5.1 Abduction
RELATED NATIONAL GUIDANCE
Working Together to Safeguard Children
There are a number of useful websites on the internet which provide information and guidance in relation to Child Abduction:
Reunite International
International Child Abduction and Contact Unit (ICACU). Offices of Court Funds,
Official Solicitor and Public Trustee
Honour Based Abuse Procedure
Missinq Children and Families Procedure
Modern Slavery Procedure
Child Sexual Exploitation - Pan Lancashire Standard Operatinq Protocol Forced Marriaqes Procedure
Contents
Introduction
Action to Safeguard
How to Police use the Law to Safeguard Children at Risk of Sexual Exploitation
Introduction
Action to Safeguard
How the Police use the Law to Safeguard Children at Risk of Sexual Exploitation
5.2 Alcohol Misusing Parents/Carers
RELATED NATIONAL GUIDANCE
Chapter 1 : Assessing need and providing help, Workinq Together to Safequard Children
Advisory Council on the Misuse of Druqs, The Home Office
Foetal Alcohol Syndrome, Drink Aware UK
Safeguarding Children Living with Substance Using Parents/Carers - to follow
Blackburn with Darwen Triage Assessment Tool
Blackburn with Darwen Screeninq and Referral for Triaqe Form Substance Misuse
Blackburn with Darwen Comprehensive Assessment
Druq Misusing Parents/Carers Procedure
AMENDMENT
In November 2013, this chapter was updated in line with Working Together to Safeguard Children.
Contents
Alcohol
Alcohol Use in Pregnance
The Child
Concerns
Referrals
Assessment and Initial Child Protection Conference
Alcohol Use in Pregnancy
"Not every child affected by prenatal alcohol exposure will experience severe learning disability, but learning disabilities are common... The primary... damage that alcohol exposure causes is to the central nervous system... it is important to emphasise that little is known about factors determining whether a child will develop alcohol-related problems, or how significant these will be. There is no cut off point that indicates that a specific amount of alcohol at a specific time will create certain types of problems, and less will not... mothers who maintain adequate nutrition even though drinking may give birth to children less severely affected
than mother's who have poor nutrition". - Foetal Alcohol Syndrome website.
The Child
Concerns
o Lack of attention to basic physical needs; o Lack of control of emotions; o Impaired judgement.
Referrals
Assessment and Initial Child Protection Conference
5.3 Bullying
RELATED NATIONAL GUIDANCE
Preventinq and Tacklinq Bullying - Advice for Headteachers. Staff and
Governing Bodies, Department for Education March 2014
Workinq Together to Safequard Children
Mental Health and Behaviour in Schools (DfE)
Disabilities and Learninq Difficulties Procedure
Peer Abuse Procedure
Self-Harm or Suicidal Ideation Procedure Online Safeguarding Procedure
Contents
Definitions
Impact of Bullying on the Child Action to Safeguard
Definitions
o Physical; o Verbal; o Emotional.
Impact of Bullying on the Child
Action to Safeguard
10.AlI settings in which children are provided with services or are living away from home should have in place rigorously enforced anti-bullying strategies.
14.A range of active listening techniques which provide a more helpful response include:
THE LISTENER: Listening patiently with full attention, encouraging, clarifying, restating, reflecting, validating, summarising;
THE DETECTIVE: Investigating the situation sensitively and patiently;
THE SUPPORTER: Seeing their side, acknowledging and allowing expression of their feelings;
THE COACH: Checking out what help is being asked for and offering practical, realistic help.
15. Parents should be informed and updated on a regular basis. They should also, when applicable, be involved in supporting programmes devised to challenge bullying behaviour.
5.4 Child Sexual Exploitation - Pan Lancashire Standard Operating Protocol
RELATED NATIONAL GUIDANCE
Child sexual exploitation: Definition and a guide for practitioners (GOV-UK) definition and a guide for practitioners, local leaders and decision makers working to protect children from child sexual exploitation.
What to do if you're worried a child is beinq abused (GOV.UK) - guidance to help practitioners identify the signs of child abuse and neglect and understand what action to take.
Child Sexual Abuse — The Children's Commissioner
Responding to Child Sexual Exploitation- College of Policinq
Criminal Exploitation of children and vulnerable adults: County Lines quidance (Home Office)
Centre of Expertise on Child Sexual Abuse
Child sexual exploitation: Practice Tool (2017) (open access) - Research in Practice. Further background information about child sexual exploitation and additional commentary around some of the complexities of practically responding to the issue.
RELATED REGIONAL GUIDANCE
Child Sexual Exploitation and Missinq from Home/Care: North West CrossBorder Information Sharing Protocol
Child Sexual Exploitation - Pan Standard Operating Protocol Pan-Lancs CSE Checklist
Pan-Lancs CSE Teams — Contact Numbers — see Local Contacts
Blackburn with Darwen Enqaqe Team: Multi-Aqency Practice Guidance
Blackburn with Darwen Childrens Services • Child Sexual Exploitation (CSE) Toolkit
Missinq Children and Families Procedure
Abduction Procedure
Transfer Across_Local Authority Boundaries Procedure
Complex (Organised or Multiple) Abuse Procedure
Sexually Active Younq People Under the Aqe of 18 Procedure
Gang, Group Activity and Criminal Exploitation Affectinq Children Procedure
AMENDMENT
The Further Information section was revised and updated in May 2018 with a link to the Centre of Expertise on Child Sexual Abuse: Key Messages from research on child sexual exploitation and Child sexual exploitation: Practice Tool (2017) (open access) - Research in Practice - further background information about child sexual exploitation and additional commentary around some of the complexities of practically responding to the issue.
5.5 Children from Abroad, including Victims of Modern Slavery, Trafficking and Exploitation
This procedure is concerned with children arriving into the UK:
Alone;
In the care of adults who, whilst they may be their carers, have no Parental Responsibility for them;
In the care of adults who have no documents to demonstrate a relationship with the child;
In the care of agents.
This is a broad cohort of children, and it may include (but is not limited to) children who have been subject to trafficking and/or modem slavery, and/or may have been exposed to the additional risks of commercial, sexual or domestic exploitation. It may also include children who have been trafficked internally within the UK.
Part 1 of this chapter covers issues which will apply across this cohort.
Part 2 of this chapter covers the additional issues which will apply where children are identified as being potential victims of trafficking and/or modern slavery.
AMENDMENT
This chapter was updated in May 2020 to take account of the new NRM digital referral form and the change to a Single Competent Authority (SCA).
Contents
Part 1 — All Children Presenting Alone or with Adults who are Not Their Parents
Part 2 — Child Victims of Trafficking and Modern Slavery
Further Information
Part 1 - All Children Presenting Alone or with Adults who are Not Their Parents
1.1 Introduction
Evidence shows that unaccompanied migrant children or those accompanied by someone who is not their parent are particularly vulnerable. Immigration legislation impacts significantly on work to safeguard and promote the welfare of children and young people from abroad.
It is important to note that regulations and legislation in this area of work are complex and subject to constant change through legal challenge. This guidance, therefore, intends to provide an overview of the additional issues faced by families and/or children set within the framework of immigration law. All practitioners need to be aware of this context in their contact with such families and/or children. Legal advice about individual cases may be required.
Additional issues are likely to arise in relation to this cohort of children, whether or not they are found to be, or suspected of being, victims of trafficking or modern slavery. Additional considerations in all cases are likely to include issues such as immigration status, the need for interpreters and specialist legal advice. Some of these children may have been persecuted and have witnessed or been subject to horrific acts of violence. Assessing the needs of these children is only possible if their legal status, background experiences and culture are understood, including the culture shock of arrival in this county.
Unaccompanied, intemally displaced children may have come to the UK seeking asylum or may be here to attend school or join their family. An unaccompanied child may be the subject of a Private Fostering arrangement, and subsequently exploited or abandoned when the arrangement fails (see Children Living Away from Home (including Children and Families living in Temporary Accommodation) Procedure).
Some children may say they are unaccompanied when claiming asylum - a trafficker may have told the child that in doing so they will be granted permission to stay in the UK and be entitled to claim welfare benefits.
A significant number of children who are referred to local authority care as trafficked children or unaccompanied asylum seeking children (UASC), often then go missing and many go missing within one week. It is thought that they are then trafficked internally, within the UK, or out of the UK to other European countries.
Whenever an unaccompanied child presents in a local authority area, all agencies dealing with the child should be alert to the possibility that the child may have been a victim of modern slavery, including the possibility that the child has been trafficked, and ensure that all relevant information about the child's circumstances is communicated to Children's Social Care. Information should be shared with consent where appropriate and where possible, but information can be shared without consent if the professional judgement is that there is good reason to do so, such as where their safety may be at risk.
If there are concerns that a child is a victim of trafficking, the practitioners will need to inform the National Referral Mechanism, which is a framework for identifying victims of human trafficking or modem slavery and ensuring that they receive the appropriate support. The child's details should be provided using the forms available on the National Referral Mechanism Digital Referral System: Report Modern Slavery.
In England and Wales, if someone is found not to be a victim of trafficking, the Competent Authority must go on to consider whether they are the victim of another form of modern slavery, which includes slavery, servitude and forced or compulsory labour.
This chapter should be read in conjunction with the following government guidance:
Care of Unaccompanied Migrant Children and Child Victims of Modern Slavery: Statutory Guidance for Local Authorities, November 2017 - This guidance sets out the steps local authorities should take to plan for the provision of support for looked after children who are unaccompanied asylum seeking children, unaccompanied migrant children or child victims of modem slavery including trafficking. Elements of this guidance will also be relevant for the care of looked after UK nationals who may also be child victims of modern slavery.
Safeguarding Children who May Have Been Trafficked (Home Office, 2011) nonstatutory government good practice guidance provides the detailed guidance on steps that local authorities should take, in partnership with other agencies, to identify and protect child victims of modern slavery, including trafficking, before they become looked after.
1.2 Issues and Challenges
The first contact with the child and carers is crucial to the engagement with the family and the promotion of trust which underpins the future support, advice and services.
Such children should be assessed as a matter of urgency as they may be very geographically mobile and their vulnerabilities may be greater. All agencies should enable the child to be quickly linked into universal services, which can begin to address educational and health needs.
The assessment has to address not only the barriers which arise from cultural, linguistic and religious differences, but also the particular sensitivities which come from the experiences of many such children and families.
Particular sensitivities which may be present include:
Concerns around immigration status;
Fear of repatriation;
Anxiety raised by yet another professional asking similar question to ones previously asked;
Lack of understanding of the separate role of Children's Social Care, and that it is not an extension of the police;
Lack of understanding of why an assessment needs to be carried out;
Previous experience of being asked questions under threat or torture, or seeing that happen to someone else;
Past trauma - past regime/experiences can impact upon the child's mental and physical health. This experience can make concerns from the Authorities about minor injury or poor living conditions seem trivial and this mismatch may add to the fear and uncertainty;
The journey itself as well as the previous living situation may have been the source of trauma;
The shock of arrival - the alien culture, system and language can cause shock and uncertainty, and can affect mood, behaviour and presentation;
The child may have also been subject to frequent changes of address or location within the UK and may be living with the fear of sudden further unexplained moves.
Agencies should ensure that the interpreter shares a common language with the child, is professionally trained and has been screened through a DBS check. It is vital that the services of an interpreter are employed in the child's first language and that care is taken to ensure that the interpreter knows the correct dialect.
1.2.1 Age Assessments
The assessment of age is a complex task, which often relies on professional judgement and discretion. Many societies do not place a high level of importance upon age and it may also be calculated in different ways. Some young people may genuinely not know their age and this can be misread as lack of co-operation. Levels of competence in some areas or tasks may exceed or fall short of our expectations of a child of the same age in this country.
Age assessments should only be carried out where there is significant reason to doubt that the claimant is a child. Age assessments should not be a routine part of a local authority's assessment of unaccompanied or trafficked children. Care of Unaccompanied Migrant Children and Child Victims of Modern Slavery Statutory Guidance for Local Authorities (November 2017) provides that where the age of a person is uncertain and there are reasonable grounds to believe that they are under 18, they will be treated as a child in order to receive immediate access to assistance, support and protection in accordance with section 51 of the Modern Slavery Act 2015. An age assessment should only be carried out if it is appropriate to do so, and should not cause a delay in referring into the NRM. Where age assessments are conducted, they must be compliant with case law of Merton and subsequent judgments.
As the issue of age assessment in social work with asylum seeking young people remains controversial, the ADCS (Association of Directors of Children's Services) Asylum Task Force has worked with the Home Office to provide jointly agreed Age Assessment Guidance and Information Sharing Guidance for UASC.
The advice of a paediatrician with experience in considering age may be needed to assist in this, in the context of a holistic assessment. However, the High Court has ruled that, unless a paediatrician's report can add something specific to an assessment of age undertaken by an experienced social worker, it will not be necessary. Please also Assessing Age for Asylum Applicants (GOV.UK) Guidance.
1.2.2 Immigration Issues
The immigration status of a child and his/her family has implications for the statutory responsibilities towards the family. It governs what help, if any, can be provided to the family and how help can be offered to the child.
All children, irrespective of their immigration status, are entitled to protection under the law. Local authorities need to ensure that child victims receive legal advice and support.
Where families are subject to immigration legislation which precludes support to the family, many will disappear into the community and wait until benefits can be awarded to them. During this interim period the children may suffer particular hardship - e.g. live in overcrowded and unsuitable conditions with no access to health or educational services. They are particularly vulnerable to exploitation because of their circumstances.
Children who disappear, where there are concerns about the child's welfare, should be considered to be missing and Missing Children and Families Procedure should be followed.
It may be appropriate for unaccompanied children to be informed of the availability of the Assisted Voluntary Return Scheme.
Asylum Process — Possible Outcomes
There are four main possible outcomes of the asylum process for an unaccompanied child, which will determine what the long term solution might be. These are outlined below including the impact they may have on care and pathway planning:
Granted refugee status (i.e. granted asylum), with limited leave to remain for five years, after which time they can normally apply for settlement (i.e. indefinite leave to remain).
Refused asylum but granted humanitarian protection, with limited leave to remain for five years, after which time they can normally apply for settlement (i.e. indefinite leave to remain). This is most commonly granted where the person is at risk of a form of 'ill treatment' in their country of origin but which does not meet the criteria of the Refugee Convention.
As it is very likely that those granted refugee status or humanitarian protection will qualify for indefinite leave to remain, their care and pathway planning should primarily focus on their long-term future in the UK, in the same way as for any other care leaver.
Refused asylum but granted Unaccompanied Asylum Seeking Child (UASC) Leave. This is normally for 30 months or until the age of 17h, whichever is the shorter period. This form of leave is granted to unaccompanied children where they do not qualify for refugee status or humanitarian protection, but where the Home Office cannot retum them to their home country because it is not satisfied that safe and adequate reception arrangements are in place in that country. It is a form of temporary leave to remain and is not a route to settlement. This decision is a refusal of the child's asylum claim and will attract a right of appeal. The child should be assisted to obtain legal advice on appealing against such a refusal. Before the child's UASC Leave expires, they can submit an application for further leave to remain and/or a fresh claim for asylum, which will be considered. It is essential that they are assisted to access legal advice and make any such further application or claim before their UASC Leave expires.
In such cases, care and pathway planning should therefore consider the possibility that the child may have to return to their home country once their IJASC Leave expires or that they may become legally resident in the UK longterm (if a subsequent application or appeal is successful). Planning should also cover the possibility that they reach the age of 18 with an outstanding application or appeal and are entitled to remain in the UK until its outcome is known.
Refused asylum and granted no leave to remain. In this case the unaccompanied child is expected to return to their home country and their care plan should address the relevant actions and the support required. The Home Office will not return an unaccompanied child to their home country unless it is satisfied that safe and adequate reception arrangements are in place in that country. Any appeal or further application should be submitted where appropriate by the child's legal adviser.
Although these are the four main types of outcomes for an unaccompanied child, there may be others. For example, a child may be granted discretionary leave depending on whether they meet other criteria such as needing to stay in the UK to help police with their enquires after being conclusively identified as a victim of trafficking. Other examples include: leave as a stateless person; limited or discretionary leave for compassionate reasons; and limited leave on the basis of family or private life.
Independent Family Returns Panel
The Secretary of State must consult the Independent Family Returns Panel in each family returns case, on how best to safeguard and promote the welfare of the children of the family, and in each case where the Secretary of State proposes to detain a family in pre-departure accommodation, on the suitability of so doing, having particular regard to the need to safeguard and promote the welfare of the children of the family.
A family returns case is a case where a child who is living in the United Kingdom is to be removed from or required to leave the United Kingdom, together with their parent/carer.
Pre-departure accommodation is a secure facility designed to be used as a last resort where families fail to co-operate with other options to leave the UK, such as the offer of assisted voluntary return.
The Panel may request information in order that any return plan for a particular family has taken into account any information held by other agencies that relates to safeguarding, welfare or child protection. In particular a social worker or manager from Children's Social Care may be invited to contribute to the Panel.
1.3 Referring a Potential Victim of Modern Slavery to the National Referral Mechanism (NRM)
A local authority (as a 'first responder') identifying a potential victim of modern slavery must refer them to the National Referral Mechanism (NRM) for consideration by the Single Competent Authority (SCA). Children's Social Care departments are able to make a referral into the NRM, as they may be entitled to further support. Victims can be of any nationality, and may include British national children, such as those trafficked for child sexual exploitation or those trafficked as drug carriers internally in the UK. The NRM does not supersede child protection procedures, so existing safeguarding processes should still be followed in tandem with the notifications to the NRM. See also National Referral Mechanism: Guidance for Child First Responders.
There js no minimum requirement for justifying a referral into the NRM and consent is not required for children. Communicate honestly with the child about your concerns and reasons for referring them into the NRM.
To complete and see where to send the forms, and the associated guidance, visit Digital Referral System: Report Modern Slavery.
The Duty to Notify - Local authorities have a duty to notify the Home Office about any potential victims of Modern Slavery. It is intended to gather better data about modern slavery. This requirement can be satisfied by completing the National Referral Mechanism Digital Form.
1.4 Protection and Action to be Taken
Whenever any professional comes across a child who they believe has recently moved into this country the following basic information should be sought:
Confirmation of the child's identity and immigration status;
Confirmation of the carer's relationship with the child and immigration status;
Confirmation of the child's health and education arrangements in this country;
Confirmation of the child's health and education arrangements in the country of origin and any other country that the child has travelled through.
This should be done in a way which is as unthreatening to the child and carer as possible.
When an unaccompanied child or child accompanied by someone who does not have Parental Responsibility comes to the attention of any practitioner, a referral should be made to Children's Social Care in accordance with the Making a Referral to Children's Social Care Procedure. An Assessment will be undertaken in order to determine whether they are a Child in Need of services, including the need for protection.
Whether they are unaccompanied or accompanied by someone who is not their parent they should be assumed to be a Child in Need unless assessment indicates that this is not the case. The assessment of need should include a separate discussion with the child in a setting where, as far as possible, they feel able to talk freely. This, in itself, may be a complex process where the assessor may not be able to speak the same language as the child.
Many unaccompanied and/or trafficked children are at risk of going missing from care, often within the first 72 hours, whilst others may be at risk of repeated missing episodes due to ongoing exploitation.
Assessment
The Assessment will be conducted in accordance with the Single Assessments Assessments under Children Act 1989 Procedure. The following additional issues will also need to be taken into consideration.
Assessing the needs of these children is only possible if their legal status, background experiences and culture are understood, including the culture shock of arrival in this country.
This is a highly complex area of work and professionals will need to have available to them a solid understanding of the asylum process or colleagues or other professionals with such expertise.
Seeking information from abroad should be a routine part of assessing the situation of an unaccompanied child. Practitioners from all key agencies - Health, Education, Children's Social Care and the Police - should all be prepared to request information from their equivalent agencies in the country or countries in which a child has lived, in order to gain as full as possible a picture of the child's preceding circumstances.
The child should be offered an Independent Visitor and, if they decline, their reasons should be recorded. Any Independent Visitor appointed should have appropriate training and demonstrate an understanding of the needs faced by unaccompanied or trafficked children.
The Assessment should take account of any particular psychological or emotional impact of experiences as an unaccompanied or trafficked child, and any consequent need for psychological or mental health support to help the child deal with them.
Unaccompanied migrant children and child victims of modern slavery will need access to specialist legal advice and support. This will be in relation to immigration and asylum applications and decisions and any associated legal proceedings. If they have been a victim of modem slavery, it may also be in relation to criminal proceedings or compensation claims. The assessment should note that specialist legal support is required and how it will be provided.
Planning for the child should include planning for a variety of possible outcomes regarding the child's immigration status - see Asylum Process — Possible Outcomes.
Part 2 - Child Victims of Trafficking and Modern Slavery
'Modern slavery' is a form of organised crime in which individuals including children and young people are treated as commodities and exploited for criminal and financial gain. It encompasses human trafficking, slavery, servitude and forced labour.
The Modern Slavery Act 2015 provides better protection for victims and increases the sentences for committing these offences.
Grooming methods are often used to gain the trust of a child and their parents, e.g. the promise of a better life or education, which results in a life of abuse, servitude and inhumane treatment.
'Trafficking of persons' means the recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation.
'Exploitation' for modern slavery purposes is defined, as a minimum, to include: sexual exploitation, forced labour, domestic servitude and organ trafficking.
Trafficked victims are coerced or deceived by the person arranging their relocation, and are often subject to physical, sexual and mental abuse. The trafficked child or person is denied their human rights and is forced into exploitation by the trafficker or person into whose control they are delivered.
Children are not considered able to give 'informed consent' to their own exploitation (including criminal exploitation), so it is not necessary to consider the means used for the exploitation - whether they were forced, coerced or deceived, i.e. a child's consent to being trafficked is irrelevant and it is not necessary to prove coercion or any other inducement.
2.2 Types of Exploitation
Boys and girls of all ages are affected and can be trafficked into, within ('internal trafficking'), and out of the UK for many reasons and all forms of exploitation.
Victims may be sexually exploited and forced into sex work. Victims have been found in brothels, saunas and lap dancing clubs. Persons subject to forced labour have been found working with little or no pay in farms, factories, nail bars, car washes, hotels and restaurants. Domestic servitude involves victims who work in a household where they are subject to long working hours with little or no pay, often in very poor working conditions. Sometimes forced marriage can lead to domestic servitude. Criminal exploitation can involve young people being forced to work in cannabis cultivation, county lines exploitation, begging and pick-pocketing. Other types of exploitation include debt bondage (being forced to work to pay off debts that realistically they will never be able to), organ harvesting, financial fraud (including benefit fraud), and illegal adoption. For further information see Typology of 17 Types of Modern Slavery Offences in the UK.
Victims often face more than one type of abuse and slavery, for example they may be sold to another trafficker and then forced into another form of exploitation.
Children and young people may be exploited by parents, carers or family members. Often the child or young person will not realise that family members are involved in the exploitation.
The Modern Slavery Act 2015 (applicable mostly in England and Wales[l]) provides two civil prevention orders - the Slavery and Trafficking Prevention Orders (STPO) and Slavery and Trafficking Risk Order (STRO), and provision for child trafficking advocates.
[1] Some provisions also concern Northern Ireland and Scotland. Also see the Human
Trafficking and Exploitation (Criminal Justice and Support for Victims) Act (Northern Ireland) 2015 and the Human Trafficking and Exploitation (Scotland) Act 2015
2.3 Indicators
Identification of potential child victims of modern slavery/trafficking may be difficult as they might not show obvious signs of distress or abuse. Some children are unaware that they have been trafficked, while others may actively participate in hiding that they have been trafficked. Even when a child understands what has happened, they may still appear to submit willingly to what they believe to be the will of their parents or accompanying adults. It is important that these children are protected too. Children do not have the legal capacity to 'consent' to their trafficking or their exploitation.
Signs that a child has been trafficked may not be obvious, or children may show signs of multiple forms of abuse and neglect. Spotting the potential signs of child slavery/trafficking in referrals and children you work with can include:
A reluctance to seek help - victims may be wary of the authorities for many reasons such as not knowing who to trust or a fear of deportation or concern regarding their immigration status and may avoid giving details of accommodation or personal details;
The child may seem like a willing participant in their exploitation, e.g. involvement in lucrative criminal activity - however this does not mean they have benefitted from the proceeds;
Discrepancies in the information victims have provided due to traffickers forcing them to provide incorrect stories;
An unwillingness to disclose details of their experience due to being in a situation of dependency;
Brought or moved from another country;
An unrelated or new child discovered at an address;
Unsatisfactory living conditions - may be living in dirty, cramped or overcrowded accommodation;
Missing - from care, home or school - including a pattern of registration and de-registration from different schools;
Children may be found in brothels and saunas;
Spending a lot of time doing household chores;
May be working in catering, nail bars, caring for children and cleaning;
Rarely leaving their home, with no freedom of movement and no time for playing;
Orphaned or living apart from their family, often in unregulated private foster care;
Limited English or knowledge of their local area in which they live;
False documentation, no passport or identification documents;
Few or no personal effects - few personal possessions and tend to wear the same clothing;
No evidence of parental permission for the child to travel to the UK or stay with the adult;
Little or no evidence of any pre-existing relationship with the adult or even an absence of any knowledge of the accompanying adult;
Significantly older partner;
Underage marriage.
Physical Appearance - Victims may show signs of physical or psychological abuse, look malnourished or unkempt, or appear withdrawn.
Physical illnesses - Including work-related injuries through poor health and safety measures, or injuries apparently as a result of assault or controlling measures. There may be physical indications of working (e.g. overly tired in school or indications of manual labour).
Sexual health indicators - Sexually transmitted infections, or pregnancy; injuries of a sexual nature and [or gynaecological symptoms.
Psychological indicators - Suffering from post traumatic stress disorder which may include symptoms of hostility, aggression and difficulty with recalling episodes and concentrating. Depression/self-harm and/or suicidal feelings; an attitude of self blame, shame and extensive loss of control; drug and or/alcohol use.
2.4 Protection and Action to be Taken
Modern slavery and trafficking are child abuse, and any potential victim of child trafficking or slavery, servitude, or forced or compulsory labour should immediately be referred to Children's Services in the area, as they may be suffering significant harm see Making a Referral to Children's Social Care Procedure.
