5. Children in specific circumstances

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5.1

Introduction

5.2

Adoption

5.3

Animal abuse and links to abuse of children and vulnerable adults

5.4

Begging

5.5

Blood-borne viruses

5.6

Boarding school

5.7

Bullying

5.8

Custodial settings for children

5.9

Custodial settings (children visiting)

5.10

Diplomats families

5.11

Disabled children

5.12

Domestic violence 

5.13

Fabricated or induced illness

5.14

Female genital mutilation 

5.15

Firesetting

5.16

Forced marriage of a child

5.17

Foreign exchange visits

5.18

Foster care

5.19

Gangs, serious youth violence and violent extremism

5.20

Harming others

5.21

Historical abuse

5.22

Honour based violence

5.23

Hospitals

5.24

Hospitals (specialist)

5.25

Information and communication technology (ICT) based forms of abuse

5.26

Left alone

5.27

Male circumcision

5.28

Missing families for whom there are concerns for children or unborn children

5.29

Missing from care and home

5.30

Not attending school

5.31

Parental lack of control

5.32

Parental mental illness

5.33

Parents with learning disabilities

5.34

Parents who misuse substances

5.35

Pregnancy and motherhood for a child

5.36

Pre-trial therapy

5.37

Private fostering

5.38

Psychiatric care for children

5.39

Psychiatric wards and facilities (children visiting)

5.40

Residential care

5.41

Self-harming and suicidal behaviour

5.42

Sexually active children

5.43

Sexually exploited children

5.44

Spirit possession or witchcraft

5.45

Surrogacy

5.46

Trafficked and exploited children

5.47

Young carers

Additional guidance

5.48

Accessing information from abroad

5.49

Criminal injuries compensation

5.50

Working with interpreters / communication facilitators

Socially excluded / isolated children and families

5.1.1

Some children's circumstances mean they are more vulnerable to abuse and / or are less able to easily access services. These children often require a high degree of awareness and co-operation between professionals in different agencies, both in recognising and identifying their needs and in acting to meet those needs.

5.1.2

This includes children whose families may be facing chronic poverty, social isolation, racism or other forms of discrimination and the problems associated with living in disadvantaged areas or in temporary accommodation. These families can become disengaged from, or have not been able to become engaged with, health, education, social care, welfare and personal social support systems.

When a family moves frequently multi-agency working must be very good in order for a child's welfare to be adequately monitored, the risk of disruption to service provision and information gathering which could happen with frequent case transfer needs to be minimised (see section 11. Mobile children and families).

5.1.3

Recently immigrant families often have a traumatic history, and / or a disrupted family life and can need support to integrate their culture with that of the host country.

5.1.4

Recently immigrant families and children who are unaccompanied asylum seekers face the additional challenge to engaging with statutory services in that English is not their first language. When working with these children and families professionals should use professional interpreters who have a clear Criminal Records Bureau check; it is not acceptable to use a family member or friend. See section 5.50. Working with interpreters / communications facilitators.

5.1.5

Professionals in all agencies should be alert to the impact of the external stressors in 5.1.2 and 5.1.3 (above):

• On a family's ability to safeguard their children and promote their welfare; and
• On a child's vulnerability to neglect or harm (within their family and in the wider community).

5.1.6

Professionals considering / making a referral to LA children's social care should do so in line with section 6. Referral and assessment. See also section 6.4. Referral criteria, which provides guidance on the difference within LA children's social care between a s47 / core assessment and an initial assessment.

5.1.7

For LA children's social care to plan appropriately for the future of unaccompanied asylum seeking children it will be necessary for key information about the child to be shared between their social worker or personal adviser and the UK Border Agency (UKBA) 'case owner' responsible for resolving the child's immigration status. This would include information:

• Relevant to the assessment of the child's identity and age (given that most unaccompanied asylum seeking children may not have reliable documentary evidence of their age and identity);
• That might be relevant to the immigration decision made in respect of the child (where, for example, the child has complex medical needs or is suffering from trauma); and
• About any efforts to trace the location of family members in the country of origin (many unaccompanied asylum seeking children will have lost contact with family members because of the circumstances of their journey to the UK).

5.1.8

Until an unaccompanied asylum seeking child has been granted British Nationality, refugee status or indefinite leave to remain, their Care Plan should also prepare for the eventuality that the child may be required to return to their country of origin.

5.2.1

An adopted child may divulge when s/he is in placement, that they have been abused at some time in their previous history. An adopted child can also be vulnerable to physical, sexual or emotional abuse and / or neglect whilst they are placed for adoption. The child may thus already have suffered, or can suffer, to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

Good quality care

5.2.2

All commissioners and providers of services for children who have a care plan for placement for adoption are responsible for ensuring that each child is safeguarded. Commissioner contracts and provider procedures should reflect the provisions and guidance relating to the Adoption and Children Act 2002.

They should be comprehensive and unambiguous in setting out the responsibilities and processes for safeguarding and promoting children's welfare.

5.2.3

Key provisions in the Adoption and Children Act 2002 include:

• Aligning adoption law with the relevant provisions of the Children Act 1989 to ensure that the child's welfare is the paramount consideration in all decisions relating to adoption;
• Placing a duty on local authorities to maintain an adoption service, including arrangements for the provision of adoption support services and an inter-country adoption service;
• Providing a right to an assessment of needs for adoption support services for adoptive families and others;
• Setting out a regulatory structure for adoption support agencies;
• Providing additional restrictions on bringing a child into the UK in connection with adoption; and
• Providing for restrictions on arranging adoptions and advertising children for adoption, other than through adoption agencies

5.2.4

Adoption guidance, based on the Adoption and Children Act 2002, outlines the following essential characteristics of adoption services:

• The focus must be firmly on the needs of the child, whose interests will be paramount in all decisions relating to adoption;
• Highly skilled professionals should lead a quality service delivered to national minimum standards;
• Focused effort should go into finding a permanent family for looked after children waiting to be adopted;
• The courts must deal with all cases involving children in an efficient and child-centred way;
• A range of potential adopters should be welcomed and assessed efficiently in an open and fair way; and
• Children and their new families must have easy access to adoption support services.

5.2.5

See Adoption Guidance: Adoption and Children Act 2002 (DCSF, 2005)

National minimum standards

5.2.6

Local authority services and third sector adoption agencies must meet national minimum service standards. The standards set out the following requirements:

• The adoption agency's service users are safeguarded from any form of abuse, exploitation and discrimination including physical, financial, psychological and sexual, through deliberate intent, negligence or ignorance in accordance with the agency's written policies and procedures;
• Where the adoption agency pr ovides adoption support services to children:
  • there is a detailed written child protection policy, including the management of and reporting plan for child protection issues
  • there are procedures for responding to suspicion or evidence of abuse and neglect which are in line with London Child Protection Procedures to ensure the safety and protection of service users. this includes the involvement of the local authority and police and passing on concerns to the regulatory authority (where appropriate)
  • all staff and volunteers are trained in child protection and are aware of and access to, the agency's child protection policy
  • all allegations and incidents of abuse in relation to the agency's staff or volunteers are followed up promptly and the details and action taken are recorded on a file, kept especially for the purpose, and on the service user's record; and
• The adoption agency has written procedures for dealing with allegations of historical abuse which may be made by service users during the course of service provision.

See The National minimum standards: Voluntary adoption agencies and LA adoption service; and the Addendum: Adoption national minimum standards.

Promoting and protecting a child's welfare

5.2.7

The period prior to the transfer of full Parental Responsibility on the making of an Adoption Order can be very challenging and prospective parent/s can under-report worrying behaviours seen with their new children. In addition it is common for these children to be placed at a significant distance from their home local authority, making close monitoring of the placement more challenging.

5.2.8

It is essential that children and their adoptive families receive good support services:

• Placements are visited and reviewed regularly;
• Children are seen alone;
• All those who use adoption services are aware that they are entitled to an assessment for support  services (including therapy for the child), to meet their needs;
• There are effective processes in place to address, challenge and monitor the quality of practice - [Adoption: messages from inspections of adoption agencies (CSCI, 2006) at www.ofsted.gov.uk]

5.2.9

Where an allegation of past or current abuse or neglect is made in respect of a child placed for adoption or in respect of a prospective or approved adopter, the following actions must be taken:

• Where a child is placed with prospective adopters and any allegation of past or current abuse or neglect is received, a referral must be made, in line with section 6. Referral and assessment, to the LA children's social care where the child is placed (the host authority);
• Where child protection enquiries are made in respect of a child by the host authority, full co-operation must be given by any other local authority with information about that child;
• Where the child is not place with prospective adopters and any allegation of past or current abuse or neglect is received, a referral must be made, in line with section 6. Referral and assessment, to the LA children's social care where the principle office of the adoption agency concerned is based;
• The registration authority must be notified of the instigation and outcome of any child protection enquiry;
• Consideration must be given as to the implications of the outcome of any allegation, and any necessary measures taken in order to protect children placed with prospective adopters;
• Adoption agencies must ensure that appropriate individuals working for the purposes of the agency, prospective adopters and children placed by the agency all have access to information to enable them to contact the host LA children's social care, plus the registration authority in respect of any concern about child welfare or safety relating to an adoptive placement.

5.2.10

The Local Safeguarding Children Board has a responsibility to ensure that children with plans for placement for adoption within or outside the local area have essential safeguards in place and that children placed in the area from other local authorities have essential safeguards in place.

5.3.1

Animal abuse is defined as intentional harm of animals, including willful neglect, inflicting injury, pain or distress or malicious killing of animals. There is increasing evidence of links between abuse of children, vulnerable adults and animals.

5.3.2

In addition, a child displaying intentional cruelty to animals could indicate that the child has been a victim of neglect and / or abuse themselves.

5.3.3

In some circumstances, acts of animal cruelty may be used to control and intimidate adults and children into being silent about their own abuse.

5.3.4

Professionals in all agencies should be aware that if serious animal abuse occurs within a household there may be an increased likelihood of family violence, and increased risk of abuse to children within the family such that it could constitute significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.3.5

Professionals working with children should:

• Be observant about the care and treatment of family pets whilst carrying out assessments;
• Ensure that assessments consider the needs and the risk of harm to children and animals within the family;
• Ensure that safety planning with victims of domestic violence considers the safety of children and animals within the family.

5.3.6

Professionals working with animals should:

• Receive training about recognition and referral processes to enable them to raise appropriate concerns about children.

5.3.7

When a referral is made to LA children's social care (see section 6. Referral and assessment) the name of the RSPCA inspector should not be given to the family unless this has been agreed between the two agencies as essential for evidential reasons. The reason for this is that the RSPCA inspector may need to do repeat visits to the household to monitor an animal's welfare.

5.3.8

The London Safeguarding Children Board and the RSPCA have developed a protocol for joint working and information sharing between child protection agencies and animal protection agencies. Local Safeguarding Children Boards (LSCBs) should adopt the protocol Safeguarding Children and Animals (RSPCA / LA children's social care), available at: www.londonscb.gov.uk.

5.3.9

To report animal cruelty, request assistance or express a concern about animal welfare, call the RSPCA's national cruelty and advice line: 0870 55 55 999.

5.4.1

An adult begging for money may seek to invoke public sympathy by having their own or someone else's child with them. A child may also beg alone or with adult support or coercion.

5.4.2

The presence of a child on the streets or on public transport raises concerns for their welfare and development (e.g. the child should be at safe at home, in an early years setting or school, or participating in out of school activities).

5.4.3

Begging is an offence, and the Metropolitan or Transport Police are responsible for:

• Dealing with the offence of begging;
• Establishing the identity and address of any involved child;
• Referring the child to the LA children's social care for the area in which they live.

5.4.4

If there is an immediate risk of significant harm to the child, professionals in all agencies and the public should make a referral to the LA children's social care where the child is found in line with section 6. Referral and assessment.

5.4.5

Children involved in begging are likely to be exposed to emotional abuse and / or neglect to such a degree that it constitutes significant harm, if their parents are unable or unwilling to refocus their lifestyle around the child's needs. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.4.6

LA children's social care should respond in line with section 6. Referral and assessment; co-ordinating a multi-agency strategy meeting / discussion and initiating a s47 investigation if information available indicates that the begging:

• Presents immediate risk of significant harm to the child; or
• Is an ongoing activity and presents as a continuing risk of significant harm to the child.

5.4.7

If this threshold is not met, an initial assessment should be undertaken and advice offered to the parent about the inappropriate use of children for begging and the risks involved.

5.4.8

Activities such as 'penny for the guy', 'trick or treat' or carol singing are not usually regarded as begging, if the arrangement is age appropriate and effectively supervised.

5.5.1

A child exposed to blood-borne viruses, can be at risk of significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.5.2

The main child protection issues likely to arise with blood-borne viruses are:

• When a mother who is known to be HIV positive refuses to accept treatment for herself in pregnancy and / or for the baby following delivery;
• When a mother who is known to be HIV positive insists on breastfeeding her baby against medical advice  (breastfeeding currently nearly doubles the risk of transmission from mother to child in the UK);
• Where a child is thought to have a blood-borne disease and their parents refuse to agree to medical testing and / or treatment;
• Where a child is on the appropriate treatment, but medication is given inconsistently or stopped altogether and there is a danger of resistance developing;
• Where a child has been sexually abused and the abuser is thought to be infected with a blood-borne disease (in these cases, HIV testing should be considered);
• Where a child has been exposed to contaminated needles and syringes.

Responding to the risks

5.5.3

In circumstances where children and parents share concerns about blood-borne viruses such as hepatitis and HIV, the reasons should be sensitively explored. If a child's concerns arise because they have suffered abuse, they may need time to make a full disclosure. Counselling should be provided as appropriate to anyone deciding whether or not to be tested for blood-borne viruses such as HIV.

5.5.4

Where a professional is concerned that a child may have been placed at risk of HIV or hepatitis B, an informed decision must be made about whether to raise this with the child or parent/s.

5.5.5

Post Exposure Prophylactic treatment (PEP) may be available to children who have been exposed to HIV or hepatitis B (e.g. through a needlestick injury or sexual assault). This treatment minimises the risk of infection. However, treatment needs to commence within hours of a child being placed at risk. Professionals should seek urgent specialist advice about treatment.

Testing and treatment

5.5.6

It takes approximately three months for antibodies to develop when someone has been infected with HIV, and differing periods for other blood-borne viruses. The appropriate test will usually show whether antibodies have developed.

5.5.7

A child aged 18 months and over who has been infected with HIV will have developed their own antibodies.  Under that age, specialist tests (known as PCR) can identify whether the child is infected in their own right. In almost all cases, the child's positive result will also identify the mother as being infected.

For other blood-borne viruses, different testing may apply.

5.5.8

When a test for a blood-borne virus is being considered, advice should be sought from local paediatricians with specialist knowledge. In the case of sexually active adolescents, it may be appropriate to involve the local genitourinary clinic. Full information must be given to individuals / families before testing (paying particular regard to their first language), and examinations should be carried out with due consideration of the needs of a potentially traumatised child.

