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Pan Sussex LSCB Manual - Volume 1

Volume 1 - Contents

1. Introduction
1.1 Introduction
1.2 Shared beliefs
1.3 Relevant staff
1.4 Accessing and updating procedures
1.5 Terminology
2. Information sharing and confidentiality
2.1 Introduction
2.2 Six key points on information sharing
2.3 Core guidance on sharing information
2.4 Further information to inform decision making
2.5 Key sources of further guidance
3. Recognition and referral
3.1 Definitions
3.2 Risk indicators
3.3 Professional response
3.4 Response by members of the public
4. Response and assessment
4.1 Common Assessment Framework (CAF)
4.2 Framework for assessing children in need and their families
4.3 Screening referrals
4.4 Initial assessment
4.5 Core assessment
5. Child protection enquiries
5.1 Significant harm
5.2 S.47 enquiries and the assessment framework
5.3 Threshold for S.47 enquiries
5.4 Single and joint agency investigations
5.5 Role of duty and allocated social worker
5.6 Immediate protection
5.7 Agency information sharing
5.8 Strategy discussion
5.9 Undertaking S.47 enquiries
5.10 Paediatric assessment
5.11 Analysis and assessment of risk
5.12 Outcome of child protection enquiries
5.13 Timescales
5.14 Recording of S.47 enquiries
6. Child protection conferences
6.1 Guiding principles
6.2 Types of child protection conference
6.3 Membership of child protection conference
6.4 Involving children and family members
6.5 Exclusion of family members from a conference
6.6 Absence of parents and/or children
6.7 Information for a conference
6.8 Chairing conferences
6.9 Actions and decisions of the conference
6.10 Challenges by professionals and parents
6.11 Administrative arrangements and record keeping for child protection conferences
6.12 Complaints by service users
6.13 Resolution of professional disagreement
7. Implementation of protection plan
7.1 Introduction
7.2 Core group
7.3 Formulation of child protection plan
7.4 Key worker role
7.5 Children's social care first line manager role
7.6 Further assessment
7.7 Intervention
7.8 Children subject to a child protection plan who go missing
7.9 Death of a child subject to a child protection plan
8. Specific circumstances
8.2 Children involved in prostitution
8.20 Pre-birth child protection procedures
8.28 Sexual activity
8.29 Unexplained child deaths

Appendices
1. Assessment framework
2. Flowcharts
3. Statutory framework
3.1 Introduction
3.2 Children Act 2004
3.3 Education Act 2002
3.4 Children Act 1989
3.5 Homelessness Act 2002
4. Glossary of terms
5. National and local contacts


Volume 2 - Contents

8. Specific circumstances
8.1 Child abuse and information communication technology
8.2 Children involved in prostitution
8.3 Children who significantly harm other children
8.4 Child witnesses in criminal prosecution and pre-trial therapy support
8.5 Complex abuse
8.6 Criminal injuries compensation scheme
8.7 Disabled children
8.8 Domestic violence
8.9 Fabricated or induced illness
8.10 Female genital mutilation
8.11 Forced marriage of a child
8.12 Foreign exchange visits
8.13 Historical abuse allegations
8.14 Learning disabled parent or carer
8.15 Looked after children
8.16 Missing and transient child, adult or family
8.17 Parental mental health
8.18 Parent or carer involvement in prostitution
8.19 Parental substance misuse
8.20 Pre-birth child protection procedures
8.21 Procedures for managing allegations against people who work with children
8.22 Racial and religious harassment
8.23 Safeguarding children from abroad
8.24 Safeguarding children at risk of trafficking and exploitation
8.25 Self-harm and suicidal behaviour
8.26 Surrogacy
8.27 Uncooperative or hostile parents
8.28 Sexual activity
8.29 Unexplained child death Protocol
8.30 Use of interpreter, signer or others with special communications skills
8.31 Violence towards staff
8.32 Vulnerability of children living away from home
8.33 Young carers
9. Roles and responsibilities
9.1 All agencies
9.2 Armed forces
9.3 British Transport police
9.4 Children and Families Court Advisory and Support Service (CAFCASS)
9.5 Connexions
9.6 Commission for Social Care Inspection (CSCI)
9.7 Faith communities
9.8 Fire and rescue authority
9.9 Health services
9.10 Immigration
9.11 Local authorities
9.12 NSPCC
9.13 Office for Standards in Education (OFSTED)
9.14 Police
9.15 Prison service and high secure hospitals
9.16 Probation service
9.17 RSPCA
9.18 Refugee council
9.19 Schools and further education institutions
9.20 Secure training centres
9.21 Sports clubs
9.22 Voluntary agencies or groups
9.23 The wider community
9.24 Young offender institutions
9.25 Youth Offending Team
10. Risk management of known offenders
10.1 Register of sexual offenders
10.2 Multi-agency public protection meetings (MAPPA)
10.3 Developing intelligence about organised or persistent offenders
10.4 Release of prisoners convicted of offences against children
10.5 Parole or temporary release of prisoners convicted of offences against children
10.6 Assessment of young people accused, finally warned about, or convicted of offences against children
10.7 Identified offenders and others who may pose a risk to children
10.8 Disclosure of information by a local authority
10.9 Visit by a child to high secure hospitals and prisons
11. Strategic management
11.1 Definition of safeguarding and promoting welfare
11.2 The establishment of the Local Safeguarding Children Board (LSCB)
11.3 Specific arrangements in the LSCB
11.4 Arrangements regarding children subject to a child protection plan
11.5 Arrangements regarding recruitment and selection
11.6 Arrangements for training staff
11.7 Relationship of policy, procedures and guidance
12. Serious case reviews
12.1 Purpose of a serious case review
12.2 Criteria
12.3 Decision to hold a serious case review and notification
12.4 Determining the scope of the review
12.5 Individual agency reports
12.6 LSCB review group overview report
12.7 LSCB action on the overview report
12.8 Timing
12.9 Communication with staff
12.10 Accountability and disclosure
12.11 Learning lessons locally
12.12 Concurrent processes
12.13 Reviewing institutional abuse

Appendices
1. Assessment framework
2. Flowcharts
3. Statutory framework
3.1 Introduction
3.2 Children Act 2004
3.3 Education Act 2002
3.4 Children Act 1989
3.5 Homelessness Act 2002
4. Glossary of terms
5. National and local contacts
6. Bibliography


Preface

The responsibility for safeguarding children belongs to everyone. Children will only be safe if families, communities and professionals work together to promote their welfare.

All children should be safe and able to develop to their full potential. The protection of vulnerable children is vital and child protection procedures must be effective and work consistently across organisational boundaries.

Three Local Safeguarding Children Boards (Brighton and Hove, East Sussex and West Sussex) commissioned the policies and procedures in this manual.

The Sussex Procedures Sub-Group will continue to keep these procedures under review to take account of changes in legislation, government policy, research findings and professional experience.

Proposals for additions or amendments should be directed to the chair of the Sussex Procedures Sub-Group.

Acknowledgments

This document reflects materials, advice and information provided by central and local government, police, health services, probation, as well as many other voluntary organisations and individuals.

Thanks are also due to the steering group who supported and advised on production of this manual.

The Procedures Group would also like to thank Children Act Enterprises for their significant contribution to the development of these procedures.


1. Introduction

1.1 Introduction
1.2 Shared beliefs
1.3 Relevant staff
1.4 Accessing and updating procedures
1.5 Terminology


1.1 Introduction

1.1.1 The production of this multi-agency manual reflects a significant consensus about best practice across the 3 LSCBs, and all those agencies in Sussex that contribute to the prevention, detection and investigation of abuse or neglect, risk management of offenders and the support and treatment of those affected.
1.1.2 The manual reflects current legislation as at 01.06.06, government statutory guidance and expectations, and accepted best practice. Area Child Protection Committees (ACPC) were replaced by 'Local Safeguarding Children Boards (LSCBs) on 01/04/06 and so LSCB is used throughout.
1.1.3 This manual incorporates, and therefore replaces, current ACPC procedures.
1.1.4 It is anticipated that the 3 relevant LSCBs, East Sussex, West Sussex, Brighton & Hove, will henceforth contribute to the further development of this single Sussex - wide document.
1.1.5 Each LSCB has made provision in Appendix 5 for the inclusion of information relevant to its own area e.g. contact details of key staff / LSCB membership etc.

1.2 Shared beliefs

1.2.1 The needs of the child are paramount and should underpin all child protection work and resolve any conflict of interests.
1.2.2 All children deserve the opportunity to achieve their full potential.
1.2.3 All children have the right to be safeguarded from harm and exploitation whatever their:
  • Race, religion, first language or ethnicity
  • Gender or sexuality
  • Age
  • Health or disability
  • Location or placement
  • Any criminal behaviour
  • Political or immigration status
1.2.4 Responsibility for the protection of children must be shared because children are safeguarded only when all relevant agencies and individuals accept responsibility and co-operate with one another.
1.2.5 Statements about, or allegations of abuse, or neglect made by children, must always be taken seriously.
1.2.6 The wishes and feelings of children are vital elements in assessing risk and formulating protection plans, and must always be sought and given weight according to the level of understanding of the child.
1.2.7 During enquiries, the involvement and support of those who have parental responsibility for, or regular care of a child, should be encouraged and facilitated, unless doing so compromises that enquiry or the child's immediate or long term welfare.
1.2.8 Practitioners should be aware that to facilitate social inclusion and equality of potential outcome, they should take all reasonable steps to support parents and children who have experienced racism and other forms of prejudice. This stance needs to be incorporated into planning, delivering, monitoring or providing training about child protection services.

1.3 Relevant staff

1.3.1 The contents of this manual are for application by staff in the following agencies with responsibilities for children living, or present in East and West Sussex and Brighton and Hove.
  • Children's social care
  • Sussex Police
  • All Health Services
  • All local authority staff including housing, education, Libraries, Youth & Leisure Services
  • All staff working with Schools and Further Education Colleges
  • Probation, Youth Offending Teams (YOTs) & Prison Service
  • Children & Families Courts Advisory & Support Service (CAFCASS)
  • Early Years Development Child Care Partnerships (EYDCPs)
  • Office for Standards in Education (OfSTED)
  • Commission for Social Care Inspection (CSCI)
  • Sure Start, Children's Fund and Connexions
  • Fire & Emergency Planning Authority
  • Ambulance Service
1.3.2 Although compliance with the expectations in this manual cannot be enforced, it is hoped that the following individuals and non-local agencies will put in writing that they will conduct their operations in a manner consistent with the procedures contained within it:
  • Elected Members
  • Crown Prosecution Service (CPS)
  • Immigration & Nationality Department (IND)
1.3.3 Where LSCB agencies commission services from private or voluntary organisations, they should seek to make compliance with this document a contractual requirement.

1.4 Accessing and updating procedures

1.4.1 Relevant staff with the required technology will be able to access a 'read only' version of these procedures. To facilitate ease of use on screen, hypertext links have been used to link entries in the contents page with relevant text.
1.4.2 Hypertext links have additionally been used to link the contents page of each chapter with the relevant text and for cross references throughout the manual. Those without access to a computer should have access to a hard copy.
1.4.3 The manual is scheduled for regular review at intervals not exceeding 3 years. Any urgent amendment, which cannot await the next scheduled edition, will (following formal agreement by the pan Sussex Procedures Sub-Group) be circulated by e-mail to the senior child protection manager in each local authority as well as to LSCB chairpersons and named individuals in the police and other agencies.
1.4.4 Senior child protection managers will be asked to act on behalf of their LSCB and accept responsibility for:
  • Distribution of the manual to staff and relevant agencies
  • Forwarding revised electronic versions and overseeing distribution of updated hard copies to those on the circulation list
  • Agreeing and inserting relevant local information in Appendix 5
  • Seeking and collating proposals for amendments and development of the manual

1.5 Terminology

1.5.1 A glossary of terms which have a technical significance or for which abbreviations have been used in the text, is provided at the end of this volume
1.5.2 To facilitate understanding of the procedures, users should note that the following social work related terms are used throughout the text:
  • Child to refer to anyone under 18 years old
  • Children's social care refers to the functional division within what have traditionally been termed social services departments which provide support, protection and care services to families and children
  • Social worker describes the practitioner with case responsibility (for children subject to a child protection plan this will be a registered social worker) NOTE: you cannot call yourself a social worker unless you are registered
  • Duty social worker to describe the departmental point of contact with respect to new referrals, closed or unallocated cases or cover provided for the unavailability of a named member of staff
  • Supervising social worker (link or family placement worker or fostering officer) to describe the practitioner working with foster carers
  • First line manager describes the team manager responsible for a team of social workers or her/his assistant, or practice manager / supervisor
  • Service manager refers to the second line manager to whom a first line manager reports (sometimes called operational manager)
  • Child protection adviser to refer to the officer in Children's social care who offers off line advice and/or provides chairing of child protection conferences (independent reviewing officer in Brighton & Hove)
  • Senior child protection manager refers to the person responsible for the database of children subject to child protection plans, conference chairs and the provision of specialist advice, and child protection advisors.


2. Information sharing and confidentiality

This chapter duplicates the information in 'Information sharing - a practitioner's guide', published by Central Government in 2006

2.1 Introduction
2.2 Six key points on information sharing
2.3 Core guidance on sharing information
2.4 Further information to inform decision making
2.5 Key sources of further guidance

2.1 Introduction

2.1.1 The aim of this cross-Government guidance is to improve practice by giving practitioners across children's services clearer guidance on when and how they can share information legally and professionally. This document summarises in one page, six key points for practitioners to remember on information sharing in respect of children and young people (see Section 2.2, Six key points on information sharing);
2.1.2 Sharing information is vital for early intervention to ensure that children and young people with additional needs get the services they require. It is also essential to protect children and young people from suffering harm from abuse or neglect and to prevent them from offending.
2.1.3 Improving information sharing practice is therefore a cornerstone of the Government Every Child Matters strategy to improve outcomes for children. This guidance complements and supports wider policies to improve information sharing across children's services.
2.1.4 These include:
  • the statutory guidance under the Children Act 2004 for agencies covered by the duty to co-operate to improve well-being and by the duty to safeguard children and promote their welfare;
  • the revised Working Together to Safeguard Children (DfES, 2006). The statutory guidance sets out how organisations and individuals should work together to safeguard and promote the welfare of children;
  • the Common Assessment Framework for children and young people (CAF), a shared assessment tool used across services to avoid children and families having to tell and retell their story and to help practitioners develop a greater shared understanding of a child's needs;
  • the lead professional to coordinate action if more than one service is involved;
  • the Common Core of Skills and Knowledge for the Children's Workforce (DfES, 2005) for everyone working with children, young people and families;
  • the Sure Start Children's Centres Practice Guidance (DfES, 2005), which focuses on identifying and intervening in the most disadvantaged and hard-to-reach families;
  • the information sharing index, to be rolled out across local authorities by end 2008, which will help practitioners contact one another more easily and more quickly to support earlier intervention and stop children falling through the net;
  • the statutory guidance to support the Multi-Agency Public Protection Arrangements (MAPPA), which form the basis of public protection, including protection to children, and which operate on a multi-agency partnership basis throughout England and Wales.
2.1.5 It is important that practitioners understand when, why and how they should share information so that they can do so confidently and appropriately as part of their day-to-day practice. This document seeks to give practitioners clear practical guidance; drawing on experience and on the consultation we have carried out.

2.2 Six key points on information sharing

2.2.1 You should explain to children, young people and families at the outset, openly and honestly, what and how information will, or could be shared and why, and seek their agreement. The exception to this is where to do so would put that child, young person or others at increased risk of significant harm or an adult at risk of serious harm, or if it would undermine the prevention, detection or prosecution of a serious crime (see glossary for definition) including where seeking consent might lead to interference with any potential investigation.
2.2.2 You must always consider the safety and welfare of a child or young person when making decisions on whether to share information about them. Where there is concern that the child may be suffering or is at risk of suffering significant harm, the child's safety and welfare must be the overriding consideration.
2.2.3 You should, where possible, respect the wishes of children, young people or families who do not consent to share confidential information. You may still share information, if in your judgement on the facts of the case, there is sufficient need to override that lack of consent.
2.2.4 You should seek advice where you are in doubt, especially where your doubt relates to a concern about possible significant harm to a child or serious harm to others.
2.2.5 You should ensure that the information you share is accurate and up-to-date, necessary for the purpose for which you are sharing it, shared only with those people who need to see it, and shared securely.
2.2.6 You should always record the reasons for your decision - whether it is to share information or not.

2.3 Core guidance on sharing information

Why Information Sharing is Important

2.3.1 Sharing information is essential to enable early intervention to help children, young people and families who need additional services to achieve positive outcomes, thus reducing inequalities between disadvantaged children and others. These services could include additional help with learning, specialist health services, help and support to move away from criminal or anti-social behaviour, or support for parents in developing parenting skills. As local areas move towards integrated children's services, professional and confident sharing of information is becoming more important to realising the potential of these new arrangements to deliver benefits for children, young people and families.
2.3.2 Information sharing is also vital to safeguarding and promoting the welfare of children and young people. A key factor in many serious case reviews has been a failure to record information, to share it, to understand the significance of the information shared, and to take appropriate action in relation to known or suspected abuse or neglect.
2.3.3 We know that practitioners recognise the importance of information sharing and that there is much good practice. But practitioners also tell us that in some situations they feel constrained from sharing information by their uncertainty about when they can do so lawfully. This guidance aims to provide clarity on that issue.
2.3.4 It is important that practitioners are supported by their employers in working through these issues; understand what information is and is not confidential, and
  • the need in some circumstances to make a judgement about whether confidential information can be shared, in the public interest, without consent; .
  • understand and apply good practice in sharing information at an early stage as part of preventative work;
  • are clear that information can normally be shared where you judge that a child or young person is at risk of significant harm or that an adult is at risk of serious harm.
2.3.5 The rest of this section covers these matters.


How Practitioners Should be Supported by their Employers

2.3.6 To give practitioners confidence to apply the guidance in practice, it is important that they have:
  • a systematic approach within their agency to explaining to children, young people and families when they first access the service how and why information may be shared, which will build the confidence of all involved;
  • clear systems, standards and protocols for sharing information. These may derive from their agency's policies, any local protocols in place, or from their professional code of conduct; access to training where they can discuss issues which concern them and explore case examples with other practitioners;
  • a source of advice and support on information sharing issues.
2.3.7 The statutory guidance on section 11 of the Children Act 2004 states that in order to safeguard and promote children's welfare, the agencies covered by section 11 should make arrangements to ensure that:
  • all staff in contact with children and young people understand what to do and the most effective ways of sharing information if they believe that a child and family may require particular services in order to achieve positive outcomes;
  • all staff in contact with children and young people understand what to do and when to share information if they believe that a child may be a child in need, including those children suffering or at risk of suffering harm;
  • appropriate agency-specific guidance is produced to complement guidance issued by  central Government, and such guidance and appropriate training is made available to  new staff as part of their induction and ongoing training;
  • guidance and training specifically covers the sharing of information between
  • professions, organisations and agencies, as well as within them, and arrangements for  training take into account the value of multi-agency as well as single agency training;  managers in children's services are fully conversant with the legal framework and good  practice guidance issued for practitioners working with children and young people.
2.3.8 The statutory guidance on section 10 of the Children Act 2004 makes it clear that effective information sharing supports the duty to co-operate to improve the well-being of children.


Confidentiality

2.3.9 In deciding whether there is a need to share information you need to consider your legal obligations including
  • Whether the information is confidential; and
  • If it is confidential, whether there is a public interest sufficient to justify sharing.
2.3.10 Not all information is confidential. Confidential information is information of some sensitivity, which is not already lawfully in the public domain or readily available from another public source, and which has been shared in a relationship where the person giving the information understood that it would not be shared with others. For example, a teacher may know that one of her pupils has a parent who misuses drugs. That is information of some sensitivity, but may not be confidential if it is widely known or it has been shared with the teacher in circumstances where the person understood it would be shared with others. If however the pupil shares it with the teacher in a counselling session, for example, it would be confidential.
2.3.11 Confidence is only breached where the sharing of confidential information is not authorised by the person who provided it or to whom it relates. If the information was provided on the understanding that it would be shared with a limited range of people or for limited purposes, then sharing in accordance with that understanding will not be a breach of confidence. Similarly, there will not be a breach of confidence where there is explicit consent to the sharing.
2.3.12 Even where sharing of confidential information is not authorised, you may lawfully share it if this can be justified in the public interest. Seeking consent should be the first option, if appropriate. Where consent cannot be obtained to the sharing of the information or is refused, or where seeking it is likely to undermine the prevention, detection or prosecution of a crime, the question of whether there is a sufficient public interest must be judged by the practitioner on the facts of each case. Therefore, where you have a concern about a child or young person, you should not regard refusal of consent as necessarily precluding the sharing of confidential information.
2.3.13 A public interest can arise in a wide range of circumstances, for example, to protect children or other people from harm, to promote the welfare of children or to prevent crime and disorder. There are also public interests, which in some circumstances may weigh against sharing, including the public interest in maintaining public confidence in the confidentiality of certain services. The key factor in deciding whether or not to share confidential information is proportionality, i.e. whether the proposed sharing is a proportionate response to the need to protect the public interest in question. In making the decision you must weigh up what might happen if the information is shared against what might happen if it is not, and make a decision based on a reasonable judgement.
2.3.14 It is not possible to give guidance to cover every circumstance in which sharing of confidential information without consent will be justified. Practitioners must make a judgement on the facts of the individual case. Where there is a clear risk of significant harm to a child, or serious harm to adults, the public interest test will almost certainly be satisfied. However there will be other cases where practitioners will be justified in sharing some confidential information in order to make decisions on sharing further information or taking action - the information shared should be proportionate.
2.3.15 It is possible however to identify some circumstances in which sharing confidential information without consent will normally be justified in the public interest. These are:  when there is evidence that the child is suffering or is at risk of suffering significant harm; or where there is reasonable cause to believe that a child may be suffering or at risk of significant harm; or to prevent significant harm arising to children and young people or serious harm to adults, including through the prevention, detection and prosecution of serious crime.
2.3.16 For the purposes of this guidance, serious crime means any crime, which causes or is likely to cause significant harm to a child or young person or serious harm to an adult.


Sharing Information as Part of Preventative Services

2.3.17 There is an increasing emphasis on integrated working across children's services so that support for children, young people and families is provided in response to their needs.
2.3.18 The aim is to deliver more effective intervention at an earlier stage to prevent problems escalating and to increase the chances of a child or young person achieving positive outcomes. In some areas there is increased use of multi-agency services, for example in children's centres to support child health development; or through youth inclusion and support panels (YISPs) to support young people to help them move away from involvement in crime and disorder.
2.3.19 Whether the integrated working is across existing services or through specific multi-agency structures, success depends upon effective partnership working between universal services (such as education and primary health care) and targeted and specialist services for those children, young people and families at risk of poor outcomes. Preventative services working in this way will be more effective in identifying concerns about significant harm, for example as a result of abuse or neglect. However, in most situations children, young people and family members will require additional services in relation to education, health, behaviour, parenting, or family support, rather than intervention to protect the child or young person from harm or to prevent or detect serious crime.
2.3.20 Effective preventative services of this type will usually require active processes for identifying children and young people at risk of poor outcomes, and passing information to those delivering targeted support. Practitioners sometimes express concern about how this can be done lawfully.
2.3.21 Seeking consent should be the first option. Practitioners in universal, targeted and specialist services, including multi-agency services, should proactively inform children, young people and families, when they first engage with the service, about their service's policy on how information will be shared, and seek their consent. The approach to sharing information should be explained openly and honestly. Where this is done, young people and families will be aware how their information may be shared, and experience shows that most will give consent.
2.3.22 Information, which is not confidential, may generally be shared where it is necessary for the legitimate purposes of preventative work. Where information is confidential, however, and consent is refused, that should be respected, unless in the practitioner's professional judgment on the facts of the case, the public interest justifies the sharing of information. Paragraphs 2.3.9 to 2.3.16 explain this and make it clear that there will be cases where practitioners are justified in sharing confidential information without consent in order to make decisions on whether to share further information or take action.


Sharing Information Where There are Concerns about Significant Harm

2.3.23 It is critical that all practitioners working with children and young people are in no doubt that where they have reasonable cause to suspect that a child or young person may be suffering or may be at risk of suffering significant harm, they should always consider referring their concerns to Children's social care. While, in general, you should seek to discuss any concerns with the family and, where possible, seek their agreement to making referrals to Children's social care, this should only be done where such discussion and agreement-seeking will not place a child at increased risk of significant harm or lead to interference with any potential investigation. The child's interests must be the overriding consideration in making any such decisions.
2.3.24 In some situations there may be a concern that a child or young person may be suffering or at risk of significant harm or of causing serious harm to others, but you may be unsure whether what has given rise to your concern constitutes 'a reasonable cause to believe'. In these situations, the concern must not be ignored. You should always talk to someone to help you decide what to do - a lead person on child protection, a Caldicott guardian, or a discussion with a trusted colleague or another practitioner who knows the child. The decision, to share information or not, should be recorded.
2.3.25 Significant harm to children and young people can arise from a number of circumstances - it is not restricted to cases of deliberate abuse or gross neglect. For example a baby who is severely failing to thrive for no known reason could be suffering significant harm but equally could have an undiagnosed medical condition. If the parents refuse consent to further medical investigation or an assessment, then you may still be justified in sharing information for the purposes of helping ensure that the causes of the failure to thrive are correctly identified.
2.3.26 Similarly, serious harm to adults is not restricted to cases of extreme physical violence. For example, the cumulative effect of repeated abuse or threatening behaviour or the theft of a car for joyriding may well constitute a risk of serious harm. Again, it may be justified to share information without consent for the purposes of identifying children or young people for whom preventative interventions in relation to such behaviour are appropriate.

2.4 Further information to inform decision making

2.4.1 To inform your decision-making this section sets out further information illustrating the key principles underlying information sharing. This section explains these through eight key questions. The relationship between them is illustrated in the flowchart at the end of this section. They are:
  • Is there a legitimate purpose for you or your agency to share the information?
  • Does the information enable a person to be identified?
  • Is the information confidential?
  • If the information is confidential, do you have consent to share?
  • Is there a statutory duty or court order to share the information?
  • If consent is refused, or there are good reasons not to seek consent to share confidential information, is there a sufficient public interest to share information?
  • If the decision is to share, are you sharing the right information in the right way?
  • Have you properly recorded your decision?


Is There a Legitimate Purpose for you or Your Agency to Share Information?

2.4.2 If you are asked to or wish to share information about a child or young person, you need to have a good reason or legitimate purpose to share information. This will be relevant to whether the sharing is lawful in a number of ways.
2.4.3 If you work for a statutory service such as education, social care, health or youth justice, or if you work in the private or voluntary sector and are contracted by one of the statutory agencies to provide services on their behalf, the sharing of information must be within the functions or powers of that statutory body. It is likely that this will be the case if you are sharing the information as a normal part of the job you do for that agency.
2.4.4 Whether you work for a statutory service or within the private or voluntary sector, any sharing of information must comply with the law relating to confidentiality, data protection and human rights. Establishing a legitimate purpose for sharing information is an important part of meeting those requirements. There is more information about the legal framework for sharing information in the document Information Sharing: Further Guidance on Legal Issues.
2.4.5 Different agencies may have different standards for sharing information. You will need to be guided by your agency's policies and procedures, any local information sharing protocols, and - where applicable - by your professional code.


Does the Information Enable a Person to be Identified?

