Wandsworth Teaching Primary Care Trust
Working Together to Safeguard and
Internal Guidelines, Policies and
Produced by Wandsworth tPCT
Safeguarding Children Team and the Nurse Advisory Committee Sub-Group for
3/4Key definitions and concepts (2005)
4/5-7What is abuse and neglect?(2005)
5/8-9The impact of maltreatment on children(2005)6/10-12Sources of stress for children and families (2005)7/13-14When clinicians suspect abuse(2005)
8/15Assessing Need and Vulnerability; Working with the Common
Assessment Framework (under development)
9/16Working with vulnerable families in the
10/17-18Safeguarding Children attending NHS walk-in centres &
minor injuries departments (2001)
11/19-20Safeguarding Children in General Practice(2005)Working with the Child Protection Process
12/22-23Child Protection Conferences(2005)
13/24-27Report writing for Child Protection Conferences
14/28Working with children on the Child Protection Register(2005)15/29-30When a baby or child dies(2005)
16/31-34Aspects of record management(2005)
17/35-37Guidelines for Clinical supervision of Community Nurses
working with children in need.(2005)
18/38Guidelines for clinicians dealing with solicitors and
police requesting information for legal purposes(2005)19/39The Unseen Child(2005)
Links to other Policies
41-45ACPC Practice Guidelines in relation to Pre-Birth Assessments
and Pre-Birth Child Protection Conferences(2004)46-48WtPCT child protection training strategy(2003)49Supervision Activity Return
50Supervision Record of Communication
51-52Supervision Contract format
53Glossary of Terms
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Wandsworth Teaching Primary Care Trust
Working Together to Safeguard Children
Internal Guidelines, Policies and Procedures
1.1.This document is written for all staff both directly and indirectly employed or contracted working within Wandsworth Teaching Primary Care Trust. (WtPCT). This includes managers, nurses, health visitors, midwives, doctors, dentists, practice staff, therapists and support staff. Some guidelines apply to specific staff groups, while others apply to all staff whose work brings them into contact with children and their families.
1.2.It is not the intention to duplicate existing statutory and non-statutory practice guidance as issued by HM Government, but to provide local direction and clarification regarding process within WtPCT. The guidance, with which all staff must be familiar, is available on WtPCT website http://www.wandsworth-pct.nhs.uk under working for us? policies and procedures?child protection.
1.3.All staff should be familiar with the practice guidance What to do if you are
worried a child is being abused produced by the Department of Health in 2003/5. It
is available on WtPCT website or from http://www.everychildmatters.gov.uk . Hard copies are also available from WtPCT safeguarding children team.
1.4.Front line staff who have a specific role in safeguarding and promoting the welfare of children through there work with children and/or their parents and carers should be familiar with the forthcoming HM Government guide Working together to
safeguard children; A guide to inter-agency working to safeguard and promote the welfare of children, 2005/6. This guidance, addressed to practitioners, front line and senior managers, will supersede the 1999 Working together. It is written in two parts, the first of which provides statutory guidance under the Children Act 2004, the second non-statutory practice guidance.
1.5.The London Child Protection Committee (LCPC) has produced extensive practice guidance to which statutory and non statutory agencies working with children and their families in London are signed up. This guidance, London Child
Protection Procedures 2003, has largely replaced the guidance previously provided by Area Child Protection Committee (ACPC) to member agencies and is available on WtPCT website or from http://www.londoncpc.gov.uk ACPCs will be stsuperseded from 1 April 2006 by statutory Local Safeguarding Children Boards (LSCB).
1.6.Working together to safeguard children; A guide to inter-agency working to safeguard and promote the welfare of children, 2005/6 signposts the reader to a
range of other documents which underpin the whole Every Child Matters: Change for Children agenda of which safeguarding children is an integral part. All are available on http://www.everychildmatters.gov.uk
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The abuse of a child has a serious impact on all aspects of the child’s health, development and well being which can last throughout adulthood.
2.1.The Children Act 1989 &2004 places a specific legal duty on health agencies and their employees to safeguard and promote the welfare of children; in the discharge of their duties; by working with parents and carers in the interests of vulnerable children; by providing services for children in need and by working in partnership with other agencies where there is reasonable cause to suspect that a child is suffering, or is likely to suffer, significant harm. Safeguarding and promoting the welfare of children is an integral part of clinical governance.
2.2.All children deserve the opportunity to achieve their full potential. Every Child
Matters: Choice for Children 2004, sets out the five outcomes for children and young
people, given legal force in the Children Act 2004. These are described on page ***.
Children’s rights in Britain are also described within the Human Rights Act 2000 and the United Nations Convention on the Rights of the Child.
2.3.All staff must be alert to the possibility of child abuse or neglect. They should be able to recognise possible indicators of abuse and be aware of particular sources of stress for children and families. Staff working with children with disabilities should be aware that their vulnerabilities might lead to an increased risk of abuse.2.4.Staff working primarily with adults must consider if the care of any child is or
might be compromised; adult mental health problems, adults with learning
difficulties, substance and alcohol misuse, domestic violence and social
exclusion are all associated with increased risk of harm and neglect of children
and should always alert professionals to the needs of the children. Working
Together to Safeguard Children 2005/6Paragraphs 8.3-8.10 discusses
sources of stress on families.
2.5.Where intervention or extra support is required to prevent significant impairment to a child’s health or development, staff must know the process to be followed. 2.6.Professional judgements on how best to intervene when there are concerns of harm to a child inevitably involve uncertainties and risk. All staff must ensure they have access to training in child protection and receive advice, support and clinical supervision from an experienced manager or supervisor. WtPCT safeguarding children team are pleased to assist in the development of suitable training and supervision for staff. See WtPCT child protection training strategy page*.
