7.1
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Duty to Conduct S47 Enquiries
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7.1.1 |
Where a child is suspected to be suffering, or likely to suffer, significant harm, the local authority is required by s47 of the Children Act 1989 to make enquiries, to enable it to decide whether it should take any action to safeguard and promote the welfare of the child. |
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7.1.2 |
Responsibility for undertaking s47 enquiries lies with LA children's social care in whose area the child lives or is found. 'Found' means the physical location where the child suffers the incident of harm or neglect (or is identified to be at risk of harm or neglect), e.g. day nursery or school, boarding school, hospital, one-off event, such as a fairground, holiday home or outing or where a privately fostered or looked after child is living with their carers. For the purposes of these procedures the LA children's social care in which the child lives, is called the 'home authority' and the LA children's social care in which the child is found is the child's 'host authority'. |
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7.1.3 |
Whenever a child is harmed or concerns are raised that a child may be at risk of harm or neglect, the host authority is responsible for informing the home authority immediately and invited to participate in the strategy meeting / discussion to plan action to protect the child. Only once agreement is reached about who will take responsibility is the host authority relieved of the responsibility to take emergency and ongoing action. Such acceptance should occur as soon as possible and should be confirmed in writing. See also section 15. Allegations against staff. |
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Responsibilities of all agencies
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7.1.4 |
All agencies have a duty to assist and provide information in support of child protection enquiries. |
7.2
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Immediate Protection
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7.2.1 |
Where there is a risk to the life of a child or the possibility of serious immediate harm, an agency with statutory child protection powers (the police, LA children's social care and the NSPCC) should act quickly to secure the immediate safety of the child. |
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7.2.2 |
Emergency action may be necessary as soon as the referral is received from a member of the public or from any agency involved with children or parents. Alternatively, the need for emergency action may become apparent only over time as more is learned about a child or adult carer's circumstances. Neglect, as well as abuse, can pose such a risk of significant harm to a child that urgent protective action is needed. |
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7.2.3 |
When considering whether emergency action is required, an agency should always consider whether action is also required to safeguard and promote the welfare of other children in the same household (e.g. siblings), the household of an alleged perpetrator, or elsewhere. |
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7.2.4 |
Responsibility for immediate action rests with the host authority where the child is found, but should be in consultation with any home authority (as described in section 7.1.1) |
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7.2.5 |
Planned emergency action will normally take place following an immediate strategy meeting / discussion between police, LA children's social care, and other agencies as appropriate (see section 7.5 strategy meeting / discussion); see Appendix 1. Statutory Framework for the range of emergency protection powers available. |
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7.2.6 |
Immediate protection may be achieved by:
- A parent taking action to remove an alleged abuser;
- An alleged abuser agreeing to leave the home;
- The child not returning to the home;
- The child being removed either on a voluntary basis or by obtaining an Emergency Protection Order (EPO);
- Removal of the child/ren or prevention of removal from a place of safety under police powers of protection;
- Gaining entry to the household under police powers and assessing to assess the situation.
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7.2.7 |
The LA children's social worker must seek the agreement of their first line manager and obtain legal advice before initiating legal action. |
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7.2.8 |
Police powers of protection should only be used in exceptional circumstances where there is insufficient time to seek an EPO or for reasons relating to the immediate safety of the child. |
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7.2.9 |
When police powers of protection are used, an independent police officer of at least inspector rank must act as the designated officer. |
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7.2.10 |
Where an agency with statutory child protection powers has to act immediately to protect a child, a strategy meeting / discussion should take place within 1 working day of the emergency action to plan the next steps. |
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7.2.11 |
Emergency action addresses only the immediate circumstances of the child/ren. It should be followed quickly by a s47 enquiry and an assessment of the needs and circumstances of the child and family as necessary. Where an EPO applies, LA children's social care will have to consider quickly whether to initiate care or other proceedings or to let the order lapse and the child/ren return home. |
7.4
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Initiating an Enquiry
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7.4.1 |
LA children's social care is the lead agency for child protection enquiries and the LA children's social care manager has responsibility for authorising a s47 enquiry. |
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7.4.2 |
In deciding whether to call a strategy meeting / discussion, the LA children's social care manager must consider the:
- Seriousness of the concern/s;
- 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 of a current Child Protection Plan);
- Predisposing factors in the family that may suggest a higher level of risk of harm (e.g. mental health difficulties, parental substance misuse, domestic violence or immigrant family issues, such as social isolation).
