Child Protection Referral

The general principle is that all suspicions, disclosures* or allegations must be reported.

The following actions should be taken when there is any concern, disclosure, suspicion or allegation about the welfare of a child or young person, which is causing or likely to cause Significant Harm. This includes 'historical abuse’ that may have occurred at some time in the past and may not have been reported or investigated.

It includes harm perpetrated by any person, including:

• Another child or young person (including serious or persistent bullying) - see Section 5 below, Allegations made against Children or Young People; and Countering Bullying Policy;
• A member of staff, or manager, see additional procedures in Allegations Against Staff Procedure;
• A visitor or person in the community;
• A teacher, social worker or other professional;
• A parent or other family member.

_{*Disclosures made as part of a therapeutic intervention or counselling session should also be reported, unless there is clear, written evidence in the child's file that the matter has been formally dealt with.}

It is important to recognise that young people with disabilities may not be able to verbally express or disclose any harm or abuse. Staff maybe required to make an assessment (for example) of an injury to a young person which on appearance seems unusual, suspicious or concerning. Staff have a duty to take reasonable steps to safeguard this young person and where (for example) the injury is unusual, suspicious or concerning then they are to take the following steps:

Staff should firstly make their report to the manager, unless the manager is implicated. In which case staff must notify one of the following:

• The Unit’s Service Manager or another manager who is not implicated;
• The Local Authority Safeguarding Officers in whose area the home is located;
• Police;
• NSPCC;
• The Regulatory Authority;
• The Placing Authority;

In an emergency, where there is an immediate risk to the child, staff must take necessary action. This may involve asking for Police assistance or seeking emergency medical assistance e.g. taking the child to hospital or contacting the emergency services via 999. If the child is taken to hospital or the Police are called, staff must inform them that there is a suspicion of abuse or harm. Thereafter staff must notify the manager (or other agency) as described above.

Where there is an injury inflicted on a young person which on appearance seems unusual, suspicious or concerning staff should carry out and record any first aid that is required and should record the injury on the units body map. Details should include: location, size, shape, colour, any all other information available that is pertinent to the injury.

Ordinarily when a child sustains an injury whilst at the Unit the parents/carers would be informed, however where to inform the parents/carers would place the child / young person at risk, staff are to report to the Unit manager, the Placing Authority or if out of office hours the Emergency Duty Team.

If it is considered that the child / young person needs to be examined by a health professional then consent from the parent / carer should ordinarily be sought. However, where a child protection referral is to be made the responsibility for arranging a medical examination lies with the social worker who will inform the parents/carers where it is in the child’s best interest to do so.

Once notified, the manager will be responsible for following the Local Safeguarding Children Board procedures and making contact with the Local Authority Children's Social Care Services. (See Section 4, Action by the Manager).

The manager must inform the Designated Safeguarding Manager or another senior manager. The manager or line manager must inform the Regulatory Authority of the instigation and outcome of any subsequent Child Protection Enquiry (see Consents and Delegated Authority Procedure).

At this stage any action taken must not alert the person(s) who may have caused or be implicated in causing the abuse or harm.

For Allegations against Staff: See Allegations against Staff Procedure.

The following is good practice that must be followed.

Staff members seeing, hearing or being told of anything that causes them to become concerned that a child or young person may be at risk of, is being or has been abused, must report it immediately to a manager.

Non-action is not an option in the protection of children and all staff have a duty to act.

Children and young people will sometimes disclose abuse to an adult who they have come to feel they can trust. If a child or young person discloses abuse it is important that staff respond appropriately by remaining calm and receptive; listening without interrupting and only asking questions of clarification.

It is important to ask open questions at the time the young person is disclosing such as “where”, “Who”, “How”, etc. It is important that staff do not miss the opportunity to find out more details, without jeopardising the investigation, as the young person may decide not to talk about the abuse or harm again. Staff should actively acknowledge the child's courage in telling and reassuring the child that they are not to blame.

It is not staff members responsibility to investigate or in any way make judgements about what is reported to them. Investigations, if necessary, must be undertaken by properly trained, independent professionals.

If a disclosure or allegation of abuse or harm has been made, staff should discuss with the child or other person who has made the complaint what steps they would like taken to protect them and their wishes should be shared and, if not in conflict with procedures, followed.

Where the allegation is of an historical nature, e.g. relating to abuse or harm that may have been perpetrated in another placement or by family members, allegations must be taken seriously and must be reported in the same way as any other allegation.

Staff must not give absolute guarantees of confidentiality to those who report possible abuse or harm, but they should guarantee that they will take steps to ensure that appropriate action is taken and the child or young person is protected

If an allegation or any suspicion is about the behaviour, past or present of another member of staff, including managers, which may in any way put children at risk, staff must follow the reporting procedures in accordance with Section 2, Reporting Concerns, Suspicions or Allegations of Abuse or Harm.

Staff must make a written record as soon as possible of their concerns, what they have been told, any questions they asked and the replies given and the actions taken and by whom. They must then give the report to the manager.

The record should be placed on the child's file except where a colleague is implicated or there is any risk to the child as a result, in which case notes/records should be given to the manager dealing with the matter.

Staff should not discuss the matter with others, including other staff, parents etc unless asked to do so by those responsible for dealing any subsequent investigation or enquiry.