In addition to the usual actions to be taken, additional considerations will apply if the child is suspected of being a victim of trafficking and/or modern slavery. Once a potential victim has been identified, practitioners should inform them of their right to protection, support, and assistance in any criminal proceedings against offenders. Practitioners should arrange access to specialist legal advice and support. Trafficked children may apply to UK Visas and Immigration for asylum or humanitarian protection. This is because they often face a high level of risk of harm if they are forced to return to their country of origin.
If the child or anyone connected to them is in immediate danger the police should be contacted as normal.
Practitioners should meet any urgent health needs and arrange emergency medical treatment if appropriate.
Practitioners must arrange safe accommodation for the potential victim.
Assessment
Where a child is a victim or potential victim of Modern Slavery/Trafficking, the Assessment should be carried out immediately as the opportunity to intervene is very narrow. Many trafficked children go missing from care, often within the first 72 hours. There should be a clear understanding between the local authority and the police of roles in planning for the protection and responding if a child goes missing.
During the Assessment, the lead social worker should establish the child's background history including a new or recent photograph, passport and visa details, Home Office papers and proof and details of the guardian or carer.
Where the outcome of the assessment is that the child becomes looked after, the social worker and carers must consider the child's vulnerability to the continuing influence/control of the traffickers and how they may seek to contact them for instance by mobile phone or the internet. Planning and actions to support the child must minimise the risk of the traffickers being able to re-involve a child in exploitative activities:
The location of the child must not be divulged to any enquirers until they have been interviewed by a social worker and their identity and relationship/connection with the child established, with the help of police and immigration services, if required;
Foster carers/residential workers must be vigilant about anything unusual e.g. waiting cars outside the premises and telephone enquiries.
The social worker must immediately pass to the police any information on the child (concerning risks to her/his safety or any other aspect of the law pertaining either to child protection or immigration or other matters) which emerges during the placement. The social worker must try to make contact with the child's parents in the country of origin (immigration services may be able to help), to find out the plans they have made for their child and to seek their views. The social worker must take steps to verify the relationship between the child and those thought to be her/his parent/s.
Anyone approaching the local authority and claiming to be a potential carer, friend, member of the family etc, of the child, should be investigated by the social worker, the police and immigration service. If the supervising manager is satisfied that all agencies have completed satisfactory identification checks and risk assessments, the child may transfer to their care.
The child should be offered an Independent Visitor and, if they decline, their reasons should be recorded. Any Independent Visitor appointed should have appropriate training and demonstrate an understanding of the needs faced by unaccompanied or trafficked children.
The Assessment should take account of any particular psychological or emotional impact of experiences as an unaccompanied or trafficked child, and any consequent need for psychological or mental health support to help the child deal with them.
Practitioners must always ensure that a victim-centred approach to tackling all types of trafficking and modern slavery is taken. This can be achieved by the following:
Dealing with the child sensitively to avoid them being alarmed or shamed building trust, as victims commonly feel fear towards the authorities;
Keeping in mind the child's:
Added vulnerability; o Developmental stage; o Possible grooming by the perpetrator.
A child's credibility can be challenged if the child is subject to immigration control on the basis of their disclosure being made in instalments. It is important that practitioners make careful notes about what is disclosed, as a child may have difficulty recalling what they've experienced as a result of trauma. This will support the child and help others understand the process of disclosure.
When questioning a potential victim, initially observe non verbal communication and body language between the victim and their perpetrator.
It is important to consider the potential victim's safety and that of their loved ones. Confidentiality and careful handling of personal information is imperative to ensure the child's safety. Practitioners must not disclose to anyone not directly involved in the case, any details that may compromise their safety.
For further advice and support the Child Trafficking Advice Centre (CTAC) provides free guidance to professionals concerned that a child or young person is a victim of modern slavery.
Further Information
Care of Unaccompanied Migrant Children and Child Victims of Modern Slavery: Statutory Guidance for Local Authorities, November 2017
Safeguarding Children who May Have Been Trafficked (Home Office, 2011) - nonstatutory government good practice guidance.
Modern Slavery Helpline and Resource Centre - Unseen (Registered Charity) NSPCC Child Trafficking Advice Centre (CTAC) - specialist advice and information to professionals who have concerns that a child may have been trafficked.
Duty to Notify the Home Office of Potential Victims of Modern Slavery - Guidance and Forms
Home Office Circular - Modern Slavery Act 2015
Modern Slavery: Duty to Notify Factsheets (GOV-UK, October 2016)
Support for victims of modern slavery (GOV.UK)
Modern slavery: how to identify and support victims - guidance for how UK Visa and Immigration identifies and helps potential victims of modern slavery.
Guidance on Processing Children's Asylum Claims - sets out the process which immigration officials follow in determining an asylum claim from a child and the possible outcomes for the child.
National Referral Mechanism: Guidance for Child First Responders - provides details on how to refer a child into the NRM and complete the referral form, reviews of decisions and the benefits of referral.
National Transfer Protocol for Unaccompanied Asylum Seeking Children interim national transfer procedure and transfer flow chart for the safe transfer of UASC from one UK local authority to another.
Child Protection: Working with Foreign Authorities - guidance on child protection cases and care orders where the child has links to a foreign country.
Local Government Association - Council Support: Refugees, Asylum Seekers and Unaccompanied Children - resource for council staff, designed to answer questions about supporting refugees, asylum seekers and unaccompanied children.
Unaccompanied Asylum-seeking Children (UASC): Funding Instructions, 28 April 2014, Guidance, UKVI: Instructions to local authorities about the UASC funding (2013 to 2014) for the support and care of unaccompanied asylum-seeking children.
Modern Slavery Act 2015
Modern Slavery Act 2015: Recent developments - Briefing Paper, July 2016
College of Policing - Modern Slavery
NSPCC - Are You a Child Who Has Come to the UK from Another Country?
Modern Slavery - Royal College of Nursing Guide for Nurses and Midwives
Refugee and Unaccompanied Asylum Seeking Children and Young People: Age
Assessment and Children in Detention (Royal College of Paediatrics and Child Health)
Refugee Council - Children's Panel - national remit to offer advice and support to unaccompanied children, and advise other professionals who are involved in their care.
Modern Slavery and Human Trafficking Unit (National Crime Agency)
Gangmasters & Labour Abuse Authority
5.6 Children Living Away from Home (including Children and Families living— in Temporary Accommodation)
RELATED NATIONAL GUIDANCE
Workinq Together to Safeguard Children
The Children's Homes (England) Regulations 2015
Guide to the Children's Homes Regulations including the Quality Standards
Joint Protocol Children and Young People Who Run Away or Go Missing from
Home or Care
Hospital Stays for Children Where there are Welfare Concerns Procedure Safeguardinq Children and Younq People in the Youth Justice System
Procedure
Bullyinq Procedure
Peer Abuse Procedure
Allegations Aqainst Persons who Work with Children (includinq Carers and Volunteers) Procedure
Missinq Children and Families Procedure Private Fosterinq Procedure
Contents
Introduction
Essential Safeguards
Children in Foster Care
Children Placed for Adoption
Children in Residential Settings
Children of Families Living in Temporary Accomodation
Introduction
Essential Safeguards
Children in Foster Care
will involve notifying the placing authority and where necessary the Police of any unauthorised absence by a child.
Children Placed for Adoption
1 1 . Where an allegation of abuse or neglect is made in respect of a child placed for adoption or in respect of a prospective or approved adopter, the following actions must be taken:
Children in Residential Settings
12.All residential settings where children and young people are placed, including children's homes and residential schools, whether provided by a private, charitable or faith based organisation, or a local authority, must adhere to the Children's Homes Regulations 2001 and all other relevant regulations and to the relevant Quality Standards.
Children of Families Living in Temporary Accommodation
5.7 Community, Voluntary and Faith Sector
RELATED NATIONAL GUIDANCE AND INFORMATION
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Multi-faith safeguarding hub: How to protect children and younq people within religious or faith settings (NSPCC) RELATED LOCAL GUIDANCE
Agreement Between Lancashire Council of Mosques and Pan Lancashire SCBs on Safequardinq Children
Guidance from the Diocese of Blackburn
Contents
Introduction Extract from Working Together to Safeguard Children
Introduction
Extract from Working Together to Safeguard Children
The following is taken from Workinq Together to Safeguard Children - Chapter 2.
Voluntary, charity, social enterprise (VCSE) and private sector organisations and agencies play an important role in safeguarding children through the services they deliver. Some of these will work with particular communities, with different races and faith communities and delivering in health, adult social care, housing, prisons and probation services. They may as part of their work provide a wide range of activities for children and have an important role in safeguarding children and supporting families and communities.
Like other organisations and agencies who work with children, they should have appropriate arrangements in place to safeguard and protect children from harm. Many of these organisations and agencies as well as many schools, children's centres, early years and childcare organisations, will be subject to charity law and regulated either by the Charity Commission or other 'principal' regulators. Charity trustees are responsible for ensuring that those benefiting from, or working with, their charity, are not harmed in any way through contact with it. The Charity Commission for England and Wales provides guidance on charity compliance which should be followed. Further information on the Charity Commission's role in safeguarding can be found on: the Charity Commission's paqe on GOV.UK.
Some of these organisations and agencies are large national charities whilst others will have a much smaller local reach. Some will be delivering statutory services and may be run by volunteers, such as library services. This important group of organisations includes youth services not delivered by local authorities or district councils.
All practitioners working in these organisations and agencies who are working with children and their families are subject to the same safeguarding responsibilities, whether paid or a volunteer.
Every VCSE, faith-based organisation and private sector organisation or agency should have policies in place to safeguard and protect children from harm. These should be followed and systems should be in place to ensure compliance in this. Individual practitioners, whether paid or volunteer, should be aware of their responsibilities for safeguarding and protecting children from harm, how they should respond to child protection concerns and how to make a referral to local authority children's social care or the police if necessary.
Every VCSE, faith-based organisation and private sector organisation or agency should have in place the arrangements described in this chapter. They should be aware of how they need to work with the safeguarding partners in a local area. Charities (within the meaning of section 1 Charities Act 2011), religious organisations (regulation 34 and schedule 3 to School Admissions) and any person involved in the provision, supervision or oversight of sport or leisure are included within the relevant agency regulations. This means if the safeguarding partners name them as a relevant partner they must cooperate. Other VCSE, faith-based and private sector organisations not on the list of relevant agencies can also be asked to cooperate as part of the local arrangements and should do so
31
5.8 Complex (Organised or Multiple) Abuse
RELATED NATIONAL GUIDANCE
College of Policing: Managing Complex Child Abuse Investigations
Contents
Introduction
Action to Safeguard Children
Process of the Investigation
Introduction
Action to Safeguard Children
Sharing of information, access to, and secure storage of records. See also Information Sharing & Confidentiality Procedure;
Access to legal advice regarding the criminal, civil and employment processes;
Process of the Investigation
Ensure team members have expertise in conducting investigations, child protection processes and children's welfare and are committed to working closely together;
Involve senior managers from involved agencies at a strategic level. The Police will appoint a Senior Investigating Officer of appropriate rank and experience;
Ensure that appropriate resources are deployed and staff supported;
Agree upon the handling of political and media issues arising from investigations;
Ensure that records are safely and securely stored;
Recognise and anticipate that an investigation may become more extensive than suggested by initial allegations;
Where it is practicable in the circumstances to conduct a rigorous and impartial investigation using the local authority's own staff, ensuring sufficient distance (in structural and geographical terms) between such staff and those being investigated This means that the inclusion of staff members or managers from the institution or workplace under investigation should be considered with particular care;
Terms of reference should include assurances that the team will have full access to records and individuals that hold important information;
Secure access to expert legal advice. The inter-relationship between criminal, civil and employment processes is complex;
Use regular Strategic Planning Meetings and reviews to consider the conduct of the investigation, next steps and the effectiveness of joint working;
Always minute meetings and records actions that have been agreed with timeframes;
Agree clear written protocols between the Police, Children's Social Care and other agencies in relation to all key operational and policy matters including information sharing. See Information Sharing & Confidentiality Procedure;
Consider first whether there are any children involved who need active safeguarding and/or therapeutic help and how this should be achieved in a way that is consistent with the conduct of criminal investigations;
Make a thorough assessment of victims' needs and provide services to meet those needs;
Provide a confidential and independent counseling service for victims and families;
Agree guidelines with counseling and welfare services on disclosure of information to avoid the contamination of evidence;
Provide welfare and support for the investigation team - much of the work may be difficult and distressing;
Put in place a means of identifying and acting on lessons learned from the investigations (e.g. in respect of policies, procedures and working practices which may have contributed to the abuse occurring) as the investigation proceeds and at its close and at the conclusion of the investigation assess its handling and identify lessons for conducting similar investigations in future;
At the conclusion of the investigation assess its handling and identify lessons for conducting similar investigations in future.
12.3.19 Concealed or Denied Pregnancy
AMENDMENT
This chapter was updated in August 2018.
Contents
1 . Introduction and Purpose of the Guidance
1 1 . Police
1. Introduction and Purpose of the Guidance
1.2 The concealment and denial of pregnancy will present a significant challenge to professionals in safeguarding the welfare and wellbeing of the foetus (unborn child) and the mother. There may be a number of reasons why a pregnancy is concealed or denied, for example:
A woman or girl may conceal their pregnancy if it occurred as the result of sexual abuse, either within or outside the family, due to her fear of the consequences of disclosing that abuse;
36
A pregnancy may be concealed in situations of domestic abuse, within a forced marriage or for a forced marriage to avoid shame on a family;
There is growing intelligence that suggests pregnant women are exploited for sham marriages and benefit fraud, likewise the unregulated nature of the surrogacy industry puts women and children at risk of exploitation and trafficking and may not therefore conceal their pregnancies due to control and coercion;
Due to stigma, shame or fear through cultural or family pressures, concealment may be a deliberate means of coping with the pregnancy or avoiding brining shame on the family;
Fear of a child being removed where a woman has had a previous child removed, or asylum seekers and illegal immigrants who may be reluctant to inform the authorities that she is pregnant;
In some cases the woman may be truly unaware that she is pregnant until very late in the pregnancy, either due to age or learning disability if they do not understand why their body is changing;
There are links between denial of pregnancy and dissociative states brought about by trauma or loss; or denial stems from an expectant mother misusing drugs or alcohol which can harm the foetus or because of mental illness, such as schizophrenia.
While concealment and denial, by their very nature, limit the scope of professional help better outcomes can be achieved by coordinating an effective inter-agency approach. This approach begins when a concealment or denial of pregnancy is suspected or in some cases when the fact of the pregnancy (or birth) has been established. This will also apply to future pregnancies where it is known or suspected that a previous pregnancy was concealed or denied.
but none were completely denied by the woman (no awareness of being pregnant). The characteristics of the women in the study were explored and over half of them lived with the child's father, and 13 of the 17 women identified were classed as professionally active with a status identical to that of the general population. The authors concluded that neonaticide appeared as a solution to an unwanted pregnancy that risked a family scandal or loss of a partner or lifestyle. (Tursz and Cook, 2010)
Good practice in antenatal care:
Midwives and GPs should care for women with an uncomplicated pregnancy, providing continuous care throughout. Obstetricians and specialist teams should be brought in where necessary;
In the first contact with a health professional, an expectant mother should be given information on folic acid supplements; food hygiene and avoiding food-acquired infections; lifestyle choices such as
smoking cessation or drug use; and the risks and benefits of antenatal screening;
The booking appointment with a midwife ideally should be around 10 weeks. This appointment should help the expectant mother plan the pregnancy, offer some initial tests and take measurements to help determine any specific risks for the pregnancy. The expectant mother should be given advice on nutritional supplements and benefits;
Give information that is easily understood by all women, including those with additional needs, learning difficulties or where English is not their first language. Ensure the information is clear, consistent and backed up by current evidence;
Remember to give an expectant mother enough time to make decisions and respect her decisions even if they are contrary to your own views;
Women should feel able to disclose problems or discuss sensitive issues with you. Be alert to the symptoms and signs of domestic violence and abuse.
Adapted from Antenatal care: Routine care for the healthy pregnant woman, NICE, 2008 (NICE update due June 2020)
The reasons will not be known until there has been a multi-agency assessment. If there is a denial of pregnancy, consideration must be given at the earliest opportunity to a referral to enable the expectant mother to access appropriate mental health services for an assessment. Advice can be sought from the designated or named professional or from Children's Social Care.
Legal considerations about concealment and denial of pregnancy:
United Kingdom law does not legislate for the rights of unborn children and therefore a foetus is not a legal entity and has no separate rights from its mother. This should not prevent plans for the protection of the unborn child being made and put into place to safeguard the baby from harm both during pregnancy and after the birth;
In certain instances legal action may be available to protect the health of a pregnant woman, and therefore the unborn child, where there is a concern about the ability to make an informed decision about proposed medical treatment, including obstetric treatment. The Mental Capacity Act 2005 states that person must be assumed to have capacity unless it is proven that she does not. A person is not to be treated as unable to make a decision because they make an unwise decision. It may be that a pregnant woman denying her pregnancy is suffering from a mental illness and this is considered an impairment of mind or brain, as stated in the act, but in most cases of concealed and denied pregnancy this is unlikely to be the case;
There are no legal means for a local authority to assume Parental Responsibility over an unborn baby. Where the mother is a child and subject to a legal order, this does not confer any rights over her unborn young person or give the local authority any power to override the wishes of a pregnant young person in relation to medical help.
Repeated rumours around school or college;
Uncharacteristically withdrawn or moody behaviour;
Missing from education, child sex exploitation and missing from home.
7 6 If there is a lack of progress in resolving the matter in the setting or escalating concerns that a young person may be concealing or denying she is pregnant, there must be a referral to Children's Social Care. Where there are significant concerns regarding the girl's family background or home circumstances, such as a history of missing from home, risk of CSE, abuse or neglect, a referral should be made immediately. As with any referral to Children's Social Care, the parents and young person should be informed, unless in doing so there could be significant concern for her welfare or that of her unborn child.
Paediatrician;
Health Visitors;
School nurses;
Sexual Health and GUM services;
General Practitioners and Practice nurses;
Midwifes and Obstetricians/Gynaecologists;
Mental Health Nurses;
Drug and Alcohol workers;
Learning Disability workers;
Psychologists and Psychiatrists;
SUDC (Sudden or Unexpected Death in Childhood) Nurses;
Commissioned termination of pregnancy services.
(This is not an exhaustive list)
This would ordinarily be done by voluntary agreement with the mother, although where the mother's consent is not freely given, consideration should be given to whether there are grounds for seeking an Emergency Protection Order to ensure the baby remains in hospital until a the discharge plan is agreed. Alternatively, the assistance of the Police - via Police Protection - may be sought to prevent the child from being removed from the hospital.
If the baby is bom at home the midwife or ambulance service (which ever professional is present), should ensure the baby is admitted to hospital even if the mother herself declines her own admission (see 4.3).
10 7 In undertaking an assessment, the social worker will need to focus on the facts leading to the pregnancy, reasons why the pregnancy was concealed and gain some understanding of what outcome the mother intended for the child. These factors, along with the other elements of the Continuum of Need Risk Sensible Framework for Multi Agency Partners and Assessment Framework will be key in determining risk.
1 0.8 Accessing psychological services in concealment and denial of pregnancy may be appropriate and consideration should be given to referring an expectant mother for psychological assessment. There could be a number of issues for the woman, which would benefit from psychological intervention. A psychiatric assessment might be required in some circumstances, such as where it is thought she poses a risk to herself or others or in cases where a pregnancy is denied.
1 0.9 The pathway for psychological or psychiatric assessment, either before or after pregnancy, is the same. A referral should be made using the single point of entry to mental health services and the referral letter copied to the woman's GP. The referral should make clear any issues of concern for the woman's mental health and issues of capacity.
11. Police
1 1 .1 The Police will be notified of any child protection concerns received by Children's Social Care where concealment or denial of pregnancy is an issue. A police representative will be invited to attend the multi-agency Strategy Meeting and consider the circumstances and to decide whether a joint Child Protection investigation should be carried out.
1 1 .2 Factors to consider will be the age of the expectant mother who is suspected or known to be pregnant, and the circumstances in which she is living to consider whether she is a victim or potential victim of criminal offences. In all cases where a child has been harmed, been abandoned, died or expected to die it will be incumbent on the Police and Children's Social Care to work together to investigate the circumstances. This will involve the Pan Lancashire SUDC team in the event of a child death or where the prognosis is poor. Where it is suspected that neonaticide or infanticide has occurred then the Police will be the primary investigating agency.
This guidance is based on the Bury Concealed and Denied Pregnancy Protocol Brezinkha, C. H. (1994). Denial of Pregnancy: obstetrical aspects. Psychosomatic Obstetrics and Gynaecology, 1-8.
DHSC. (2002). Learning from Past Experience - A Review of Serious Case Reviews. London: Department of Health and Social Care.
Earl, G. B. (2000). Concealed pregnancy and child protection. Childright Volume 171 , 19-20.
Friedman, S. H. (2007). Characteristics of Women Who Deny or Conceal Pregnancy. Psychosomatics, 117-122.
Friedman, S. M. (2005). Child murder by mothers: A critical analysis of the current state of knowledge and a research agenda. The American Journal of Psychiatry, 15781587.
Moyer, P. (2006). Pregnant Women in Denial rarely receive Psychiatric Evaluation. Medscape Medical News (p. Abstract NR930). APA 159 Annual Meeting (May 25 2006).
Nirmal, D. T. (2006). The incidence and outcome of concealed pregnancies among hospital deliveries: an 1 1 year population based study in South Glamorgan. Journal of Obstetrics and Gynaecology, 118-121.
Reder, P. (1993). Beyond blame; Child Abuse tragedies revisited. London: Routledge. Reder, P. D. (1999). Lost Innocents: A follow-up study of fatal child abuse. London: Routledge.
Royal College of Obstetrics and Gynaecology. (2006). Law and Ethics in relation to court authorised obstetric intervention. London: RCOG.
Spielvogel, A. H. (1995). Denial of Pregnancy: a review and case reports. Birth, 220226.
Spinelli, M. (2005). In S. Friedman, Infanticide.
Tursz, A., & Cook, J. M. (2010, December 6). A population-based survey of neonaticides using judicial data. Retrieved October 3, 2011 , from Arch Dis Child Foetal Neonatal Ed
Vallone, D. H. (2003). Preventing the Tragedy of Neonaticide. Holistic Nursing Practice, 223-228.
Wessel, J. B. (2002). Denial of Pregnancy: Population based study. British Medical Journal (International Edition), 458.
14. Additional Reading
Antenatal Care: Routine care for the healthy pregnant woman, Quick Reference Guide. National Institute for Clinical Excellence, 2008
Law and Ethics in relation to court-authorised obstetric intervention; Ethics Committee
Guideline No. 1 Royal College of Obstetricians and Gynaecologists. Sept 2006
Lancashire Safeguarding Boards Serious Case Reviews
5.10 Dangerous or Out of Control Pets
This guidance explains the importance of professionals making routine enquiries regarding dogs in the household whenever they are working with children and families. It then looks at the action which is required when a child is injured by a dog and / or when there are concems that a dog in the household may be dangerous or prohibited.
AMENDMENT
In May 2018, this chapter was reviewed and updated.
Contents
Introduction and Definition
Legislation Relating to Dangerous Dogs and Other Pets
Assessing Risks to Children and Young People
Protection and Action to be Taken
Practitioner Safety
Animal Welfare
Further Information
Introduction and Definition
The benefits of owning pets are well established. Living in a pet owing household can have physical and emotional benefits for children as well as teaching them about responsibility and caring for living creatures. However, in recent years a number of children of different ages have been seriously injured or have died from attacks by dogs, and it is important therefore that professionals working with children and families are aware of the issues around dangerous dogs and the risks they can pose to children and young people.
The aim of this chapter is to help practitioners to understand how to assess any risks which dogs in then household might pose to children and take action as necessary to protect children from serious injuries which can be inflicted by pets that are prohibited, dangerous or badly looked after or mistreated by their owners. It also provides advice for practitioners to enable them to undertake home visits more safely.
The guidance covers the following:
How to routinely ask questions about dogs in the household or in regular contact with children and young people and how to assess any associated risks;
The action that should be taken if a child is living in a household with a prohibited or dangerous dog; and
The information that should be gathered when any child is injured by a pet and the issues to be considered when making a referral in line with the Making a Referral to Children's Social Care Procedure.
The abuse of animals can be part of a constellation of intra-familial abuse, which can include maltreatment of children and domestic violence and abuse. However, this does not imply that children who are cruel to animals necessarily go on to be violent adults, or that adults who abuse animals are also violent to their partners and/or children. Effective investigation and assessment are crucial to determine whether there are any links between these factors and the possible risks to the safety and welfare of children and/or vulnerable adults.
Note that the chapter refers to pets throughout in order to promote the need for practitioners to consider the risks presented by any animal, however specific legislation only applies to dogs.
Legislation Relating to Dangerous Dogs and Other Pets
The Dangerous Dogs Act (1991) provides detailed information about the legislation covering certain types of dogs, sets out the responsibilities of the owners and described the actions that can be taken to remove and/or control dogs:
Certain dogs are 'prohibited' and if any agency has any knowledge or report of a dog of this type, the matter should be reported to the Police immediately;
Any dog can be 'dangerous' (as defined by the Act) if it has already been known to inflict or threaten injury;
Injuries inflicted by certain types of dog are likely to be especially serious and damaging. Strong, powerful dogs such as Pit Bull Types will often use their back jaws (as opposed to 'nipping') and powerful neck muscle to shake their victims violently as they grasp;
When reports of 'prohibited' dogs and known or potentially dangerous dogs are linked to the presence of children, all agencies should be alert to the possible risks to children and potential consequences.
Lancashire Constabulary have provided the additional guidance included within Section 6, Further Information which provides more detailed guidance for identifying dangerous dogs.
Part 7. of the Anti-social Behaviour, Crime and Policing Act 2014 strengthens powers to tackle irresponsible dog ownership by extending the offence of owning or being in charge of a dog that is dangerously out of control in a public place to also cover private places. It also provides that a dog attack on an assistance dog constitutes an aggravated offence.
