Children's safeguarding policy & procedure

Policy Aim

Children/young people have a right to be safeguarded and protected. This is enshrined within the Children (Northern Ireland) Order 1995 (the Children Order) and the United Nations Convention on the Rights of the Child (UNCRC). The UNCRC's own preamble affords equal status to ALL convention rights and inter-dependence on each of the others.

Child/Young Person in Need of Protection

A child/young person in need of protection is a child/young person who is at risk of, or likely to suffer, significant harm which can be attributed to a person or persons or organisation, either by an act of commission or omission; or a child who has suffered or is suffering significant harm as defined in Article 50 of the Children Order.

Responsibility for Safeguarding

All staff who work with children, young people or families - in whatever capacity - have a responsibility to safeguard and protect children/young people. According to Co-operating to Safeguard Children and Young People in Northern Ireland (revised August 2017), they must be alert to signs and indicators of harm, and know how to respond when concerns are identified. The term safeguarding is intended to be used in its widest sense, encompassing the full range of promotion, prevention and protection activity. Effective safeguarding arrangements should aim to meet the following key principles:

Safeguarding is everyone's responsibility: for services to be effective, each individual and organisation should play their full part;
A child-centred approach: for services to be effective, they should be based on a clear understanding of the needs and views of children in accordance with Article 12 UNCRC and Article 3 UNCRC in relation to the best interests of the child/young person;
The child/young person's welfare must be the paramount consideration.

This Policy and Procedure sets out how Direct Medics Ltd will work to safeguard and promote the welfare of children/young people.

Preparing staff for work

Provision of healthcare services falls within the scope of ‘Regulated Activity’ in relation to adults and children, as defined in the Safeguarding Vulnerable Groups Order 2007 (SVGO) and as amended by the Protection of Freedoms Act 2012 (PoFA). Procedures for safeguarding child/young person at risk of harm are therefore included in the induction of all staff proposed to register with the company by:

having proposed staff complete an enhanced AccessNI Disclosure;
having proposed staff complete training on safeguarding child/young person at risk of harm (training will include protection from abuse; indicators of abuse; responding appropriately to suspected, alleged or actual abuse; and reporting suspected, alleged or actual abuse). This training is refreshed every three years as a minimum.

There is a continuum of services necessary to safeguard children/young people including early intervention which aims to prevent avoidable harm to children/young people. Many children/young people, especially some of the most vulnerable and those at greatest risk of social exclusion, will need early intervention and prevention services. Candidates involved in healthcare provision to children/young people should:

Be aware of potential indicators of child abuse and neglect;
Be alert to the risks which abusers, or potential abusers, may pose to children/young people;
Be alert to the existence of domestic and/or sexual violence, sexual exploitation and abuse;
Listen to and ascertain the views of children/young people and give this due consideration;
Share and help to analyse information so that an assessment can be made of the child/young person's needs and circumstances;
Contribute to whatever actions are needed to protect and promote the child/young person's welfare;
Take part in regularly reviewing the outcomes for the child/young person against specific plans;
Work co-operatively and in partnership with parents, unless this is inconsistent with ensuring the child/young person's safety;
Ensure professional and personal competence levels and Continuous Professional Development (CPD) in safeguarding are monitored and updated in line with required standards and the identified needs of staff.

Harm and Significant Harm

Harm is defined in the Children Order as ill-treatment or the impairment of health or development. The Order states that 'ill-treatment' includes sexual abuse, forms of ill-treatment which are physical and forms of ill-treatment which are not physical; 'health' means physical or mental health; and 'development' means physical, intellectual, emotional, social or behavioural development.

The significance of harm will be a matter for assessment and judgment in relation to each individual child. The question of whether harm is significant should be determined in accordance with Article 50(3) of the Children Order, which states that 'where the question of whether harm suffered by a child is significant turns on the child's health or development, his health or development shall be compared with that which could reasonably be expected of a similar child.'

Consideration of the significance of harm may include the degree and the extent of physical harm, the duration and frequency of abuse and neglect, the extent of premeditation, the presence or degree of threat and the assessed impact of the harm upon the child/young person.

