SECTION 3 - REFERRAL AND INVESTIGATIONThis section describes what should happen in County Durham when someone has concerns about the welfare of a child and is concerned that a child may be suffering, or is at risk of suffering, abuse or neglect. It includes:
It sets out clear expectations that all agencies and professionals will work together in the interests of children’s safety and wellbeing. In addition, each agency, organisation or professional group is recommended to have in place its own set of written procedures which are compatible with their responsibilities as described inWorking Together to Safeguard Children (2006). In line with Working Together to Safeguard Children (2006) the new terminology is sued in this document. Children who were previously on the Child Protection Register are now subject of a Child Protection Plan and their names included on the Child Protection List. Being alert to children’s welfare Everybody who works with children and young people, with parents and with other adults in contact with children should have an awareness that child abuse and neglect may occur. They should understand that children may be abused or neglected anywhere including in their own homes, in day care, in educational and play settings, in residential settings away from home and in leisure environments. They should know that children can be abused or neglected by a wide range of people including relatives, paid carers, professionals, staff, managers and volunteers in any service or organisation and by other young people inside or outside the family home. Concerns about abuse and neglect may arise from a number of sources including:
Safeguarding & Specialist Services Eligibility Criteria Children in Need of Protection The Children Act 1989 states the Local Authority has a duty to investigate when they “have reasonable cause to suspect a child who lives, or is found, in their area is suffering, or is likely to suffer significant harm”. (s47, Children Act 1989) All referrals to Safeguarding & Specialist Services are referrals of Children In Need and Safeguarding & Specialist Services undertake assessments of children, under their Children in Need procedures, where a child’s health or development is being impaired or there is a high risk of impairment without services (s17, Children Act 1989). Where there is only one specific issue the identified need may be met within universal services such as Health or it may be more appropriate to refer to another agency/service e.g.:
Responding to a child/young person who reports abuse or neglect It should be borne in mind that it is difficult for children and young people to report abuse or neglect. If they choose to do so, the person who they have trusted to receive this information is in a key position to support and help that child. How that person responds to any disclosure will influence what the child is able to do next, and how that child feels about having disclosed. Any child or young person who reports abuse or neglect either about themselves or another child should be taken seriously and responded to in accordance with the following guidance:
Parental Involvement and Agreement While in general, you should seek to discuss any concerns with the family and, where possible, seek their agreement to making referrals, 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. It is good practice usually in the interests of children that, wherever possible, agencies and parents should work together to safeguard and promote children’s welfare but there will be times where this is not possible. In cases where there are reasonable grounds to believe that the child is at risk of serious harm the necessary inter-agency discussions and referrals should proceed whether or not parents are in agreement, but the parents should usually be fully informed beforehand about what is being done and why. The exception to this is when it is believed that to inform a parent(s) and/or seek their agreement would place the child at further risk of significant harm or seriously jeopardise the safety of other children, the child’s carers or others. Examples of when it may be unsafe to inform parents before making a referral to Police or Safeguarding & Specialist Services are:
In such circumstances how and when to inform and involve the parents and whether to interview the child without a parent’s consent should be a decision of a Strategy Discussion and/or Meeting that involves the Police, Safeguarding & Specialist Services and other relevant professionals who have knowledge of the child and family. Common characteristics of abusive situations Certain characteristics have been frequently noted in child abuse situations and whereas child abuse can occur in any situation, a high concentration of these should raise awareness regarding possible risk:
Some indicators of possible Physical Abuse
Some indicators of possible Neglect
Some indicators of possible Emotional Abuse
Some indicators of possible Sexual Abuse