Part 7. also ensures that the courts can take account of the character of the owner of the dog, as well as of the dog itself, when assessing whether a dog should be destroyed on the grounds that it is a risk to the public.
The Home Office Crime Classification 8/21 is amended to: "Owner or person in charge allowing a dog to be dangerously out of control in any place in England or Wales (whether or not in a public place) injuring any person or assistance dog." Section 3 (1 ) Dangerous Dogs Act 1991 as amended by Section 106 Anti-Social Behaviour Crime and Policing Act 2014.
The Dangerous Wild Animals Act 1976 requires keepers of dangerous or wild animals to hold a licence. These are issued by unitary and district authorities who may be able to advise practitioners who encounter unusual pets in the course of home visits.
Assessing Risks to Children and Young People
When a practitioner from any agency undertakes a home visit and there are both children and pets in the household, the practitioner should routinely consider whether the presence of the pets presents any kind of risk to the welfare of the child/ren. This should involve a discussion with the parents or the pet owner about the dog's behaviour. This is particularly important when there is a new baby in the household. The pet owner should be asked whether the dog's behaviour has changed since the baby was brought home. This assessment of risk should be repeated when the baby begins to become mobile.
There will be times when even the most well cared for pet, behaves in a way that had not been expected. The care, control and context of a pet's environment will impact on the pet's behaviour and the potential risks it may pose. Research indicates that neutered or spayed pets are less likely to be territorial and aggressive towards other dogs and people. Pets that are kept and/or bred for the purpose of fighting, defending or threatening others are likely to present more risks than genuine pets.
All children are potentially vulnerable from an attack by a pet but very young children are likely to be at greatest risk. A young child will be unaware of the potential dangers they could face and will be less able to protect themselves. Small children are of a size that leaves especially vulnerable parts of their body exposed. The question should be asked: 'is the pet left alone with the child?' This applies even if the child is in a cot, bed or seat of some kind.
See also Animal Welfare for guidance from the RSPCA on assessing the whether a dog's welfare needs are being met.
If it is the professional judgement of the practitioner that a pet is prohibited or presents a risk to a child, the Police or Children's Social Care should be contacted immediately.
National animal welfare charities provide a wide array of useful advice and information about looking after pets and ensuring the safety of children. The general advice that is provided from all animal welfare charities includes:
Do not leave babies and young children unattended around pets;
Do not leave doors open to children's rooms allowing pets access to sleep areas;
Ensure children are not sleeping in areas of the house where the pets may usually also sleep;
Do not ignore pets when they show aggression — always separate pets away from children; and
Teach children not to disturb pets when they are sleeping, eating, caring for their offspring or when pets are ill or injured.
Protection and Action to be Taken
Any agency that becomes aware of a dog that could be prohibited or considered dangerous, should collect the following information: The dog's name and breed and/or description;
Information about the owner;
The reason for keeping the dog and information about other family members, particularly young children.
Where there is a report of a child having been injured by any pet (or exposed to the risk of injury) a referral to Children's Social Care should be considered. In deciding whether or not to make a referral, consideration should be given to:
The nature of the injuries;
The circumstances of the attack / incident;
Whether the parents or dog owner sought medical advice;
Whether the dog has previously shown any aggression; and
What action the pet owner has taken to prevent a recurrence of any attack.
Remember, if a practitioner has reason to believe that a dog in the household is prohibited or presents a risk to a child, the Police or Children's Services should be contacted immediately. Other considerations before making a referral should be:
The injured child is under two years of age;
The child is under five years of age and the injuries have required medical treatment;
The child is over five years and under 18 and has been injured more than once by the same pet;
The child/young person is under 18 years of age, the injuries have required medical treatment and initial information suggests the dog responsible could be prohibited and/or dangerous;
A prohibited and/or dangerous dog is reported and/or treated and is believed to be living with and/or frequently associated with children under five years.
A referral should also be made where a prohibited and/or dangerous dog is reported and/or treated and is believed to be living with and/or frequently associated with children.
Some referrals might be logged 'for information only' by the agencies, for example if it is clearly established that no significant or continued risk is likely to the child, or other children (for example, if the pet — which was the only dog in the household has already been 'put down' or removed to another house where no children are present).
Some referrals might prompt 'information leaflets' on Pets and Safe Care of Children to be issued for example, if the incident or injury was clearly minor, if the child was older or if the family have clearly shown themselves to be responsible pet owners. See
In more serious cases a Strategy Discussion and joint Section 47 investigation should lead to further discussions with other agencies and home visits to complete assessments and to inform judgements on parenting and the care and control of the pet(s).
Advice might be sought from a veterinary professional to help determine the likely nature or level of risk presented by the pet(s). As with all other assessments 'the welfare of the child is paramount.'
Practitioner Safety
The following advice is adapted from East Riding LSCB and Lancashire Constabulary:
Animal Welfare
The RSPCA offer the following advice to all professionals who are in contact with a household where there is a dog/s present:
"When looking at, or asking about a dog think about the following points, which should not be considered an exhaustive list but are intended to prompt a professional's curiosity as to the state of the dog's welfare along with suggested courses of action."
"The points relate to Section 9 of the Animal Welfare Act, 2006 which imposes a duty of care on a person who is permanently or temporarily responsible for an animal. This duty of care requires that reasonable steps in all the circumstance are taken to ensure that the welfare needs of an animal are met to the extent required by good practice. The welfare needs are:
The need for a suitable environment;
The need for a suitable diet;
The need to be able to exhibit normal behaviour patterns;
The need it has to be housed with, or apart from, other animals;
The need to be protected from pain, suffering, injury and disease.
During the visit ask if there is a dog in the property including the back garden. If there is, and the dog isn't in the same room as you, ask to see him."
Further Information
The Blue Cross Be Safe with Dogs Leaflet - Guidance for Families
The Dogs Trust: Staying Safe With Dogs
Battersea Dogs and Cats Home
Kennel Club's Safe & Sound Programme with Resources for Schools
National Animal Welfare Trust Advice Sheet/Free Webinar
Parent Tips - Keeping Babies and Children Safe Around Dogs in the Home (Institute of Health Visiting)
Advice on Dangerous Dogs — Powerpoint (Lancashire Constabulary)
RSPCA website
Pets, Toys and Play (Safekids website)
5.11 Disabilities and Learning Difficulties
RELATED NATIONAL GUIDANCE
Chapter 1 : Assessing need and providing helm Workinq Toqether to Safeguard Children
Safequardinq Disabled Children Practice Guidance published by the Department for Children, Schools and Families, in July 2009
Mental Health and Behaviour in Schools (DfE
Use of Interpreters, Signers or Others with Communication Skills Procedure
AMENDMENT
This chapter was extensively updated in November 2017 and should be read throughout.
Contents
Introduction Practice Guidance for Professionals
Introduction
1 . It is a fundamental principle that children with disabilities and learning difficulties have the same right as children without disabilities and learning difficulties to be protected from harm and abuse and that standard procedures should be followed for Referrals, Sinqle Assessment and, when appropriate, Strateqy Discussions/Meetinqs (local processes for including disability and learning difficulty specialists in the safeguarding processes will vary). However in order to ensure that the welfare of children with disabilities is safeguarded and promoted, it needs to be recognised that additional action is required in particular assessing and addressing their equality needs in line with the Equality Act duties. This is because children with disabilities and learning difficulties have additional needs related to physical, sensory, cognitive and/or communication requirements and many of the problems they face are caused by negative attitudes, prejudice and unequal access to things necessary for a good quality of life.
Practice Guidance for Professionals
1 1 The following are some indicators of possible abuse or neglect:
Bruises, injuries or pressure sores in a site that might not be of concern on an ambulant child, but might be a concern on a non-mobile child or child with restricted ability to move;
Not getting enough help with feeding leading to malnourishment;
Poor toileting arrangements;
Lack of stimulation;
Unjustified and/or excessive use of restraint;
Unwillingness to try to learn a child's means of communication;
Ill-fitting equipment e.g. calipers, sleep boards, inappropriate splinting;
Misappropriation of a child's finances;
Invasive procedures which are unnecessary or are carried out against the child's will;
Patterns of missed appointments with medical and social care specialists (including consistently refusing assistance or parents/carers not being available to professionals) leaving the child with unaddressed needs;
Over identifying with the child's parents/carers and being reluctant to accept that abuse or neglect is taking or has taken place, or seeing it as being attributable to the stress and difficulties of caring for a child with disabilities and learning difficulties;
A lack of knowledge about the impact of disability and learning difficulties on the child;
A lack of knowledge about the child, e.g. not knowing the child's usual behaviour;
Not being able to understand the child's method of communication;
Confusing behaviours that may indicate the child is being abused with those associated with the child's disability;
Denial of the child's sexuality;
Behaviour, including sexually harmful behaviour or self-injury, may be indicative of abuse;
Being aware that certain health/medical complications may influence the way symptoms present or are interpreted. For example, some particular conditions cause spontaneous bruising or fragile bones, causing fractures to be more frequent.
What is the disability, special need or impairment that affects the child? Ask for a description of the disability or impairment;
Make sure that you spell the description of an impairment correctly;
How does the disability or impairment affect the child on a day-to-day basis?
How does the child communicate? If someone says the child cannot communicate, simply ask the question: 'How does the child indicate he or she wants something?
o How does the child show s/he is unhappy?
Has the disability or condition been medically diagnosed?
5.12 Diversity
RELATED NATIONAL GUIDANCE AND LEGISLATION
Macpherson Inquiry Report (2000)
Working Together to Safeguard Children
Equality Act 2010
Bullyinq Procedure
AMENDMENT
In November 2015 this chapter was extensively updated and should be re-read.
Contents
Introduction
Principles
Eights Strands of Diversity
Institutional Racism
Principles
The Blackburn with Darwen, Blackpool and Lancashire Children's Safeguarding Assurance Partnership (CSAP) and its agencies are committed to promoting equal opportunities and valuing diversity in all its functions, roles and services it provides. The regions covered by the CSAP are multi-racial, multi-religious, multi-language and multi-cultural. All our policies, procedures, practice and services should positively acknowledge, reflect and respect this fact.
This means the CSAP and its agencies will:
Work to achieve social justice and inclusion that enables all children and their families to have equality of opportunity;
Oppose and prevent discrimination, victimisation or harassment against any of the eleven characteristics of equality (nine characteristics required by the Equality Act 2010 and two adopted by local partnerships to reflect local needs);
Treat all citizens fairly and with respect;
Recognise the rights of individuals to participate fully in the social and economic life.
Eight Strands of Diversity
There are eight characteristics to this Diversity Policy which the CSAP and its agencies are committed to adhere to:
Age;
Disability;
Gender / gender identity;
Marriage & Civil Partnerships;
Pregnancy & Maternity;
Religion or Belief;
Sexual Orientation;
Section 149 of the Equality Act (2010) requires the following provisions to be made by agencies (public sector bodies) for their employees and service users:
Eliminate any discrimination, victimisation or harassment;
Advance equality of opportunity and foster good relations between persons who share a protected characteristic and persons who do not share it;
Remove or minimise disadvantages suffered by persons who share a protected characteristic that are connected to that characteristic;
Take steps to meet the needs of persons who share a relevant protected characteristic that are different from the needs of persons who do not share it;
Encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionally low
Foster good relations between persons who share a relevant protected characteristic and persons who do not share to tackle prejudice and promote understanding.
Working Together to Safeguard Children outlines two key principles that underpin effective safeguarding arrangements and services: that safeguarding is everyone's responsibility; and the need for agencies to have a child-centred approach in their safeguarding work.
The following six competencies can be used as a framework for effective safeguarding practice:
Child Development — knowing how a healthy child presents or behaves so that signs of distress and impaired development can be identified as early as possible (Level 1 of the Continuum of Need and Response Framework);
Listening to the child and taking what they say seriously, including communication with the child (and family) in their preferred language;
Good holistic assessments that address all the principles and the three assessment domains in the Assessment Protocol, and take account of the Borough's Risk Sensible Model;
Awareness of the local and statutory protected characteristics so that in undertaking an assessment and providing services, due regard is given to what is prohibited, and what requires promotion, under the Equality Act (2010) and Human Rights Act (1998);
Knowing, learning about or seeking expert advice on a particular protected characteristic by which the child and family lives their daily lives; and
Knowing about local services (depending on the type of protected characteristic maybe even regional or national services) that are available to provide relevant input into prevention, support and rehabilitation services for the child (and their family).
Agencies must have essential safeguards in place to promote the welfare of children, particularly those vulnerable due to their protected characteristics not being effectively assessed and met:
Children should feel valued and respected with their self-esteem promoted;
Agencies should recognise that needs within each protected characteristic will not be uniform and attention needs to be given to the specific needs of the child and family;
Staff should recognise the importance of ascertaining the wishes and feelings of children and their families including their preferred means of communication and language interpretation needs;
That staff are trained and have access to resources to help them identify and assess vulnerabilities that can arise from not meeting the needs relating to protected characteristics of a child and/or their family;
Providing access to services for specific groups of children that can promote their different needs;
That agencies should fully understand the communities they serve and the needs and challenges in terms of safeguarding that these communities may have and how services will have to be delivered to promote welfare; and
Complaints and comments procedures are clear, effective, user-friendly and accessible.
Institutional Racism
5.13 Domestic Violence and Abuse
RELATED NATIONAL GUIDANCE
Chapter 1: Assessinq need and providing help, Working Together to Safeguard Children
Violence against Women and Girls in the UK (GOV.UK) - guidance and regulation Safe Lives
Multi-Aqency Risk Assessment Conferences (MARAC)
Controllinq or Coercive Behaviour in an Intimate or Family Relationship:
Statutory Guidance Framework (December 2015)
Royal College of Nursing — Domestic Abuse: Professional Resources
Domestic Abuse: A Resource for Health Professionals (DHSC. 2017)
RELATED LOCAL GUIDANCE
Blackpool MARAC referral form
Information Sharinq and Confidentiality Procedure
Processes for Manaqinq Risk Procedure, Multi-Aqency Risk Assessment
Conference (MARAC)
Honour Based Abuse Procedure
Female Genital Mutilation Procedure
Forced Marriaqes Procedure
See also Domestic violence and abuse services such as Blackpool Children's Independent. Domestic Violence Advisers (CIDVA), Multi Agency Risk Assessment Conference (MARAC) and Victim Support.
AMENDMENT
In November 2019 a link to the refreshed HM Government Strategy for Ending Violence against Women and Girls Strategy 2016 — 2020, was added into Definition.
Contents
Introduction
Definition
Impact of Children and Young People
Action to Safeguard Children
Roles of Agencies
Checks with and Referrals to Children's Social Care
Strategic Work and Partnerships
Domestic Violence Protection Orders and the Domestic Violence Disclosure Scheme
Introduction
Definition
The new definition is:
%Any incident or pattem 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.
'Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.
Coercive behaviour is: an act or a pattem of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.'
While the cross-government definition above applies to those aged 16 or above, 'Adolescent to parent violence and abuse' (APVA) can involve children under 16 as well as over 16. See: Information guide: adolescent to parent violence and abuse (APVA)Home Office.
For more details of the national plans to tackle domestic violence and abuse
see: Endinq Violence against Women and Girls Strategy 2016 — 2020
(refreshed 2019) which sets out a life course approach to ensure that all victims and their families - have access to the right support at the right time to help them live free from violence and abuse.
Impact on Children and Young People
Action to Safeguard Children
There should be arrangements in place between the Police and Children's Social Care to enable the Police to find out whether any such children are the subject of a Child Protection Plan.
11 The Police are already required to determine whether any court orders or injunctions are in force in respect of members of the household. The Police should make an assessment and, if they have specific concerns about the safety or welfare of a child, they should make a referral to Children's Social Care (see the Makinq a Referral to Children's Social Care). It is also important that there is clarity about whether the family is aware that a referral is to be made. Any response by Children's Social Care to such referrals should be discreet, in terms of making contact with victims in ways that will not further endanger them or their children. In some cases, a child may be in need of immediate protection. As indicated above, the amendment to the Children Act 1989 made in Section 120 of the Adoption and Children Act 2002 clarifies the meaning of 'harm' in the Children Act, to make explicit that 'harm' includes, for example, impairment suffered from seeing or hearing the ill-treatment of another.
|
CIDVA), |
Roles of Agencies
Children's Social Care
Education Services
Police
Health Service
21.All health care professionals must recognise that their response to individuals experiencing domestic violence and abuse is of great importance. It is essential that there is an understanding of the inter-relationship which frequently exists, between domestic violence and abuse and the abuse and neglect of children.
Probation Service
Blackpool Children's Independent Domestic Violence Advisor (Children's IDVA)
0 1:1 support - a chance for the individual to talk about their experiences in a safe environment using age appropriate resources, language and a flexible approach to meet each person's individual needs;
Checks with and Referrals to Children's Social Care
26.As stated there is frequently an inter-relationship between domestic violence and abuse and the abuse and Neglect of children and young people. Where there is domestic violence and abuse the implication of children remaining in the household should be considered. This includes the possibility that the children themselves may be subject to violence or other harm.
29.A serious incident of domestic violence and abuse which has been witnessed by a child or where children were present in the household at the time of the incident should result in a referral to Children's Social Care. Consideration should then be given to undertaking Section 47 Enquiries.
30. Concerns in respect of children should be referred to Children's Social Care, who will ensure all enquiries contain clear, precise and accurate information. Children's Social Care, in line with the Assessment Framework will make a decision as to the response within 24 hours. As such a Strategy Discussion is likely to be necessary.
31 Following completion of enquiries the allocated Social Worker should ensure that all professionals involved with the child / family and the parent / carers receive an outcome letter. If there are concerns regarding the outcome these should be addressed with the appropriate Social Work Team Manager.
32.ShouId there remain disagreement regarding the need for a Child Protection Conference the matter should be referred to the manager.
Strategic Work and Partnerships
33.A Domestic Violence and Abuse Strategic Partnership exists in all three areas, to raise awareness of domestic violence and abuse, to promote co-ordination between agencies in preventing and responding to violence, and to encourage the development of services for those who are subjected to violence or suffer its effects. There are Domestic Violence and Abuse Forums in most of the District Council Areas. They exist to raise awareness of issues and to promote the coordination and development of services. There should be a clear link between the Forum and the CSAP.
Domestic Violence Protection Orders and the Domestic Violence Disclosure Scheme
Domestic Violence Protection Orders
Domestic Violence Protection Orders (DVPOs) were implemented across England and Wales in March 2014.
They provide protection to victims by enabling the Police and magistrates to put in place protection in the immediate aftermath of a domestic violence incident.
With DVPOs, a perpetrator can be banned with immediate effect from returning to a residence and from having contact with the victim for up to 28 days, allowing the victim time to consider their options and get the support they need.
Before the scheme, there was a gap in protection, because Police could not charge the perpetrator for lack of evidence and so provide protection to a victim through bail conditions, and because the process of granting injunctions took time.
Domestic Violence Disclosure Scheme ('Clare's Law')
The Domestic Violence Disclosure Scheme (DVDS) (also known as 'Clare's Law') commenced in England and Wales in March 2014. The DVDS gives members of the public a formal mechanism to make enquires about an individual who they are in a relationship with, or who is in a relationship with someone they know, where there is a concern that the individual may be violent towards their partner. This scheme adds a further dimension to the information sharing about children where there are concerns that domestic violence and abuse is impacting on the care and welfare of the children in the family.
Members of the public can make an application for a disclosure, known as the 'right to ask'. Anybody can make an enquiry, but information will only be given to someone at risk or a person in a position to safeguard the victim. The scheme is for anyone in an intimate relationship regardless of gender.
Partner agencies can also request disclosure is made of an offender's past history where it is believed someone is at risk of harm. This is known as 'right to know'.
If a potentially violent individual is identified as having convictions for violent offences, or information is held about their behaviour which reasonably leads the Police and other agencies to believe they pose a risk of harm to their partner, the Police will consider disclosing the information. A disclosure can be made if it is legal, proportionate and necessary to do so.
For further information, see Domestic Yiolence Disclosure Scheme (GOV.UK website).
The Serious Crime Act 2015 created a new offence of controlling or coercive behaviour in intimate or familial relationships. Controlling or coercive behaviour does not relate to a single incident, it is a purposeful pattem of behaviour which takes place over time in order for one individual to exert power, control or coercion over another. Such behaviours might include:
Isolating a person from their friends and family;
Depriving them of their basic needs;
Monitoring their time;
Monitoring a person via online communication tools or using spyware;
Taking control over aspects of their everyday life, such as where they can go, who they can see, what to wear and when they can sleep;
Depriving them of access to support services, such as specialist support or medical services;
Repeatedly putting them down such as telling them they are worthless;
Enforcing rules and activity which humiliate, degrade or dehumanise the victim;
Forcing the victim to take part in criminal activity such as shoplifting, neglect or abuse of children to encourage self-blame and prevent disclosure to authorities;
Financial abuse including control of finances, such as only allowing a person a punitive allowance;
Threats to hurt or kill;
Threats to a child;
Threats to reveal or publish private information (e.g. threatening to 'out' someone).
Criminal damage (such as destruction of household goods);
Preventing a person from having access to transport or from working.
5.14 Drug Misusing Parents/Carers
RELATED NATIONAL GUIDANCE
Hidden Harm - Responding to the Needs of Children of Problem Drug Users, Advisory Council on the Misuse of Drugs (ACMD)
Chapter 1 : Assessinq need and providing help, Workinq Together to Safeguard Children
Foetal Alcohol Syndrome, Drink Aware UK
Safeguarding Children Living with Substance Using Parents/Carers (Blackburn with Darwen) - to follow
arwen . na e sse s |
Blackburn with Darwen Screening and Referral for Triage Form Substance
Misuse
Druq Misusinq Parents/Carers Procedure
Information Sharinq and Confidentiality Procedure
AMENDMENT
In November 2013, this chapter was updated in line with Working Together to Safeguard Children.
Contents
The Impact on Children and Families Eight Golden Rules
Confidentiality and Information Sharing
Assessments Initial Screening Assessment
Checklist
Children in the Family - Provision of Good Basic Care
Accommodation and Home Environment
Procurement of Drugs
Health Risks
If the Parent(s) Inject:
Family and Social Supports Parent's Perception of the Situation
Child Centred Assessment
Key Areas that could be Explored
Analysis: Making Sense of the Information
Pregnancy and Neo-Natal Care
The Impact on Children and Families
1 A child's growth and development depends on a variety of interacting social and biological factors, which can be broadly grouped into three categories: conception and pregnancy, parenting, and the wider family and environment.
Eight Golden Rules
Problem substance users normally want to be good parents;
Problem substance users should be treated in the same way as other parents whose personal difficulties interfere with their ability to provide good parenting;
Base your judgements on evidence, not optimism;
There will be many aspects of the child's life that are nothing to do with drugs or alcohol and may be equally or more important;
Recognise that the parents are likely to be anxious. They may be worried that they could lose their children. Children, especially older ones, may also share similar anxieties;
Do not assume that abstinence will always improve parenting skills;
The family situation will not remain static, assessment should be revisited at least every six months or when ever new concerns arise; whichever is sooner; Understand what is the child's experience of living with substance misusing parents; speak to them alone or with an advocate.
Confidentiality and Information Sharing
Assessments
Initial Screening Assessment
The child(ren's) age and gender;
Who is their primary carer?
Who else is living in the household?
Are there support agencies in touch with the family who are supporting the children (identify the child's Health Visitor, GP, School Nurse, Children's Centre, Drugs worker and, where involved, Social Worker). Is there is a Lead Professional?
How do parent(s) views the impact of their substance use on their child?
Can the extended family and / or friends can help?
Is the parent/s willing to accept help?
1 1 . When assessing parental substance misuse the following two models give an overview of the process. Examples of specific questions and areas for consideration and expansion are also detailed. To ensure good multi-agency working and information sharing, this assessment must be entered onto a CAF in line with local quidance.
Checklist
12.All Staff should be able to answer the following questions:
Are children usually present at home visits, clinic or office appointments during normal school or nursery hours?
What reason has been given for the child being absent from school?
Is the child attending school/nursery regularly?
Is the child punctuat for school/nursery?
How much money does the family spend on drug use? What % of the weekly income does this come to?
Who will look after the children if the parent is arrested or is unable to care for them?
13. When deciding whether a child may need help, agencies should consider the following questions:
Are there any factors which make the children particularly vulnerable, e.g. very young child, other special needs such as physical illness, behavioural and emotional problems, psychological illness or learning difficulty, threatened or actual loss of accommodation?
Consider the needs of the unborn child.
Are there any protective factors that may reduce risk to the child? (It may be necessary to consult with specialist children's service workers to determine this.)
How does the child's health and development compare to that of other children of the same age and in similar situations?
What kind of help do you think the child needs?
Do the parents perceive any difficulties and how willing are they to accept help and work with professionals?
What do you think might happen to the child? What would make it more or less likely?
Is there suspicion of neglect, injury or abuse, now or in the past? What happened? What effect did/does that have on the child? Is it likely to recur?
Is the concem the result of a single incident, a series of incidents or a culmination of concerns over a period of time?
What does the child think? What do other family members think? How do you know?
Children in the Family - Provision of Good Basic Care
How many children are in this family?
What are their names and ages (wherever possible, include dates of birth)?
Are there any children living outside the family home and, if so, where? Why, and with whom?
Do the parents see any of the children as being particularly demanding?
Are there any other special circumstances such as illness, disability which need to be considered?
For each child:
Is there adequate food, clothing and warmth for the child? Are height and weight normal for the child's age and stage of development?
Is the child receiving appropriate nutrition and exercise?
Is the child's health and development consistent with their age and stage of development? Has the child received necessary immunisations? Is the child registered with a GP and a dentist? Do the parents seek health care for the child appropriately?
Does the child attend nursery or school regularly? If not, why not? Is s/he achieving appropriate academic attainment?
Does the child present any behavioural or emotional problems? Does the parent manage the child's distress or challenging behaviour appropriately?
Who normally looks after the child?
Is the child engaged in age-appropriate activities?
Are there any indications that any of the children are taking on a parenting role within the family (e.g. caring for other children, excessive household responsibilities, etc)?
Is the care for the child consistent and reliable? Are the child's emotional needs being adequately met?
