SAFEGUARDING TRAINING GP LEVEL 3 ESSEX WIDE Updated

SAFEGUARDING TRAINING GP LEVEL 3 ESSEX WIDE Updated 2013

HOUSE KEEPING

Aim For participants to develop their knowledge in relation to safeguarding children to meet: – ‘Working Together’ Group 3 Competencies; and – Core ‘Intercollegiate Document’ Level 3 Competencies.

DUTY TO SAFEGUARD CHILDREN All staff have a duty to maintain their skills in the recognition of abuse and neglect, and to be familiar with the procedures to be followed if it is suspected

Safeguarding and promoting the welfare of children: is defined as by Working Together (2013) as: • Protecting children from maltreatment • Preventing impairment of children’s health or development • Ensuring that children grow up in circumstances consistent with the provision of safe and effective care • Taking action to enable children to have the best outcomes.

Working Together (2013) “the child’s needs are paramount, and the needs and wishes of each child, be they a baby or infant, or an older child, should be put first, so that each child receives the support they need before a problem escalates”

Working Together (2013) Children have said that they need: • Vigilance • Understanding and action • Stability • Respect • Information and engagement • Explanation • Support • Advocacy

Why it is Important to get safeguarding right (vigilance, understanding & action) Victoria Climbie Keanu Williams Daniel Pelka Hamzah Khan Holly Wells & Jessica Chapman

Toxic Trio Mental health Domestic Abuse Alcohol /Substance misuse

Local Safeguarding Children Boards The LSCB is the key statutory mechanism for agreeing how the relevant organisations in each local area will co-operate to safeguard and promote the welfare of children in that locality, and for ensuring the effectiveness of what they do. Working Together (2013): Chapter 3

How do we protect children? What Laws Apply? • There is no single piece of legislation that covers child protection • Children Act (1989 /2004) Section 17, Section 47 • SET procedures encompass the legislation into working document

Social Presentation nta l pm e ev elo s. D ild ’ Ch y Family and Social Relationships Safeguarding and promoting welfare cit Identity Child Ensuring Safety a ap Emotional & Behavioural Development g. C tin Education Basic Care ren Ne Health Pa ed s The Assessment Framework Emotional Warmth Stimulation Guidance & Boundaries Stability Family and Environmental Factors Family History and Functioning Wider Family Housing Employment Income Family’s Social Integration Community Resources

Essex Effective Support Windscreen

Levels 1 -4 • Level 1 -Children & young people who make progress in most areas of development • Level 2 -Children & young people whose needs require some extra support, not specialist services • Level 3 -Vulnerable Children whose needs are more complex, likely to need more than one service • Level 4 - Children and young peoples whose needs are complex and enduring, cross many domains

Safeguarding in Thurrock • Threshold of Need Document Ø 4 Tiers Of Intervention • CAF • M. A. S. H Multi Agency Safeguarding Hub Ø single point of entry • Early Offer of Help Ø universal and targeted services in each locality Ø aims to provide support, challenge and change parenting when needed at appropriate levels depending on the identified needs

Safeguarding in Southend • CAF • Team around the child and family • CP referrals can be made over the phone to First Contact team and should be followed up in writing as soon as possible

Staged Model Of Intervention - Southend

What to do if you are concerned about a child • Refer for a second opinion if you are unsure about the injury • Refer to Children’s Social Care if you are concerned • Be honest with the parents and explain why you want other’s involvement • Document all discussions and decisions • Follow the GMC/NMC guidance on sharing information and confidentiality

If at any time you feel a child is at risk of immediate/significant harm you must follow the SET procedures immediately

Social care assessments Initial Assessment- significant concerns Yes. May call strategy meeting Core assessment /section 47 enquiry - Likely / Risk of significant harm identifiedyes No No Is there a need for extra multi agency support? yes no Case Conference Risk of significant harm identified no yes Child Protection plan Child in Need plan Professional to offer support as required

Why do we find safeguarding children difficult? • • • • Looking for the wrong thing; Underestimating the problem; Normalising the problem; Not seeing the child; (Not Speaking to the Child) Not looking; The hidden problem; Over Optimistic Doing nothing; The jigsaw of child protection; Relationships and trust; Communication across the professional partnership; Lack of confidence in the system and Cultural Relativism.

Tip of the iceberg?

Introduction to further learning

7 golden rules of information sharing Be open and honest Data Protection Act Record your decisions and reasons Seek advice Necessary Proportionate relevant accurate timely secure Consider safety and well being Share with consent

Looked After Children (separate core training must be accessed) • Children and Young People currently looked after and/or accommodated by the Local Authority • Main reason being in care is a result of abuse or neglect • Highly vulnerable group. • Majority placed with registered foster carers. • Private Fostering

FABRICATED AND INDUCED ILLNESS (FII) • In fabricated illness the perpetrator does not directly harm the child but reports to doctors a clinical story which is eventually established to be fabricated • In induced illness the perpetrator inflicts direct (hands on) harm to the child. This can range from trivial injuries such as pricking the child to add blood to urine, through to suffocation • Three ingredients: a dependent child, a carer and a healthcare system

What to do if you suspect a case of FII • Discuss or inform Designated Doctor or Designated Nurse • If child attends and parent requesting referral – advise first discussion with lead consultant • Referral to Social Care will not include disclosure to parents/carers of professional concern prior to professional meetings • Prepare chronological report of attendances • Attend CP conference - vital

Definition of Domestic Abuse "Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass but is not limited to the following types of abuse: • psychological • physical • sexual • financial • emotional Home Office 2013

Female genital mutilation (FGM) Also known as female genital cutting and female circumcision, is defined by the World Health Organization (WHO) as "all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. "

Honour Based Violence The terms ‘honour crime’, ‘izzat’ or ‘honourbased violence’ embrace a variety of crimes of violence (mainly but not exclusively against women), including assault, imprisonment and murder where the person is being punished by their family or community.

“Blood is thicker than water…. . Honour is thicker than blood” If referring a case of honour based abuse or forced marriage DO NOT inform or discuss anything with family and refer by phone to Honour based lead in Social care or police

Forced Marriage A forced marriage is where one or both people do not (or in cases of people with learning or physical disabilities, cannot) consent to the marriage and pressure or abuse is used.

Child Sexual Exploitation Sexual exploitation is a form of sexual abuse in which a young person is manipulated or forced into taking part in a sexual act. This could be as part of a seemingly consensual relationship, or in return for attention, affection, money, drugs, alcohol or somewhere to stay.

Useful Resource Sites Essex LSCB/ Southend LSCB www. escb. co. uk / www. southend. gov. uk Family Solutions Website http: //www. essex. gov. uk/Health-Social-Care/Care-for. Adults/Pages/Family-Solutions. aspx NSPCC http: //www. nspcc. org. uk RCGP http: //www. rcgp. org. uk Integrated Working Website https: //ecclms. co. uk/goecclms. asp

Useful Resource Sites Thurrock Safeguarding Children Board website www. thurrocklscb. org. uk NSPCC http: //www. nspcc. org. uk RCGP http: //www. rcgp. org. uk Integrated Working Website https: //ecclms. co. uk/goecclms. asp

Further training to undertake • Domestic Abuse • Child Sexual Exploitation • Looked After Children (if not undertaken joint training) • Fabricated and Induced Illness • Honour Based Abuse