2.4.6 In most cases the information covered by this guidance will be about a named child or young person. It may also identify others, such as a parent or carer. If the information is anonymised, it can lawfully be shared as long as the purpose is legitimate. If, however, the information does allow a person to be identified, it is subject to data protection law and you must be open about what information you might need to share and why and you must also take account of other relevant laws.


Is the Information Confidential?

2.4.7 Confidential information is explained in paragraph 2.3.10. This section provides further information.
2.4.8 There are different types of confidential relationship. One is where a formal confidential relationship exists, as between a doctor and patient, social worker and client, or counsellor and client. In these relationships all information shared, whether or not directly relevant to the medical, social care or personal matter which is the main reason for the relationship, needs to be treated as confidential.
2.4.9 Another is an informal confidential relationship that exists between, say, a teacher and a pupil. A pupil may tell a teacher a whole range of information some of which is not confidential, but may also ask the teacher to treat some specific information as confidential. Then, for the purposes of the confidential information only, the teacher and pupil will have a formal confidential relationship.
2.4.10 Sometimes people may not specifically ask you to keep information confidential when they discuss their own problems or pass on information about others, but may assume that personal information will be treated as confidential. In these situations you should check whether the information is or is not confidential, the limits around confidentiality and under what circumstances information may or may not be shared with others.
2.4.11 Public bodies that hold information of a private or sensitive nature about individuals for the purposes of carrying out their functions (for example Children's social care) may also owe a duty of confidentiality, as people have provided information on the understanding that it will be used for those purposes. In some cases the body may have a statutory obligation to maintain confidentiality, for example in relation to the case files of looked after children.


Do you Have Consent to Share?

2.4.12 Consent issues can be complex, and lack of clarity about them can sometimes lead practitioners to incorrect assumptions that no information can be shared. This section gives further information to help you understand and address the issues. It covers:
  • What constitutes consent;
  • Whose consent should be sought;
  • When not to seek consent.
2.4.13 Consent must be 'informed' - this means that the person giving consent needs to understand why information needs to be shared, who will see their information, the purpose to which it will be put and the implications of sharing that information.
2.4.14 Consent can be 'explicit' or 'implicit'. Obtaining explicit consent is good practice and it can be expressed either orally or in writing, although written consent is preferable since that reduces the scope for subsequent dispute. Implicit consent can also be valid in many circumstances. Consent can legitimately be implied if the context is such that information sharing is intrinsic to the activity, and especially if that has been explained at the outset, for example when conducting a common assessment. A further example is where a GP refers a patient to a hospital specialist and the patient agrees to the referral; in this situation the GP can assume the patient has given implied consent to share information with the hospital specialist.
2.4.15 The approach to securing consent should be transparent and respect the individual. For example, it is good practice to set out clearly your agency's policy on sharing information to children, young people and families, when they first access the service. Consent should not be secured through coercion, or inferred from a lack of response to a request for consent. If there is a significant change in the use to which the information will be put to that which has previously been explained, or in the relationship between the agency and the individual, consent should be sought again. Individuals have the right to withdraw consent after they have given it, although in practice this is rarely exercised.


Whose Consent Should be Sought

2.4.16 You may also need to consider whose consent should be sought. Where there is a duty of confidence it is owed to a person who has provided the information on the understanding it is to be kept confidential and, in the case of medical or other records, the person to whom the information relates. A young person aged 16 or 17, or a child under 16 who has the capacity to understand and make their own decisions, may give (or refuse) consent to sharing.
2.4.17 Children aged 12 or over may generally be expected to have sufficient understanding. Younger children may also have sufficient understanding. When assessing a child's understanding you should explain the issues to the child in a way that is suitable for their age, language and likely understanding. Where applicable, you should use their preferred mode of communication.
2.4.18 The following criteria should be considered in assessing whether a particular child on a particular occasion has sufficient understanding to consent, or refuse consent, to sharing of information about them:
  • Can the child understand the question being asked of them?
  • Does the child have a reasonable understanding of:
  • What information might be shared?
  • The main reason or reasons for sharing the information?
  • The implications of sharing that information, and of not sharing it?

Can the child or young person:

  • Appreciate and consider the alternative courses of action open to them?
  • Weigh up one aspect of the situation against another?
  • Express a clear personal view on the matter, as distinct from repeating what someone else thinks they should do?
  • Be reasonably consistent in their view on the matter, or are they constantly changing their mind?
2.4.19 In most cases, where a child cannot consent or where you have judged that they are not competent to consent, a person with parental responsibility should be asked to consent on behalf of the child.
2.4.20 Where parental consent is required, the consent of one such person is sufficient. In situations where family members are in conflict you will need to consider carefully whose consent should be sought. If the parents are separated, the consent of the resident parent would usually be sought. If you judge a child or young person to be competent to give consent, then their consent or refusal to consent is the one to consider even if a parent or carer disagrees.
2.4.21 These issues can raise difficult dilemmas. You must always act in accordance with your professional code of practice and in the best interests of the child, even where that means overriding refusal to consent.


When Not to Seek Consent

2.4.22 There will be some circumstances where you should not seek consent, for example where to do so would:
  • Place a child or young person at increased risk of significant harm; or place an adult at risk of serious harm; or
  • Prejudice the prevention or detection of a serious crime; or
  • Lead to unjustified delay in making enquiries about allegations of significant harm.


Is There a Statutory Duty or a Court Order to Share Information?

2.4.23 In some situations you are required by law to share information, for example, in the NHS where a person has a specific disease about which environmental health services must be notified. There will also be times when a court will make an order for certain information or case files to be brought before the court.
2.4.24 These situations are relatively unusual and where they apply you will know or be told about them. In such situations you must share the information, even if it is confidential and consent has not been given. Wherever possible, you should inform the individual concerned that you are sharing the information, why, and with whom.


Is There Sufficient Public Interest to Share Information?

2.4.25 Eliciting the views of children, young people and parents is important and represents good practice. However, even if consent is refused, that does not automatically preclude you from sharing information about a child about whom you have a concern. Paragraphs 2.3.6 to 2.3.12 explain this in more detail, including the public interest test, the need to consider the public interest in maintaining confidence in confidentiality and how a risk of significant harm to a child or serious harm to an adult increases the public interest in sharing. There will be cases where sharing limited information without consent is justified to enable practitioners to reach an informed decision about whether further information should be shared or action should be taken.
2.4.26 In deciding whether the public interest justifies disclosing confidential information without consent, you should be able to seek advice from your line manager or a nominated individual whose role is to support you in these circumstances. If you are working in the NHS or a local authority the Caldicott Guardian may be helpful. Advice can also be sought from professional bodies, for example the General Medical Council or the Nursing and Midwifery Council, and the General Social Care Council.
2.4.27 If the concern is about possible abuse or neglect, all organisations working with children and young people will have a named person who undertakes a lead role for child protection; so consulting this person may also be helpful.
2.4.28 If you decide to share confidential information without consent, you should explain to the person that you intend to share the information and why, unless one of the points at Paragraph 2.4.22 is met.
2.4.29 If the decision is to share, are you sharing the proper information in the proper way?
2.4.30 If your decision is to share, you should share information in a proper way. This means:
  • share the information which is necessary for the purpose for which it is being shared;
  • share the information with the person or people who need to know;
  • check that the information is accurate and up-to-date;
  • share it in a secure way;
  • establish with the recipient whether they intend to pass it on to other people, and
  • ensure they understand the limits of any consent which has been given;
  • inform the person to whom the information relates, and, if different, any other person who provided the information, if you have not already and it is safe to do so.


Have you Properly Recorded Your Decision?

2.4.31 You should record your decision and the reasons for it whether or not you decide to share information. If the decision is to share, you should record what information was shared and with whom.
2.4.32 You should work within your agency's arrangements for recording information and within any local information sharing protocols in place. These arrangements and protocols must be in accordance with the Data Protection Act 1998 - the key provisions of which are summarised in Information Sharing: Further Guidance on Legal Issues.
2.4.33 Key sources of additional guidance on information sharing are listed at Section 2.5, Key sources of further guidance . A glossary is included at Appendix 4

Click here to view Key Principles for Information Sharing Flowchart.

2.5 Key sources of further guidance

Further information and guidance can be found from the following sources:

Department for Education

Information Commissioner's Office

  • The Data Protection Act 1998 Information available at the ICO website

Department for Constitutional Affairs

  • Privacy and data-sharing: the way forward Information available at DCA website

Department of Health

General Medical Council

Youth Justice Board and the Association of Chief Police Officers

Sharing Personal and Sensitive Personal Information on Children and Young People at Risk of Offending: A Practical Guide (Youth Justice Board, 2005)  Document available at the Youth Justice Board website.

Multi Agency Public Protection Arrangements; available at the National Probation Service website.


3. Recognition and referral

3.1 Definitions
3.2 Risk indicators
3.3 Professional response
3.4 Response by members of the public

3.1 Definitions

3.1.1 'Child abuse and neglect' is a generic term encompassing all ill treatment of children including serious physical and sexual assaults as well as cases where the standard of care does not adequately support the child's health or development.
3.1.2 Abuse and neglect are forms of maltreatment of a child. Somebody may cause or neglect a child by inflicting harm, or failing to act to prevent harm. Children may be abused in a family, or in an institutional or community setting; by those known to them or, more rarely by a stranger. They may be abused by an adult or adults or another child or children.
3.1.3 Working Together to Safeguard Children sets out definitions and examples of the 4 broad categories of abuse which are used for the purposes of recognition:
  • Neglect
  • Physical abuse
  • Sexual abuse and
  • Emotional abuse
3.1.4 These categories overlap and an abused child does frequently suffer more than one type of abuse. This chapter provides definitions of these categories and information to help identify potential abuse and neglect and the required response.
3.1.5 It is the responsibility of Children's social care to make a judgement if a referral about abuse and / or neglect of a child involves the suspicion that the child is suffering or likely to suffer significant harm see Section 5.1, Significant harm for definition of this term. If any professional wishes to challenge the decision of Children's social care, see Section 6.13, Resolution of professional disagreement.


PHYSICAL ABUSE

3.1.6 Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child.
3.1.7 It may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces illness in a child. This unusual and potentially dangerous form of abuse is described as fabricated or induced illness in a child (see Section 8.9, Fabricated or induced illness)


EMOTIONAL ABUSE

3.1.8 Emotional abuse is the persistent emotional ill treatment of a child such as to cause severe and persistent adverse effects on the child's emotional development. It may:
  • Involve conveying to a child that s/he is worthless or unloved, inadequate, or valued only insofar as s/he meets the needs of another person
  • Feature age or developmentally inappropriate expectations being imposed on children. This includes interactions beyond the child's developmental capability, as well as over protection and limitation of exploration and learning, or preventing the child's participating in normal social interaction
  • Involve seeing and hearing the ill treatment of another
  • Involve serious bullying causing children frequently to feel frightened or in danger, or the exploitation or corruption of children
3.1.9 Some level of emotional abuse is involved in most types of ill treatment of a child, though emotional abuse may occur alone.


SEXUAL ABUSE

3.1.10 Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, including prostitution whether or not the child is aware of what is happening
3.1.11 The activities may involve physical contact, including penetrative (e.g. rape, buggery or oral sex) or non-penetrative acts.
3.1.12 They may also include non-contact activities, such as involving children in looking at, or in the production of, pornographic material or watching sexual activities, or encouraging children to behave in sexually inappropriate ways.
3.1.13 The Sexual Offences Act 2003 (implemented in full on May 1 2004) generally strengthened protection for children and introduced a range of new sexual offences designed to address all inappropriate activity with children.
3.1.14 Child sexual abuse includes:
  • Rape: vaginal, anal or oral penetration committed by a male on a female or male without consent (this is the only sexual offence that can be committed exclusively by a man, as the penetration must be by a penis)
  • Sexual assault by penetration: penetration of the vagina or anus with a part of the body or anything else (this is a new offence that replaces indecent assault and recognises the seriousness of penetration)
  • Sexual assault: touching a person sexually without consent (this also replaces the offence of indecent assault and covers non-penetrative touching of a victim and would include fondling, masturbation, digital penetration and oral-genital contact)
  • Sexual activity with a child: a person 18 or over intentionally sexually touching a child under 16 (this offence replace the offences of indecent assault and unlawful sexual intercourse - a separate offence deals with the situation where both persons involved are under 18 and reduces the penalty); these offences include situations where there is consent between the parties; where this consent exists, and the parties are of a similar age, it is not anticipated that any criminal proceedings will take place
  • Causing or inciting a child to engage in sexual activity: a person aged 18 or over making a child under 16 commit a sexual act on another person (including making a child touch the offender)
  • Other forms of sexual activity e.g. taking indecent photographs of children or exposing children to abusive images of children 
3.1.15 In law children under 16 years of age cannot consent to any sexual activity occurring, although in practice young people may be involved in sexual contact to which, as individuals, they may have agreed. Children under 13 years cannot in law under any circumstances consent to sexual activity and specific offences, including rape, exist for child victims under this age (see Section 8.28, Sexual activity for further guidance and additional procedures).


NEGLECT

3.1.16 Neglect is the persistent failure to meet a child's basic physical and/or psychological needs, likely to result in the serious impairment of the child's health and development.
3.1.17 Neglect may occur during pregnancy as a result of maternal substance misuse. Once the child is born, neglect may involve a parent or carer:
  • Failing to provide adequate food and clothing, shelter (including exclusion from home or abandonment)
  • Failing to protect a child from physical and emotional harm or danger
  • Failing to ensure adequate supervision including the use of inadequate care-takers
  • Failing to access appropriate medical care or treatment
  • Failing to meet a child's basic emotional needs.
3.1.18 Severe neglect of young children is associated with major impairment of growth and intellectual development. Persistent neglect can lead to serious impairment of health and development, long-term difficulties with social functioning, relationships and educational progress. Neglect can also result, in extreme cases, in death.

3.2 Risk indicators

3.2.1 The factors described in this section are frequently found in cases of child abuse. Their presence is not proof that abuse has occurred, but:
  • Must be regarded as indicators of possible significant harm
  • Must prompt the professional to seek further information
  • Justify the need for careful assessment and discussion with designated / named / lead person, manager, (or in the absence of all those individuals, an experienced colleague)
  • May require consultation with and/or referral to Children's social care
3.2.2 In an abusive relationship the child may:
  • Appear frightened of the parent/s
  • Act in a way that is inappropriate to her/his age and development  (though full account needs to be taken of different patterns of development and different ethnic groups)
3.2.3 The parent or carer may:
  • Persistently avoid child health services and treatment of the child's illnesses
  • Have unrealistic expectations of the child
  • Frequently complain about / to the child and fail to provide attention or praise (a high criticism / low warmth environment)
  • Be absent
  • Be misusing substances
  • Persistently refuse to allow access on home visits
  • Be involved in domestic violence
  • Be socially isolated
3.2.4 Consideration must be given to the impact on the care of the child of any issues / problems affecting the parents e.g. substance misuse, mental health problems, learning disabilities, childhood experiences of severe neglect.
3.2.5 Staff should be aware of the potential risk to children when individuals, previously known or suspected to have abused children, move into or have substantial access in the household (see Section 10, Risk management of known offenders).
3.2.6 It should be recognised that those who pose a risk to children often will not be honest with others. Staff should be mindful of this. Of particular note are carers who present a risk due too either fabricating or inducing illnesses within the children they are responsible for.


RECOGNISING PHYSICAL ABUSE

3.2.7 This section provides information about the sites and characteristics of physical injuries that may be observed in abused children. It is intended primarily to assist staff in the recognition of bruises, burns and bites which should be referred to Children's social care and / or require medical assessment. Further information can be found on the Core Info website
3.2.8 The following are often regarded as indicators of concern:
  • An explanation which is inconsistent with an injury
  • Several different explanations provided for an injury
  • Unexplained delay in seeking treatment
  • Parents / carers who are uninterested or undisturbed by an accident or injury
  • Parents who are absent without good reason when their child is presented for treatment
  • Repeated presentation of minor injuries (which may represent a 'cry for help' and if ignored could lead to a more serious injury) or may represent fabricated or induced illness (see Section 8.9, Fabricated or induced illness)
  • Family use of different doctors and A&E departments
  • Reluctance to give information or mention previous injuries


Bruising

3.2.9 Children can have accidental bruising, but the following must be considered as highly suspicious of a non accidental injury unless there is an adequate explanation provided and experienced medical opinion sought:
  • Any bruising or other soft tissue injury to a pre-crawling or pre-walking infant or non mobile disabled child.
  • Bruising in or around the mouth, particularly in small babies which may indicate force feeding
  • 2 simultaneous bruised eyes, without bruising to the forehead,  (rarely accidental, though a single bruised eye can be accidental or abusive)
  • Repeated or multiple bruising on the head, or on sites unlikely to be injured accidentally
  • The outline of an object used e.g. belt marks, hand prints or a hair brush (a pinch causes small double bruises, a punch or kick causes an irregular bruise with a paler centre, gripping causes ovals from fingertips or lines between fingers)
  • Linear pink marks, haemorrhages or pale scars may be caused by ligature, especially at wrists, ankles, neck, male genitalia
  • Bruising or tears around, or behind, the earlobe/s indicating injury by pulling or twisting
  • Bruising around the face
  • Broken teeth and mouth injuries (a torn frenulum - the flap of tissue in the midline under the upper lip - is highly suspicious)
  • Grasp marks on small children
  • Bruising on the arms, buttocks and thighs may be an indicator of sexual abuse
3.2.10 Bruises are difficult to age accurately because they change colour at differing rates.


Bite Marks

3.2.11 Bite marks can leave clear impressions of the teeth. Human bite marks are oval or crescent shaped. Those over 3cm in diameter are more likely to have been caused by an adult or older child.
3.2.12 A medical opinion from a forensic dentist / odontologist should be sought where there is any doubt over the origin of the bite.


Burns and Scalds

3.2.13 It can be difficult to distinguish between accidental and non- accidental burns and scalds, and will always require experienced medical opinion. Any burn with a clear outline may be suspicious e.g:
  • Circular burns from cigarettes are characteristically punched out lesions 0.6 - 0.7 cm in diameter, and healing, usually leaves a scar
  • Friction burns resulting from being dragged
  • Linear burns from hot metal rods or electrical fire elements
  • Burns of uniform depth over a large area
  • Scalds that have a line indicating immersion or poured liquid (a child getting into hot water of her/his own accord will struggle to get out and cause splash marks)
  • Old scars indicating previous burns / scalds which did not have appropriate treatment or adequate explanation
3.2.14 Scalds to the buttocks of a small child, particularly in the absence of burns to the feet, are indicative of dipping into a hot liquid or bath.


Fractures

3.2.15 Fractures may cause pain, swelling and discolouration over a bone or joint.
3.2.16 Non-mobile children rarely sustain fractures.
3.2.17 There are grounds for concern if:
  • The history provided is vague, non-existent or inconsistent with the fracture type
  • There are multiple fractures or old fractures (in the absence of major trauma, birth injury or underlying bone disease)
  • Medical attention is sought after a period of delay when a fracture has caused symptoms e.g. swelling, pain or loss of movement
  • There is an unexplained fracture in the first year of life


Scars

3.2.18 A large number of scars or scars of different sizes or ages, or on different parts of the body, may suggest abuse.


Shaken Baby Syndrome

3.2.19 Shaking a baby often results in no visible injury. Nevertheless, significant internal injuries may be caused, e.g. intra-cranial bleeding, brain injury, small fractures to the ends of the long bones, other fractures (such as ribs and neck) and retinal haemorrhages. Signs and symptoms can be non-specific, which may result in a delay in seeking advice.
3.2.20 The infant can present with:
  • Lethargy
  • Poor feeding
  • Vomiting
  • Stops in breathing
  • Pallor
  • Variable consciousness
  • Irritability
  • Convulsions
3.2.21 In suspected cases it is essential that an opthalmological examination and skeletal survey are carried out.


Self Harming and Siblings

3.2.22 Caution must be used when interpreting an explanation by parents/carers that an injury or series of injuries was self-inflicted or caused by a sibling. This is especially important in young or disabled children not able to offer a reliable explanation themselves.
3.2.23 Due consideration must be given to the possibility that the injury may:
  • Be non-accidental, particularly if the explanation appears discrepant for the nature of the injury
  • Possibly have occurred in circumstances where neglect is a consideration
3.2.24 In these circumstances referral to Children's social care should be made in accordance with Section 3.3, Professional response and Section 4, Response and assessment


INJURIES IN INFANTS UNDER 12 MONTHS

3.2.25 Physical injuries in infants may be life threatening or cause permanent neurological damage. Any suspicious injury in a pre or non mobile child must be regarded with extreme concern including:
  • Minor injuries with an inconsistent explanation
  • Significant bruising
  • Any fractures
  • Any major injury
3.2.26 Any injury and its explanation must be assessed in relation to the infant's developmental abilities and the likelihood of the occurrence.
3.2.27 Infants are highly vulnerable and may have a serious injury without obvious physical signs e.g. shaking injuries may result in internal head injuries. Nevertheless significant internal injuries may be caused and result in:
  • Lethargy, poor feeding, apnoea or irregular breathing
  • Fits
  • Variable consciousness
  • Intra-cranial bleeding and retinal haemorrhages
  • Skull and rib fractures
  • Failure to thrive / faltering growth
  • Death


Response

3.2.28 In addition to the procedures in Chapter 2, Information sharing and confidentiality, Chapter 3, Recognition and referral and Chapter 5, Child protection enquiries, the following procedures apply when an infant presents at hospital with a:
  • Major injury
  • Fracture
  • Repeated minor injuries or
  • Minor injury of concern
3.2.29 The process to be followed is summarised below
3.2.30 When a diagnosis, by a consultant or other senior paediatrician, indicates that non accidental injury is likely, the infant should not be returned to relevant parent / carer/s without a strategy discussion, and S.47 enquiries being carried out.

Click here to view Flowchart on Injuries in Infants Under 12 Months


RECOGNISING EMOTIONAL ABUSE

3.2.31 Emotional abuse may be difficult to recognise, as the signs are usually behavioural rather than physical.
3.2.32 Indicators of emotional abuse are also often associated with other forms of abuse.
3.2.33 Recognition of emotional abuse is usually based on observations over time and the following offer some associated indicators:


Parent / Carer and Child Relationship Factors

  • Abnormal attachment between a child and parent / carer e.g. anxious, indiscriminate or failure to attach
  • Persistent negative comments about the child or 'scape-goating' within the family
  • Inappropriate or inconsistent expectations of the child e.g. over-protection or limited exploration


Child Presentation Concerns

  • Delay in achieving developmental, cognitive and / or other educational milestones
  • Failure to thrive / faltering growth
  • Behavioural problems e.g. aggression, attention seeking
  • Frozen watchfulness, particularly in preschool children
  • Low self esteem, lack of confidence, fearful, distressed, anxious
  • Poor relationships with peers, including withdrawn or isolated behaviour


Parent / Carer Related Issues

  • Dysfunctional family relationships including domestic violence
  • Parental problems that may lead to lack of awareness of child's needs e.g. mental illness, substance misuse, learning difficulties
  • Parent or carer emotionally or psychologically distant from the child
  • Contextual factors may include:
  • Child left unsupervised / unattended
  • Child left with multiple carers
  • Child regularly late attending, or, not being collected from school
  • Child repeatedly reported lost / missing
  • Parent/carer regularly unaware of child's whereabouts
  • Child regularly not available for meetings with childcare workers


RECOGNISING SEXUAL ABUSE

3.2.34 Boys and girls of all ages may be sexually abused and are frequently scared to say anything due to guilt and/or fear. This is particularly difficult for a child to talk about and full account should be taken of the cultural sensitivities of any individual child / family.
3.2.35 Recognition can be difficult, unless the child discloses and is believed. There may be no physical signs and indications are likely to be emotional / behavioural.


Behavioural Indicators

  • Inappropriate sexualised conduct
  • Sexually explicit behaviour, play or conversation, inappropriate to the child's age
  • Continual and inappropriate or excessive masturbation
  • Self-harm (including eating disorder), self mutilation and suicide attempts
  • Involvement in prostitution or indiscriminate choice of sexual partners
  • An anxious unwillingness to remove clothes for - e.g. sports events (but this may be related to cultural norms or physical difficulties)
  • Running away


Physical Indicators

  • Pain or itching of genital area
  • Vaginal discharge
  • Sexually transmitted diseases
  • Blood on underclothes
  • Pregnancy
  • Physical symptoms symptoms e.g. injuries to genital or anal area, bruising to buttocks, abdomen and thighs, sexually transmitted disease, presence of semen on vagina, anus, external genitalia or clothing


RECOGNISING NEGLECT

3.2.36 Evidence of neglect is built up over a period of time and can cover different aspects of parenting.


Child Related Indicators

  • An unkempt, inadequately clothed, dirty or smelly child
  • A child who is perceived to be frequently hungry
  • A child who is observed to be listless, apathetic and unresponsive with no apparent medical cause; displaying anxious attachment; aggression or indiscriminate friendliness
  • Failure of a child to grow or develop within normal expected patterns with an accompanying weight loss or speech / language delay
  • Recurrent / untreated infections or skin conditions e.g. severe nappy rash, eczema or persistent head lice / scabies
  • Unmanaged / untreated health / medical conditions including poor dental health
  • Frequent accidents or injuries
  • A child frequently absent from or late at school
  • Poor self esteem
  • A child who thrives away from the home environment


Indicators in the Care Provided

  • Failure by parents or carers to meet basic essential needs e.g. adequate food, clothes, warmth, hygiene, sleep
  • Failure by parents or carers to meet the child's health and medical needs e.g. poor dental health, failure to attend or keep appointments with health visitor, GP or hospital, lack of GP registration, failure to seek or comply with appropriate medical treatment
  • A dangerous or hazardous home environment including failure to use home safety equipment, risk from animals
  • Poor state of home environment e.g. unhygienic facilities, lack of appropriate sleeping arrangements, inadequate ventilation (including passive smoking) and lack of adequate heating
  • A lack of opportunities for child to play and learn
  • Child left with adults who are intoxicated or violent
  • Child abandoned or left alone for excessive periods
  • Neglect of pets
3.2.37 Where there are any concerns about the neglect of a child in a household, consideration must be given to the possibility that other children in the household may also be at risk of neglect or abuse.

3.3 Professional response

IMMEDIATE ACTION

Urgent Medical Attention

3.3.1 If the child is suffering from a serious injury, medical attention must be sought immediately from Accident & Emergency (A&E). Children's social care and the duty consultant paediatrician must be informed.
3.3.2 Except in cases where emergency treatment is needed, Children's social care and the Police Child Protection Team (CPT) are responsible for ensuring that any medical examinations required as part of enquiries are initiated (see Section 5.10, Paediatric assessment).


Ensuring Immediate Safety

3.3.3 The safety of children is paramount in all decisions relating to their welfare. Any action taken by members of staff from an LSCB agency should ensure that no child is left in immediate danger.
3.3.4 The law (S.3 (5) Children Act 1989) empowers anyone who has actual care of a child to do all that is reasonable in the circumstances to safeguard her/his welfare.
3.3.5 A teacher, foster carer, childminder or any professional should for example, take all reasonable steps to offer a child immediate protection from an aggressive parent.
3.3.6 Where abuse is alleged, suspected or confirmed in a child presented at A & E or admitted to hospital, s/he must not be sent home / discharged until:
  • Children's social care are notified by phone that there are child protection concerns
  • Written confirmation is provided within 24 hours on an inter-agency referral form
  • A strategy discussion / meeting has been held including relevant hospital staff


PROFESSIONAL CONSULTATION

3.3.7 Professionals in most agencies should have internal procedures, which identify child protection designated / named managers /staff, able to offer advice and decide upon the necessity for a referral.
3.3.8 Consultation may also be accomplished directly with Children's social care.
3.3.9 A formal referral or any urgent medical treatment must not be delayed by the need for consultation.