5.5.9

Authorisation for consent to testing is the same as for any form of medical treatment. Particular care should be given to whether a child under 16 is Fraser competent.

5.5.10

The testing of any abuser requires their consent.

5.5.11

Where the views of the parents conflict with the child's health needs, the welfare of the child is paramount. Parents' views should be considered fully and every effort made to work in partnership. However, if the child is considered likely to suffer significant harm, advice should be sought about legal action.

Confidentiality

5.5.12

Agencies have a duty to ensure the confidentiality of all parties. However, they also have a duty to safeguard and promote the welfare of children.

5.5.13

Exceptionally, information may be shared with other agencies and only if:

• The disclosure of information would be in the best interests of the child or protect an individual at risk of infection;
• The professionals / agencies receiving the information are aware of its confidential nature and able to maintain the confidence.

5.5.14

The child or family's wishes with regard to confidentiality may only be overruled if:

• The child is at risk of significant harm if disclosure is not made;
• There is a legal requirement for information to be disclosed;
• There is an ongoing police investigation, which makes disclosure important in order to prevent others being put at risk. In these circumstances, legal advice should be sought.

5.5.15

If it is considered necessary to go against the wishes of the child or parents, the worker must:

• Consult with their manager;
• Have the decision authorised by the senior manager chairing a legal planning meeting;
• Provide the child and / or family with a full written explanation of the reason for overruling their wishes.

5.5.16

Sometimes an abuser may be known to be HIV positive or to be suffering from, or a carrier of, hepatitis B or hepatitis C. If the welfare of the child could benefit, it may be appropriate to consider sharing this information even if the abuser will not give consent.

5.5.17

In the above circumstances, professionals must seek specialist and legal advice without initially revealing the person concerned. If the final decision is to reveal the person's status, this should be recorded in the child's case record and a full written explanation should be given to the abuser, explaining what is to be shared and why.

Advice, support and guidance

5.5.18

Professionals in all agencies should contact local paediatric family clinics, local authority HIV liaison officers, the genitourinary clinic or lead officers within their own agencies for specialist advice and support.

See also Children in Need and Bloodborne Viruses: HIV and Hepatitis (DH, 2004).

5.5.19

Agencies should ensure there is a named legal advisor for blood borne viruses.

5.6.1

A child in boarding school is vulnerable to physical, sexual or emotional abuse and / or neglect. If there are lapses in the care provided for them, the child can suffer to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

Good quality care

5.6.2

The welfare and safety of children living in boarding school should be promoted and provided for at a minimum, in line with the relevant National Minimum Standards (see www.ofsted.gov.uk).

5.6.3

All commissioners and providers of services for children living in boarding school are responsible for ensuring that children are safeguarded. Commissioner contracts and provider procedures should be comprehensive and unambiguous in setting out the responsibilities and processes for safeguarding and promoting children's welfare. Local Safeguarding Children Boards should monitor the welfare of children living in boarding school (see section 18. LSCBs, quality assurance and conflict resolution).

5.6.4

The standards for children living in boarding school include that:

• Children feel valued and respected and their self-esteem is promoted;
• There is an openness on the part of the boarding school to the external world and external scrutiny, including contact with families and the wider community;
• Boarding school staff are trained in all aspects of safeguarding children, are alert to children's vulnerabilities and risks of harm, and knowledgeable about how to implement safeguarding children procedures;
• Children who live in boarding school are listened to and their views and concerns responded to;
• Children have ready access to a trusted adult outside the boarding school setting (e.g. a family member, the child's social worker, independent visitor, children's advocate). Children should be made aware of the help they could receive from independent advocacy services, external mentors, and ChildLine (see section 2. Roles and responsibilities, 2.25.12 NSPCC);
• Boarding school staff recognise the importance of ascertaining the wishes and feelings of children and understand how individual children communicate by verbal or non-verbal means;
• There are clear procedures for referring safeguarding concerns about a child to the relevant LA children's social care service;
• In relation to complaints:
  • complaints procedures should be clear, effective, user friendly and readily accessible to children and young people, including those with disabilities and those for whom english is not their preferred language;
  • procedures should address all expressions of concern, including formal complaints. systems that do not promote open communication about 'minor' complaints will not be responsive to major ones, and a pattern of 'minor' complaints may indicate more deeply seated problems in management and culture which need to be addressed;
  • records of complaints should be kept by providers of children's services (e.g. there should be a complaints register in every boarding school which records all representations including complaints, the action taken to address them, and the outcomes);
  • children should be genuinely able to raise concerns and make suggestions for changes and improvements, which are taken seriously.
    
    See section 18. LSCBs, quality assurance and conflict resolution.
• Bullying is effectively countered (see section 5.7. Bullying);
• Recruitment and selection procedures are rigorous and create a high threshold of entry to deter abusers (see section 17. Safer recruitment);
• There is effective supervision and support, which extends to temporary staff and volunteers (see section 16. Supervision and training);
• The boarding school's contractor staff are effectively checked and supervised when on site or in contact with children;
• Clear procedures and support systems are in place for dealing with expressions of concern by boarding school staff about other staff or carers (see section 15. Allegations against staff);
• Organisations should have a code of conduct instructing boarding school staff on their duty to their employer and their professional obligation to raise legitimate concerns about the conduct of colleagues or managers. There should be a guarantee that procedures can be invoked in ways which do not prejudice the 'whistle-blower's' own position and prospects;
• There is respect for diversity and sensitivity to race, culture, religion, gender, sexuality and disability;
• Boarding school staff are alert to the risks of harm to children in the external environment from people prepared to exploit the additional vulnerability of children living in boarding school.

5.6.5

See also section 8. Child protection conferences.

5.7.1

Bullying is deliberately hurtful behaviour, usually repeated over a period of time, where it is difficult for the victims to defend themselves. 

5.7.2

The damage inflicted by bullying is often underestimated. It can cause considerable distress to children, to the extent that it affects their health and development and can be a source of significant harm, including self-harm and suicide.

5.7.3

Bullying can include emotional and / or physical harm to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.7.4

The three main types of bullying are:

• Physical abuse (e.g. hitting, kicking, stabbing and setting alight), including for filming with mobile telephones and theft, commonly of mobile telephones;
• Verbal or mobile telephone / online (internet) message abuse (e.g. racist, sexist or homophobic name-calling or threats) - this type of non-physical bullying may include sexual harassment;
• Mobile telephone or online (internet) visual image abuse - these can include real or manipulated images;
• Emotional abuse (e.g. isolating an individual from the group or emotional blackmail).

See also section 5.25. ICT based forms of abuse.

5.7.5

There is the potential for bullying wherever groups of children spend time together on a regular basis or live together, such as in schools, detention centres, children's homes etc. Agencies should promote a culture of healthy adult / child and child / child interaction and discourages bullying.

5.7.6

Bullying outside the home can be an indication that a child could be experiencing abuse at home. Bullying can be present within families where there is a child with special needs.  There can be aggression directed towards the child with special needs or by the child towards another family member, sometimes a sibling. This can be physical, emotional or sexual abuse. See section 5.10 Disabled children.

5.7.7

Bullying can rapidly escalate into sexual or serious physical or emotional abuse. See section 5.20. Harming others.

5.7.8

Professionals in all agencies should be alert to bullying and competent to support and manage both the victim and the abuser.

5.7.9

Staff should be supported by locally agreed thresholds and single agency policies to combat bullying. In the more serious cases, these should include discussion with the agency's nominated safeguarding children adviser and making a referral to LA children's social care. Separate referrals for assessment and support should be made, one for the child victim and the other for the child abuser in line with section 5.20. Harming other and section 6. Referral and assessment.

5.7.10

See also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

5.7.11

Where the bullying may involve an allegation of crime (assault, theft, harassment) a referral should be made to the police at the earliest opportunity. Many schools now operate a Crime Reporting in Schools (CRIS) programme to facilitate this.

5.7.12

DfE information about good practice in anti-bullying strategies for schools includes:

• Safe to Learn: Embedding Anti-bullying Work in Schools - comprehensive suite of guidance for schools (2006 - 8)
• Safe from Bullying  - suite of guidance documents on tackling bullying outside of schools (2009)
• DVD resource pack on bullying related to SEN and disabilities (2009)
• Guidance for schools on preventing and tackling sexist, sexual and transphobic bullying

These documents can be accessed at www.teachernet.gov.uk.

5.7.13

Children's Trust partners should consider tackling bullying as part of their wider role in safeguarding children and young people. The Anti-Bullying Alliance can provide support to local areas to tackle bullying in their communities.

5.8.1

Settings in which children may be held in custody include young offender institutions (YOIs), Secure Training Centres (STCs) and secure children's homes provided by local authorities, adult prison settings or immigration detention centres.

5.8.2

A child in a custodial setting is vulnerable to physical, sexual or emotional abuse.  If there are lapses in the care provided for him / her, the child can suffer to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.8.3

The welfare and safety of children living in custodial settings should be promoted and provided for at a minimum, in line with the National Standards for Youth Justice Services 2004, Youth Justice Board and Home Office, in all custodial settings.

5.8.4

All commissioners and providers of custodial services for children are responsible for ensuring that children are safeguarded.  Commissioner contracts and provider procedures should be comprehensive and unambiguous in setting out the responsibilities and processes for safeguarding and promoting children's welfare. Local Safeguarding Children Boards should monitor the welfare of children living in custodial settings. See section 18. LSCBs, quality assurance and conflict resolution.

Good quality care

5.8.5

The standards for children living in custodial settings include that:

• Children feel valued and respected and their self-esteem is promoted;
• There is an openness on the part of the custodial setting to the external world and external scrutiny, including contact with families and the wider community;
• Custodial settings and support staff are trained in all aspects of safeguarding children, are alert to children's vulnerabilities and risks of harm and are knowledgeable about how to implement safeguarding children procedures;
• Children who live in custodial settings are listened to and their views and concerns responded to;
• Children have regular access to a trusted adult from outside the custodial setting (e.g. a family member, the child's social worker, independent visitor, children's advocate). Children should be made aware of the help they could receive from independent advocacy services, external mentors, and ChildLine (see section 2. Roles and responsibilities, 2.25.12 NSPCC);
• Custodial service staff recognise the importance of ascertaining the wishes and feelings of children and understand how individual children communicate by verbal or non-verbal means;
• There are clear procedures for referring safeguarding concerns about a child to the relevant LA children's social care service;
• In relation to complaints:
  • complaints procedures should be clear, effective, user friendly and readily accessible to children and young people, including those with disabilities and those for whom english is not their preferred language;
  • procedures should address all expressions of concern, including formal complaints. systems that do not promote open communication about 'minor' complaints will not be responsive to major ones, and a pattern of 'minor' complaints may indicate more deeply seated problems in management and culture which need to be addressed;
  • records of complaints should be kept by providers of children's services (e.g. there should be a complaints register in every boarding school which records all representations including complaints, the action taken to address them, and the outcomes);
  • children should be genuinely able to raise concerns and make suggestions for changes and improvements, which are taken seriously.
    
    See section 18. LSCBs, quality assurance and conflict resolution.
• Bullying is effectively countered - this is especially important in any institution providing accommodation and care for groups of young people (see section 5.7. Bullying);
• Recruitment and selection procedures are rigorous and create a high threshold of entry to deter abusers (see section 17. Safer recruitment);
• There is effective supervision and support, which extends to temporary staff and volunteers (see section 16. Supervision and training);
• The custodial service contractor staff are effectively checked and supervised when on site or in contact with children;
• Clear procedures and support systems are in place for dealing with expressions of concern by custodial service staff about other staff or carers (see section 15. Allegations against staff);
• Organisations should have a code of conduct instructing staff on their duty to their employer and their professional obligation to raise legitimate concerns about the conduct of colleagues or managers. There should be a guarantee that procedures can be invoked in ways which do not prejudice the 'whistle-blower's' own position and prospects;
• There is respect for diversity and sensitivity to race, culture, religion, gender, sexuality and disability;
• Custodial service staff are alert to the risks of harm to children in the external environment from people prepared to exploit the additional vulnerability of children living away from home.

5.8.6

See also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

LA children's social care

5.8.7

Children living in custodial settings should be assessed as potential children in need under section 17 of the Children Act 1989 and all children subject to a court ordered secure remand (COSR) automatically acquire the status of a looked after child. See 5.40 Residential Care.

5.8.8

LA children's social care's duties and powers extend to children who are in prison (subject to the necessary requirements of imprisonment). Accordingly they are obliged to investigate any concerns about the welfare of children in custodial settings as they would if the child lived in the community or a non-custodial setting. All LA children's social care services should implement the requirements set out in Safeguarding and promoting the welfare of children and young people in custody (LA circular [2004] 26). In addition, the Prison Service has an obligation to safeguard the welfare of children in its care and to reflect the principles and spirit of the Children Act 1989.

5.8.9

LA children's social care in areas where there is a young offender institution, prison, Secure Training Centre or detention and deportation centre should:

• Have agreed local protocols for referral, assessment and the provision of services to children in custody, including child protection and allegations against staff procedures;
• Ensure that there are effective protocols to support links with a child's home authority, which, together with the home Yot, has continuing responsibility for the child;
• Ensure that the governor of the custodial establishment is invited to be a member of the Local Safeguarding Children Board (LSCB);
• Ensure, through the LSCB, that arrangements are in place to safeguard the welfare of children in custody (e.g. liaison arrangements for undertaking s47 enquiries, holding strategy meetings / discussions and undertaking serious case reviews) and that LA children's social care is represented on the young offender institution's safeguarding committee;
• Have local protocols in place in the event of the death of a child in custody, taking into account national guidelines from the Youth Justice Board, Department for Children, Schools and Families (formerly the DfES) and Prisons and Probation Ombudsman.

In discharging their duties, local authority children's social care services should consider seconding social workers to work in secure establishments.

5.8.10

LA children's social care should ensure they fulfil their statutory responsibilities for contact with any children placed in custody for whom they have parental responsibility.

5.8.11

Children remanded by family proceedings or criminal courts to secure accommodation are looked after children within the meaning of s22 of the Children Act 1989. The responsibilities on the local authority are those set out in Part 3 and Schedule 2 of the Children Act 1989; the local authority does not acquire parental responsibility. These responsibilities fall on the local authority where the child is ordinarily resident, not on the authority where the secure accommodation is located. The safeguarding duties are the same as those for other looked after children in terms of promoting and safeguarding the child's welfare, taking account of the child's wishes, producing and reviewing care plans and consulting with other agencies.

5.8.12

As with other children, in any situation in which there is reason to suspect a looked after child is suffering or is likely to suffer significant harm, child protection enquiries must be initiated.