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7.4.3 |
A s47 enquiry may run concurrently with police investigations. When a joint enquiry takes place, the police have the lead for the criminal investigation (see section 7.6. Police CAIT criminal investigations) and LA children's social care have the lead for the s47 enquiries and the child's welfare. |
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Inter-agency checks
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7.4.4 |
Whenever a s47 enquiry is initiated, even when there has been a recent initial assessment, the LA children's social worker must contact the other agencies involved with the child to inform them that a child protection enquiry has been initiated and to seek their views. |
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7.4.5 |
The social worker, together with their manager, must decide whether to seek parental permission to undertake inter-agency checks. |
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7.4.6 |
If the manager decides not to seek permission, they must record the reasons, e.g:
- Prejudicial to the child's welfare;
- Serious concern about the behaviours of the adult;
- Concern that the child would be at risk of further Significant Harm.
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7.4.7 |
Where permission is sought and denied, the manager must determine whether to proceed, and if so, record the reasons. |
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7.4.8 |
The checks should be undertaken directly with involved professionals and not through messages with intermediaries. |
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7.4.9 |
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. |
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7.4.10 |
Agency checks should include accessing any relevant information that may be held in one or more other countries. See section 5.45. Accessing information from abroad. |
7.5
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Strategy Meeting/Discussion
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7.5.1 |
Whenever there is reasonable cause to suspect that a child is suffering, or is likely to suffer, significant harm, there should be a strategy meeting / discussion. See section 7.3. s47 enquiry thresholds and the core assessment. |
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7.5.2 |
A strategy meeting / 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 Meeting / 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;
- Determine if legal action is required.
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7.5.3 |
Relevant matters 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 in 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 is required;
- Considering the needs of other children who may be affected (e.g. siblings and other children, such as those living in the same establishment, in contact with alleged abusers).
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7.5.4 |
Strategy discussions by telephone will usually be adequate to plan an enquiry, but meetings are likely to be more effective where:
This list is not exhaustive. |
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7.5.5 |
The strategy meeting / discussion should be convened by LA children's social care. In addition to LA children's social care and the police, the meeting / discussion may need to involve the other agencies (e.g. schools and health services) which hold information relevant to the concerns about the child. |
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7.5.6 |
More than one strategy meeting / discussion may be required. |
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7.5.7 |
Where it is decided that there are grounds to initiate a s47 enquiry, decisions should be made about whether this is a single or joint investigation and should consider:
- Further information required and how it should be obtained;
- The scope of the enquiry, including siblings and other children at possible risk of harm;
- The need for any paediatric or specialist assessment;
- How to meet the best interests of the child/ren in the enquiry, taking account of any additional needs such as that arising from a disability or a need for an interpreter, speech and language therapist;
- How the child's wishes and feelings will be ascertained so that they can be taken into account;
- When, how and who will undertake interviews with the child/ren and if a video interview will be used;
- Any further action if consent is refused for interview or medical assessment;
- The needs of other children in contact with the alleged abuser/s, including all children in the household;
- Who other than the family should be interviewed, by whom, when, and for what purpose (e.g. the referrer);
- Agree what other actions may be needed to protect the child or provide interim services and support, including securing the safe discharge of a child in hospital;
- What information may be shared, with whom and when, taking into account the possibility of information sharing placing a child at risk of Significant Harm or jeopardising police investigations;
- Any implications for disciplinary action, e.g. use of evidence statements (see section 15. Allegations against staff);
- Any legal action required;
- The need for further strategy meetings / discussions;
- Timescales, agency and individual responsibility for agreed actions, including the timing of police investigations and relevant methods of evidence gathering;
- Any need to reconvene the Strategy Meeting / discussion during the enquiry if the circumstances are particularly complex or unknown;
- The mechanism and date for reviewing the completion of agreed actions (i.e. further strategy meetings / discussions in complex cases).