Is there a risk of repeated separation for example because of periods of imprisonment (e.g. short custodial sentences for fine default)?
How does the child relate to unfamiliar adults?
Are there non-substance using adults in the family readily accessible to the child who can provide appropriate care and support when necessary?
Does the child know about his/her parents substance use?
Is there evidence of drug/alcohol use by the child?
Describing Parental Substance Use
14. Identify sources of information, including conflicting reports, give consideration to negative impact on the child
Specify drug of choice and how this is used, e.g. method, frequency quantity.
Is the drug use by parent:
Identify whether the drug used is illicit or prescribed and whether use is regularly supplemented / 'topping up'
Does the user move between these types of drug use at different times?
Does the parent misuse alcohol?
What patterns of drinking does the parent have?
Is the parent a binge drinker with periods of sobriety? Are there patterns to their bingeing? i.e. weekends or at times of stress.
Is the parent a daily heavy drinker?
Does the parent use alcohol concurrently with other drugs?
How reliable is current information about the parent's drug use?
Is there a drug-free parent/non-problematic drinker, supportive partner or relative?
Is the quality of parenting or childcare different when a parent is using drugs and when not using?
Is there any history of self harm?
Is there any history of sexual abuse?
Is there any history of domestic abuse?
Accommodation and Home Environment
Procurement of Drugs
Health Risks
If the Parent(s) Inject:
Family and Social Supports
Parent's Perception of the Situation
Do the parents know what responsibilities and power agencies have to support and protect children at risk?
Child Centred Assessment
Key Areas that could be Explored:
What they do on a daily basis;
Whether or not they feel safe;
Where do they turn for help, protection and comfort;
What it is like when their parents are under the influence of drugs and/or alcohol;
What it is like when they are not;
What fears, hopes and anxieties they have about their parents' behaviour;
What they would most like to change;
What they would most like to stay the same; Is there violence in the home;
Does anything else happen that frightens them;
Extent of caring responsibilities they might assume because of parental drug/alcohol use;
The extent to which developmental milestones are being met;
Are they being bullied at school?
Analysis: Making Sense of the Information
Is the parents' drug or alcohol use significantly affecting parenting capacity?
Is the parents' drug or alcohol use and associated behaviour significantly impacting upon the child's health and safety, social, emotional and educational development?
What are the resources and strengths in this family and how might they impact on the care of the child?
What is the parents' understanding and attitude on the need for change?
What change might be acceptable and attainable?
What types of professional intervention will help reduce the harm to the children?
Consider the use of universal provision as the preferred option as this is often less stigmatising for the children.
Where, on the continuum of early help, children in need, children in need of protection, does this particular family sit?
O The views and perspectives of all interested parties, including children, parents, family, neighbours and members of the community and other professionals/agencies; o Checks to test the reliability of information/evidence and its sources;
86
Pregnancy and Neo-Natal Care
Introduction
Management of Antenatal Care
Effects of Substances on the Foetus and Baby
Maternal Health Problems
Management of Labour
Neonatal Withdrawal
31 . Many babies will not need paediatric interventions, but it is important to have access to skilled neonatal paediatric care. However, all babies of substance using mothers will be subject to a withdrawal scoring sheet, which some women might interpret as intervention.
Postnatal Management
Specialist advice should be sought if she is HIV positive. Methadone treatment is not a contraindication to breastfeeding.
Discharge Planning
Prescribing Drugs for Pregnant Drug Users
37 Expectant mothers who are drinking dependently should be referred as a matter of priority to a Drug and Alcohol Service and not be advised to stop without supervision due to the risk of withdrawal.
Pan-Lancs Safeguarding Children Boards
FABRICATED OR INDUCED ILLNESS
Fll
April 2016
Acknowledqement
I would like to thank many colleagues who have significantly contributed to the development of the Fll guidelines. A number of meetings were held in the process of developing these guidelines involving colleagues working in the field of children safeguarding from health, children social care (CSC) and police. I would like to thank them all for their time and effort in this respect. The discussions that took place in these meetings helped to enrich the understanding on Fll and in developing the guidelines. An excellent Fll conference organised by CSC in early 2015 significantly helped in clarifying many aspects within Fll. Many colleagues suggested some changes to earlier drafts of the guideline and I am indebted to them. A special mention goes to Dr Danya Glaser whose contribution to the conference mentioned earlier, and her work and many publications on Flt have greatly assisted me in developing these guidelines.
Dr Dhia Mahmood, Consultant Paediatrician,
Designated doctor for safeguarding,
Contents
Headinq Page
1. Definition 4
2. The spectrum of Fll 5
3. Impact of Fll on Child 6
4. When to suspect Fll 7
5. Characteristics of Perpetrator of Fll 8
6. What to do when you suspect Fll 9-1 1
7. The strategy meeting 12-13
8. Information sharing and consent 14
9. The Chronology 14
10. Outcome of section 47 investigation 15
1 1 . Court Video Surveillance 16
Appendix 1: Flt warning signs Template(WST) 17
Appendix 2: Fll WST explained 18-20
Appendix 3: The Chronology proforma 21
Appendix 4: Flowchart when Fll is suspected 22
References 23
Fabricated or Induced Illness (FII)
1 . Definition
Fabricated or Induced Illness (Fll) (Known previously as Munchhausen Syndrome by Proxy; other synonyms: Factitious disorder imposed on another) is a spectrum of conditions where a child experiences or likely to experience significant harm and impairment due to the health care seeking behaviour and actions of the caregiver(s), usually the mother. Such behaviour and actions may take one or more of the following forms:
False reporting of non-existing symptoms and signs,
Exaggeration of existing symptoms and signs,
Misinterpretation of real events on the basis of mistaken belief about their meaning.
Falsification of medical records
Interference with investigations, specimens, intravenous lines, ... .etc
Inducing illness in the child by overdosing, poisoning (e.g. Adding salt to baby's feed), suffocation, none administration of medications (e.g. inhalers for asthma, medication for epilepsy, thyroxin for under active thyroid gland), Etc.
For the abuse in Fll to occur, there needs to be a three way interaction between the caregiver (usually the mother), the child, and health professionals as illustrated below.
Mother
tnterf0iۥs with
Might have a genuine
Illness or disorder
The Fll spectrum includes cases with varying degree of severity. The emphasis when investigating such cases should be on the impact of parents' health care seeking behaviour on the child. Cases therefore may be classified as high risk (to the child), and lower risk, cases.
It must be made clear from the outset that the way in which various cases within the spectrum are dealt with may vary significantly: In "high risk" cases when there is suspicion of induction or deception by carer(s) with significant risk of harm to the child as a result, an immediate referral to social services is indicated.
Lower risk "of harm" cases listed above are usually dealt with by health care professionals to change carer's perception of their children's health issues. In these cases referral to social services would be considered when such attempts by health care professionals fail, and the child continued to be at risk of harm from parents' actions.
The guidelines will in the main be dealing with the "higher risk" aspect of the spectrum of cases. In situations when we will be dealing with other low risk cases, these will be specifically mentioned as such.
The impact of FII on the child can be significant. Research suggests that Flt can result in death (6%), requirement for intensive care treatment (12%), and significant emotional problems in the child. There are also significant risks of re-abuse. Following identification of Flt in a child, the way in which the case is managed has a major impact on the developmental outcomes and morbidity for the child.
The harm to the child can be grouped within three domains:
B. Daily life and functioninq
C. Psychological health
g. Develop a distorted view of health
h. Develop anxiety
Develop fabricated or somatoform (characterised by symptoms suggesting a physical disorder but for which there is no known organic cause or physical findings) disorders in the future
j. Collude with illness presentation
4. When to suspect FII
The following are indicators that should alert professionals that a child is likely to be suffering harm as a result of FII. These indicators form the basis for the template used to assist in the diagnosis Fll (appendix 1 &2):
Child usually presents with specific unexplained episodic problems such as apnoea, fits, choking or collapse.
l. The alleged perpetrator is typically knowledgeable about the child's illness and treatment, is happy to be in hospital and forms close, and often controlling, relationships with the healthcare staff.
l. Medical / health practitioners are ideally placed to recognise anxiety related, misconstrued, and exaggerated illness, within the context of any perplexing or medically unexplained conditions.
d. There is no medical treatment
Further investigations and repeat presentations to medics are more harmful than doing nothing
i. disagree with or dispute independent / clinical observations and / or request more investigations ii. seek more medical opinions when more than one already obtained iii. decline rehabilitation plan & child's functioning is being impaired
Then a referral to CSC should be considered in conjunction with the named/ designated safeguarding individual. The referrer should make it clear that s/he is making the referral under Fll procedures.
Or
Then a referral to Children Social services should be made. Parents in these categories should not be informed of Fll suspicions at this stage.
s. It is expected that the paediatric consultant responsible for the child's healthcare is the lead health professional and therefore has lead responsibility for all decisions appertaining to the child's healthcare. All previous records, plus out of area, should be scrutinised by the consultant paediatrician
7. The Strateqy Meeting:
A. If there is a reasonable cause to suspect that the child is suffering, or likely to suffer, significant harm, or that parent(s) actions have significant negative impact on the child, children's social care (CSC) should convene and chair a strategy meeting, in line with section 47 child protection enquiries, involving all the key professionals. Participants must include as a minimum:
Chaired by IRO (or an alternative chair as per each specific LSCB guidelines)
Children social care.
The "responsible Paediatrician" GP or their report.
School/ nursery if applicable
As medical information are crucial in these meetings, it is extremely important that as much as possible, the date, time and place of the meeting should be suitable for the GP and Paediatrician to attend.
Other professionals are invited as appropriate and may_jnclude:
A senior ward nurse if the child is an in-patient;
A medical professional with expertise in the relevant branch of medicine;
Allied health professionals
Health visitor or school nurse;
CAMHS services
Named/ designated safeguarding professionals.
Local authority Legal Advisor (In some LSCBs this is a must attend)
(if not already explicit)
9. Chronoloqv (Pro forma Appendix 3)
At A child's chronology forms an important tool in the identification and management of cases of Fll and therefore should be compiled in all cases of suspected Fll.
Warninq Signs Template |
|
Appendix 1 FII
Category |
arning signs of Fabricated or Induced Illness |
1 |
Reported symptoms and signs are not explained by any medical condition from which the child may be suffering. |
2. |
Physical examination and results of medical investigations do not support/ explain reported symptoms and signs. |
3. |
There is an inexplicably poor response to prescribed medication and other treatment. |
4. New symptoms are reported on resolution of previous ones. |
|
5. |
Reported symptoms and signs are not seen when the carer is not present. |
6. |
Once the perpetrator's access to the child is restricted, signs and symptoms fade and eventually disappear. |
7. |
Repeated presentation to a variety of doctors with the same or different health problems. |
8. History of unexplained illnesses or deaths or multiple surgery in parents or siblings. |
|
9. |
The child's normal, daily life activities are being curtailed beyond that which might be expected for any medical disorder from which the child is known to suffer. |
10. |
Incongruity between seriousness of story and action of parents |
1 1 . |
Erroneous or misleading information provided by the parent. |
12. |
other extended family members are |
*Please Note: The categories within the template are not absolutes — there may be numerous possible explanations one of which is possible FII.
1 |
Reported symptoms and signs found on examination are not explained by any medical condition from which the child may be suffering. Information obtained through history and physical examination do not correlate with any recognised disease or where there is a disease known to be present. A very simple example would be a skin rash, which did not correlate with any known skin disease and had, in fact, been produced by the perpetrator. An experienced doctor should be on their guard if something described is outside their previous experience. |
2. |
Physical examination and results of medicai Investigations do not explain reported symptoms and signs. Physical examination and appropriate investigaiions do not confirm the reported clinical story. For example, it is reported a child turns yellow (has jaundice) but no jaundice is confirmed when the child is examined and a test for jaundice, if appropriate, is negative. A child with frequent convulsions every day.. has no abnorma;ittes on a 24-hour v:aeo telemetry (continuous video and EEG recording) even during a so-called 'convulsion' |
3.
|
There is an inexplicably poor response to prescribed medication and other treatment. The practitioner should be alerted when treatment for the agreed condition does not produce the expected effect, for example asthma medications not making any difference to described wheezing and cough. This can result in escalating drugs with no apparent response, using multiple medications to control a routine problem and multiple changes in medication due to either poor response or frequent reports of side effects. On investigation, toxic drug levels commonly occur but may be interspersed with low drug levels suggesting extremely variable administration of medication fluctuating from over- medication to withdrawal of medication. Another feature may be the welcoming of intrusive investigations and treatments by the parent. |
New symptoms are reported on resolution of pcevlous ones. New symptoms often bear no likely relationship to the preuious set of symptoms. For example, in a child where the focus has been on diarrhoea and vomiting, when appropriate assessments tail to confirm this, the story changes to one of convulsions Sometimes this is manifest by the parents transferring consultation behaviour to another child in the family, |
|
5. |
Reported symptoms and found signs are not seen to begin in the absence of the carer, In this respect, the perpetrator is the only witness of the signs and symptoms. For example, reported symptoms and signs are not observed at school or during admission to hospital. This should particularly raise anxiety of Fll where the severity and/or frequency of symptoms reported is such that the lack of independent observation is remarkable. Caution should be exercised when accepting statements from non-medically qualified people that symptoms have been observed. Example would be school describing episodes as fits' because they were told that was the appropriate description of the behaviour they were seeing. |
6. |
Once the perpetrator's access to the child is restricted. signs and symptoms fade and evefituauy disappeaiA (similar to category S aboveh T nis is a planned separation of perpetrator and child which it nas Deen agreed Will nave a high likelihood ot proving (or disproving) Fil abuse It can be difficult in practice, and appear heartless, to separate perpetrator and child. The perpetrator frequently insists on remaining at the child's bedside, is unusually close tc the medical team and thrives in a hospttai environment-
Repeated presentation to a variety of doctors with a same or different health problems. At its most extreme this has been referred to as 'doctor shopping'. The extent and extraordinary nature of the additional consultations is orders of magnitude greater than any concerned parent would explore. Often consultations about the same or different problems are concealed in different medical facilities. Thus the patient might be being investigated in one hospital with one set of problems and the parent will initiate assessments elsewhere for a completely different set of problems (or even the same) without informing these various medical professionals about the other consultations.
History of unexplained ihnesses or deaths or multiple surgery in parents or siblings of the family. The emphasis here is on the unexpgained, Illness and deaths in parents or slDllngs can frequently be a clue to further investigation and hence a diagnosis in naturally occurring illness. In Fll abuse, perpetrators frequently have had multiple unexplained medical problems themselves, ranging from frequent consultations with the general practitioner through to the extreme of Munchausen syndrome where there are multiple presentations with fabricated or induced illness resulting in multiple (unnecessary) operations. Self-harm, often multiple; and eating disorders are further common features in perpetrators. Additionally, other children either concurrently or sequentially might have been subject to Fll abuse and their medical history should also be examined |
|
7
|
||
9. |
The child's normal, daily life activities are being curtailed beyond that which might be expected for any medical disorder from which the child is known to suffer. The carer limits the child's activities to an unreasonable degree and often either without knowledge of medical professionals or against their advice. For example, confining a child to a wheelchair when there is no reason for this, insisting on restrictions of physical activity when not necessary, adherence to extremely strict diets when there is no medical reason for this, restricting child's school attendance |
|
10. |
Incongruity between the seriousness of the story and the actions of the parents Given a concerning story, parents by and large will cooperate with medical efforts to resolve the problem. They will attend outpatients, attend for investigations and bring the child for review urgently when requested. Perpetrators ot Fli abuse, apparently paradoxically, can be extremely creative at avoiding contacts which would resolve the problem. There is incongruity between their expressed concerns and the actions they take. They repeatedly fail to attend for crucial investigations They go to hospitals that do not have The background information. They repeatedly produce the flimsiest of excuses for failing to attend for crucial assessments (somebody else's birthday, thought the hospital was closed, went to outpatients at one o'clock in the morning). |
|
Il |
Erroneous or misleading information provided by parent. These perpetrators are adept at spinning a web of misinformation which perpetuates and amplifies the illness story, increases access to interventions in the widest sense (more treatment, more investigations, more restrictions on the child or help, etc.). An extreme example of this is spreading the idea that the child is going to die when in fact no-one in the medical profession has ever |
|
suggested this. Changing or inconsistent stories should be recognised and challenged. Accurate and detailed documentation is key here. |
1 2. |
Exaggerated catastrophes or tahricated bereavements and other extended family problems are reported. Trus IS an extension of category 8. On exploring reported illnesses or deaths in other farnily members (ovcen very dramatic stories) no evidence is found to confirm these stones. They were largely or wno;ty fictitious |
Appendix 3 The Chronology
Date |
Source |
Event |
Action taken |
Actual/ potential impact/harm on child |
Template category corresponding to FII warning signs. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Practitioner has concerns about possible Fll in a child
Practitioner shares concerns and seeks support and advice from Line Manager and Safeguarding
Children's Team. If at any time there is concern regarding child safety or welfare, refer to
Medical evaluation led by Paediatrician in consultation with all other involved health care professionals including GP. HV, School nurse, CAMS.. etc. (if no
Paediatrician involved, refer to Paeds)
Explanation for
Completion of medical tests, with care Signs and taken to avoid iatrogenic harm (harm symptoms found. from medical investigation/treatment) Treatment given
No explanation for signs or
symptoms |
Fabrication or induction of illness strongly suspected. Professional meeting may be held (to include Paeds, GP. named professionals. HVI school nurse, other health |
|
Further specialist advice and treatment provided ensuring care taken to avoid |
rofessionalsi thera -ists / |
|
iatrogenic harm |
Suspected deception/ |
No suspected deception: |
|
Suspected induction of illness/ |
Paediatrician explains to |
|
Unwillingness to accept medical |
parents results of tests. |
|
opinion regarding results |
Reassure regarding health. |
Discuss with named designated doctor |
Problems resolve: No further |
|
Compile a chronology |
action needed |
Initiate referral to social services/ police
5.16 Female Genital Mutilation
AMENDMENT
In July 2019 this chapter was updated to incorporate the FGM tool.
Contents Definition Indicators
NHS Actions
Mandatory Reporting of FGM
Protection and Action to be Taken
Further Information
Law
Definition
Female genital mutilation (FGM) is a collective term for procedures, which include the removal of part or all of the external female genitalia for cultural or other nontherapeutic reasons. The practice is medically unnecessary, extremely painful and has serious health consequences, both at the time when the mutilation is carried out and in later life. The procedure is typically performed on girls aged between 4 and 13, but in some cases it is performed on new-born infants or on young women before marriage or pregnancy.
FGM has been a criminal offence in the U.K. since the Prohibition of Female Circumcision Act 1985 was passed. The Female Genital Mutilation Act 2003 replaced the 1985 Act and made it an offence for the first time for UK nationals, permanent or habitual UK residents to carry out FGM abroad, or to aid, abet, counsel or procure the carrying out of FGM abroad, even in countries where the practice is legal.
The rights of women and girls are enshrined by various universal and regional instruments including the Universal Declaration of Human Rights, the United Nations Convention on the Elimination of all Forms of Discrimination Against Women, the Convention on the Rights of the Child, the African Charter on Human and Peoples' Rights and Protocol to the African Charter on Human and Peoples' Rights on the rights of women in Africa. All these documents highlight the right for girls and women to live free from gender discrimination, free from torture, to live in dignity and with bodily integrity.
FGM has been classified by the World Health Organisation (WHO) into four types:
Type 1 — Clitoridectomy: partial or total removal of the clitoris (a small, sensitive and erectile part of the female genitals) and, in very rare cases, only the prepuce (the fold of skin surrounding the clitoris);
90
Type 2 — Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are the 'lips' that surround the vagina);
Type 3 — Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris; and
Type 4 — Other: all other harmful procedures to the female genitalia for nonmedical purposes, e.g. pricking, piercing, incising, scraping and cauterising the genital area.
For more detail, please refer to the Multi-aqency statutory guidance on female qenital mutilation April 2016 (GOV.UK).
Click here to access the GOV.UK website for Female Genital Mutilation.
Indicators
These indicators are not exhaustive and whilst the factors detailed below may be an indication that a child is facing/at risk of FGM, it should not be assumed that is the case simply on the basis of someone presenting with one or more of these warning signs. These warning signs may indicate other types of abuse such as forced marriage or sexual abuse that will also require a multi-agency response. See also statutory guidance Annex B: Risk, for details.
The following are some signs that the child may be at risk of FGM:
A female child is bom to a woman who has undergone FGM or whose older sibling or cousin has undergone FGM;
The family belongs to a community in which FGM is practised or have limited level of integration within UK community;
The family indicate that there are strong levels of influence held by elders and/or elders are involved in bringing up female children;
If a female family elder is present, particularly when she is visiting from a country of origin, and taking a more active / influential role in the family;
The family makes preparations for the child to take a holiday, e.g. arranging vaccinations, planning an absence from school;
The child talks about a 'special procedure/ceremony' that is going to take place;
An awareness by a midwife or obstetrician that the procedure has already been carried out on a mother, prompting concern for any daughters, girls or young women in the family;
Repeated failure to attend or engage with health and welfare services or the mother of a girl is very reluctant to undergo genital examination including cervical smears;
Where a girl from a practising community is withdrawn from Sex and
Relationship Education (also known to withdrawn from mainstream education completely to either home education/religious education institutions) - they may be at risk from their parents wishing to keep them uninformed about their body and rights.
Consider whether any other indicators exist that FGM may have or has already taken place, for example:
A Strategy Discussion will determine the need for a medical assessment and where it is believed that FGM has already taken place
It should be remembered that this will have lifelong consequences, and can be highly dangerous at the time of the procedure and directly afterwards.
If you are worried about a girl under 18 who is either at risk of FGM or who you suspect may have had FGM, you should share this information with Children's social care or the Police immediately, whichever is most appropriate see Protection and Action to be Taken. See also Female Genital Mutilation Pan - Lancashire Multi-Aqency Pathway for Children.
From the 31st October 2015, regulated professionals in health and social care and teachers/teaching assistants in England and Wales have a duty to report 'known' cases of FGM in under 18s to the Police see Mandatory Reportinq of FGM.
Professionals must take into consideration that by alerting the girl's or woman's family to the fact that she is disclosing information about FGM may place her at increased risk of harm and professionals should therefore take sufficient steps to minimise this risk.
It should not be assumed that families from practising communities will want their girls and women to undergo FGM, however a multi-agency response must take place to establish the risk if any.
NHS Actions
Since April 2014 NHS Acute hospital Trusts have been required to record
If a patient has had Female Genital Mutilation;
If there is a family history of Female Genital Mutilation;
If a Female Genital Mutilation-related procedure has been carried out on a patient.
Since September 2014 all acute hospitals have been required to report this data centrally to the Department of Health and Social Care on a monthly basis. This was the first stage of a wider ranging programme of work in development to improve the way in which the NHS will respond to the health needs of girls and women who have suffered Female Genital Mutilation and actively support prevention.
A midwife/obstetrician/gynaecologist/General Practitioner may become aware that Female Genital Mutilation has occurred when treating a female patient. This should trigger concern for other females in the household.
For further information, see Female Genital Mutilation Datasets (NHS).
Mandatory Reporting of FGM
From the 31st October 2015, regulated professionals in health and social care and teachers/teaching assistants in England and Wales have a duty to report 'known' cases of FGM in under 18s which they identify in the course of their professional work to the Police. Following consultation with social care professionals as well as other relevant professionals, only then will the Police take action to ensure the girl/young woman is safe and her needs are prioritised.
'Known' cases are those where either a girl informs the person that an act of FGM — however described — has been carried out on her, or where the person observes physical signs on a girl appearing to show that an act of FGM has been carried out and the person has no reason to believe that the act was, or was part of, a surgical operation within Section I(2)(a) or (b) of the FGM Act 2003.
A failure to report the discovery in the course of their work could result in a referral to their professional body. The Home Office has produced guidance Mandatory Reportinq of Female Genital Mutilation — procedural information to support this duty and a fact sheet on the New Duty for Health and Social Care Professionals and Teachers/teachinq assistants to Report Female Genital Mutilation (FGM) to Police.
If there are suspicions that a girl under the age of 18 years may have undergone FGM or is at risk of FGM professionals must still report the issue by following their internal safeguarding procedures. Professionals must share the information about their concerns, potential risk and/or the actions which are to be taken. Next steps should be discussed with the safeguarding lead and if necessary a social care referral made.
Protection and Action to be Taken
Where concerns about the welfare and safety of a child or young person have come to light in relation to FGM a referral to Children's social care should be made in accordance with Makinq @ R_eferral to Children's Social Care Procedure.
Please also see FGM Assessment Tool that can be used where there are concerns about FGM.
Children's social care will undertake an assessment and, jointly with the Police, will undertake a Section 47 Enquiry if they have reason to believe that a child is likely to suffer or has suffered FGM. A strategy discussion/meeting should include the relevant Health professionals and, if the child is of school age, the relevant school representative.
Where a child has been identified as having suffered, or being likely to suffer, Significant Harm, it may not always be appropriate to remove the child from an otherwise loving family environment. Parents and carers may genuinely believe that it is in the girl's best interest to conform to their prevailing custom. Professionals should work in a sensitive manner with families to explain the legal position around FGM in the UK. The families will need to understand that FGM and re-infibulation (the process of resealing the vagina after childbirth) is illegal in the UK and that if they are insistent upon carrying out the practice, it can lead to child protection and criminal justice actions taken against them. Interpretation services should be used if English is not spoken or well understood and the interpreter should not be an individual who is known to the family.
Where a child appears to be in immediate danger of mutilation, legal advice should be sought and consideration should be given, for example, to seeking a Female Genital Mutilation Protection Order, an Emergency Protection Order or a Prohibited Steps Order, making it clear to the family that they will be breaking the law if they arrange for the child to have the procedure.
The 2003 Female Genital Mutilation Act makes it illegal for any residents of the UK to perform FGM within or outside the UK. The punishment for violating the 2003 Act carries 14 years imprisonment, a fine or both.
If the outcome of social care enquiries is that female child may be at risk of future harm, community agencies (school nurses, GPs, schools etc.) with regular contact with the child should be informed of any risks and requested to make an immediate referral should any of the indicators above are identified.
Where is FGM Practised?