Looked after children and custody

5.8.13

Where a looked after child who is the subject of a care order, meaning that their responsible authority shares parental responsibility for them, enters a young offender institution (YOI), either on sentence or on remand, the responsible authority has continuing responsibilities as a corporate parent to visit and continue to assess their needs. The responsible authority must make arrangements for regular contact with the looked after child, continue to ensure that reviews of their care plan take place at the prescribed intervals and facilitate ongoing contact with parents and siblings where that is part of the care plan. These responsibilities will mean that the responsible authority must be closely involved in making plans for resettling the child in their community once they are able to be released from custody. For some children this will involve them returning to foster care or other kind of supported placement.

5.8.14

Where a child under 16 who has previously been accommodated as a result of a third sector agreement under section 20 of the Children Act enters custody they do not remain a looked after child. However, regulations to be enacted as a result of section 15 of the Children and Young Persons Act 2008 will require a responsible local authority to ensure that they appoint a representative to visit all children and young people who have ceased to be accommodated. The representative will be responsible for assessing the child's needs in order to make recommendations about the support they will need whilst detained, and, in particular, the support necessary on release which could include planning for the child to become looked after again.

5.8.15

Children aged 16+ who were looked after prior to being sentenced may well be 'relevant children' as defined by section 23A of the Children Act 1989248. Their responsible authority must appoint a personal adviser and prepare a pathway plan setting out the support that they will provide to prepare the child for the responsibilities of adulthood. The pathway plan must include information about where the child will live on release and the support they will receive to re-establish themselves in their communities with positive plan for their futures, to minimise the possibility of their re-offending.

Young offender institutions, Secure Training Centres and secure children's homes

5.8.16

The Governors of Young offenders institutes (YOIs), secure training centres ( STCs) and secure children's homes have obligations set out in PSO 4950 - Regimes for Juveniles with respect to child protection (see section 2. Roles and responsibilities). The same measures should apply to children in other custodial settings, such as children in adult prison settings (e.g. women's establishments which have mother and baby units) or immigration detention centres.

5.8.17

All custodial settings which accommodate children should have internal policies and procedures, in line with these London Child Protection Procedures, to safeguard and promote the welfare of children.  Accordingly, if information comes to light, from whatever source, that a young person has suffered or is at risk of suffering significant harm, the professional who receives the information or has a concern must report this immediately to the safeguards manager or equivalent nominated safeguarding children adviser, and the Governor.

5.8.18

The Governor must ensure an assessment is undertaken by the safeguards manager or equivalent nominated safeguarding children adviser as soon as possible (but in any case within 12 hours) and overseen by the setting's safeguards committee. LA children's social care should be consulted for expert advice as required.

5.8.19

A referral to LA children's social care should be made in line with section 6. Referral and assessment. The Governor or the safeguards manager / equivalent nominated safeguarding children adviser should participate in the strategy meeting / discussion. If the child is involved with a Youth Offending Team, their supervising officer should also participate. See section 7. Child protection enquiries.

Transition into adult services or the community

5.8.20

Good safeguarding practice and resettlement planning requires that all the agencies involved with a child must work together to provide continuity of services when the child transfers into and out of the secure estate. This includes ensuring that the child has suitable supported accommodation, help with mental health and substance misuse issues and with identifying appropriate education, training or employment.

5.8.21

Transition to adult services for children in the youth justice system can be challenging due to the different thresholds for children's and adult services and the complexity of need posed by many young people in the youth justice system.

5.8.22

See Healthy Children, Safer Communities: a strategy and action plan to promote the health and well being of those in contact with the youth justice system. See also Lord Bradley's review of people with mental health problems or learning disabilities in the criminal justice system (April 2009).

Definition of contact

5.9.1

Contact with a child includes correspondence, prisoner's telephones (PinPhones) or social visits. Telephone contact will include any access to office telephones where permission has been granted. It will also include any contact with children who have been invited to visit the prison as part of a group. 

5.9.2

When a child visits a custodial setting s/he could be at risk of significant harm through physical, sexual and / or emotional harm from the adult s/he is visiting or from others in the prison establishment. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

Contact requests and registers

5.9.3

If a prisoner wishes to apply to have child contact, the enquiring prison officer must provide an application form for the prisoner to complete. A separate request must be made for contact with each individual child.

5.9.4

It is possible that a request for contact could be made by a parent or from the child directly. If such a request is received, the prisoner will be informed and asked if they wish to submit a request for contact.

5.9.5

A register providing a record of applications must be held on file.  This record will become part of the prisoner's main record and will follow the prisoner on transfer. Each prison establishment should maintain a central record indicating which prisoners are subject to restrictions due to the risk they represent to children, details of prisoners allowed child visits, or other contact and details of prisoners who have been refused child visits or other contact.

Parental support for contact

5.9.6

The prison establishment should ask the parent of the child whether they support contact. The LA children's social care for the area where the child is living, should ascertain the wishes and feelings of the child during a home visit. For the visit to take place the LA children's care must also ascertain that the person who has parental responsibility and is currently caring for the child supports the contact. In cases where the parent does not support contact, the prison establishment should inform the LA children's social care of the parents' decision. See 5.9.8. Multi-agency assessment.

Looked after children   

5.9.7

When a prison establishment contacts LA children's social care as part of the multi-agency assessment below, it may become apparent that a child is looked after by the local authority. In such cases, the local authority's view of the appropriateness of contact must be obtained in writing. The test is always whether contact is in the child's best interest.

Multi-agency assessment

5.9.8

The prison establishment should undertake a multi-agency risk assessment to determine the risk to which a child may be exposed or the risk that a prisoner presents. The following agencies must be contacted to gather information before an assessment of risk can be made:

• The police in the child's home authority (see section 11. Mobile children and families, 11.9.2. Definition of home and host authorities):
  • the prison establishment police liaison / intelligence officer must be provided with the details of the prisoner and the child/ren (including photographs of the child/ren);
  • the police liaison / intelligence officer will then make contact with the police in the child's home authority requesting any information about the risk of harm to the child or further information about the prisoner;
• LA children's social care in the child's home authority (see section 11. Mobile children and families, 11.9.2. Definition of home and host authorities):
  • the first approach by the prison establishment should be by letter (with a photograph of the child) to the Director of Children's Services, followed by a telephone call to the LA child protection adviser (LA children's social care should reply within two working days);
  • LA children's social care should undertake an assessment and provide a written report with recommendations within three weeks; 
  • the views of the child should be an important element of the assessment;
• The prison establishment's probation officer should be provided with the details of the prisoner's application for contact;
  • where a prisoner will be subject to licence supervision on release or has been recalled for breach of licence for the current offence. In these cases, the probation officer should contact the relevant home probation area with a request for information and comments concerning the prisoner's application for contact;
  • where the prisoner applying for contact is a young offender and is supervised. In these cases, LA children's social care in the child's home authority must be contacted;
• Where appropriate, the NSPCC may be contacted for additional information. Some prison establishments who have developed a relationship or a partnership with the NSPCC have negotiated an arrangement where the NSPCC will search their database for information relating to the risk of harm to a child. There is no obligation for the NSPCC to do this check, but it would enhance the assessment if such an arrangement were in place.

Prison establishment operational manager's decision

5.9.9

When the operational manager with delegated authority is in possession of all the available multi-agency information, an assessment should be made. It is most likely that the operational manager who carries out this function will be the Head of Resettlement or Throughcare who has responsibility for public protection. The operational manager's decision should take into account the follow factors:

• The child's needs, wishes and feelings;
• The capacity of the parent to protect the child from likely harm;
• The prisoner's risk to the public;
• The OASys assessment;
• Static risk assessment (Thornton's Risk Matrix 2000);
• Pre -sentence report;
• Previous convictions;
• Custodial behaviour and any other documentation highlighting risk.

Level of contact decided

5.9.10

The operational manager should decide the level of contact that will be permitted. The level of contact should be proportionate to the risk identified, and the best interests of the child should always be the overriding principal in making these decisions. Contact restrictions should be incremental - one of the following levels of restriction will be applied:

• Level one: full restrictions apply. No contact with any child is permitted and all correspondence and telephone calls will be monitored;
• Level two: contact is only permitted via written correspondence. All correspondence and telephone calls will be monitored;
• Level three: contact is permitted via written correspondence and telephone. All correspondence and telephones calls will be monitored;
• Level four: no restrictions necessary. May have contact via correspondence, telephone, visits and family visit (if available). Routine sampling applies - reading of correspondence, listening to telephone calls, general observation in visiting area.

Monitoring

5.9.11

The level and frequency of monitoring will be proportionate to the risk of harm identified. Monitoring should focus on whether the prisoner is attempting to contact children inappropriately and what references about children are made in general correspondence (i.e. grooming or manipulation of a child or a parent).

5.9.12

Monitoring of prisoners who present a risk of harm to children in the visiting area is required to establish if appropriate contact is taking place between an offender and a child, where child visits have been permitted. Other prisoners who present a risk of harm to children and have not been permitted contact with a child must be supervised in such a way that contact is not possible.

5.9.13

Recorded and electronic information needs to be monitored (e.g. audio cassettes, CD Roms and video CDs) because it affords an easy disguise for inappropriate information.

Ensuring correct identification of children

5.9.14

It is necessary to take steps to prevent a child with whom a prisoner may have contact being substituted with another, possibly more vulnerable child. Prison staff monitoring letters and telephone calls and visiting areas need to be vigilant and prevent inappropriate contact where identified. Children entering the establishment for social visits must be identified from photographs by prison staff.

5.9.15

Four passport-style photographs of each child will be required from the parent. Prison staff at the establishment may take the photos where arrangements to do so are in place. The first and second photographs will be sent to the police and LA children's social care, attached to the written request for information. Staff who are required to identify the child when entering the prison will use the third, and the fourth will be retained on file. Photographs should be returned to the parent if contact is not supported.

5.9.16

Photographs should be updated annually or earlier if there is a significant change in a child's appearance.

Reviewing contact decisions

5.9.17

Where a decision has been made to restrict contact, the decision will be reviewed when there is reason to believe that circumstances have changed. Reviews can be made at any time on the initiative of prison staff or at the request of the prisoner. It is good practice to review decisions every six months.

5.9.18

Any decision to change the level of contact permitted must be based on what is best for the child. The child's welfare is paramount at all times. The decision must take into account the views of the police, probation and LA children's social care, via the LA child protection adviser.

5.9.19

Reviews may take the form of a child protection conference (see section 8. Child protection conferences). The prison establishment public protection lead is responsible for liaising with LA children's social care with regard to arranging a child protection conference.

Appeals process

5.9.20

All prison establishments have procedures for prisoners who wish to appeal about a decision not to permit or to restrict contact with a child. If the prisoner wishes to challenge the information held on file, the information provided by other agencies should only be disclosed to the prisoner with the agreement of the other agency.

5.10.1

Professionals may be concerned that a child who is a member of a diplomat's family is at risk of significant harm through physical, sexual and / or emotional harm (see section 4.3. Recognition of abuse and neglect), or that a child in a diplomatic family has abused another person.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.10.2

Professionals in all agencies should make a referral to LA children's social care in line with section 6. Referral and assessment. See also section 5.18 Harming others. However, all professionals should be aware that legal advice about the diplomatic immunity of the particular child and family must be sought from the outset, including before attempting to remove a child in emergency (in most instances, it will be advisable to consider removing the child from school or another place outside the diplomatic residence).

Diplomatic immunity

5.10.3

Diplomats, members of their household and their residences have immunity from civil, criminal and administrative jurisdiction. They cannot be detained or arrested and their homes cannot be entered without consent.

5.10.4

Different categories of staff of the service are entitled to different forms of immunity, so the rank of the person in question must therefore be established as a priority.

5.10.5

The head of the service is entitled to full criminal and civil immunity.

5.10.6

Technical, administrative and general (e.g. domestic service) members of staff are only entitled to full criminal and civil immunity for acts within the course of their duties (e.g. a chauffeur is subject to the Children Act 1989 for acts that fall outside of the course of his duties).

5.10.7

All agencies should be aware that they may be unable to enforce any order should the child return to the diplomat's residence and refuse to surrender. This does not deprive LA children's social care, the police and other agencies of the power or duty to take action as appropriate.

Action by LA children's social care and the police

5.10.8

Where LA children's social care and / or the police need to respond to a concern that a child in a diplomatic family is being harmed, professionals must immediately establish the extent to which the particular family may claim diplomatic immunity.

5.10.9

The LA children's social care manager should contact the Foreign and Commonwealth Office, 'Immunities section of the Protocol Department', for advice on the family's immunity: 0207 210 6383.

5.10.10

Out of office hours, the police should be requested to determine the status of an individual or family by consulting the central index of privileged persons maintained by the police Diplomatic Protection Group.

5.10.11

In all cases, the local authority lawyer should be consulted prior to action being taken.

5.10.12

The child protection manager must be notified of all enquiries which may involve diplomatic families and s/he, in consultation with the local authority's legal department, is responsible for co-ordinating any necessary action via the Foreign Office.

5.10.13

As far as possible, children from diplomatic backgrounds should be subject to ordinary processes, including information transfer (preferably at a child protection conference) should the family move to a new area.

5.11.1

Any child with a disability is by definition a 'child in need' under s17 of the Children Act 1989. The Disability Discrimination Act 1995 makes it unlawful to discriminate against a disabled person in relation to the provision of services.  This includes making a service more difficult for a disabled person to access or providing them with a different standard of service.

5.11.2

Research suggests that children with a disability may be generally more vulnerable to significant harm through physical, sexual, emotional abuse and / or neglect than children who do not have a disability. See section 4.3. Recognition of abuse and neglect and 5.11.3 below.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.11.3

The national guidance Safeguarding Disabled Children - Practice Guidance (DCSF 2009) provides a framework collaborative multi-agency responses to safeguard disabled children.

5.11.4

The available UK evidence on the extent of abuse among disabled children suggests that disabled children are at increased risk of abuse, and that the presence of multiple disabilities appears to increase the risk of both abuse and neglect (see Standards 5, 7 and 8 of the National Service Framework for Children, Young People and Maternity Services (DH, 2004)). Disabled children may be especially vulnerable to abuse for a number of reasons:

• Many disabled children are at an increased likelihood of being socially isolated with fewer outside contacts than non-disabled children;
• Their dependency on parents and carers for practical assistance in daily living, including intimate personal care, increases their risk of exposure to abusive behaviour;
• They have an impaired capacity to resist or avoid abuse;
• They may have speech, language and communication needs which may make  it difficult to tell others what is happening;
• They often do not have access to someone they can trust to disclose that they have been abused; and/or
• They are especially vulnerable to bullying and intimidation.

5.11.5

Looked after disabled children are not only vulnerable to the same factors that exist for all children living away from home, but are particularly susceptible to possible abuse because of their additional dependency on residential and hospital staff for day to day physical care needs.