This list is not exhaustive. |
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7.5.8 |
For sharing information between the local authority and criminal justice professionals, the Protocol on the Exchange of Information in the Investigation and Prosecution of Child Abuse Cases (2003), may be needed. The protocol was developed by CPS, ACPO, LGA, ADSS; endorsed by HO, DfES and Welsh Assembly. |
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7.5.9 |
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. See section 7.8. Visually recorded interviews / achieving best evidence. |
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The strategy meeting/discussion
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7.5.10 |
The strategy meeting / discussion should be co-ordinated and chaired by the LA children's social care first line manager. |
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7.5.11 |
The strategy meeting / discussion must involve LA children's social care and the police. The referring agency may need to be included, as may other agencies which are likely to include the child's nursery / school, health visitor / GP / local hospital accident and emergency etc.. |
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7.5.12 |
Professionals participating in strategy meetings / discussions must have all their agency's information relating to the child to be able to contribute it to the meeting / discussion, and must be sufficiently senior to make decisions on behalf of their agencies. |
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7.5.13 |
Where issues have significant medical implications, or a paediatric examination has taken place or may be necessary, a paediatrician should always be included. If the child is receiving services from a hospital or child development team, the meeting / discussion should involve the responsible medical consultant and, in the case of in-patient treatment, a senior ward nurse. |
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7.5.14 |
A professional may need to be included in the strategy meeting / discussion who is not involved with the child, but who can contribute expertise relevant to the particular form of abuse or neglect in the case. |
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Strategy meeting/discussion record
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7.5.15 |
It is the responsibility of the chair of the strategy meeting / discussion to ensure that the decisions and agreed actions are fully recorded using an appropriate form, (e.g. Strategy Discussion Record (DH 2002), Integrated Children's System). A copy should be made available immediately for all participants. |
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7.5.16 |
For telephone discussions, decisions authorised by the LA children's social care manager should be circulated within one working day to all parties to the discussion. |
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Timing of strategy meeting/discussion
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7.5.17 |
Strategy meetings / discussions should be convened within three working days of child protection concerns being identified, except in the following circumstances:
- For allegations / concerns indicating a serious risk of harm to the child (e.g. serious physical injury or serious neglect) the Strategy Meeting / discussion should be held on the same day as the receipt of the referral;
- For allegations of penetrative sexual abuse, the strategy meeting / discussion should be held on the same day as the receipt of the referral if this is required to ensure forensic evidence;
- Where immediate action was required by either agency, the strategy meeting / discussion must be held within one working day;
- Where the concerns are particularly complex (e.g. organised abuse / allegations against staff) the strategy meeting / discussion must be held within a maximum of five working days, but sooner if there is a need to provide immediate protection to a child.