LISTENING TO THE CHILD

3.3.10 Responsibility for making enquiries and investigating allegations rests with Children's social care and police child protection team (CPT), along with other relevant agencies.
3.3.11 Where abuse is alleged, the initial response should be limited to listening carefully to what the child says in order to:
  • Clarify the concerns
  • Offer re-assurance about how s/he will be kept safe and
  • Explain what action will be taken
3.3.12 The child must not be pressed for information, led or cross-examined,  or given false assurances of absolute confidentiality.  Such well-intentioned actions could prejudice police investigations, especially in cases of sexual abuse.
3.3.13 If the child is though to be able to understand the significance and consequences of making a referral to Children's social care, s/he should be asked her/his view.
3.3.14 Regardless of a child's expressed view, it remains the responsibility of the professional to take whatever action is required to ensure her/his safety and that of any other children.


PARENTAL CONSULTATION

3.3.15 Where practicable, concerns should be discussed with the family and agreement sought for a referral to Children's social care unless this may:
  • Place the child at risk of significant harm e.g. by the behavioural response it prompts or by leading to an unreasonable delay
  • Lead to the risk of losing evidential material or
  • In cases where fabricated or induced illness is suspected
3.3.16 A decision by any professional not to seek parental consent before making a referral to Children's social care must be recorded and the reasons given.
3.3.17 Where a parent has agreed to a referral, this must be recorded and confirmed in the referral to Children's social care.
3.3.18 Referrals from named professionals cannot be treated as anonymous, so the parent will ultimately become aware of the identity of the agency making the referral.
3.3.19 Where the parent refuses to give consent for the referral, further advice should, unless this would cause undue delay, be sought from a manager or the nominated child protection officer and the outcome fully recorded.
3.3.20 If, having taken full account of the parent's wishes, it is still considered that there is a need for a referral:
  • The reason for proceeding without parental agreement must be recorded
  • Children's social care should be told that the parent has withheld her/his consent
  • The parent should be contacted to inform her/him that after considering her/his wishes a referral has been made (unless this action may increase the risk of harm to the child)
3.3.21 For a full discussion about information sharing and confidentiality, see Section 2, Information sharing and confidentiality.


REFERRAL CRITERIA

3.3.22 Staff in LSCB member agencies and contracted service providers must make a referral to Children's social care if there are signs that a child under the age of 18 years or an unborn baby:
3.3.23 The timing of such referrals must reflect the level of perceived risk, but should usually be within 1 working day of the recognition of risk.
3.3.24 In urgent situations, out of office hours, the referral should be made to the Emergency Duty Service / Out of Hours Team (see Appendix 5).
3.3.25 Where consultation with Children's social care is sought about a child and Children's social care then conclude that a referral is required, the information provided will be regarded and responded to as such.

Where consultation with Children's social care is sought about a child and Children's social care then conclude that a referral is required, the information provided will be regarded and responded to as such.

3.3.26 Anonymous referrals will be investigated thoroughly by Children's social care, but professional referrals cannot be anonymous and should be made in the knowledge that during the course of enquiries it will be made clear which agency has originated the referral.


MAKING THE REFERRAL

3.3.27 Referrals should be made to the Children's social care office where the child is living or is found (see Appendix 5).
3.3.28 If the child is known to have an allocated social worker, referrals should be made to her/him or in her/his absence the manager or a duty officer. In other circumstances referrals should be made to the duty officer.
3.3.29 Where available, the following information should be provided with the referral (but absence of information must not delay referral):
  • Cause for concern including details of any allegations, their sources, timing and location
  • What the child said
  • Child's current location and emotional and physical condition
  • Whether the child needs immediate protection
  • Full names, date of birth and gender of child/ren
  • Family address (current and previous)
  • Identity of those with parental responsibility
  • Names and date of birth of all household members and any known regular visitors to the household
  • Details of child's extended family or community who are significant for the child
  • Ethnicity, first language and religion of children and parents / carers
  • Any need for an interpreter, signer or other communication aid
  • Any special needs of child/ren and other household members
  • Any significant / important recent or historical events / incidents in child or family's life, including previous concerns
  • Details of any alleged perpetrators (if relevant)
  • Background information relevant to referral e.g. positive aspects of parents care, previous concerns, pertinent parental issues (such as mental health, domestic violence, drug or alcohol abuse, threats and violence towards professionals)
  • Referrer's relationship and knowledge of child and parents / carers
  • Known current or previous involvement of other agencies / professionals e.g. schools, GPs
  • Information regarding parental knowledge of, and agreement to, the referral
3.3.30 All professional referrals must be confirmed in writing, by the referrer, within 24 working hours, using an interagency referral form.
3.3.31 If there is no acknowledgement by Children's social care of the referral within a further 24 working hours, the professional should contact Children's social care to establish the current status of the referral.


RECORDING

3.3.32 The referrer should keep a written record of:
  • Discussions with child
  • Discussions with parent
  • Discussions with managers
  • Information provided to Children's social care
  • Decisions taken (clearly timed, dated and signed)
3.3.33 The referrer should confirm verbal and telephone referrals in writing, within 24 hours on an interagency referral form


FLOW CHARTS

3.3.34 See Appendix 2 for flow charts for responding to physical, emotional and sexual abuse and neglect.

3.4 Response by members of the public

3.4.1 When members of the public are concerned about the welfare of a child or an unborn baby, they should contact the local Children's social care of the area in which the child lives / is found or, in the case of an unborn baby, where the mother lives.
3.4.2 Referrers should be offered the opportunity of an interview
3.4.3 The NSPCC help line offers an alternative means of reporting concerns
3.4.4 Individuals may prefer not to give their name to Children's social care or NSPCC. Alternatively they may disclose their identity, but not wish for it to be revealed to the parents / carers of the child concerned.
3.4.5 Wherever possible, staff should respect the referrer's request for anonymity. There are however, certain limited circumstances in which the identity of a referrer may have to be given i.e. the court arena.
3.4.6 Local publicity material should make the above position clear to potential referrers.


4. Response and Assessment

4.1 Common Assessment Framework (CAF)
4.2 Framework for assessing children in need and their families
4.3 Screening referrals
4.4 Initial assessment
4.5 Core assessment

4.1 Common Assessment Framework (CAF)

4.1.1 The Common Assessment Framework (CAF) is a nationally standardised approach to conducting an assessment of the needs of a child or young person and deciding how those needs should be met.
4.1.2 The CAF has been developed for use by practitioners in all agencies, so that they can communicate and work more effectively together and should be particularly useful in universal services (health and education).
4.1.3 Local areas have been able to implement CAF since its publication in April 2005. After anticipated further revision in early 2006, all areas are expected to implement the framework between April 2006 and 2008.
4.1.4 The CAF has been developed from combining the underlying model of the Framework for the Assessment of Children in Need and their Families (see Section 4.2, Framework for assessing children in need and their families and Appendix 1) with the main elements of other assessment frameworks.
4.1.5 Whilst CAF has not yet been wholly implemented in Sussex, staff should already be aware of this conceptual framework and what it might mean for them in terms of their contribution to assessments of children in need.
4.1.6 Use of the CAF should not delay referral to Children's social care if there are concerns that a child is in need, or suspected of having being / at risk of being abused or neglected. If a CAF has already been completed (or in progress) when the concerns are recognised, this will contribute to the assessment process of Children's social care.

4.2 Framework for assessing children in need and their families

4.2.1 The Framework for Assessing Children in Need and their Families (or assessment framework) provides a standardised approach to the referral and assessment process within Children's social care and all referrals of children to Children's social care are subject to this screening and assessment.
4.2.2 Where there are concerns about adults at risk of harm or abuse, a referral should be made to adult social care
4.2.3 For any referral to adult social care, the duty social worker should check whether the adult has parenting responsibilities for a child aged under 18. If so, the initial assessment should use the framework to explore and assess child and parenting issues.
4.2.4 The assessment framework enables systematic analysis, understanding and recording of what is happening to children within their families and within the wider community by an:
4.2.5 These assessment stages involve gathering and analysing information about the 3 domains of the assessment framework (see Appendix 1). These are the:
  • Children's developmental needs
  • Parents' or caregivers' capacity to respond appropriately
  • Impact of the wider family and environmental factors on parenting capacity and children
4.2.6 At all stages of referral and assessment, consideration must be given to issues of diversity, so that the impact of cultural expectations and obligations are understood.
4.2.7 It is vital that where there are any communication difficulties an independent interpreter is used. This includes families who may speak English adequately for day to day interactions, but whose linguistic abilities may not be sufficient to understand sensitive and complicated discussions about parenting and the needs of their children.
4.2.8 Some families may have little knowledge of the law with regard to the power of the state to intervene in the area of child welfare and may not appreciate the implications of this for their child/ren.
4.2.9 Throughout the assessment processes, the safety of the child remains paramount at all times and in all circumstances.
4.2.10 Incidents of abuse and neglect within families are on a continuum and situations where abuse is developing can, at times, be resolved by preventative services outside the child protection procedures.
4.2.11 The assessment process in Children's social care determines whether a referral should be responded to only as a child in need of support (S.17 Children Act 1989) or additionally as a child in need of protection (S.47 Children Act 1989).
4.2.12 The result of the assessment may inform a 'child's plan', which may include family group conferences and other service provision to support the child and their family. 


LINK WITH CHILD PROTECTION ENQUIRIES

4.2.13 A decision to initiate a child protection enquiry (S.47 enquiry) may be taken at any time, whenever the criteria are met. This may be at the point of referral, during the early consideration of a referral, the initial or core assessment or at any time in an open case when the threshold criteria are satisfied.
4.2.14 The particular procedures involved are included in Section 5, Child protection enquiries.
4.2.15 The S.47 enquiry is usually the outcome of an initial assessment. This process may be very brief if the criteria for initiating S.47 enquiries are met i.e. where a family is well known to Children's social care, or the facts clearly indicate the need for a S.47 enquiry.
4.2.16 The decision to take emergency action to provide immediate protection for the child may also be taken at any time there is evidence that the risk to the child is sufficiently acute (see Section 5.6, Immediate protection).
4.2.17 A decision to cease child protection enquiries should, after checks have been completed (and where relevant in consultation with the police child protection team and other involved agencies) be taken in a flexible manner when it is clear that the criteria for S.47 are not satisfied. There must be consideration to the completing the core assessment. This decision must be authorised and recorded by a manager.

4.3 Screening referrals

This section should be read in conjunction with the following Children and Young People's Trust Procedure(s): Referrals of Children in Need

4.3.1 All referrals to Children's social care should initially be regarded as children in potential need, and the referral should be evaluated on the day of receipt (and no later than within 1 working day), and a decision made and recorded (by the locally defined appropriate level of social worker / manager) regarding the next course of action.
4.3.2 All contacts by public and professionals expressing any concerns about the welfare of a child must be treated as a referral and recorded as such (i.e. not screened out on a contact record e.g. of the Integrated Children's System)
4.3.3 Children's social care must acknowledge referrals within 1 working day of receipt.
4.3.4 When taking a referral, staff must establish as much of the following information as possible:
  • Cause for concern including details of any allegations, their sources, timing and location
  • Child's current location and emotional and physical condition
  • Whether the child needs immediate protection
  • Full names, date of birth and gender of child/ren
  • Family address (current and previous)
  • Identity of those with parental responsibility
  • Names and date of birth of all household members and any known regular visitors to the household
  • Details of child's extended family or community who are significant for the child
  • Ethnicity, first language and religion of children and parents / carers
  • Any need for an interpreter, signer or other communication aid
  • Any special needs of child/ren and other household members
  • Any significant / important recent or historical events / incidents in child or family's life, including previous concerns
  • Details of any alleged perpetrators (if relevant)
  • Background information relevant to referral e.g. positive aspects of parents care, previous concerns, pertinent parental issues (such as mental health, domestic violence, drug or alcohol abuse, threats and violence towards professionals)
  • Referrer's relationship and knowledge of child and parents / carers
  • Known current or previous involvement of other agencies / professionals e.g. schools, GPs
  • Information regarding parental knowledge of, and agreement to, the referral
4.3.5 This screening process should establish:
  • The nature of the concern
  • How and why it has arisen
  • What the child's needs appear to be
  • Whether the concern involves abuse or neglect and
  • Whether there is any need for any urgent action to protect the child or any other children in the household or children in any other household
4.3.6 This above process will involve:
  • Discussion with referrers
  • Consideration of any existing records for the child and for any other members of the household (including if any child protection plans)
  • Involving other agencies as appropriate (including the police if any offence has been or is suspected to have been committed)
4.3.7 Personal information about non-professional referrers should not be disclosed to third parties (including subject families and other agencies) without consent.
4.3.8 Parents' consent should be sought before discussing a referral about them with other agencies (see Section 2, Information sharing and confidentiality) unless this may:
  • Place the child at risk of significant harm e.g. by the behavioural response it prompts or by leading to an unreasonable delay
  • Lead to the risk of loss of evidential material
4.3.9 The first line manager should authorise any decision to discuss the referral with other agencies without parental knowledge or permission and the reasons for such action recorded.
4.3.10 This screening stage must involve immediate evaluation of any concerns about either the child's health and development, or actual and/or potential harm, which justify further enquiries, assessments and/or interventions.
4.3.11 The first line manager should be informed of any potential S.47 enquiries and authorise the decision to initiate a strategy discussion. If the child and/or family are well known to Children's social care and/or the facts clearly indicate S.47 enquiries are required, it may be appropriate to hold a strategy discussion without further assessment - when the referral information will also constitute the initial assessment.
4.3.12 The threshold may be met for a S.47 enquiry at the time of referral, during initial or core assessment or at any point of Children's social care involvement.
4.3.13 The police must be informed at the earliest opportunity if a crime may have been committed. The police must decide whether to commence a criminal investigation and a discussion held to plan how parents are to be informed of concerns without jeopardising police investigations (see Section 5.4, Single and joint agency investigations).
4.3.14 The immediate response to referrals may be:
  • No further action or
  • Provision of services and/or
  • A fuller initial assessment of needs (which may be very brief if the criteria for initiating S.47 enquiries are met)
  • A core assessment, if indications exist the case is particularly complex or several initial assessments have been completed
  • Emergency action to protect a child
  • A S.47 strategy discussion (where child and / or family are well known or the facts clearly indicate that this is required)
4.3.15 A manager must sign and approve the outcomes of the referral and ensure a chronology has been commenced and / or updated.
4.3.16 All referrals must be acknowledged within 1 working day.


No Further Action

4.3.17 Where there is to be no further action, feedback should be provided to family and referrers about the outcome of this stage of the referral.
4.3.18 In the case of referrals from members of the public, feedback must be consistent with the rights to confidentiality of child and her/his family.

4.4 Initial assessment

This section should be read in conjunction with the following Children and Young People's Trust Procedure(s): Initial Assessments

4.4.1 The initial assessment using the Framework for the Assessment of Children in Need and their Families or the Integrated Children's System must be completed within a maximum of 7 working days of the date of the referral to Children's social care.
4.4.2 Any extension to this time-scale must be authorised by the first line manager, with reasons recorded. For example, there may be a need to delay in order to arrange for an interpreter, or avoid a religious festival. Any delay must be consistent with the welfare of the child.
4.4.3 The initial assessment should be led by a qualified & experienced social worker. It should be carefully planned, with clarity about who is doing what, as well as when and what information is to be shared with parents
4.4.4 The planning process and decisions about the timing of the different assessment activities should be taken in collaboration with all those involved with the child and family. It should involve:
  • Seeing and speaking with the child  (according to age and understanding) and family members where appropriate
  • Drawing together and analysing available information from a range of sources (including existing records) and
  • Involving and obtaining information from professionals and others in contact with the child and family
4.4.5 Parents' permission should be sought before discussing a referral about them with other agencies (see Section 2, Information sharing and confidentiality) unless this may:
  • Place the child at risk of significant harm e.g. by the behavioural response it prompts or by leading to an unreasonable delay
  • Lead to the risk of loss of evidential material
4.4.6 The first line manager should authorise any decision to discuss the referral with other agencies without parental knowledge or permission and the reasons for such action recorded (see also Paragraph 5.7.2).
4.4.7 Professionals approached by Children's social care and asked to share information must respond in accordance with Section 2, Information Sharing and Confidentiality and record:
  • The explanation provided by Children's social care for sharing information
  • The information consequently shared and
  • The rationale for decisions to share and / or withhold any information
4.4.8 If the child and / or carers have moved into the authority, all professionals should seek information covering previous addresses from their respective agencies. This is equally important for children and carers who have spent time abroad.
4.4.9 Children's social care should make it clear to families (where appropriate) and other agencies, that the information provided for this assessment may be shared with other agencies and contribute to the written form completed at the end of the assessment.
4.4.10 If during the course of the assessment it is discovered that a school age child is not attending an educational establishment, the authority with LEA responsibilities must be contacted to establish the reason for this.
4.4.11 If the criteria for initiating S.47 enquiries are met at any stage during an initial assessment, the assessment should be regarded as concluded and a strategy discussion held immediately to decide if a S.47 enquiry and core assessment is required.
4.4.12 The possible outcomes of the initial assessment are:
  • No further action
  • Immediate provision of child in need services (using the initial plan on the initial assessment if using the Integrated Children's System)
  • Instigation of a core assessment
  • Instigation of a strategy discussion, S.47 enquiry and core assessment
  • Emergency action to protect a child (see Section 5.6 Immediate protection)
4.4.13 Taking account of confidentiality, written information on the outcome of the initial assessment should be provided to professional referrers with a copy of the form provided for family members. Exceptions are justified only where this might jeopardise an enquiry or place any individual at risk.
4.4.14 A manager must sign and approve the outcomes of an initial assessment and ensure:
  • The child/ren have been seen and spoken to or there has been a recorded management decision that this is not appropriate e.g. a S.47 enquiry initiated which will plan method of contact with child
  • The needs of all children in the household have been considered
  • The initial plan is completed for cases which are provided with a service, but not progressed to S.47 and / or core assessment
  • A chronology is commenced or updated
4.4.15 Feedback should be provided to non-professional referrers about the outcome of this stage of the referral in a manner consistent with respecting the confidentiality and welfare of the child.

4.5 Core assessment

4.5.1 Core assessments commence:
  • At the conclusion of an initial assessment which recommends that such a further complex assessment is required and/or
  • When a strategy discussion / meeting initiates a S.47 enquiry and/or
  • When new information obtained on an open case indicates a core assessment should be undertaken
4.5.2 A core assessment, using the assessment framework, must be completed within a maximum of 35 working days.
4.5.3 Children's social care are responsible for the co-ordination and completion of the assessment, drawing upon information provided by partner agencies.
4.5.4 Any request from another agency for a core assessment must be given serious consideration and clear reasons communicated and recorded for a refusal.
4.5.5 A manager must sign and approve the outcomes of a core assessment and ensure that:
  • There has been direct communication with the child and her/his views and wishes have been recorded and taken into account
  • All the children in the household have been seen and their needs considered
  • The parent / carer has been seen and her/his views and wishes have been recorded and taken into account
  • The analysis has been completed
  • The chronology at the front of the file is up-to-date.
4.5.6 If the assessment indicates that further support is required, a child's plan should be agreed with family and other agencies. This should be monitored and reviewed regularly (minimum of 6 monthly).


5. Child protection enquiries

This section should be read in conjunction with the following Children and Young People's Trust Procedure(s): Initial Assessments and Core Assessments

5.1 Significant harm
5.2 S.47 enquiries and the assessment framework
5.3 Threshold for S.47 enquiries
5.4 Single and joint agency investigations
5.5 Role of duty and allocated social worker
5.6 Immediate protection
5.7 Agency information sharing
5.8 Strategy discussion
5.9 Undertaking S.47 enquiries
5.10 Paediatric assessment
5.11 Analysis and assessment of risk
5.12 Outcome of child protection enquiries
5.13 Timescales
5.14 Recording of S.47 enquiries


5.1 Significant harm

5.1.1 The Children Act 1989 provides the legal framework for defining the situations in which a local authority has a duty to make enquiries about what, if any, action to take to safeguard or promote a child's welfare.
5.1.2 S.47 of the Act requires that if a local authority has 'reasonable cause to suspect that a child who lives or is found in their area is suffering or is likely to suffer significant harm' the authority shall make, or cause to be made, such enquiries as they consider necessary.....'
5.1.3 In S.31 Children Act 1989 as amended by the Adoption and Children Act 2002:
  • 'Harm' means ill treatment, or the impairment of health or development, including, for example, impairment suffered from seeing or hearing the ill treatment of another
  • 'Development' means physical, intellectual, emotional, social or behavioural development
  • 'Health' includes physical and mental health
  • 'Ill treatment' includes sexual abuse and forms of ill treatment, which are not physical and
  • Where the question of whether harm suffered by the child is significant turns on the child's health and development, his/her health and development must be compared with that which could reasonably be expected of a similar child
5.1.4 There are no absolute criteria on which to rely to determining what constitutes significant harm. Children's social care must adjudge if a referral about abuse and / or neglect satisfies S.47 enquiries criteria (see Section 5.3, Threshold for S.47 enquiries).


DUTY TO CONDUCT S.47 ENQUIRIES

Obligations and Responsibilities of all Agencies

5.1.5 All agencies have a duty to assist and provide information in support of child protection enquiries.


Responsibility of Children's Social Care

5.1.6 Children's social care have the duty to:
  • Make, or cause to be made, enquiries when the circumstances defined in S.47 Children Act 1989 exist
  • Safeguard and promote the child's welfare (S.17 Children Act 1989)
  • Inform the police in a case referred which constitutes or may constitute a criminal offence against a child
5.1.7 The responsibility for undertaking S.47 enquiries lies with the local authority in which the child lives or is found.
5.1.8 Where the child's home address is in another authority (the 'home' authority), the 'host' authority has responsibility for undertaking enquiries e.g. alleged abuse on a school trip out of city / county.
5.1.9 In this case, the child's 'home' authority should be informed as soon as possible and involved in strategy discussions / meetings. It may sometimes be appropriate for the 'home' authority to undertake the necessary enquiries on behalf of the host authority e.g. in the case of a looked after child.
5.1.10 The home authority should take responsibility for further support of the child or family, following the S.47 enquiry.


Responsibility of the Police

5.1.11 The police have a responsibility to:
  • Investigate allegations of criminal offences against children
  • Refer any suspicion, allegation or disclosure that a child is suffering or likely to suffer significant harm to Children's social care
  • Pass all information received by child protection teams relating to people under 18 to Children's social care
5.1.12 In dealing with alleged offences involving a child victim, the police should normally work in partnership with other agencies. Whilst the responsibility to instigate a criminal investigation rests with the police, they should consider the views expressed by the other agencies.

5.2 S.47 enquiries and the assessment framework

5.2.1 S.47 enquiries should be initiated, usually following an initial assessment, whenever the threshold criteria are met (see Section 5.3, Threshold for S.47 enquiries).
5.2.2 S.47 enquiries may be justified at the point of referral, during the early consideration of a referral, the initial or core assessment or at any time in an open case when the threshold criteria are satisfied. A core assessment is the means by which a s47 enquiry is carried out. It should be led by a qualified and experienced social worker
5.2.3 The core assessment, under s47 of the Children Act, should begin by focusing primarily on information identified during referral and initial assessment and which appears most important in relation to the risk of significant harm. It should, however cover all relevant dimensions in the Assessment Framework, including the systematic gathering of information about the history of the child, family and household members, including any previous specialist assessments before its completion.
5.2.4 Those making the enquiries should be always alert to the potential needs and safety of siblings, or other children in the household of the child in question. In addition, enquiries may also need to cover children in other households, with whom the alleged offender may have had contact.

5.3 Threshold for S.47 enquiries

5.3.1 A child's status - e.g. 'in need', or 'at risk of significant harm' must be ascribed in a flexible manner, which recognises the possibility of change and a consequent need to re-ascribe that status.
5.3.2 If at any point during assessment, the threshold for S.47 enquiries is reached, the procedures outlined in this chapter should be followed.
5.3.3 S.47 enquiries start when:
  • There is reasonable cause to suspect that a child who lives in. or is found in, a local authority area is suffering or likely to suffer significant harm in the form of physical, sexual, emotional abuse or neglect
  • Following an Emergency Protection Order or Police Protection
  • A child breaches curfew criteria in which case the response must be initiated within 48 hours of receipt of the information [S.47(1)(a)(iii) Children Act 1989 inserted by S.15 (4) Crime and Disorder Act 1998]
5.3.4 Children's social care is the lead agency for child protection enquiries. In making a final decision about whether the threshold for a S.47 enquiry is met, Children's social care should consult the police child protection team (CPT) and other appropriate agencies so that relevant information can be taken into account.
5.3.5 If professionals are concerned about the decision made by Children's social care, they may wish to challenge it through using the Resolution of Professional Disagreement procedure (see Section 6.13, Resolution of professional disagreement)


S.47 Intervention Threshold

5.3.6 The Children's social care' first line manager has the responsibility, on the basis of available information, to authorise a S.47 enquiry. In undertaking the necessary assessment of risk, the manager must consider both the probability of the event or concern in question and its actual or likely consequence.
5.3.7 In reaching her/his conclusion as to the justification for a S.47 enquiry, the manager must consider the following variables:
  • Seriousness of the concern/s
  • Combinations of concerns
  • Repetition or duration of concern/s
  • Vulnerability of child (through age, developmental stage, disability or other predisposing factor -e.g. 'looked after')
  • Source of concern/s
  • Accumulation of sufficient information
  • Context in which the child is living - e.g. a child in the household already subject to child protection plan
  • Emotional environment of child, especially high criticism / low warmth
  • Any predisposing factors in the family that may suggest a higher level of risk e.g. domestic violence, substance misuse
  • The impact on the child's health and development
5.3.8 A child protection enquiry must always be commenced immediately there is a disclosure, allegation or evidence that a child is suffering or likely to suffer significant harm. This applies equally to new, re-referred and open cases.


Liaison with Police

5.3.9 Once a decision is made to initiate a S.47 child protection enquiry the first line social work manager should ensure that the case is discussed with the child protection team (CPT) before a decision is made regarding whether a single agency or joint investigation should take place.


Police Referrals to Children's Social Care

5.3.10 Details of all children coming to the notice of police, in circumstances giving rise to any concerns, will be passed to Children's social care.
5.3.11 A decision as to whether or not a child protection enquiry (single or joint) will be initiated will be taken in accordance with the above procedures i.e. depending on the circumstances the decision may be appropriate at referral or following checks / information gathering.

5.4 Single and joint agency investigations

5.4.1 The primary responsibility of CPT staff is to undertake criminal investigations of suspected, alleged or actual crime. Children's social care have the statutory duty to make, or cause to be made, enquiries when circumstances defined in S.47 Children Act 1989 exist.
5.4.2 Where both agencies have responsibilities with respect to a child, they must co-operate to ensure the joint investigation (combining the process of a S.47 enquiry and a criminal investigation) is undertaken in the best interests of the child. This should be achieved primarily through co-ordination of activities at strategy discussions and / or meetings).
5.4.3 Generally there should be a presumption of a joint investigation unless agreed otherwise.
5.4.4 If the agencies agree that a single agency enquiry or investigation is appropriate, there should still be an exchange of relevant information, possible involvement in strategy discussions and agreement reached as to the feedback required by the non participating agency.
5.4.5 Any decision to terminate enquiries must be communicated to the other agency for it to consider, and the rationale recorded by both agencies.
5.4.6 The decision regarding single or joint agency investigations should be authorised and recorded by first line managers in both the police CPT and Children's social care.


