This is the practice agreed policy, applicable to all clinicians and staff as well as official visitors to the premises, and it represents the means by which the practice intends to keep children safe.
Under the 1989 and the 2004 Children Acts a child or young person is anyone under the age of 18 years.
Child Protection refers to the activity that is undertaken to protect specific children who are suffering or at risk of suffering significant harm. All agencies and individuals should be proactive in safeguarding and promoting the welfare of children.
The practice recognises that all children have a right to protection from abuse and the practice accepts its responsibility to protect and safeguard the welfare of children with whom staff may come into contact. We intend to:
- Respond quickly and appropriately where abuse is suspected or allegations are made.
- Provide both parents and children with the chance to raise concerns over their own care or the care of others.
- Have a system for dealing with, escalating and reviewing concerns.
- Remain aware of child protection procedures and maintain links with other bodies, especially the primary care organisation appointed contacts.
- The practice will ensure that all staff are trained to a level appropriate to their role, and that this is repeated on a refresher basis. New starters will receive training within 1 month of start date.
- The welfare of the child is paramount.
- It is the responsibility of all adults to safeguard and promote the welfare of children and young people. This responsibility extends to a duty of care for those adults employed, commissioned or contracted to work with children and young people.
- Adults who work with children are responsible for their own actions and behaviour and should avoid any conduct which would lead any reasonable person to question their motivation and intentions.
- Adults should work and be seen to work, in an open and transparent way.
- The same professional standards should always be applied regardless of culture, disability, gender, language, racial origin, religious belief and/or sexual identity.
- Adults should continually monitor and review their practice and ensure they follow the guidance contained in this document and elsewhere.
Dr Howard Sunderland is the appointed Clinical Safeguarding Lead within the practice.
The Clinical Safeguarding Lead is responsible for all aspects of the implementation and review of the children’s safeguarding procedure in this practice.
WHAT CHILD ABUSE IS.
There are 4 main categories of child abuse:
- Physical abuse
- Sexual abuse
- Emotional abuse
- Neglect/failure to thrive
These are not however exclusive, and abuse in one of these areas may easily be accompanied by abuse in the others.
Physical abuse may include:
- Hitting, shaking, throwing, poisoning, burning or scalding, or other forms of physical harm
- Where a parent or carer deliberately causes ill-health of a child
- Single traumatic events or repeated incidents
Sexual abuse may include:
- Forcing or enticing a child under 18 to take part in sexual activities where the child is unaware of what is happening
- May include both physical contact acts and non—contact acts
Emotional abuse may include:
- Persistent ill-treatment which has an effect on emotional development
- Conveyance of a message of being un-loved, worthless or inadequate
- May instil feeling of danger, being afraid
- May involve child exploitation or corruption
Neglect may include:
- Failure to meet the child’s physical or psychological needs
- Failure to provide adequate food or shelter
- Failure to protect from physical harm
- Neglect of a child’s emotional needs
Common presentations and situations in which child abuse may be suspected include:
- Disclosure by a child or young person
- Physical signs and symptoms giving rise to suspicion of any category of abuse
- The history is inconsistent or changes
- A delay in seeking medical help
- Extreme or worrying behaviour of a child, taking account of the developmental age of the child
- Accumulation of minor incidents giving rise to a level of concern, including frequent A&E attendances
Some other situations which need careful consideration are:
- Disclosure by an adult of abusive activities
- Girls under 16 presenting with pregnancy or sexually transmitted disease, especially those with learning difficulties
- Very young girls requesting contraception, especially emergency contraception
- Situations where parental mental health problems may impact on children
- Parental alcohol, drug or substance misuse which may impact on children
- Parents with learning difficulties
- Violence in the family
- Unexplained or suspicious injuries such as bruising, bites or burns, particularly if situated unusually on the body
- The child says that she or he is being abused, or another person reports this
- The child has an injury for which the explanation seems inconsistent or which has not been adequately treated
- The child’s behaviour changes, either over time or quite suddenly, and he or she becomes quiet and withdrawn, or aggressive
- Refusal to remove clothing for normal activities or keeping covered up in warm weather
- The child appears not to trust particular adults, perhaps a parent or relative or other adult in regular contact
- An inability to make close friends
- Inappropriate sexual awareness or behaviour for the child’s age
- Fear of going home or parents being contacted
- Reluctant to accept medical help
- Fear of changing for PE or school activities
- Concerns should immediately be reported to the Lead clinician within the practice or his / her deputy (above).