As a result of immigration and refugee movements, FGM is now being practiced by ethnic minority populations in other parts of the world, such as USA, Canada, Europe, Australia and New Zealand. FORWARD estimates that as many as 6,500 girls are at risk of FGM within the UK every year.
The most recent estimates of prevalence within England & Wales down to local authority level can be found at the City University London website.
The report draws on prevalence data from across 27 countries where FGM is known to be part of cultural practices. From census and education data it is known that across Pan-Lancashire residents originate from at least two-thirds of FGM practising countries (including eight out of the eleven countries where FGM prevalence rates are above 70% in women.
The City University London and Equality Now report along with the indicators outlined above will allow professionals to analyse the likelihood of risk and the types of risk girls may face.
There is no Biblical or Koranic justification for FGM and religious leaders from all faiths have spoken out against the practice - There are however some extreme views within some religious teachings that FGM is required to maintain female chastity and purity which may therefore perpetuate the practice and cause conflict within families and communities around FGM practice.
Consequences of FGM
Depending on the degree of mutilation, FGM can have a number of short-term health implications:
Long-term implications can entail:
1 . Extensive damage of the external reproductive system;
In addition to these health consequences there are considerable psycho-sexual, psychological and social consequences of FGM.
Justifications of FGM
The justifications given for the practise are multiple and reflect the ideological and historical situation of the societies in which it has developed. Reasons include:
1 . Custom and tradition;
FGM is a complex and sensitive issue that requires professionals to approach the subject carefully. An accredited female interpreter may be required. Any interpreter should ideally be appropriately trained in relation to FGM, and in all cases should not be a family member, not be known to the individual, and not be someone with influence in the individual's community.
In light of this, professionals must give careful thought and consideration to developing a safety and support plan for the girl/woman prior to meeting with her. If a girl/woman is seen by someone within the community who she perceives as 'hostile' this may pose a risk to her safety. By mutually agreeing in advance another reason why they are there and/or why they are meeting could potentially minimise this risk.
Further Information
Female Genital Mutilation Pan - Lancashire Multi-Aqency Pathway for Children
AFRUCA (Child Protection of African Children)
Forward (Foundation for Women's Health Research and Development)
Multi-Aqency Statutory Guidance on Female Genital Mutilation
FGM Protection Orders: Factsheet
Female Genital Mutilation and its Management: Royal College of Obstetricians and Gynaecoloqists 2015
Female Genital Mutilation: Resource Pack (GOV.UK)
Mandatory Reporting of Female Genital Mutilation — procedural information
Working Together to Safequard Children
Female Genital Mutilation Risk and Safequardinq - Guidance for Professionals (Department of Health and Social Care)
FGM Mandatory Reportinq Duty (Department of Health and Social Care)
FGM Mandatory Reporting Duty - What you need to do (Department of Health and Social Care)
FGM — Supportinq Girls. Information for Patients (NHS)
Statement opposinq Female Genital Mutilation (Health passport) Female Genital Mutilation (FGM)
Law
The Female Genital Mutilation (FGM) Act was introduced in 2003 and came into effect in March 2004. The act:
The Serious Crime Act 2015 has amended the Female Genital Mutilation Act
5.17 Forced Marriages
RELATED NATIONAL GUIDANCE
Working Together to Safequard Children
Please also see further information from the Forced Marriage Unit in relation to Forced Marriage and Adults with Learninq Disabilities (circulated by ADASS)
Co-ordinated Action Aqainst Domestic Abuse (CAADA) Risk Identification
Checklist (RIC) & Quick Start Guidance for Domestic Abuse, Stalkinq and Honour-Based Violence (DASH)
Multi-Aqency practice quidelines: Handling cases of forced marriage (2014) Forced Marriage Unit (GOV.UK) Contact the Forced Marriage Unit (FMU) if you're trying to stop a forced marriage or you need help leaving a marriage you've been forced into.
Apply for a forced marriage protection order (GOV.UK)
Protocol on the handling of 'so-called' Honour Based Violence/Abuse and
Forced Marriage Offences between the National Police Chiefs' Council and the
Crown Prosecution Service
RELATED LOCAL GUIDANCE
Flowchart for Cases Where Forced Marriage is Suspected
Honour Based Abuse Procedure
Missinq Children and Families Procedure
Abduction Procedure
Modern Slavery Procedure
Child Sexual Exploitation - Pan Lancashire Standard Operatinq Protocol
AMENDMENT
In November 2017, links were updated in the Related National Guidance section.
Contents
Introduction
Motives Prompting Forced Marriage
The Legal Position
Symptoms of Risk Factors
Dealing with Concerns and the "One Chance Rule"
Notes of Caution
Flowchart for Cases Where Forced Marriage is Suspected
Introduction
1 . A 'forced' marriage (as distinct from a consensual "arranged" marriage) is defined as one which is conducted without the valid consent of both of the parties and where duress is a factor. Duress includes both physical and emotional pressure and cannot be justified on religious or cultural grounds. Forced marriage is child abuse and can put children and young people at risk of physical, emotional and sexual abuse. Children's Social Care has a duty to make enquiries into allegations of abuse or neglect against a child under s.47 Children Act 1989 (and where appropriate s. 17 of the Act);
The term "Forced Marriage" can cover a variety of crimes including assault, imprisonment and murder where the person is being punished by their family or community for actually or allegedly undermining what the family or community believes to be the correct code of behaviour and therefore bringing 'shame' or 'dishonour' onto the family or community. (Home Office)
4 All professionals working with victims of forced marriage and honour based violence need to be aware of the 'one chance rule'. That is, they may only have one chance to speak to a potential victim and thus they may only have one chance to save a life. This means that all professionals working within statutory agencies need to be aware of their responsibilities and obligations when they come across forced marriage cases. If the victim is allowed to walk out of the door without support being offered, that one chance might be wasted;
Motives Prompting Forced Marriage
Controlling unwanted behaviour and sexuality (including perceived promiscuity, or being gay, lesbian, bisexual or transgender) - particularly the behaviour and sexuality of women;
Protecting 'family honour';
Responding to peer group or family pressure;
Attempting to strengthen family links;
Ensuring land, property and wealth remain within the family;
Protecting perceived cultural or religious ideals (which can often be misguided or out of date);
Preventing unsuitable relationships, e.g. outside the ethnic, cultural, religious or caste group;
Assisting claims for residence and citizenship;
Fulfilling long standing family commitments.
The Legal Position
ll .ln addition, the Forced Marriage (Civil Protection) Act 2007, which was implemented in November 2008, makes provision for protecting children, young people and adults from being forced into marriage without their full and free consent (through Forced Marriage Protection Orders);
The Anti-social Behaviour, Crime and Policing Act 2014 made it a criminal offence, with effect from 16 June 2014, to force someone to marry. This includes:
Taking someone overseas to force them to marry (whether or not the forced marriage takes place);
Marrying someone who lacks the mental Capacity to consent to the marriage (whether they're pressured to or not).
Breaching a Forced Marriage Protection Order is also now a criminal offence. The civil remedy of obtaining a Forced Marriage Protection Order through the family courts, as set out above, continues to exist alongside the criminal offence, so victims can choose how they wish to be assisted.
Forcing someone to marry can result in a sentence of up to 7 years in prison.
Disobeying a Forced Marriage Protection Order can result in a sentence of up to 5 years in prison.
Symptoms of Risk Factors
See also the Multi-agency Practice Guidelines on Forced Marriage Chart of Potential Warning Signs or Indicators.
Dealing with Concerns and the "One Chance Rule"
Notes of Caution
Flowchart for Cases Where Forced Marriage is Suspected
5.18 Gambling
o From the area of the premises where the activities take place o From the premises as a whole; at the time the activities take place; or o At all times.
5.19 Gang, Group Activity and Criminal Exploitation Affecting Children
RELATED INFORMATION
Knife, Gun and Ganq Crime (GOV.UK)
Statutory Guidance Injunctions to Prevent Gang-Related Violence and GanqRelated Druq Dealing, May 2016 (Home Office)
YOT Practitioner's Guide: Injunctions to prevent gang related violence (Youth Justice Board July 2015)
Preventinq Gang and Youth Violence: Spottinq Signals of Risk and Supportinq Children and Younq People
Criminal Exploitation of children and vulnerable adults: County Lines quidance (Home Office) - This guidance outlines what county lines (and associated criminal exploitation) is, signs to look for in potential victims, and what to do about it.
County Lines - Gang Violence Exploitation and Drug Supply (NCA 2019)
Children's Voices - A review of evidence on the subjective wellbeinq of children involved in gangs in England (Children's Commissioner, November 2017) RELATED CHAPTERS
Child Sexual Exploitation - Pan Lancashire Standard Operating Protocol
Radicalisation Procedure
AMENDMENT
This chapter was updated in May 2018 to include a link to the Home Office publication Criminal Exploitation of Children and Vulnerable Adults: County Lines. Information was also added throughout to describe how organised criminal groups exploit young people and use them to distribute money and illegal drugs along 'county lines'.
Contents Definition
Risks
Indicators
Protection and Action to be Taken
Definition
Defining a gang is difficult. They tend to fall into three categories: peer groups, street gangs and organised crime groups. It can be common for groups of children and young people to gather together in public places to socialise, and although some peer group gatherings can lead to increased antisocial behaviour and low level youth offending, these activities should not be confused with the serious violence of a street gang.
A street gang can be described as a relatively durable, predominantly street-based group of children who see themselves (and are seen by others) as a discernible group for whom crime and violence is integral to the group's identity.
A street gang will engage in criminal activity and violence and may lay claim over territory (not necessarily geographical for example it could include an illegal economy territory). They have some form of identifying structure featuring a hierarchy usually based on age, physical strength, propensity to violence or older sibling rank. There may be certain rites involving antisocial or criminal behaviour or sex acts in order to become part of the gang. They are in conflict with other similar gangs.
An organised criminal group is a group of individuals normally led by adults for whom involvement in crime is for personal gain (financial or otherwise). This involves serious and organised criminality by a core of violent gang members who exploit vulnerable young people and adults. This may also involve the movement and selling of drugs and money across the country, known as 'county lines' because it extends across county boundaries and is coordinated by the use of dedicated mobile phone lines. It is a tactic used by groups or gangs to facilitate the use of vulnerable people or children to sell drugs in an area outside of the area in which they live, which reduces their risk of detection.
Selling drugs across county lines often involves the criminal exploitation of children and young people. Child criminal exploitation, like other forms of abuse and exploitation, is a safeguarding concern and constitutes abuse even if the young person appears to have readily become involved. Child criminal exploitation is typified by some form of power imbalance in favour of those perpetrating the exploitation and usually involves some form of exchange (e.g. carrying drugs in return for something). The exchange can include both tangible (such as money, drugs or clothes) and intangible rewards (such as status, protection or perceived friendship or affection). Young people who are criminally exploited are at a high risk of experiencing violence and intimidation and threats to family members may also be made. Gangs may also target vulnerable adults and take over their premises to distribute Class A drugs in a practice referred to as 'cuckooing'.
Young people can become indebted to the gang/groups and then exploited in order to pay off debts. Young people who are criminally exploited often go missing and travel to other towns (some of which can be great distances from their home addresses). They may have unexplained increases in money or possessions, be in receipt of an additional mobile phone and receive excessive texts or phone calls.
White British children are often targeted because gangs perceive they are more likely to evade police detection and some children may be as young as 12, although 15 to 16 years old is the most common age range. The young people involved may not recognise themselves as victims of any abuse and can be used to recruit other young people.
It is important to remember the unequal power dynamic within which this exchange occurs and to remember that the receipt of something by a young person or vulnerable adult does not make them any less of a victim.
If a young person is arrested for drugs offences a long way from home in an area where they have no local connections and no obvious means of getting home, this should trigger questions about their welfare and they should potentially be considered as victims of child criminal exploitation and trafficking rather than as an offender.
Agencies also need to be proactive and make contact with statutory services in the young person's home area to share information.
Where there are concerns that children are victims of child criminal exploitation they should be referred to the National Referral Mechanism - see Modern Slavery Procedure. Referring a Potential Victim of Modern Slavery to the National Referral Mechanism (NRM).
There is a distinction between organised crime groups and street gangs based on the level of criminality, organisation, planning and control. However, there are significant links between different levels of gangs for example street gangs can be involved in drug dealing on behalf of organised criminal groups Young men and women may be at risk of sexual exploitation in these groups.
Children may be involved in more than one 'gang', with some cross-border movement, and may not stay in a 'gang' for significant periods of time. Children rarely use the term 'gang', instead they used terms such as 'family', 'breddrin', 'crews', 'cuz' (cousins), 'my boys' or simply 'the people I grew up with'.
Safeguarding should focus on both young people who are / vulnerable of making the transition to gang involvement as well as those already involved in gangs. Practitioners should be aware of particular risks to young people involved in gangs from violence and weapons; drugs and sexual exploitation.
Risks
The risk or potential risk of harm to the child may be as a victim, a gang member or both - in relation to their peers or to a gang-involved adult in their household. Teenagers can be particularly vulnerable to recruitment into gangs and involvement in gang violence. This vulnerability may be exacerbated by risk factors in an individual's background, including violence in the family, involvement of siblings in gangs, poor educational attainment, or poverty or mental health problems.
A child who is affected by gang activity, criminal exploitation or serious youth violence can be at risk of significant harm through physical, sexual and emotional abuse. Girls may be particularly at risk of sexual exploitation.
Violence is a way for gang members to gain recognition and respect by asserting their power and authority in the street, with a large proportion of street crime perpetrated against members of other gangs or the relatives of gang members.
The specific risks for males and females may be quite different. There is a higher risk of sexual abuse for females and they are more likely to have been coerced into involvement with a gang through peer pressure than their male counterparts.
There is evidence of a high incidence of rape of girls who are involved with gangs. Some senior gang members pass their girlfriends around to lower ranking members and sometimes to the whole group at the same time. Very few rapes by gang members are reported.
Gang members often groom girls at school using drugs and alcohol, which act as disinhibitors and also create dependency, and encourage / coerce them to recruit other girls through school / social networks.
Indicators
Child withdrawn from family;
Sudden loss of interest in school or change in behaviour. Decline in attendance or academic achievement (although it should be noted that some gang members will maintain a good attendance record to avoid coming to notice);
Being emotionally 'switched off, but also containing frustration / rage;
Starting to use new or unknown slang words;
Holding unexplained money or possessions;
Staying out unusually late without reason, or breaking parental rules consistently;
Sudden change in appearance — dressing in a particular style or 'uniform' similar to that of other young people they hang around with, including a particular colour;
Dropping out of positive activities;
New nickname;
Unexplained physical injuries, and/or refusal to seek / receive medical treatment for injuries;
Graffiti style 'tags' on possessions, school books, walls;
Constantly talking about another young person who seems to have a lot of influence over them;
Breaking off with old friends and hanging around with one group of people;
Associating with known or suspected gang members, closeness to siblings or adults in the family who are gang members;
Starting to adopt certain codes of group behaviour e.g. ways of talking and hand signs;
Going missing;
Being found by Police in towns or cities many miles from their home;
Expressing aggressive or intimidating views towards other groups of young people, some of whom may have been friends in the past;
Being scared when entering certain areas; and
Concerned by the presence of unknown youths in their neighbourhoods.
An important feature of gang involvement is that, the more heavily a child is involved with a gang, the less likely they are to talk about it.
There are links between gang-involvement, criminal exploitation and young people going missing from home or care. Some of the factors which can draw gang-involved young people away from home or care into going missing are linked to their involvement in canying out drugs along county lines. There may be gang-associated child sexual exploitation and relationships which can be strong pull factors for girls who go missing.
In suspected cases of radicalisation, social workers and local authorities have a duty to refer the case to the local Channel panel, which will then decide the correct, if any, intervention and support to be offered to that individual.
Protection and Action to be Taken
Any agency or practitioner who has concerns that a child may be at risk of harm as a consequence of gang activity including criminal exploitation should contact Children's Social Care or the police for the area in which the child is currently located. The Makinq a Referral to Children's Social Care Procedure should be followed. An Early Help Assessment may be crucial in the early identification of children and young people who need additional support due to risk of involvement in gang activity.
Support and interventions should be proportionate and based on the child's needs identified during the assessment.
A Child in Need Assessment should be led by a qualified social worker and evidence and information sharing across all relevant agencies will be key. It may be appropriate for the social worker to be embedded in or work closely with, a team (for example in the Police or Youth Offending Service), which has access to 'real time' gang intelligence in order to undertake a reliable assessment.
Practitioners should be aware that children who are Looked After by the Local Authority can be particularly vulnerable to becoming involved in gangs and being criminally exploited. There may be a need to review their Care Plan in light of the assessment and to provide additional support.
Where there are concerns about a child or young person being criminally exploited (for example If a young person is arrested for drugs offences away from home in an area where they have no local connections and with no obvious means of getting home) the Police and Children's Social Care, from the first point of contact with the young person, should consider whether they are victims of child criminal exploitation or trafficking and pursue a safeguarding, rather than criminal justice, response.
Children are often in fear of ending their contact with the gang because it might leave them vulnerable to reprisals from those former gang members and rival gang members who may see the young person as without protection.
If there is a possible "threat to life",the Police may consider it appropriate to issue an Osman Warning. In these circumstances this should trigger an automatic referral by the Police to Children's Social Care, (see the Makinq a Referral to Children's Social Care Procedure) the initiation of a Strategy Discussion and consideration of the need for immediate safeguarding action, unless to do so would place the child at greater risk.
Any decision not to refer a child should be actively reviewed to allow a referral to Children's Social Care to be made at an appropriate stage in order to protect the young person's safety.
Information and local knowledge about the specific gang should be shared, including the use, or suspected use, of weapons or drug dealing. There should also be consideration of possible risk to members of the child's family and other children in the community.
Unless there are indications that parental involvement would risk further harm to the child, parents should be involved as early as possible where there are concerns about gang activity.
Gang Injunctions
"Gang injunctions offer local partners a way to intervene and to engage a young person aged 14-17 with positive activities, with the aim of preventing further involvement in gangs, violence and/or gang-related drug dealing activity. " (Home Office, June 2015)
The Serious Crime Act 2015) amended the Crime and Security Act 2010 to extend this provision from 18 years and to include children and young people (14-17 year olds). Gang injunctions also now covers drug dealing activity" as well as "violence" including the threat of violence. Applications should focus on gang related behaviour that may lead to violence, and not other problematic antisocial behaviour.
In order to make a gang injunction, the court must be satisfied that the respondent has engaged in, encouraged or assisted gang-related violence or drug dealing activity. In addition, the court must then be satisfied that:
The gang injunction is necessary to prevent the respondent from engaging in, encouraging or assisting gang-related violence or drug dealing activity; and/or
The gang injunction is necessary to protect the respondent from gang related violence or drug taking activity
Children involved in gangs may be known to other services for offending behaviour or school exclusion.
Girls and young women involved with gangs can be affected by sexual violence, domestic violence, drug and alcohol misuse, school exclusion and going missing from home. Girls will often be controlled and manipulated by male gang members and sexual violence is a common feature of the experience of girls involved with gangs. Sisters or female family members who are not actively involved with gangs can be targeted and sexually assaulted by rival gangs.
Children may often be at the periphery of involvement for some time before they become active gang members. Children may also follow older siblings into gang involvement. This may provide opportunities for preventative work to be undertaken with children.
5.20 Historical Abuse Allegations
RELATED NATIONAL GUIDANCE
Workinq Together to Safeguard Children
Safe Recruitment. Selection and Supervision of Staff Procedure
Complex (Organised or Multiple) Abuse Procedure
Contents
Introduction
Significance
Action to Safeguard
Introduction
Significance
Action to Safeguard
5.21 Honour Based Abuse
RELATED NATIONAL GUIDANCE
Workinq Together to Safeguard Children
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College of Policing website, Forced Marriage and Honour Based Violence
Forced Marriage Guidance—Home Office — information and practice quidelines for professional protecting. advising and supporting victims. This includes MultiAgency Statutory Guidance for dealing with forced marriage and Multi-Agency practice guidelines: Handling cases of forced marriage.
Endinq Violence against Women and Girls (VAWG) Strategy: 2016 to 2020 (refresh)
Protocol on the handlinq of 'so-called' Honour Based Violence/Abuse and
Forced Marriage Offences between the National Police Chiefs' Council and the
Crown Prosecution Service
Missinq Children and Families Procedure
Abduction Procedure
Modern Slavery Procedure
Child Sexual Exploitation - Pan Lancashire Standard Operating Protocol Forced Marriages Procedure
Contents
Introduction
Assessment Tool
Introduction
The definition of honour based abuse is:
A variety of crimes including assault, imprisonment and murder where the person is being punished by their family or community for actually or allegedly undermining what the family or community believes to be the correct code of behaviour and therefore bringing 'shame' or 'dishonour' onto the family or community." (Home Office);
All professionals working with victims of honour based abuse need to be aware of the 'one chance rule'. That is, they may only have one chance to speak to a potential victim and thus they may only have one chance to save a life. This means that all professionals working within statutory agencies need to be aware of their responsibilities and obligations when they come across these cases. When a case of HBA is first reported it is important to obtain as much information as possible as there may not be another opportunity for the individual reporting to make contact. Ifthe victim is allowed to walk out of the door without support being offered, that one chance might be wasted.
Assessment Tool
The SafeLives Risk Identification Checklist (RIC) & Quick Start Guidance for Domestic Abuse, Stalkinq and Honour-Based Violence (DASH).
Young people, especially those aged 16 and 17, can present specific difficulties to agencies as there may be occasions where it is appropriate to use both child and adult protection frameworks. For example, some 16 and 17 year olds may not wish to enter the care system but prefer to access refuge accommodation. Victims aged 16 and over should be assessed using the SafeLives/DASH Risk Assessment and, if assessed as high risk, referred to the MARAC.
This Assessment Tool can be used to identify the risk of violence or abuse. Domestic abuse can take many forms but it is usually perpetrated by men towards women in an intimate relationship such as boyfriend/girlfriend, husband/wife. This checklist can also used for lesbian, gay, bisexual relationships and for situations of "honour?-based violence or family violence. Domestic abuse can include physical, emotional, mental, sexual or financial abuse as well as stalking and harassment. They might be experiencing one or all types of abuse; each situation is unique. It is the combination of behaviours that can be so intimidating. It can occur both during a relationship or after it has ended.
The purpose of the tool is to give a consistent and simple tool for practitioners who work with adult victims in order to help them identify those who are at high risk of harm and whose cases should be referred to a MARAC meeting in order to manage their risk. If you are concerned about risk to a child or children, you should make a referral to ensure that a full assessment of their safety and welfare is made.
5.22 Hospital Stays for Children Where there are Welfare Concerns
RELATED NATIONAL GUIDANCE
National Service Framework for Children, Younq People and Maternity Services. Executive Summary - Standards 6 and 7. DHSC. October 2004
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Workinq Together to Safeguard Children
Private Fostering Procedure
Pan-Lancashire Procedure for the Supervision of Parents/Carers in Hospital
Settings when there are Child Protection Concerns
AMENDMENT
In November 2013, this chapter was updated in line with Working Together to Safeguard Children and the Single Assessment Framework.
Contents
Introduction
Considerations When Child is in Hospital
Actions to Safeguard
Category A Cases (Child Protection Cases)
Category B Cases (High Level Concerns)
Category C Cases (Children in Need)
Introduction
Considerations When Child is in Hospital
Actions to Safeguard
Hospital Discharge Arrangements
Category A Cases (Child Protection Cases)
Actual non- accidental injuries;
Serious health concerns of presentation; or o Repeated presentations that are considered to be fabricated illness;
Significant injuries where there are serious doubts about the explanation or inconsistent explanations;
Actual sexual abuse;
Mental health/disability; or
Drug/alcohol abuse having an immediate and significant impact on the child or the parent's ability to parent adequately;
Evidence of domestic violence;
The death of sibling under suspicious circumstances.
Category B Cases (High Level Concerns)
11. This category will include:
Unusual inappropriate behaviour of parent/carer; o Unexplained delay in seeking medical attention for significant injuries;
Serious or repeated weight loss;
Failure to thrive without medical reason;
Previous child protection registration/strategy meeting in respect of a child in the family;
Serious concerns about drug or alcohol misuse;
Suspicion of sexual abuse;
Serious concerns about home conditions;
Suspicion of domestic violence;
Serious concerns about a parent's reluctance or inability to cope with a child with disabilities;
o Significant mental health of child/parent.
Category C Cases (Children in Need)
12. This category will include:
Frequent visits to the GP;
Number of child or sibling A & E attendance's in last 12 months;
Non-suspicious death of a sibling;
Not registered with a GP;
A display of fear or apprehension when partner/carer visits;
Parental ability to cope;
Concerns Child/YP's drug or alcohol misuse;
o Concerns parent's drug or alcohol misuse where it may affect their children;
History of repeated separation of parents/partners/carers;
Frequent change of address;
Concerns about a parent's reluctance or inability to cope with a child with disabilities;
Parent's reluctance to visit child in hospital;
Concerns about the mental health/disability of the parent;
Aggression or violence on the ward (Immediate internal response).
5.23 International Cross-Border Child Protection Cases Under the 1996—— Hague Convention
RELATED GUIDANCE AND INFORMATION
Non-statutory advice from the Department for Education: The 1996 Haque Convention - Departmental Advice.
The International Child Abduction and Contact Unit
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AMENDMENT
In May 2015, a link to information about the International Child Abduction and Contact Unit and Working with Foreign Authorities: Child Protection Cases and Care Orders Departmental advice for local authorities, social workers, service managers and children's services lawyers July 2014 was added to Related Guidance and Information.
Contents
Introduction
Key Points
The Central Authority
Making Requests for Information or Action
Requesting Information on the Need for Protective Measures
Taking Action when a Child Usually Lives in Another State
Transferring Jurisdiction
Placing a Child Living in England in Foster/ResidentiaI Care
Asking Another State to Trace a Child
Asking Another State to Protect a Child Living in that State
Providing a Report to Support Parents Contacting a Child
Handling Requests from Other Contacting States
Introduction
The 1996 Hague Convention on Jurisdiction, Applicable Law, Recognition, Enforcement and Co-operation in Respect of Parental Responsibility and Measures for the Protection of Children ('the Hague Convention') (implemented in the UK on 1 November 2012) provides an agreed set of legal provisions and cooperation arrangements to cover the handling of cross-border cases where children's safety or welfare may be an issue.
