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2.2.4 Disabled Children

Contents

  1. Vulnerability of Some Disabled Children
  2. Essential Safeguards
  3. Employing a Personal Assistant
  4. Assessment and Support
  5. The Court Process
  6. Further Guidance


1. Vulnerability of Some Disabled Children

Evidence cited in Working Together to Safeguard Children 2010 (now archived) suggests disabled children are at increased risk of abuse and the presence of multiple disabilities increases the risk of both abuse and neglect. They are also found to be less likely to be consulted in routine assessments.

All practitioners and agencies working with disabled children should have regard to Safeguarding Disabled Children: Practice Guidance (DCSF 2009).

The disabled child may be especially vulnerable because of a number of reasons:

  • Many disabled children are at an increased likelihood of being socially isolated with fewer outside contacts than non – disabled children;
  • Their dependency on parents and carers for practical assistance in daily living, including intimate personal care, increases their risk of exposure to abusive behaviour;
  • They have an impaired capacity to resist or avoid abuse;
  • They may have speech, language and communication needs which may make it difficult to tell others what is happening;
  • They often do not have access to someone they can trust to disclose that they have been abused; and/or
  • They are especially vulnerable to bullying and intimidation;
  • Children may have multiple care placements.

It should be remembered that disabled children are children first and foremost and have the same rights to protection as any other child. Disabled children must be responded to as individuals with their own specific needs, feelings, thoughts and opinions. Safeguards for disabled children are essentially the same as for all other children  Particular attention should be paid to promoting a high level of awareness of the risks of harm and high standards of practice, and strengthening the capacity of children and families to help themselves. Measures should include:

  • Making it common practice to help disabled children make their wishes and feelings known in respect of their care and treatment;
  • Ensuring that disabled children receive appropriate personal, health, and social education (including sex education);
  • Making sure that all disabled children know how to raise concerns, and giving them access to a range of adults with whom they can communicate. Those disabled children with communication impairments should have available to them at all times a means of being heard;
  • An explicit commitment to, and understanding of disabled children’s safety and welfare among providers of services used by disabled children;
  • Close contact with families, and a culture of openness on the part of services;
  • Guidelines and training for staff on good practice in intimate care; working with children of the opposite sex; handling difficult behaviour; consent to treatment; anti-bullying strategies; and sexuality and sexual behaviour among young people, especially those living away from home; and
  • Guidelines and training for staff working with disabled children aged 16 and over to ensure that decisions about disabled children who lack capacity will be governed by the Mental Health Capacity Act 2005 once they reach the age of 16;
  • Children who receive overnight short breaks and residential school should have their care plan reviewed by an Independent Reviewing Officer (IRO).

In addition to the universal indicators of abuse / neglect mentioned (see Recognition of Significant Harm Procedure) the following abusive behaviours must be considered:

  • Force feeding;
  • Unjustified or excessive physical restraint;
  • Rough handling;
  • Extreme behaviour modification including the deprivation of liquid, medication, food or clothing;
  • Misuse of medication, sedation, heavy tranquillisation;
  • Invasive procedures against the child’s will;
  • Deliberate failure to follow medically recommended regimes;
  • Misapplication of programmes or regimes;
  • Ill fitting equipment e.g. callipers which may cause injury or pain, or inappropriate splinting;
  • Misappropriation/misuse of a child’s finances;
  • Not allowing a child to develop and have social and educational opportunities;
  • Parents may fabricate and induce illness in their disabled children (see procedures on Fabricated and Induced Illness).

Some disabled children live, or receive short breaks away from home and this may increase their vulnerability.

Where a child is unable to tell someone of the abuse they may convey anxiety or distress in some other way, e.g. behaviour or symptoms and carers and staff must be alert to this.


2. Essential Safeguards

Safeguards for disabled children are essentially the same as for all other children. Where there are concerns about the welfare of a disabled child, they should be acted upon in accordance with guidance in the same way as with any other child. Expertise in both safeguarding and promoting the welfare of child and disability has to be brought together to ensure that disabled children receive the same levels of protection from harm as other children (see Safeguarding Disabled Children: Practice Guidance (DCSF 2009).

Providers of services must have:

  • An explicit commitment to, understanding of disabled children’s safety and a culture of openness and ensure that concerns are properly followed up;
  • Guidelines and training for staff on good practice in intimate care, working with children of the opposite sex, handling difficult behaviour, consent to treatment, anti-bullying strategies, sexuality and sexual behaviour among young people, especially those living away from home;
  • LADO must be involved when an allegation is made about a professional.


