Safeguarding children Flashcards
What are GDC expectations regarding child safeguarding
expects you to raise concerns about possible abuse/neglect of children/vulnerable adults
your responsibility to know who to contact for further advice and how to refer to an appropriate authority
What is child protection
activity undertaken to protect specific children who are suffering, or at risk of suffering, significant harm
Who are children in need
those who require additional support or services to achieve full potential
What are the measures taken to minims risk of harm to children
protecting children from maltreatment
preventing impairment of children health and development
ensuring that children are growing up in a safe and caring environment
What is child abuse/neglect
anything those entrusted with care of child do/fail to do that damages child’s prospects of safe and healthy development into adulthood
What are 3 elements of child abuse
significant harm to child
carer has some responsibility for that harm
significant connection between carer’s responsibility for child and harm to child
What are the 4 major themes to the Children & Young People’s Act
children right
getting it right for every child
early learning and child care
looked after children
What is the GIRFEC in CYPA 2014
national practice model
creates a shared language and approach to identifying and meeting concerns
shared approach to organizing and recording information about a child and discussing ways of addressing concerns about well being
When can information be shared
when safety is at risk
where the benefits of sharing the info outweighs the public and individual’s interest in keeping info confidential
What are the rights of a child
right to: respect info about yourself protected from harm have a say in your life good start to life to be and feel secure
What does UNCRC criticize UK in regards to protection
against physical abuse - reasonable chastisement used
teenagers in penal system don’t have access to health care, education and child protection
lack of benefits and access to health care from asylum seeker children
Where does UNCRC criticize UK in regards to participation
full participation for disabled children
access to information - lack of recognition for the need to respect childs rights in gov documents
Where does UNCRC criticize UK in regards to provision
standard of living adequate for physical, mental, spiritual, moral and social development
What is the etiology/contributing factor for child abuse from adults point of view
drugs, alcohol, unemployment, marital stress, mental illness, disabled, domestic violence, step parents, isolation, abused as child, unrealistic expectations
What is the etiology/contributing factor for child abuse in regards to the children
crying, soling, disability, unwanted pregnancy, failed expectations, wrong gender, product of forced, coercive or commercial sex
What is the community/environmental contributing factors for child abuse
dwelling place and housing condition
neighbor hood
What is the family violence and dysfunctional family contributing factors for child abuse
intergenerational cycle
violence towards pets
social isolation
poverty
What are the 3 big concerns for parenting capacity
domestic violence
drug alcohol misuse
mental health problems
cumulative problems increase likelihood of a negative outcome
What are categories of child abuse
physical emotional neglect sexual non organic failure to thrive
Who are vulnerable children
under 5s
irregular attenders (repeatedly do not attend, return in pain, exposed risk of GA)
medical problems and disabilities
Why are children w medical problems and disabilities more at risk
more at risk fo experiencing abuse of all kinds
serious impairment of health or development is more likely as a result of untreated dental disease
In coltan dhow many children are killed
10 each year
What are a childs needs
nutrition warmth/clothing/shelter hygiene and health care stimulation and education affection
What are the effects of neglect
failure to thrive/short stature
inappropriate clothing; cold injury, sunburn
ingrained dirt (finger nails); head lice, dental caries
developmental decay
withdrawn or attention seeking behavior
Why is neglect of neglect possible
as neglect is less incidence focused
or because less shared understanding by what is meant by neglect and how to respond
What is short term damage of neglect
physical health
emotional health
social development
cognitive development
What is the long term damage of neglect
as adults have higher incidence of arrest suicide attempt major depression diabetes heart disease
What is the definition of dental neglect
the persistent failure to meet a child’s basic oral health needs, likely to result in serious impairment of a child’s oral or general health and development
What is general dental neglect
severe dental disease which can cause
toothache
disturbed sleep
difficulty eating/change in food preferences
absence from school
What can dental disease put a child at risk of
teasing due to poor appearance