Non-statutory advice from the Department for Education: The 1996 Haque Convention - Departmental Advice is designed to help local authorities when dealing with cross-border child protection cases.
The advice sets out the key steps that local authorities can take to:
Ask for help or essential information from authorities abroad when dealing, for example, with a child from this country who is in need of support or protection; and
Respond to similar requests put to them by authorities abroad.
Key Points
The Convention applies to situations where contracting states need to cooperate over child protection and welfare cases when there is an international dimension. This can include Care Proceedings, contact cases and foster placements abroad.
The aim of the Convention is to bring about better co-operation between countries so that the handling of cases and protections put in place is more efficient, avoids delays and delivers better outcomes for the children involved;
This advice is distinct from Department guidance that already exists on the other main types of cross-border cases — inter-country adoption and child abduction;
The Convention's provisions do not mean major change for local authorities — in a number of respects they mirror arrangements already in place governing co-operation arrangements between EU member states on these types of children's cases;
The Convention does, however, extend these arrangements in some situations, and will mean that similar co-operation processes will now also apply between this country and countries outside the EU which have implemented the Convention. It will not apply between England and the other jurisdictions of the
Under the Convention, contracting states can ask each other for information or other types of help when a child's welfare or protection is at issue. The different types of requests include, for example:
Asking for another state's help in tracing a child;
Asking for a report on a child habitually resident in another contracting state;
Asking another state to take measures to protect a child's welfare;
Seeking the agreement of another state for a child to be placed there in foster or residential care; and
Asking for the transfer of jurisdiction for a child from his/her home state, enabling an authority to make decisions about a child's welfare if it feels it is best placed to do so.
Local authorities may also be asked by a parent to consider preparing a report on their suitability to have contact with a child living in another state.
Under the Convention contracting states can ask each other for information or other types of help when a child's welfare or protection is at issue.
A list of the countries that have implemented the Convention (referred to as 'contracting states') can be found on the Haque Conference for Private International Law website. In this list only those States which have 'Entered into Force' (EIF) are operating the Convention.
The Central Authority
Each country is required to establish a Central Authority to help ensure effective communication between child welfare authorities in contracting states. For England the day-to-day administration of the Central Authority's role will be carried out by the International Child Abduction and Contact Unit (ICACU) which is co-located in the office of Official Solicitor and Public Trustee.
Certain types of request have to be made via Central Authorities, while in some cases local authorities can deal directly with their counterparts abroad. It is recommended, however, that local authorities consult ICACU in the first instance for advice about the most appropriate way to make their request. The Central Authority holds useful information about authorities in other countries, and has a wealth of practical experience of cross-border cooperation on child protection cases.
The English Central Authority also monitors the volume and effectiveness of cases handled under the Convention. If local authorities decide to deal directly with their counterparts in other contracting states it is recommended that they notify the Central Authority so they can build as complete a picture as possible of the work arising from the Convention.
There are other agencies too that can offer practical advice, direct services and support on handling cross-border cases. These include:
Children and Families Across Borders (CFAB). CFAB runs a national advice line on inter-country casework (funded by the DfE);
Africans Uni@Aqainst Child Abuse (AFRUCA).
Although the Regulations that support the Convention place a duty on local authorities to respond in a timely way to certain types of request, there is no prescription as to the form that responses should take. As far as possible, authorities should follow their existing local procedures, based on a proportionate response to the level of risk of harm to the child.
Local authorities are encouraged to agree a first point of contact to manage any communications between the Central Authority and relevant frontline staff and to let the Central Authority know the contact details. The nominated person should be of sufficient seniority to make decisions on action for international cases, and there should be cover to ensure that urgent requests can be dealt with promptly.
Making Requests for Information or Action
The Convention enables a local authority to:
Ask another state to provide a report/information to inform decisions on whether child protection measures should be taken;
Take action to protect a child at immediate risk of harm, even if the child is usually resident in another contracting state;
Ask another contracting state to transfer jurisdiction for a child if a local authority feels it is better placed to make decisions about his/her welfare, or ask another state to take on jurisdiction in the reverse situation;
Consult with the relevant authority in another state about placing a child in foster or residential care in that state;
Ask for help in tracing a child in a contracting state when a local authority is concerned about his/her welfare;
Ask another state to consider taking measures to protect a child who lives in that state;
Provide a report to support a parent's case for contact with a child living in another contracting state.
Requesting Information on the Need for Protective Measures
If a local authority is considering action to protect or safeguard a child, it can ask a competent authority in another contracting state to communicate information it holds that is relevant to the case, regardless of where the child is habitually resident.
If a local authority has welfare concerns about a child who is temporarily living in or visiting their area, it can ask the child's main country of residence for a report on his/her situation — see Chart 1 -requesting a report to support decisions on the need for child protection measures for the recommended process for this.
The authority in the contracting state is not formally obliged to provide this report. If a local authority has difficulty in getting the information it needs, the English Central Authority may be able to help through liaison with the other state's Central Authority. A contracting state can specify that these requests for information must be routed through their Central Authority. You can check whether the country you need to approach has specified this by checking the 'Reservations/Declarations' column for that country in the Hague Convention Status Table, available at the Haque Conference for Private International Law website.
Taking Action when a Child Usually Lives in Another State
If a local authority identifies a child in need of immediate protection, it must exercise its duties to safeguard and promote the welfare of that child under the Children Act 1989. In urgent cases the Convention provides the local authority with the jurisdiction to take any necessary steps to protect the child until the authorities in the state where the child is habitually resident have taken any necessary action. The presence of an international element to the case should not delay the necessary protective measures.
If the child is only temporarily present in England, the child's home country will have jurisdiction, and the appropriate authority there is responsible for decisions about the child's welfare and protection beyond the immediate measures taken (unless a transfer of jurisdiction is sought — see Section 7, Transferrinq Jurisdiction).
Once steps have been taken to protect the child, the local authority should contact the relevant authority in the child's home country to inform them of the action taken, ask for information about the child's circumstances, and agree what further action is needed. Chart 2 - Takinq action for a child at immediate risk sets out the recommended process for such cases.
An initial approach to the English Central Authority is recommended, although in these cases contact can be via Central Authorities, or directly to the local authority's equivalent in the other state. The Central Authority of the other state should be able to provide information on the child protection procedures in that state and may be able to supply the contact details for the appropriate equivalent authority.
If the child needs continuing protection while the local authority is liaising with authority in the other state, the Parental Responsibility and Measures for the Protection of Children (International Obligations) (England and Wales and Northern Ireland) Regulations 2010 allow for an application for an Interim Care Order or Interim Supervision Order, even though it is anticipated that another state will take over jurisdiction before a final order is required.
Transferring Jurisdiction
A local authority can seek a transfer of jurisdiction for a child who is habitually resident in another state if it feels it is better placed to make decisions about that child's welfare. This is done via an application to the High Court, who will then make the request to the child's home country if appropriate.
The authority in the child's home country may itself ask for jurisdiction to be transferred to the English local authority. The Central Authority in England aims to keep a record of transfers of jurisdiction, and local authorities are therefore asked to notify ICACU when such arrangements are made.
Placing a Child Living in England in Foster/Residential Care
The types of situation that this part of the Convention apply to include those where:
A local authority feels that the most appropriate placement for a child is with family or other Connected Persons in another state;
A child's foster carer may want to move abroad and the local authority considers it in the child's best interests to stay with that carer; and
Where a child may need placement in a specialist residential unit in another country.
If a local authority wants to make arrangements for a child in their care (i.e. one subject to a Care Order or Interim Care Order) to live outside England and Wales, it must make an application to court for leave to place the child outside their jurisdiction in accordance with the Children Act 1989 Schedule 2 paragraph 19. If the child is Accommodated under section 20 the Court's leave is not required, but the authority must obtain the consent of every person with Parental Responsibility for the child before placing the child outside of this jurisdiction.
Under the Convention, a local authority considering this type of placement must consult the relevant authority in the other state, and a placement cannot be made unless consent is given by this authority. This is one of the areas however where there is a practical difference between the application of the Hague 1996 Convention and the EU Council Regulation known as Brussels Ila. If local authorities are considering a placement in a country that is a Member State of the EU, they must do so under Brussels Ila. Placement to another Member State requires their consent only if the law of that state requires public authority intervention for the type of placement concerned. Where consultation is required, the local authority must provide a report on the child and the reasons for the proposed placement. The Child's Permanence Report, Foster Carer's assessment report or any matching report would contain adequate information for this purpose - there should be no need to create a new report form. The Convention allows for requests to be made either via the Central Authority of the proposed state of placement or to a competent authority. It is recommended however that local authorities route these requests through the English Central Authority who will then liaise with the Central Authority in the other state. Chart 3 - Placinq a child currently livinq in England in foster of residential care in another contractinq state sets out the recommended process for making this type of request.
If the child is the subject of court proceedings the court may approach the authority in the other state for permission to place the child. If the court sends the request directly to the Central Authority or competent authority in the other state, it must also send a copy of the request to the Central Authority for England.
The local authority must also satisfy the requirements of Regulation 12 of the Care Planning, Placement and Case Review (England) Regulations 2010 in placing a child in care outside England and Wales, ensuring that adequate arrangements are in place for supervising and reviewing the placement. See the Placements Outside England and Wales Procedure in your Children's Social Care procedures manual:
Blackburn with Darwen Children's Services Procedures;
Blackpool Social Work and Safeguardinq Service Procedures;
Lancashire Children's Social Care Procedures.
This part of the Convention does not apply to:
Adoptive placements (these are governed by the 1993 Hague Convention on Inter country Adoption);
Placements which are private family arrangements; or
Placements of children under Special Guardianship Orders— these are private law orders and do not constitute a placement by a local authority.
It will however apply to placements of a child in care for assessment in a possible adoptive placement. If a placement of this sort is contemplated the local authority should seek legal advice.
Asking Another State to Trace a Child
If a local authority has taken steps to safeguard a child's welfare (or plans to do so) and believes that he/she has been taken out of the local authority area to another contracting state, the Convention enables the local authority to ask another contracting state for help in determining the child's location. Chart 4 - askinq a central authority in another state to locate a child describes the process for this type of request.
These requests should be made to the Central Authority of the state to which it is believed the child has moved, but it is recommended that this is done via the English Central Authority. The requests should be accompanied by an explanation of the child's circumstances and any information which might assist the other state in tracing the child's address.
If the child is habitually resident in England and court proceedings are started or ongoing, the court can request the authorities in the other state to assume jurisdiction over the child if they appear better placed to do so.
If there are serious concerns about a child suffering Siqnificant Harm and this child is moved into another state, the local authority must inform the relevant authorities of that other state of the danger to that child and also of any measures they were taking or considering to protect the child.
Asking Another State to Protect a Child Living in that State
The Convention enables a local authority to ask another contracting state to consider the need to protect a child from harm who is habitually resident in that state. Local authorities should provide sufficient information for the authority in the other state to make a decision. This request can be made via the English Central Authority or directly to the Central Authority in the other state. The Central Authority in that state can ask its competent authority to consider the need to take protective measures, but the authority is not obliged to do so.
Providing a Report to Support Parents Contacting a Child
If a parent in England is seeking by court proceedings to obtain or maintain contact with a child living in another contracting state, he/she can ask their local authority to prepare a report on their suitability to have this contact for submission as evidence to the authorities in the other state.
There is no duty on an English local authority to agree to prepare such a report or provide any information. However local authorities must exercise their discretion reasonably and cannot have a blanket policy of refusing to prepare such reports.
If a local authority agrees to this request, it can gather information about the parent's suitability to have contact with the child and about any conditions that it thinks it would be appropriate for the overseas court to impose. The court or authority dealing with the application for contact in the child's home state must consider the local authority's report before making their decision.
A local authority may charge a 'reasonable' fee for providing this service. This means a charge that is as close as possible to the actual costs of providing that service, including indirect costs (for example a proportion of the on costs). Local Authorities will need to include their charging scheme, if any, as part of their policy on providing this service.
A local authority may provide a service under this Article by subcontracting the work to another agency.
Handling Requests from Other Contacting States
Just as local authorities in this country can ask for certain types of help or information from other contracting states, other contracting states can ask for a similar range of help from our authorities.
Handling a request for information on a child's situation
A local authority may be asked for information about a child by a competent authority in another contracting state that is considering protection measures for that child, regardless of where the child usually lives. These types of request to an English local authority should be routed through the English Central Authority.
If a child is habitually resident and present in England, an authority of another contracting state with which the child has a substantial connection may ask the English Central Authority to provide a report on the child's situation. If the Central Authority thinks that it is appropriate to do so, it will pass the request on to the local authority which must provide a report as soon as reasonably practicable.
The implementing Regulations for the Convention allow local authorities to supply relevant information lawfully, providing that doing so would not put the child or their property at risk, or threaten the life or liberty of a member of the child's family. Further advice on information sharing can be found in the Question and Answer Section of the 1996 Haque Convention Advice DfE website.
There is no prescribed format for responding to these requests. A letter may be enough, or if a more detailed report is required, a format similar to those used to respond to Court requests for reports under section 7 (a welfare report) or section 37 (Court direction to investigate child's circumstances and consider whether to apply for a Care or Supervision Order) of the Children Act 1989 would be appropriate.
On occasions the local authority approach for this type of information may be made to CAFCASS — for example, in situations where Cafcass has been involved with the child or the family in other court proceedings.
Chart 5 - Handlinq a request for a report/information on a child's situation sets out the recommended process for handling this type of request. Handling requests to transfer jurisdiction for a child
An authority in another contracting state can seek a transfer of jurisdiction for a child if it feels that it is better placed to assess the child's best interests.
The other contracting state will need to make an application to the High Court for transfer of jurisdiction, unless the child is already the subject of court proceedings. In this case the court dealing with the matter will need to transfer the request to the High Court for consideration.
12.3 Request from another state for foster care or home transfer
An authority in another contracting state can only place a child in foster care or a residential unit in England if the competent authority has consented to the placement. This restriction applies to a placement of a child for whom the authority of another state is responsible. It does not apply to placements for adoption as these are governed by the 1993 Hague Convention on Inter-country Adoption.
In England, the competent authority for these purposes is the local authority with responsibility for children's services in the area where the contracting state proposes to place the child.
In many cases, the child will not be the subject of any proceedings here. The authority in the contracting state must provide the English local authority with a report about the child and the reasons why the placement is being considered. The relevant local authority should deal with the placement request as quickly as possible.
Before consenting to the placement, the local authority, acting as the competent authority, will need to make its own independent assessment of whether the proposed placement is appropriate in the best interests of the child and provides him or her with the same safeguards as a comparable arrangement for the placement of an English child.
For example the authority may wish to consider such issues as:
Whether based on the information provided about the child's needs the placement for the child appears to be appropriate;
The frequency and suitability of arrangements for keeping the plan under review;
Arrangements for family contact (if appropriate);
Whether the plan has taken the wishes and feelings of the child into account and allows for the child to have access for support should they wish; and
The planned duration of placement and aftercare arrangements.
Should a local authority, (acting as a competent authority), not have sufficient information to be able to give informed consent that confirms that the proposed placement is appropriate for the child concerned, it may seek further information from the authority in the contracting state wishing to make the placement.
The competent authority will be entitled to refuse consent. For example, following scrutiny of information, the authority could come to the view that the proposed placement is unsuitable for the individual child — perhaps because arrangements for review of the plan or for aftercare are not suitable; or because the authority is concerned about the quality of the proposed placement indicating its unsuitability, because of other information in its possession about the care and safety of other children placed there.
If the local authority controls, manages or has some other interest in the institution at which the child is proposed to be placed, the local authority must ensure that the decision as regards consent is made autonomously from its involvement in running the institution.
If the local authority agrees to the placement, the legal framework under which the child will be placed should be established. The two authorities should agree the responsibility for monitoring and review of the placement. Such monitoring and review arrangements must be compatible with the equivalent arrangements for placing English children in comparable placements. See the Looked After Reviews Procedure in your Children's Social Care procedures manual:
Blackburn with Darwen Children's Services Procedures;
Blackpool Social Work and Safequardinq Service Procedures;
Lancashire Children's Social Care Procedures.
Where the child is to be placed with a foster carer, the local authority should establish whether the legal structure of the placement gives the carer Parental Responsibility. If it does not, regardless of any agreement between the authorities, the local authority will have responsibility to monitor the placement as a Private Fostering arrangement. If the child is the subject of any court proceedings in England and Wales the competent authority to make the decision is the court, which will fix a directions hearing to consider the request.
Requests to locate a child believed to be in the LA area
If an authority in a contracting state is concerned that a child needs protection and believes the child has been removed from their area and taken to England, they may request assistance from the English Central Authority in tracing that child. Chart 6 Request to locate a child believed to be in the local authority area sets out the recommended process for handling these requests.
Local authorities have a duty to assist with these requests. It is suggested that the starting point should be the usual local authority procedure for tracing a child missing from care or education. If initial checks of any relevant databases do not trace the child, local authorities can decide what level of further checking is proportionate to the risk factors described by the requesting authority.
If the risk of harm to a child is significant and there is a credible reason to believe that the child is in the local authority's area, it may be proportionate to share information with other professionals, including community and voluntary agencies.
If an address is found for the child, the local authority should consider whether disclosing this information will pose a risk of harm to the child or his family, or be a criminal offence or contempt of court. Local authorities can withhold information in these circumstances. If in contempt of court cases the local authority feels it is in the child's interests to disclose information, they must seek the court's leave to do so.
Handling requests to protect a child living in the LA area
If a Central or other authority in a contracting state has concerns about the welfare of a child habitually resident and present in England, it can ask the relevant local authority to take measures to protect that child. The request needs to be made with supporting reasons to the Central Authority in England, who may pass the request on to the local authority.
5.24 Learning Difficulties and Disabilities of a Parent/Carer
RELATED NATIONAL GUIDANCE
Chapter 1 : Assessing need and providing help, Working Together to Safeguard
Children
Disabilities and Learning Difficulties Procedure
Contents
Introduction
Risk to Children
Action to Safeguard
Introduction
Risk to Children
Action to Safeguard
referral must be made using the Making a Referral to Children's Social Care Procedure.
5.25 Licensed Premises
RELATED INFORMATION
Portman Group - Information for Licensees about Best Practice in relation to Alcohol
o From the area of the premises where the activities take place o From the premises as a whole o At the time the activities take place; or o At all times.
5.26 Mental Illness of a Parent or Carer
RELATED NATIONAL GUIDANCE
Chapter 1 : Assessinq need and providinq help, Working Together to Safeguard Children
Think Parent - Think Child - Think Family
AMENDMENT
In November 2013, this chapter was updated in line with Working Together to Safeguard Children and the Single Assessment Framework.
Contents
Introduction
Risk Indicators
High Risk Indicators
Action to Safeguard
Risk Indicators
High Risk Indicators
Psychotic beliefs particularly if involving the child;
Persistent negative views expressed about a child, including rejection ongoing emotional unavailability, unresponsiveness and neglect;
Inability to recognise a child's needs and to maintain appropriate parentchild boundaries;
Ongoing use of a child to meet a parent's own needs;
Distorted, confusing or misleading communications with a child including involvement of the child in the parent's symptoms or abnormal thinking. For example, delusions targeting the child, incorporation into a parent's obsessional cleaning/contamination rituals, or a child kept at home due to excessive parental anxiety or agoraphobia;
Ongoing hostility, aggression, irritability and criticism of the child;
Serious neglect of the child;
Any history of domestic violence.
Action to Safeguard
Meetings and Reviews; o Early Help — CAF Assessment Meeting, CAF Reviews.
24.Approprjate completion of the Health and Children's Social Care assessment documentation under the CPA should ensure that any childcare issues are highlighted so that a referral to Children's Social Care can be made where appropriate under the Makinq Referral to Children's Social Care Procedure. This should be documented and any subsequent childcare responsibilities also documented in the adult's care plan.
5.27 Missing Children and Families
RELATED NATIONAL GUIDANCE AND INFORMATION
Chapter 1: Assessinq need and providinq help, Working Together to Safeguard Children
Statutory guidance on children who run away or go missinq from home or care (DE. January 2014)
n |
ance o |
1 |
The International Child Abduction and Contact Unit
Keeping Children Safe in Education (DfE, GOV.UK)
Children Missinq Education (DfE, GOV.UK)
Joint Protocol Children and Younq People who Run Away or Go Missing From
Home or Care
Blackburn with Darwen
Procedures and Protocol for Children Missinq From or Not Receiving a Suitable
Education
Blackpool
Children Missinq Or Not Receivinq a Suitable Education Procedure Handbook
2017
Forced Marriages Procedure
AMENDMENT
In November 2017, a link was added to Children Missing from Education.
Contents
Children Who Go Missing Families Who Go Missing
Introduction
Initial Action
Strategy Discussion/Meeting
Follow-up Action by Children's Social Care
When the Child, Family or Adult is Found
Children Missing from other Local Authorities
Children Who Go Missing from Education
Introduction
Children Likely to Go Missing from Education
What the Local Authority Does Regarding Children who are Missing from Education
Attendance Strategy
Common Transfer Form (CTF)
Admissions and Leavers Database
Choice Adviser
School Admissions Elective Home Education
Independent Schools
Truancy and Beat-Sweep Patrols
Education Welfare Officers (EWOs)
Government Lost Pupil Database (s2s)
Pupil Referral Unit (PRU) Other Agencies
Children Who Go Missing
See also Joint Protocol Children and Younq People who Run Away or go Missinq from Home or Care.
Families Who Go Missing
Introduction
Enquiry,
Initial Action
1 1 The Children Missing from Education Office should notify colleagues in other areas about a pupil whose name may show up on the roll of a new school. See Children Missinq from Education (Blackburn with Darwen local policy);
Strategy Discussion/Meeting
17.A senior member of Children's Social Care should seek assistance from the Department for Work and Pensions if the Police have not already contacted them;
Follow-up Action by Children's Social Care
O The circumstances causing concern;
Action required if a child is found, including any immediate protective action to be taken;
When the Child, Family or Adult is Found
Immediate safety issues;
Whether to instigate a Section 47 Enquiry and agree if a single or joint agency enquiry is necessary;
Who will interview the child if a Section 47 Enquiry is to be initiated;
Who will interview the child if a Section 47 Enquiry is not required;
Who needs to be informed of the child's return (locally and nationally).
Children Missing from Other Local Authorities
Children Who Go Missing from Education
See also Blackburn with Darwen Procedures and Protocol for Children Missinq from or not Receivinq a Suitable Education and Blackpool Children Missing From Education.
Introduction
Children Likely to Go Missing from Education
Below is a list of children who are likely to go missing from education:
Young people who have committed criminal offences;
Children living in women's refuges;
Children in homeless families, perhaps living in temporary accommodation, houses of multiple occupancy or Bed and Breakfast accommodation;
Young runaways;
Children with long-term medical or emotional health problems;
Unaccompanied Asylum Seekers and refugees, or the children of asylum seeking families;
Looked After children; o Children from Gypsy/Roma/TraveIler background;
Young carers;
Children from transient families, i.e. students who have experienced high levels of mobility between different education providers;
Teenage mothers;
Children excluded from school;
Children in Private Fosterinq arrangements;
Children informally excluded from school and/or those placed on longterm part-time timetables;
Children taken off roll following a lengthy absence due to an extended family holiday taken in term-time;
Children entering or leaving the independent schools sector;
EC nationals who have the right of abode in the UK - this now includes a significant number of asylum seekers granted status by other EC countries and who have subsequently moved to the UK;
Others who have come from abroad to live and/or work in the UK.
What the Local Authority Does Regarding Children who are Missing from
Education
Maintaining a regularly updated central register of all local children know to be missing from education;
Attendance Strategy
advises schools on procedures that must be followed if a child fails to return to school by the date agreed with parents/carers.
Common Transfer Form (CTF)
Admissions and Leavers Database
Choice Adviser
School Admissions
41 . UK Visas and Immigration provides details to the local authority of any asylum seeking families moving into the borough.
Elective Home Education
Independent Schools
Truancy and Beat-Sweep Patrols
Education Welfare Officers (EWOs)
Government Lost Pupil Database (s2s)
Pupil Referral Unit (PRU)
Other Agencies
5.28 Modern Slavery
Victims of modem slavery should be given protection, get the help they need to recover from their experiences and access to the justice they deserve. This chapter sets out guidance on how to identify and respond to a child or young person where there are concerns that they are a victim or a potential victim of modern slavery. It should be read in conjunction with the Makinq a Referral to Children's Social Care Procedure.
Child Sexual Exploitation - Pan Lancashire Standard Operating Protocol
Missinq Children and Families Procedure
International Cross-Border Child Protection Cases Under the 1996 Haque Convention Procedure
This chapter was added to the manual in November 2017.
Contents
Definition
Risk Factors and Vulnerable Circumstances
Indicators
Protection and Action to be Taken
Issues and Challenges
Further Information
Definition
Modern slavery is a form of organised crime in which individuals including children and young people are treated as commodities and exploited for criminal gain. Traffickers and slave drivers trick, force and/or persuade children and parents to let them leave their homes. Grooming methods are used to gain the trust of a child and their parents,
e.g. the promise of a better life or education, which results in a life of abuse, servitude and inhumane treatment.
Child trafficking or child modem slavery is identified as child abuse which requires a child protection response (see Protection and Action to be Taken). It is an abuse of human rights, and all children, irrespective of their immigration status, are entitled to protection under the law.
Children are recruited, moved or transported and then exploited, forced to work or sold. The Modern Slavery Act 2015 (applicable mostly in England and Wales[l] includes two substantive offences i) human trafficking, and ii) slavery, servitude and forced or compulsory labour.
Children are not considered able to give 'informed consent' to their own exploitation (including criminal exploitation), so it is not necessary to consider the means used for the exploitation - whether they were forced, coerced or deceived, i.e. a child's consent to being trafficked is irrelevant and it is not necessary to prove coercion or any other inducement.