Each of these elements has been associated with more severe effects on the child/young person, and/or relatively greater difficulty in helping the child/young person overcome the adverse impact of the maltreatment.

Sometimes, a single traumatic event may constitute significant harm (for example. a violent assault, suffocation or poisoning). More often, significant harm is a compilation of significant events, both acute and long-standing, which interrupt, change or damage the child/young person's physical, sexual and/or psychological development.

Some children/young people live in family and social circumstances where their health and development are neglected. For them, it is the corrosiveness of neglect, emotional, physical or sexual abuse that causes impairment to the extent of constituting significant harm.

Likelihood

Although not defined in legislation, 'likely' clearly means more than merely possible but less than certain. As a working definition, likely can be taken to mean 'more likely than not.'

Recognising signs of abuse

Candidates assigned for work through Direct Medics Ltd must always be aware of their responsibilities in respect of safeguarding, and alert to the signs of abuse, which can take many forms. For example:

Physical Abuse: is deliberately physically hurting a child. It might take a variety of different forms, including hitting, biting, pinching, shaking, throwing, poisoning, burning or scalding, drowning or suffocating a child.

Sexual Abuse: occurs when others use and exploit children sexually for their own gratification or gain or the gratification of others. Sexual abuse may involve physical contact, including assault by penetration (for example, rape, or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside clothing. It may include non-contact activities, such as involving children in the production of sexual images, forcing children to look at sexual images or watch sexual activities, encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse (including via e-technology). Sexual abuse is not solely perpetrated by adult males. Women can commit acts of sexual abuse, as can other children.

Emotional Abuse: is the persistent emotional maltreatment of a child/young person. It is also sometimes called psychological abuse and it can have severe and persistent adverse effects on a child's emotional development

Emotional abuse may involve deliberately telling a child that they are worthless, or unloved and inadequate. It may include not giving a child opportunities to express their views, deliberately silencing them, or 'making fun' of what they say or how they communicate. Emotional abuse may involve bullying – including online bullying through social networks, online games or mobile phones – by a child's peers.

Neglect: is the failure to provide for a child/young person's basic needs, whether it be adequate food, clothing, hygiene, supervision or shelter that is likely to result in the serious impairment of a child/young person's health or development. Children/young people who are neglected often also suffer from other types of abuse. It may also include neglect of, or unresponsiveness to a child's basic emotional, social and educational needs.

Exploitation [1]: is the intentional ill-treatment, manipulation or abuse of power and control over a child or young person; to take selfish or unfair advantage of a child or young person or situation, for personal gain. It may manifest itself in many forms such as child labour, slavery, servitude, engagement in criminal activity, begging, benefit or other financial fraud or child trafficking. It extends to the recruitment, transportation, transfer, harbouring or receipt of children for the purpose of exploitation. Exploitation can be sexual in nature.

[1] Although 'exploitation' is not included in the categories of registration for the Child Protection Register, professionals should recognise that the abuse resulting from or caused by the exploitation of children and young people can be categorised within the existing CPR categories as children who have been exploited will have suffered from physical abuse, neglect, emotional abuse, sexual abuse or a combination of these forms of abuse (Co-operating to Safeguard Children and Young People revised 2017).At each new client, staff should familiarise themselves with any policies and procedures relating to safeguarding and be aware of the signs that may indicate abuse or neglect.

Responding to allegations of abuse

Children/young people who are suffering or at risk of suffering significant harm often feel unable to disclose this to others. They may have communication/language difficulties for example, through having a disability, or due to their age, that may make it difficult to tell others what is happening. Some children/young people may not recognise they are being abused. However, whenever a child/young person does report that they are suffering or have suffered significant harm through abuse or neglect, or have caused or are causing physical, emotional or sexual harm to others, the initial response from all staff should be to listen carefully to what the child/young person says and to observe the child/young person's behaviour and circumstances. It is essential that the child/young person's cognitive skills in terms of their ability to understand and their communication needs are established to allow staff to:

Listen carefully and record as precisely as possible what the child/young person says;
Observe the child/young person's behaviour;
Clarify the information provided regarding the concerns;
Offer re-assurance about how the child/young person will be kept safe;
Explain what action will be taken and within what timeframe;
Find out the views of the child/young person;
Explain, if the child/young person can understand the significance and consequences of making a referral, that whilst their views will be taken into account, staff have a responsibility to take whatever action is required to ensure the child/young person's safety and the safety of other children/young people;
Communicate effectively. Any cognitive, communication or language barriers present should be addressed, the child/young person should receive the necessary support to ensure full participation in the process. This may include the use of Interpreters/translator/registered intermediaries, the involvement of appropriate staff such as speech and language therapists and or communication tools. Explanatory leaflets and communication methods can be used if appropriate.

Staff must not:

Give false assurances of absolute confidentiality;
Press the child/young person for information, lead, or cross-examine, as this could prejudice police investigations.

Reporting suspected, alleged or actual abuse

All suspected, alleged or actual incidents of abuse are to be reported both to the Company and to either the Gateway Service at the Health and Social Care Trust or the Registered Manager of the independent sector setting within which the suspected, alleged or actual abuse has taken place.

THE OUT OF HOURS NUMBER FOR ALL TRUSTS IS 028 9504 9999

The Gateway Service may report the alleged abuse to PSNI for investigation. The Company will take a statement from the person reporting the suspected, alleged or actual abuse for use in any resulting investigation, either by the relevant Health and Social Care Trust, the PSNI and/or any other relevant organisations. The Company will keep written records of all such investigations, including the outcome and any action taken by the Company. Where shortcoming in Company systems are highlighted as a result of any such investigation, procedures will be reviewed with a view to adding safeguards.

Parental Consultation

Concerns about the safety or welfare of a child/young person, should, where practicable, be discussed with the parent and consent sought for a referral to children's social services in the local HSC Trust, unless seeking agreement is likely to place the child/young person at further risk through delay or undermine any criminal investigative process (for example in circumstances where there are concerns or suspicions that a crime has taken place); or there is concern raised about the parent's actions or reactions. The communication/language needs of the parents/carers should be established for example in relation to disability/ethnicity and the parent's/carer's capacity to understand should be ascertained. These should be addressed through the provision of appropriate communication methods, including, where necessary, translators, signers, intermediaries or advocacy services.

Effective protection for children/young people may, on occasions, require the sharing of information without prior parental/carer consent in advance of that information being shared.

Where staff decide not to seek parental consent before making a referral to children's social services in the local Health and Social Care Trust or the police, the reason for this decision must be clearly noted in the child/young person's records and included within the verbal and written/UNOCINI referral. Staff should consult with their line manager/Nominated Safeguarding Lead in accordance with each individual agency's policies and procedures.

When a referral is deemed to be necessary in the interests of the child/young person, and the parents/carers have been consulted and do not consent, the following action should be taken:

The reason for proceeding without parental consent must be recorded;
The withholding of permission by the parent/carer must be included in the verbal and written referral to children's social services;
The parent/carer should be contacted to inform them that, after considering their wishes, a referral has been made.

Staff making a referral may ask for their anonymity to be protected as far as possible because of a genuine threat to self/family. In such instances this anonymity should be protected with an explanation to the staff member that absolute confidentiality cannot be guaranteed as information may become the subject of court processes.

Allegations of abuse against Company Staff

Allegations of abuse or neglect against candidates working through Direct Medics Ltd will be taken very seriously. If we receive complaints of this sort against a member of staff, the following will take place:

The Registered Manager will inform the candidate whether the company will be able to offer work whilst the allegation is being investigated;
Advice will be sought from the Nursing & Midwifery Council as to whether a referral is appropriate, whilst the allegation is investigated

In the event that the Protocol for Joint Investigation of Adult Safeguarding Cases is invoked, company investigation will cease save for an initial statement until the external investigation is concluded. Following this, and in the event that allegations are proven, the following may take place:

The candidate is subject to the company disciplinary procedure;
The candidate may have their registration with the company removed;
The candidate may be referred to the Disclosure & Barring Service;
The candidate may be referred to the Nursing & Midwifery Council (if a referral was deemed unnecessary by NMC at the outset of the investigation).