3. Employing a Personal Assistant

Advice to Parents / Young Person

Where those with parental responsibility wish to employ a personal assistant through the use of direct payments to support a disabled child (or when a 16/17 year old disabled person wishes to employ an assistant), they should be advised to:

  • Obtain an Enhanced check from the Disclosure and Barring Service (DBS) via Local Authority Children’s Services;
  • Work with an advocacy service in taking up references and interview processes;
  • Avoid employing an under 18 year old as s/he cannot be held legally responsible for harm befalling a child in her/his care;
  • Avoid employing anyone about whom they have doubts;
  • Consider recruiting someone else if they are unhappy with the person working for them.

Disclosure and Barring Service Checks

The potential employee should submit her/his application for Disclosure and Barring Service (DBS) checks to Local Authority Children’s Services. The potential employee should be advised that the results of this check will be shared with the young person / parent.

Whilst this is carried out, potential users of direct payments who are already in receipt of services commissioned by the local authority, should continue to receive existing support.

If a DBS check has been requested, but has not been received by the time the personal assistant is required to start work, the parent/carer/young person should be advised that the personal assistant should not be left alone with the child/young person they are providing care to until DBS clearance is received.

Consideration should be given to asking the parent/carer to enter into a written agreement to confirm the personal assistant will not be left alone with the child/young person until the DBS clearance has been obtained. It is preferable if the employment of a PA can wait until clearance is received (providing this is appropriate), as it avoids action being taken to terminate employment if the DBS is unsatisfactory.

Local authorities must be satisfied that a direct payment used for this service will safeguard and promote the welfare of the child (see A Guide to Receiving Direct Payments from your Local Council, DH September 2009). Once the check is received the responsible manager must decide whether the direct payment can be progressed.

If the person is deemed to be unsuitable, the direct payment should be declined, pending a more suitable candidate. The practitioner would discuss the circumstances with the parent or young person (possibly with her/his advocate).

DBS checks should be updated every three years.

If Parent / Young Person Decline to Pursue DBS Checks

If the parent / young person decline to pursue DBS checks, Specialist Children’s Services (Kent)/Children’s Social Care Services (Medway) may be unable to agree to Direct Payments as they would need to check that the a potential employee is suitable by ensuring that they do not have a criminal record which may indicate they may pose a risk to children. If Specialist Children’s Services (Kent)/Children’s Social Care Services (Medway) declines a direct payment on these grounds, reasons should be sensitively shared with the young person / parent and clearly recorded.

If the young person and/or parent decline to pursue a DBS check, they (or an advocate) should be asked to sign a disclaimer.


4. Assessment and Support

Disabled children must receive the same level of protection from harm as other children and the procedures described in elsewhere in this manual apply equally to them.

If a disabled child has a communication impairment or learning disability special attention should be paid to her/his needs.

When a child is unable to tell someone of her/his abuse, s/he may convey anxiety or distress in some other way, e.g. behaviour or symptoms, and carers and staff must be alert to this and use observation skills to interpret what the child may be attempting to communicate.

When responding to concerns about the welfare of disabled children it is important that there is liaison and a close working relationship between staff working in the duty assessment teams and those in the disabled children’s service.

Each child should be assessed carefully and supported to participate in the child protection and criminal justice system, when this is in the child’s best interests and the interests of justice. A specialist practitioner should be involved in any Section 47 Enquiry and Strategy Discussion.

Agencies must consider how best to enable a disabled child to give credible evidence and to withstand the rigours of the court process e.g. portable video equipment (see Interpreters, Signers and others with Special Communication Skills Procedure).


5. The Court Process

Agencies should not make assumptions about the ability of a disabled child to give credible evidence, or to withstand the rigours of the court process. Each child should be assessed carefully, and helped and supported to participate in the criminal justice process when this is in her/his best interest and the interests of justice.

In criminal proceedings witnesses aged under 17 are automatically eligible for assistance with giving their evidence. Special measures may include screens around the witness box so they do not see the defendant; video recorded evidence in chief and live video links so they may not have to go into the courtroom at all, and intermediaries and aids to communication to facilitate good communication. Achieving Best Evidence in Criminal Proceedings (March 2011) - includes comprehensive guidance on planning and conducting interviews with children and a specific section about interviewing disabled children.


6. Further Guidance

See also Intimate Care Good Practice Guidelines.

End