• Force feeding;
• Unjustified or excessive physical restraint;
• Rough handling;
• Extreme behaviour modification, including the deprivation of liquid, medication, food or clothing;
• Misuse of medication, sedation, heavy tranquillisation;
• Invasive procedures against the child's will;
• Deliberate failure to follow medically recommended regimes;
• Misapplication of programmes or regimes;
• Ill fitting equipment (e.g. callipers, sleep board that may cause injury or pain, inappropriate splinting);
• Undignified age or culturally inappropriate intimate care practices.

5.11.6

Safeguards for disabled children are essentially the same as for non-disabled children. Particular attention should be paid to promoting a high level of awareness of the risks of harm and high standards of practice, and strengthening the capacity of children and families to help themselves. Measures should include:

• Making it common practice to help disabled children make their wishes and feelings known in respect of their care and treatment;
• Ensuring that disabled children receive appropriate personal, health, and social education (including sex education);
• Making sure that all disabled children know how to raise concerns, and giving them access to a range of adults with whom they can communicate. Those disabled children with communication impairments should have available to them at all times a means of being heard;
• An explicit commitment to, and understanding of disabled children's safety and
• Welfare among providers of services used by disabled children;
• Close contact with families, and a culture of openness on the part of services;
• Guidelines and training for staff on good practice in intimate care; working with children of the opposite sex; handling difficult behaviour; consent to treatment;
• Anti-bullying strategies; and sexuality and sexual behaviour among young people, especially those living away from home; and
• Guidelines and training for staff working with disabled children aged 16 and over to ensure that decisions about disabled children who lack capacity will be governed by the Mental Health Capacity Act once they reach the age of 16.

5.11.7

Where there are concerns about the welfare of a disabled child, they should be acted upon in accordance with the guidance in Chapter 5, in the same way as with any other child. Expertise in both safeguarding and promoting the welfare of child and disability has to be brought together to ensure that disabled children receive the same levels of protection from harm as other children (see Safeguarding Disabled Children - Practice Guidance (2009)).

5.11.8

Where a disabled child has communication impairments or learning disabilities, special attention should be paid to communication needs, and to ascertain the child's perception of events, and his or her wishes and feelings. In every area, children's social care and the police should be aware of non-verbal communication systems, when they might be useful and how to access them, and should know how to contact suitable interpreters or facilitators. Agencies should not make assumptions about the inability of a disabled child to give credible evidence, or to withstand the rigours of the court process. Each child should be assessed carefully, and helped and supported to participate in the criminal justice process when this is in the child's best interest and the interests of justice.

5.11.9

In criminal proceedings under the Youth Justice and Criminal Evidence Act 1999112 witnesses aged under 17 (to be raised to under 18 by the end of 2010) may be eligible for special measures assistance when giving evidence in court. There is a presumption that child witnesses should give their evidence by video recorded statement (if taken) and live link, which allows a witness to give evidence during a trial from outside the courtroom through a televised link to the courtroom. The other special measures available to vulnerable witnesses include clearing the public gallery in sexual offence cases and those involving intimidation, screens to shield the witness from seeing the defendant, and assistance with communication through an intermediary or communication aid.

5.11.10

Achieving Best Evidence in Criminal Proceedings: Guidance on vulnerable and intimidated witnesses including children gives detailed guidance on planning and conducting interviews with children and vulnerable adults and includes a section on interviewing disabled children and also those that are very young or psychologically disturbed.

See section 5.50 Working with interpreters / communications facilitators.

Definition and impact

5.12.1

This section is a summary of the supplementary London child protection procedure: Safeguarding Children Abused Through Domestic Violence (London Board, 2007), and the two should be read in conjunction.

5.12.2

Domestic violence is defined by the Home Office as:

'Any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been, intimate partners or family members, regardless of gender or sexuality'.

The main characteristic of domestic violence is that the behaviour is intentional and is calculated to exercise power and control within a relationship.

5.12.3

Victims / survivors of intimate partner violence include a sizeable proportion of teenage girls who are in relationships. Having an older partner, especially if he is 'much older', is associated with the highest levels of victimisation.

5.12.4

These girls, as well as, children of all ages living with a mother who is experiencing domestic violence, are vulnerable to significant harm through physical, sexual, emotional abuse and / or neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.12.5

The legal definition of 'significant harm' was amended from 31 January 2005 to include "the harm that children suffer by seeing or hearing the ill-treatment of another, particularly in the home".  This is not a new ground under s31 Children Act 1989 but it does recognise Domestic Violence formally as a cause of harm to children and therefore can be used in supporting applications to the Court.

5.12.6

In almost a third of cases, domestic violence begins or escalates during pregnancy and it is associated with increased rates of miscarriage, premature birth, foetal injury and foetal death. The mother may be prevented from seeking or receiving proper ante-natal or post-natal care. In addition, if the mother is being abused this can affect her attachment to her child, more so if the pregnancy is a result of rape by her partner.

5.12.7

The three central imperatives of any intervention for children and teenage girls living with domestic violence are:

• To protect the children, including unborn children / teenage girl;
• To empower the mother / teenage girl to protect herself, and her children;
• To hold the abusive partner accountable for his violence and provide him with opportunities to change.

5.11.8

The victim / survivor is referred to here as female and the perpetrator as male because this reflects the majority of cases where there are child protection concerns. However, professionals should apply the guidance to all situations of domestic violence (i.e. where it is perpetrated by women or girls against men and boys, within same sex relationships, and to or from a child or adult a carer may be caring for).

5.12.9

Domestic violence can diminish a mother's capacity to parent and protect her child/ren. Mothers can become so preoccupied with their own survival within the relationship that they are unaware of the effect on their child/ren.

5.12.10

Professionals should always consider each domestic violence incident in relation to severity, frequency and duration, as this will indicate the length of time that children have been exposed to a traumatic and abusive event.

Recognition and response

5.12.11

All women, teenage girls and children should be offered the opportunity of being seen alone, including in all assessments, with a female professional, and asked direct questions about whether they have experience of domestic violence.

5.12.12

Everyone working with women, teenage girls and children should be alert to the frequent inter-relationship between domestic violence, substance misuse and mental ill health.

5.12.13

Professionals who come into contact with teenage girls (teachers, school nurses, sexual health professionals, GPs etc.) should be aware of the possibility that the young person could be experiencing violence within an intimate partner relationship.

5.12.14

Professionals in all agencies should take all disclosures seriously, and the impact of the domestic violence on the mother and her child/ren should be clearly explained to her.

5.12.15

Professionals should record fully all disclosures, details of injuries, photographic evidence, abuse history etc in case it is needed as evidence for court at a later date.

5.12.16

Professionals should explain that no information will be passed on without the mother or teenage girl's consent unless there is risk of harm to her child/ren - in which case, the overriding duty is to protect the child/ren.

5.12.17

As soon as a professional becomes aware of domestic violence within a family, they should help the mother and each child, according to their age and understanding, develop a safety plan.

5.12.18

The London procedure Safeguarding Children Abused Through Domestic Violence (LSCB, 2007) provides proformas to aid disclosure and safety planning for children and mothers, and a risk assessment matrix to support judgements about the degree of risk of harm that children may be being exposed to. Professionals with concerns that a young woman / teenage mother is being abused within a relationship should follow the procedures  adapting as appropriate to focus on the circumstances and locations in which the young woman / mother meets her partner (e.g. choosing safer venues, locations and peer groups to meet, being able to identify trigger points which lead to violence and practicing safe ways to leave and go home etc).

5.12.19

In some cases, the emergency safety plan should be for the children and, if possible, the mother not to remain in / return to the home. In all other cases, emergency safety plans should be in place whilst assessments, referrals and interventions are being progressed.

5.12.20

Where a mother's safety plan is to separate from the abusive partner, professionals should ensure that there is sufficient support in place to enact this plan. The possibility of removing the abusive partner rather than the mother and child/ren should be considered first.

5.12.21

Where an interim care order is made the Court may make an 'exclusion requirement' under s38A(2) of the Children Act 1989. The Court must be satisfied that if the abusive partner is excluded from the home the children will cease to suffer, or be likely to suffer significant harm.

5.12.22

Professionals should discuss with the mother the potential for escalating the risk if the professionals address their concerns with the abusive partner. If this will put the mother and children at further risk of harm, the mother should be supported to plan for separation.

5.12.23

Where a mother proposes to remain with the abusive partner, a multi-agency assessment (in the supplementary London procedure: Safeguarding Children Abused Through Domestic Violence) should be undertaken of whether the safety plan is sufficient to safeguard the children.

Referral and assessment

5.12.24

Where professionals are concerned about the care a child is receiving or about a mother's parenting, the presence of domestic violence should be considered.

5.12.25

Professionals should make contact with the mother first and in a way which prioritises her safety, unless there are immediate risks of harm to the child/ren. Giving or sending written materials to a mother or children may jeopardise their safety.

5.12.26

Professionals in all agencies should, use the CAADA risk identification checklist (RIC) to assess the risk of harm to a mother. The checklist is available at: www.caada.org.uk

5.12.27

Professionals in all agencies should, preferably together with their nominated safeguarding children adviser, use the domestic violence risk identification matrix (DVRIM) in the London procedure Safeguarding Children Abused Through Domestic Violence to assess the risk of harm to each child.

5.12.28

The risk assessment should inform a decision to refer the child/ren and their mother to LA children's social care for assessment, see 5.12.42 Section 47 referral, below . See also section 6. Referral and assessment, including 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

5.12.29

Normally one serious or several lesser incidents of domestic violence where there is a child in the household indicate that children's social care should carry out an initial assessment of the child and family, including consulting existing records. Babies under 12 months old are particularly vulnerable to violence. Where there is domestic violence in families with a child under 12 months old (including an unborn child), even if the child was not present, professionals should make a referral to children's social care if there is any single incident of domestic violence.

5.12.30

The mother experiencing the violence will usually, but not always, be well placed to predict the risks she faces and the likelihood of further violence. Practitioners should nevertheless be aware that mothers can underestimate the risk of harm to themselves and their children from domestic violence abusers.

The mother should be encouraged and / or helped to complete a personal risk assessment.

5.12.31

LA children's social care should use the proformas in the London procedure Safeguarding Children Abused Through Domestic Violence to support their response to domestic violence referrals.

5.12.32

LA children's social care and other agencies should make all reasonable efforts to engage the abusive partner and refer them to appropriate services.

The Police

5.12.33

The police are often the first point of contact with families in which domestic violence takes place. When responding to incidents of violence the police should:

• Find out whether there are any children living in the household
• See any children present in the house to assess their immediate safety
• Have an arrangement with la children's social care which enables them to find out whether any such children are the subject of a child protection plan
• Determine whether any court orders or injunctions are in force in respect of members of the household
• Make an assessment of risk of harm to the children and their mother using a dedicated assessment tool for example, the domestic abuse, stalking and harassment and honour based violence (dash) 2009 risk assessment model

5.12.34

If the police have specific concerns about the safety or welfare of a child they should make a referral to children's social care and to a Multi-Agency Risk Assessment Conference (MARAC) - a multi-agency meeting that focuses on the safety of high-risk domestic violence victims. MARACs and LSCBs should agree joint working arrangements for identifying, protecting and supporting children affected by domestic violence. See section 13.5. MARACs.

5.12.35

Professionals and their managers must consider staff safety when visiting the family home and any other settings. See section 10. Working with unco-operative families.

5.12.36

See section 13.7 for risk management of adult sexual and violent offenders under the MAPPA.

Core support group

5.12.37

Where the domestic violence is assessed as minor or moderate, professionals should offer or refer for family support services.

5.12.38

A core support group of key agencies should be convened (e.g. LA children's social care, LA housing, health professionals, an advocacy worker, the police, Women's Aid refuge). A professional from the group should be appointed by the agencies to proactively engage with the mother and maintain contact, particularly immediately after separation (this professional could be an independent advocate).

5.12.39

The core group should meet regularly to review progress on the safety / separation plan. Wherever possible, core groups should include professionals who can advise on safety planning in a domestic violence context.

5.12.40

Professionals should ensure that the core support group of key agencies (and the mother) develops a plan for the longer term support needs for the child/ren. This may include referrals to relevant local activity groups and / or therapeutic services.

5.12.41

Professionals should keep the safety of the children constantly under review and make a child protection referral / call for a child protection conference or removal of the children if there is a serious risk of immediate harm.

Section 47 referral

5.12.42

Whenever a professional becomes concerned that a child is at risk of significant harm, a referral must be made to LA children's social care in accordance with section 4. Recognition and response and section 6. Referral and assessment.

5.12.43

Babies under 12 months old are particularly vulnerable to violence. Where there is domestic violence in families with a child under 12 months old (including an unborn child), even if the child was not present, any single incident of domestic violence will fall within scale 4 (see Safeguarding Children Abused Through Domestic Violence). Professionals should make a referral to LA children's social care, in line with section 6. Referral and assessment. See also section 6.4.4. Section 47 / initial assessment indicator table and section 7. Child protection enquiries.

5.13.1

Fabricated or induced illness is a condition whereby a child is at risk of, or suffers, harm through the deliberate action of their parent and which is attributed by the parent to another cause.

5.13.2

There are three main ways of the parent fabricating (making up or lying about) or inducing illness in a child:

• Fabrication of signs and symptoms, including fabrication of past medical history;
• Fabrication of signs and symptoms and falsification of hospital charts, records, letters and documents and specimens of bodily fluid;
• Induction of illness by a variety of means.

5.13.3

The above three methods are not mutually exclusive. Existing diagnosed illness in a child does not exclude the possibility of induced illnesses. The very presence of an illness can act as a stimulus to the abnormal behaviour and also provide the parent with opportunities for inducing symptoms.

Impact on the child

5.13.4

Fabricated or induced illness is most commonly identified in younger children. Although some of these children die, there are many that do not die as a result of having their illness fabricated or induced, but who suffer significant long term physical or psychological health consequences.

5.13.5

Fabrication of illness may not necessarily result in a child experiencing physical harm, but there may be concerns about the child suffering emotional harm. They may suffer emotional harm as a result of an abnormal relationship with their parent and / or disturbed family relationships. See section 4.3. Recognition of abuse and neglect.

5.13.6

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful there needs to be compulsory intervention by child protection agencies in the life of the child and their family.

5.13.7

In working with cases of suspected fabricated or induced illness, the focus must be on the child's physical and emotional health and welfare in the long and short term, and the likelihood of the child suffering significant harm.

Abusers

5.13.8

Clinical evidence indicates that fabricated or induced illness is usually carried out by the child's mother or a female carer, usually the child's mother (Safeguarding children in whom illness is fabricated or induced, DCSF 2008). Aspects of their behaviour may include: - [Fabricated or Induced Illness by Carers (Royal College of Paediatricians and Child Health, 2009)]

• Not as concerned about the child as medical personnel;
• Remaining with child on ward constantly;
• Investing significant emotional / intellectual effort in the illness;
• Having a history of conduct or eating disorders / contact with mental health agencies;
• Other carer uninvolved in child care;
• Reports of distant passive father.

