Safeguarding Children Policy (extract)

 

Background & Principles

 

Safeguarding children and young people is a fundamental goal for the Willerby and Swanland Surgery. This policy has 

taken into account legislative and government guidance requirements and other internal policies. These include: 

ERSCB Threshold of Need documents and NHS Commissioner Safeguarding Children Policy and the BMA Children & Young People Policy (Card Toolkit) 

 

In England the relevant legislation and guidance is: 

• Adoption and Children Act 2002 

• The Children Act 1989 

• The Children Act 2004 

• The Protection of Children Act 1999 

• The Human Rights Act 1998 

• The United Nations Convention on the Rights of the Child (ratified by UK Government in 1991 and became 

  statutory in Wales 2011) 

• The Data Protection Act 1998 (UK wide) 

• Sexual Offences Act 2003 

• NICE CG89 Child Maltreatment Guidance 200911 

• Working Together to Safeguard Children 2010 

• Practice Equal Opportunity Statement 

• Practice Disciplinary Policy 

• Accidents and Child Development 2009 (www.capt.org.uk) 

 

What is Abuse? 

 

Abuse and neglect are forms of maltreatment of a child. Somebody may abuse or neglect a child by inflicting harm, or by 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. An unborn child may suffer harm if his/her mother is subject to domestic abuse, is a tobacco, drug or alcohol abuser or fails to attend for antenatal care. 

 

There are usually said to be four types of child abuse or maltreatment [with a fifth recognised in Scotland] but they often overlap and it is not unusual for a child or young person to have symptoms or signs from several categories (for full descriptions see the NICE guidance11 ). 

1. Physical Abuse 

2. Emotional Abuse 

3. Sexual Abuse 

4. Neglect 

 

Practice Arrangements 

 

Willerby and Swanland Surgery recognises that it is the role of the practice to be aware of maltreatment and share concerns but not to investigate or to decide whether or not a child has been abused 

 

The Practice has an appointed a Safeguarding Children & Young People Lead GP and the Practice Manager deputises in that role and there is a minimum safety criteria in use for safe recruitment and staff are trained to relevant levels of learning requirements with level 1 being basic induction for all practice staff, level 2 for practice nurses/practice manager and level 3 for GPs 

 

Whistle Blowing 

 

Willerby and Swanland Surgery recognises the importance of building a culture that allows all Practice Staff to feel comfortable about sharing information, in confidence and with a lead person, regarding concerns they have about a colleague’s behaviour.

This will also include behaviour that is not linked to child abuse but that has pushed the boundaries beyond acceptable limits. Open honest working cultures where people feel they can challenge unacceptable colleague behaviour and be supported in doing so, help keep everyone safe.

Where allegations have been made against staff, the standard disciplinary procedure and the early involvement of the

Local Authority Designated Officer (LADO) may be necessary (section 11 Children Act 2004). 

 

Management of Disclosure of an Allegation of Abuse

 

If a child makes allegations about abuse, whether concerning themselves or a third party, our employees must immediately pass this information on to the lead for child protection and follow the child protection procedures as laid out in the practice policy.

 

It is important to also remember that it can be more difficult for some children to tell than for others (see earlier section on barriers). Children who have experienced prejudice and discrimination through racism may well believe that people from other ethnic groups or backgrounds do not really care about them. They may have little reason to trust those they see as authority figures and may wonder whether you will be any different. 

 

Children with a disability, especially a sensory deficit or communication disorder, will have to overcome additional barriers before disclosing abuse. They may well rely on the abuser for their daily care and have no knowledge of alternative sources. They may have come to believe they are of little worth and simply comply with the instructions of adults. 

 

Responding to a Child Making an Allegation of Abuse 

 

• Stay calm 

• Listen carefully to what is being said 

• Reassure the child that they have done the right thing by telling you 

• Find an appropriate early opportunity to explain that it is likely the information will need to be shared with 

  others – do not promise to keep secrets 

• Allow the child to continue at his/her own pace 

• Ask questions for clarification only and at all times avoid asking questions that are leading or suggest a 

  particular answer 

• Tell them what you will do next and with whom the information will be shared 

• Record in writing what has been said using the child’s own words as much as possible – note date, time, any 

  names mentioned, to whom the information was given and ensure that paper records are signed and dated 

  and electronic subject to audit trails 

• Do not delay in discussing your concerns and if necessary passing this information on 

• Follow the referral pathway detailed in the policy

 

Sharing Information 

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The practice will follow the policy on sharing information in child protection cases which is as follows. 