Joint Agency Investigation

5.4.7 A joint investigation must always be initiated whenever there is an allegation or reasonable suspicion that one of the circumstances described below has been committed against a child, regardless of the likelihood of a prosecution:
5.4.8 Cases of minor injury should always be considered for a joint investigation if the:
  • Child is already subject to a child protection plan
  • Child is looked after by the local authority
5.4.9 In other cases of minor injury, the circumstances surrounding the incident must be considered to determine the 'seriousness' of the alleged abuse. The following factors should be included in any consideration by the CPT and Children's social care:
  • Age, special needs and vulnerability of the child
  • Any previous history of minor injuries
  • The intent of the assault e.g. strangulation may leave no marks, but is very serious
  • If a weapon was used
  • Previous concerns from a caring agency
  • Consistency with and clarity / credibility of the child's account of the injuries
  • Predisposing factors about the alleged perpetrator e.g. criminal conviction/s, history of violence, substance misuse and / or mental health problems
5.4.10 There will be times when, after discussion or preliminary work, cases will be judged less serious and it will be agreed that the best interests of the child are served by a Children's social care led intervention, rather than a joint investigation.
5.4.11 In all cases the welfare of the child remains paramount and always takes precedence over the need to commence or conclude any criminal investigation.


Children's Social Care Single Agency

5.4.12 Where Children's social care assess that the circumstances of the case satisfy one of the following criteria, it may, following discussion with the CPT (and making relevant checks) progress single agency enquiries:
  • Purely emotional abuse with no apparent physical symptoms
  • Minor physical abuse, except for injuries to infants
  • Minor neglect through inappropriate supervision or poor parenting skills
  • Indirect suspicions of sexual abuse, including over-sexualised behaviour of a child
5.4.13 Where a minor crime, initially agreed by CPT as inappropriate of further police investigation, is subsequently discovered to be more serious than originally perceived, the case must be referred back to the CPT.


Police Single Agency

5.4.14 Criteria for police single agency investigations are those where the:
  • Allegation is by an adult of abuse which occurred in childhood and there are no current child protection issues
  • Alleged offender is not known to the child or child's family i.e. stranger abuse (but in accordance with Achieving Best Evidence, consideration will still be given to joint investigative interview/s)
5.4.15 In all cases where the police undertake a single agency investigation, details of any victim aged under 18 must be referred to Children's social care, which is responsible for assessing if the investigation raises any child protection issues and if supportive or therapeutic services are appropriate.
5.4.16 Where the police conduct a single agency investigation out of hours (because they have a duty to respond and take action to protect the child or obtain evidence), Children's social care must be informed immediately and if appropriate a joint investigation commenced.


Dispute Resolution

5.4.17 If there is any disagreement between agencies about the need for a joint investigation or the 'seriousness' of alleged abuse, further discussion should occur between the line managers.
5.4.18 If line managers disagree, the disputes should be resolved by agreement between senior managers from the agencies involved (see Section 6.13, Resolution of professional disagreement). A note of the resolution must be recorded.

5.5 Role of duty and allocated social worker

5.25.1 All child protection enquiries must be undertaken by social workers.
  • A duty worker will usually undertake enquiries on closed or unallocated cases
  • A duty worker or the allocated worker will undertake the enquiry on an allocated case, in line with local arrangements
5.25.2 The duty / social worker should:
  • Obtain clear, detailed information about the concerns, suspicion or allegation
  • Make a check on the child database
  • Ascertain if there is or has been a previous child protection enquiry or child protection plan
  • Obtain history and background information including agency files
  • Report to the responsible manager
  • Undertake any necessary emergency action - see Section 5.6, Immediate protection
  • Agree with manager if parental agreement to be sought prior to undertaking agency checks, recording the decision
  • Contact the local police child protection team  
  • Undertake agency checks with  all agencies that are involved with the child and family

5.6 Immediate protection

5.6.1 Where there is a risk to the life of a child or the possibility of serious immediate harm, the police officer or social worker must act quickly to secure the safety of the child.
5.6.2 Emergency action may be necessary as soon as the referral is received or at any point during involvement with the child/ren, parents or carers.
5.6.3 Responsibility for immediate action rests with the authority where the child is found, but should be in consultation with any 'home' authority.
5.6.4 Immediate protection may be achieved by:
  • An alleged abuser agreeing to leave the home
  • Removal of the alleged abuser
  • Voluntary agreement for the child/ren to move to a safer place with / without a protective person
  • Application for an EPO (emergency protection order)
  • Removal of the child/ren under police powers
  • Gaining entry to the household under police powers
5.6.5 The social worker must seek the agreement of her/his first line manager and obtain legal advice before initiating legal action.
5.6.6 Children's social care should only seek police assistance to use their powers in exceptional circumstances where there is insufficient time to seek an EPO or other reasons relating to the child's immediate safety.
5.6.7 The agency taking protective action must always consider whether action is also required to safeguard other children in
  • the same household,
  • the household of an alleged perpetrator or elsewhere.
5.6.8 Planned immediate protection will normally take place following a strategy discussion (see Section 5.8, Strategy discussion)
5.6.9 Where an agency has to act immediately (prior to a strategy discussion) to protect a child, a strategy discussion should take place within 1 working day of that emergency action, to plan the next steps.

5.7 Agency information sharing

5.7.1 The social worker must consult with other agencies involved with the child and family in order to obtain a fuller picture of the child's circumstances and those of any others in the household, including risk factors and parenting strengths. 
5.7.2 Generally consent is sought from parents prior to seeking such information, but the first line manager may authorise 'checks' to be completed without such permission if:
  • Seeking permission is likely to increase the risk to children concerned or other individuals
  • A request for permission has been refused, the reason for refusal considered and sufficient professional concern remains to justify disclosure
  • Seeking permission is likely to impede a criminal investigation
5.7.3 The responsible manager should record the reasons for such a decision. See Section 2, Information sharing and confidentiality for further discussion of the issues involved in information sharing.
5.7.4 Even when there has been a recent initial assessment, agencies should be consulted and informed of the new information / referral.
5.7.5 The checks should be undertaken directly with involved professionals and not through messages with intermediaries.
5.7.6 The relevant agency should be informed of the reason for the enquiry, whether or not parental consent has been obtained and asked for their assessment of the child in the light of information presented.
5.7.7 Agency checks should include accessing any relevant information that may be held in other local authorities, or abroad (see Appendix 5 for sources of information for children from abroad).

5.8 Strategy discussion

5.8.1 If there is reasonable cause to suspect a child is suffering, or is likely to suffer significant harm, Children's social care should convene a strategy discussion
5.8.2 Depending on the nature of the concerns and the urgency of the situation this may be undertaken via an actual meeting and / or through a series of telephone discussions with the participants (see 5.8.7 onwards).
5.8.3 Strategy discussions by phone will usually be adequate to plan a straightforward enquiry or joint investigation. Meetings are likely to be more effective in complex types of maltreatment or neglect such as when there is:
  • Allegations against staff, carers and volunteers or anyone professionally involved with the child
  • Serious physical abuse
  • Fabricated or induced illness
  • An allegation that a child has abused another child (separate strategy meetings may be held for both children (see Section 8.3, Children who significantly harm other children)
  • An ongoing, cumulative concerns about the child's welfare and a need to involve all key agencies, share concerns and agree a course of action e.g. in cases of neglect
  • Concerns about the future risk to an unborn child
  • Direct communication between more than 2 agencies being required for meaningful discussion
5.8.4 More than 1 strategy discussion will often be required.
5.8.5 The discussion should be used to:
  • share available information;
  • agree the conduct and timing of any criminal investigation;
  • decide whether a core assessment under s47 of the Children Act 1989 (s47 enquiries) should be initiated, or continued if it has already begun;
  • plan how the s47 enquiry should be undertaken (if one is to be initiated), including the need for medical treatment, and who will carry out what actions, by when and for what purpose;
  • agree what action is required immediately to safeguard and promote the welfare of the child, and/or provide interim services and support. If the child is in hospital, decisions should also be made about how to secure the safe discharge of the child;
  • determine what information from the strategy discussion will be shared with the family, unless such information sharing may place a child at increased risk of significant harm or jeopardise police investigations into any alleged offence(s); and
  • determine if legal action is required.
5.8.6 Relevant matters will include:
  • agreeing a plan for how the core assessment under s47 of the Children Act 1989 will be carried out - what further information is required about the child(ren) and family and how it should be obtained and recorded;
  • agreeing who should be interviewed, by whom, for what purpose, and when. The way in which interviews are conducted can play a significant part in minimising any distress caused to children, and increasing the likelihood of maintaining constructive working relationships with families. When a criminal offence may have been committed against a child, the timing and handling of interviews with victims, their families and witnesses, can have important implications for the collection and preservation of evidence;
  • agreeing, in particular, how the child's wishes and feelings will be ascertained so that they can be taken into account when making decisions under s47 of the Children Act 1989;
  • in the light of the race and ethnicity of the child and family, considering how this should be taken into account, and establishing whether an interpreter will be required; and considering the needs of other children who may affected, for example, siblings and other children, such as those living in the same establishment, in contact with alleged abusers.


Participants to Strategy Discussion

5.8.7 The strategy discussion requires professionals sufficiently senior to be able to contribute, although exceptional circumstances may arise where others may usefully contribute.
5.8.8 The strategy discussion should ordinarily be co-ordinated by the Children's social care first line manager, who will chair any strategy meetings held.
5.8.9 The discussion must generally involve, as a minimum, both Children's social care and CPT with other agencies involved with the child included, in particular the referring agency, the child's nursery / school, health and (where relevant) registered owner of service and the registration authority (for example Ofsted)
5.8.10 Where issues have significant medical implications, or a paediatric examination has taken place or may be necessary, a paediatrician should always be included.
5.8.11 If the child is or has recently been receiving services from a hospital or child development team, the discussion should involve the responsible medical consultant and, in the case of in-patient treatment, a senior ward nurse or medical consultant must be considered essential.
5.8.12 The local authority solicitor's involvement may be appropriate.
5.8.13 Consideration should be given to the need to include a professional with expertise in particular cases of complex forms of alleged abuse and neglect.


Location of Strategy Discussion

5.8.14 Discussions that take the form of a face to face meeting should be held at a convenient location and time for the key attendees e.g. Children's social care office, police station, hospital, GP surgery or school.


Notes of Discussion

5.8.15 It is the responsibility of the chair of the discussion to ensure that the decisions and agreed actions are fully recorded using the agreed form. A copy should be made available as soon as possible and within one working day for all participants.
5.8.16 For telephone discussions, a copy of the notes authorised by the first line manager should be faxed to all participants.
5.8.17 Parents seeking access to these records should follow the appropriate agency's disclosure processes. All parties need to be consulted prior to disclosure of the records.


Timing of Strategy Discussion

5.8.18 Initial strategy discussions and any follow up discussions should generally be held within 3 working days, but see exceptions below.
5.8.19 In the following circumstances, a strategy discussion must be held on the day of referral:
  • Allegations / concerns indicating a serious risk to the child (e.g. serious physical injury or serious neglect)
  • Allegations of recent penetrative sexual abuse (to ensure forensic evidence)
5.8.20 Where immediate action was required by either agency prior to a strategy discussion, a discussion must be held within 1 working day of the action.
5.8.21 Where the concerns are particularly complicated e.g. complex abuse, a strategy discussion must occur on the day of referral, but the (first) face to face meeting may be delayed to within a maximum of 5 working days, unless there is a need to provide immediate protection to a child
5.8.22 The plan made at the strategy discussion/meeting should reflect the requirement to convene an initial child protection conference within 15 working days of the last strategy discussion (Working Together paragraph 5.81)

5.9 Undertaking S.47 enquiries

INVOLVING PARENTS, FAMILY MEMBERS & CHILDREN

5.9.1 The social worker has the prime responsibility to engage with family members in order to assess the overall capacity of the family to safeguard the child, as well as ascertaining the facts of the situation causing concern.
5.9.2 Parents and those with parental responsibility should;
  • Be informed at the earliest opportunity of concerns, unless to do so would place the child at risk of significant harm, or undermine a criminal investigation.
  • Be offered a verbal explanation of the child protection enquiry process; be provided with an explanatory leaflet.
5.9.3 In planning any intervention with parent/s, the following points must be covered:
  • An explanation of the reason for concern and where appropriate the source of information 
  • The procedures to be followed (this must include an explanation of the need for the child to be seen, interviewed and/or medically examined and seeking parental agreement for these aspects of the enquiry and/or investigation)
  • An explanation of their rights as parents including the need for support and guidance from an advocate whom they trust (advice should be given about the right to seek legal advice)
  • That in the event of any conflict between the needs and wishes of the parents and those of the child, the child's welfare is the paramount consideration in any decision or action
  • An explanation of the role of the various agencies involved in the enquiry / investigation and of the wish to work in partnership with them to secure the welfare of their child
  • The need to gather initial information on the history and structure of the family, the child and other relevant information to enable an assessment of the injuries and/or allegations and the continuing risk to the child to be made
  • In situations of domestic violence, the possibility of working with the parents separately
  • Assessment of evidential opportunities in a police investigation and recovery of evidence that may confirm or refute an allegation or suspicion of crime
  • The provision of an opportunity for parents to be able to ask questions and receive support and guidance
5.9.4 Due consideration must be given to the capacity of the parents to understand this information in a situation of significant anxiety and stress.
5.9.5 Consideration must be given to those for whom English is not their first language or who may have a physical / sensory / learning disability and may need the services of an appropriate interpreter.
5.9.6 It is also essential that factors such as race, culture, religion, gender and sexuality together with issues arising from disability and health are taken into account.
5.9.7 It may be necessary to provide the information in stages and this must be taken into account in planning the enquiry.
5.9.8 Parents should be provided with an early opportunity to explain their perception of the concerns, recognising that there may be alternative accounts and discrepancies.


MEETING THE CHILD

5.9.9 All children within the household must be directly communicated with during an enquiry. Those who are the focus of concern should be seen alone, subject to age and preferably with parental permission.
5.9.10 Working Together to Safeguard Children paragraph 5.65 states that 'exceptionally, a joint enquiries / investigation team may need to speak to a suspected child victim without the knowledge of the parent or carer. Relevant circumstances would include the possibility that a child would be threatened or coerced into silence; a strong likelihood that important evidence would be destroyed; or that the child in question did not wish the parent to be involved at that stage, and is competent to take that decision.'
5.9.11 Consideration must be given to child's developmental stage and cognitive ability. Specialist help may be needed if:
5.9.12 Consideration should also be given to the gender of interviewers, particularly in cases of alleged sexual abuse.
5.9.13 Factors such as race, culture, religion, gender and sexuality and issues arising from disability / health must also be taken into account.
5.9.14 It may be necessary to provide the information in stages and this must be taken into account in planning the enquiry. Children may need time, and more than one opportunity, in order to develop sufficient trust to communicate any concerns they may have.
5.9.15 The objectives in seeing the child are to:
  • Record and evaluate her/his appearance, demeanour, mood state and behaviour
  • Hear the child's account of allegations or concerns
  • Observe and record interactions of child and her/his carers
  • See and record the circumstances in which the child is currently living and sleeping and, if different, her/his ordinary residence
  • Evaluate the physical safety of the environment including the storage of hazardous substances e.g. bleach, drugs
  • Ensure that any other children who need to be seen are identified
  • Assess the degree of risk and possible need for protective action
  • Meet the child's needs for information and re-assurance
5.9.16 The strategy discussion / meeting must decide where, when and how the child/ren should be seen and if a video interview is required. The child should be seen within 24 hours if the child
  • Is reported to have sustained a physical injury
  • Has disclosed sexual abuse and is to be returned to a situation that might place her/ him at risk
  • Is already subject to a child protection plan
  • Is suffering from severe neglect or other severe health risk
  • Is abandoned
5.9.17 To avoid undermining any subsequent criminal case, in any contact with a child prior to an interview, staff must:
  • Listen to the child rather than directly questioning her/him
  • Never stop the child freely recounting significant events
  • Fully record the discussion including timing, setting, presence of others as well as what was said
5.9.18 All subsequent events up to the time of any video interview must be fully recorded.


INVESTIGATIVE INTERVIEWS

5.9.19 The conduct of and criteria for visually recorded interviews with children are clearly laid out in the current guidance Achieving Best Evidence in Criminal Proceedings (Home Office 2001).


INABILITY TO ACCESS THE CHILD

5.9.20 If a child's whereabouts are unknown, or they cannot be traced by the social worker within 24 hours, the following action must be taken:
  • A strategy discussion / meeting held with the CPT
  • Agreement reached with the manager responsible as to what further action is required to locate and see the child and carry out the enquiry
5.9.21 If access to a child is refused or obstructed the social worker, in consultation with her/his manager, should have a strategy discussion with the police and seek legal advice as appropriate.


KEEPING OTHER AGENCIES INFORMED

5.9.22 In the course of an enquiry it may be necessary for statutory agencies to make decisions or initiate actions to protect children, or require the parents to agree to such action.
5.9.23 The social worker must inform relevant agencies of any such decisions or actions and confirm them in writing without delay

5.10 Paediatric assessment

5.10.1 Where the child appears in urgent need of medical attention s/he should be taken to the nearest A & E Department e.g. suspected fractures, bleeding, loss of consciousness,
5.10.2 In other circumstances the strategy discussion or meeting will determine, in consultation with the paediatrician, the need and timing for a paediatric assessment.
5.10.3 A paediatric assessment involves a holistic approach to the child and considers the child's well being, including development, if under 5 years old and her/his cognitive ability if older (educational psychologists can offer further expertise).
5.10.4 This assessment should always be considered when there is a suspicion or disclosure of child abuse and/or neglect involving:
  • A suspicious or serious injury (thought to be non-accidental or obvious/an inconsistent explanation)
  • Suspected sexual abuse or assault
  • Suspected neglect
5.10.5 Additional considerations are the need to:
  • Secure forensic evidence
  • Obtain medical documentation
  • Provide re-assurance for the child, parent and Children's social care
  • Provide treatment follow up and review for the child (any injury, infection, new symptoms including psychological) 
5.10.6 Only doctors may physically examine the whole child, but other staff should note any visible marks or injuries on a body map and document details in their recording.


CONSENT FOR PAEDIATRIC ASSESSMENTS OR MEDICAL TREATMENT

5.10.7 The following may give consent to a paediatric assessment:
  • A child of sufficient age and understanding (as per Fraser guidelines)
  • Any person with parental responsibility (see Appendix 4)
  • The local authority when the child is the subject of a care order (though the parent/carer should be informed)
  • The local authority when the child is accommodated under S.20 Children Act 1989, and the parent/carers have abandoned the child or are physically or mentally unable to give such authority
  • The High Court when the child is a ward of court
  • A Family Proceedings Court as part of a direction attached to an Emergency Protection Order, an interim Care Order or a Child Assessment Order
5.10.8 When a child is looked after under S.20 and a parent / carer has given general consent authorising medical treatment for the child, legal advice must be taken about whether this provides consent for paediatric assessment for child protection purposes (the parent / carer still has full parental responsibility for the child)
5.10.9 A child of any age who has sufficient understanding (generally to be assessed by the doctor with advice from others as required) to make a fully informed decision can provide lawful consent to all or part of a paediatric assessment or emergency treatment.
5.10.10 A young person aged 16 or 17 has an explicit right (S.8 Family Law Reform Act 1969) to provide consent to surgical, medical or dental treatment and unless grounds exist for doubting her/his mental health, no further consent is required.
5.10.11 Though a child of sufficient understanding (and who is subject of an interim Supervision or Care Order, a Child Assessment Order, Emergency Protection Order or a full Supervision Order) may refuse some or all of the paediatric assessment, the High Court can (potentially) override such refusal by use of its inherent jurisdiction.
5.10.12 Wherever possible, the permission of a parent should be sought for children under 16 prior to any paediatric assessment and/or other medical treatment. 
5.10.13 Where circumstances do not allow permission to be obtained and the child needs emergency medical treatment the medical practitioner may:
  • Regard the child to be of an age and level of understanding to give her/his own consent
  • Decide to proceed without consent
5.10.14 In these circumstances, parents must be informed as soon as possible and a full record must be made at the time.
5.10.15 In non-emergency situations, when parental permission is not obtained, the social worker and manager must consider whether it is in the child's best interests to seek a court order.


ARRANGING PAEDIATRIC ASSESSMENTS

5.10.16 Paediatric assessments are the responsibility of the consultant paediatrician, although an appropriately trained registrar or staff grade or exceptionally a police forensic medical examiner (FME) may conduct them.
5.10.17 Referrals for child protection paediatric assessments from a social worker or a member of the CPT are made to the local paediatric service.
5.10.18 The paediatrician may arrange to examine the child her/himself, or arrange for the child to be seen by a member of the paediatric team in the hospital or community.
5.10.19 Before the paediatric assessment, a CPT officer should directly brief the doctors and afterwards take possession of evidential items.
5.10.20 Child sexual abuse paediatric assessments should be undertaken in accordance with the guidance for paediatricians and FMEs issues by the Royal College of Paediatrics and Association of Police Surgeons Child Health Guidelines (2004). Specific practical procedures may vary according to local arrangements.
5.10.21 In cases of severe neglect, physical injury or penetrative sexual abuse, the assessment should be undertaken on the day of referral, where compatible with the welfare of the child.
5.10.22 Normally the order in which the paediatric assessment takes place (as part of the enquiry) will be decided at the strategy discussion.
5.10.23 The social worker should, (unless this would cause undue delay) consult parents about the gender of the medical practitioner prior to the examination being conducted.
5.10.24 The need for a specialist assessment by an appropriate mental health professional should be considered.
5.10.25 In planning the examination, the social worker, the manager responsible, the child protection team and relevant doctor must consider whether it might be necessary to take photographic evidence for use in care or criminal proceedings.
5.10.26 Where such arrangements are necessary, the child and parents must be informed and prepared and careful consideration given to the impact on the child.


Recording of Paediatric Assessment

5.10.27 The paediatrician should supply a report or statement to the social worker, GP and where appropriate the child protection team. Reports should be produced in accordance with the Sussex Police forensic medical examination record.
5.10.28 The timing of a letter from the paediatrician to parents should be determined in consultation with Children's social care and child protection team.
5.10.29 The report should include:
  • A verbatim record of the carer's and child's accounts of injuries and concerns noting any discrepancies or changes of story
  • Documentary findings in both words and diagrams
  • Site, size, shape and where possible age of any marks or injuries
  • Date, time and place of examination
  • Those present
  • Who gave consent and how (child / parent, written / verbal)
  • Other findings relevant to the child e.g. squint, learning or speech problems etc.
  • Confirmation of the child's developmental progress
  • Professional opinion
  • Time examination ended
5.10.30 All reports and diagrams should be signed and dated by the doctor undertaking the examination.

5.11 Analysis and assessment of risk

5.11.1 The scope and focus of the assessment during the S.47 enquiry will be that of a core assessment which specifically addresses the risks for the child/ren and should:
  • Identify clearly the initial cause for concern
  • Collect information from agency records and other agencies
  • Describe the family history and that of the child/ren
  • Describe the family structure and network
  • Evaluate the quality of attachments between child/ren and carers
  • Evaluate the strengths of the family
  • Evaluate the risks to the child/ren
  • Consider the child's need for protection
  • Evaluate information from all other sources (see paragraph 5.2.3 and Section 5.7 Agency information sharing)
  • Consider the ability of parents and wider family and social networks to safeguard and promote the child's welfare
5.11.2 Where the child's circumstances are about to change the assessment must include the safety of the new environment e.g. if a child is to be discharged from hospital, the assessment must have established the safety of the home environment and implemented any support plan required to meet the child's needs.

5.12 Outcome of child protection enquiries

5.12.1 At the completion of the planned enquiry, a strategy discussion should share information, agree the outcome of the enquiry or plan any further enquiries and ensure all parties are clear about the final outcome. 
5.12.2 Outcomes of enquiries must be clearly recorded by the social worker, with the reasons for decisions clearly stated and signed off by her/his manager on the outcome of S.47 Enquiries Record (Integrated Children's System) or equivalent form and signed by the manager.
5.12.3 When the outcome is agreed, the original concerns may be:
  • Unsubstantiated
  • Concerns are substantiated, but the child is not judged at continuing risk of significant harm
  • Concerns are substantiated and the child is judged to be at continuing risk of significant harm
5.12.4 Where the concerns are substantiated, but the child is not judged at continuing risk  of significant harm the relevant manager must authorise the decision, having ensured that the child, any other children in the household and the child's carers have been seen and spoken with.
5.12.5 In these circumstances, consideration must be given to the completion of the core assessment (if incomplete), provision of services, any future monitoring by agencies. If Children's social care continue to provide services to the child / family a child's plan should be initiated or reviewed.
5.12.6 Where concerns are substantiated and the child is assessed to be at continuing risk of significant harm, the authorised manager / child protection advisor (in East Sussex), must authorise the convening of an initial child protection conference and completion of the core assessment, having ensured the child, any other children in the household and the child's carers have been seen.
5.12.7 The manager may also agree / decide to initiate legal action.


FEEDBACK FROM ENQUIRIES

5.12.8 Parents, children (depending on level of understanding), professionals and other agencies that have had significant involvement should be provided with written feedback of the outcome of the enquiry (in a letter for the family and in an appropriate format for professionals).
5.12.9 Feedback about outcomes should be provided to referrers who are members of the public, in a manner that respects the confidentiality and welfare of the child.
5.12.10 If there are ongoing criminal investigations, the content of the social workers feedback should be agreed with the CPT


DISPUTED DECISIONS

5.12.11 In this situation professionals and agencies involved with the child and the family have a right to request that Children's social care convene a child protection conference if they have serious concerns that the child's welfare may not be adequately safeguarded.
5.12.12 Any such request that is supported by a senior manager or a named or designated professional should normally be agreed. Where differences of views remain then the resolution of professional disagreement procedure (Section 6.13, Resolution of professional disagreement) is used to resolve the differences as soon as possible.

5.13 Timescales

Routine

5.13.1 The initial strategy discussion instigates the S.47 enquiry.
5.13.2 The core assessment must be completed within 35 working days from the date of the strategy discussion/meeting (see the Framework for the Assessment of Children in Need and their Families paragraph 3.11).
5.13.3 The maximum period from the strategy discussion (or last discussion if more than 1 held) to the date of the initial child protection conference is 15 working days, which means that initial conferences may be held prior to the completion of the core assessment.


Exceptions

5.13.4 The time-scales above are the minimum standards required by Working Together. Where the welfare of the child requires shorter time-scales, these must be achieved.
5.13.5 There may be exceptional circumstances where it is not in the child's interests to work to the above time-scales. The circumstances which may lead to an alternative time-scale include:
  • A need to engage interpreters, translators etc. for those with communication needs (including disabled children)
  • Pre-birth assessments
  • Complex cases e.g. fabricated or induced illness, those involving suspected organised or institutional abuse, cases where paid or voluntary carers are involved and cases which require co-ordination with other local authorities because the child is found outside the borough
5.13.6 Any proposal to justify variation of routine time scales must be authorised by the service manager / child protection advisor following line manager's consultations with the child protection team and any relevant agencies.
5.13.7 Reasons for diverging from these time-scales must be fully recorded together with a plan of action detailing alternative arrangements.

