Child Support and Protection

Question 1

Define abuse/neglect based on National Guidance Scotland 2021 definition

Answer 1

These may involve inflicting harm or failing to act to prevent harm.

Can happen at home; within a family or peer network; in care placements; institutions or community settings; and in the online and digital environment, increasingly so.

Those responsible for abuse may be unknown, familiar, in positions of trust or family members.

Children may be harmed pre-birth (e.g. domestic abuse of a mother or through parental alcohol and drug use)

Question 2

What actions go under definition of abuse/neglect?

Answer 2

• Directly inflicting harm
• Failing to act to prevent harm

Question 3

Where may abuse or neglect take place?

Examples

Answer 3

• Home
• Within family/peer network
• Care placements
• Institutions
• Community settings
• Online/digital environment

Question 4

What are the 5 R’s of dealing with cases of suspected abuse/neglect of children?

Answer 4

Concerns about potential ‘significant harm’ to a child from abuse, neglect or exploitation should always be shared with police or social work, without delay.

Question 5

What individuals must you share concerns of potential ‘significant harm’ to a child from abuse, neglect or exploitation?

Answer 5

• Police or
• Social worker

WITHOUT DELAY

Question 6

Is there a statutory definition as to what is classed as significant harm?

Answer 6

No uniform deifning criteria for significant harm

Question 7

Which article in the UNCRC 1998 act protects children form violence, abuse and neglect?

UNCRC: United Nations Convention on the rights of the child

Answer 7

Article 19

Question 8

What is the role of a doctor in potential case of child abuse?

Answer 8

• Recognition of obvious signs of harm (e.g. injuroes not fitting Hx, emotuional abuse/neglect seen every contact?
• Recognise risk factors linked to abuse and neglect
• If treating an adult patient, concider if you patient poses a risk to children/young people
• Keep open mind/ objectivity(work in partenrship with family where possible)
• If unsure whether the child is at riks/how best to act -> ask senior

Question 9

What indiciators may raise your concerns for a childs risk of abuse/neglect?

Answer 9

Recognition of:
* What a child says
* Working with the child over time
* Response to particular incident
* Direct observations
* Child not being brought to appointments (NHSG Policy)
* Reports from family/3rd party/anonymous source
* Child known to social work/have an existing child’s plan
* Awareness that a child may become member of a household with a person with Schedule 1 offence (sexual offences)

Question 10

What tool may be used to correctly follow the 5 R’s and know what to do in case of possible concern for chidl abuse/neglect?

Answer 10

Public Protection E-card- Child protection

Contact:
* Aberdeen city
* Aberdeenshire
* Moray

Availble on Intranet

Question 11

What module is now manditory to complete in order to be well equipped when dealing with chidlren that have come from difficult circumstances?

Answer 11

TURAS
Trauma-Informed Practice Tool kit

Question 12

What does GIRFEC stand for?

Answer 12

**Getting it right for every child **(our commitment to provide all children, young people and their families with the right support at the right time)

Question 13

How may you be able to identify a vulnerble child via their health record?

Answer 13

Systems and Flagging
Next to childs name:
* “Looked after child”
* From Jan 2018, a yellow triangle warning on the right hand side of their name

Acessing teh register where there are concerns

Question 14

What are some resons for chidlren being registered under child protection register?

Specific to aberdeen

Answer 14

Other (8%):
* Drug offences
* History of violence and offending
* Vulnerable child, potential for exploitation from older peers, violence within the family home between child and parent
* Exploitation
* Emotional neglect
* Offending behaviours and potential risk of harm

Question 15

Approximately how many chidlren are “Looked after” in the Grampian?

Answer 15

~1200

Question 16

What environemnts are the “looked after” children in the Grampian live in?

Answer 16

• Home
• Placements
• Residential homes

Question 17

What may be some physical signs that are found on examiation that would be red flags for child abuse?

Answer 17

Bruising:
* Pattern (liner?)
* Unusual area of injury?
* History?

Mustn’t be suggestive of what you belive the cause of teh bruising is in documentation (e.g. cannot say, bruise caused by hand) instead must descirbe the pattern, placement, appearance of the injury and indicate that it is “suggestive of a hand”.
Important as recorded info may be used later in court proceedings

Question 18

What conditions mimic bruising?

Answer 18

• Congenital dermal melanocytosis (CDM)- blue/grey birthmarks present at birth/soon after (rare in white europeans, more common in african/asian)
• Haemangioma: Salmon patch/ stork mark

Practitioners are not there to diagnose. They are there to identify potential concerns

Question 19

What may be some presentations that would suggest abuse/neglect in a child?

