Lecture 1- Safeguarding children and reviewing child deaths Flashcards
Legislation and guidance
- Extensive
- Key points
- Safeguarding is everyone’s business
- Put child first and at the centre of all decision
- Communicatee, particularly if concerned
- Cooperate- work together with other professionals and support safeguarding investigations
- Think family
- Recognise the importance of language, faith and culture
- Remember that children can be in need of services as well as needing protecting
What is abuse and neglect?
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 others ( e.g. via the internet). They may be abused by an adult or adults or another child or children.
Assessment framework triangle
Immediate referral into social care
Children at immediate risk of signif harm, including physical, sexual, emotional harm and neglect
which children should be immediatley reffered into social care
- Children with unexplained injuries, suspicious injuries where there is an inconsistent explanation of the injury
- Children under 2 having unexplained bruising
- Child victims of trafficking
- Children where there is evidence of repeated domestic violence witnessed or experienced by a child; adult mental health issues and substance use
- Triad of vulnerability
- Children who are experiencing, or at risk of, sexual abuse or exploitation
- Concerns regarding risk of signif harm to unborn baby
- Children who live or have contact with adults who are known to pose a risk to children
- Children left home alone
- Children who allege abuse, inc sexual abuse and grooming
- Primary age children reporting self harming
Physical abuse
May be caused when a parent or carer fabricates symptoms or deliberately induces illness in a child (fabricated or induced illness- Munchausen’s)
- Hitting
- Shaking
- Throwing
- Poisoning
- Burning
- Scalding
- Drowning
- Suffocating
- Physical harm to a child
Emotional Abuse
- Is the persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development.
- It may involve conveying to children that they are worthless or unloved, inadequate, or valued only in so far as they meet the needs of another person.
- It may include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate.
- It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction.
- It may involve seeing or hearing the ill-treatment of another. Some level of emotional abuse is involved in all types of
- maltreatment of a child, though it may occur alone.
- Adverse Childhood Experiences
Sexual abuse
Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening.
Sexual abuse: Activities may involve
- Physical contact including assault by penetration or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing
- Non contact activity such as involving children in looking at, or in the production of sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, grooming a child into preparation for abuse (inc via internet)
- Not solely perpetrated by adult males, women can also commit acts of sexual abuse as can other children
Child sexual exploitation (form of child sexual abuse)
Neglect
- Is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development.
- Neglect may occur during pregnancy as a result of maternal substance abuse.
Once a child is born, neglect may involve a parent or carer failing to:
- Provide adequate food, clothing, shelter (including exclusion from home or abandonment)
- Protect a child from physical and emotional harm or danger
- Ensure adequate supervision (including the use of inadequate care-givers)
- Ensure access to appropriate medical care or treatment.
- It may also include neglect of, or unresponsiveness to, a child or young person’s basic emotional needs.
Medical neglect
This involves carers minimising or ignoring children’s illness or health (including oral health) needs, and failing to seek medical attention or administrating medication and treatments. This is equally relevant to expectant mothers who fail to prepare appropriately for the child’s birth, fail to seek ante-natal care, and/or engage in behaviours that place the baby at risk through, for example, substance misuse; (Horwath 2007
example of medical neglect
- E.g. Child S died at the age of 7 years as a result of a severe medical condition.
- Several agencies were working with Child S and the family to offer support at home and with medical treatments. The family did not always attend medical appointments, or have medication available to Child S when it was needed. Child S was frequently rushed to hospital for emergency treatment. In the 12 months preceding death Child S had four admissions to hospital, two of which were to intensive care.
- Rethinking “Did Not Attend”
Key themes from serious case reviews
- Need to be aware of confirmatory bias and for practitioners to reflect on their own biases and ensure these do not cloud their work with children and families
- Value of using chronologies, inc medical and medication review, to support referrals to children’s social care and provide clarity to all involved of the extent, pattern and severity of concern
- Where information comes to the attention of practioners which suggests that a primary age child has self-harmed serious consideration must be given whether there are underlying factors, inc abuse
- Recognising males who may pose a risk
- Balancing the needs of parents and children (needs of child paramount)
Handling a disclosure by a child
- Listen rather than ask questions
- Do not stop a young person who is freely recalling signif events
- Remain calm, do not give the young person the impression that what they have said is shocking or upsetting
- Document everything
- Don’t promise not to tell anyone else or that everything will be okay
- Report as soon as possible
- Record timing, setting, people present, content, quotes
- Record all subsequent events up to the time of the decision as to whether to start a formal child protection investigation
- Reassure the child and tell them it was the right thing to do in telling
Why review child deaths?
- To establish, where possible, a cause or causes of child deaths (with the coroner)
- To identify any potential contributory & modifiable factors
- To provide ongoing support to the family
- To learn lessons in order to reduce the risk of future child deaths
National picture of child death
- Annually ~6000 child deaths in UK
- 2/3 in 1st year of life
- Above 1yr, injuries most frequent cause of death, many of which are preventable.
- Association between deprivation and mortality rates across lifespan.
- Infant & child mortality falling, but lagging behind other comparable countries
Be broadly aware of the type of process undertaken to investigate and review serious events relating to child deaths (no requirement to have detailed knowledge of complex legislative frameworks, instead to have an awareness of which type of agencies/professionals are involved in the process)