repeated AB
repeated GA
severe infect
When is dental neglect willful neglect
after dental problems have been pointed out there is:
irregular attendance, repeated failed appointments, repeated late cancellations
failure to complete tx
returning in pain at repeated intervals
repeated GA for dental extractions
What are indicators of dental neglect
obvious dental disease
impact on child
practical care has been offered yet the child has not returned for tx
What are the 3 stages of managing dental neglect
preventive dental team management
preventive multi-agency management
child protection referral
What is preventive dental team management
raise concerns with parents, offer support, set targets, keep records, monitor progress
What is preventive multi agency management
liaise with other professionals - health visitor, school nurse, GP
child may be subject to common assessment framework at this level
check if child is subject to a child protection plan
agree joint plan of action, review at agreed intervals
letter to HV of children <5 who fail appointments and have failed to respond to letter from dental practice
What is child protection referral
in complex or deteriorating situations
follow local guidelines
referral is to socials services usually by telephone followed by in writing
What is physical abuse classified into
over chastisement (cultural) acute/compassionate (shaken) chronic/pathological (way of life)
Describe acute/compassionate physical abuse
spontaneous uncalculated action
remorse, take appropriate action
childs needs are priority
Describe chronic/pathological physical abuse
help sought but not actively
no remote
childs needs not a priority
In Scotland what is the law on physical abuse
illegal to physically punish a child
What are the types of physical abuse injury
head - 95% of serious head injuries in first year of life are non accidental
body
What % of injuries in abuse cases are on the head and neck
60%
What are extra oral signs of physical abuse
bruising of phase - punch, slap, pinch bruising of ears - pinch, pull abrasions and lacerations burns and bites neck - choke or cord marks eye injuries hair pulling fractures (nose>mandible>zygoma)
What are major clinical features of physical abuse
skin lesions - bruises, burns, bites, lacerations
bone lesions - fractures
intracranial lesions - from shaking
visceral lesions - intraabdominal blunt trauma
What are warning bruises
bruising of different vintages (not same stages of healing)
grip marks
slap marks
tattoo bruising
What are intra oral signs of physical abuse
contusions bruises abrasions and lacerations burns tooth trauma frenal injuries
What are medical equivalents to signs of abuse
impetigo - similar to cigarette burns
birthmarks - mistaken for bruises
facial infection - mistaken for trauma
coagulation problems - bruise easily
What is the index of suspicion regarding physical abuse
delay in seeking help
story is vague, lacking in detail and varies from person to person
account not compatible with injury
parents mood is abnormal - preoccupied
parents behavior gives cause for concern
child’s appearance and interaction with parents is abnormal
child may say something contradictory
history of previous injury
history of violence within the family
What is the final checklist questions for physical abuse
could the injury have been caused accidentally and if so how?
does the explanation fit the age and the clinical findings
if the explanation is consistent with the injury, is the itself within normally acceptable limits of behavior
if there has been delay in seeking advice, are there good reasons for this
What are the final checklist observations for physical abuse
general demeanor of the child
nature of relationship between guardian and child
childs reaction to other ppl
reaction of the child to any medical or dental examination
any comments by the child and or guardian that give concern about child’s upbringing or lifestyle
What is expected of the dental team for referral
observe
record
communciate
refer for assessment
Who do we go to for help and advice
experience colleague named safeguarding nurse child protection adviser named doctor for safeguarding social work/services children service department NSPCC helpline
How do you refer/share concerns
telephone initially, follow up in writing
facts
statement of concerns
What does the notification form/shared referral form mention
referral details designated contact person referral to subject of referral family details other adults in household siblings not subject to referral summary of concerns reason for referral agreed actions agency involvement
What happens after referral if the child is in immediate danger
there is a child protection order
exclusion order
child assessment order
removal by police or authority of JP
What happens after referral
investigation, initial assessment and discussion to decide if child is at risk of significant harm
What happens after child risk is decided
no further CP action, may get additional support
joint investigation