Answer 19

• Burns (majority accidental, 10-14% due to abuse)
• Looking symmetry/ glove/ stocking appearance
• Bites (require forensic/ dental examination. Possible to identify perpetrator Swabs can be taken for saliva)
• Fabricaled/Induced Illness (perplecxing poresentation)

Question 20

What are the red flags that immediately flag possible child abuse/neglect?

Answer 20

Concerns are heightened if:
* no explanation for the injuries
* explanations shift during assessment
* explanations do not fit the injuries
* unreasonable delays in seeking treatment (days following injudry)
* Parental / carer responses are unexpected

Question 21

What are some indicators upon presentation of a patinet that may point to human trafficing?

Answer 21

• How might they present to services?
• SH services?
• Always accompanied?
• Being spoken for?
• Nervous?
• Private childcare arrangelemts?
• Private fostering?

Question 22

What are the common reasons for trafficing children?

Answer 22

• Labour exploitation
• Sexual exploitation

More Girls> Boys

Question 23

Define Country lines?

Answer 23

Where illegal drugs are transported from one area to another, often across police and local authority boundaries (although not exclusively), usually by children or vulnerable people who are coerced into it by gangs. The ‘County Line’is the mobile phone line used to take the orders of drugs.

Question 24

What are signs that a child may be exploited by gangs for Country Lines?

Answer 24

• Missing from school
• Multiple phones?
• Gifts received?

Question 25

Define cuckooing

Answer 25

Type of crime where a drug dealer befriends an individual who lives on his/her own. The drug dealer moves in, takes over the property and turns it into a drug den

Victims are often lonely, isolated and vulnerable and may be using drugs themselves

Question 26

What are signs of cuckooing?

Answer 26

• Increased visitors to address/number of vehicles outside the property throughout day and night
• Bags of clothing/extra bedding in people’s homes
• Increase in antisocial behaviour (build up of rubbish in communial areas/incraesed noise/evdience of drug misuse)
• Barricades within address/weapons
• Evidence of drug use in public areas
• Secure doors wedged open

Question 27

Step 1

What should you do if you have immediate concerns for a child’s safety and wellbeing?

Answer 27

Concider:
* Disclosure of abuse by child during appointment (risk going home with adult/carer that child made allegation against? How safe does the child feel?)

Act:
* Discuss discloruse info with Social worker who will liase with Police (about Initial Referal Discussion)
* Have converstaion with accompanying adult

Same process eg child at Nursery/ school makes same disclosure
IRD usually takes place within around of an hour

Question 28

Step 2

Describe the Initial Referral Discusison process?

Answer 28

• Child protection concerns brought up at this time
• Medical treatment not delayed
• Multi-agency telephone conference (CP Intranet)
• Discuss information from all agencies (assess risk)
• A minute made of meeting (can only be shared with those attending), however other health input, elements can be shared as seen relevant and proportionate

Question 29

Step 3

Following IRD, what happens next?

Answer 29

Following Initial Referral discussion:
* Can be single agency response (e.g. Hleath visitor support/social work, strengten plan)
* Joint CP investiagtion
* Police: investiagte whether criminal offence took place
* +/- Joint interview of child (Police and Social work)
* +/- Medical assessment (inc. forensic exam)
* Together agencies take plan of action to immediately safeguard and protect the child – including child stay with other family member/ family friend/ seeking legal advice/ accommodating the child last resort

Some incidents of appears ‘one off’ smacking require Police follow up re equal from protection legislation. Often cultural aspects are involved and a period of education

Question 30

How may you record your concern for a child, to CP?

Answer 30

• Write down the facts of what happened – observed/ reported?
• Use parent/ carer’s own words where significant
• Be clear what you did, when, and why
• Criminal investigations – can take some time. You may have to refer to words written long ago. They need to have made sense at the time.

Question 31

What are the possible outcomes for a CP investiagation?

Answer 31

**Investiagtion could: **
* Conclude evidence (child discharged to parent’s care. Usually follow up)

• Child discharged and family member comes to stay while investigation being completed.
• Child goes to stay with family member – provide a space
• Seeking voluntary consent through a S25 that a child resides elsewhere meantime
• Need to seek a legal order for child in hospital or being discharged from hospital (CPO) when there is a dispute by parent when investigation ongoing
• Child Protection Planning meeting to consider whether child should be on the Child Protection Register (CPR) this process has national timescales to adhere to re review etc.
• Could be we are seeking legal support through the Children’s Hearing system. We may have had multiple incidents that require this element