5.14 Recording of S.47 enquiries

5.34.1 A full written record must be completed by each agency involved in a S.47 enquiry, using the required agency pro-formas, (legibly) signed and dated by the staff or inputted into their electronic record.
5.34.2 The responsible manager must countersign Children's social care' S.47 recording and forms.
5.34.3 Practitioners should wherever possible, retain signed and dated rough notes until the completion of anticipated legal proceedings.
5.34.4 Children's social care recording of enquiries should include:
  • Agency checks
  • Content of contact cross referenced with any specific forms used
  • Strategy discussion / meeting notes
  • Details of the enquiry
  • Body maps (where applicable)
  • Assessment including identification of risks and how they may be managed
  • Decision making processes
  • Outcome / further action planned
5.34.5 At the completion of the enquiry the social work manager should ensure that the concern and outcome have been entered on a chronology kept at the front of each file / on the electronic record.


6. Child protection conferences

This section should be read in conjunction with the following hildren and Young People's Trust Procedure(s): Core Assessments

6.1 Guiding principles
6.2 Types of child protection conference
6.3 Membership of child protection conference
6.4 Involving children and family members
6.5 Exclusion of family members from a conference
6.6 Absence of parents and/or children
6.7 Information for a conference
6.8 Chairing conferences
6.9 Actions and decisions of the conference
6.10 Challenges by professionals and parents
6.11 Administrative arrangements and record keeping for child protection conferences
6.12 Complaints by service users
6.13 Resolution of professional disagreement


6.1 Guiding principles

6.1.1 The focus of the child protection conference is to decide what future action is required to safeguard & promote the welfare of the child/ren and any siblings.
6.1.2 All agencies must make reasonable efforts to ensure that staff involved in child protection work are committed to and achieve:
  • Sharing of information
  • Careful preparation for conferences, including the provision of reports
  • Attendance at conferences
  • Contribution to decision making
  • Delivery of actions that are planned to safeguard the child/ren
6.1.3 All those participating in conferences, either directly or through the provision of written information should clearly distinguish between fact, observation, allegation and opinion.

6.2 Types of child protection conferences

INITIAL CHILD PROTECTION CONFERENCE

Purpose of Initial Conference

6.2.1 The initial child protection conference brings together family members, the child where appropriate, and those professionals most involved with the child and family, following s47 enquiries. Its purpose is:
  • to bring together and analyse, in an inter-agency setting, the information which has been obtained about the child's developmental needs, and the parents' or carers' capacity to respond to these needs to ensure the child's safety and promote the child's health and development within the context of their wider family and environment;
  • to consider the evidence presented to the conference, make judgements about the likelihood of a child suffering significant harm in future and decide whether the child is at continuing risk of significant harm; and
  • to decide what future action is required to safeguard and promote the welfare of the child, how that action will be taken forward, and with what intended outcomes.
6.2.2 The conference must consider all the children in the household, even if concerns are only being expressed about one child.
6.2.3 In some cases, it may be appropriate to develop a child protection plan for only one (or more) of the children within a household. If significant concerns arise subsequently about a sibling (or others in the household), a further initial conference must be held. It should be combined with a review conference concerning the child who is already subject to a child protection plan.


TIMING OF INITIAL CHILD PROTECTION CONFERENCE

6.2.4 The initial child protection conference should take place within 15 working days of the last strategy discussion of the S.47 enquiry.
6.2.5 The initial conference should, where possible, be held before expiry of an Emergency Protection Order, if further legal action is planned.
6.2.6 Where a Child Assessment Order has been made the conference should be held immediately on conclusion of examinations and assessments.
6.2.7 Any delay must have written authorisation from the service manager / child protection advisor  (including reasons for the delay) and Children's social care must ensure risks to the child are monitored and action taken to safeguard the child.


PRE-BIRTH CONFERENCE

Purpose

6.2.8 A pre-birth conference is an initial child protection conference concerning an unborn child. Such a conference has the same status and purpose and must be conducted in a comparable manner to an initial child protection conference.
6.2.9 A pre-birth conference should be held where a:
  • Pre- birth assessment gives rise to concerns that an unborn child may be at risk of significant harm
  • Previous child has died or been removed from parent/s as a result of significant harm
  • A child is to be born into a family or household which already have children subject to a child protection plan
  • A person identified as presenting a risk, or potential risk, to children resides in the household or is known to be a regular visitor
6.2.10 Other risk factors to be considered are:
  • The impact of parental risk factors such as mental ill-health, learning disabilities, substance misuse and domestic violence
  • A mother under 16 for whom there are concerns regarding her ability to self care and/or to care for the child
6.2.11 All agencies involved with pregnant women who have concerns should consider the need for an early referral to Children's social care, so that assessments are undertaken, and family support services provided, as early as possible in the pregnancy.


Timing of Conference

6.2.12 The pre-birth conference should take place at least 10 weeks before the due date of delivery, so as to allow as much time as possible for planning support for the pregnancy and the birth of the baby.
6.2.13 Where there is a known likelihood of a premature birth, the conference should be held earlier.


Attendance

6.2.14 Those who normally attend an initial child protection conference must be invited (see Section 6.3, Membership of child protection conference). In addition representatives of the midwifery and relevant neo-natal services should also be invited.


The Development of a Pre-birth Child Protection Plan

6.2.15 If a decision is made that the child requires a child protection plan, the main cause for concern must determine the category of concern and a protection plan be outlined to commence prior to the birth of the baby.
6.2.16 The core group must be established and is expected to meet prior to the birth, and certainly prior to the baby's return home after a hospital birth.


Timing of Review Conference Following a Pre Birth Conference

6.2.17 The first review conference will be scheduled to take place within 2 months of the child's birth. The conference chair will determine the date.


TRANSFER CONFERENCE

6.2.18 When Children's social care is notified that a child subject to a child protection plan moves into the authority's area, the responsibility for the child protection plan rests with the original authority until the conference has been held, but local staff should co-operate with the key worker from the originating authority to implement the child protection plan.
6.2.19 A transfer conference should be held within 15 working days of the notification of the move by the originating authority.
6.2.20 The key worker from the originating authority must be invited to the transfer conference and asked to submit a report.
6.2.21 The transfer conference is a review conference. The discontinuing of the child protection plan should only be agreed following a full risk assessment of the child and family in their new situation.
6.2.22 A review conference should review the child protection plan within three months of a transfer conference


REVIEW CHILD PROTECTION CONFERENCE

Purpose of Review Child Protection Conference

6.2.23 The purpose of the review conference is to:
  • Review the safety, health and development of the child against the planned outcomes set out in the child protection plan
  • Ensure that the child continues to be safeguarded from harm
  • Consider whether the child protection plan should continue in place or should be changed.


Timing

6.2.24 If a child is subject to a Child Protection Plan, the first review conference must be held within 3 months of the initial conference.
6.2.25 Further reviews must be held at intervals of not more than 6 months, for as long as the child' is subject to a Child Protection Plan.
6.2.26 Consideration should always be given to bringing the date of a conference forward:
  • Where child protection concerns relating to a new incident or allegation of abuse have been sustained
  • When there are significant difficulties in carrying out the child protection plan
  • Where a child is to be born into the household of a child who is subject to a child protection plan
  • Where a person known to pose a risk to children (schedule 1 offender or otherwise) is to join or commences regular contact with, the household
  • When there is a significant change in the circumstances of the child or family not anticipated at the previous conference and with implications for the safety of the child
  • Where a child subject to a child protection plan is looked after by a local authority and consideration is being given to returning her/him to the circumstances which required a child protection plan (unless this step is anticipated in the existing protection plan)
  • Where the core group believe that the child protection plan is no longer required

6.3 Membership of a child protection conference

6.3.1 Those attending conferences should be there because they may have a significant contribution to make, arising from professional expertise, knowledge of the child or family or both.
6.3.2 Those who have a relevant contribution to make may include:
  • the child, (if of sufficient age and understanding: (see paragraphs 6.4.9 to 6.4.21, Criteria for Presence of Child at Conference) or his or her representative;
  • family members (including the wider family);
  • LA children's social care staff who have led and been involved in an assessment of the child and family;
  • foster carers (current or former);
  • residential care staff;
  • professionals involved with the child (for example, health visitors, midwife, school nurse, children's guardian, paediatrician, school staff, early years staff, the GP, NHS Direct)
  • professionals involved with the parents or other family members (for example, family support services, adult mental health services, probation, the GP, NHS Direct);
  • Professionals with expertise in the particular type of harm suffered by the child or in the child's particular condition, for example, a disability or long term illness;
  • those involved in investigations (for example, the police);
  • local authority legal services (child care);
  • NSPCC or other voluntary organisations involved;
  • a representative of the armed services, in cases where there is a Service connection.


Legal Attendance at Conferences

6.3.3 The Law Society provides professional guidance on attendance by lawyers at child protection conferences. Their role is as a supporter or representative for the child, parents or on behalf of the local authority, but the process is not a court or tribunal and the adversarial role is not appropriate.
6.3.4 The local authority solicitor is both a legal advisor to the chair and to the local authority, although will not normally provide this advice during the conference. S/he may not question parents directly and in exceptional circumstances may have to withdraw if any indications that admissions are to be made by parents.
6.3.5 The solicitor for a parent or child may attend in the role of representative of child or supporter of parent to assist her/his clients to participate and, with the chair's permission to speak on their behalf.


Attendance of Agency Representatives

6.3.6 Representatives of agencies should confer with their colleagues beforehand and bring sufficient copies of legible and signed reports to ensure that relevant information is shared at the conference.
6.3.7 Professionals who are invited but unable to attend for unavoidable reasons should:
  • Arrange wherever possible for another representative to attend on her / his behalf
  • Inform the conference administrator
  • Submit a written report
6.3.8 A professional observer can only attend with the prior consent of the chair and the family and must not take part in discussions or decision-making. Requests should be made to the Children's social care social worker a minimum of 3 working days before the conference.
6.3.9 Agencies are expected to share information about the child and family members, relevant to the core assessment of the child's situation.


QUORATE CONFERENCES

6.3.10 The primary principle for determining quoracy is that there should be sufficient agencies or key disciplines present to enable safe decisions to be made in the individual circumstances. Normally, minimum representation is Children's social care and at least 2 other agencies or key disciplines that have had direct contact with the child and family.
6.3.11 Where a conference is inquorate it should not ordinarily proceed and the chair must ensure that either:
  • An interim protection plan is produced or
  • The existing plan is reviewed with the professionals and family members that do attend, so as to safeguard the welfare of the child/ren (this must not be recorded as a conference record)
6.3.12 Another conference date, usually within a month, must be set immediately.
6.3.13 In the following circumstances the chair may decide to proceed with the conference despite lack of agency representation. This would be relevant where:
  • Children's social care and 1 other agency are represented
  • A child does not have relevant contact with 3 agencies
  • There are local difficulties concerning agency attendance (this must also be reported to the senior child protection manager and the LSCB)
  • Where sufficient information is available and
  • A delay will be detrimental to the child
6.3.14 Where an inquorate conference is held, an early review conference should be arranged.

6.4 Involving children and family members

INVOLVING PARENTS / CARERS

6.4.1 Parents and carers must be invited to conferences (unless exclusion is justified as described in Section 6.5, Exclusion of family members from a conference). Parents / others with parental responsibility who no longer live with the children should also be invited.
6.4.2 The social worker must facilitate their constructive involvement by ensuring in advance of the conference that they are given sufficient information and practical support to make a meaningful contribution This includes:
  • Explaining to parents/carers the purpose of the meeting, who will attend, the way in which it will operate, the purpose and meaning of being made subject to a child protection plan and the complaints process.
  • Consideration of childcare arrangements to enable the attendance of parent/s.
  • Those for whom English is not a first language must be offered, if required, an interpreter. A family member should not be expected to act as an interpreter of spoken or signed language (see Section 8.30, Use of interpreters, signer or others with special communication skills).
  • Provision should be made to ensure that visually or hearing impaired or otherwise disabled parents / carers are enabled to participate.
6.4.3 If parents / carers feel unable to attend the conference, alternative means should be provided for them to communicate with the chair of the conference.
6.4.4 Written information about conferences should be left with the family and include references to:
  • The right to bring a friend, supporter or an advocate
  • The fact that if the family is accompanied by a solicitor her /his role is limited to that  of a supporter
  • Details of local advice and advocacy services and
  • The conference complaints procedure
6.4.5 The role of the supporter is to enable the parent/carer to put her/his point of view, not to take an adversarial position or cross-examine participants.


INVOLVING CHILDREN

6.4.6 The child, subject to her/his level of understanding, needs to be given the opportunity to contribute meaningfully to the conference.
6.4.7 In practice, the appropriateness of including an individual child must be assessed in advance and relevant arrangements made to facilitate attendance at all or part of the conference.
6.4.8 Where it is assessed, in accordance with the criteria below, that it would be inappropriate for the child to attend, alternative arrangements should be made to ensure her/his wishes and feelings are made clear to all relevant parties - e.g. use of an advocate, written or taped comments.


Criteria for Presence of Child at Conference

6.4.9 The primary issues to be addressed are:
  • The child's level of understanding of the process
  • Any expressed or implicit wish to be involved
  • The parent / carer's views about the child's proposed presence
  • Whether inclusion is assessed to be of benefit to the child
6.4.10 The test of 'sufficient understanding', is partly a function of age and partly the child's capacity to understand.
6.4.11 Generally, a child of less than 12 years of age is unlikely to be able to be a direct and/or full participant in a conference. An older child is potentially able to contribute, but each should be considered individually in the light of maturity, and cognitive development.
6.4.12 In order to establish her/his wish with respect to attendance, the child must be first provided with a full and clear explanation of purpose, conduct, membership of the conference and potential provision of an advocate or support person.

Written information translated into the appropriate language should be provided to those able to read and an alternative medium e.g. tape, offered those who cannot read.

6.4.13 A declared wish not to attend a conference (having been given such an explanation) must be respected.
6.4.14 Consideration should be given to the views of and impact on parent/s of their child's proposed attendance.
6.4.15 Consideration must be given to the impact of the conference on the child e.g. if they have a significant learning difficulty or where it will be impossible to ensure they are kept apart from a parent who may be hostile and/or attribute responsibility onto them.
6.4.16 In such cases, energy and resources should be directed toward ensuring by means of an advocate and/or preparatory work by a social worker, that the child's wishes and feelings are effectively represented.


Indirect Contributions When a Child is not Attending

Indirect contributions from a child might include a pre-meeting with the conference chair.
6.4.17 Other indirect methods include written statements, emails, text messages and taped comments prepared alone or with independent support, and representation via an advocate.


Direct Involvement of a Child in a Conference

In advance of the conference, the chair and social worker should agree whether:
  • The child attends for all or part of the conference, taking into account confidentiality of parents and/or siblings
  • S/he should be present with one or more of her/his parents
  • The chair meets the child alone or with a parent / carer prior to the meeting
6.4.18 If the child attends all or part of the conference, it is essential that s/he is prepared by the social worker or independent advocate, who can help her/him prepare a report or rehearse any particular points that the child wishes to make.
6.4.19 Those for whom English is not a first language should be offered and provided with an interpreter.
6.4.20 Provision should be made to ensure that a child who has any form of disability is enabled to participate.
6.4.21 Consideration should be given to enabling the child to be accompanied by a supporter or an advocate.

6.5 Exclusion of family members from a conference

6.5.1 Exceptionally it may be necessary to exclude 1 or more family members from part or all of a conference.
6.5.2 These situations will be rare, and the conference chair must be notified by the social worker, or a worker from any agency, if they believe based on the criteria below, that a parent should be excluded. This representation must be made, as soon as possible and at least 3 days in advance of the conference.
6.5.3 The worker concerned must indicate which of the grounds it believes are met and the information, or evidence, the request is based on. The chair must consider the representation carefully and may need legal advice.
6.5.4 The chair should make a decision in response to:
  • Indications that the presence of the parent might seriously prejudice the welfare of the child
  • Sufficient evidence that a parent / carer may behave in such a way as to interfere seriously with the work of the conference e.g. violence, threats of violence, racist, or other forms of discriminatory or oppressive behaviour or being in an unfit state perhaps through drug, alcohol consumption or acute mental health difficulty (but in their absence a friend or advocate may represent them at the conference)
  • A child asking that a parent/ person with parental responsibility or carer are not present while s/he is present
  • The likelihood that the presence of parents would prevent a participant from making her/his proper contribution
  • The need (agreed in advance with the conference chair) for members to receive confidential information that would otherwise be unavailable, such as legal advice or information about a criminal investigation
  • Potential conflicts between different family members indicating that they should attend at separate times e.g. in situations of domestic violence
6.5.5 If, in planning a conference, it becomes clear to the chair that there may be conflict of interests between the children and parents, the conference should be planned so that the welfare of the child can remain paramount.
6.5.6 This may mean arranging for the child and parents to participate in separate parts of the conference and for separate waiting arrangements to be made.
6.5.7 Any exclusion period should be for the minimum duration necessary and must be clearly recorded in the conference record.
6.5.8 It may also become clear at the beginning or in the course of a conference, that its effectiveness will be seriously impaired by the presence of the parent/s. In these circumstances, the chair may ask them to leave.
6.5.9 Where a parent is on bail, or subject to an active police investigation, it is the responsibility of the chair to ensure that the police can fully present their information and views and also that the parents participate as fully as circumstances allow. This may involve the chair and police having a confidential meeting prior to the conference to agree a way of managing the process and the information.
6.5.10 The decision of the chair over matters of exclusion is final regarding both parents and the child/ren.
6.5.11 If the chair has decided, prior to the conference, to exclude a parent, this must be communicated in writing to the parent 3 days prior to the conference. The social worker should have prepared the parent for the possibility that this may occur.
6.5.12 The parent must be informed about how to make their views known, how s/he will be told the outcome of the conference and about the complaints procedure (see Section 6.12 Complaints by service users). The parent should be advised on the possibility of preparing a contribution for the conference e.g. a letter, others attending on her/his behalf e.g. solicitors, advocate.
6.5.13 Those excluded should be provided with a copy of the social workers report to the conference and be provided with the opportunity to have their views recorded and presented to the conference.
6.5.14 If a decision to exclude a parent is made, this must be fully recorded in the minutes. Exclusion from one conference is not reason enough in itself for exclusion from a further conferences.

6.6 Absence of parents and/or children

6.6.1 If parents and/or children do not wish to attend the conference they must be provided with full opportunities to contribute their views. The social worker must facilitate this by:
  • Exploring the use of an advocate or supporter to attend on behalf of the parent or child
  • Enabling the child or parent to write, or tape, or use drawings to represent their views
  • Agreeing that the social worker, or any other professional, expresses their views

6.7 Information for a conference

SOCIAL WORK REPORT

6.7.1 The child protection conference report should include:
  • A chronology of significant events, agency and professional contact
  • Information on the child's current and past state of developmental needs
  • Information on the capacity of the parents and other family members to ensure the child is kept safe from harm, and to respond to the child's developmental needs within their wider family and environmental context
  • The expressed views, wishes & feelings of the child, parents, and other family members
  • An analysis of the implications of the information obtained for the child's future safety and meeting of his or her developmental needs
6.7.2 The report should be provided to parents and older children (to the extent that it is believed to be in their interests) at least 3 working days in advance of initial conferences, and 10 working days before review conferences, to enable any factual inaccuracies to be identified, amended, and areas of disagreement noted.
6.7.3 Where necessary, the reports should be translated into the relevant language or medium.
6.7.4 The report should be provided to the chair at least 24 hours prior to the initial conference and 3 working days in advance of the review conference.
6.7.5 All reports must make it clear which children are the subjects of the conference (previously decided by the social worker and her/his manager). Even if not the subject of the conference, all children in the household need to be considered at the initial conference and information must be provided on each of them in the record.
6.7.6 The report will be sent out after the conference (with the conference record) to those invited to the conference.


INFORMATION FROM OTHER AGENCIES

6.7.7 It is the responsibility of all the agencies who have participated in the enquiry, or who have relevant information, to make this available to the conference. Contributors should, wherever possible, provide in advance a written report to the conference that should be made available to those attending.
6.7.8 Where any agency representatives are unable to attend the conference they must ensure that a written report is made available to the conference, through the chair and, if possible, that a colleague attend in their place.
6.7.9 For agencies in contact with the family, the reports should be shared before the conference, in the same way and within the same timescales as described for social work (see paragraph 6.7.2) and where necessary, should be translated into the appropriate language or medium.


All Written Reports

6.7.10 All written reports will be attached to the chair's report for circulation or incorporated into the conference record.


INFORMATION FROM CHILDREN AND FAMILIES

6.7.11 Children and family members should be helped in advance to consider what they wish to convey to the conference, how they wish to do so and what help and support they will require e.g. they may choose to communicate in writing, by tape or with the help of an advocate. Families may benefit from advice on the length of their submission, to enable proper consideration within the time constraints of the conference.

6.8 Chairing conferences

6.8.1 The chair of a child protection conference will be a social work manager or an independent chair. S/he must not have operational or line management responsibility for the case. The conference chair is accountable to the Director of Children's Services.
6.8.2 The chair must meet with the family, child and social worker prior to the conference to ensure they understand the purpose of the conference and how it will be conducted.
6.8.3 Where necessary, interpreters, etc. should be made available to facilitate family participation.
6.8.4 At the start of the conference the chair will:
  • Set out the purpose of the conference
  • Confirm the agenda
  • Emphasise the need for confidentiality
  • Address equal opportunities issues e.g. specifying that racist, homophobic, religious hatred and threatening behaviour will not be tolerated
  • Clarify the contributions of those present, including supporters of the family
6.8.5 During the conference the chair will ensure that:
  • The conference maintains a focus on the welfare of the child/ren
  • Consideration is given to all the children in the household
  • All those present, including the parents and child/ren if present, make a full contribution and that full consideration is given to the information they present. This may include the use of interpreters if English is not the first language of family members.
  • Reports of those not present are made known to parties
  • The wishes and feelings of the child/ren are clearly outlined
  • Issues of race, religion, language, class, gender, sexuality and disability are fully taken into account in the work of the conference
  • Appropriate arrangements are made to receive third party confidential information
  • All concerned are advised/reminded of the complaints procedure
  • Arrangements are made with the social worker for absent parents or carers to be informed of the decisions of conferences
  • A decision is made as to whether the child should become the subject of a child protection plan

6.9 Action and decisions of the conference

IS THE CHILD AT RISK OF CONTINUING HARM ?

6.9.1 As described in 'Working Together to Safeguard Children' (paragraph 5.103) the conference should consider the following question when determining whether to make a child subject to a child protection plan:
  • Is the child at continuing risk of significant harm?
6.9.2 The test is that either:
  • The child can be shown to have suffered ill-treatment  or impairment of health or development as a result of physical, emotional, or sexual abuse or neglect, and professional judgement is that further ill-treatment or impairment is likely; or
  • A professional judgement, substantiated by the findings of enquiries in this individual case or by research evidence, predicts that the child is likely to suffer ill-treatment or the impairment of health and development as a result of physical, emotional or sexual abuse or neglect
6.9.3 If the child is at continuing risk of significant harm, s/he will require inter-agency help and intervention delivered through a formal child protection plan.


DECISION MAKING PROCESS

All Conferences

6.9.4 The chair of a conference is responsible for the conference decision. S/he will consult conference members, aim for a consensus as to the need for a plan or not, but ultimately will make the decision and note any dissenting views.
6.9.5 The decision making process will normally take place with parents / carers present.
6.9.6 The chair must make a decision about the need for a child protection plan 'based on the views of all agencies represented at the conference and also take into account any written contributions that have been made' (Working Together to Safeguard Children paragraph 5.105).


Discontinuing the Child Protection Plan

6.9.7 The same decision making procedure should be used to reach a judgement for discontinuing the child protection plan as used in the initial conference.
6.9.8 As indicated in Working Together to Safeguard Children (para. 5.140) a child should no longer be subject to a child protection plan if:
  • it is judged that the child is no longer at continuing risk of significant harm requiring safeguarding by means of a child protection plan (for example, the likelihood of harm has been reduced by action taken through the child protection plan; the child and family's circumstances have changed; or reassessment of the child and family indicates that a child protection plan is not necessary). Under these circumstances, only a child protection review conference can decide that a child protection plan is no longer necessary;
  • the child and family have moved permanently to another local authority area. In such cases, the receiving local authority should convene a child protection conference within 15 working days of being notified of the move, only after which event may discontinuing the child protection plan take place in respect of the original local authority's child protection plan (see paragraph 6.2.18);
  • the child has reached 18 years of age, has died or has permanently left the UK.
6.9.9 When a child is no longer the subject of a child protection plan, notification should be sent, as minimum, to all those agency representatives who were invited to attend the initial child protection conference that led to the plan.
6.9.10 Where one or more agencies currently working with a child are not present at the conference deciding on whether to discontinue the child protection plan, the chair may decide to seek their views first. This should be done in writing within 10 working days and written responses provided within 10 working days.
6.9.11 The discontinuation of the child protection plan should not lead to the automatic withdrawal of help. The key worker must discuss with parents and child/ren what services are wanted and needed, based on the re-assessment of the child and family and a child's plan made if support continues.
6.9.12 Consideration should be given to holding a multi-agency meeting 10 days following the discontinuing of the child protection plan  to develop a detailed child's plan and 3 months afterwards to provide a first review to the child's plan. Subsequently the plan should be reviewed at least every 6 months.


CATEGORIES OF ABUSE OR NEGLECT

6.9.13 If the decision is that the child is at continuing risk of significant harm and in need of a child protection plan, Working Together to Safeguard Children paragraph 5.106 states the chair should determine under which category of abuse or neglect the child has suffered or is at risk of suffering.
6.9.14 The category used will indicate to those consulting the child's social care record the primary presenting concern at the time the child became subject to a child protection plan. For further information on the definition of these categories see Section 3, Recognition and referral.
6.9.15 Multiple categories should not be used to cover all eventualities, and 'other significant concerns' recorded instead. On occasions it may be appropriate to use more than 1 category if:
  • Each of the categories reaches the threshold for significant harm and
  • A specific risk might otherwise be underestimated
6.9.16 Emotional abuse should only be used as a second category if substantial concern is indicated.
6.9.17 The need for a child protection plan should be considered separately in respect of each child in the family or household.
6.9.18 Where a pre-birth conference has decided that an unborn child is to be the subject of a child protection plan, her/his name and expected D.O.B may be placed on the child's social care record immediately and their name and D.O.B confirmed at birth.