Recognition

5.13.9

All professionals who come into contact with children and their families, or adults who are parents, may come into contact with a child or parent where there are suspicions of fabricated or induced illness. These suspicions are likely to centre on discrepancies between what a parent says and what the professional observes.

5.13.10

Fabricated or induced illness is most commonly identified in younger children (77% under five years old) - [McClure et al (1996) study]. The average length of time to identification was greater than six months in a third of cases and more than a year in a fifth of the cases. - [Schreier and Libow (1993)]

5.13.11

In identifying and recognising fabricated or induced illness, professionals need to concentrate on the interaction of three variables:

• The state of health of the child, which may vary from being entirely healthy to being sick;
• The parental view which at one end is neglectful, and at the other end causes excessive intervention either directly or indirectly;
• The medical view, which is equally on a spectrum from being dismissive at one end to performing excessive intervention or treatment at the other.

5.13.12

Concerns may arise when:

• Reported symptoms and signs found on examination are not explained by any 'normal' medical condition;
• Physical examination and results of investigations do not explain reported symptoms and signs;
• New symptoms are reported on resolution of previous ones;
• Reported symptoms and identified signs are not observed in the absence of the parent;
• The child's normal daily life activities are being curtailed beyond that which may be expected from any known medical disorder from which the child is known to suffer;
• Treatment for an agreed condition does not produce the expected effects;
• Repeated presentations to a variety of doctors and with a variety of problems;
• The child denies parental reports of symptoms;
• Specific problems (e.g. apnoea, fits, choking or collapse);
• Child becoming drawn into the parent's illness;
• History of unexplained illnesses or deaths or multiple surgery in parents or siblings of the family;
• A past history in the parent of child abuse, self harm or somatising, or false allegations of physical or sexual assault.

There may be a number of explanations for these circumstances, and each requires careful consideration and review.

Response

5.13.13

All professionals who have concerns about a child's health should discuss these with their line manager, their agency's nominated safeguarding children adviser and the GP or paediatrician responsible for the child's health. If the child is receiving services from LA children's social care, the concerns should also be discussed with them.

5.13.14

If any professional considers that their concerns are not taken seriously or responded to appropriately, they should discuss this as soon as possible with the designated doctor or nurse for child protection in their local authority area.

5.13.15

If any concerns relate to a member of staff, professionals should discuss this with their line manager and their agency's nominated safeguarding children adviser. See also section 15. Allegations against staff.

5.13.16

All concerns and discussions must be recorded contemporaneously by both parties in their agency records for the child, dated and signed.

Medical assessment and referral

5.13.17

The signs and symptoms require careful medical evaluation for a range of possible diagnoses. This is likely to include health professionals working closely with professionals in other agencies who have day-to-day contact with the child (e.g. daycare providers or schools).

5.13.18

Where a reason cannot be found for the signs and symptoms, a second medical opinion should be sought and specialist advice and tests may be required.

5.13.19

If a paediatrician has suspicions that a child is being abused s/he should both seek a second medical opinion and make a referral in line with section 6. Referral and assessment to LA children's social care - promptly, rather than waiting to be sure. Failure to alert the LA children's social care and / or the police early enough is likely, in proven cases, to lead to greater suffering by the child. - [Fabricated or Induced Illness by Carers (Royal College of Paediatricians and Child Health, 2009)]

See also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

5.13.20

While the child's signs and symptoms are being evaluated and before concerns are confirmed, the consultant paediatrician should retain the lead role, and the priority of police officers (and LA children's social care) should be to assist the paediatrician with identification of the reason for the child's symptoms. The balance will change when it becomes clear that a crime appears to have been committed.

5.13.21

Whilst professionals should usually discuss any concerns with the family and, where possible, seek agreement to making referrals to LA children's social care, at no time should concerns about the reasons for the child's signs and symptoms be shared with parents if this information would jeopardise the child's safety or undermine a criminal investigation. See section 6. Referral and assessment for what to do when not seeking parental permission.

Initial consideration of referral

5.13.22

As with all other referrals, LA children's social care should decide, within one working day, what response is necessary. Delay should be avoided by all agencies in all circumstances.

5.13.23

The decision must be taken in consultation with the consultant paediatrician responsible for the child's health care, or the designated doctor for child protection in the local authority area, and the police because any suspected case of fabricated or induced illness may also involve the commission of a crime.

5.13.24

All decisions about what information is shared with parents should be agreed between the police, LA children's social care and consultant paediatrician, bearing in mind the safety of the child and the conduct of any police investigations.

5.13.25

The potential outcome of referrals is the same as for any other referral.  See section 6. Referral and assessment.

Initial assessment, outcomes and immediate protection

5.13.26

LA children's social care should usually undertake an initial assessment, as with all referrals (see section 6. Referral and assessment), in collaboration with the paediatrician responsible for the child's health care, as well as relevant other agencies (e.g. the child's school).

5.13.27

The potential outcomes of the initial assessment should be as described for other referrals in section 6. Referral and assessment. If there is reasonable cause to suspect the child is suffering, or likely to suffer, significant harm and immediate protection is required (e.g. if a child's life is in danger through poisoning or toxic substances being introduced into the child's bloodstream) (see section 7. Child protection enquiries) an immediate strategy meeting / discussion should take place (see sections 5.13.29 to 5.13.33 below) and legal advice must be sought.

5.13.28

Concerns should not be raised with a parent if there is concern that this action will jeopardise the child's safety or where it may undermine a timely criminal investigation.

Strategy meeting

5.13.29

If there is reasonable cause to suspect the child is suffering, or likely to suffer, significant harm, LA children's social care should convene and chair a strategy meeting involving all the key professionals. A meeting, rather than telephone discussion, is strongly advised when considering this complex form of abuse.

5.13.30

The strategy meeting should be convened in line with section 7. Child protection enquiries. The meeting should be chaired by the LA children's social care first line manager or the LA child protection adviser.

5.13.31

Participants must include LA children's social care, police and the paediatrician responsible for the child's health, and as appropriate:

• A senior ward nurse if the child is an in-patient;
• A medical professional with expertise in the relevant branch of medicine;
• GP;
• Health visitor or school nurse;
• Staff from education settings;
• Local authority legal adviser.

In cases of possible FII, it may be necessary not to tell the parents about the meeting prior to it taking place in order to protect the child.

5.13.32

When it is decided there are grounds to initiate a child protection investigation (s47, Children Act 1989), decisions should be made about how the investigation, as the core assessment, will be carried out, including:

• Whether the child requires constant professional observation and, if so, whether the carer should be present;
• The designation of a medical clinician to oversee and co-ordinate the medical treatment of the child to control the number of specialists and hospital staff the child may be seeing;
• Arrangements for the medical records of all family members, including children who may have died or no longer live with the family, to be collated by the consultant paediatrician or other suitable medical clinician;
• The nature and timing of any police investigations, including analysis of samples and covert surveillance (this will be police led and co-ordinated, with advice available from the National Crime Faculty);
• The need for extreme care over confidentiality, including careful security regarding supplementary records;
• The need for expert consultation;
• Any particular factors, such as the child's and family's race, ethnicity, language and special needs, which should be taken into account;
• The needs of the siblings and other children with whom the alleged abuser has contact;
• The needs of parents;
• Obtaining legal advice over evaluation of the available information (if a legal adviser is not present at the meeting).

5.13.33

See section 7. Child protection enquiries.

5.13.34

It may be necessary to have more than one strategy meeting, as the child's circumstances are likely to be complex and a number of discussions may be required to consider whether and when to initiate a s47 enquiry.

Police investigation

5.13.35

Evidence gathered by the police should usually be available to other relevant professionals, to contribute to the s47 enquiry and core assessment. There will be occasions when police will not share information to protect a person's identity.  However, if the need to protect the child is greater than the need to protect the source of information, the necessary authority will be sought to share that information.

5.13.36

Suspects' rights are protected by adherence to the police and Criminal Evidence Act 1984, which would usually rule out any agency other than the police confronting any suspect persons.

Outcome of enquiries

5.13.37

As with all child protection investigations, the outcome may be that concerns are not substantiated (e.g. tests may identify a medical condition that explains the signs and symptoms).

5.13.38

It may be that no protective action is required, but the family should be provided with the opportunity to discuss whether they require support.

5.13.39

Where FII is suspected, the child protection investigation may take more time than usual. However, whenever possible and consistent with the child's best interests, professionals should ensure any child protection conference is held within 15 working days of the last strategy meeting / discussion and that regular strategy meetings / discussions take place throughout the investigation.

5.13.40

Concerns may be substantiated, but an assessment may be formed that the child is not at continuing risk of harm. In this case, the decision not to proceed to a child protection conference must be endorsed by the LA children's social care manager or child protection adviser.

5.13.41

Where concerns are substantiated and the child is judged to be suffering, or at risk of suffering, significant harm, a child protection conference must be convened. All evidence should be thoroughly documented by this stage and the protection plan for the child already in place.

Initial child protection conference

5.13.42

Attendance at this conference should be as for other initial conferences (see section 8. Child protection conferences), with additional experts invited as appropriate:

• Professional with expertise in working with children in whom illness is fabricated or induced and their families;
• Paediatrician with expertise in the branch of paediatric medicine able to present the medical findings.

5.13.43

LA childrens' social care should only convene an initial conference after reaching the point of discussing professional concerns openly with the parent/s i.e. when it has been agreed that to do so will not place the child at increased risk of significant harm. This may be some time after the commencement of enquiries under s47 and a series of strategy discussions / meetings while the medical professionals undertake continuing evaluation and the police progress a criminal investigation.

 In some cases legal action may be necessary before this point is reached, in which case the appropriateness of holding an initial conference at this stage will need to be considered.

5.13.44

For further information see:

• The Government guidance Safeguarding Children in Whom Illness is Fabricated or Induced (DCSF 2008).
• The DVD Incredibly Caring (DCSF 2009) to support the Government guidance.
• The guidance Fabricated or Induced Illness by Carers (Royal College of Paediatricians and Child Health, 2009).

Legal status

5.14.1

This section is a summary of the supplementary London child protection procedure: Safeguarding Children at Risk of Abuse through Female Genital Mutilation (London Board 2007), and the two should be read in conjunction.

5.14.2

The World Health Organisation (WHO) defines female genital mutilation (FGM) as: "all procedures (not operations) which involve partial or total removal of the external female genitalia or injury to the female genital organs whether for cultural or other non-therapeutic reasons" (WHO, 1996).

5.14.3

FGM has been a criminal offence in the UK since the Prohibition of Female Circumcision Act 1985 was passed. The Female Genital Mutilation Act 2003  extended the prohibition making it also illegal to take a child abroad to undergo FGM. In Scotland FGM is illegal under the Prohibition of FGM (Scotland) Act 2005.

5.14.4

A child for whom FGM is planned is at risk of significant harm through physical abuse and emotional abuse, which is categorised by some also as sexual abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

Cultural underpinnings

5.14.5

Female genital mutilation is much more common than people realise. It is a complex issue because despite the harm it causes, many women from FGM practising communities consider FGM normal to protect their cultural identity.

5.14.6

Although FGM is practiced by secular communities, it is most often claimed to be carried out in accordance with religious beliefs. However, neither the Bible nor the Koran support the practice of FGM. In addition to giving religious reasons for subjecting their daughters to FGM, parents say they are acting in a child's best interests because it:

• Brings status and respect to the girl;
• Preserves a girl's virginity / chastity;
• Is a rite of passage;
• Gives a girl social acceptance, especially for marriage;
• Upholds the family honour;
• Helps girls and women to be clean and hygienic.

See Safeguarding Children at Risk of Abuse through Female Genital Mutilation (London Board, 2007) for a fuller list of reasons.

5.14.7

The age at which girls are subjected to female genital mutilation varies greatly, from shortly after birth to any time up to adulthood. The average age is 4 to 13 years, in some cases it is performed on new born infants or on young women before marriage or pregnancy.

Types of FGM

5.14.8

Female genital mutilation has been classified by the WHO into four types:

• Type 1: Circumcision -  Excision of the prepuce with or without excision of part or all of the clitoris;
• Type 2: Excision (Clitoridectomy) - Excision of the clitoris with partial or total excision of the labia minora. After the healing process has taken place, scar tissue forms to cover the upper part of the vulva region;
• Type 3: Infibulation (also called Pharaonic Circumcision) -This is the most severe form of female genital mutilation. Infibulation often (but not always) involves the complete removal of the clitoris, together with the labia minora and at least the anterior two-thirds and often the whole of the medial part of the labia majora;
• Type 4: Unclassified - This includes all other procedures on the female genitalia, and any other procedure that falls under the definition of female genital mutilation given above.

Implications of FGM for a child's health and welfare

5.14.9

Short-term health implications can range from severe pain and emotional / psychological trauma to death from blood loss or infection.

5.14.10

The health problems caused by FGM Type 3 are severe - urinary problems, difficulty with menstruation, pain during sex, lack of pleasurable sensation, psychological problems, infertility, vaginal infections, specific problems during pregnancy and childbirth, including flashbacks.

Women with FGM Type 3 require special care during pregnancy and childbirth.

Identifying a child who has been subjected to FGM or who is at risk of being abused through FGM

5.14.11

Indications that FGM may be about to take place include:

• The family comes from a community that is known to practise FGM;
• A child may talk about a long holiday to her country of origin or another country where the practice is prevalent, including African countries and the Middle East;
• A child may confide to a professional that she is to have a 'special procedure' or to attend a special occasion;
• A child may request help from a teacher or another adult;
• Any female child born to a woman who has been subjected to FGM must be considered to be at risk, as must other female children in the extended family;
• Any female child who has a sister who has already have undergone FGM must be considered to be at risk, as must other female children in the extended family.

5.14.12

Indications that FGM may have already taken place include:

• A child may spend long periods of time away from the classroom during the day with bladder or menstrual problems if she has undergone Type 3 FGM;
• A prolonged absence from school with noticeable behaviour changes on the girl's return could be an indication that a girl has recently undergone FGM;
• Professionals also need to be vigilant to the emotional and psychological needs of children who may/are suffering the adverse consequence of the practice (e.g. withdrawal, depression etc.);
• A child requiring to be excused from physical exercise lessons without the support of her GP;
• A child may ask for help.

Responding to FGM - referral to LA children's social care

5.14.13

Any information or concern that a child is at immediate risk of, or has undergone, female genital mutilation should result in a child protection referral to LA children's social care in line with section 6. Referral and assessment. See also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment. See also Safeguarding Children at Risk of Abuse through Female Genital Mutilation (London Board, 2007), appendices 1-4.

5.14.14

Where a child is thought to be at risk of FGM, practitioners should be alert to the need to act quickly - before the child is abused through the FGM procedure in the UK or taken abroad to undergo the procedure.

