision session. Supervision sessions
      should last approximately 2 hours. A separate session could be arranged of
      necessary.

6.    Health Visitors and School Nurses will have the opportunity to consider areas
      of concern and how these impact on the welfare of children.

7.    Health Visitors/School Nurses will discuss the requirements of the Child
      Protection Plan as it affects health professionals. This will include attendance
      at core group or other multi-agency meetings.

8.    Health Visitors/School Nurses will agree action with the Child Protection
      Advisor/Trained Supervisor, who will record this. A review date will be
      agreed and noted for six months time. This does not preclude staff seeking
      advice or supervision at an earlier date.


                                          25
Outcomes

1.   A record of supervision dates will be maintained by the Child Protection
     Advisor/Trained Supervisor for statistical and audit purposes.

2.   A written record of the supervision session will be completed by the Child
     Protection Advisor/Trained Supervisor. This will be signed by the supervisor
     and the supervisee. A photocopy of this document will be made by the Child
     Protection Advisor/Trained Supervisor and given to the supervisee. One copy
     will be filed in the child‟s records maintained by the Health Visitor/School
     Nurse and the original will be kept in the records held by the Child Protection
     Advisor.

3.   Regular supervision will enable Health Visitors /School Nurses and the Child
     Protection Advisor/ Trained Supervisor to establish a baseline of some of the
     supportive visiting, monitoring and surveillance that health professionals are
     currently undertaking.

4.   The files for children whose names are on Walsall‟s Child Protection Register
     or causing concern can be closed once the children have been de-registered or
     causes for concern lessened.




                                       26
                           SUPERVISORY AGREEMENT

Practical Arrangements

a) Frequency – to take place every 6 months, though this does not preclude the
   supervisee bringing a cause for concern to the supervisor at an earlier date.

b) Duration – sessions should last approximately 2 hours. If necessary a separate
   session could be arranged.

c) Location – this should be at the supervisee‟s base where there is access to case
   files. Supervision should be held in a private room free from interruptions.

Rights and Responsibilities

a) Limits of confidentiality will be made clear – in most circumstances neither party
   will divulge to a third party what takes place during supervision. However, there
   may be occasions when confidentiality cannot be maintained. This would be
   discussed at the appropriate time.

b) Contribution to the session – it is the responsibility of both the supervisor and
   supervisee to prepare for the session including reviewing previous case notes and
   action plans to ascertain that the necessary pre work has been done. This is so that
   both may contribute to the session and make it effective.

c) Equality issues – both parties are responsible for ensuring that case reviews take
   account of equality issues and anti-oppressive practices. It is important that both
   supervisor and supervisee have an open manner to discuss such issues.

d) Personal commitment to sessions – the importance of supervision should be
   recognised by both parties, who take responsibility for joint ownership. This
   includes keeping to appointments, being on time and an agreement about
   interruptions.

e) Written records – both parties will ensure that an agreed written record is made at
   the time of the session, recorded on the standard form. Both parties will sign the
   record and keep a copy. The supervisee‟s copy will be kept in the child‟s records
   and the supervisor‟s copy will be kept by the Child Protection Advisor.

Supervision Tasks

a) Supervision will only relate to child protection matters, Looked After Children or
   vulnerable children/families.

b) Matters relating to other aspects or managerial supervision will not be covered.

Signature:     Supervisee __________________         Date _________________

               Supervisor __________________         Date _________________



                                          27
                            WALSALL PRIMARY CARE TRUST
                               Child Protection Supervision


SURNAME/S…………………………………………………………………………..
.
CHILDREN………………………DOB………………SCHOOL…………………...
        ………………………   ………………      …………………...
        ………………………   ………………      …………………...
        ………………………   ………………      …………………...
        ………………………   ………………      …………………...
        ………………………   ………………      …………………...


Child Protection Register: YES/NO                Category:       Physical / Sexual
                                                                 Emotional / Neglect
Date Registered………………………..

Relevant Changes Since Last Supervision




Summary of Concerns

Domestic Violence                YES / NO        Alcohol / Drug Misuse    YES / NO
Adult Learning Disability        YES / NO        Mental Health Problems   YES / NO




Current Programme of Care / Plan




Agreed Action




Review Date…………………………

Signature:       Supervisee…………………………. Date…………………………

                 Supervisor…………………………. Date ………………………...