IF A CHILD IS MADE SUBJECT TO A CHILD PROTECTION PLAN

6.9.19 Where a child is made subject to a child protection plan, it is the role of the conference to consider and make recommendations on how agencies, professionals and the family should work together to ensure that the child will be safeguarded from harm in the future. This should enable both professionals, and the family, to understand exactly what is expected of them and what can they expect of others.
6.9.20 The chair must ensure that the following tasks are completed:
  • That a key worker is identified, and if this is not possible that a first line manager from Children's social care is identified to act in that role in the interim
  • Identify the membership of the core group
  • Establish how the child, parents (including all those with parental responsibility) and wider family members should be involved in the ongoing assessment, planning and implementation process, and the support, advice and advocacy available to them
  • Establish timescales for meetings of the core group, production of a child protection plan, and for child protection review meetings;
  • Identifying in outline what further action is required to complete the core assessment and what other specialist assessments of the child and family are required to make sound judgements on how best to safeguard and promote the welfare of the child;
  • Outline the child protection plan, especially, identifying what needs to change in order to achieve the planned outcomes to safeguard and promote the welfare of the child;
  • Ensure a contingency plan is in place if agreed actions are not completed and/or circumstances change; for example, if a caregiver fails to achieve what has been agreed, a court application is not successful or a parent removes the child from a place of safety;
  • Clarify the different purpose and remit of the initial conference, the core group, and the child protection review conference; and
  • Agreeing a date for the first child protection review conference, and under what circumstances it might be necessary to convene the conference before that date.


Outline Plan

6.9.21 The outline child protection plan should:
  • identify factors associated with the likelihood of the child suffering significant harm and ways in which the child can be protected through an inter-agency plan based on the current findings from the assessment and information held from any previous involvement with the child and family;
  • establish short-term and longer-term aims and objectives that are clearly linked to reducing the likelihood of harm to the child and promoting the child's welfare, including contact with family members;
  • be clear about who will have responsibility for what actions - including actions by family members - within what specified timescales;
  • outline ways of monitoring and evaluating progress against the planned outcomes set out in the plan; and
  • be clear about which professional is responsible for checking that the required changes have taken place, and what action will be taken, and by whom,  when they have not.


IF A CHILD IS NOT MADE SUBJECT TO A CHILD PROTECTION PLAN OR THE PLAN IS DISCONTINUED

6.9.22 If it is decided that the child is not at risk of continuing significant harm, but the child is in need of support to promote her/his health or development, the conference must ensure that recommendations are made to this effect.
6.9.23 Subject to the family's views and consent, it may be appropriate to:
  • Continue the core assessment (if not already completed) of the child's needs to help determine the support required
  • Make recommendations about support and help
  • Establish commitment to inter-agency working, particularly where the child's needs are complex (this should involve a regularly reviewed child's plan)
6.9.24 The decision must be put in writing to the parent/s, and where appropriate the child, as well as communicated to them verbally. 

6.10 Challenges by professionals and parents

DISSENT FROM THE CONFERENCE DECISION

6.10.1 The chair of a conference is responsible for the conference decision. S/he will consult conference members, aim for a consensus as to the need for a child protection plan, but ultimately will make the decision and note any dissenting views.
6.10.2 When dissent occurs, the social worker must involve that agency in future decision-making and in the child protection plan if there is one.
6.10.3 Research and serious case reviews have shown that differences of opinion between agencies can lead to conflict resulting in a less favourable outcome for the child.
6.10.4 A professional who dissents from the chair's decision must determine whether s/he wishes to further challenge the result.
6.10.5 If the dissenting professional believes the decision reached by the chair places a child at (further) risk of significant harm, s/he should seek advice from her/his named / designated / lead professional or manager and follow the procedures for Section 6.13 Resolution of profession disagreement


COMPLAINT ABOUT THE PROCESS

6.10.6 When professionals are concerned about the management of the conference s/he must seek advice from her/his named / designated / lead professional or manager.
6.10.7 A senior manager of an agency may support these concerns and write to the senior child protection manager, with copy to the chair and the agency professional.


DISAGREEMENT BY PARENTS

6.10.8 If parents / carers disagree with the Conference's decision, the chair must discuss the issue with them and explain their right to and the process for challenge (see Section 6.12, Complaints by service users).

6.11 Administrative arrangements and record keeping for child protection conferences

RESPONSIBILITY FOR ADMINISTRATION

6.11.1 Children's social care are responsible for administering the child protection conference service.
6.11.2 Each authority must have clear arrangements for the organisation of child protection conferences including:
  • Information leaflets for children and for parents translated into appropriate languages and
  • Standard invitations to children, parents / carers and professionals
  • Report formats for initial and review conferences


RECORDING OF THE CONFERENCE

6.11.3 All initial and review conferences should be noted by a dedicated person whose sole task within the conference is to provide a written record of the meeting in a consistent format.


Decision Letter

6.11.4 The decision letter (indicating whether the child/ren was/were made subject to a child protection plan(s), the outline child protection plan, name of the key worker and details about the right to complain) should be dispatched within 1 working days to all who have been invited to the conference including parents / carers and child/ren identified by the chair as having sufficient understanding.


Conference Record

6.11.5 Conference records should include:
  • Name, date of birth and address of the subject/s of the conference, parents / carers and other adults in the household
  • Who was invited, who attended the conference and who submitted their apologies
  • A list of written reports available to conference and whether available to parents or not
  • The purpose of the conference
  • All the essential facts
  • Opinions of conference members, clearly identified as such
  • Views of child
  • Views of parents / carers
  • A summary of discussion at the conference, accurately reflecting contributions made
  • All decisions reached, with information outlining the reasons
  • An outline or revised child protection plan
  • Name of key worker
  • Members of the core group and date of first meeting
  • Date of next conference
6.11.6 The conference record, signed by the conference chair, should be sent to all those who attended or were invited, within 10 working days of the conference. Any amendment to accuracy of record should be sent, in writing, within 10 working days of the receipt of that record.
6.11.7 Copies of the conference record should be given to the parents by the social worker. The parent/s' copy of the conference record should be clearly 'watermarked' on all pages. Confidential material may be excluded from the parent/s' copy.
6.11.8 Where an advocate, supporter or solicitor has been involved the chair should clarify with the parent whether the record should be provided for those individuals.
6.11.9 Where a child has attended a child protection conference, the social worker must arrange to see her/him and arrange to discuss relevant sections of the record.
6.11.10 Consideration should be given to whether that child should be given copies of the minutes. They may be supplied to a child's legal representative on request.
6.11.11 Where parents and / or the child/ren have a sensory disability or where English is not their first language, steps must be taken to ensure that they can understand and make full use of the minutes.
6.11.12 Conference minutes are confidential and should not be passed to third parties without the consent of either the conference chair or order of the court
6.11.13 In criminal proceedings the police may reveal the existence of child protection records to the Crown Prosecution Service and in care proceedings the record of the conference may be revealed in court.
6.11.14 Every agency must establish arrangements for the storage of child protection conference records in accordance with their own confidentiality and record retention policies.

6.12 Complaints by service users

ELIGIBILITY

6.12.1 Working Together to Safeguard Children Paragraph 5.110 clarifies that parents / carers or a child (considered by the conference chair to have sufficient understanding), may make a complaint in respect of 1 or more of the following aspects of the child protection conferences:
  • The process employed by the conference
  • The outcome, in terms of the fact of and/or the category of primary concern at the time the child became subject of a child protection plan
  • a decision for the child to become, or not to become , the subject of a child protection plan or to cease the child being the subject of a child protection plan
6.12.2 All parties must be made aware that
  • this complaints process cannot itself change the decision to have a child protection plan and
  • during the course of the complaints process, the decision made by the conference stands.
6.12.3 The end result for a complainant will be either that
  • a conference is re-convened under a different chairperson,
  • a review conference is brought forward or
  • that it confirms the status quo.
6.12.4 Complaints about individual agencies, their performance and provision (or non-provision) of services should be responded to in accordance with the relevant agency's ordinary complaints handling processes.


IMMEDIATE RESOLUTION

6.12.5 An expressed concern about the conference itself, which arises in the course of the meeting, must be noted and an attempt made by the chair to resolve it with the service user.
6.12.6 If this initial attempt to resolve matters fails, the service user should be reminded of the conference complaints process, and be invited (and if necessary assisted by the social worker) to write within 28 days of receipt of minutes, to the conference chair.


STAGE 1 - Exploration by Conference Chair and/or their manager

6.12.7 The conference chair should inform the senior child protection manager, social services complaints manager, and all the professionals who attended the conference, that s/he has received the complaint.
6.12.8 Complaints made outside the 28-day time limit may, in exceptional circumstances and at the discretion of the conference chair, be accepted.
6.12.9 The conference chair should meet with the complainant (who may be supported by a friend or relative) within 7 working days of receipt of the complaint so as to:
  • Ensure the complainant sufficiently understands the child protection process
  • Clarify the grounds for, and nature of, the complaint/s
  • Establish the outcome desired by the complainant
  • Ensure the complainant understands the scope and relevance of this complaints process with regard to their circumstances 
  • Gather relevant information
6.12.10 At the meeting with the complainant the conference chair should be accompanied by a colleague who can take minutes.
6.12.11 Within a further 7 working days, the conference chair should provide a written response to the complainant including notes of their meeting. This letter should include information on how to pursue concerns further if the complainant remains dissatisfied.
6.12.12 The response provided to the complainant should be copied to the Children's social care complaints manager.


STAGE 2 - Formal Consideration by Complaints Manager

6.12.13 If, within 28 days of days of receipt of the stage 1 letter the complainant notifies the complaints manager that s/he remains dissatisfied and specifies reasons, arrangements must be made to convene, within 28 days, a panel of a minimum of 3 individuals from the LSCB.
6.12.14 The complaints manager in liaison with the senior child protection manager will make arrangements for this meeting, and the representative of the agency least directly involved in the case will normally fulfil the role of chairperson.
6.12.15 The panel membership should include at least 2 from amongst child protection team, Children's social care, education and health agencies and the individuals should have had no previous or present direct line management responsibility for the case in question.
6.12.16 The panel must be provided with the following documentation:
  • A formal request to convene
  • A copy of the relevant conference record and the reports that were made available to the conference
  • Stage 1 meeting notes and correspondence
  • A list of names, addresses and telephone numbers of the conference chair, all other professionals involved and the family concerned
6.12.17 The complaints manager will liaise with the complainant throughout, and be available at the panel, to advise on relevant processes.
6.12.18 The panel should be convened within 28 days of the receipt of the complainant's letter and consider whether:
  • Relevant inter-agency protocols and procedures have been observed correctly and
  • If any decision in dispute follows reasonably from the processes employed and information presented
6.12.19 The panel will:
  • Hear (either directly or in writing) from the complainant, the chairperson of the relevant child protection conference and any other relevant person
  • Consider written material
  • Reach a decision
  • Agree the content of their decision letter to the complainant
6.12.20 The chair should ensure that the panel's conclusions should be put in writing to the complainant within 7 days of its meeting and will:
  • Confirm membership of the panel
  • State the decision reached
  • Provide concise information about how the decision was reached
6.12.21 A recommendation must be made to re-convene the conference, under a different chair if:
  • Procedures / protocols relating to the conference were not correctly followed or
  • The procedures / protocols were correctly followed but the decision of the conference was unreasonable
6.12.22 If the panel concludes that procedures relating to the conference were correctly followed and that the decision/s reached were reasonable, it must confirm that the conclusions of the original conference stands and will be routinely reviewed when the review conference is held.
6.12.23 The panel should also consider any specific concerns that may be relevant to communicate to agencies involved with the case and may make recommendations relating to practice or procedure to any LSCB agency.


RECONVENED CONFERENCE

6.12.24 The chair of a reconvened child protection conference (initial or review) must ensure that all those present have seen or are briefed at the conference about the decisions reached by the panel.
6.12.25 A distinction must be made by the chair between the need to discuss the conclusions of the panel and the task of the child protection conference, which is to consider the child/ren's current circumstances.


FURTHER CHALLENGE

6.12.26 No further internal processes exist in those cases where the panel concludes that all relevant processes were followed and that the decisions which were made were reasonable.
6.12.27 A complainant who nonetheless remains dissatisfied may wish to pursue her/his grievances via the Ombudsman or a Judicial review.
6.12.28 In what are likely to be very rare cases, where a re-convened conference has been recommended, held and the complainant does not accept the outcome, the same panel may, (at the discretion of the complaints manager in liaison with the senior child protection manager) be asked to re-convene and review any remaining and clearly specified concerns.

6.13 Resolution of professional disagreement

DISSENT AT ENQUIRY STAGE

6.13.1 Disagreements over the handling of concerns typically occur when:
  • The referral is not considered to meet eligibility criteria for assessment by children's social care
  • Advice is sought and a social worker has concluded that a referral is required, however the professional does not want to make a referral
  • Children's social care concludes that further information should be sought by the referrer before the referral is progressed
  • Children's social care believe that an initial assessment can be started without invoking child protection procedures
  • Children's social care considers that child protection procedures must be invoked and the referrer does not
  • Children's social care and CPT place different interpretations on the need for a s47 enquiry / criminal investigation
6.13.2 If the professionals are unable to resolve differences through discussion and/or meeting within a time scale, which is acceptable to both of them, their disagreement must be addressed by more experienced / more senior staff.
6.13.3 With respect to most day-to-day difficulties this will require a Children's social care team manager liaising with her/his equivalent in the relevant agency, e.g.:
  • A detective sergeant in the CPT
  • A senior health visitor / nurse / GP
  • Designated teacher
6.13.4 If agreement cannot be reached following discussions between the above 'first line' managers the issue must be referred without delay through the line management to the equivalent of service manager / detective inspector / head teacher.
6.13.5 At any stage advice should be sought from designated/named/lead officer/ child protection adviser or other designated professional such as the designated doctor or nurse.
6.13.6 Records of discussions must be maintained by all the agencies involved.


DISSENT WITH DECISION TO CALL A CHILD PROTECTION CONFERENCE

6.13.7 A request to convene a Child Protection Conference may be made by a senior staff member of any of the member agencies and should be made and responded to in writing to either a Service Manager or a Child Protection Advisor. 
6.13.8 A decision not to convene a conference must be confirmed in writing to the requesting agency/ies giving reasons.
6.13.9 Where there remain differences of view over the need for a conference in a specific case, every effort will be made to resolve them through discussion and explanation.
6.13.10 As a last resort the decision to hold the conference will be made by the senior child protection manager following discussion with the relevant LSCB members.


PROFESSIONAL DISSENT AT CHILD PROTECTION CONFERENCES

6.13.11 If the chair of a conference is unable to achieve a consensus as to the need for a child protection plan or the discontinuing of a plan, s/he will make a decision and note any dissenting views.
6.13.12 The agency or individual who dissents from the chair's decision must consider whether s/he wishes to further challenge the decision.
6.13.13 If the dissenting professional believes that the decision reached by the chair places a child at (further) risk of significant harm, it is expected that s/he will formally raise the matter with the Senior child protection manager.
6.13.14 The senior child protection manager will liaise with the conference chair and either:
  • Uphold the decision reached by the conference chair
  • Require the conference be re-convened


DISSENT REGARDING THE IMPLEMENTATION OF THE PROTECTION PLAN

6.13.15 Concern or disagreement may arise over another professional's decisions, actions or lack of actions in the implementation of the child protection plan, including core group meetings.
6.13.16 In the first instance the line managers of the professionals involved should always address concerns at a local level
6.13.17 If agreement cannot be reached following discussions between the above 'first line' managers the issue must be referred without delay through the line management to the equivalent of service manager / detective inspector / head teacher.
6.13.18 At any stage advice should be sought from designated/named/lead officer/ child protection adviser) or other designated professional such as the designated doctor or nurse.
6.13.19 Records of discussions must be maintained by all the agencies involved.


WHERE PROFESSIONAL DIFFERENCES REMAIN

6.13.20 In the unlikely event that the issue is not resolved by the steps described above and serious professional disagreements remain unresolved /or the discussions raise significant policy issues, the matter should be raised with the professional leads for safeguarding and child protection within the agencies involved and include the Senior child protection manager.
6.13.21 Records of challenges should be kept for statistical purposes by the Chair of the LSCB and included in the annual report.


7. Implementation of a protection plan

7.1 Introduction
7.2 Core group
7.3 Formulation of child protection plan
7.4 Key worker role
7.5 Children's social care first line manager role
7.6 Further assessment
7.7 Intervention
7.8 Children subject to a child protection plan who go missing
7.9 Death of a child subject to a child protection plan


7.1 Introduction

7.1.1 When the decision is made to make a child subject to a child protection plan the Conference must
  • Formulate an outline child protection plan (see paragraph 6.9.21),
  • Ensure a key worker from Children's social care is appointed to co-ordinate and lead all aspects of the inter-agency child protection plan, and
  • Identify members of the core group and set the date of the first meeting
7.1.2 The core group is responsible for the formulation and implementation of the detailed child protection plan, previously outlined at the conference.

7.2 Core group

Responsibilities

7.2.1 All members of the core group are jointly responsible for:
  • Collecting information to assist the key worker in completing the core assessment
  • Participating in the compilation of the core assessment
  • Formulating and implementing the child protection plan, refining it as necessary
  • Monitoring progress of the child protection plan against specified objectives
  • Providing clear information to review conferences on the implementation, progress and outcomes of the protection plan
7.2.2 Where any member of the core group is aware of difficulties implementing the protection plan due to changed or unforeseen circumstances, the key worker must be informed immediately and consideration given to recalling the core group meeting to re-consider the protection plan.
7.2.3 Circumstances, about which the key worker should be informed, include the inability to gain access to the child who is subject to a Child Protection Plan, for whatever reasons, on 2 consecutive home visits.
7.2.4 If the difficulty in implementing the protection plan impacts on the safety of the child, the key worker and all core group members should consider the need for a s.47 enquiry and / or bringing forward the date of the review child protection conference and / or for immediate legal action.
7.2.5 If members are concerned that there are difficulties implementing the protection plan arising from disagreement amongst professional agencies or a core group member not carrying out agreed responsibilities this must be addressed:
  • Firstly, by discussion with other core group members and first line managers
  • Secondly, if required, by referral to respective professional advisers i.e. child protection advisors for Children's social care, designated/named doctor, nurse, teacher and
  • If the situation remains unresolved, the matter should be referred to the senior child protection manager
7.2.6 See Section 6.13 Resolution of professional disagreement for additional information on the procedure to be followed for resolution of professional disagreement.


Membership

7.2.7 Membership of the core group will have been identified at the child protection conference and must include the key-worker / key worker's manager as chair.
7.2.8 It will include parents/carers, child (if appropriate) and other relevant family members.
7.2.9 Professionals and foster carers in direct regular contact with the child should also be included.


Timing

7.2.10 Working Together to Safeguard Children (paragraph 5.120) states that the date of the first core group meeting must be within 10 working days of the initial child protection conference.
7.2.11 This date must be arranged at the end of the conference, along with an indication of the required frequency of subsequent meetings.
7.2.12 Good practice would be for the core groups to meet within 6 weeks of their initial meeting, and at a minimum frequency of once every 2 months following the first review conference. More regular meetings may be required according to the needs of the child.
7.2.13 Where the review conference recommends major changes to the outline plan, the core group should meet within 10 days of the conference.
7.2.14 Dates for future meetings must be agreed at the first core group meeting following each conference.

7.3 Formulation of a child protection plan

7.3.1 Each child subject to a child protection plan must have a written child protection plan, using the child protection plan pro-forma.
7.3.2 The purpose of this plan is to facilitate and make explicit a co-ordinated approach to the protection from further harm of each child subject to a child protection plan.
7.3.3 Parents must be enabled to understand:
  • The causes for concern which resulted in the child's child protection plan
  • What needs to change in the future and
  • What is expected of them as part of the plan for safeguarding the child
7.3.4 All parties must be clear about the respective roles and responsibilities of family members and different agencies in implementing the plan.
7.3.5 The plan will be outlined at the conference and the key-worker and core group are responsible for ensuring it is drawn up in detail and acted upon.
7.3.6 The core group will, as described above, regularly review and where necessary modify the child's protection plan.
7.3.7 The child protection plan will constitute an agenda item at each review conference.
7.3.8 The child protection plan should be used to clarify expectations and assist in joint working towards shared goals. It can also be used as evidence, in any legal proceedings,  of the efforts made to work in partnership (this must be made clear to parents).


Outline child protection plan

7.3.9 An outline plan must be drawn up at initial and review conferences, following the decision to develop a child protection plan or continue with that plan. (See paragraph 6.9.21)
7.3.10 The aim of the outline plan is to assist the core group to form a clearer focus of work with the family and to explicitly define individual professional responsibilities.
7.3.11 There should be no reduction in service level or significant change to the child protection plan without:
  • The recorded agreement of other core group members and
  • The recorded agreement of the first line manager and
  • Consulting the conference chair by e-mail and
  • Consideration with the chair and line manager of any need to reconvene the conference


Child protection plan

7.3.12 The core group is responsible for drawing up in more detail the child protection plan for each child. This plan should be based on the outline child protection plan
7.3.13 The plan, based on the findings of the core assessment should cover:
  • A description of identified developmental needs, strengths and difficulties with regard to health, education, emotional & behavioural development, identity, family & social relationships, social presentation, self-care skills and family and environmental factors
  • Services or actions designed to respond to the identified needs
  • Start date, frequency and length of each input
  • Person / agency responsible, including family members
  • Planned outcomes of each intervention, including required progress to be achieved within specified timescales
  • Frequency of reviews of the plan and the date of the next core group meeting
7.3.14 The planned interventions should additionally address:
  • Ethnic / cultural / religious considerations - e.g. necessity for an interpreter, avoidance of appointments with family on significant religious festivals
  • Issues arising from any disability
  • Identification of risks to the child and means of protection
  • Identification of parenting strengths
  • Identification of what needs to change to reduce the risk of significant harm
  • Identification of actions to promote the child's health and development and actions to support the family and wider family members in promoting the welfare of the child
  • Description of the nature and frequency of contact with the child and roles and responsibilities of professionals, including specialist resources
  • Identification of any further core and/or specialist assessments
  • Establishment of specific short and long term aims and objectives, with clear time scales
  • Identification of measurements for success (how will the family and professionals know there has been change?)
  • Method of monitoring and evaluating progress, including identifying professional/s responsible 
  • Consideration of a contingency plan if circumstances change quickly, or if insufficient change occurs
7.3.15 The plan should be constructed with the family in their preferred language and signed by relevant family members.
7.3.16 The plan must consider the views of the child and the parents, insofar as this is consistent with the child's welfare. Both child and parents should be provided with the opportunity to record their comments, including areas of disagreement.
7.3.17 If the aim and content of the plan has not been discussed with any of the parties / agency concerned, the reasons must be stated on the plan.
7.3.18 Any dissent about the plan, by family or professionals, must be recorded, with reasons.
7.3.19 The key worker must record the protection plan and circulate it to all core group members and conference chair within 5 working days of the meeting. The signed plan should be returned to the key worker within another 5 working days.
7.3.20 The family must be told about their right to complain and the procedure for so doing.
7.3.21 All agencies are responsible for the implementation of the child protection plan and all professionals must ensure they are able to deliver their commitments, or if not possible, that these are re-negotiated.

7.4 Key worker role

7.4.1 At every initial or pre-birth conference, where a child is made subject to a child protection plan, the chairperson will name a qualified social worker, identified by the social work team manager, to fulfil the role of key worker for the child.
7.4.2 The key worker should:
  • Convene and chair second and subsequent core group meetings
  • Ensure that the outline child protection plan is developed, in conjunction with members of the core group, into a detailed multi-agency protection plan
  • Clearly note and include in the written record any areas of disagreement
  • Ensure core group members, child (where appropriate) and family have the opportunity to sign the protection plan and that it is copied and circulated to all signatories and maintained on the child's file / electronic record
  • Obtain a full understanding of the family's history (which must involve reading Children's social care records, including those relating to other children who have been part of any households including the current carers of the child - additional information should be obtained from relevant other agencies and local authorities)
  • Complete the core assessment of the child and family (if not previously completed), securing contributions / information from core group members and any other agencies with relevant information
  • Co-ordinate the contribution of family members and all agencies in putting the plan into action and reviewing the objectives stated in the plan
  • Ensure the child/ren are seen at least every 10 working days by the key worker or by another member of the core group
  • Ensure that the key worker her/himself sees the child at home at least every 6 weeks (in West Sussex the key worker must see the child every 10 working days)
  • Ensure that the child's bedroom is seen at least once between each conference (see below)
  • Ensure s/he see the child alone (with parent's agreement) or babies awake at least every 6 weeks (if parents refuse the Children's social care line manager must be informed)
7.4.3 The frequency of contact by key worker or core group members detailed above is the minimum standard. In exceptional circumstances the core group may decide that the required contact level should be less frequent. Any such decision should be authorised by Children's social care line manager / child protection adviser.
7.4.4 If the key worker has difficulty obtaining direct access to the child, the Children's social care line manager must be informed, as well as other core group members.
7.4.5 In these circumstances formal agreement must be reached that a member of another agency carry out the face-to-face contact, or that a review conference is called. Such a decision must be recorded and authorised by managers of the agencies concerned and agreed in the child / young person's plan.


Routine Written Records

7.4.6 The key worker must maintain a complete and up-to-date signed record on the current file / electronic record, to include:
  • The time and date of every home visit, stating who was present, confirmation that the key worker spoke with the child (including if alone), or providing a clear reason why not
  • Any information gained or observations made during the visit relevant to the identified risks to the child
  • Circumstances of all family members
  • Specific information about key subjects such as meals and sleeping arrangements (the key worker must observe the child's bedroom at least once between conferences)
  • Factual reports of the child's presentation and behaviour (these should be specific and avoid non-specific labels such as 'disturbed')
  • Any new incidents or injuries, which must be subject to full enquiries using the S.47 paperwork
  • A chronology on the front of the file / in the electronic record to include significant events in the child's life, including incidents, injuries, family changes etc.
  • The date, time and content of any communication which relates to the child and family (distinguishing between fact and opinion)


Responsibility for convening conferences

7.4.7 The key worker is responsible, in liaison with the child protection chair and administrator, for convening the review child protection conference, the dates for which should have been set at the previous conference for no more than:
  • 3 months after the initial conference
  • 6 months after a review conference
7.4.8 Consideration should be given to bringing forward the date of a review conference in the following circumstances:
  • Following a new and significant incident relating to concerns about child protection, usually involving a s.47 enquiry
  • When there is a significant change in the circumstances of the child or family
  • When there are significant difficulties in carrying out the child protection plan
7.4.9 The request to bring forward the date of a review conference should be made by a strategy discussion/meeting of a S.47 enquiry or by the social worker following consultation with core group members, conference chair, and must be authorised by the first line manager.


Absence of the key worker

7.4.10 It is the responsibility of the key worker, in liaison with the social work manager to ensure that clear cover arrangements are made when the key worker is absent on planned annual leave, training etc.
7.4.11 Parents and child must be informed of planned absences of the key worker, who will be covering the role and what contacts will be made.

7.5 Children's social care first line manager role

7.5.1 The first line manager has a vital role in managing the progress of the case and supporting the key worker.
7.5.2 The manager should:
  • Read and countersign all significant recordings, assessments and decisions on the child's file / electronic record, including the chronology
  • Discuss the progress of the protection plan and any concerns in supervision, including ensuring that there has been adequate direct contact with the child/ren
  • Ensure supervision and management case decisions are clearly visible and dated in the child's record
  • Read and countersign conference reports and the child protection plan
  • Review the plan with the key worker when unexpected developments or crises occur, and together make a decision whether to recommend that a review child protection conference date be brought forward
  • Attend all initial conferences and as many review conferences as possible
  • Confirm the visiting frequency of the key worker and the frequency of core group meetings


Absence of the Key Worker

7.5.3 The manager must arrange cover for the key worker in case of sickness and ensure arrangements are in place when the key worker is on annual leave and training, including the checking and any necessary action, resulting from post, e-mails and telephone contacts.
7.5.4 If the key worker is to be absent from work for an extended period her / his manager should consider reallocating the case.
7.5.5 The manager must ensure that other members of the core group are informed of the key worker's absence and of cover arrangements.

