Child protection and safeguarding Flashcards
What is the difference between safeguarding and child protection?
Safeguarding includes prevention, whilst child protection means that a child is at risk of harm or has been harmed
What is a section 47 investigation?
there is a full child protection investigation going on
What is a section 17?
If they say s17 they mean a child in need, hence the family are receiving support to help to ensure that the children’s needs are met.
What are some examples of safeguarding issues?
Peer on peer abuse
FGM
Cyberbullying & Sexting
Hidden Harm
Domestic Abuse
Slavery
Child sexual exploitation
Harmful sexual behaviour
Forced marriage
Honour killing
Etc
4 Types of Child abuse
Physical Abuse
Sexual Abuse
Emotional Abuse
Neglect
How common is child abuse?
Much abuse is never disclosed or reported to professionals
Around 10% adults report abuse during their childhood
More than 500 Sheffield children have a child protection plan
Approximately 650 children “looked after” by the local authority
What is a child protection plan
Much abuse is never disclosed or reported to professionals
Around 10% adults report abuse during their childhood
More than 500 Sheffield children have a child protection plan
Approximately 650 children “looked after” by the local authority
RFs for child abuse
Parental
Lack of support
Generational effect
Deprivation
Mental health problems
Learning difficulty
Alcohol and substance misuse
Domestic violence
ACEs- adverse childhood experiences
Child
Difficult to care for
Preterm
Disabled
How can a child undergoing child abuse present?
Disclosure
Injury observed e.g. At school
Found incidentally when attending for other reason
Injury presented with or without explanation.
How does the Child Protection Medical assessment work?
History
Examination - Child protection medical assessment
Investigation
Provision of opinion to support further assessment by social care. Contribution to the ‘jigsaw.’
How should history be taken for child abuse?
Part of “Whole Child” assessment
Separate histories taken from social worker, parent/carer and child.
Document who is present ,who said what and when
Identify discrepancies
Your approach should be similar to how you handle any type of medical problem. You start wit h the history of presentation, direct questioning and make your way down to the family and social history.
When should concerns be raised
A history that does not fit with observed injuries
Too many injuries
Wrong site
Unusual shape or pattern
Wrong type of incident
Not consistent with child’s development
Delay in presentation
No history
A history that changes
In the examination what should be observed?
Use body chart to document injuries
Record any explanations offered
Photographs
What are the types of injuries that could happen with child abuse?
Superficial
Bruises
Scratches
Marks from implements (Patterned injuries)
Burns and scalds
Fractures
Multiple
long bones, ribs, metaphyseal
Internal Organ Damage
Abdominal
Intracranial
What can happen if you Shake your baby?
Shaking and impact effects
Cerebral Hypoxia*
Subdural haematoma*
Rib fractures
Retinal haemorrhages*
May have other fractures ,torn frenulum, bruises etc.
hypoxia, intracranial haemorrhage like subdural haemorrhage, rib fractures and retinal haemorrhages
- Known as Shaken Baby Syndrome
Where would you expect to see bruising?
Head injuries - involve parietal bone, occiput or forehead
Nose
Chin
Elbows
Knees
Skins
What do you need to remember about accidental injuries
Involve bony prominences
Match the history
in keeping with development of the child
What are bruises that we should worry about?
Ears - pinch marks
Triangle of safety - ears, side of face, neck, top of shoulders
Inner arms
Back and trunk
Black eyes
Forearms
Groin
Inner aspects of thighs
Soles of feet
What do you need to remember about suspect injuries?
Injury to both sides of the body
Injuries to soft tissue
Injuries with particular patterns
Injury that doesnt fit the explanation
Delays in presentation
Untreated injuries
DDs apart from abuse
Birthmarks
Congenital dermal melanocytosis
Paint
Bleeding tendency
“Brittle” bones
Normal accidents
What is congenital Dermal melanocytosis?
Birth mark. Need to note that it is not always evident at birth, may appear later and it is not only confined to the buttock region. Around the ankles also common. We often get HV refer babies in because when they saw them 10 days before it was not there and they are worried about bruising.
What is needed from a parent to a child?
Food and drink
Warmth
Shelter
Clothing
Grooming
Health and dental care
Education
Appropriate social opportunities
Emotional support
Protection from harm
Boundaries and behaviour
What are the types of neglect?
Emotional neglect
Abandonment
Medical neglect
Educational neglect
Physical neglect
Failure to provide supervision and guidance.
What are some diseases which could show neglect
Repeated head lice
Frost bite
Dental abscesses
Frozen watchfulness - anxious looking baby
What can emotional harm do to a child?
Common
Often unrecognised
Damaging
Relationship high in criticism ,low in warmth
Coexists with other abuse types
Includes children exposed to domestic abuse
What is sexual abuse?
Boys and girls
Any age
Family vs. stranger abuse
Wide spectrum of activities ,including on-line grooming, pornography
Linked to other abuse types
What is the presentation of sexual abuse?
Disclosure or allegation
Behaviour change
Sexualised
Indicative of distress
Physical symptoms
Bleeding
Discharge
Soreness
Wetting or soiling
STI
Pregnancy
What are the child protection medical investigations?
Laboratory tests e.g. FBC, clotting if bruising/bleeding
Swabs for possible infection
Bone profile ,vitamin D ,PTH
Radiology e.g. Skeletal survey ,CT,MRI
Developmental assessment
What kind of imaging is used to monitor child abuse?
Skeletal survey for all children with bruises/fractures who are less than 2 years of age.
Children aged 2-3 years skeletal survey is discretional
CT head scan for babies less than 12 months
Repeat skeletal survey after 2 weeks
Who are safeguarding concerns investigated by?
Safeguarding concerns are investigated by Social Care with the help of information from Health and police
All safeguarding referrals go to social care
What do Social Care do?
Social Care will organise and lead on
Strategy Meetings
Case Conferences
Police will address any criminal aspects
Roles and responsibilities of other agencies can also be?
Strategy Meetings Outcome
NFA
s17 investigation
s47 investigation
What else can occur in a case conference?
Multiagency
Parents invited
Purpose is to agree that the child has suffered significant harm or is at risk
If agreed, the child is placed on a CP plan.
Plan addresses what needs to change to make things better for the child
Regular core group meetings to review and make sure plan is progressing
Review conferences 3-6monthly
What is an emergency Protection order (EPO)
Lasts for 8 days. Can be extended
Put in place to give social Care time to get an interim care order (ICO)
Most often not needed as parents voluntarily agree for child to go into care under s20
What happens if you see a child under an ICO with a social worker?
the SW can give consent if however the child is on the ward under a police protection order, you have to get consent from the police to do your medical.
What is a Police Protection Order (PPO)
Lasts for 3 days
What is a Full Care Order, Special Guardinship order, Residency Order
Provides more permanent placement for the child