Duty to Conduct Enquiries under Section 47 of the 1989 Children Act Safeguarding & Specialist Services has the statutory duty to make, or cause to be made, enquiries when the circumstances defined in s47 exist. This section gives Local Authorities a duty to make enquires as to whether to take action to safeguard or promote the welfare of a child who is suffering, or likely to suffer significant harm. The Police have a parallel duty to protect life and are responsible for any criminal investigation. The responsibility for undertaking s47 enquiries lies with the Local Authority in which the child lives or is found. Where this is a different authority to where the child lives (his/her ‘home’ authority) this may be usually be described as the ‘host’ authority. Where a child is living in another authority his/her ‘home’ authority should be informed as soon as possible and be involved in Strategy Discussions and/or Meetings. The ‘home’ authority may undertake the necessary enquiries on behalf of the ‘host’ authority. This is likely to be appropriate in the case of a Looked After child. (Refer to Section 6 “Cross Boundary Issues”). Following a referral to Social Care Direct, a screening process will determine whether an Initial Assessment is carried out by the Initial Assessment Team. If there is sufficient information to indicate that a s47 enquiry is needed, this will be immediately referred to the relevant Children in Need Team where arrangements for a Strategy Discussion and/or Meeting will take place. Obligations and Responsibilities of All Agencies Assessing the needs of a child and the capacity of his/her parents or wider family network to adequately ensure the child’s safety, health and development depends on building a picture of the child’s situation on the basis of information from a wide variety of sources. All agencies have a duty to assist and provide information in support of child protection enquiries. Threshold for s47 Enquiries 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 it. An Initial or Core Assessment should be undertaken unless it is clear at any point that the threshold for s47enquiries is met. s47 enquiries start when there is reasonable cause to suspect that a child is suffering or likely to suffer significant harm in the form of physical, sexual, emotional abuse or neglect. Safeguarding & Specialist Services and the Police should inform and consult each other about any potential child protection referrals received so that relevant information can be taken into account before a final decision is made on whether the threshold is met for a s47 enquiry. The Named Nurse Child Protection should also be consulted. The Police should be notified immediately by the agency/organisation receiving the information where a criminal offence appears to have been committed, or is suspected of having been committed, against a child. A criminal investigation or further Police involvement may not be required in every case. The Police decision will take account of the best interests of the child/ren. The following is a non-exhaustive list of situations that require consideration of the need for a s47 enquiry, which must be evidenced:
A combination of any of the factors which taken individually would require only an Initial Assessment, but with the additional factors of parental mental illness, excessive drinking or drug use may justify considering an immediate s47 enquiry. Outcomes of enquiries must be clearly recorded by the Social Worker, with the reasons for decisions clearly stated and signed off by his/her Team Manager. Feedback about outcomes should be provided to non-professional referrers in a manner which respects the confidentiality and welfare of the child. Parents, children (depending on their level of understanding), professionals and other agencies, with significant involvement, must be provided with a copy of the written record of the outcome of the enquiry within one week. Referrals by Members of the Public The NSPCC helpline offers an alternative means of reporting concerns. Individuals may prefer not to give their name when referring a concern. Alternatively, they may disclose their identity but not wish for it to be revealed to the parents/carers of the child concerned. Wherever possible, staff will respect the referrer’s request for anonymity. However, staff cannot give referrers any guarantees of confidentiality, as there are certain limited circumstances in which the identity of a referrer may have to be given, for example in court proceedings or criminal investigations. Feedback to members of the public will be given where possible within the rights to confidentiality of the child and her/his family. Professionals should follow their own agency procedures and discuss concerns with the nominated person their agency. Prior to making a referral to Safeguarding & Specialist Services consideration should be given to the complexity of the child’s needs and the need for an assessment. Complex situations requiring co ordination of services and in depth assessment are appropriate referrals under the Children In Need Procedures. Outcomes of discussions within the agency may be:
Where abuse is alleged or suspected and the child has been taken to hospital, they must not be discharged until Social Care Direct are notified by telephone that there are child protection concerns. Referrals to Safeguarding & Specialist Services Referrals should generally be made to Social Care Direct 0845 850 50 10 for a child living within the County. Social Care Direct will advise, re-direct or take a referral. All new referrals are screened and, if deemed of moderate or serious concern, passed to the appropriate Children in Need Team Manager. A referral should be made if there are any signs that a child under the age of 18 years, is experiencing or may already have experienced abuse or neglect or is suffering, or likely to suffer 'significant harm' in the future. Professionals should never delay a referral if there is a concern that a child may be, or is likely to suffer significant harm. If a referral is made verbally, this should be followed up in writing within two working days. Referrals should be specific to an individual child and not on sibling groups, unless the referrer believes each one requires an assessment. They will need as much of the following information as possible to complete the referral, e.g.:
Referrers should receive acknowledgement from Safeguarding & Specialist Services in writing within one working day of receipt. It is the responsibility of the referrer to contact the Safeguarding & Specialist Services if a response to the referral has not been received. It the referrer is not satisfied with the response they should contact the Children in Need Team Manager to discuss their concerns. The referrer should keep a written record of:
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. If any agency encounters a child, in what they consider to be a life endangerment situation requiring immediate protection, contact should be made with the Police in the first instance. Emergency action may be necessary as soon as the referral is received or at any point during involvement with children and families. Responsibility for immediate action rests with the authority where the child is found, but should be in consultation with any “home” authority. Immediate protection is achieved by:
The Social Worker must seek the agreement of his/her Team Manager and obtain legal advice before initiating legal action. Safeguarding & Specialist Services should seek the assistance of the Police to use Police Protection if the child’s safety is at immediate risk. The agency taking protective action must always consider whether action is also required to safeguard other children in the same household, in the household of an alleged perpetrator or elsewhere. Planned immediate protection will normally take place following a Strategy Discussion and/or Meeting. Where an agency (e.g. the Police) has to act immediately to protect a child, a Strategy Discussion and/or Meeting must take place within one working day to plan the next steps. The Children in Need Team Manager must make any decision that the threshold for s47 enquiries has been met and consequently authorise the instigation of s47 enquiries. The Social Worker must consult the Team Manager to decide, on the basis of known information, whether to seek consent to undertake inter-agency checks from one person with Parental Responsibility. If there are safeguarding issues in regard to a disabled child, the Disabled Children & Their Families Team Manager will make the decision whether to undertake a s47. If the safeguarding issues are in regard to a family where there are disabled child/children and non disabled child/ children then discussions will take place between Team Manager of the Children in Need Team and the Team Manager of the Disabled Children & Their Families Team and clear recorded decisions made regarding who will conduct the Strategy Meeting and be responsible for investigation. Co-working will take place with the Disabled Children and Their Families Team taking case responsibility for the disabled child/children and working closely with the Children in Need Team. 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, including risk factors and parenting strengths. If an Initial Assessment has already taken place, involving consultation with other agencies, the Team Manager must decide if further checks are required. The checks should normally be undertaken again unless they were completed within the previous working week and are based on current information and concerns. If the Team Manager decides not to seek consent, he/she must record the reasons demonstrating the following grounds:
Where consent is sought and denied, the Team Manager must decide whether to proceed without this consent, and record the reasons. The checks should be undertaken directly with involved professionals and not through messages with intermediaries. These checks will include:
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 light of the information presented. If parents have not given consent, information can still be shared in light of child protection matters. All referrals of children in need of protection will be subject to an Initial Assessment. Social Care Direct and the Initial Assessment Team will plan and carry out such enquiries, as it considers appropriate. If a situation constitutes, or may constitute a criminal offence, against a child, the Police must be informed at the earliest opportunity in these circumstances. All Initial Assessments for disabled children are undertaken by the Disabled Children and Their Families Team. The Initial Assessment is carried out in accordance with the Framework for Assessment of Children in Need and their Families DoH (2000) Guidelines (Appendix 4) and should be initiated within 24 hours of receipt of a referral and completed in a maximum of seven working days from this. An Initial Assessment and should be carried out on all relevant children for whom there are health or welfare concerns. An Initial or Core Assessment should be undertaken for a child in need unless it is clear that the threshold criteria for s47 enquires have been met. Where an application is made by family under Private Law proceedings in respect of the residence of a child during or following s47 enquiries but prior to completion of enquiries Safeguarding & Specialist Services must consult with Corporate & Legal Services to allow the Local Authority to inform the Court that s47 enquiries are underway and have not been completed. This will allow any known relevant information to be given to the Court in order for them to make informed decisions. Strategy Discussion and/or Meeting A Strategy Discussion and/or Meeting should be held:
For complex/organised abuse see Section 6. Strategy Discussion and/or Meetings can be held in other situations to help plan enquiries. There may be occasions when more than one Strategy Discussion and/or Meeting is necessary according to the characteristics of the case. The timing of the Strategy Discussion and/or Meeting will be determined by the assessed level of risk and the urgency of the required intervention. Where there are concerns about serious inflicted injuries, sexual abuse involving penetration, a Strategy Discussion involving telephone contact between the Police and Safeguarding & Specialist Services should be held. If the child is a hospital in or outpatient or receiving services from a child development team, the medical consultant responsible for the child’s health care should be involved, as should the senior ward nurse if the child is an inpatient. Where a medical examination may be necessary or has taken place a senior doctor from those providing the services should also be involved. Consideration to be given to contacting the Consultant Paediatrician, in order to ensure that forensic evidence is collected and parties interviewed without the risk of contamination. A Strategy Discussion and/or Meeting must be held between Safeguarding & Specialist Services, the Police and other relevant professionals. The purpose of this is to:
Both Strategy Discussions and/or Meetings must:
Chairing of Strategy Discussion and/or Meetings The Strategy Discussion and/or Meeting should be co-ordinated and chaired by the Team Manager. Participants to Strategy Discussion and/or Meeting The Strategy Discussion and/or Meeting must involve Children and Young People’s Services, the Vulnerability Unit, Senior Nurse (Child Protection), referrer (if from an education setting) and other agencies as appropriate. These colleagues should be advised of the meeting and given the opportunity to attend. Where a paediatric opinion is likely to be required, consultation should be made with a paediatrician prior to the meeting to discuss their availability. Substance Misuse Services staff must be invited to a Strategy Meeting if involved. Where there is an allegation that a child has abused another child separate Strategy Meeting should be held for both children and Youth Engagement Service staff must be involved. In the event that an allegation or concern is received relating to a person who works with children and young people, the Local Authority Designated Officer (LADO) and the Nominated Officer (NO) from the person’s employing officer should be invited to the Strategy Meeting. Guidance is given in Section 6 of these procedures for allegations against staff, volunteers and carers. Other agencies to consider including, as appropriate are;
The Team Manager should use the Strategy Meeting form and circulated to those invited and those consulted as part of initial checks within one working day. These could be circulated in written form as long as the writing is legible. It is essential that all apologies are recorded. The Team Manager should use the Strategy Meeting form and circulated to those invited and those consulted as part of initial checks within one working day. These could be circulated in written form as long as the writing is legible.. Timing of Strategy Discussion and/or Meeting Strategy Discussions and/or Meetings should be convened within two working days except in the following circumstances:
The plan made at the Strategy Discussion and/or Meeting must be consistent with the requirement to convene an Initial Child Protection Conference within 15 working days of the commencement of the s47 enquiry. Generally the Strategy Meeting is held at the Children in Need locality office, but can be convened elsewhere to facilitate the attendance of key personnel. If the child is in hospital, the Strategy Meeting must be held in hospital in order ensure the full involvement of the consultant paediatrician/medical/nursing staff. Possible Outcomes of a Strategy Discussion
In the case of a sudden or suspicious death or serious injury of a child the subsequent enquiries would be Police led. However, Police would share all relevant information and allow access to family members as appropriate for Safeguarding & Specialist Services to safeguard the welfare of all children who may be involved. In such circumstances consideration would be given to the need for the convening of the Serious Case Review Panel. Refer to Section 8 of these procedures. The primary responsibility of Vulnerability Unit staff is to undertake criminal investigations of suspected or actual crime. Safeguarding & Specialist Services have the statutory duty to make, or cause to be made, enquiries when the circumstances defined in s47 Children Act 1989 exist. Where both agencies have responsibilities with respect to a child, they must co-ordinate 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 the co-ordination of activities at all Strategy Discussions and/or Meetings. Referral to Vulnerability Units Any suspected, alleged or actual crime must be referred to the Vulnerability Units within 24 hours. Telephone referrals should be followed up, within the next 48 hours, in writing. The Vulnerability Unit will make a decision based on checks and information shared whether to initiate a criminal investigation. The following matters will always be investigated by the Police:
In respect of other offences of a minor nature the Vulnerability Unit will determine the necessity for a criminal investigation according to a number of criteria which include whether the facts are clear and undisputed, known history and likely impact on the child, etc. If a minor crime, initially assessed by the Vulnerability Unit as inappropriate of further investigation, is subsequently discovered to be more serious than originally perceived, then the case must be referred back to the Vulnerability Unit for assessment. Criminal Investigation and Strategy Discussion and/or Meeting Where the Vulnerability Unit is undertaking a criminal investigation, the Police are responsible for all the associated investigative activities, e.g. conducting interviews of witnesses and suspects; visiting crime scenes and in conjunction with Safeguarding & Specialist Services arrange medical examinations. The Vulnerability Unit should through Strategy Discussions and/or Meetings discuss with those involved in processes relevant to other agencies, in particular timing and methods of information gathering likely to impinge on a s47 enquiry. Some activities will be best undertaken collaboratively between Safeguarding & Specialist Services and the Police, e.g. interviews of child/ren and parents/carers, unless this is prejudicial to the criminal investigation. In urgent criminal cases (critical incidents) the Police may need to act independently of partner agencies, however the Police will advise the appropriate agencies of the matter as soon as is practicable. Following a full assessment of the available facts the Vulnerability Unit may decide at any stage, e.g. during or following a Strategy Discussion and/or Meeting, to terminate a criminal investigation and will inform Safeguarding & Specialist Services of the decision. Allegations of child abuse are sometimes made by adults and children a long time after the abuse has occurred. There are many reasons for an allegation not being made at the time including fear of reprisals, the degree of control exercised by the abuse, shame, or simply fear that the allegation may not be believed. The allegation may be triggered by awareness that the abuser is being investigated for a similar matter or suspicion that the abuse is continuing against other children. Staff dealing with cases of this nature should bear in mind that even though the offences are termed as “historical” the alleged perpetrator could well be in contact with children/young people as a parent, carer or volunteer, at the time of the investigation. There are cases in which it is thought that abuse has been carried out by an adult previously unknown to the child and the family. In such cases, the application of inter-agency procedures may not be necessary or appropriate for the purpose of investigation but a lack of adequate parental care may be a factor or the child’s parents may not be able to give him/her the necessary care, support and protection in the future. The alleged abuser may live with or in close proximity to other children. For all these reasons the Police should, at the appropriate time, consult with Safeguarding & Specialist Services via Social Care Direct to enable them to decide the most appropriate course of action. This process should not inhibit the Police action to secure evidence on which to prosecute the alleged abuser. A joint investigation must always commence when there is an allegation or reasonable suspicion that one of the criminal offences described below has been committed:
A joint investigation must also be considered in cases of:
For other cases of minor injury the following factors must be considered in determining the seriousness of the allegation or concerns and whether the threshold for joint investigation has been met:
Disputes about the threshold for a joint enquiry must be resolved between senior managers of the agencies involved. Involving Parents, Family Members & Children Those with Parental Responsibility must be informed at the earliest opportunity of concerns, unless to do so would jeopardise the child’s safety, or that of other children, or undermine a criminal investigation. Parents should, in addition to being offered a verbal explanation of the child protection enquiry process, be provided with a copy of the Durham LSCB information. Child Protection Enquiry Child Protection Conference In planning any intervention with parents, the following points must be covered:
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. Parents should be provided with an early opportunity to explain their perception of the concerns, recognising that there may be alternative accounts and disparities. 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. Due consideration must be given to the capacity of the parents to understand this information in a situation of significant anxiety and stress. Consideration must be given to those for whom English is not their preferred language or who may have a physical/sensory disability and may need the services of an appropriate interpreter. It may be necessary to provide the information in stages and this must be taken into account in planning the enquiry. In conducting s47 enquiries, it is essential that factors such as race, language, culture, religion and gender and sexuality together with issues arising from disability and health are taken into account. In the course of an enquiry it may be necessary for statutory agencies to take decisions or actions to protect children, or require the parents to agree to such action. The Social Worker must confirm such decisions/actions in writing within two working days of any verbal notification. Meeting & Interviewing the Child All children within the household must be visited and spoken to during an enquiry. Those who are the focus of concern should be seen alone, subject to age and preferably with parental permission. Consideration must be given to the child’s developmental stage and cognitive ability. Children may need time and more than one opportunity to develop sufficient trust to communicate concerns. The objectives in seeing the child is to:
In order to avoid undermining any subsequent criminal case, in any contact with a child prior to an interview, staff must:
All interviews with children should be conducted in a sensitive manner by those with specialist training and experience in interviewing children. Additional specialist help may be required:
Vulnerable and Intimidated Witnesses - Visually Recorded Interviews 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 (HO 2001). Video recorded interviews serve two primary purposes:
Interviews with witnesses with special communication needs may require the use of an interpreter or an intermediary and are generally much slower. The interview may be long and tiring for the witness and might need to be broken into two or three parts, preferably, but not necessarily held on the same day. A child should always be interviewed in the language of his/her choice. Relevant information from this process can be used to inform s47 enquiries, subsequent civil childcare proceedings or disciplinary proceedings against adult carers. Criteria for video recording an interview Video recorded interviews should be used for children giving evidence in sexual offence cases or in cases involving an offence of violence, abduction or neglect, unless the child objects and/or there are other difficulties, e.g. abuse of the child has involved the use of videos. Consideration whether or not to videotape a child’s evidence should take place at a Strategy Meeting. In other cases of children giving evidence the decision on whether or not to video should take account of the:
A full written record of the assessment must be kept and referred to in the statement, which records the interview. At all times interviewers should take steps to inform the child of the purpose of the video recorded interview, at a level appropriate to the child’s age and understanding. The child should be advised that, whether a video recording is made or not, s/he may be required to attend court to answer questions directly (e.g. cross-examination). Written consent to be video recorded is not necessary from the child but it is unlikely to be practicable or desirable to video record an interview with a reluctant or hostile child. Exceptionally, the investigation team may need to speak to a suspected child victim without the knowledge of a parent or carer. The child’s non-abusing carer(s) should be provided with suitable information at this stage. The investigating team should consider who is best qualified to conduct the interview. The lead interviewer should be a person who understands how to communicate effectively with children and who has a proper grasp of the rules of evidence and criminal offences. Provided both the Police Officer and the Social Worker have been adequately trained in evidential interviewing, there is no reason why either should not lead the interview. The designated member of the interviewing team should take responsibility for checking the availability and working order of the equipment ahead of the interview. The pace of the interview itself will be dictated by the age of the child and interviewers should allow comfort breaks during the interview as necessary. The interviewer should always explain the reason for any breaks on the video recording. Inability to Access the Child subject to the Enquiries 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:
If access to a child is refused or obstructed, the allocated Social Worker, in consultation with her/his Team Manager, should have a Strategy Discussion with the police and seek legal advice as appropriate in order to reach a decision as to what steps to take next. Where the child is in urgent need of medical attention (e.g. suffering from fractures, bleeding, loss of consciousness) he/she should be taken to the nearest Accident & Emergency Department. In other circumstances the Strategy Discussion and/or Meeting will determine, in consultation with the Consultant Paediatrician, the need for a Paediatric Assessment. A Paediatric Assessment involves a holistic approach to the child and considers the child’s wellbeing, including development, if under five years old and cognitive ability if older. Only doctors may physically examine the whole child, but other staff should note any visible marks or injuries on a body map. Paediatric Assessments for alleged child abuse are undertaken by a Consultant Paediatrician at the request of Vulnerability Unit/Social Worker or as a second opinion from other medical colleagues e.g. GPs. Consultant Paediatricians can be contacted via the hospital switchboard or their secretaries, on a rota basis. Consent for a medical must be obtained from:
In non-emergency situations when parental consent is not obtained, the allocated social worker and Team Manager, in consultation with other agencies, must consider whether it is in the child’s interest to seek a court order. If consent is refused, consideration must be given to the possibility of an application for a Child Assessment Order/Emergency Protection Order as appropriate in consultation with the Local Authority Corporate & Legal Services. The assessing Social Worker must provide the Medical Practitioner with as much relevant information as possible, and if possible, in writing. If there is a disagreement between professionals in relation to cause of injury and whether the child is at risk of significant harm, an inter-agency meeting must be convened, Chaired by a Team Manager, or a telephone call if time is limited, attended by the Medical Practitioner, to discuss the next steps. Following the examination, the Consultant Paediatrician’s opinions, conclusions and follow up arrangements (where appropriate) should be verbally communicated to the attending Police Officer and/or Social Worker as well as the child/parents/carers, if present. The assessment of the child/young person should include:
The consultation should be clearly documented in the child’s medical records. The Consultant Paediatrician should provide a written report of the assessment within seven days of the assessment. The written report should cover the following areas:
Copies of the Consultant’s assessment report should be sent, in all cases, to the investigating Social Worker, the child’s GP, Senior Nurse (Child Protection) and a copy retained in the child’s medical records. The need to send copies to other professional colleagues and agencies would depend on the circumstances of each case; this decision would be at the discretion of the Consultant Paediatrician. Senior Nurse (Child Protection) will liaise with Health Visitor, School Nurse. Professionals should also refer to the Information Sharing Protocol Covering The County Durham, Tees Valley And North Yorkshire Area (March 2006) and “Information Sharing: Information Sharing: Practitioners Guide” DFES, 2006. Referrals to other services where appropriate, (including screening for sexually transmitted infections, in cases of penetrative sexual abuse) should be made as soon as possible after the assessment. Admission of a child to hospital where there is a suspicion of deliberate harm When a child is admitted to hospital with suspected deliberate harm:
If a parent/carer threatens or actually attempts to remove a child from hospital, staff should:
The issue of Police Protection needs to be seriously considered and where applicable instituted. Prior to discharge there should be an agreement between the Consultant Paediatrician and Safeguarding & Specialist Services about discharge arrangements for children and the following checklist completed.
The scope and focus of the assessment during the enquiry will be that of a Risk Assessment which:
There are two phases of Risk Assessment to determine the level of suitable intervention:
Outcome of Child Protection Enquiries At the completion of the planned enquiry, a Debriefing Meeting should be held for joint enquiries to agree the outcome of the enquiry or plan any further investigations. When the outcome is agreed, the original concerns may be:
Where concerns are substantiated and the child is assessed to be at continuing risk of significant harm the Children in Need Team Manager is responsible for the decision to convene and Initial Child Protection Conference and should ensure this happens. Where the concerns are not substantiated or substantiated but the situation is assessed as no continuing risk of significant harm consideration must be given to:
A planning meeting should be considered where a child has suffered significant harm but that his/her needs can be met as a child in need. The meeting to develop a plan which sets out what services are to offered, by whom and with what expected outcome and outcome measure. The meeting should be Chaired by a Team Manager where concerns were/are significant and the plan should include what action will be taken if not successfully implemented and include a review mechanism. All involved agencies should be invited and the Named Nurse Child Protection. Where Safeguarding & Specialist Services have concluded that no further action is required but professionals in other agencies remain seriously concerned about the safety of a child, they should seek further discussion with the Social Worker and his/her manager. If concerns remain, the issue must be referred without delay through the agency’s line management to the relevant Service Manager (Children in Need) and if not resolved, to the Strategic Manager (Safeguarding & Specialist Services). The initial Strategy Discussion and/or Meeting instigates the s47 enquiry. The Initial Assessment must be completed within seven working days from the date of the referral, unless s47 enquiries have been instigated. The Core Assessment must be completed within 35 working days from the date of the Strategy Discussion and/or Meeting. The maximum period from the decision to commence s47 to the date of the Initial Child Protection Conference is 15 working days, which means that Initial Child Protection Conferences are held even though the Core Assessment may be incomplete. The timescales above are the minimum standards. Where the welfare of the child requires shorter timescales these must be achieved. There may be exceptional circumstances where it is not in the child’s interests to work to the above timescales. The circumstances which may lead to an alternative timescale include:
Any proposal to justify variation of routine timescales must be authorised by the relevant Service Manager (Children in Need) following the Team Manager’s consultation with the Police and any relevant agencies, whose views should be recorded. Reasons for diverging from these timescales must be fully recorded together with a plan of action detailing alternative arrangements. A full written record must be completed by each agency involved in a s47 enquiry, using agency agreements. All rough notes made must be retained for any future legal proceedings.
What Happens Following Initial Assessment?
Urgent Action to Safeguard Children
What Happens after the Strategy Discussion? What Happens after the Child Protection Conference including the Review Process?
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