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7.5.18 |
The plan made at the strategy meeting / discussion should reflect the requirement to convene an initial child protection conference within 15 working days of the last strategy meeting / discussion. If the strategy meeting / discussion concludes that further strategy meetings / discussions are required, then a timescale should be set for this (see What To Do If You're Worried A Child Is Being Abused, DfES, 2006). |
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Location of strategy meeting
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7.5.19 |
Where the strategy discussion is a meeting, it should be held at the venue, which is most likely to maximise attendance of those who are vital to share information (e.g. a hospital, school, police station, LA children's social care office). If the child is an in-patient in hospital or if the case is one where hospital staff hold key information, the strategy meeting should be held at the hospital to maximise input from relevant staff. |
7.6
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Police Child Abuse Investigation Team (CAIT) Criminal Investigations
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7.6.1 |
The primary responsibility of police CAIT officers is to undertake criminal investigations of suspected or actual crime and to inform LA children's social care when they are undertaking such investigations. |
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7.6.2 |
The police and LA children's social care must co-ordinate their activities to ensure the parallel process of a s47 enquiry and a criminal investigation is undertaken in the best interests of the child. This should primarily be achieved through planning at strategy meetings / discussions. |
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7.6.3 |
At the strategy meeting / discussion, the police CAIT officers should share current and historical information with other services where it is necessary to do so to ensure the protection of a child. |
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Referral to the police CAIT
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7.6.4 |
All suspected, alleged or actual crime must be referred to the police CAIT. Telephone referrals should be confirmed in writing, within 48 hours, using MPS form 87A (available at the London Safeguarding Children Board website.) |
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7.6.5 |
The police CAIT referral manager will make a decision, based on police threshold policy (see below) and following checks and information sharing, on whether to initiate a criminal investigation. |
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7.6.6 |
The following matters will always be investigated by police:
- All alleged sexual assaults;
- Allegations of physical abuse amounting to offences of actual bodily harm (s47 Offences Against the Person Act 1861) and more serious assaults;
- Allegations of serious neglect / cruelty;
- Allegations and concerns involving minor offences where there are aggravating features.
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7.6.7 |
In respect of other offences of a minor nature, the police CAIT referral manager will determine the necessity for a criminal investigation according to a number of criteria (threshold policy) which include whether the facts are clear and undisputed, known history and likely impact on child. |
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7.6.8 |
If a minor crime, initially assessed by the police referral manager as inappropriate for further investigation, is subsequently discovered to be more serious than originally perceived, then the case must be referred back to the police CAIT for further consideration. |
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Criminal investigation and strategy meeting/discussion
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7.6.9 |
Where the police CAIT is undertaking a criminal investigation, the police are responsible for all the associated investigative activities and keeping social care informed (e.g. conducting interviews of witnesses and suspects; visiting crime scenes and, in conjunction with LA children's social care, arranging medical examinations). |
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7.6.10 |
At the strategy meeting / discussion, the police CAIT should agree with the other agencies whether this is a single or joint investigation, and the timing and methods of evidence gathering which are likely to affect the s47 enquiry. |
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7.6.11 |
In urgent criminal cases (critical incidents) the police may need to act unilaterally, however the police will advise the appropriate agencies of the actions and outcomes as soon as possible. |
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7.6.12 |
Following a full assessment of the available facts, the police CAIT may decide at any stage (e.g. during or following a strategy meeting / discussion), to terminate a criminal investigation and will inform LA children's social care of the decision. Among other factors, the police decision will take account of the best interests of the child/ren. |
7.7
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Involving Parents, Family Members and Children
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7.7.1 |
Section 47 enquiries should always be carried out in such a way as to minimise distress to the child, and to ensure that families are treated sensitively and with respect. LA children's social care should explain the purpose and outcome of s47 enquiries to the parents and child/ren (having regard to age and understanding) and be prepared to answer questions openly, unless to do so would affect the safety and welfare of the child. |
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7.7.2 |
LA children's social care should provide written information about the purpose, process and potential outcomes of s47 enquiries to the parents and child/ren (having regard to age and understanding). The information should be both general and specific to the particular circumstances under enquiry. It should include information about how advice, advocacy and support may be obtained from independent sources. |
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7.7.3 |
In the majority of cases, children remain with their families following s47 enquiries, even where concerns about abuse or neglect are substantiated. As far as possible, s47 enquiries should be conducted in a way that allows for future constructive working relationships with families. |
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7.7.4 |
The way in which a case is managed initially can affect the entire subsequent process. Where handled well and sensitively, there can be a positive effect on the eventual outcome for the child/ren. |
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7.7.5 |
Where a child is living in a residential establishment, consideration should be given to the possible impact on other children living in the same establishment. |
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Involving parents
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7.7.6 |
The LA children's social care social worker has the prime responsibility to engage with family members. 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. See section 6.6. Initial assessment. |
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7.7.7 |
Consideration should be given to:
- The capacity of the parents to understand this information in a situation of significant anxiety and stress;
- 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 (see section 5.47. Working with interpreters / communications facilitators);
- Factors such as race, culture, religion, gender and sexuality together with issues arising from disability and health.