• In England and Wales, the Children’s Acts of 1989 and 2004 give GPs a statutory duty to co-operate with 

   other agencies (Children Act 1989 section 27, 2004 section 11) if there are concerns about a child’s safety 

   or welfare. Health authorities (PCOs) (section 47.9) have a duty to assist local authorities (Social/Childcare 

   Services) with enquiries, named Doctors for child protection can be powerful advocates for this function. 

• The Children, Schools and Families Act 2010 section 8 amends The Children Act 2004 providing further 

   statutory requirements for information sharing when the LSCB requires such information to allow it to carry 

   out its functions adding Section 14b see www.legislation.gov.uk/ukpga/2010/978010542103/section/8. 

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This means that the default position is that the practice will share information with Social Care and not doing so maybe legally indefensible. 

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General Principles

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The ‘Seven Golden Rules’ of information sharing are set out in the government guidance, Information Sharing: 

Pocket Guide 30 . This guidance is applicable to all professionals charged with the responsibility of sharing 

information, including in child protection scenarios. 

1. The Data Protection Act is not a barrier to sharing information but provides a framework to ensure personal information about living persons is shared appropriately

2. Be open and honest with the person/family from the outset about why, what, how and with whom information will be shared and seek their agreement, unless it is unsafe or inappropriate to do so 

3. Seek advice if you have any doubt, without disclosing the identity of the person if possible. 

4. Share with consent where appropriate and where possible, respect the wishes of those who do not consent to share confidential information, You may still share information without consent if, in your judgement, that lack of consent can be overridden in the public interest.

5. Consider safety and well-being, base your information sharing decisions on considerations of the safety  and well-being of the person and others who may be affected by their actions. 

6. Necessary, proportionate, relevant, accurate, timely and secure, ensure that the information you share  is necessary for the purpose for which you are sharing it, is shared only with those people who need to have  it, is accurate and up to date, is shared in a timely fashion and is shared securely. 

7. Keep a record of your concerns, the reasons for them and decisions Whether it is to share information  or not. If you decide to share, then record what you have shared, with whom and for what purpose 

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Safeguarding Adults Policy (extract)

 

Background & Principles

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What is abuse?

There are many different types of abuse and they all result in behaviour towards a person that deliberately or intentionally cause harm.

It is a violation of an individual’s human and civil rights and in the worst cases can result in death.

Victims may suffer severe neglect, injury, distress and/or depression and people without capacity, such as those people with severe dementia, are particularly vulnerable.

There is additional legal protection for such people under the Mental Capacity Act 2005 - For further information please refer to the Useful Links section.

Cases of abuse can result in criminal prosecution and action being taken by the courts.

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Who are 'Adults at Risk of harm'?

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The safeguarding duties apply to an adult who:

• is 18 and over

• has needs for care and support (whether or not the local authority is meeting any of those needs)

• is experiencing, or at risk of harm of, abuse or neglect and as a result of those care and support needs is unable to protect themselves from either the risk of harm of, or experience of abuse or neglect.

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Who may have Care and Support Needs?

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this may be a person who:

• is elderly and frail due to ill health, physical disability or cognitive impairment

• has a learning disability and or a sensory impairment

• has mental health needs including dementia or a personality disorder

• has a long term illness/condition

• misuses substances or alcohol

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What is the definition of abuse?

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Whilst neither the Care Act of 2015 nor its statutory guidance specifically defines abuse, it does state that professionals should not limit their view of what constitutes abuse or neglect as it can take many forms and the circumstances of the individual case should always be considered.

The Care Act statutory guidance goes on to provide a detailed definition of each of the ten types of abuse which is listed below. Further to this, the guidance highlights that incidents of abuse may be one-off or multiple, and affect one person or more. Therefore professional should look beyond single incidents or individuals to identify patterns of harm.

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Why might a person be vulnerable?

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There are many factors that could increase the risk of abuse. Some of these are listed below:

• People dependant on others for assistance, especially with finances and personal care

• Mental incapacity, communication difficulties, decreased mobility

• Those without visitors

• Those subjected to hate crimes

• People having care in their own homes

• Not knowing where to turn to for help

• People might also think that the standard of care they are receiving is all they can expect.

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Everyone is a potential victim of crime or abuse but the following conditions can increase that vulnerability:

• a learning disability

• mental health issues

• a physical or sensory impairment

• is frail or an older person

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Abuse of Adults at Risk does not have to be deliberate, malicious or planned. It sometimes happens when people are trying to do their best but do not know the right thing to do. Sometimes the person who causes harm does so because of frustration even in the caring context.