7.6 Further assessment

7.6.1 The key worker and first line manager must, in supervision, regularly consider the risks to the child and whether updated core or further specialist assessments should be undertaken.
7.6.2 Updated assessments may be helpful in the following circumstances:
  • On transfer of a case
  • Following the birth of a child who was subject to a Child Protection Plan before birth
  • When a child has been subject to a child protection plan for a year
  • Prior to consideration of discontinuing the child protection plan
  • When consideration is being given to the implementation of care proceedings
  • In particularly complex cases

7.7 Intervention

7.7.1 Intervention must be provided to give the child and family the best opportunities of achieving the required changes. If a child cannot be cared for safely at home, s/he will need to be placed elsewhere whilst work is undertaken with both child and family.
7.7.2 Intervention should address the child's needs and may involve action to promote her or his health, development and safety, particularly with regard to the need to develop a secure parent-child attachment.
7.7.3 Critically, decision-making must consider if the child's developmental needs can be responded to within the family and within timescales appropriate for that child.
7.7.4 See Chapter 4 of the Assessment Framework (DH 2000) for guidance on decisions about interventions.

7.8 Children subject to a child protection plan who go missing

7.8.1 If a professional/agency becomes aware that a child who is subject to a child protection plan has gone missing they should inform the keyworker immediately
7.8.2 If the child cannot be traced the keyworker should inform the Senior child protection manager and follow the procedure in Section 8.16 Missing and transient child, adult or family.

7.9 Death of a child subject to a child protection plan

7.9.1 When a child is subject to a child protection plan dies, from whatever cause, the key worker or her/his manager must inform the senior child protection manager, who will notify the chair of the LSCB.


8. Specific circumstances

8.2 Children involved in prostitution
8.20 Pre-birth child protection procedures
8.28 Sexual activity
8.29 Unexplained child deaths


8.2 Children involved in prostitution

DEFINITION

8.2.1 Prostitution of children is a form of sexual exploitation of those under the age of 18 whose ability to provide informed consent may be compromised for a variety of reasons and children involved must be viewed as potential victims of abuse.
8.2.2 This exploitation takes the form of the exchange of sexual activities by these children for commodities such as money, drink, drugs, shelter, protection, accommodation etc. and is often perpetrated by an adult through coercion, violence or threats of violence.
8.2.3 The involvement of a child in prostitution, whether a boy or girl, is abuse in itself and must be responded to accordingly.
8.2.4 See ‘Safeguarding children involved in prostitution’ (DH 2000), for further guidance on the management of young people involved in prostitution.


Legal position

8.2.5 Prostitution is not of itself illegal, though there are offences that make the selling or buying of sexual services on a street or in a public place illegal.
8.2.6 Girls and boys under the age of 16 cannot, by law, consent to sexual intercourse and anyone engaging in sexual activity with a child under the age of 16 is committing an offence and liable to prosecution.
8.2.7 The Sexual Offences Act 2003 introduced a range of new offences and measures designed to address all inappropriate activity with children including:
  • Specific offences of paying for the sexual services of a child, causing or inciting child prostitution or pornography, controlling a child prostitute or a child involved in pornography, arranging or facilitating child prostitution or pornography, causing or inciting prostitution for gain and controlling prostitution for gain, trafficking into, within and out of the UK for sexual exploitation,
  • Increased maximum penalties for many offences
  • A provision that sexual intercourse with a child under 13 (consensual or not) will be regarded as rape and attracts a life sentence
8.2.8 Children involved in prostitution may be found on the streets, but many are kept in rooms and flats against their will. Consequently such children will not be readily identifiable.
8.2.9 Parents, carers, including foster carers and staff in children’s homes, must be alert to the following behaviours that may indicate a child’s involvement (or ‘grooming’ for involvement), but are not conclusive signs in themselves:
  • Physical symptoms such as sexually transmitted diseases, or bruising consistent with physical or sexual assault
  • Reports from reliable sources that a child has been seen soliciting or noticed in places where soliciting occurs
  • Being contacted by unknown adult men outside the child’s usual range of social acquaintances
  • Development of a relationship, usually with someone older, who encourages emotional dependence and controls the relationship by violence and threats
  • Persistent absconding or late return with no plausible explanation (also see Section 8.16 Missing and transient child, adult or family)
  • Returning after being missing, looking well cared for without a known base
  • Truancy from school
  • Being picked up by unauthorised adults in cars
  • Acquisition of money, possessions or accounts of social activity with no plausible explanation
  • An adult loitering outside the home to meet up with the child
  • Having keys to unknown premises
  • Self-harming behaviour
  • Substance, drug and alcohol abuse
8.2.10 Common predisposing factors associated with a child becoming involved in prostitution are low self esteem and a history of being a victim of abuse, in particular sexual abuse.
8.2.11 Health professionals may become aware of children suffering sexually transmitted diseases, or requesting contraception advice or termination in circumstances that may indicate an involvement in prostitution.
8.2.12 Police officers executing warrants or investigating drug offences may encounter children involved in prostitution, and need to be aware that immediate action may have to be taken to protect a child.


RESPONSE

Principles

8.2.13 The main priority for all agencies concerned is securing the welfare of the child.
8.2.14 A child involved in prostitution and other forms of commercial sexual exploitation should be:
  • Treated primarily as the victim of abuse, and as such her/his needs require careful assessment
  • Regarded as a child in need, who may be suffering, or may be likely to be suffering, significant harm
8.2.15 Concerns that a child may be involved in prostitution should be taken seriously and thoroughly investigated.
8.2.16 Primary law enforcement should be against abusers and coercers, not the child involved in prostitution. The identification and prosecution of those adult offenders involved in the procurement of, or sexual activity with children, is of secondary concern to the welfare of the child.
8.2.17 Only rarely will it be appropriate for the child to enter the criminal justice system and then only if aged sixteen and over, when all attempts to divert the child have failed and in full knowledge of her/his circumstances after inter-agency discussion.


Aims of intervention

8.2.18 The aims of intervention by agencies are to:
  • Identify any child in the sex industry, including prostitution and the production or promotion of abusive images of children
  • Help the child understand the physical and emotional dangers of these activities
  • Identify and prosecute those adults involved in either coercing or abusing the child
  • Protect the child from further abuse and to support her/him out of prostitution
8.2.19 All agencies should establish whether those who are known to pay for sex with children are themselves parents or carers of children. If this is the case an assessment of the needs of those children should be considered, including whether they are at risk of, or are suffering, significant harm.
8.2.20 Parents should report concerns to Children’s social care or CPT.
8.2.21 Foster carers should report concerns to their supervising social worker or the child’s social worker.
8.2.22 Staff in children’s homes must report concerns to the manager of the home, who must refer the concern to the child’s social worker.
8.2.23 Uniformed police and CID may become aware that a child is involved in prostitution through the course of their duties. Unless immediate action is required to provide protection they should inform the CPT, who will inform Children’s social care.
8.2.24 Health professionals, youth workers and teachers should consult the designated/named child protection adviser and subsequently refer to Children’s social care.
8.2.25 Professionals and volunteers involved with young people may have developed a trusting relationship with the child and be concerned that a referral to Children’s social care will result in the child withdrawing from support services which may be providing some protection for the child, e.g. contraception, counselling or substance misuse treatment.
8.2.26 The professional must share their dilemma with the lead child protection professionals within their own agency (some agencies may have officers specifically nominated to lead on child prostitution). In making a final decision, the welfare of the child must be considered, together with their vulnerability and the level of coercion they are likely to be experiencing.
8.2.27 The decision making process must be recorded.


Referral

8.2.28 Whenever there is a suspicion that a child is involved in prostitution or commercial sexual exploitation a referral should be made to Children’s social care or the CPT (See also Section 8.28 Sexual activity). Health staff should consider Fraser guidelines to assist in making judgements about referrals.
8.2.29 The professional identifying concerns should seek consent from the child or her/his parents unless this may:
  • Place the child at risk of further significant harm e.g. alienate her/him from intervention or services
  • Jeopardise a criminal investigation by alerting the alleged offender
8.2.30 All referrals must be shared between Children’s social care and the CPT and should be regarded as ‘children in need’ who may be at risk of significant harm. This discussion will determine within 24 hours of the referral whether:
  • The child is a child in need, at risk of sexual exploitation and an assessment of their needs is required (S.17 response)
  • The child is suspected of being at risk of significant harm (S.47 response)
  • Immediate protective action is required


Threshold for child protection enquiries

8.2.31 The threshold for child protection enquiries is:
  • All cases where it is known or believed that a child is involved / at risk of involvement in prostitution / sexual exploitation
  • Concern that prostitution / sexual exploitation is being actively encouraged by a parent / carer
  • Concern that prostitution / sexual exploitation is facilitated by the parent/carer failing to protect the child
  • Concern that a related or unrelated adult, in a position of trust or responsibility to the child, is organising or encouraging prostitution
  • Concern about coercion by peers
8.2.32 The younger the child the more likely it is that child protection procedures will be appropriate.
8.2.33 As with all referrals child protection procedures should be initiated at any point that it is recognised that the threshold has been met.


Strategy discussion

8.2.34 Where the threshold for child protection enquiries is met, a strategy discussion (usually a meeting) must be held involving Children’s social care, CPT, the community paediatrician and other relevant professionals.
8.2.35 In planning any intervention the strategy discussion / meeting must:
  • Share and clarify information
  • Establish the exact nature of the concerns
  • Treat the child primarily as a victim of abuse and consider the need for immediate protection
  • Ensure the collation of the child’s background and family circumstances
  • Plan an interview with the child themselves
  • Plan a medical assessment with a child paediatrician experienced in child protection
  • Establish risks for any other children
  • Provide the child with strategies to leave prostitution
  • Consider the police role to investigate and prosecute those who coerce, exploit and abuse children
  • Plan to assess the needs of any children in regular contact with those who abuse children
  • Agree a date for a review discussion / meeting
8.2.36 At the conclusion of the enquiry a further strategy discussion / meeting should be held. Where the child is aged between 16 to 18 years, a member of the YOT should be invited.
8.2.37 The discussion/meeting should:
  • Consider what further actions are necessary and appropriate in relation to the investigation
  • What further assessment and support will be required to ensure the child’s on-going safety
  • A successful exit strategy to enable the child to re-integrate into a life free from abuse through prostitution, dependent on the child’s agreement to work with caring agencies
  • The role of family members in supporting the child and the exit strategy
  • Consider any need for a child protection conference – normally only appropriate if the child’s parents are actively involved or colluding with the child’s involvement in prostitution
8.2.38 Where the child involved in prostitution is difficult to engage and / or suspicious of contact with Children’s social care or the police, the investigating agencies will need to consider other strategies e.g. the possibility of informal contact with a health or voluntary sector worker to develop a child’s trust prior to the involvement of statutory agencies.
8.2.39 An initial child / young person’s plan should be agreed and reviewed within three months. If an initial child protection conference is to be held, the decision about the plan should be taken at the conference.
8.2.40 If an adult abuser is identified as a result of the investigation, enquiries must be made to establish his / her contact with children in other settings, including if s/he is a parent, grandparent, etc.
8.2.41 A strategy discussion / meeting must be held in relation to any children with whom the identified abuser has regular contact and a S.47 initiated if s/he is a parent or carer of child/ren.


Looked after children involved in prostitution

8.2.42 When a referral is received regarding a looked after child, the social worker must immediately inform their line manager.
8.2.43 The S.47 strategy discussion must consider the additional factors:
  • Risks to other children in placement
  • Whether the child should remain in placement
  • The feasibility of controlling the child’s movements and the likely effects of doing so
8.2.44 The discussions must consider and record the appropriateness and method of informing the child’s parents.
8.2.45 Any decision that has implications for restriction of liberty or confiscation of property must have the written agreement of the service manager.
8.2.46 The support plan will form part of the care plan for the child and pathway plan in the case of care leavers.


Involvement of groups of looked after children

8.2.47 Where knowledge or suspicion exists that looked after children are involved together or being controlled by the same person there must be:
  • Consideration of the need to apply complex abuse procedures
  • Efforts made to ensure that strategy meetings and /or multi-agency planning meetings on different children result in consistent plans
  • Involvement of a consistent chair for the meetings


Police action

8.2.48 The police have the lead in the investigation and detection of crime in relation to the abuse of children through their involvement in prostitution. The primary law enforcement effort will be against those who coerce, exploit and abuse children, not the child involved in prostitution.
8.2.49 Police must also consider any need to take urgent action to secure the immediate safety of a child who may be involved in prostitution e.g. use of police protection under Section 46 of The Children Act 1989 may be appropriate.
8.2.50 In cases where a child persistently returns to prostitution, and in doing so commits an offence, police will consider whether criminal prosecution is necessary. This action will only be considered following a strategy discussion, when all diversion work has failed over a period of time, and a judgement made that further diversionary work will not prove effective in the foreseeable future.

8.20 Pre-birth child protection procedures

8.20.1 UK law does not legislate for the rights of the unborn baby. In some circumstances, agencies or individuals are able to anticipate the likelihood of significant harm with regard to an expected baby.
8.20.2

Such concerns should be addressed as early as possible to maximise time for:

  • Full assessment, including establishing the whereabouts of any previous children
  • Enabling a healthy pregnancy
  • Supporting the parents so that (where possible) they can provide safe care


RECOGNITION

8.20.3 Where agencies or individuals anticipate that prospective parents may need support services to care for their baby or that the baby may be at risk of significant harm, a referral to Children's social care must be made at the earliest opportunity.
8.20.4

Referrals must always be made in the following circumstances:

  • There has been a previous unexplained death of a child whilst in the care of either parent
  • A parent or other adult in the household is a person identified as presenting a risk, or potential risk, to children
  • Children in the household / family currently subject to a child protection plan or previous child protection concerns
  • A sibling has previously been removed from the household either temporarily or by court order
  • Where there is knowledge of parental risk factors including substance misuse, mental illness, domestic violence
  • Where there are concerns about parental ability to self care and/or to care for the child e.g. unsupported young or learning disabled mother
  • Where there are maternal risk factors e.g. denial of pregnancy, avoidance of antenatal care (failed appointments), noncooperation with necessary services, non compliance with treatment with potentially detrimental effects for the unborn baby
  • Any other concern exists that the baby may be at risk of significant harm
8.20.5 Where the concerns centre around a category of parenting behaviour e.g. substance misuse, the referrer must make clear how this is likely to impact on the baby and what risks are predicted.
8.20.6

Delay must be avoided when making referrals in order to:

  • Provide sufficient time to make adequate plans for the baby's protection
  • Provide sufficient time for a full and informed assessment
  • Avoid initial approaches to parents in the last stages of pregnancy, at what is already an emotionally charged time
  • Enable parents to have more time to contribute their own ideas and solutions to concerns and increase the likelihood of a positive outcome to assessments
  • Enable the early provision of support services so as to facilitate optimum home circumstances prior to the birth
8.20.7 Concerns should be shared with prospective parent/s and consent obtained to refer to Children's social care unless this action in itself may place the welfare of the unborn child at risk e.g. if there are concerns that the parent/s may move to avoid contact.


RESPONSE

8.20.8 All pre-birth referrals to Children's social care must be subject to an initial assessment and a multi-agency strategy meeting must be held in the circumstances described at Section 8.20.4.


Pre-birth multi-agency strategy discussion

8.20.9

This discussion should be in the form of a meeting chaired by a Children's social care line manager and involve:

  • Community midwife
  • Maternity services manager
  • GP
  • Health visitor
  • Police
  • Social worker
  • Other professions as appropriate e.g. obstetricians, mental health services, probation
  • Where required, a legal advisor
8.20.10

The purpose of the meeting is the same as that of other strategy discussion and should determine:

  • Particular requirements of the pre-birth core assessment
  • Whether a S.47 enquiry is to be initiated
  • Role and responsibilities of agencies in the assessment
  • Role and responsibilities of agencies to provide support before and after the birth
  • Identity of responsible social worker to ensure planning and communication of information
  • Timescales for the assessments and enquiries, bearing in mind the expected date off delivery
  • How and when parent/s are to be informed of the concerns
  • Required action by ward staff when the baby is born
  • The need for a pre-birth conference, or (where this will depend on the outcome of assessments) establish the date by which this decision must be made,
8.20.11 The assessment plan must be consistent with standards required for possible court proceedings, including clear letters of instruction.
8.20.12 Parents should be informed as soon as possible of the concerns and the need for assessment, except on the rare occasions when medical guidance advice suggests this may be harmful to the health of the unborn baby and/or mother.


Pre-birth assessment

8.20.13

The overall aim of the pre-birth assessment is to identify and understand:

  • Parental and family history, life style and support networks and their likely impact on the child's welfare
  • Risk factors
  • Parental needs
  • Strengths in the family environment
  • Factors likely to change and why
  • Factors that might change, how and why
  • Factors that will not change and why
8.20.14 A concluding risk assessment must make recommendations regarding the need, or not, for a pre-birth child protection conference which should wherever possible be held at least 10 weeks  prior to the expected delivery date or earlier if a premature birth is likely.

8.28 Sexual activity

8.28.1 Research has shown that more than a quarter of young people are sexually active before they reach 16 years. Young people under 16 are the group least likely to use contraception and concern about confidentiality remains the biggest deterrent to seeking advice.
8.28.2 The major task for child protection agencies is to ensure that all children and young people are given appropriate protection from sexual abuse whilst ensuring that they are also able to access advice and treatment about contraception, sexual and reproductive health including abortion.


DEFINITION

The Sexual Offences Act 2003

8.28.3 The legal age for young people of either gender to consent to have sex is 16 years irrespective of their sexual orientation.
8.28.4 Sexual activity with children under 13 is always illegal as children of this age can never legally give their consent. There should always be a referral made to Children's social care or the police in cases involving children aged less than 13.
8.28.5 Although the age of consent is 16 years, there is no intention to prosecute young people of a similar age involved in mutually agreed consensual sex unless it involves abuse or exploitation.
8.28.6 Under the Sexual Offences Act 2003, young people still have a right to confidential advice on contraception, condoms, pregnancy and abortion even if they are less than 16 years old. Working within the Sexual Offences Act Home Office May 2004 SOA / 4
8.28.7

The Act states that a person is not guilty of aiding, abetting or counselling a sexual offence against a child where they are acting for the purpose of:

  • Protecting a child from pregnancy or sexually transmitted infection
  • Protecting the physical safety of a child
  • Promoting a child's emotional well-being by the giving of advice
8.28.8 This exception, in statute, covers not only health professionals, but anyone who acts to protect a child, for example teachers, school nurses, Connexions personal advisers, youth workers, Children's social care practitioners and parents.


RECOGNITION

8.28.9 In assessing the nature of any particular behaviour, it is essential to look at the facts of the actual relationship between those involved.
8.28.10

The following factors in the sexual activity indicate a risk to the child:

  • The age of the child. Sexual activity at a young age is a very strong indicator that there are risks to the welfare of the child (whether boy or girl) and, possibly, others;
  • the level of maturity and understanding of the child;
  • what is known about the child's living circumstances or background;
  • age imbalance, in particular where there is a significant age difference;
  • overt aggression or power imbalance;
  • coercion or bribery;
  • familial child sex offences;
  • behaviour of the child i.e. withdrawn, anxious;
  • the misuse of substances as a disinhibitor;
  • whether the child's own behaviour, because of the misuse of substances, places him/her at risk of harm so that he/she is unable to make an informed choice about any activity;
  • whether any attempts to secure secrecy have been made by the sexual partner, beyond what would be considered usual in a teenage relationship;
  • whether the child denies, minimises or accepts concerns;
  • whether the methods used are consistent with grooming; and
  • whether the sexual partner/s is known by one of the agencies.
8.28.11 SeeSection 8.2, Children involved in prostitution if at this stage there are concerns that the young person may be at risk of Sexual Exploitation Through Prostitution or Section 8.1, Child abuse and information communication technology if concerns about Abusive Images Of Children & The Internet.


RESPONSE

Confidentiality

8.28.12 The duty of confidentiality owed to a person under 16 in any setting is the same as that owed to any other person, but the right to confidentiality is not absolute.
8.28.13 Where there is a serious child protection risk to the health, safety or welfare of a young person or others this outweighs the young person's right to privacy. In these circumstances professionals should act in accordance with Section 3, Recognition and referral of this manual.
8.28.14 Research and experience have shown repeatedly that keeping children safe from harm requires professionals and others to share information. Such information sharing must be in accordance with legal requirements and professional guidance (see Section 2, Information sharing and confidentiality).


Action

8.28.15 All staff working for member agencies of the LCSB have a responsibility to ensure all children and young people are appropriately safeguarded. Where staff have concerns that a child or young person is being sexually abused this must be referred to the police and social services in accordance with procedures in this manual.
8.28.16 Cases involving under 13s should always be discussed with a nominated child protection lead in the organisation. There should be a presumption that the case will be reported to children's social care and that a strategy discussion will be held in accordance with Section 5, Child protection enquiries. All cases involving under 13s should be fully documented including detailed reasons where a decision is taken not to share information.
8.28.17 Professionals working with young people have different statutory responsibilities both with regard to advice given to young people and the actions they take when aware of under-age sexual activity. These differences are detailed below:


Health staff

8.28.18 Doctors and other health professionals should consider the following issues when providing advice or treatment to young people under 16 on contraception, sexual and reproductive health.
8.28.19

If a request for contraception is made, doctors and other health professionals should establish rapport and give a young person support and time to make an informed choice by discussing (Best practice guidance for doctors and other health professionals on the provision of advice and treatment to young people under 16 on contraception, sexual and reproductive health - DH gateway reference 3382):

  • The emotional and physical implications of sexual activity, including the risks of pregnancy and sexually transmitted infections 
  • Whether the relationship is mutually agreed and whether there may be coercion or abuse
  • The benefits of informing the GP and the case for discussion with a parent or carer - any refusal should be respected -in the case of abortion, where the young woman is competent to consent but cannot be persuaded to involve a parent, every effort should be made to help them find another adult to provide support, for example another family member or specialist youth worker
  • Any additional counselling or support needs.
8.28.20

Additionally they should follow the Fraser Guidelines and establish that:

  • The young person understands the health professional's advice
  • The health professional cannot persuade the young person to inform her/his parents or allow the doctor to inform the parents that s/he is seeking contraceptive advice including terminations
  • The young person is very likely to begin or continue having intercourse with or without contraceptive treatment
  • Unless s/he receives contraceptive advice or treatment, the young person's physical or mental health or both are likely to suffer
  • The young person's best interests require the health professional to give contraceptive advice, treatment or both without parental consent


Education staff

8.28.21 Young people need to be able to talk to a trusted adult about sex and relationship issues. Although it is desirable that this person is their parent or carer, this is not always possible. The law allows staff to respect young people's rights to confidentiality when discussing sex and relationship issues and a disclosure of under-age sex is not of itself a reason to break confidentiality.
8.28.22 Young people should be made aware that confidentiality might be breached if they or another young person is at risk. In these circumstances staff should consult the young person and endeavour to gain their co-operation to a child protection referral but if that is not possible they should be advised that their confidentiality would be breached.


Police and Children's social care staff

8.28.23 Whilst police and Children's social care staff may provide advice and guidance to a young person involved in under-age sexual activity both agencies have specific responsibilities with regards to criminal activities.
8.28.24 Children's social care staff should inform police of criminal offences at the earliest possible opportunity in order to consider jointly how to proceed in the best interests of the child. Any decisions not to do so must be made at a senior level and recorded on the child's file.
8.28.25 Recent guidance for Children's social care staff indicates that as Working Together is issued under S.7 of the Local Authority Social Services Act 1970 the decision not to inform the police where an offence has been committed against a child should only be made where 'exceptional circumstances justify a variation' (LASSL (2004) 21).
8.28.26 This is likely to be where the sexual relationship is considered consensual and not abusive and may be most relevant in respect of 'looked after' children where the social worker is also acting as the 'corporate parent' for the child.
8.28.27 In those circumstances it may be more important that the child receives appropriate advice regarding sexual health and contraception. This may be difficult if the young person is concerned that the police will be involved. Such a decision should always be made following consultation with line managers and be recorded.
8.28.28 The police must investigate all criminal activities even if they may decide that there is no need for prosecution.
8.28.29 The priority for the police is the identification and investigation of under age sexual activity where the relationship is abusive, either by being intra-familial in nature, or where there is a significant age / power gap between the parties involved.
8.28.30 Where young people of similar age are involved in consensual sexual activity, or in other sensitive cases, the police role may be confined to the undertaking of information checks only. In such cases police will not become directly involved in the investigation unless enquiries by the police or other agencies indicate the relationship is in fact abusive.
8.28.31 Both police and Children's social care staff together may decide that there is no need for prosecution but young people should be advised that their confidentiality cannot be maintained if staff from these agencies are involved.


ADDITIONAL GUIDANCE

Best practice guidance for doctors and other health professionals on the provision of advice and treatment to young people under 16 on contraception, sexual and reproductive health - DOH gateway reference 3382

  • 'Sex and relationship Education Guidance' DfEE 0116 / 2000
  • Guidance on Professional Practice for Connexions Personal Advisors
  • Confidentiality and Young people RCGP&B 2000
  • Children & Families : Safer from Sexual Crime Home Office 2004-08-23 Working Within the Sexual Offences Act Home Office 2004-08-23

8.29 Unexplained child death protocol

This section of Volume 1 of the Sussex Child Protection Procedures contains information taken from the Sussex Unexplained Child Death Protocol to enable effective early management of the situation. Professionals who are involved when a child dies should immediately access the full protocol in Volume 2 of the Sussex Child Protection Procedures to ensure sensitive, effective management of the situation. The full protocol can also been found on line at the Sussex police website.

INTRODUCTION

8.29.1 The third and latest version of the Sussex Joint Agency Protocol for Unexplained Child Deaths, which was originally published in 1999, is dated 2006. The latest version takes account of ‘Sudden Unexpected Death in Infancy’ published in September 2004 by the Royal College of Pathologists and the Royal College of Paediatrics and Child Health and Working Together to Safeguard Children 2006 published by the Department of Health. These reports contain further detail on this subject and recommendations relating to the investigation of such deaths. These reports can be accessed via Royal College websites: the Royal College of Paediatrics and Child Health website or the Royal College of Pathologists and the Department of Health website respectively.


Children to whom the protocol should be applied

8.29.2 The aim of the full protocol is to combine thorough investigation and support when children die unexpectedly and the cause is either unknown or raises concern about possible abuse. The protocol should be applied to all unexplained deaths of children up to the age of 2 years, and followed with discretion to unexplained deaths between 2 and 17 years.
8.29.3 At present the protocol will not be implemented following a diagnosed disease, road traffic collision, birth complications etc., nor if, with the agreement of the Coroner, the cause of death can be certified by the attending doctor. If, after appropriate initial investigation it is clear that the remainder of the protocol is no longer relevant, then with the agreement of all the professionals involved, its further implementation will cease.


The Coroner

8.29.4 The Coroner must be informed at the earliest opportunity of any violent or unnatural death, sudden death of unknown cause, or death within 24 hours of admission to hospital.
8.29.5 Individual cases can always be discussed with a Coroner’s Officer or, in an emergency, with the Coroner directly. The Coroner should normally be contacted via the Coroner’s Officer.
8.29.6 The Coroner has control of what happens to the child’s body in these circumstances and decides which pathologist will complete the postmortem.