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7.7.8 |
It may be necessary to provide the information in stages to parents and to repeat it; this must be taken into account in planning the enquiry. The information should cover:
- 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);
- An explanation of the role of the various agencies involved in the enquiry and/or investigation and of the wish to work in partnership with them to secure the welfare of their child.
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7.7.9 |
Planning intervention with parents should cover:
- 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 current concerns and the risk of harm to the child to be made;
- In situations of domestic violence and where parents live apart, opportunity should be made for the parents to be seen separately;
- The risk of damaging evidence that may impact on 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.
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7.7.10 |
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. |
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7.7.11 |
Parents should be provided with an early opportunity to explain their perception of the concerns, recognising that there may be alternative accounts and disparities. |
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7.7.12 |
In the course of an enquiry it may be necessary for statutory agencies to make decisions or initiate legal action to protect children, or require the parents to agree to such action. The statutory agency which has undertaken any legal action should inform relevant agencies in writing without delay. |
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Involving children
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7.7.13 |
All children within the household must be seen alone and directly communicated with (in their own first language) during an enquiry. The objectives in seeing the child are to:
- Record and evaluate their appearance, demeanour, mood state and behaviour;
- Hear the child's account of allegations or concerns;
- Observe and record the interactions of the child and their carers;
- See and record the circumstances in which the child is currently living and sleeping and, if different, their ordinary residence;
- Evaluate the physical safety of the environment, including seeing the child's bedroom;
- Ensure that any other children who need to be seen are identified;
- Assess the degree of risk of harm and possible need for protective action;
- Meet the child's needs for information and re-assurance;
- Observe and record any injury without removing the child's clothing.
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7.7.14 |
A child for whom there are significant health concerns (e.g. serious physical injury, malnourishment, acute mental ill health etc.) should be seen and clinically examined on the same working day as the referral is received. |
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7.7.15 |
Exceptionally, a joint enquiry team may need to speak to a suspected child victim without the knowledge of the parent or carer:
- When there is a concern that the child would be threatened; or
- Coerced into silence; or
- There is a strong likelihood that important evidence would be destroyed; or
- The child does not wish the parent to be involved, and is Gillick Competent.
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7.7.16 |
All interaction and communication with the child/ren must take account of:
- The child/ren's developmental stage and cognitive ability;
- Factors such as race, culture, religion, gender and sexuality together with issues arising from disability and health;
- The gender of interviewers, particularly in cases of alleged sexual abuse. A child should not be interviewed by a single professional who is the same sex as the abuser.
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7.7.17 |
In order 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 them;
- Never stop the child freely recounting significant events;
- Fully record the discussion including timing, setting, presence of others as well as what was said.
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Missing or inaccessible children
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7.7.18 |
If the whereabouts of a child subject to s47 enquiries are unknown and cannot be ascertained by the LA children's social care social worker, the following action must be taken within 24 hours:
- A Strategy Meeting / discussion with police CAIT;
- Agreement reached with the LA children's social care manager responsible as to what further action is required to locate and see the child and carry out the enquiry.
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7.7.19 |
If access to a child is refused or obstructed the social worker, in consultation with their manager, should co-ordinate a strategy strategy meeting / discussion, including legal representation, to develop a plan to locate or access the child/ren and progress the s47 enquiry.