5.14.15

On receipt of a referral, a strategy meeting / discussion must be convened within two working days, and should involve representatives from the police, LA children's social care, education, health and third sector services.  Health providers or third sector organisations with specific expertise (e.g. FGM, domestic violence and / or sexual abuse) must be invited, and consideration may also be given to inviting a legal advisor.

5.14.16

Every attempt should be made to work with parents on a voluntary basis to prevent the abuse.  It is the duty of the investigating team to look at every possible way that parental co-operation can be achieved, including the use of community organisations and / or community leaders to facilitate the work with parents / family. However, the child's interest is always paramount.

5.14.17

If no agreement is reached, the first priority is protection of the child and the least intrusive legal action should be taken to ensure the child's safety.

5.14.18

If the strategy meeting / discussion decides that the child is in immediate danger of mutilation and parents cannot satisfactorily guarantee that they will not proceed with it, then an emergency protection order should be sought.

5.14.19

If the child has already undergone FGM, the strategy meeting / discussion will need to consider carefully whether to continue enquiries or whether to assess the need for support services. If any legal action is being considered, legal advice must be sought.

5.14.20

A child protection conference should only be considered necessary if there are unresolved child protection issues once the initial investigation and assessment have been completed.

5.14.21

Where FGM has been practiced, the police child abuse investigation team (CAIT) will take a lead role in the investigation of this serious crime, working to common joint investigative practices and in line with strategy agreements.

Responding to FGM - the role of health

5.14.22

Health professionals in GP surgeries, sexual health clinics and maternity services are the most likely to encounter a girl or woman who has been subjected to FGM.

5.14.23

Health professionals encountering a girl or woman who has undergone FGM should be alert to the risk of FGM in relation to her:

• Younger siblings;
• Daughters or daughters she may have in the future;
• Extended family members.

5.14.24

All girls / women who have undergone FGM (and their boyfriends / partners or husbands) must be told that re-infibulation is against the law and will not be done under any circumstances. Each woman should be offered counselling to address how things will be different for her afterwards.

5.14.25

After childbirth, a girl / woman who has been de-infibulated may request and continue to request re-infibulation. This should be treated as a child protection concern, as the girl / woman's apparent reluctance to comply with UK law and / or consider that the process is harmful raises concerns in relation to girl child/ren she may already have or may have in the future. Professionals should consult with their agency's nominated safeguarding children adviser and with LA children's social care about making a referral to them (see sections 5.14.13 to 5.14.21 above).

5.14.26

See also the BMA guidance: FGM: Caring for patients and child protection.

Reducing the prevalence of FGM

5.14.27

Local Safeguarding Children Boards should promote awareness in the local area, particularly amongst local communities which practice FGM, that female genital mutilation is abusive to children and not legal in the UK.

5.14.28

See the Local Authority Social Services Letter LASSL (2004)4 for details of organisations able to advise on this form of community outreach work.

5.14.29

See also section 5.48. Accessing information from abroad.

5.15.1

Fireplay and firesetting behaviour by a child must always be taken seriously, because it can put a child at risk of significant harm:

• There is a very real risk of possible death and injury; and
• When a child sets fires, it may indicate that they are at risk of, or experiencing, serious mental or emotional harm (see section 4.3. Recognition of abuse and neglect).

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful there needs to be compulsory intervention by child protection agencies in the life of the child and their family.

5.15.2

Consideration should be given to undertaking a common assessment and / or making a referral to LA children's social care and the police, in line with section 6. Referral and assessment, depending on the seriousness of the firesetting incident/s.

5.15.3

Several factors may lead to firesetting:

• Curiosity;
• A cry for help;
• Lack of parental control;
• Serious emotional disturbance, which may be related to abuse and neglect.

5.15.4

Whilst all groups of children may become involved in firesetting, boys, children in one-parent families, and looked after children are over-represented.

5.15.5

Issues for consideration in an assessment include the child's development needs, stressful environment factors, the degree of guidance and boundaries the child is receiving or is willing to accept, basic care and ensuring safety (e.g. where a young child can access matches and lighters).

5.15.6

All professionals should discuss their concerns with their line manager and their agency's nominated safeguarding children adviser.

5.15.7

The London Fire Brigade's Juvenile Firesetters Intervention Scheme is available by referral from the family or professionals. The scheme takes an educational approach with children and their parents, and can help identify the cause of the behaviour. It works across the spectrum from curiosity fireplay in young children to arson in older children.

5.16.1

Hundreds of people in the UK (particularly girls and young women), some as young as nine, are forced into marriage each year. A 'forced' marriage, as distinct from a consensual 'arranged' one, is a marriage conducted without the full consent of both parties and where duress is a factor. Duress cannot be justified on religious or cultural grounds.

5.16.2

In 2004, the Government's definition of domestic violence was extended to include acts perpetrated by extended family members as well as intimate partners. Consequently, acts such as forced marriage and so-called 'honour crimes' (which can include abduction and homicide) now come under the definition of domestic violence.

Recognition

5.16.3

A child who is being forced into marriage is at risk of significant harm through physical, sexual and emotional abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.16.4

The majority of forced marriages reported to date in the UK have involved families from South Asia; other communities in which there have been cases include Europe, East Asia, the Middle East and Africa. Some forced marriages take place in the UK with no overseas element, while others involve a partner coming from overseas or a British national being taken abroad.

5.16.5

The reasons given by parents who force their children to marry include protecting their children, building stronger families, strengthening family links, protecting family honour (e.g. promiscuity or homosexuality), retaining or acquiring wealth, appeasement etc.

5.16.6

Suspicions that a child may be forced into marriage may arise in a number of ways, including:

• A family history of older siblings leaving education early and marrying early;
• Depressive behaviour including self-harming and attempted suicide;
• Unreasonable restrictions such as being kept at home by their parents ('house arrest') or being unable to complete their education;
• A child being in conflict with their parents;
• A child going missing / running away;
• A child always being accompanied including to school and doctors' appointments;
• A child talking about an upcoming family holiday that they are worried about, fears that they will be taken out of education and kept abroad, or
• A child directly disclosing that they are worried s/he will be forced to marry.

5.16.7

Information about a forced marriage may come from one of the child's peer group, a relative or member of the child's local community, from another professional or when other family issues are addressed, such as domestic violence between parents.

Response

5.16.8

Situations where a child fears being forced into marriage have similarities with both domestic violence and honour based violence.  Forced marriage may involve the child being taken out of the country (trafficked) for the ceremony, is likely to involve non-consensual and/or underage sex, and refusal to go through with a forced marriage has sometimes been linked to so-called 'honour killing'.

5.16.9

Professionals should respond in a similar way to forced marriage as with domestic violence and honour based violence (i.e. in facilitating disclosure, developing individual safety plans, ensuring the child's safety by according them confidentiality in relation to the rest of the family, completing individual risk assessments etc). See section 5.12. Domestic violence and section 5.22. Honour based violence.

5.16.10

The needs of victims of forced marriage will vary widely. The child may need help avoiding a threatened forced marriage, or help dealing with the consequences of a forced marriage that has already taken place.

5.16.11

Where a suspicion or allegation of forced marriage or intended forced marriage is raised, there may be only one opportunity to speak to a potential victim, so an appropriate initial response is vital. The professional should:

• See the child immediately in a secure and private place;
• See the child on their own;
• Explain to the child the limits of confidentiality;
• Tailor their approach according to whether the child is already married or is at risk of being married
• Gather as much information as possible (e.g. the details of  a the plan to force the child to marry, including a traceable address overseas) as a victim may never be seen again.
• Encourage and/or help the child to complete a personal risk assessment (see the proformas in the supplementary London procedure Safeguarding Children Abused Through Domestic Violence);
• Develop an emergency safety plan with the child;
• Explain all the options to the child (starting with the fact that forced marriage is illegal in the UK) and recognise and respect the child's wishes. If the child does not want LA children's social care to intervene, the professional will need to consider whether the child's wishes should be respected or whether the child's safety requires that further action be taken. This requires the professional to make an assessment of the risk of harm facing the child;
• Agree a means of discreet future contact with the child;
• Contact, as soon as possible, the agency's nominated safeguarding children adviser, who should be involved in the assessment of risk;
• Record all discussions and decisions (including rationale if no decision is made to refer to LA children's social care).

5.16.12

The professional or their agency's nominated safeguarding children adviser should contact the Forced Marriage Unit where experienced caseworkers will be able to offer support and guidance, on 020 7008 0151 or through www.fco.gov.uk/forcedmarriage.

5.16.13

Professionals should not:

• Minimise the potential risk of harm
• Approach or inform the child's family, friends or members of the community that the victim has sought help as this is likely to increase the risk to the victim significantly. For example attempting to mediate could
• Share information outside child protection information-sharing protocols without the express consent of the child;
• Attempt to be a mediator. This has in the past resulted in the victim being removed from the country and not traced /or murdered.

5.16.14

Where a conclusion is reached that a child is at risk of harm, the professional should make a referral to LA children's social care in line with section 6. Referral and assessment and, if the situation is acute, the appropriate police child abuse investigation team (CAIT). See also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

Considerations for all agencies   

5.16.15

When dealing with allegations of forced marriage, all professionals should:

• Keep information from case files and databases strictly confidential, and preferably restricted to named members of staff only;
• Consider, with their managers, staff safety when visiting the family home and any other settings (see section 10. Working with unco-operative families);
• Get as much information as possible when a case is first reported, as there may not be another opportunity for the individual reporting to make contact - particularly if the child is going overseas;
• When referring a case of forced marriage to other agencies, ensure they are capable of handling the case appropriately. If in doubt, consider approaching established women's groups who have a history of working with survivors of domestic violence and forced marriage and ask these groups to refer them to reputable agencies;
• Recognise the police responsibility to initiate and undertake a criminal investigation as appropriate;  

Action by LA children's social care

5.16.16

LA children's social care should respond in line with the relevant sections of these procedures (see section 6. Referral and assessment, including section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment). In an acute situation, LA children's social care should convene an immediate strategy meeting / discussion and proceed accordingly. See section 7. Child protection enquiries.

5.16.17

Local Safeguarding Children Boards should promote awareness in the local third sector agencies and faith communities that forced marriage is abusive to children and not legal in the UK. Where a case of forced marriage has resulted in the serious harm of a child or young person, practitioners should also consider undertaking a Serious Case Review.

Criminal Justice disposals

5.16.18

Although there is no specific criminal offence in England and Wales of 'forcing someone to marry', criminal offences may nevertheless be committed. Perpetrators - usually parents or family members - could be prosecuted for offences including threatening behaviour, assault, kidnap, abduction, theft (of passport), threats to kill, imprisonment and murder. Sexual intercourse without consent is rape, regardless of whether this occurs within a marriage or not. A woman who is forced into marriage is likely to be raped and may be raped until she becomes pregnant.

5.16.19

Anyone threatened with forced marriage or forced to marry against their will can apply for a Forced Marriage Protection Order. Third parties, such as relatives, friends, voluntary workers and police officers, can also apply for a protection order with the leave of the court. Fifteen county courts deal with applications and make orders to prevent forced marriages. Local authorities can now seek a protection order for vulnerable adults and children without leave of the court. Guidance published by the Ministry of Justice explains how local authorities can apply for protection orders and provides information for other agencies. - [This is available at www.justice.gov.uk/guidance/forced-marriage.htm]

National guidelines

5.16.20

Government guidelines for responding to forced marriage situations are available at: the Department of Education website.

5.16.21

The Association of Chief Police Officers of England Wales and Northern Ireland (ACPO) guidelines for the police for responding to forced marriage situations are available at www.acpo.police.uk.

5.16.22

LA children's social care should report details of the case, with full family history, to the Community Liaison Unit at the Foreign and Commonwealth Office.

5.16.23

The Right to Choose: Multi-agency statutory guidance for dealing with forced marriage. This statutory guidance sets out the responsibilities of Chief Executives, directors and senior managers.

In addition, all practitioners working with children should have access to Multi-agency practice guidelines: Handling cases of Forced Marriage, published in 2009.

There is also Guidance for local authorities on applying for forced marriage protection orders and information for other agencies at: Forced marriage guidance for local authorities and relevant third parties.

5.16.24

Local Safeguarding Children Boards should promote awareness in the local third sector agencies and faith communities that forced marriage is abusive to children and not legal in the UK. Where a case of forced marriage has resulted in the serious harm of a child or young person, practitioners should also consider undertaking a Serious Case Review.

5.17.1

Children on foreign exchange visits and in some language schools stay with families selected by the school (or hosting organisation) in the host country and are vulnerable for reasons comparable to others living away from home (see section 5.18. Foster care). If there are lapses in the care provided for them, the child can suffer to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.17.2

Children may be at additional risk as the assessment and supervision that would apply if the child was privately fostered are not applicable because most exchanges last less than 28 days. It is unlikely the school (or hosting organisation) selecting the host family will have been able to conduct a thorough assessment of the suitability of the host family.

5.17.3

Advice and assistance can be given by the LA children's social care to schools wishing to conduct more thorough assessments, for example the host family could be asked to give consent for checks of the local children and family social care service database, and also for checks with other local agencies (for example with GPs).

5.17.4

In the event that a pupil's host family has been the subject of s47 enquiries, unless or until there is a satisfactory resolution of concerns, the family should be regarded by the UK school as unsuitable to receive or continue hosting a pupil from an overseas school.

5.17.5

UK schools and agencies should take reasonable steps to ensure that a comparable approach is taken by relevant schools abroad.

5.18.1

A child in foster care is vulnerable to physical, sexual or emotional abuse and / or neglect. If there are lapses in the care provided for them, the child can suffer to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.18.2

Children who are placed in local authority foster care should not be confused with children placed by their parents or carers in private foster care.  These children are not looked after by a local authority, although the local authority does have duties to assess the care they are receiving and if there are concerns about their welfare to consider what action to take. See section 5.37 Private fostering.

Good quality care

5.18.3

The welfare and safety of children living in foster care should be promoted and in accordance with the relevant National Minimum Standards (see www.ofsted.gov.uk).

5.18.4

All commissioners and providers of services for children living in foster care are responsible for ensuring children are safeguarded. Commissioner contracts and provider procedures should be comprehensive and unambiguous in setting out the responsibilities and processes for safeguarding and promoting children's welfare. Local Safeguarding Children Boards should monitor the welfare of children living in foster care. See section 18. LSCBs, quality assurance and conflict resolution.