However, irrespective of why the abuse might happen, any abuse of a Adult at Risk is harmful. This makes it vitally important to ensure that those involved with the care and well being of Adults at Risk have a clear sense of what signifies abuse and what must happen should abuse be suspected or discovered.

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The ten types of abuse

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The types of abuse have been categorised and placed under ten headings, you will find that on occasions the actual behaviour you might observe or be told about could fit under more than one heading, do not worry about this, others will make a decision later in the process as to the most appropriate category under which to record the event. The seven categories are:

• Discriminatory 

• Psychological 

• Financial or material 

• Organisational 

• Neglect and acts of omission 

• Physical 

• Sexual 

• Domestic

• Modern slavery

• Self-neglect 

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Where does abuse occur?

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Abuse can occur anywhere and is not confined to any one setting. Just because there are no records of abuse having occurred does not mean it has not happened or is happening now. It is important to remain alert for the signs at all times, for example abuse can occur:

• In a nursing, residential or day care setting 

• In a persons' own home 

• In another place previously assumed safe for example; prison 

• In a hospital or public place 

• In education, training or a work place setting 

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Sharing Information of a Vulnerable Adult

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What if a person does not want you to share their information? - Adult safeguarding: sharing information Frontline workers and volunteers should always share safeguarding concerns in line with their organisation’s policy, usually with their line manager or safeguarding lead in the first instance, except in emergency situations. As long as it does not increase the risk to the individual, the member of staff should explain to them that it is their duty to share their concern with their manager. The safeguarding principle of proportionality should underpin decisions about sharing information without consent, and decisions should be on a case-by-case basis.

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Individuals may not give their consent to the sharing of safeguarding information for a number of reasons. For example, they may be frightened of reprisals, they may fear losing control, they may not trust social services or other partners or they may fear that their relationship with the abuser will be damaged. Reassurance and appropriate support along with gentle persuasion may help to change their view on whether it is best to share information.

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If a person refuses intervention to support them with a safeguarding concern, or requests that information about them is not shared with other safeguarding partners, their wishes should be respected. However, there are a number of circumstances where the practitioner can reasonably override such a decision, including:

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• the person lacks the mental capacity to make that decision – this must be properly explored and recorded in line with the Mental Capacity Act other people are, or may be, at risk, including children sharing the information could prevent a crime the alleged abuser has care and support needs and may also be at risk a serious crime has been committed staff are implicated 

• the person has the mental capacity to make that decision but they may be under duress or being coerced the risk is unreasonably high and meets the criteria for a multi-agency risk assessment conference referral a court order or other legal authority has requested the information. 

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If none of the above apply and the decision is not to share safeguarding information with other safeguarding partners, or not to intervene to safeguard the person:

• support the person to weigh up the risks and benefits of different options ensure they are aware of the level of risk and possible outcomes offer to arrange for them to have an advocate or peer supporter offer support for them to build confidence and self-esteem if necessary agree on and record the level of risk the person is taking record the reasons for not intervening or sharing information regularly review the situation try to build trust and use gentle persuasion to enable the person to better protect themselves. 

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If it is necessary to share information outside the organisation:

• explore the reasons for the person’s objections – what are they worried about? 

• explain the concern and why you think it is important to share the information tell the person who you would like to share the information with and why explain the benefits, to them or others, of sharing information – could they access better help and support? 

• discuss the consequences of not sharing the information – could someone come to harm? 

• reassure them that the information will not be shared with anyone who does not need to know reassure them that they are not alone and that support is available to them. 

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If the person cannot be persuaded to give their consent then, unless it is considered dangerous to do so, it should be explained to them that the information will be shared without consent. The reasons should be given and recorded.

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If it is not clear that information should be shared outside the organisation, a conversation can be had with safeguarding partners in the police or local authority without disclosing the identity of the person in the first instance. They can then advise on whether full disclosure is necessary without the consent of the person concerned.

 

It is very important that the risk of sharing information is also considered. In some cases, such as domestic violence or hate crime, it is possible that sharing information could increase the risk to the individual. Safeguarding partners need to work jointly to provide advice, support and protection to the individual in order to minimise the possibility of worsening the relationship or triggering retribution from the abuser.

 

Domestic abuse cases should be assessed following the CAADA-DASH risk assessment and referred to a multi-agency risk assessment conference where appropriate. Cases of domestic abuse should also be referred to local specialist domestic abuse services.

 

The above is from the SCIE Information Sharing Guidance that is post Care Act Statutory Guidance and is clear that only for the reasons stated above can you go against the persons wishes not to share information.

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