                                            28
        CHILD PROTECTION SUPERVISION – OPERATIONAL POLICY



The Child Protection Advisor and a group of Health Visitors, School Nurses and
Managers, who have received specific training in this area of work, will provide Child
Protection Supervision to all Health Visitors and School Nurses employed by Walsall
Primary Care Trust.

A list of all Child Protection Supervisors will be kept by the Child Protection Advisor
and the Training Department. This list will be updated quarterly and amended as
necessary.

The Child Protection Advisor will supervise all Health Visitors and School Nurses
employed by Walsall Primary Care Trust once a year. The other trained professionals
will also supervise an identified group of staff once a year. This will fulfil the
requirement for all Health Visitors and School Nurses to be supervised twice a year.


Additional supervision identified by a supervisor or requested by the Health Visitor or
School Nurse will be provided by the Child Protection Advisor.


Supervisors will meet at regular intervals (at least quarterly) with the Child Protection
Advisor to discuss supervision practice. This will also provide the opportunity to
ensure that the requirements of the Child Protection Supervision Policy have been
met. Support to supervisors will be provided by the Child Protection Advisor at this
meeting as well as on an individual basis if required.

The Child Protection Advisor will ensure that all supervisors are aware of any
changes in procedures/policy and relevant up to date research in this area of work.

Supervisors will inform the Child Protection Advisor about any concerns they identify
during supervision. If the supervisor has been unable to resolve the concerns the
Child Protection Advisor will address these with the member of staff and their
manager if necessary.

Supervisors will inform the Child Protection Advisor of any staff that have large
numbers of children on the Child Protection Register or vulnerable families on their
caseload. The Child Protection Advisor will support the member of staff‟s manager
to address this.

It will be the responsibility of the Child Protection Advisor to address any training
issues identified by the supervisors or Child Protection Advisor.




                                           29
     FRAMEWORK FOR THE ASSESSMENT
         OF CHILDREN IN NEED AND
              THEIR FAMILIES



                                                                     S
                                                                  ED


                                            Health                                                   Basic Care
                                                               NE
                                                            AL




                                    Education                                              PA
                                                                                                                       Ensuring Safety
                                                           T




                                                                                               RE
                                                        EN




               Emotional &                                                                       NT
          Behavioural Development
                                                  PM




                                                                                                                             Emotional Warmth
                                                                                                     IN
                                            O




                                                                                                       G
                  Identity
                                         EL




                                                                                                            CA

                                                                   CHILD                                                                 Stimulation
                                         V




                                                                                                                        PA
                                      DE




        Family & Social                                        Safeguarding &
                                                                                                                          CI

         Relationships                                           promoting
                                   S




                                                                                                                                               Guidance & Boundaries
                                D’




                                                                                                                             TY


                                                                   welfare
                             IL




Social Presentation
                        CH




                                                                                                                                                   Stability
Selfcare Skills

                              FAMILY & ENVIRONMENTAL FACTORS
                                          Family‟s Social




                                                                                                                              Family History
                                                                                                                              & Functioning
                       Community




                                                                                                        Wider Family
                                            Integration




                                                                              Employment
                        Resources




                                                                                           Housing
                                                                Income




                                                                         30
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILTY

                             WHAT IS CHILD ABUSE?


There are four categories of abuse:

      Physical Abuse
      Sexual Abuse
      Emotional Abuse
      Neglect


                                      Physical Abuse


“Physical abuse may involve hitting, shaking, throwing, poisoning, burning or
scalding, drowning, suffocating or otherwise cause physical harm to a child. Physical
harm may also be caused when a parent or carer feigns symptoms of, or deliberately
causes ill health to a child whom they are looking after. This situation is commonly
described using terms such as factitious illness by proxy or Munchausen syndrome by
proxy”.

Working Together to Safeguard Children (1999) D.O.H.


The most common injuries are:

      Bruising- burns- bites

      Friction burns – marks consistent with the shape of an object e.g. bar marks
       from an electric fire, iron etc.