- In the absence of one of the nominated persons, the matter should be brought to the attention of the primary care organised appointed person, or, if it is an emergency, and the designated persons cannot be contacted, then the most senior clinician will make a decision to report the matter directly to social services or the police.
- If the suspicions relate to the designated person, then the deputy should be notified and the primary care organisation appointed person and / or social services should be contacted directly.
- Suspicions should not be raised or discussed with third parties other than those named above.
- Any individual has the ability to make direct referrals to the child protection agencies; however, staff are encouraged to use the route described here where possible. In the event that the reporting staff member feels that the action taken is inadequate, untimely or inappropriate they should report the matter direct. Staff members taking this action in good faith will not be penalised.
- Where emergency medical attention is necessary it should be given. Any suspicious circumstances or evidence of abuse should be reported to the designated clinical lead.
- If a referral is being made without the parent’s knowledge and non urgent medical treatment is required, social services should be informed. Otherwise, speak to the parent/carer and suggest medical attention be sought for the child.
- If appropriate the parent/carer should be encouraged to seek help from the Social Services Department prior to a referral being made. If they fail to do so in situations of real concern the designated person will contact social services directly for advice.
- Where sexual abuse is suspected the designated person will contact the Social Services or Police Child Protection Team directly. The designated person will not speak to the parents.
- Neither the designated person or any other practice team should carry out any investigation into the allegations or suspicions of sexual abuse in any circumstances. The designated person will collect exact details of the allegations or suspicion and to provide this information to the child protection agencies that will investigate the matter under the Children Act 1989.
ABUSE REPORTED OR ALLEGATIONS RECEIVED FROM A CHILD
- React calmly.
- Reassure the child that they were right to tell you, and that they are not to blame and take what the child says seriously.
- Be careful not to lead the child or put words into the child’s mouth – ask questions.
- Do not promise confidentiality
- Fully document the conversation on a word by word basis.
- Fully record dates and times of the events and when the record was made, and ensure that all notes are kept securely.
- Inform the child/ young person what you will do next.
- Refer to the practice designated clinician or deputy.
- Decide if it is safe for a child to return home to a potentially abusive situation. It might be necessary to immediately refer the matter to social services and/or the police to ensure the child’s safety and that they do not return home.
Staff are required to have access to confidential information about children and young people in order to do their jobs, and this may be highly sensitive information. These details must be kept confidential at all times and only shared when it is in the interests of the child to do so, and this applies to the restriction of the information within the clinical team. Care must be taken to ensure that the child is not humiliated or embarrassed in any way.
If an adult who works with children is in any doubt about whether to share information or keep it confidential he or she should seek guidance from the designated clinical Safeguarding Children lead. Any actions should be in line with locally agreed information sharing protocols, and the Data Protection Act applies.
Whilst adults need to be aware of the need to listen and support children and young people, they must also understand the importance of not promising to keep secrets. Neither should they request this of a child or young person under any circumstances.
Additionally, concerns and allegations about adults should be treated as confidential and passed to a designated or appointed person or agency without delay.
A parent or carer should be present at all times, or a chaperone offered. Children should only be touched under supervision and in ways which are appropriate to, and essential for clinical care.
Permission should always be sought from a child or young person before physical contact is made and an explanation of the reason should be given, clearly explaining the procedure in advance. Where the child is young, there should be a discussion with the parent or carer about what physical contact is required. Regular contact with an individual child or young person is normally part of an agreed treatment plan and should be understood and agreed by all concerned, justified in terms of the child’s needs, consistently applied and open to scrutiny.
Physical contact should never be secretive or hidden. Where an action could be misinterpreted a chaperone should be used or a parent fully briefed beforehand, and present at the time. Where a child seeks or initiates inappropriate physical contact with an adult, the situation should be handled sensitively and a colleague alerted.
ATTITUDE OF PARENTS OR CARERS
Parental attitude may indicate cause for concern:
- Unexpected delay in seeking treatment
- Denial of injury pain or ill-health
- Incompatible explanations, different explanations or the child is said to have acted in a way that is inappropriate to his/her age and development
- Reluctance to give information or failure to mention other known relevant injuries
- Unrealistic expectations or constant complaints about the child
- Alcohol misuse or drug/substance misuse
- Violence between adults in the household
- Appearance or symptoms displayed by siblings or other household members
If any Patient has any reason to suspect that a child it “at risk”, please contact one of the named leads below – in confidence.
CHILD PROTECTION: SOURCES OF ADVICE & SUPPORT
|Practice Clinical Safeguarding Children Lead
|Dr Howard Sunderland
|Practice Clinical Safeguarding Children Deputy Lead