5.18.5

The standards for children living in foster care include that:

• Children feel valued and respected and their self-esteem is promoted;
• There is an openness on the part of the fostering service and the foster carers to the external world and external scrutiny, including contact with families and the wider community;
• Foster carers are trained in all aspects of safeguarding children, are alert to children's vulnerabilities and risks of harm, and are knowledgeable about how to implement safeguarding children procedures;
• Children who live in foster care are listened to and their views and concerns responded to;
• Children have ready access to a trusted adult outside the foster care setting (e.g. a family member, the child's social worker, independent visitor, children's advocate). Children should be made aware of the help they could receive from independent advocacy services, external mentors, and ChildLine (see section 2. Roles and responsibilities, 2.25.12 NSPCC);
• Foster carers recognise the importance of ascertaining the wishes and feelings of children and understand how individual children communicate by verbal or non-verbal means;
• The foster carer is aware of the procedures for referring safeguarding concerns about a child to the relevant LA children's social care service;
• In relation to complaints:
  • complaints procedures should be clear, effective, user friendly and readily accessible to children and young people, including those with disabilities and those for whom english is not their preferred language
  • procedures should address all expressions of concern, including formal complaints. systems that do not promote open communication about 'minor' complaints will not be responsive to major ones, and a pattern of 'minor' complaints may indicate more deeply seated problems in management and culture which need to be addressed
  • records of complaints should be kept by providers of children's services (e.g. there should be a complaints register in every boarding school which records all representations including complaints, the action taken to address them, and the outcomes)
  • children should be genuinely able to raise concerns and make suggestions for changes and improvements, which are taken seriously
    
    See section 18. LSCBs, quality assurance and conflict resolution.
• Bullying is effectively countered (see section 5.7. Bullying);
• Recruitment and selection procedures for local authority foster carers are rigorous and create a high threshold of entry to deter abusers (see section 17. Safer recruitment);
• There is effective supervision and support, which extends to temporary or back-up carers, fostering service staff and volunteers (see section 16. Supervision and training);
• Clear procedures and support systems are in place for dealing with expressions of concern by foster carers and fostering service staff about other staff or carers (see section 15. Allegations against staff);
• Organisations should have a code of conduct instructing foster carers and fostering service staff on their duty to their employer and their professional obligation to raise legitimate concerns about the conduct of colleagues or managers.  There should be a guarantee that procedures can be invoked in ways which do not prejudice the 'whistle-blower's' own position and prospects;
• There is respect for diversity and sensitivity to race, culture, religion, gender, sexuality and disability;
• Foster carers and fostering service staff are alert to the risks of harm to children in the external environment from people prepared to exploit the additional vulnerability of children living away from home.

Promoting and protecting a child's welfare

5.18.6

Foster care is undertaken in the private domain of carers' own homes. It is important that children have a voice outside the family. Social workers are required to see children in foster care on their own (taking appropriate account of the child's wishes and feelings) at regular intervals and evidence of this should be recorded.

5.18.7

Foster carers should be provided with full information about the foster child and their family, including details of abuse or possible abuse and whether the child has harmed others, both in the interests of the child and of the foster family.

5.18.8

Foster carers should monitor the whereabouts of their foster children, including their patterns of absence and contacts. Foster carers should follow the recognised procedure of their agency on sharing general concerns about a child, and whenever a foster child is missing from their home. This will involve notifying the placing authority and, where necessary, the police of any unauthorised absence by a child. See section 5.29. Missing from care and home.

5.18.9

Foster carers should have guidance on sharing more general concerns (e.g. alerting other professionals, considering child behaviour around contact, absences, school, moods etc.).

5.18.10

The local authority's duty to undertake s47 enquiries, when there is reasonable cause to suspect that a child is suffering, or is likely to suffer, significant harm, applies on the same basis to children in foster care as it does to children who live with their own families.

5.18.11

Such enquiries will consider the safety of any other children living in the household, including the foster carers' own children. If child protection concerns are raised about the care that a foster carer is giving to a child, the local authority in which the child is living has the responsibility to convene a strategy meeting / discussion, which should include representatives from the responsible local authority that placed the child; a representative from Ofsted should also be invited. At the strategy meeting / discussion, it should be decided which local authority should take responsibility for the next steps, which may include a s47 investigation.

For further details on this see section 15. Allegations against staff, section 6. Referral and assessment, including section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment; and section 7. Child protection enquiries.

5.18.12

See section 8. Child protection conferences.

5.19.1

The risk or potential risk of harm to the child may be as a victim, a perpetrator or both - in relation to their peers or to a gang-involved adult in their household.

5.19.2

A child who is affected by gang activity or serious youth violence can be at risk of significant harm through physical, sexual and emotional abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection.

Definition of a gang

5.19.3

Groups of children often gather together in public places to socialise, and peer association is an essential feature of most children's transition to adulthood. Groups of children can be disorderly and/or anti-social without engaging in criminal activity.

5.19.4

Defining a gang is difficult, however it can be broadly described as a relatively durable, predominantly street-based group of children who see themselves (and are seen by others) as a discernible group for whom crime and violence is integral to the group's identity.

5.19.5

Children may be involved in more than one 'gang', with some cross-border movement, and may not stay in a 'gang' for significant periods of time. Children rarely use the term 'gang', instead they used terms such as 'family', 'breddrin', 'crews', 'cuz' (cousins), 'my boys' or simply 'the people I grew up with'.

5.19.6

Definitions may need to be highly specific to particular areas or neighbourhoods if they are to be useful. Furthermore, professionals should not seek to apply this or any other definition of a gang too rigorously; if a child or others think s/he is involved with or affected by 'a gang', then a professional should act accordingly.

5.19.7

Violence is a way for gang members to gain recognition and respect by asserting their power and authority in the street, with a large proportion of street crime perpetrated against members of other gangs or the relatives of gang members.

5.19.8

Youth violence, serious or otherwise, may be a function of gang activity. However, it could equally represent the behaviour of a child acting individually in response to his or her particular history and circumstances.

5.19.9

The Metropolitan Police Service defines serious youth violence as is 'any offence of most serious violence or weapon enabled crime, where the victim is aged 1-19' i.e. murder, manslaughter, rape, wounding with intent and causing grievous bodily harm. 'Youth violence' is defined in the same way, but also includes assault with injury offences.

5.19.10

The factors which influence a child's propensity to initiate violence include:

• Parenting which is cold / uncaring, non-nurturing and neglectful;
• Parenting which includes harsh disciplining;
• Maltreatment, such as physical or sexual abuse in childhood (abuse by adults and peers within and outside of the family); and/or
• Trauma such as domestic violence or involvement in or witnessing conflict violence (see also the London procedure for Safeguarding children abused through domestic violence, London Board, 2008).

5.19.11

One factor which influences a child's propensity to imitate violence is:

• Parenting which is permissive and neglectful, resulting in a lack of guidance and creating ineffectiveness and poor self-control for a child. The child is then not equipped to resist an environment or group which instigates violence.

Community and family circumstances

5.19.12

Circumstances which can foster the emergence of gangs include:

• Areas with a high level of social and economic exclusion and mobility (which weakens the ties of kinship and friendship and the established mechanisms of informal control and social support);
• Areas made up of predominantly social housing, and especially where it is high rise / high density social housing. There is a perfect correlation in London with 'gang neighbourhoods' and being amongst the 20% most deprived government lower level super output areas (based on the Indices of Multiple Deprivation 2007);
• Areas with poor performing schools - in terms of leadership, positive ethos, managing behaviour and partnership working;
• Lack of access to pro-social activities (e.g. youth service) and to vocational training and opportunities;
• Communities who have experienced war situations prior to arrival in the UK;
• Areas with a high level of gang activity / peer pressure and intimidation, particularly if the family is denying this or is in fear of the gangs; and
• Family members involved in gang activity and criminality.

5.19.13

Many parents are aware of the widespread perception that the gang problem is ultimately a product of poor parenting and that the solution lies in assuming responsibility for their children. However, they feel unable either to control or to protect their children.

5.19.14

Fear and a need for self-protection is a key motivation for children to carry a weapon - it affords a child a feeling of power. Neighbourhoods with high levels of deprivation and social exclusion generally have the highest rates of gun and knife crime. Children are more likely to carry knives and other weapons than guns.

5.19.15

Professionals working with children who may have reason to be fearful in their neighbourhood or school / FE college should be alert to the possibility that a child may carry a weapon. See sections 10.7. Keeping professionals safe and 10.8. Management responsibility, and 2.10.38 Screening and searching pupils for weapons in schools.

Girls & sexual exploitation

5.19.16

There is evidence of a high incidence of rape of girls who are involved with gangs. Some senior gang members pass their girlfriends around to lower ranking members and sometimes to the whole group at the same time.  Very few rapes by gang members are reported,

5.19.17

Gang members often groom girls at school using drugs and alcohol, which act as disinhibitors and also create dependency , and encourage / coerce them to recruit other girls through school / social networks.

5.19.18

See also the London procedure for safeguarding sexually exploited children (London Board, 2006); and the London procedure for safeguarding trafficked and sexually exploited children (London Board, 2006).

Professional response

5.19.19

The London supplementary procedure for Safeguarding children affected by gangs and serious youth violence (2009) details a professional response and risk assessment framework for children affected by gangs and serious youth violence. See also sections 5.20 Harming others and 13. Risk management of known offenders.

5.19.20

Professionals should always take what the child tells them seriously. They should assess this together with the child's presenting behaviours in the context of whatever information they know or can gather from the child about the risk factors described in the risk assessment framework for children affected by gangs and serious youth violence.

5.19.21

Potentially a child involved with a gang or with serious violence could be both a victim and a perpetrator. This requires professionals to assess and support his/her welfare and well-being needs at the same time as assessing and responding in a criminal justice capacity.

5.19.22

Local authorities are recommended to nominate a local professional who can develop specialist knowledge in relation to gangs and serious youth violence to act as an adviser to other professionals in cases where there are concerns that a child is/could be affected by gangs and/or serious youth violence.

5.19.23

If a professional is concerned that a child is at risk of harm as a victim or a perpetrator of serious youth violence, gang-related or not, the professional should:

• Wherever possible, consult with their agency's nominated safeguarding children adviser, their manager and, if available, the local multi-agency gang intelligence forum and/or professional with specialist knowledge in relation to gangs;
• Consider section 5.20 Harming others; and
• If the threshold is met for significant harm, then a referral must be made to LA children's social care, in line with sections 6. Referral and assessment.

Looked after children

5.19.24

Looked after children are particularly vulnerable to being affected by gangs and serious youth violence due to their low self-esteem, low resilience, attachment issues and the fact that they are often isolated from family and friends. Looked after children say that bullies, gangs and the risk of serious youth violence are the worst thing about where they live.

Agency responses

5.19.25

LA children's social care professionals need to be alert to the possibility that a child referred to them or a child they are already working with may, in addition to any of the child's other presenting issues, be or become vulnerable to / involved with, a gang or serious youth violence.

5.19.26

A high proportion of gang-involved children are known to Yots and a recent UK study findings were that almost two thirds of a sample of active gang members interviewed had been permanently excluded from school.

5.19.27

The police, especially safer neighbourhood policing teams, should be aware of siblings or other children living in households which are affected by gang activity and/or serious youth violence, including parents as adult gang members, and should share this information internally with child abuse investigation teams and externally with LA children's social care at the earliest opportunity.

5.19.28

If the police give an Osman Warning - [The Osman v United Kingdom case (1998) placed a positive obligation on the authorities to take preventive measures to protect an individual whose life is at risk from the criminal acts of another individual e.g. where a gang member threatens to kill another gang member] - to a child they should inform LA children's social care at the earliest opportunity.

5.19.29

Schools affected by gang issues and potential or actual serious youth violence will need to work in partnership with the police (the Safer Neighbourhoods Policing Team), Yots and LA children's social care. Safer school partnerships can be an effective forum for this multi-agency working.

5.19.30

Community groups / third sector agencies can be well placed to know the profile and location of local gang activity and potential or actual serious youth violence through their community links.

5.19.31

See also: Safeguarding Children and young People who may be affected by Gang Activity (DCSF, 2010).

Violent extremism

5.19.32

Particularly from their teenage years onwards children can be vulnerable to getting involved with radical groups through direct contact with members or, increasingly, through the internet. This can put the child at risk of being drawn in to criminal activity and has the potential to cause significant harm.

Prevention

5.19.33

Channel forms part of the cross-Government Prevent Strategy to stop people becoming terrorists or supporting violent extremism. Channel is the mechanism for making referrals and accessing support for children (and adults) at risk of violent extremism. Channel guidance states that if a referred individual is under the age of 18 the Channel co-ordinator must liaise with the common assessment framework (CAF) co-ordinator or LA children's social care service (the latter should be represented on the Prevent partnership and multi-agency Channel panel) to agree how best to manage the case.

5.19.34

Following initial discussion a decision needs to be made on how to progress the case (e.g. as a safeguarding issue, under Channel, CAF, or another support process) and establish how this will be reviewed. This decision can be taken on a case by case basis or a decision can be made by all local partners to use one particular system for the referral of all children.

5.19.35

If an area does not have Channel, local areas should incorporate referrals of children within local CAF and safeguarding procedures i.e. in line with section 6. Referral and assessment.

5.19.36

See the Prevent Strategy at www.dcsf.gov.uk/violentextremism . Also the Channel guidance.

There is a toolkit for schools available at Learning together to be safe: A toolkit to help schools contribute to the prevention of violent extremism

5.19.37

Local strategic partnerships, children's trusts or equivalent and crime and disorder partnerships, advised by LSCBs, should have an agreed processes in place for safeguarding children vulnerable to gangs, serious youth violence and violent extremism. Local safeguarding strategies should:

• Promote awareness of the relationship between 'good enough' parenting and aggression in children, and
• Promote early years service-led parenting support;
• Promote capacity-building in the community for parental self-help groups to educate and support 'good enough' parenting; and
• Promote targeted youth support, re-engagement and participation.

5.20.1

The harm caused to children by the harmful and bullying behaviour of other children can be significant (see section 4.3. Recognition of abuse and neglect). This may involve single incidents or ongoing physical, sexual or emotional (including verbal) harm perpetrated by a single child or by groups / gangs of children.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.20.2

In addition, children of both genders can direct physical, sexual or emotional violence towards their parents, siblings and / or partner.

5.20.3

Such abuse should be subject to the same safeguarding children procedures as apply in respect of children being abused by an adult. Children who harm others should be held responsible for their harmful behaviour and professionals responding to them should be alert to the fact that they are likely to pose a risk to children other than the current victim.

5.20.4

Children who harm others are likely to have considerable needs themselves.  Evidence suggests these children may have suffered significant disruption in their lives, been exposed to violence within the family, may have witnessed or been subject to physical or sexual abuse, have problems in their educational development and may have committed other offences.

See also section 5.7 Bullying, and 2.10.38. Screening and searching pupils for weapons.