Boys and girls of all ages are affected and can be trafficked into, within ('internal trafficking'), and out of the UK for many reasons and all forms of exploitation - e.g. sex trafficking - children can be groomed and sexually abused before being taken to other towns and cities where the sexual exploitation continues. Victims are forced into sexual acts for money, food or a place to stay. Other forms of slavery involve children who are forced to work, criminally exploited and forced into domestic servitude. Victims have been found in brothels or saunas, farms, in factories, nail bars, car washes, hotels and restaurants and commonly are exploited in cannabis cultivation. Criminal exploitation can involve young people as drug carriers, begging and pick-pocketing. Debt bondage (forced to work to pay off debts that realistically they will never be able to), organ harvesting and benefit fraud are other types of modern slavery.
Victims often face more than one type of abuse and slavery, for example they may be sold to another trafficker and then forced into another form of exploitation.
Children and young people may be exploited by parents, carers or family members. Often the child or young person will not realise that family members are involved in the exploitation.
The Modern Slavery Act 2015 (applicable mostly in England and Wales[l]) provides two civil prevention orders - the Slavery and Trafficking Prevention Orders (STPO) and Slavery and Trafficking Risk Order (STRO) and provision for child trafficking advocates.
Some young people may not be victims of human trafficking but are still victims of modern slavery. Slavery, servitude and forced or compulsory labour may also be present in trafficking cases; however, not every young person who is exploited through forced labour has been trafficked. In all cases, protection and support is available through the National Referral Mechanism (NRM) process (in England and Wales[2]). The NRM is a 'victim identification and support process' for all the different agencies that may be involved (e.g. the Police, Home Office, including Border Force, UK Visas and Immigration, local authorities and voluntary organisations). See Referrinq a Potential Victim of Modern Slavery to the National Referral Mechanism (NRM)
[1] Some provisions also concem Northern Ireland and Scotland. Also see the Human Trafficking and Exploitation (Criminal Justice and Support for Victims) Act (Northern Ireland) 2015 and the Human Trafficking and Exploitation (Scotland) Act 2015 [2] (In Scotland and Northern Ireland, however, only trafficking cases (rather than all modern slavery cases) are processed through the NRM
Risk Factors and Vulnerable Circumstances
Victims may not always be recognised by those who come into contact with them. They may be unwilling to come forward to agencies not seeing themselves as victims, or fearing further reprisals from their abusers.
Vulnerable circumstances include:
Poverty, limited opportunities at home, low levels of education, and the effects of war are some of the key drivers that contribute to trafficking of victims;
Poor and displaced families may hand over care of their children to traffickers who promise to provide them with a source of income, education or skills training, but ultimately exploit them;
Wanting to help their families back at home or seeking better futures;
Escaping familial situations of harm and abuse, homelessness or being orphaned;
A lack of equal opportunities, discrimination or marginalisation and social customs such as children being expected to respect and follow the adult in charge. Faith abuse and other specific practices may be used to control the child. A demand for cheap or free labour or a workforce who can be easily controlled and forced into criminal activity;
Unaccompanied, internally displaced children;
Some children may say they are unaccompanied when claiming asylum - the trafficker may have told the child that in doing so they will be granted permission to stay in the UK and be entitled to claim welfare benefits;
Former victims of modern slavery or trafficking;
Trafficked children have an increased risk of going missing from care in the UK, with some rejoining those who exploited them in the first place.
Indicators
Signs that a child has been trafficked may not be obvious, or children may show signs of multiple forms of abuse and neglect. Spotting the potential signs of child slavery/trafficking in referrals and children you work with can include:
A reluctance to seek help - victims may be wary of the authorities for many reasons such as not knowing who to trust or a fear of deportation or concern regarding their immigration status and may avoid giving details of accommodation or personal details;
The child seeming like a willing participant in their exploitation, e.g. involvement in lucrative criminal activity - however this does not mean they have benefitted from the proceeds;
Discrepancies in the information victims have provided due to traffickers forcing them to provide incorrect stories;
An unwillingness to disclose details of their experience due to being in a situation of dependency;
Brought or moved from another country;
An unrelated or new child discovered at an address;
Unsatisfactory living conditions - may be living in dirty, cramped or overcrowded accommodation;
Missing - from care, home or school - including a pattern of registration and de-registration from different schools;
Children may be found in brothels and saunas;
Spending a lot of time doing household chores;
May be working in catering, nail bars, caring for children and cleaning;
Rarely leaving their home, with no freedom of movement and no time for playing;
Orphaned or living apart from their family, often in unregulated private foster care;
Limited English or knowledge of their local area in which they live;
False documentation, no passport or identification documents;
Few or no personal effects - few personal possessions and tend to wear the same clothing;
No evidence of parental permission for the child to travel to the UK or stay with the adult;
Little or no evidence of any pre-existing relationship with the adult or even an absence of any knowledge of the accompanying adult;
Significantly older partner;
Underage marriage.
Physical Appearance - Victims may show signs of physical or psychological abuse, look malnourished or unkempt, or appear withdrawn. Physical illnesses - including work-related injuries through poor health and safety measures, or injuries apparently as a result of assault or controlling measures. There may be physical indications of working (e.g. overly tired in school or indications of manual labour).
Sexual health indicators - sexually transmitted infections, or pregnancy; injuries of a sexual nature and [or gynaecological symptoms.
Psychological indicators - suffering from post traumatic stress disorder which may include symptoms of hostility, aggression and difficulty with recalling episodes and concentrating. Depression/self-harm and/or suicidal feelings; an attitude of self blame, shame and extensive loss of control; drug and or/alcohol use.
Protection and Action to be Taken
Modern slavery is child abuse, and any potential victim of child trafficking or slavery, servitude, or forced or compulsory labour should immediately be referred to Children's Services in the area, as they may be suffering significant harm - see Makinq a Referral to Children's Social Care Procedure.
Once a potential victim has been identified, practitioners should inform them of their right to protection, support, and assistance in any criminal proceedings against offenders.
Practitioners should meet any urgent health needs and arrange emergency medical treatment if appropriate. Local Community Safety Partnerships commission services for victims of modern slavery and should be contacted to identify the relevant services required for victims.
Any agency or individual practitioner or volunteer who has a concern regarding the possible trafficking of a child should immediately make a referral to Children's Social Care. Practitioners should not do anything which would heighten the risk of harm or abduction to the child.
Prompt decisions are needed when the concerns relate to a child who may be trafficked in order to act before the child goes missing (practitioners must be alert that there will be a high risk of the victim going missing from any accommodation due to their pull factors with abusers).
Decision-making following the receipt of a referral will normally follow discussions with the Police, the person making the referral and may involve other professionals and services.
Specific action during the Single Assessment of a child who is possibly trafficked should include:
Seeing and speaking with the child and family members as appropriate - the adult purporting to be the child's parent, sponsor or carer should not be present at interviews with the child, or at meetings to discuss future actions;
Drawing together and analysing information from a range of sources, including relevant information from the country or countries in which the child has lived. All agencies involved should request this information from their counterparts overseas. Information about who to contact can be obtained via the Foreign and Commonwealth Office or the appropriate embassy or consulate in London (see National Contacts);
Checking all documentation held by child, the family, the referrer and other agencies. Copies of all relevant documentation should be taken and together with a photograph of the child be included in the social worker's file.
Even if there are no apparent concerns, child welfare agencies should continue to monitor the situation until the child is appropriately settled.
The Strategy Discussion / Section 47 enquiry should decide whether to conduct a joint interview with the child and, if necessary, with the family or carers. Under no circumstances should the child and their family members or carers be interviewed together.
Professional interpreters, who have been approved and checked, should be used where English is not the child's preferred language. Under no circumstances should the interpreter be the sponsor or another adult purporting to be the parent, guardian or relative.
On completion of a Section 47 Enquiry a multi-agency meeting should be held convened by the social worker, and involving the social worker's manager, the referring agency if appropriate, the Police and other relevant professionals to decide on future action. Further action should not be taken until this meeting has been held and multi-agency agreement obtained to the proposed plan, including the need for a Child Protection Conference and possible Child Protection Plan.
Where it is found that the child is not a member of the family with whom he or she is living and is not related to any other person in this country, consideration should be given to whether the child needs to be moved from the household and/or legal advice sought on making a separate application for immigration status.
Any law enforcement action regarding fraud, trafficking, deception and illegal entry to this country is the remit of the Police and the local authority should assist in any way possible.
Trafficked children may be accommodated by the local authority under Section 20 of the Children Act 1989. The assessment of their needs to inform their Care Plan and should include a risk assessment of how the local authority intends to protect them from any trafficker being able to re-involve the child in exploitative activities. This plan should include plans to prevent the child from going missing and contingency plans to be followed if the child goes missing. Whilst the child is Looked After, residential and foster carers should be vigilant about, for example, waiting cars outside the premises, telephone enquiries etc.
The local authority should continue to share with the Police any information which emerges during the placement of a child who may have been trafficked, concerning potential crimes against the child, risk to other children or relevant immigration matters.
Trafficked children need:
Professionals to be informed and competent in matters relating to trafficking and exploitation;
Someone to spend sufficient time with them to build up a level of trust;
Separate interviews - at no stage should adults purporting to be the child's parent, sponsor or carer be present at interviews or at meetings with the child to discuss future action;
Safe placements if children are victims of organised trafficking operations and for their whereabouts to be kept confidential;
Legal advice about their rights and immigration status;
Discretion and caution to be used in tracing their families;
Risk assessments to be made of the danger if he or she is repatriated; and
Where appropriate, accommodation under Section 20 of the Children Act 1989 or an application of an Interim Care Order.
Referring a Potential Victim of Modern Slavery to the National Referral Mechanism (NRM)
Referrals to the NRM for consideration by the competent authority should be made by the local authority for all potential child victims of trafficking and modern slavery, as they may be entitled to further support - victims can be of any nationality, and may include British national children, such as those trafficked for child sexual exploitation or those trafficked as drug carriers internally in the UK. The NRM does not supersede child protection procedures, so existing safeguarding processes should still be followed in tandem with the notifications to the NRM. See also: How to Report a Victim of Modern Slavery factsheet.
There is no minimum requirement for justifying a referral into the NRM and consent is not required for children. Communicate honestly with the child about your concerns and reasons for referring them into the NRM.
To complete and see where to send the forms, and the associated guidance, visit Modern Slavery Victims: Referral and Assessment Forms.
The Duty to Notify - Local authorities have a duty to notify the Home Office about any potential victims of Modern Slavery. For children, completing the NRM form is sufficient to satisfy this requirement.
If the child or anyone connected to them is in immediate danger the Police should be contacted as normal.
Practitioners must arrange safe accommodation for the potential victim.
Where there is reason to believe a victim could be a child, the individual must be given the benefit of the doubt and treated as a child until an assessment is carried out. An age assessment should only be carried out if appropriate to do so, and should not cause a delay in referring into the NRM.
Practitioners must always ensure that a victim-centred approach to tackling all types of trafficking and modern slavery is taken. This can be achieved by the following:
Dealing with the child sensitively to avoid them being alarmed or shamed building trust, as victims commonly feel fear towards the authorities;
Keeping in mind the child's:
Added vulnerability; o Developmental stage; o Possible grooming by the perpetrator.
It is important that practitioners make careful notes about what is disclosed, as a child's credibility can be challenged if the child is subject to immigration control on the basis of their disclosure being made in instalments. This will support the child and help others understand the process of disclosure.
When questioning a potential victim, initially observe non verbal communication and body language between the victim and their perpetrator.
It is important to consider the potential victim's safety and that of their loved ones. Confidentiality and careful handling of personal information is imperative to ensure the child's safety. Practitioners must not disclose to anyone not directly involved in the case, any details that may compromise their safety.
For further advice and support the Child Traffickinq Advice Centre (CTAC) provides free guidance to professionals concerned that a child or young person is a victim of modern slavery.
Issues and Challenges
Children who are trafficked outside of the UK may intrinsically be linked to the immigration system. Practitioners should be aware of the risk of harm to the child if the adult is not able to confirm their immigration status, to avoid a potential child trafficking situation being misconstrued as an 'immigration matter' and thus preventing victims from being recognised. It is important that plans for the child's long term safety are linked to their immigration status, in order to fully understand the child's real identity and the reasons for not having identification documents or false documentation.
Modern slavery is often hidden in nature, and goes unnoticed in our communities, with under-reporting a major concern. Practitioners have the challenge of reaching out to a vulnerable and an 'invisible' set of children. As well as assessing the significant harm to the child, there will need to be consideration for other key areas such as organised crime, working with UK Visas and Immigration, foreign authorities and the National Crime Agency.
Further Information
Child Traffickinq Advice Centre (CTAC) - helpline for professionals dealing with potential victims of modern slavery Modern Slavery Helpline
Support for victims of modern slavery (GOV.UK)
National Referral Mechanism: Guidance for Child First Responders
Modern slavery: how to identify and support victims
Home Office Circular - Modern Slavery Act 2015
Modern Slavery Act 2015
Modern Slavery Act 2015: Recent developments - Briefing Paper, July 2016 College of Policing - Modern Slavery
Modern Slavery and Human Traffickinq Unit (National Crime Aqency)
Modern Slavery: Duty to Notify Factsheets (GOV.UK, October 2016)
Workinq Witb_Eoreiqn Authorities Guidance
Care of Unaccompanied Miqrant Children and Child Victims of Modern Slavery
NSPCC - Are You a Child Who Has Come to the UK from Another Country? Unseen
Modern Slavery - Royal Colleqe of Nursing Guide for Nurses and Midwiv_es
5.29 Neglect
Neglect is the ongoing failure to meet a child or young person's basic needs.
This includes:
Neglect is the most common form of child abuse. It is dangerous and can cause serious, long-term damage to children and young people. It can result in death.
Neglect Strategies
Blackburn with Darwen Neglect Strategy
Blackpool Neglect Strateqy
Lancashire Multi Agency Neglect Strategy
Neglect Indicators and Toolkits
Blackpool
Lancashire
5.30 Online Safeguarding
RELATED NATIONAL GUIDANCE
Child Exploitation and Online Protection Centre
Chapter 1 : Assessinq need and providing help, Working Together to Safeguard
Children
Pan-Lancashire
Pan-Lancashire LSCB Online Safeguardinq Strategy 2017 - 2019
Bullyinq Procedure
AMENDMENT
In November 2017, this chapter was extensively updated and should be read throughout.
Contents mpac o
Working Practices
Policy Decisions
Communications Policy
Impact of the Online Environment for Information Communication Technology (ICT) on Children and Young People
or use mobile phone cameras to capture violent assaults of other children for circulation;
Working Practices
Where agencies use social media, software and broader communication technologies to monitor if a child is suffering or likely to suffer significant harm, the agency must have in place robust and effective policies and procedures compliant with local information sharing protocols and safeguarding policies.
Policy Decisions
Communications Policy
1 1 . Staff and the Online Safety Policy
12. Enlisting Parents' Support
o The attention of those with parental responsibility will be drawn to the organisation's Online Safety Policy.
For further information, guidance and resources can be found on the below link: http://www.Iancashiresafequardinq.orq.uWonIinesafeguardinq.aspx
5.31 Peer Abuse
LOCAL GUIDANCE
Pan-Lancashire Procedure for Children and Young People Who Display Sexually
Harmful Behaviour (added November 2013)
AMENDMENT
In November 2013, this chapter was updated in line with the Single Assessment Framework.
The needs of children and young people who abuse others should be considered separately from the needs of their victims. This should include both the risk posed to the child and the risk posed by the child;
1 1 . Consideration should be given to separate Strategy Discussions being held for the child who is alleged to have abused another and for the alleged victim(s);
20.1n assessing a child or young person who abuses another, relevant considerations include:
21 Decisions for local agencies (including the Crown Prosecution Service where relevant) according to the responsibilities of each include:
The most appropriate course of action within the criminal justice system, if the child is above the age of criminal responsibility;
o Whether the young abuser should be the subject of a Child Protection Conference;
What plan of action should be put in place to address the needs of the young abuser, detailing the involvement of all relevant agencies.
29.0n completion of the assessment, the same forum will be reconvened to consider the outcome, to review and co-ordinate roles of relevant agencies in providing any identified intervention, including specialist input with regard to service users with special needs. Care must be taken to provide services culturally appropriate to the needs of the child and the family;
Criminal Proceedings
The Child Victim
5.32 Private Fostering
RELATED NATIONAL GUIDANCE
Working Together to Safeguard Children
Lancashire Private Fostering Procedure
Blackpool Private Fostering Procedure
Safeguarding Children and Young People in the Youth Justice System
Procedure
AMENDMENT
In May 2016, Actions for Safeguarding was updated to include all referrals to notify and request assessment for private fostering must be made through local MultiAgency Safeguarding Hub (MASH) arrangements, including by social workers already working with a family. The MASH process will involve checks through Police (PNC, PND & Borders Agency) and determine allocation for assessment.
Contents
Introduction
Principles
Actions for Safeguarding
Raising Awareness
Introduction
with the intention that it should last for 28 days or more.
Any children's home;
Accommodation provided by or on behalf of any voluntary organization;
Any school in which he/she is receiving full-time education;
Any health service hospital;
Any residential care home, nursing home or mental nursing home;
Any other home or institution provided, equipped and maintained by the Secretary of State.
Principles
19.All agencies should encourage parents and carers to notify Children's Social Care of any private fostering arrangements and take steps to check that notification takes place. Assessment of Private Fostering Arrangements will be undertaken using the Single Assessment and will be subject to Children's Social Care case management and supervision arrangements.
Actions for Safeguarding
20.All referrals to notify and request assessment for private fostering must be made through local Multi-Agency Safeguarding Hub (MASH) arrangements, including by social workers already working with a family. The MASH process will involve checks through Police (PNC, PND & Borders Agency) and determine allocation for assessment.
21 Children's Social Care will arrange for a social worker to visit the parents and talk about their child's needs and the proposed private fostering arrangements. The social worker will also visit the person who is fostering, or intends to foster the child within 7 days of receiving notification and will inspect the accommodation. Everyone over 16 years of age will be required to undergo checks including a Disclosure and Barring Service enhanced check.
Raising Awareness
5.33 Radicalisation
The guidance provides advice on how to manage and respond to concerns of children and young people identified as being vulnerable to and affected by the radicalisation of others.
RELATED NATIONAL GUIDANCE
Channel: Protectinq vulnerable people from beinq drawn into terrorism 2015
Prevent Duty Guidance
DfE Prevent Duty Guidance
Association of Directors of Children's Services — Resources Educate Aqainst Hate website (HM Government)
Advice For Local Authorities — Safequardinq Children Returning To The UK
From Syria (Home Office)
AMENDMENT
In November 2017, a link was added to Advice For Local Authorities — Safeguarding Children Returning To The UK From Syria (Home Office) in the Related National Guidance section.
Contents
National Guidance and Strategies
Understanding and Recognising Risks and Vulnerabilities of
Radicalisation
Channel: Referral and Intervention Processes
Local and National Support
Introduction
National Guidance and Strategies
7 The new legislation builds upon the Prevent Strategy 2011, which aims to reduce the threat to the UK from terrorism by stopping people becoming terrorists or supporting terrorists, and has three specific strategic objectives:
Understanding and Recognising Risks and Vulnerabilities of Terrorism or Extremism
21 Potential indicators identified by the Channel Guidance include:
Use of inappropriate language;
Possession or accessing violent extremist literature;
Behavioural changes;
The expression of extremist views;
Advocating violent actions and means;
Association with known extremists;
Articulating support for violent extremist causes or leaders;
Using extremist views to explain personal disadvantage;
Joining or seeking to join extremist organisations;
Seeking to recruit others to an extremist ideology.
22.Annex C of the Channel Duty Guidance 2015 provides the Vulnerability Assessment Framework that Channel Panels will use to guide decision making. It is also a useful tool for agencies to use to guide their assessment and referral decision making processes;
Channel: Referral and Intervention Processes
Diagram 1 : Appropriate, Proportionate Responses and Interventions
Click here to view Diagram 1: Appropriate, Proportionate Responses and Interventions.
Diagram 2: Channel Referral Process
Click here to view Diagram 2: Channel Referral Process.
36. Some concerns which are identified may have a security dimension to them. For this reason, it is important that liaison with the Police forms an early part of all investigations;
37 The named or designated safeguarding professional, in discussion with other professionals (including the local Police Prevent team) as appropriate, will need
to determine the most appropriate level and type of support to offer the child and their family:
40.A discussion with the local Prevent team will advise how the referral can be made;
41 . The Channel Panel will discuss each new referral to determine where multiagency response, co-ordination and review are beneficial. Also at each meeting, all Channel Panel cases will be reviewed to determine if services are effective in safeguarding the child or young person and reducing the risks of radicalisation and extremism. All services, provided at any tier, will have a responsibility to the Channel Panel to regularly report on progress being made.
The local Prevent team on behalf of the Channel Panel chair will co-ordinate responses and attendance to the Channel Panel;
Local and National Support
If you are concerned about the safety or welfare of a child please contact:
Blackburn with Darwen Children's Social Care
Lancashire Children's Social Care
Blackpool Children's Social Care Social Work Team
For Strategic or Policy Support or advice contact Blackburn with Darwen or Burnley Prevent Co-ordinators:
Medina Patel
Prevent Co-ordinator
Community Safety Team
Blackburn with Darwen Borough Council
Environment, Housing & Neighbourhoods
3rd Floor, Old Town Hall
Blackburn
Tel: 01254 585 263
Email: Medina.Patel(Oblackburn.qov.uk
Rob Grigorjevs
Programme & Projects Co-ordinator
Burnley Borough Council
Burnley Town Hall
Manchester Road
Burnley
Lancashire
BB11 9SA
Tel: 01282 477112
Mobile: 07854 784 611
For non urgent safeguarding concerns around terrorism, extremism and radicalisation, email the Police Channel Team on concern@Iancashire.pnn.Police.uk.
Duty Desk: 01772 412 742 (8am to 6pm weekdays).
Out of Hours: Contact Police on 101 or 999 — ask that the Duty Inspector and Force Incident Manager are made aware and make necessary contact with CounterTerrorism Branch.
For advice and arrangements for training: Prevent Teams can be contacted on:
East Lancashire (BwD, Burnley, Pendle etc) — 01254 353 541 ;
, West/South/North Lancashire (Blackpool, Lancaster, Chorley etc) — 01772 209
733;
National Prevent Training can be accessed at the E-LearninA_Traininq on Prevent website (Uome Office);
National E-learning on the Channel Panel can be accessed at the Channel General Awareness website.
5.34 Religious Beliefs and Linked Abuse
RELATED NATIONAL GUIDANCE AND INFORMATION
Working Together to Safeguard Children
Research Report RR750 by Eleanor Stobart: Child Abuse Linked to Accusations of Possession and Witchcraft, (2006)
Safeguarding Children from Abuse Linked to a Belief in Spirit Possession, DCSF (2007).
Further contacts for advice can be found from the local representatives for some faiths from organisations such as the Churches Child Protection Advisory Service (CCPAS) who provide information about exorcism; Churches Together in England and the the Muslim Parliament of Great Britain, all of whom are consulting about and developing guidance.
Complex (Organised or Multiple) Abuse Procedure
Community, Voluntary and Faith Sector Procedure
AMENDMENT
In November 2013, links were added to: Part 3 of this manual for Managing Individual
Cases where there are Concerns about a Child's Safety and Welfare, Community, Voluntary and Faith Sector Procedure and Working Together to Safeguard Children.
Contents
Key Considerations
Definitions and Incidence
Forms of Abuse
Why are Children Abused or Neglected in this Way?
Assessment
Action to Safeguard
Services to Support Children
Concerns about a Place of Worship
Key Considerations
1. The following points can assist in understanding the issues and actions to safeguard children from, abuse or neglect linked to a belief in spirit possession are:
Definitions and Incidence
Forms of Abuse
Why are Children Abused or Neglected in this Way?
o Rationalising misfortune by attributing it to spiritual forces: As in many child abuse cases, abuse linked to a belief in spirit possession generally occurs when problems within a family or in their broader circumstances exist. In these particular cases a spiritual explanation is sought in order
to rationalise misfortune. Child abuse can occur when rationalisation takes the form of believing oneself to be cursed and that a child is the source of the problem because they have become possessed by evil spirits;
A child is scapegoated because of an obvious or perceived difference: The reason why a particular child is singled out and accused of being possessed is complex. It often results from a combination of a weak bond of affection between a child and parent or carer, a belief that the child is violating family norms and above all a perception that the child is 'different I . It may be that the child is being cared for by adults who are not the parents, and who do not have the same affection for the child as their own children. A child can also be viewed as being different for disobedience, rebelliousness, over independence, bedwetting, nightmares, illness, perceived or actual physical abnormality or a disability. Disabilities involved in documented cases included learning disabilities, mental health, epilepsy, autism, a stammer and deafness. Many of the children were also described by their families or carers as being naughty. In other cases there were no obvious reasons, but a perceived issue;
Belief in evil spirits: In the cases identified by Stobart's (2006) research (see Child Abuse Linked to Accusations of Possession and Witchcraft), every child had an accusation of 'evil' made against him or her. This was commonly accompanied by a belief that they could 'infect' others with such 'evil'. The explanation for how a child becomes possessed varies widely but includes through food that they have been given or through spirits that have been in contact with them;
Social factors: A range of social factors that may make a child more vulnerable to accusations of being possessed were also identified by Stobart (2006). These included:
Changes in family structure or dynamics - The research found that children had become more vulnerable following a change in family structure. Carers often had new, transient or several partners. The family structure also tended to be complex so that exact relationships to the child were not immediately apparent. This may mean the child is living with extended family or in a private fostering arrangement. In some cases this may even take on a form of servitude;
A family's disillusionment with life or negative experience of migration - In the majority of identified cases the families were first or second generation migrants to the UK. The research suggested that the families often suffered from the difficulties and stress of migration including isolation from extended family, a sense of not belonging, alienation or feeling threatened or misunderstood, as well as significantly unfulfilled expectations of quality of life;
A parent's or carer's mental health - In over a quarter of identified cases there were concerns for the mental health of a parent or carer. The illnesses involved included post-traumatic stress disorder, depression and schizophrenia.