2.7.Line managers of all new staff working directly with children and families should ensure the staff member knows:
•What to do in an emergency situation to protect a child;
•how to access the policies and guidance discussed within this document;•the importance of documentation, including the rational of any decisions made;•the supervision arrangements appropriate to their role (see page*)
•how to contact WtPCT safeguarding children team;
•what training in safeguarding children is required. (see page*).
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3. Key definitions and concepts:
In this document, as in the Children Acts 1989 and 2004, a child is anyone who has not yet threached their 18 birthday. “Children” therefore means “children and young people” throughout.
3.2. Safeguarding, promoting welfare and child protection
are defined as:
•protecting children from maltreatment;
•preventing impairment of children’s health and/or development;
•ensuring that children grow up in circumstances consistent with the provision of safe and effective care;
•and sometimes taking the role to enable children to have optimum
life chances and to enter adulthood successfully.
Protecting children from maltreatment is important in preventing the impairment of health or development. However all children deserve the opportunity to achieve their full potential.
3.3. Every Child Matters: Change for Children 2004 DfES
This guidance to the Children Act 2004, sets out the five outcomes identified as being key to children and young people’s wellbeing.
•Enjoy and achieve
•Make a positive contribution
•Achieve economic well-being
Stay Safe includes:
•Safe from maltreatment, neglect, violence and sexual exploitation.
•Safe from accidental injury and death
•Safe from bullying and discrimination
•Safe from crime and anti-social behaviour in and out of school
•Have security, stability and are cared for.
3.4.Child protection is a subset of safeguarding and promoting welfare.
This refers to activities undertaken to protect specific children who are suffering or are at risk of suffering significant harm. Effective child protection is essential as part of wider work to safeguard and promote the welfare of children. However, all agencies and individuals should aim to proactively safeguard and promote the welfare of children so that the need for action to protect children from harm is reduced.
3.5.Children in need
Children who are defined as being “in need”, under section 17 of the Children Act 1989, are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health and development will be significantly impaired, without the provision of services (section 17(10) of the Children Act 1989), plus those who are disabled. The critical factors to be taken into account in deciding whether a child is in need under the Children Act 1989 are what will happen to a
child’s health or development without services being provided, and the likely effect the
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services will have on the child’s standard of health and development. Local Authorities have a duty to safeguard and promote the welfare of children in need.3.6.The Concept of Significant Harm
Some children are in need because they are suffering or likely to suffer significant harm. The Children Act 1989 introduced the concept of significant harm as the threshold that justifies compulsory intervention in family life in the best interests of children, and gives local authorities a duty to make enquiries to decide whether they should take action to safeguard or promote the welfare of a child who is suffering, or likely to suffer significant harm.
Under s31(9) of the Children Act 1989 as amended by the Adoption and Children Act
“harm” means ill-treatment or the impairment of health or development, including, for example, impairment suffered from seeing or hearing the ill-treatment of another;“development” means physical, intellectual, emotional, social or behavioural development;
“health” means physical or mental health; and
“ill-treatment” includes sexual abuse and forms of ill-treatment which are not physical.Under s31(10) of the Act:
“Where the question of whether harm suffered by a child is significant turns on the child’s health and development, his health or development shall be compared with that which could be reasonably be expected of a similar child.”
There are no absolute criteria on which to rely when judging what constitutes significant harm. For further guidance and debate refer to Section one ofWorking together to safeguard children, 2005/6
3.7.Framework for the Assessment of Children in Need
The Framework for the Assessment of Children in Need and their Families was
published in 2000 by the Department of Health. This is still current guidance and provides a systematic basis for collecting and analysing information to support professional judgements about how to help children and families. The three main aspects of the framework – the child’s developmental needs, parenting capacity, and wider family and environmental factors – are diagrammatically portrayed on three sides of a triangle with the child in the middle. See appendix***** and guidance on assessing need and vulnerability.
3.8.The Common Assessment Framework
The Common Assessment Framework (CAF) is a standardised approach to
assessing children’s needs for services. It has been designed for practitioners in all agencies to help them communicate and work together more effectively. It is particularly suitable for use in universal services such as health and education to identify problems before they become too serious. It is a key component in the Every Child Matters: Change for Children programme, playing an important role in the provision of early intervention. The CAF is being widely consulted on and piloted
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during 2005 with full guidance and implementation expected in April 2006. See ECM fact sheet.
Sharing information for the purpose of safeguarding and promoting the welfare of children by professionals is essential. In many case it is only when information from a range of sources is put together that a child can be seen to be in need or at risk of harm.
Professionals may be anxious about the legal or ethical restrictions on sharing information with other agencies and should be aware of the law and guidance applicable to their professions. There is rarely an absolute barrier to disclosure and professionals should be prepared to exercise professional judgement. All decisions and the rational behind them, must be fully documented. The potentially serious consequences of not passing on information must be considered.
Consent to share information with other professionals should always be sought from the parent or child unless to do so would place the child at further risk of harm. The principal remains from the Children Act 1989 that “the interest of the child is
Further discussion and guidance on information sharing may be found in What to do
if you are worried a child is being abused 2003; Working together to safeguard
children2005/6 and in the consultation document, Sharing Information on Children
and Young People. Aug 05, DfES; or contact WtPCT safeguarding children team.
3.10. The Children’s, Young People’ and Maternity National Service
Published as part of HM Governm