See also section 5.27. Missing from care and home. |
7.8
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Visually Recorded Interviews/ABE
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7.8.1 |
Visually recorded interviews must be planned and conducted jointly by LA children's social care and the police CAIT in accordance with the Achieving Best Evidence in Criminal Proceedings: Guidance for Vulnerable or Intimidated Witnesses, including Children (Home Office 2002) |
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7.8.2 |
All events up to the time of the video interview must be fully recorded. |
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7.8.3 |
Visually recorded interviews serve two primary purposes:
- Evidence gathering for criminal proceedings;
- Examination in chief of a child witness.
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7.8.4 |
Relevant information from this process can also be used to inform s47 enquiries, subsequent civil childcare proceedings or disciplinary proceedings against adult carers. |
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7.8.5 |
In accordance with Achieving Best Evidence, all joint interviews with children should be conducted by those with specialist training and experience in interviewing children. Specialist / expert help may be needed:
- If the child's first language is not English (see section 5.47. Working with interpreters / communications facilitators);
- They appear to have a degree of psychiatric disturbance but are deemed competent;
- They have a physical / sensory / learning disability;
- Where interviewers do not have adequate knowledge and understanding of the child's racial religious and cultural background.
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Criteria for visually recorded interviews
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7.8.6 |
Achieving Best Evidence covers all children under the age of 17 years who may be witnesses to any type of crime, both as victims or witnesses to crimes perpetrated on others. Interviewing in this way may not take place if the child objects and / or there are other difficulties (e.g. abuse of the child has involved the use of video.) |
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7.8.7 |
The decision to interview a child in line with Achieving Best Evidence would normally be taken jointly by police and LA children's social care at a strategy meeting / discussion. Exceptionally, there will be occasions when police will have the autonomy to carry out the interview (i.e. when LA children's social care is not available or in urgent matters to assist in forensic retrieval). |
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7.8.8 |
In other cases of children giving evidence the decision on whether or not to video should take account of the:
- Individual child's needs and circumstances;
- Likelihood of maximising the quality of that particular child's evidence;
- Type and severity of offence;
- Circumstances of offence (e.g. relationship to alleged abuser);
- Child's state of mind;
- Perceived fears regarding intimidation and recrimination.
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7.8.9 |
Consideration should be given to the:
- Purpose and likely value of the specific video recorded interview;
- Competency, compellability and availability of child for cross-examination;
- Child's ability and willingness to talk in a formal interview setting.
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7.9
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Paediatric Assessment
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7.9.1 |
Where the child appears in urgent need of medical attention (e.g. suspected fractures, bleeding, loss of consciousness), they should be taken to the nearest accident and emergency department. |
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7.9.2 |
In other circumstances, the strategy meeting / discussion will determine, in consultation with the paediatrician, the need and timing for a paediatric assessment. Where a child is also to be interviewed by police and / or LA children's social care, this interview should take place prior to a medical examination unless there are exceptional circumstances agreed with the police and social work service. |
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7.9.3 |
A paediatrician may refer on to other professionals, particularly if there are suspicions of sexual abuse. |
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7.9.4 |
A paediatric assessment should demonstrate an holistic approach to the child and assess the child's well being, including mental health, development and cognitive ability. |
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7.9.5 |
A paediatric assessment is necessary to:
- Secure forensic evidence;
- Obtain medical documentation;
- Provide re-assurance for the child, parent and LA children's social care;
- Inform treatment follow-up and review for the child (any injury, infection, new symptoms including psychological).