1 1 . In working to identify such child abuse or neglect it is important to remember every child is different. Some children may display a combination of indicators of abuse whilst others will attempt to conceal them. In addition to the social factors above, there is a range of common features across identified cases. These indicators of abuse, which may also be common features in (other kinds of abuse), include:
Assessment
How do I understand the particular risk of harm to the child?
The completion of a Common Assessment Framework assessment may provide a helpful way of gathering and summarising information about a child so as to clarify whether there is a safeguarding concern or whether other action to assist the child should be undertaken.
How do I build a relationship of trust with the child?
Children and young people will usually stick to their account and not speak until they feel comfortable. It will be important to spend time with the child alone and build a relationship of trust. It is important to ascertain the child's wishes and feelings and understand the environment in which the child lives;
The child must be seen and spoken to on his/her own. Their bedroom or sleeping arrangements must be inspected.
What are the beliefs of the family?
Beliefs in spirits and possession are widespread. The key feature in cases of abuse is not the beliefs of a family, but that the perpetrator of abuse uses these beliefs as a justification for abuse of a child;
You should seek advice if you are dealing with a culture or set of beliefs that you do not understand, or which are unfamiliar to you. Professionals need to have an understanding of religious beliefs and cultural practices in order to help gain the trust of the family or community. The use of correct terminology will help to build up trust with the child and family. Asking questions or seeking advice about a culture, religion, or set of beliefs you are not familiar with.
What is the family structure?
In cases of abuse linked to a belief in possession, the relationship between the child and their carer may be unclear. These cases of abuse will sometimes relate to the arrival of a new adult into the household, or the arrival of the child, perhaps from abroad. What are the roles of the adults in the household? Who looks after the child? Is the child being privately fostered? If the child has recently arrived, what was their care structure in their country of origin? What is the immigration status of the child? The identities and relationships of all members of the household should be identified, including with documentation. It may be appropriate to consider DNA testing.
Are there reasons why the child might be picked on?
Are they different from other children in the family or community? Are they disabled? Have their parents been labelled as possessed?
Do I need a professional interpreter? What is the preferred language of the child and family?
There may be a need for neutral, high quality, gender-appropriate translation or interpretation services. Children should never be expected to interpret on behalf of adults or other family members. If working with a very small community, what is the relationship between interpreter and the family? Are they part of the same social network?
Action to Safeguard
Is there anything you can do to address relevant pressures on the family? These cases of abuse will sometimes relate to blaming the child for something that has gone wrong in the family;
o Anyone with concerns that a child may have suffered, or is likely to suffer Significant Harm linked to spiritual or religious beliefs should follow the procedures in Part 3 of this manual for Managing Individual Cases where there are Concerns about a Child's Safety and Welfare.
Services to Support Children
Concerns about a Place of Worship
21 . Services should consider how best to tackle the concerns, whether intervention is needed to safeguard children and whether concerns can be addressed through influence and engagement.
5.35 Safeguarding Children and Young People in the Youth Justice System
RELATED GUIDANCE
For additional information please see:
Pan-Lancashire Procedure for Children and Young People Who Display Sexually Harmful Behaviour
Mental Health and Behaviour in Schools (DfE)
Contents
Legal Requirements
Actions to Safeguard Children of Prisoners
Legal Requirements
4. All these establishments have a duty to effectively safeguard and promote the welfare of children and young people, which should include:
o Protection of harm from self; o Protection of harm from adults; and o Protection of harm from peers.
o Child protection allegations; o Incidents of self-harm and suicide; and o Incidents of violence and bullying.
Actions to Safeguard
10. The Manager of the Record of Children subject to a Child Protection Plan should be notified of any serious incidents or if a child dies in custody in an establishment in the region. If the child was ordinarily resident in the region, the Serious Case Review Panel will then consider whether to commission a Serious Case Review - see the Serious Case Reviews Procedure.
Children of Prisoners
Where there is concern for the welfare of a prisoner's child within a custodial establishment, the procedures in Part 3, Managing Individual Cases where there are concerns for the welfare and safety of a child, will apply (see Making a Referral to Children's Social Care Procedure).
5.36 Safeguarding Guidance for Early Years Settings
RELATED GUIDANCE
Statutory framework for the early years foundation stage, Setting the standards for learning, development and care for children from birth to five
Contents
Principles
Designated Lead Practitioner for Safeguarding
Procedures — Significant Harm — Immediate Harm
Injuries
Where a Staff Member Believes a Parents/Carer May be Under the Influence of Alcohol or Drugs
Prevent Duty
Confidentiality
Managing Allegations Against Members of Staff or Volunteers
Recommended Documentation
This chapter provides guidance for Early Years settings to support them in their statutory duty to 'take all necessary steps to keep children safe'. This guidance should be used alongside the setting's own safeguarding and child protection policies and procedures and national guidance 'Working Together to Safeguard Children', What to do if you're worried a child is being abused - GOV.UK, and the Prevent Duty 2015.
The purpose of this guidance is to make sure that the actions of any adult in the context of the work carried out by Early Years settings are transparent and safeguard and promote the welfare of all young people.
Early Years registered providers are responsible for ensuring that their staff are competent and confident in carrying out their responsibilities for safeguarding and promoting children's welfare.
Principles
This guidance is underpinned by two key principles:
Safeguarding is everyone's responsibility: for services to be effective each professional and organisation should play their full part; and
A child-centred approach: for services to be effective they should be based on a clear understanding of the needs and views of children.
Designated Lead Practitioner for Safeguarding
The EYFS requires that:
"A practitioner must be designated to take lead responsibility for safeguarding children in every setting. Childminders must take the lead responsibility themselves. The lead practitioner is responsible for liaison with local statutory children's services agencies, and with the LSCP. They must provide support, advice and guidance to any other staff on an ongoing basis, and on any specific safeguarding issue as required."
It is important that all members of staff and any volunteers know who this designated practitioner is, and also what to do if that person is not available when an urgent safeguarding concern arises.
The Role and Responsibilities of the designated lead practitioner are:
To ensure all staff and volunteers are aware of what they should do and who they should go to if they are concerned that a child/young person may be subject to any form of abuse;
To ensure any concerns about a child/young person are acted on promptly, clearly recorded, referred on where necessary and, followed up to ensure the issues are addressed;
To record any reported incidents in relation to a child/young person or breach of Child Protection policies and procedures. This must be kept in a secure place and its contents must be confidential;
To ensure any concerns about the actions of any member of staff, volunteer, or person living or working on the premises are acted on promptly, clearly recorded, referred on where necessary and followed up to ensure the issues are addressed;
To liaise with the Registered Provider and ensure they are fully aware of any serious concerns within the setting;
To ensure information is shared when necessary, in line with Working Together to Safeguard Children guidance, and that information and records are passed on to the appropriate person if the child transfers to another setting or school.
Procedures — Significant Harm — Immediate Harm
Any member of staff who believes that a child may be suffering, or is likely to be at risk of suffering, significant harm, including sexual, physical or emotional abuse or neglect, must make a referral to the Children's Social Care Duty and Assessment Team as follows:
NO ATTEMPT SHOULD BE MADE BY STAFF TO CONDUCT AN INVESTIGATION INTO CASES OF SUSPECTED ABUSE. NO CHILD SHOULD BE TOUCHED OR EXAMINED. Social Care and the Police are responsible for undertaking investigations. Inappropriate actions by others may negate or contaminate evidence.
Key points when making a referral:
Parents should be alerted of your intention to inform the Children's Social Care Duty and Assessment Team, unless you feel this would put the child at further risk;
When speaking to the Children's Social Care, give your name and your role within the setting; (HAVE THE CHILD'S PERSONAL RECORD WITH YOU AND THE RECORD OF THE CONCERN);
Explain your concerns, giving as much information as possible. It may be difficult at the time but try to give clear, concise and accurate information based on your professional judgement. The Social Care Worker will discuss with you any concerns you have about your immediate course of action. For example, if you are caring for a child and the parent is due to collect them;
Obtain and record the name and role of person who you have spoke along with the date and time the telephone call was made;
Ensure all information is recorded accurately and in a timely manner.
Advice
If you are unsure about your referral and wish to have a discussion, you can contact Children's Social Care for advice, you may be put through to one of the Advanced Practitioners or a Social Work Assistant.
Making a referral when the child already has a Social Worker:
If the child you have concerns about already has a Social Worker, telephone them directly. If the Social Worker is unavailable escalate your concerns to a Manager;
Please note: it is not appropriate just to email the social worker in these cases; contact must be made with the social worker/duty worker/team manager by telephone on the same day;
The Social Care Worker will assess the situation and, if required, initiate the appropriate procedures to protect the child. The designated lead practitioner will need to co-ordinate any further action the setting is required to take by the social worker, this may involve gathering information and discussions with other team members;
A record of any discussions and/or actions should be added to the child's safeguarding file;
As with all significant events staff should ensure the chronology at the front of the file is completed.
Professional Disagreements
If the designated lead practitioner has a concern regarding the advice given or action taken once they have referred to Social Care they should follow the Resolving Professional Disagreements (Escalation and Conflict Resolution) Procedure.
Injuries
If a staff member notices a mark or injury on a child they must report the injury to the designated lead practitioner immediately and record that they have done so. Staff should use a body / face map to record the details of an injury/mark, and be as specific as possible about size, shape, location and colouration of any mark or injury.
If a staff member notices a mark or injury on a child on arrival at the setting, the staff member should complete an 'Injuries on Arrival Form' (detailing the time the injury was noticed). This should be done with the person who has brought the child to the setting present, the explanation of the injury should be recorded as described, and the form should be signed by the person bringing the child. The staff member should immediately report this to the designated lead practitioner. If a staff member does not notice the mark or injury on arrival but later into the session then they must complete an 'Injuries on Arrival Form' retrospectively (detailing the time the injury was noticed). The staff member should immediately report this to the designated lead practitioner. The injury should be discussed with the parent when they return, explanation recorded and the form signed retrospectively.
If the child with an injury has a Social Worker then the designated lead practitioner must immediately report it to them (by telephone and then followed up in writing). If the Social Worker is unavailable by telephone concerns should be discussed with a duty social worker or a team manager. Please note: it is not appropriate just to email the social worker in these cases; contact must be made with the social worker/duty worker/team manager by telephone, on the same day.
If the child with an injury does not have a Social Worker then the designated lead practitioner would use their professional judgement to assess the situation. This may involve seeking advice from Social Care depending on the nature of the injury and any history of injuries, in most cases however the designated lead practitioner would usually ask the child's Key Worker/Person to speak to the child's parent and ask how the injury occurred. This information given by the parent must be immediately shared with the designated lead practitioner and accurately recorded. The lead practitioner will then assess using their professional judgement if the explanation is plausible and consistent with the children's development level or whether it is a safeguarding issue (if it is safeguarding a cause for concern will be actioned).
When noting explanations from parents/carers regarding injuries staff should record whether a parent/carer volunteered the information on arrival or whether the staff member had to ask for the explanation.
Where a Staff Member Believes a Parents/Carer May be Under the Influence of Alcohol or Drugs
If parent/carer presents at a setting and a member of staff feels the parent/carer maybe under the influence of Alcohol or Drugs staff member should immediately alert the designated lead practitioner. If it is felt that the parent/carer is impaired to such an extent that they are not able to care for the child, and letting the child leave the setting with them would put them at risk, the practitioner should ask if there is another family member who could collect and care for the child. If there is no other suitable and responsible adult available, the setting should contact Children's Social Care, and if necessary to prevent the parent from taking the child, the Police. If the parent/carer is not presenting as impaired, the incident should be recorded and any repeat occurrences should be discussed with the parent, including undertaking an Early Help assessment and signposting to alcohol and substance misuse services where appropriate.
Prevent Duty
See: Radicalisation Procedure.
Section 36 to 41 of the Counter-Terrorism and Security Act 2015 sets out the duty on Local Authorities and partners of local Panels to provide support for people vulnerable to being drawn into terrorism. In England and Wales this duty is the Channel programme. The term "Channel" refers to the duty as set out in the Counter Terrorism and Security Act. Channel is a key aspect of the Prevent strategy which in turn is a fundamental part of the UK Governments Counter Terrorism Strategy (CONTEST).
Channel is a multi-agency approach to protecting people at risk from radicalisation. Channel uses existing collaboration between local authorities and statutory partners to:
Identify individuals at risk of being drawn into terrorism;
Assess the nature and extent of that risk;
Develop the most appropriate support plan for the individuals concerned.
Channel is focused around safeguarding children and adults who may be at risk of being drawn into committing terrorist-related activity. Channel uses early intervention to protect and divert people away from the risks they face before the threat from extremism and violent extremism is posed.
Confidentiality
See: Information Sharing and Confidentiality Procedure.
Personal information about children and families held by professionals and agencies is subject to a legal duty of confidentiality and should not normally be disclosed without the consent of the family. The law does however permit the disclosure of confidential information without permission if it is necessary to safeguard a child or children; this includes cases of Safeguarding. In addition all staff must follow their own setting's confidentiality policy.
Keeping children safe from harm requires people who work with children to share information - see Information sharing: advice for safeguarding practitioners.
Managing Allegations Against Members of Staff or Volunteers
See: Allegations Against Persons who Work with Children (Including Carers and Volunteers) Procedure.
All staff are required to disclose any convictions, cautions, court orders, reprimands and warnings which may affect their suitability to work with children (whether received before or during their employment at the centre). Providers must not allow people, whose suitability has not been checked, including through a Disclosure and Barring Service (DBS) check, to have unsupervised contact with children being cared for. If you have information which suggests an adult who works with children (in a paid or unpaid capacity) has:
Behaved in a way that has harmed or may have harmed a child;
Possibly committed a criminal offence against, or related to, a child;
Behaved towards a child/ren in a way that indicated s/he is unsuitable to work with children.
You should speak immediately to the designated lead practitioner. They should consult with/make a referral to the LADO (Local Authority Designated Officer) Safeguarding Children Unit.
Please note: If the designated lead practitioner is implicated in the concerns, the matter should be discussed with someone of responsibility within the setting if possible, for example the manager or registered provider. If this is not possible, the person with the concem should discuss the concem directly with the LADO.
Ofsted must also be informed on: 0300 1231231 as soon as is reasonably practicable, but at the latest within 14 days of the allegation being made.
Recommended Documentation
Safeguarding Notification - Initial Cause for Concern Form;
Body Map;
Safeguarding Notification - Subsequent Report Form;
Safeguarding Children Meeting - Attendees Own Record of Meeting;
Early Years Setting internal Action Plan for work with families on a statutory plan (level 4);
Safeguarding Notification - Final Report Form;
Safeguarding File Chronology Form;
Injuries on Arrival.
5.37 Self-Harm or Suicidal Ideation
RELATED NATIONAL GUIDANCE
Chapter 1 : Assessing need and providing help, Working Together to Safeguard Children
Mental Health and Behaviour in Schools (DfE)
RELATED GUIDANCE
Prompt sheet for people working with children who self-harm or have the potential for suicide
Contents
Introduction
Who is this Document for?
Definitions to Support the Care Pathway Why do some Young People Self-Harm?
Risk Factors
Responding to Self-Harm
Levels of Risk and Suggested Action
Do's and Dont's
Appendix 1 - Care Pathway
Appendix 2 - Checklist for Agencies/EstabIishments - Supporting the Development of Effective Practice
Introduction
Who is this Document for?
Definitions to Support the Care Pathway
, Child
This is any child under the age of 18.
Suicide is an intentional, self-inflicted, life-threatening act resulting in death from a number of means.
This is indicated by evidence of premeditation (such as saving up tablets), taking care to avoid discovery, failing to alert potential helpers, carrying out final acts (such as writing a note) and choosing a violent or aggressive means of deliberate self-harm allowing little chance of survival.
Self-harm
"Self-harm might be described as the term used to describe the coping strategy that some people use to deal with stresses in their life:
Cutting, often to the arms using razor blades, or broken glass;
Burning using cigarettes or caustic agents;
Punching and Bruising;
Inserting or swallowing objects;
Head banging;
Hair pulling;
Restrictive or binge eating;
Overdosing;
Problematic substance misuse;
Frequent and repetitive risk taking behaviour e.g. taking away and driving cars, 'playing chicken'.
(Mental Health Foundation 2006)
The term self-harm is often used as an all encompassing term referring to suicidal ideation and attempted suicide.
Why do some Young People Self-Harm?
To express emotional distress: "you're showing other people how much you're hurting inside"; (Bywaters and Rolfe 2002)
Release and relief from pressure: "it's like a release. It feels better after I've taken tablets"; (Spandler 1996)
Letting bad feelings 'out': "getting all the anger and the hurt out, and the pain"; (Bywaters and Rolfe 2002)
Distraction from emotional pain: "Taking the pain away from what's in your head and transferring it onto your body"; (Bywaters and Rolfe 2002)
To gain control over seemingly out-of-control situations and feelings: "You've got to have control over something"; (Spand/er 1996)
To induce a pleasurable state: "my whole body goes kind of calm", (Bywaters and Rolfe 2002)
To feel special, to express individuality: "l took a certain pride in being able to take pain. It was like I was good at something"; (Spandler 1996)
To physically express emotional pain: "it's my way of turning emotion and pain, and things like that into something physical, which is a lot easier to handle in the long-run (Bywaters and Rolfe 2002)
13. According to 'Youth and self-harm" (Samaritans 2002), the most common reasons given for self-harm by school-age young people were 'to find relief from a terrible state of mind'. Contrary to popular belief, few were 'trying to frighten someone' or 'get attention'.
Risk Factors
Issues that may trigger self-harm
14.A number of factors may trigger the self-harm incident:
Family relationship difficulties (the most common trigger for younger adolescents);
Difficulties with peer relationships e.g. break up of relationship (the most common trigger for older adolescents);
Bullying;
Significant trauma, e.g. bereavement, abuse;
Self-harm behaviour in other students (contagion effect);
Self-harm portrayed or reported in the media;
Difficult times of the year (e.g. anniversaries);
Trouble in school or with the Police;
Feeling under pressure from families, school and peers to conform/achieve;
Exam pressure;
Times of change (e.g. parental separation/divorce).
Individual factors:
Previous deliberate self-harm or suicide attempt;
Intent - does the young person wish to die? What do they understand by death? Do they think that what they have done, or are planning to do, will kill them? N.B. it is the young person's perception of or belief in potential lethality that is important here, not what a professional thinks;
Evidence of mental illness, especially depression, anxiety, psychosis or eating disorder;
Poor problem-solving skills - are problems seen as over-whelming? Does the young person see themselves as capable of solving, or coping with, problems? Have they been able to solve problems in the past? May be linked to poor communication skills;
Impulsivity/planning - Were steps taken to avoid discovery? Were any preparations for death made? A tendency to impulsive behaviour may increase risk of repetition and thus the likelihood of significant harm, but evidence of planning may indicate higher levels of seriousness for any given attempt. But remember that an impulsive act can be just as damaging as a planned one;
Substance use including alcohol and volatile substances (especially important in impulsive males);
Hopelessness - is there a future, or any reason to continue living? What plans for the future does the young person have? This has been described as "the missing link" between depression and suicide. It can be especially significant if there has been previous deliberate self-harm or attempts at suicide;
Anger/hostility/anti-social behaviour - some research suggests conduct disorder may be a higher risk factor than depression. This may be difficult to assess, as information will be needed from sources other than the young person;
Low self esteem;
Drug or alcohol abuse.
Family factors:
Instability (this can mean more than divorce or separation and can include repeated house moves). History of depression, deliberate self-harm, suicide or mental illness in the family, especially in first-degree relatives. History of substance use. Arguments or disputes can be important;
History of neglect or abuse, whether physical, emotional or sexual, but especially the latter;
Has the young person experienced prolonged parenting style characterised by "High Criticism and Low Warmth"?
Experiencing or witnessing domestic abuse;
Loss or bereavement - this may include such things as loss of status as well as deaths. Anniversaries of losses can be significant;
Unreasonable expectations;
Poor parental relationships and arguments.
Social factors:
Persistent bullying, peer rejection or other victimisation, such as experiencing racial or sexual discrimination, and including homophobic bullying (see next point);
Issues of gender or sexual orientation - a very high proportion of young people who either are homosexual or think they might be, self-harm or attempt suicide;
Current stressors or life events;
Absence of a supportive helping network (could be family, extended family, peers, or professional);
Absence of a trusted approachable adult;
Difficulty in making relationships/loneliness;
Easy availability of drugs, medication or other methods of self-harm.
Other considerations:
Function of deliberate self-harm (other than a clear suicide attempt) - what did the young person hope the act would achieve: a sense of relief or release; punishment; purification; a desire to feel physical rather than emotional pain; a form of communication of distress or other significant matter; something else?
Method of self-harm - be aware of unintended consequences, such as liver damage from repeated 'Paracetamol' overdoses, stomach ulceration from aspirin overdose, brain damage from oxygen starvation in attempted hanging, drowning or exhaust poisoning, or bone damage resulting from jumping;
Time of year may be significant, especially when school-related factors are involved, such as bullying or exams. Hence the start of terms or exam periods may see an increase in self-harming behaviour;
Young people may be highly ambivalent in their views of themselves and any act of self-harm.
Responding to Self-Harm
Immediate response to injuries
It is ok and appropriate to show concern. Make sure the child / young person is safe; give them something to treat any injuries (e.g. plaster or bandage) and/or seek medical advice and attention as required. Encourage the young person to seek medical attention if they are reluctant and provide the necessary support to facilitate this.
The young person who has just harmed themselves usually feels upset and vulnerable (although they may hide this). Just because they caused the harm to themselves this does not mean that they will not feel hurt, frightened or shocked by their injuries. Be reassuring rather than questioning them at this stage. They may want to talk, so allow for this.
People often fear that being sympathetic will somehow 'reinforce' the behaviour as an 'attention-seeking' strategy, thereby perpetuating it and possibly making it worse. In fact, being punitive, hostile or withholding care and support is likely to make the young person feel even worse about themselves, thereby increasing risk. (However, avoid 'amateur' psychology and/or therapy at all costs, unless you are trained and/or qualified to provide either or both!)
Messages to give young people
15. It is usual for people to feel shocked, frightened, anxious and/or upset when they first encounter a child or young person who is self-harming. However, the messages that adults give at this initial point of contact are crucial:
Calmness - Remain calm and do not openly display the very powerful feelings of shock, anger, distress or panic that you may have;
Acceptance - Tell the young person that it is okay to talk about selfharm, it is something that you know about and can handle;
Acknowledgement - Tell the young person how hard it can be to talk about this and acknowledge the courage that it takes to do so;
Concern - Demonstrate that you are concerned about the distress which lies behind the self-harm;
Understanding - Make it clear that self-harm is something that can be understood, that there are reasons for it and that other young people do it too - they are not alone;
o Respect and Reassurance - Acknowledge their use of this particular coping strategy and with how frightening it might feel if they think someone is going to take it away;
Hope - Some people who self-harm think it absolutely impossible to stop; let them know that lots of people who do it are able to stop hurting themselves;
Information - Provide information about appropriate resources and sources of further help, advice and support but do not rush the young person on to someone else; remember that being available to listen and talk is important in itself and avoids giving messages of being fobbed off or that the problem is simply too big for anyone to deal with);
Confidentiality - Respect confidentiality whilst ensuring that appropriate procedures are followed. The 'usual' balance needs to be struck here e.g. make it clear why and to whom you may have to pass information on and encourage and support a young person to talk to an appropriate person. (See Information Sharing and Confidentiality Procedure)
Levels of Risk and Suggested Action
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Suicidal thoughts are fleeting and soon dismissed |
Ease distress as far as possible. Consider what may be done to resolve difficulties |
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No plan |
Link to other sources of support |
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Few or no signs of depression |
Make use of line management or supervision to discuss particular cases and concems |
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No signs of psychosis |
Review and reassess at agreed intervals |
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No self-harming behaviour |
Consider completing a CAF |
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Current situation felt to be painful but bearable |
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Suicidal thoughts are frequent but still fleeting |
Ease distress as far as possible. Consider what may be done to resolve difficulties |
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No specific plan or immediate intent |
Consider safety of young person, including possible discussion with parents/carers or other significant figures |
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Evidence of current mental disorder, especially depression or psychosis |
Seek specialist advice |
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Significant drug or alcohol use |
Possible mental health assessment discussion with, for example, service's safeguarding champion, primary mental health workers in CAMHS/AMHS |
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Situation felt to be immediate crisis |
painful, |
but no |
Consider consent issues for the above |
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Previous, especially attempt |
recent, |
suicide |
Consider increasing levels of support/professional input |
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Current self-harm |
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Review and reassess at agreed intervals - likely to be quicker than if risk is low |
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Frequent suicidal thoughts, which are not easily dismissed |
Ease distress as far as possible. Consider what may be done to resolve difficulties |
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Specific plans with access to potentially lethal means |
Safety - discussion with parents/carers or other significant figures more likely |
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Evidence of current mental illness |
Request for Specialist CAMHS involvement |
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Significant drug or alcohol use |
Consider consent issues |
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Situation felt to be causing unbearable pain or distress |
Consider increasing levels of suppoffprofessional input in the mean time |
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Increasing self-harm, either frequency, potential lethality or both |
Monitor in light of level of Specialist CAMHS involvement |
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N.B. at any time during assessment and review, emergency medical treatment may be found to be necessary or child protection concerns may be raised. See Making a Referral to Children's Social Care Procedure.
Direct referral route to Specialist or Emergency Care
Do's and Dont's
Do's
Make an assessment of risk e.g. emergency medical attention;
Take suicide gestures seriously;
Be yourself, listen, be non-judgemental, patient, think about what you say;
Check associated problems such as bullying, bereavement, relationship difficulties, abuse, and sexuality questions;
Check how and when parents will be contacted;
Encourage social connection to friends, family, trusted adults;
Implement initial care pathway;
Implement support/contact with young person;
Seek risk assessment from those in your service who have been trained to provide this level of assessment;
Make appropriate referrals;
Using CAF processes set up a meeting to plan the care pathway interventions based upon an understanding of the risks and difficulties;
Provide opportunities for support, and to strengthen existing support systems.
Don'ts
Jump to quick solutions;
Dismiss what the children or young people are saying;
Believe that a young person who has threatened to harm themselves in the past will not carry it out in the future;
Disempower the child or young person;
Ignore or dismiss people who self-harm;
See it as att