      Brain and/or retinal haemorrhage

      Fractured long bones – spiral fractures
                             Fractures in children under 2 years

      Fractured skull

      Internal injuries to abdomen/chest

      Poisoning / suffocation




                                            31
            CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY

                                      Sexual Abuse

“Sexual abuse involves forcing or enticing a child or young person to take part in
sexual activities, whether or not the child is aware of what is happening. The
activities may involve physical contact, including penetrative (e.g. rape or buggery) or
non-penetrative acts. They may include non-contact activities, such as involving
children in looking at, or in the production of pornographic material or watching
sexual activities or encouraging children to behave in sexually inappropriate ways”.

Working Together to Safeguard Children (1999) D.O.H.


Signs of Sexual Abuse include:

      Bruising in the genital region

      Unexplained bleeding, discharges or abdominal pain

      Social withdrawal

      Genital and rectal itching and soreness

      Secondary enuresis

      Sexually provocative / promiscuous

      Pregnancy

      Self mutilation


Young People Drawn into Prostitution

All professionals must be able to recognise situations where children might be
involved in, or at risk of becoming involved in prostitution. The identification of a
child involved in prostitution, or at risk of being drawn into prostitution, should
always trigger the agreed local Area Child Protection Committee (ACPC) procedures
(see page 52) to ensure the child‟s safety and welfare and to enable the police to
gather evidence about abusers and coercers.


“Children dawn into prostitution come from may backgrounds. The most common
factors are vulnerability and low self esteem. The vast majority of children do not
voluntarily enter prostitution: they are coerced, enticed or are utterly desperate. It is
not a free economic or moral choice”.

Safeguarding Children Involved in Prostitution (2000) D.O.H.



                                            32
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


                                  Emotional Abuse


“Emotional abuse is the persistent emotional ill treatment of a child such as to cause
severe and adverse effects on the child‟s emotional development. It may involve
conveying to the children that they are unloved, worthless, inadequate or valued only
so far as they meet the needs of another person. It may feature age or
developmentally inappropriate expectations being imposed on children. It may cause
children frequently to be frightened or in danger, or the exploitation of children.
Some level of emotional abuse is involved in all types of ill treatment of a child,
though it may occur alone”.

Working Together to Safeguard Children (1999) D.O.H.



Signs of Emotional Abuse:

      Physical, mental or emotional developmental delay

      Low self esteem

      Speech disorders

      Inappropriate emotional responses to situations

      Neurotic behaviour e.g. rocking

      Self mutilation


Researchers believe that the impact of long term emotional abuse is usually more
damaging than the effects of physical and sexual abuse.




                                          33
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


                                           Neglect


“Neglect is the persistent failure to meet a child‟s basic physical and/or psychological
needs, likely to result in the serious impairment of the child‟s health or development.
It may involve a parent or carer failing to provide adequate food, shelter sand
clothing, failing to protect a child from physical harm or danger, or failure to ensure
access to appropriate medical care or treatment. It may also include neglect of, or
unresponsiveness to, a child‟s basic emotional needs”.

Working Together to Safeguard Children 91999) D.O.H.



Signs of neglect:

      Non organic failure to thrive

      Poor growth (weight and height)

      Hunger

      Poor personal hygiene

      Inappropriate or poor state of clothing

      Untreated medical conditions

      Frequent lateness or non-attendance at school

      Low self esteem

      Children left alone or unsupervised

      Poor ability to interact socially

      Developmental delay including speech and language.




                                             34
           CHILD PROTECTION IS EVERYONES‟ RESPONSIBILITY


                                 BIBLIOGRAPHY




Wilson, K and James, A. (eds) (1995) The Child Protection Handbook, London,
Bailliere Tindall.




Bainham, A. (1995) Children The Modern Law, Bristol, Jordan and Sons Ltd.




Children Act 1989, London, HMSO.




Department of Health (2000), Framework for the Assessment of Children in Need and
their Families, London, The Stationery Office.


The Children Act 1989 Guidance and Regulations Volume 1 (1991) London, HMSO.




The Children Act 1989 Guidance and Regulations Volume 7 (1995) London, HMSO.




Department of Health, (1999), Working Together to Safeguard Children, London, The
Stationery Office.




U.K.C.C. Guidelines for Professional Practice.




Walsall Area Child Protection Committee Child Protection Procedures, (September
2001)



                                         35