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7.9.6 |
Only doctors may physically examine the whole child. All other staff should only note any visible marks or injuries on a body map and record, date and sign details in the child's file. |
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Consent for paediatric assessments or medical treatment
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7.9.7 |
The following may give consent to a paediatric assessment:
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7.9.8 |
When a child is looked after under s20 and a parent 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 still has full parental responsibility for the child). |
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7.9.9 |
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. |
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7.9.10 |
A young person aged 16 or 17 has an explicit right (s8 Family Law Reform Act 1969) to provide consent to surgical, medical or dental treatment and unless grounds exist for doubting their mental health, no further consent is required. |
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7.9.11 |
A child who is of sufficient age and understanding may refuse some or all of the paediatric assessment, though refusal can potentially be overridden by a court. |
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7.9.12 |
Wherever possible the permission of a parent should be sought for children under sixteen prior to any paediatric assessment and / or other medical treatment. |
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7.9.13 |
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 their own consent;
- Decide to proceed without consent.
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7.9.14 |
In these circumstances, parents must be informed by the medical practitioner as soon as possible and a full record must be made at the time. |
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7.9.15 |
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. |
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Arranging the paediatric assessments
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7.9.16 |
In the course of s47 enquiries, appropriately trained and experienced practitioners must undertake all paediatric assessments. |
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7.9.17 |
Referrals for child protection paediatric assessments from a social worker or a member of the police are made to the local service. |
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7.9.18 |
The paediatrician may arrange to examine the child themselves, or arrange for the child to be seen by a member of the paediatric team in the hospital or community. |
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7.9.19 |
In cases of suspected abuse, GP's must not perform a detailed examination unless this is agreed by the police and the LA children's social care. |
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7.9.20 |
The assessment may be carried out jointly by a forensic medical examiner and a paediatrician. If a forensic medical examiner is not available, two paediatricians may carry out the assessment provided one has received forensic training. |
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7.9.21 |
In these cases, a child abuse investigation team (CAIT) officer should directly brief the doctors and take possession of evidential items. |
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7.9.22 |
Single examinations should only be undertaken if the person has the requisite skills and equipment. For further guidance for paediatricians and forensic medical examiners (see the Royal College of Paediatrics and Association of Police Surgeons Child Health Guidelines [2002].) |
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7.9.23 |
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. |
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7.9.24 |
The need for a specialist assessment by a child psychiatrist or psychologist should be considered. |
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7.9.25 |
In planning the examination, the police CAIT officer and relevant doctor must consider whether it might be necessary to take photographic evidence for use in care or criminal proceedings. |
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7.9.26 |
Where such arrangements are necessary, the child and parents must be informed and prepared and careful consideration given to the impact on the child. |
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Recording of paediatric assessment
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7.9.27 |
The paediatrician should supply a report to the social worker, GP and, where appropriate, the police. The timing of a letter to parents should be determined in consultation with LA children's social care and police. |
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7.9.28 |
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;
- Opinion of whether injury is consistent with explanation;
- 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 (especially important in cases of neglect);
- The time the examination ended.
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7.9.29 |
All reports and diagrams should be signed and dated by the doctor undertaking the examination. |
7.11
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Outcome of Child Protection Enquiries
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7.11.1 |
LA children's social care is responsible for deciding how to proceed based on the strategy meeting / discussion and taking into account the views of the child, their parents and other relevant parties (e.g. a foster carer.) |
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7.11.2 |
At the completion of a s47 enquiry, LA children's social care may need to undertake a number of actions. |
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7.11.3 |
The outcome will reflect that the original concerns may be:
- Unsubstantiated;
- Substantiated, but assessed as posing no continuing risk of significant harm;
- Substantiated and at continuing risk of Significant Harm.