Background

8.29.7 The majority of unexplained child deaths have natural causes and are unavoidable tragedies. The incidence of unexplained child deaths is highest in infancy. About 300 babies die suddenly and unexpectedly each year in the UK. A minority of unexplained deaths will be the consequence of abuse or neglect, or be found to have abuse or neglect as an associated factor. It is as important to identify medical causes and hereditary disorders, and to absolve a family from blame, as to identify unnatural deaths or homicides.
8.29.8 Professionals from a number of different agencies and disciplines will become involved following an unexplained child death to try to establish the cause of the death and support the family. The protocol is intended to provide guidance to the professionals confronted with one of these tragic events. It is acknowledged that each death has unique circumstances and each professional has their own experience and expertise to draw on in their handling of individual cases. There are, however, common aspects to the management of unexplained child deaths and it is important to achieve good practice and a consistent approach.
8.29.9 All professionals need to strike a balance between managing the sensitivities of a bereaved family and identifying and preserving anything that may help to explain why a child has died.


What is in the full protocol?

8.29.10 The protocol contains general guidance about responding to unexplained child deaths and information about individual agency responsibilities. It describes some of the factors that may raise concern about a death.
8.29.11 The key events described in the protocol are:
  • Child taken to an A and E Department
  • Early investigation
  • Early inter-agency strategy discussion
  • Joint home visit
  • Paediatric pathology
  • Late multi-agency meeting


Principles

8.29.12 When dealing with an unexplained child death all agencies need to follow five principles which are all of equal importance:
  • Sensitive, open minded balanced approach
  • Inter-agency response
  • Sharing of information
  • Appropriate response to the particular circumstances
  • Preservation of evidence


GENERAL ADVICE FOR PROFESSIONALS WHEN DEALING WITH THE FAMILY

8.29.13 This is a very difficult time for everyone. The time spent with the family may be brief but events and words used can greatly influence how the family deals with their bereavement in the long term. It is essential to maintain a sympathetic and supportive attitude, whilst objectively and professionally seeking to identify the cause of death.
8.29.14 Remember that people are in the first stages of grief. They are likely to be shocked and may appear numb, withdrawn, angry or very emotional.
8.29.15 The child should always be referred to and handled as if he or she were still alive and his or her name used throughout.
8.29.16 Professionals need to take account of any religious and cultural beliefs that may have an impact on procedures. Such issues must be dealt with sensitively, whilst maintaining a consistent approach to the investigation.
8.29.17 All professionals must record any history and background information given by parents or carers in detail. Initial accounts about circumstances, including timings, must be recorded verbatim.
8.29.18 It is normal and appropriate for a parent or carer to want physical contact with his or her dead child. In all but very exceptional circumstances this should be allowed with discreet observation by an appropriate professional.
8.29.19 Parents/carers should always be allowed time to ask questions and be provided with information about where their child will be taken and when they are likely to be able to see him or her again.
8.29.20 Parents should always be made aware that Her Majesty’s Coroner will be involved and that a post-mortem will be necessary.
8.29.21 Staff from all agencies need to be aware that on occasions in suspicious circumstances the early arrest of parents or carers may be essential in order to secure and preserve evidence and to conduct the investigation. Professionals must be prepared to provide statements of evidence promptly in these circumstances.

Factors which may arouse suspicion

8.29.22 Some factors in the history or examination of the child may give rise to concern about the circumstances surrounding the death. If any of these are identified it is important that the information is documented and shared with senior colleagues and relevant professionals in other key agencies involved in the investigation. The following list is not exhaustive and is intended only as a guide.
  • Previous child deaths in the family
    Two or more unexplained child deaths occurring within the same family is unusual and should raise questions both about an underlying medical or genetic condition as well as possible unnatural events.
  • Unexplained injury
    Unexplained bruising, burns, bite marks on the dead child or a previous history of these injuries should cause serious concern. A child may have no external evidence of trauma but have serious internal injuries.
  • Neglect
    Observations about the condition of the accommodation, cleanliness, adequacy of clothing, bedding and the temperature of the environment in which the child is found are important. A history of previous concerns about neglect may be relevant.
  • Previous child protection concerns within the family
  • Inconsistent information
    The account given by the parents or carers of the circumstances of the child’s death should be documented verbatim. Inconsistencies in the story given on different occasions or to different professionals should raise suspicion, although it is important to be aware that inconsistencies may occur as a result of the shock and trauma of the death.
  • Inappropriate delay in seeking help
  • Evidence of drug, alcohol or substance misuse particularly if the parents are still intoxicated or sedated.
  • Evidence of parental mental health problems
  • Presence of blood around nose or mouth
    A pinkish frothy residue around the nose or mouth is a normal finding in some children whose deaths are due to Sudden Infant Death Syndrome. Fresh blood from the nose or mouth is less common, but can occur in some natural deaths.
8.29.23 Initial actions required by staff who are likely to have first contact with the child and their family are outlined below.

AMBULANCE SERVICE

8.29.24 The ambulance service communication centre will immediately notify the police control room when there is a call to the scene of an unexplained child death
8.29.25 The recording of the initial call to the ambulance service should be retained in case it is required for evidential purposes.
8.29.26 Ambulance staff should follow the Joint Royal Colleges Ambulance Liaison Committee Guidelines and the Sussex Ambulance Service Child Protection Procedures.
  • Do not automatically assume that death has occurred, clear the airway and if in any doubt about death apply full cardiopulmonary resuscitation
  • Transport the child to an accident and emergency department
  • Inform the accident and emergency department giving estimated time of arrival and patient’s condition
  • Take note of how the body was found - including the position of the child (e.g. prone) clothing worn and the reported circumstances
  • Note any comments made by the carers, any background information given, any evidence of possible substance misuse and the conditions of the living accommodation
  • Pass on all relevant information to the accident and emergency department receiving doctor and to the police.
8.29.27 Any suspicions should be reported directly to the police and the receiving doctor at the hospital as soon as possible.


GENERAL PRACTITIONERS

8.29.28 There are times when a GP is called to the child first. In such circumstances the GP should adhere to the same general principles as the ambulance staff (see above).
8.29.29 It is essential for the GP to contact the police or Coroner’s officer if they are the first on the scene, after taking into account their primary responsibility of saving life or declaring death. The best route is the Police Call Centre.
8.29.30 A GP may not issue the death certificate in these circumstances. Children who have died without explanation should be seen in the Accident & Emergency Department by a paediatrician and not sent directly to the mortuary. This enables the clinical history, examination and any initial investigations to be completed and information given to parents.


HOSPITAL STAFF

8.29.31 Ensure that the child is taken to the appropriate area of the Accident & Emergency Department even if they appear to have been dead for some time. The child should not be taken straight to the mortuary.
8.29.32 Call the duty paediatrician and the resuscitation team. Find out the identity of the people with the child and their relationship to the child. Use the child’s first name.
8.29.33 Allocate a nurse to look after the family to keep them informed about what is happening. The nurse should record any medical or other information they obtain.
8.29.34 When resuscitation attempts have been discontinued a senior paediatrician should speak to the child’s parents. The paediatrician must complete a detailed examination and history and take the samples for medical investigations that have been agreed by the Sussex Coroners. The Coroner has authority over what happens to a child’s body in these circumstances and it is essential that the full protocol’s guidance about samples is followed. Medical findings and investigations must be fully recorded, preferably on a proforma provided in Volume 2 of the child protection procedures.
8.29.35 A duty consultant paediatrician must be informed. This consultant is responsible for the paediatric contribution to the next phase of the inter agency investigation or for contacting and passing this on to an alternative designated consultant paediatrician.


POLICE

Introduction

8.29.36 It is important for police officers to remember that most unexplained child deaths have natural causes. Police actions therefore need to be a careful balance between consideration for the bereaved family, and the possibility that a crime has been committed.


Who should attend?

8.29.37 Police attendance should be kept to the minimum required. Several Police officers arriving at the house can be distressing, especially if they are uniformed officers in marked police cars. Whenever possible consideration should be given to the initial response being from plain clothed specialist officers, but this may not be possible if a speedy response is necessary. Officers maintaining the integrity of any scene should use unmarked cars where possible.


Initial action at the scene

8.29.38 Police attendance should be kept to the minimum required. Several Police officers arriving at the house can be distressing, especially if they are uniformed officers in marked police cars. Whenever possible consideration should be given to the initial response being from plain clothed specialist officers, but this may not be possible if a speedy response is necessary. Officers maintaining the integrity of any scene should use unmarked cars where possible.
8.29.39 The first officer at the scene must make a visual check of the child and his/her surroundings, noting any obvious signs of injury. Handle the child as if he or she were alive; ascertain and use the child’s name whenever referring to the child.
8.29.40 Normally the first officer attending the scene will be responding to an emergency call relating to a child’s death. This officer will assume control of the situation and ensure that the appropriate following specialist officers are contacted and attend:
  • A detective inspector must attend the scene. This will preferably be the SIU detective inspector.
    • Assess and appropriately preserve the scene
    • Decide what level of investigation is necessary
    • Discuss the circumstances with the duty senior investigating officer (SIO). If the death is thought to be suspicious the SIO must be contacted immediately
    • Consider the need for seizure of exhibits and any photography/video recording
    • Discuss with the Coroner’s officer/Coroner any need to undertake a skeletal survey prior to the PM, and if authorised arrange in consultation with the consultant paediatrician. Arrangements will vary between Coroner’s areas.
    • Ensure the child is examined by a consultant paediatrician at the hospital
    • Ensure the attendance of an appropriate police officer at the PM to fully brief the pathologist
  • A detective sergeant from the relevant Child Protection Team (CPT). If unavailable, a detective constable from the CPT should attend. They will:
    • Act as a source of advice on child protection matters to the DI
    • Consider any apparent child protection issues at the scene
    • Consider the needs of any siblings
    • Undertake enquiries at the direction of the DI
    • Arrange a joint home visit with a consultant paediatrician
    • Inform the Coroner’s Officer(see below)
    • Liaise with social services and ensure a strategy meeting is arranged
    • Notify circumstances of the death to HQ CID
    • Ensure in liaison with the paediatrician that all medical records and a copy of the pathologists enquiry form are made available at the PM
    • Request and retain the relevant personal child health record form the parents
    • Ensure parents are aware of available support organisations and that the following are given to them:
8.29.41 Guide to the post-mortem examination: brief notes for parents and families who have lost a baby in pregnancy or early infancy’. DOH
When a baby dies suddenly and unexpectedly’. FSID
Memory folder’. Child Bereavement Trust


SOCIAL CARE AND HEALTH

See ‘inter-agency working’ below.


INTER-AGENCY WORKING

All unexplained child deaths must be treated as a multi-agency child protection investigation. Surviving siblings may be the subject of enquiry under section 47 of the Children Act 1989.

Early strategy discussion
A multi-agency strategy discussion will be convened by social services within 72 hours of the child’s death to share information relevant to the investigation of the death, and support of the parents.

Early joint home visit
Following the death of a young child all families should be visited at home within 24-48 hours a by police officer responsible for investigating the child’s death and an appropriate Paediatrician. The Police are responsible for arranging this with the duty Consultant Paediatrician. This joint visit may also be appropriate following the unexplained death of an older child.

Professionals are reminded to access the full protocol in Volume 2 of the Sussex Child Protection Procedures as soon as possible. They should contact their lead child protection professional for further advice and guidance as needed.


Click here to view Summary of Professional Responsibilities Following Unexplained Child Deaths Flowchart.


Appendices

1. Assessment framework
2. Flowcharts
3. Statutory framework
3.1 Introduction
3.2 Children Act 2004
3.3 Education Act 2002
3.4 Children Act 1989
3.5 Homelessness Act 2002
4. Glossary of terms
5. National and local contacts


1. Assessment framework

Click here to view Assessment Framework Chart.


2. Flowcharts

Click here to view Flowchart One - Referral

Click here to view Flowchart Two - What Happens After Initial Assessment?

Click here to view Flowchart Three - Urgent Action to Safeguard Children

Click here to view Flowchart Four - What Happens After the Strategy Discussion?


3. Statutory framework

3.1 Introduction

3.1.1 All organisations that work with children and families share a commitment to safeguard and promote their welfare, and for many agencies that is underpinned by a statutory duty or duties.
3.1.2 This Appendix briefly explains the legislation most relevant to work to safeguard and promote the welfare of children.

3.2 Children Act 2004

3.2.1 Section 10 requires each Local Authority to make arrangements to promote co-operation between the authority, each of the authority's relevant partners (see; the table below) and such other persons or bodies, working with children in the local authority's area, as the authority consider appropriate. The arrangements are to be made with a view to improving the well being of children in the authority's area - which includes protection from harm or neglect alongside other outcomes. This Section of the Children Act 2004 is the legislative basis for children's trust arrangements.
3.2.2 Section 11 requires a range of organisations (see table) to make arrangements for ensuring that their functions, and services provided on their behalf, are discharged having regard to the need to safeguard and promote the welfare of children.
3.2.3 Section 12 enables the Secretary of State to require local authorities to establish and operate databases relating to the section 10 or 11 duties or the section 175 duty, or to establish and operate databases nationally. The section limits the information that may be included in those databases and sets out which organisations can be required to, and which can be enabled to, disclose information to be included in the databases.
3.2.4 Section 13 of the Children Act 2004 requires a range of organisations (see table) to take part in Local Safeguarding Children Boards. Sections 13-16 set out the framework for LSCBs, and the LSCB regulations, issued for consultation alongside this document, set out the requirements in more detail in particular on LSCB functions.

3.3 Education Act 2002

3.23.1 Section 175 puts a duty on local education authorities, maintained (state) schools, and further education institutions, including sixth form colleges, to exercise their functions with a view to safeguarding and promoting the welfare of children - children who are pupils, and students under 18 years of age, in the case of schools and colleges.
3.23.2 And the same duty is put on Independent schools, including Academies, by regulations made under s157 of that Act.

Table: Bodies Covered by Key Duties

Body (in addition to Local Authorities) CA 2004 Section 10 (duty to co-operate) CA 2004 Section 11 (duty to safeguard & promote welfare) Ed Act 2002 Section 175 (duty to safeguard & promote welfare and regulations) CA 2004 Section 13 (statutory partners in LSCBs) CA 1989 Section 27 (help with children in need) CA 1989 Section 47 (help with enquiries about significant harm)
District councils X X
X X X
Police authority X X



Chief officer of police X X
X

Local probation board X X
X

Youth offending team X X
X

Strategic Health Authority X X
X X X
Primary Care Trust X X
X X X
Connexions Service X X
X

Learning and Skills Council X




Special Health Authority
X (as designated by the Secretary of State)

X X
NHS trust
X
X X X
NHS foundation trust
X
X X X
British Transport Police
X



Prison or secure training centre
X
X (which detains children)

CAFCASS


X

Maintained schools

X


FE colleges

X


Independent schools

X


Contracted services X X X



3.4 CHILDREN ACT 1989

3.24.1 The Children Act 1989 places a duty on Councils with Social Services Responsibilities (CSSRs) to promote and safeguard the welfare of children in need in their area.

Section 17(1) of the Children Act 1989 states that:

It shall be the general duty of every local authority -

  • To safeguard and promote the welfare of children within their area who are in need; and
  • So far as is consistent with that duty, to promote the upbringing of such children by their families, by providing a range and level of services appropriate to those children's needs.

Section 17(10) states that a child shall be taken to be in need if:

  1. he is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by a local authority under this Part
  2. his health or development is likely to be significantly impaired, or further impaired, without the provision or such services
  3. he is disabled
3.24.2 The primary focus of legislation about children in need is on how well they are progressing and whether their development will be impaired without the provision of services.
3.24.3 It also places a specific duty on other local authority services and health bodies to co-operate in the interests of children in need in s27. Section 322 of the Education Act 1996 places a duty on social services to assist the local education authority where any child has special educational needs.

Where it appears to a local authority that any authority or other person mentioned in sub-section (3) could, by taking any specified action, help in the exercise of any of their functions under this Part, they may request the help of that other authority or persons, specifying the action in question. An authority whose help is so requested shall comply with the request if it is compatible with their own statutory or other duties and obligations and does not unduly prejudice the discharge of any of their functions.

The persons are;

  1. Any local authority;
  2. Any local education authority;
  3. Any local housing authority;
  4. Any health authority, special health authority, Primary Care Trust or National Health Services Trust; and
  5. Any person authorised by the Secretary of State for the purpose of this section

Children Act 1989 s27

3.24.4 Under s47 of the Children Act 1989, the same agencies are placed under a similar duty to assist local authorities in carrying out enquiries into whether or not a child is at risk of significant harm.
3.24.5 Section 47 also sets out duties for the local authority itself, around making enquiries in certain circumstances to decide whether they should take any action to safeguard or promote the welfare of a child.
3.24.6

Every local authority;

  1. Shall facilitate the provision by others (including in particular voluntary organisations) or services which the authority have power to provide by virtue of this section, or section 18, 20, 23
  2. May make such arrangements as they see fit for any person to act on their behalf in the provision of any such service

Children Act 1989 s17(5)

3.24.7 Section 53 of the Children Act 2004 amends both section 17 and section 47 of the Children Act 1989, to require in each case that before determining what services to provide or what action to take, the local authority shall, so far as is reasonably practicable and consistent with the child's welfare:
  • Ascertain the child's wishes and feelings regarding the provision of those services; and
  • Give due consideration (having regard to his age and understanding) to such wishes and feelings of the child as they have been able to ascertain.


Emergency Protection Powers

3.24.8 There are a range of powers available to local authorities and their statutory partners to take emergency action to safeguard children:

Emergency Protection Orders

The court may make an emergency protection order under s44 of the Children Act 1989 if it is satisfied that there is reasonable cause to believe that a child is likely to suffer significant harm if:

  • he is not removed to accommodation; or
  • he does not remain in the place in which he is then being accommodated

An emergency protection order may also be made if s47 enquiries are being frustrated by access to the child being unreasonably refused to a person authorised to seek access, and the applicant has reasonable cause to believe that access is needed as a matter of urgency.

  • An emergency protection order gives authority to remove a child, and places the child under the protection of the applicant for a maximum of eight days (with a possible extension of up to seven days.)


Exclusion Requirement

The court may include an exclusion requirement in an emergency protection order or an interim care order (section 38A and 44A of the Children Act 1989.) This allows a perpetrator to be removed from the home instead of having to remove the child. The Court must be satisfied that:

  • there is reasonable cause to believe that if the person is excluded from the home in which the child lives, the child will cease to suffer, or cease to be likely to suffer, significant harm or that enquiries will cease to be frustrated; and
  • another person living in the home is able and willing to give the child the care which it would be reasonable to expect a parent to give, and consents to the exclusion requirement.


Police Protection Powers

Under s46 of the Children Act 1989, where a police officer has reasonable cause to believe that a child would otherwise be likely to suffer significant harm, s/he may:

  • remove the child to suitable accommodation and keep him or her there; or
  • take reasonable steps to ensure that the child's removal from any hospital, or other place in which the child is then being accommodated is prevented.

No child may be kept in police protection for more than 72 hours.

3.5 HOMELESSNESS ACT 2002

3.25.1 Under section 12, housing authorities are required to refer homeless persons with dependent children who are ineligible for homelessness assistance or are intentionally homeless, to social services, as long as the person consents. If homelessness persists, any child in the family could be in need. In such cases, if social services decides the child's needs would be best met by helping the family to obtain accommodation, they can ask the housing authority for reasonable assistance in this and the housing authority must respond.


4. Glossary of terms

Glossary of Terms
A&E Accident & Emergency Department
AF Assessment Framework
LSCB Local Safeguarding Children Board
ASSET An assessment instrument used by probation and YOTs
CAF Common Assessment Framework
CAFCASS Children & Families Courts' Advisory & Support Service
CAMHS Child & Adolescent Mental Health Service
CSCI Commission for Social Care Inspection
CID Criminal Investigation Division
CPC Child Protection Conference
CPN Community Psychiatric Nurse
CPS Crown Prosecution Service
CPT Police child protection team
CPSU NSPCC Child Protection Sports Unit
CRB Criminal Records Bureau
CSU Community Safety Unit
DfES  Department for Education & Skills
DH Department of Health
DI Detective Inspector
DS Detective Sergeant
EDT Emergency Duty Team, Children's social care
EPO Emergency Protection Order
EWO Education Welfare Officer
FME Forensic Medical Examiner
FORM 78 Police form used for recording details of children who come to the attention of police; copies are routinely passed to partner agencies
HOME AUTHORITY The authority which holds case responsibility, or if not known to Children's social care, where the child is living - this could be either an originating or receiving authority
HOST AUTHORITY The authority where a child may be found, is visiting for a short break or in receipt of specified services (e.g. education) - this could be either a receiving authority without case responsibility or an entirely different authority
ICS Integrated Children's System
JOINT INVESTIGATION A shared responsibility for the conduct and decision making process of a S.47 enquiry between police, Children's social care and where appropriate other caring agencies
LAC Looked After Child
LIARMM Local Inter Agency Risk management Meeting
MAPPA Multi-agency Public Protection Arrangements
MERLIN A police database
MHT Mental Health Trust
MISPER Police acronym for missing persons
MIT Police Serious Crime Group Major Investigation Team
NAI Non-accidental injury
NASS  National Asylum Support Service
NMC Nursing & Midwifery Council
NPFS Naval Personal & Family Services
NSPCC National Society for the Prevention of Cruelty to Children
OFSTED Office for Standards in Education
OOH Out of Hours (Children's social care)
ORIGINATING AUTHORITY The authority where the child/ family previously lived
PCHR  Personal Child Health Record
PCT Primary Care Trust
PPU Public Protection Unit
PROtect A police database
RECEIVING AUTHORITY The authority where the child / family has moved
RMP  Risk Management Plan
SINGLE AGENCY Following consultation between agencies, Children's social care undertaking a S.47 enquiry OR police undertaking a criminal investigation, without the other agency
SMG Senior Management Group: plan and oversee complex investigations
CHILDREN'S SOCIAL CARE Social Services Departments, Children & Families Social Services, Children, Families & Schools
SOCO Scene of Crime Officer
SSAFA-FH Soldiers, Sailors, Air Force Association - Forces Help 
TERRITORIAL POLICE Those who have generic or non child protection related roles
YOT Youth Offending Team


5. National and Local Contacts

5.1 NATIONAL CONTACTS

ARMED FORCES

Army and RAF

Requests from the child protection database should be sought from:

The Director of Social Work
SSAFA Forces Help
19 Queen Elizabeth St.
London, SE1 2LP

Tel: 020 7403 8783
Fax: 020 7403 8815


Army

The point of contact for child protection matters concerning Army families resident within London is:

AWS Personal Support Intake and Assessment
AWS Windsor and West London
66 Furness Way
Broom Farm Estate
Windsor Berkshire SL4 4XW

Tel: 01753 862307 or 01753 755198

In the event of difficulty, Children's social cares should liaise directly with the Chief Personal Support Officer:

Army Welfare Service,
HQ Land Command,
Erskine Barracks Wilton,
Salisbury,
Wiltshire SP2 0AG

Tel: 01722 436564
Fax: 01722 436307


Royal Navy

Naval Personal and Family Service (NPFS) area offices:

NPFS Eastern Area Portsmouth
Tel: 02392 72212
Fax: 02393 725803

NPFS Northern Area Helensburgh
Tel: 01436 672798
Fax: 01436 674965

NPFS Western Area Plymouth
Tel: 01752 555041
Fax: 01752 555647


Royal Marines

Contact SO3 (WFS)
Tel: 02392 547542


CHILD-LINE

FREEPHONE 0800 1111 (24 hours)


CHILDREN FROM ABROAD (SOURCES OF INFORMATION)

Documentation held by the child / family e.g. benefits letter, GP, hospital letters, letters from other social services

The Foreign and Commonwealth Office:
Tel. 020 7008 1500

The appropriate Embassy or Consulate: The London Diplomatic List, ISBN 0 11 591772 1 can be obtained from the Stationery Office on 0870 600 5522, or from FCO website. It contains information about all the Embassies based in London.

International directory enquiries - dial 155, if address abroad known

International Social Service of the UK,
Cranmer House,
3rd floor,
39 Brixton Road,
London
SW9 6DD

Tel. 020 7735 8941/4
Fax 7582 0696


FAMILY RIGHTS GROUP

Offers specialist advice for parents involved in child protection via a free service 1-30pm - 3-30pm Monday to Friday on FREEPHONE 0800 731 1696


FOOTBALL ASSOCIATION

Head of Education & Child Protection:
Tel: 020 7745 4909


FORCED MARRIAGE UNIT

Single point of confidential advice and assistance for those at risk of being forced into marriage overseas and concerned professionals

Foreign & Commonwealth Office
Tel. 020 7008 0230 / 0135 / 8706

Email: fmu@fco.gov.uk


THE FOUNDATION FOR THE STUDY OF INFANT DEATHS

Artillery House
11-19 Artillery Row
London SW1P 1RT

Helpline: 0870 787 0554

General: 0870 787 0885

Fundraising: 0870 443 6814

Media: 0870 787 0726

Email: fsid@sids.org.uk (If you know the name of the person you wish to email then follow the rule firstname.secondname@sids.org.uk)

Fax: 0870 787 0725

Website: www.sids.org.uk/fsid


INTERNET SAFETY

INTERNET WATCH FOUNDATION:

The IWF website acts as a focal point for removing illegal materials from the internet.

The Think U Know website - a website for young people full of information about staying safe online

Keep Your Child Safe on the Internet - January 2004
An online leaflet of practical guidance for parents and carers.

Good Practice Models and Guidance for the Industry
Guidance on chat rooms, instant messaging and web-based services that encourages clear safety messages and advice, and user-friendly ways of reporting abuse.


NSPCC

National child protection help line 0800 800 500 / text phone 0800 056 0566

Asian child protection help-line 0800 096 7719 provides advice in Punjabi, Hindi, Urdu, Gujarati, Bengali and Sylheti 


PUBLIC CONCERN AT WORK

Can give free confidential advice on how to raise a concern about malpractice at work Tel: 020 7404 6609

5.2 LOCAL CONTACTS

In an emergency

Police/Fire/Health 999


If you are worried about a child

Children and Young People's Services offices
Adur 01273 268800
Arun 01903 738905
Chichester 01243 752999
Crawley 01293 895100
Horsham 01403 213100
Mid Sussex 01444 446100
Worthing 01903 839100
Out-of-Hours Service 01903 694422
Register for children subject to a child protection plan 01243 642476
Police 0845 60 70 999


Advice on safeguarding matters

Strategic Health Authority
Carol Maddocks 01293 778828
County Child Protection Advisor
Brian Relph 01243 642420
Independent Reviewing Service
Jenny Clifton 01243 753680
Probation/NOMS
Nick Smart 01273 227979
Police
Eddie Hick 01273 859086
Health
Lorraine Smith (Designated Nurse) 07770 800247
Anne Wallace (Designated Doctor) 01243 815443
Education
Neil Holden 01243 752049
NSPCC
Area Children’s Service Manager 01293 651842
District / Borough* Councils (Lead officers)
Adur (Natalie Brahma–Pearl) 01273 263347
Arun (Frank Hickson) 01903 737718
Chichester (Steve Hansford) 01243 534789
Crawley* (Phil Rogers) 01293 438462
Horsham (Chris Dier) 01403 215250
Mid Sussex (Karen Picksley) 01444 458166
Worthing* (Tim Everett) 01903 221302


End.