Abuse and Harm can be perpetrated upon one child or young person by another in many different ways, including persistent or serious bullying, sexual exploitation, aggressive, exploitative or other threatening behaviour which places a child or young person at risk, see Countering Bullying and Peer Abuse Procedure.

Where there is any suspicion or allegation of abuse or harm perpetrated by one child or young person upon another, the procedures in Section 2, Reporting Concern, Suspicions or Allegations of Abuse or Harm should be followed.

Protecting the rights of both victim and alleged perpetrator is important. It may be necessary, dependent on an assessment of all the facts, to separate the alleged perpetrator and victim but it may not be possible to explain why this is necessary to the perpetrator.

Throughout the process thereafter it will be necessary to ensure that children or young people with allegations made against them are properly supported, by an Independent Person if appropriate or required, as well as their social worker and parent(s).

Once the investigation is complete, consideration will then need to be given to the needs and interests of both alleged victim and perpetrator, and whether counselling and/or other support should be given.

Children or young people who are known to have sexually abused other children cannot live together unless a risk assessment has been undertaken by someone specially qualified to do so, that is independent of the home.

What we know about disabled children's experiences of abuse

Research suggests that:

• Disabled children are at a greater risk of physical, sexual and emotional abuse and neglect than non-disabled children;
• Disabled children at greatest risk of abuse are those with behaviour/conduct disorders. Other high-risk groups include children with learning difficulties/disabilities, children with speech and language difficulties, children with health-related conditions and deaf children;
• Disabled children in residential care face particular risks;
• Bbullying is a feature in the lives of many disabled children.

What might help improve the protection of disabled children

Research has identified a number of activities that can help to protect disabled children. These include:

• Personal safety skills activities, including sex and relationships education, that raise disabled children's awareness of abuse and ability to seek help;
• Peer support, which can have a beneficial effect on reducing bullying and enabling children to explore issues and make decisions;
• Creative therapies, which can provide children with opportunities to express themselves through indirect and non-verbal means.

How else we can improve protection for disabled children

We need to share and build on existing knowledge and good practice and work together towards ensuring equal protection for disabled children. There is a need:

• To develop a wider and deeper evidence base to help us better understand the vulnerability of disabled children to abuse and how they can be protected;
• To raise awareness about the abuse of disabled children and challenge attitudes and assumptions that act as barriers to protection;
• To promote safe and accessible services;
• To raise disabled children's awareness of abuse and ability to seek help including access to personal safety skills training;
• For agencies to build on good practice and measures already in place that help ensure the effective delivery of child protection and criminal justice services for disabled children.

Signs of Abuse in Disabled Children

When undertaking an assessment (and considering whether significant harm might be indicated) professionals should always take into account the nature of the child’s disability. The following are some indicators of possible abuse or neglect:

• A bruise in a site that might not be of concern on an ambulant child, such as the shin, might be of concern on a non-mobile child;
• Not getting enough help with feeding leading to malnourishment;
• Poor toileting arrangements;
• Lack of stimulation;
• Unjustified and/or excessive use of restraint;
• Rough handling, e.g. when changing clothes, continence pads;
• Extreme behaviour modification e.g. deprivation of liquid, medication, food or clothing;
• Unwillingness to try to learn a child’s means of communication, e.g. BSL, Makaton;
• Ill-fitting equipment e.g. splints, sleep boards, inappropriate splinting; misappropriation of a child’s finances;
• Invasive procedures which are unnecessary or are carried out against the child’s will.

Some of the above behaviours can constitute criminal offences. For example misuse of medication to manage behaviour, depending on the circumstances, might be classed as assault and breach of the Medicines Act 1968 or breach of the Children’s Homes (England) Regulations 2015.

Similarly, inappropriate restraint, sanctions, humiliation, intimidation, verbal abuse, and having needs ignored may all, depending on the circumstances, be criminal offences. If insufficient time is given for a child with restricted arm and hand movement to have an adequate lunch, the child could experience hunger or dehydration. A one off experience like this may not be very damaging, but the impact if such an experience is repeated over a few days or weeks is considerable.

Removing batteries out of an electric wheelchair to restrict liberty solely for the convenience of staff might equate to a non-disabled child being locked in a room or having their legs tied.

Our Values and Knowledge

Professionals may find it more difficult to attribute indicators of abuse or neglect, or be reluctant to act on concerns in relation to disabled children, because of a number of factors, which they may not be consciously aware of. These could include:

• A lack of knowledge about the impact of disability on the child;
• A lack of knowledge about the child, e.g. not knowing the child’s usual behaviour;
• Not being able to understand the child’s method of communication;
• Confusing behaviours that may indicate the child is being abused with those associated with the child’s disability;
• Denial of the child’s sexuality;
• Behaviour, including sexually harmful behaviour or self-injury, may be indicative of abuse;
• Over identifying with the child’s parents/carers and being reluctant to accept that abuse or neglect is taking or has taken place, or seeing it as being attributable to the stress and difficulties of caring for a disabled child;
• Being aware that certain health/medical complications may influence the way symptoms present or are interpreted. For example some particular conditions cause spontaneous bruising or fragile bones, causing fractures to be more frequent.

IF YOU ARE CONCERNED OR UNSURE … SEEK ADVICE AND GUIDANCE