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Concerns are not substantiated
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7.11.4 |
Where the concerns are not substantiated, the LA children's social care manager must authorise whether the decision that no further action is necessary, having ensured that the child, any other children in the household and the child's carers have been seen and spoken with. |
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7.11.5 |
In these circumstances, the core assessment will have ended and services provided where needed to improve the welfare of the child. |
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7.11.6 |
In some cases, there may remain concerns about the welfare of the child. It may be appropriate to put in place arrangements to monitor the child's welfare. Monitoring should never be used as a means of deferring or avoiding difficult decisions. The purpose of monitoring should always be clear, that is, what is being monitored and why, in what way and by whom. It will also be important to inform parents about the nature of any on-going concern. There should be a time set for reviewing the monitoring arrangements through the holding a further meeting / discussion. |
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Concerns are substantiated but the child is not considered to be at continuing risk of significant harm
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7.11.7 |
There may be substantiated concerns that a child has suffered significant harm, but the agencies most involved may judge that a parent or members of the child's wider family are willing and able to co-operate with actions to ensure the child's future safety and welfare and that the child is therefore not at continuing risk of significant harm. |
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7.11.8 |
Other reasons which may or may not contribute to a judgement that the child is not at continuing risk of harm include that:
- The caregiver has taken responsibility for the harm they caused the child;
- The family's circumstances have changed;
- The person responsible for the harm is no longer in contact with the child;
- The Significant Harm was incurred as the result of an isolated abusive incident e.g. abuse by a stranger.
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7.11.9 |
A child protection conference may not be required when there are sound reasons, based on an analysis of evidence obtained through s47 enquiries, for judging that a child is not at continuing risk of significant harm. |
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7.11.10 |
In taking the decision that a family's co-operation is sufficient to ensure a child's future safety, LA children's social care should take into account:
- All relevant information obtained during a s47 enquiry;
- A soundly based assessment of the likelihood of successful intervention;
- Recently sought wishes and feelings of the child;
- The need for clear evidence;
- The dangers of misplaced professional optimism;
- The pressure that can be felt by professionals not to challenge hostile and obstructive families.
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7.11.11 |
LA children's social care may convene a meeting involving the child and their family and professionals engaged with the family. The meeting should agree:
- What actions should be undertaken in response to the Core Assessment findings;
- Who is responsible for which actions;
- The intended outcomes for the child's health and development;
- The timescale for the actions;
- How progress will be reviewed and by whom.
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Concerns are substantiated and the child is considered to be at continuing risk of significant harm
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7.11.12 |
Where concerns are substantiated and the child is assessed to be at continuing risk of significant harm, there must be a child protection conference. |
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Feedback from enquiries
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7.11.13 |
The LA children's social worker is responsible for recording the outcome of the s47 enquiries consistent with the requirements of the integrated children's system. This should be put on the child's electronic record with a clear record of the discussions, authorised by the LA children's social care manager. |
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7.11.14 |
A copy of the requirements of the integrated children's system should be given to all the agencies who have been significantly involved, the parents and children of sufficient age and appropriate level of understanding, in particular in advance of any initial child conference that is convened. This information should be conveyed in an appropriate format for younger children and those people whose preferred language is not English. See section 5.47. Working with interpreters / communications facilitators. |
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7.11.15 |
Feedback about outcomes should be provided to non-professional referrers in a manner that respects the confidentiality and welfare of the child. |
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7.11.16 |
If there are ongoing criminal investigations, the content of the LA children's social worker's feedback should be agreed with the police. |
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7.11.17 |
Where the child concerned is living in a residential establishment which is subject to inspection, the relevant inspectorate should be informed. |
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Disputed decisions
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7.11.18 |
Where LA children's social care have concluded that an initial child protection conference is not required but professionals in other agencies remain seriously concerned about the safety of a child, these professionals should seek further discussion with the LA children's social worker, their manager and/or the nominated safeguarding children adviser. The concerns, discussion and any agreements made should be recorded in each agency's files. |
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7.11.19 |
If concerns remain, the professional should discuss with a designated / named / lead person or senior manager in their agency. If concerns remain the agency may formally request that LA children's social care convene an initial child protection conference. LA children's social care should convene a conference where one or more professionals, supported by a senior manager / named or designated professional requests one. |
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7.11.20 |
If this approach fails to achieve agreement, the procedures for resolution of conflicts should be followed. See section 18. LSCBs, quality assurance and conflict resolution. |