Recognition and referral of abuse

5.20.5

Professionals must base their decision on whether behaviour directed at another child should be categorised as harmful or not on the circumstances of each case.  It will be helpful to consider the following factors:

• The relative chronological and developmental age of the two children (the greater the difference, the more likely the behaviour should be defined as abusive);
• Whether the alleged abuser is supported or joined by other children;
• A differential in power or authority (e.g. related to race, gender, physical, emotional or intellectual vulnerability of the victim);
• The actual behaviour (both physical and verbal factors must be considered);
• Whether the behaviour could be described as age appropriate or involves inappropriate sexual knowledge or motivation;
• The degree of physical aggression, intimidation or bribery;
• The victim's experience of the behaviour and the impact it is having on their routines and lifestyle (e.g. not attending school, see section 5.30. Not in school);
• Attempts to ensure secrecy;
• Duration and frequency of behaviour

5.20.6

All professionals should make a referral to LA children's social care in line with section 6. Referral and assessment when there is a suspicion or an allegation of a child:

• Having been seriously physically abused or being likely to seriously physically abuse another child or an adult;
• Having been seriously emotionally abused or being likely to seriously emotionally abuse another child or an adult;
• Having harmed another child or an adult.

Sexual abuse and serious physical and emotional abuse

5.20.7

These procedures are written with particular reference to sexually harmful behaviour, though when there are serious child protection concerns as a result of serious non-sexual violence or serious emotional abuse by a child or children, these procedures should also be followed.

5.20.8

Whenever a child may have harmed another, all agencies must be aware of their responsibilities to both children and multi-agency management of both cases must reflect this.

5.20.9

The interests of the identified victim must always be the paramount consideration.

5.20.10

It is possible that the child with harmful behaviours may pose a significant risk of harm to their own siblings, other children and / or adults.  The child will have considerable needs themselves, and may also be or have been the victim of abuse.

Strategy meeting / discussion

5.20.11

When any agency makes a referral to LA children's social care about a child who has been or is a victim of abuse, an initial strategy meeting / discussion must take place between LA children's social care, the police and other relevant agencies to share the information and determine whether the threshold for s47 enquiries has been reached. See section 6. Referral and assessment, including section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment; and section 7. Child protection enquiries.

5.20.12

Where the suspected abuser is a child, a similar strategy meeting / discussion (usually meeting) should be convened within the appropriate Government prescribed timescales, involving the police and LA children's social care. See section 6. Referral and assessment and section 7. Child protection enquiries.

5.20.13

When the children concerned are the responsibility of different LA children's social care services, each local authority service must be represented at the strategy meeting / discussion, which will usually be convened and chaired by the LA children's social care for the local authority in which the victim lives.

5.20.14

Different social workers should be allocated for the child who is the victim and the child who has harmed, even when they remain living in the same household, to ensure both are supported through the process of the enquiry and that each child's needs are fully assessed and met.

5.20.15

The strategy meeting / discussion should be convened and chaired by LA children's social care and a record made. The following individuals should be invited to the meeting:

• Social worker for the child who is suspected or alleged to have harmed another child / adult;
• Social worker for the child/ren alleged to have been abused;
• Social workers' first line manager;
• Police;
• Youth Offending Team representative, where the child who is alleged to have caused the harm is aged eight or over;
• School representative/s (particularly if the concerns suggest that other children in the school setting have been or may be at risk of being abused);
• School nurse or other health services staff, as required;
• Child and adolescent mental health services (CAMHS) representative;
• Representatives of fostering or residential care, as applicable;
• Consideration should also be given to inviting a local specialist third sector agency and any other professional or agency involved with the child alleged to have caused the harm.

5.20.16

The meeting must plan in detail the respective roles of those involved in the enquiries and ensure the following objectives are met:

• The safety of all children concerned, with particular attention needing to be paid to living and contact arrangements while concerns are being investigated;
• Information relevant to the protection needs of the alleged victim is gathered;
• Any criminal aspects of the abuse are investigated;
• Any information relevant to abusive experiences and protection needs of the child who has harmed is gathered.

5.20.17

In planning the investigation, the following factors should be considered:

• Age of all children and adults who may be involved (both victims and children who have harmed);
• Whether the child who harmed was/is supported by other children;
• Seriousness of the alleged incident;
• Effect on the victim/s and their own view of their safety;
• The victim's parents' attitude and ability to protect their child/ren;
• The abuser's parents' response to their child's behaviour;
• Whether there is a suspicion that the child who is alleged to have harmed has also been abused;
• Whether there is reason to suspect that adults are also involved;
• The likelihood and desirability of criminal prosecutions taking place;
• The level of ability of the child and any communication problems that they may have;
• The mental state of the child and their capacity to be interviewed.

5.20.18

Where there is a suspicion that the child is both an abuser and a victim of abuse, the strategy meeting / discussion must decide the order in which any interviews will take place.

5.20.19

In boroughs which have a Youth Inclusion Support Panel (YISP), consideration should be given to referring unconvicted children aged 8 and above to it.

Criminal investigation

5.20.20

The police will decide whether an alleged offence should be subject to criminal investigation. Such allegations may not be the responsibility of the police Child Abuse Investigation Team (CAIT) but where they are, the police CAIT manager will decide whether or not to investigate. The police CAIT will maintain responsibility in cases where there is a familial connection between the young people or children concerned.

5.20.21

From the perspective of the criminal investigation, when a child aged ten or over is alleged to have committed an offence, the first interview with them must be undertaken by the police (i.e. it will be a recorded interview held in a police station, under caution and with parent or another appropriate adult present).

5.20.22

On occasion, this approach may not be in the best interests of the overall management of the investigation or of the welfare of the children involved.  In these circumstances, the police may agree that it would be preferable for a LA children's social worker (and other professionals as appropriate) to interview the child as a potential victim of abuse. This should only be the case where explicit police agreement has been obtained to this course of action.

5.20.23

Where police decide to conduct a separate 'offender' interview, a social worker or other agency professional (subject to local arrangements) should be involved in the interview, to perform the statutory responsibility to the child/ren of an appropriate adult.

5.20.24

If during the course of being interviewed as a victim of, or witness to, alleged abuse, a child discloses offences that they have committed or been subjected to, these incidents should normally be the subject of a separate interview as detailed in Achieving Best Evidence 2.151 - 2.154.

5.20.25

Throughout the enquiry, the immediate protection of all child/ren involved must be ensured.

5.20.26

Where a decision is reached that the alleged behaviour does not constitute abuse and there is no need for further enquiry or criminal investigation, the details of the referral and the reasons for the decision must be recorded. In each case and in respect of each child involved or potentially involved, LA children's social care will determine whether or not an initial or core assessment of need is warranted.

Outcome of enquiries

5.20.27

The outcome of enquiries is as described in section 7. Child protection enquiries. However, the position of the alleged victim and the alleged abuser must be considered separately.

5.20.28

If the information gathered in the course of the enquiries suggests that the abuser is also a victim or potential victim of abuse (including neglect), a separate child protection conference must be convened for him or her.

5.20.29

Where there are no grounds for a child protection conference, but concerns remain regarding the child's sexually / physically / emotionally harmful behaviour, they should be considered as a child in need. In such cases, a multi-agency planning meeting should be held and a plan for the provision of services for the child and his / her family agreed. Service provision should:

• Be informed by an assessment of the child's needs and the risk they pose to others;
• Set out who will have responsibility for what actions, including what course of action should be followed if the plan is not being successfully implemented; and
• Include a timescale for review of progress against planned outcomes.

Family Group Conferences may have a role to play in fulfilling these tasks. For information about Family Group Conferences see: Family Group Conferences: Principles and Practice Guidance (2002, Barnardo's / Family Rights Group / NCH).

Child protection conference

5.20.30

Consideration should be given to inviting a Youth Offending Team (Yot) representative to the conference of any child/ren aged eight or over presenting harmful behaviours, and informing the local Yot of the meeting in cases of younger children.

5.20.31

In addition to carrying out the usual functions, the child protection conference must consider how to respond to the child's needs as a possible abuser.

5.20.32

Where the alleged abuser is not deemed to require a protection plan to protect them, consideration should be given to the need for services to address any abusive behaviour and the multi-agency responsibility to manage any risk, through the use of multi-agency planning meetings.

Criminal proceedings

5.20.33

The decision as to how to proceed with the criminal aspects of a case will be made by the police and the Crown Prosecution Service. The police must operate in accordance with the duty to seek to investigate and prosecute all crimes. Agencies working with young offenders should ensure that actions by staff do not undermine the need to ensure a criminal conviction if the substance of the allegation so warrants it.

Multi-agency planning meetings

5.20.34

Children who are victims and those who are abusers are likely to have complex needs requiring a multi-agency response. Therefore, in cases where there are no grounds for holding a child protection conference, or where one has been held but a protection plan did not result, a multi-agency meeting should be convened to plan multi-agency services for a child in need.

5.20.35

It is not envisaged that universal services would be able to deal with such a degree of complexity through the processes associated with the Common Assessment Framework (CAF).

5.20.36

These multi-agency meetings should not be confused with the borough Multi-Agency Public Protection Arrangements (MAPPA), in which arrangements are made to protect the community from known potentially dangerous offenders.  However, the local co-ordinator for the MAPPA in either the police or probation service must be advised of concerns posed by young abusers, especially where the abuser has been cautioned or convicted, in which latter case the local Youth Offending Team (Yot) will also become involved. See section 13.7 for risk management of adult sexual and violent offenders under the MAPPA.

5.20.37

For each child (the victim and the child with harmful behaviours), a multi-agency planning meeting should be convened by LA children's social care to:

• Share information;
• Agree to undertake:
  • An assessment of the needs of the victim/s;
  • An assessment of the needs and risks posed by the child with harmful behaviours;
• Agree to refer for a specialist assessment for either child, as required;
• Set a timetable for both assessments;
• Co-ordinate interim:
  • Support for the victim/s;
  • Risk management for the child with harmful behaviours;
• Allocate agency and professional roles, including which agency will take responsibility for the interim risk management plan.

5.20.38

Those invited should include participants of the strategy meeting / discussion and representatives from health, including child and adolescent mental health services (CAMHS), the school and any other professionals with relevant knowledge of the child and their parent/s.

5.20.39

On completion of the assessments, the multi-agency meeting should be reconvened for each child to consider the outcome, and to review and co-ordinate the roles of relevant agencies in providing identified interventions, including a risk management plan and specialist input for children with special needs.

5.20.40

It should be clear which agency is responsible for the risk management plan for a child with harmful behaviours. The plan should always address the risk to other children wherever the child spends time, including at school and within or near to the home address or placement whenever a child is looked after by a local authority. A plan must be in place to minimise risk of future offending.

5.20.41

Both the risk management plan and support for a child who is the victim should be reviewed at regular multi-agency meetings. The Chair of the multi-agency meeting should decide the frequency of the review meetings according to each child's needs / risk. At the point of closure, the review must consider the possible need for long term monitoring and the availability of advice and other services.

Children moving into or re-entering a local authority area

5.20.42

Children with inappropriate sexual or very violent behaviour who are re-entering the community following a custodial sentence or time in secure accommodation, or who move into an area from another local authority, require the multi-agency response (assessment / intervention) described in sections 5.20.34 to 5.20.41 above. The response should be initiated at the earliest opportunity.

5.20.43

Where a child who has been convicted of sexual offences involving the abuse of other children is released into the community, the Multi-Agency Public Protection Arrangements (MAPPA) must be invoked to ensure the safety of the community, in line with section 13.7 risk management of adult sexual and violent offenders under the MAPPA.

Carrying of offensive weapons and gangs

5.20.44

Offensive weapons are defined in the Prevention of Crime Act 1953 as 'any article made or adapted for causing injury to the person; or intended by the person having it with him for such use by him'. S139 and s139A of the Criminal Justice Act 1988 refer to 'any article which has a blade or point or is sharply pointed'. The only exceptions are small folding pocket knives where the blade is less than 3 inches long. But this exception does not of course prevent schools from imposing their own bans on pupils carrying such weapons. There are three categories of offensive weapons:

• 'Made' could include a dagger or gun;
• 'Adapted' could include a broken bottle; and
• 'Intended' for such use could include a rock or stone.

Clearly many articles are capable of being an offensive weapon, but in the latter category there would need to be evidence of an intention to use that particular article as a weapon.

5.20.45

Behavioural problems by a group of young people can impact upon a neighbourhood but does not necessarily mean that they are a gang. It is common practice for groups of young people to gather together in public places to socialise. Groups of young people can be disorderly and / or anti-social but not engage in criminal activity.

5.20.46

There are specific organised gangs who engage in criminal activity. Problems between gangs can be further enhanced by the use of 'gangs' websites where they publicise themselves.

5.20.47

Children who carry offensive weapons and / or are members of specific gangs (who engage in criminal activities) could place themselves and others at risk of significant harm.

5.20.48

Preventative work in relation to offensive weapons and gangs should be a key part of each LSCB's strategy, establishing safer environment by engaging with young people, challenging unacceptable behaviour, and helping young people develop respect for themselves and their community. Police, schools, Youth Offending Teams and other appropriate local agencies should mutually establish and develop strong partnerships and policies.

5.20.49

In 2007, the Department for Education and Skills (DfES) provided new guidance to schools on screening for offensive weapons, following the enactment of s45 of the Violent Crime Reduction Act 2006. See www.teachernet.gov.uk.

Children moving into or re-entering a local authority area

5.20.50

Children with inappropriate sexual or very violent behaviour who are re-entering the community following a custodial sentence or time in secure accommodation, or who move into an area from another local authority, require the multi-agency response (assessment / intervention) described in sections 5.20.34 to 5.20.41 above. The response should be initiated at the earliest opportunity.

5.20.51

Where a child who has been convicted of sexual offences involving the abuse of other children is released into the community, the Multi-Agency Public Protection Arrangements (MAPPA) must be invoked to ensure the safety of the community, in line with section 13.7 risk management of adult sexual and violent offenders under the MAPPA.

5.21.1

It is not unusual for people to disclose experiences of physical, sexual and / or emotional abuse and / or neglect which constitute significant harm (see section 4.3. Recognition of abuse and neglect) only when they reach adulthood.

Significant harm is defined in section 4. Recognition and response as a situation where as a child the person suffered a degree of physical, sexual and / or emotional harm (through abuse or neglect), which was so harmful that there should have been compulsory intervention by child protection agencies into the life of the child and their family.

5.21.2

Organisational responses to allegations by an adult of abuse experienced as a child must be of as high a standard as a response to current abuse because:

• There is a significant likelihood that a person who abused a child/ren in the past will have continued and may still be doing so;
• Criminal prosecution may be possible if sufficient evidence can be carefully collated.

5.21.3

Wherever historical abuse enquiries relate to alleged abuse within institutions such as children's homes or residential / boarding schools, professionals should follow the processes in section 14. Organised and complex abuse; and consult the Government guidance Complex Child Abuse Investigations: Inter-Agency Issues (Home Office and DH, 2002).

Required response

5.21.4

When an adult discloses childhood abuse, the professional receiving the information should record the discussion in detail. If possible, the professional should establish if the adult has any knowledge of the alleged abuser's recent or current whereabouts and contact with children.

5.21.5

In view of the potential continuing risk the alleged abuser may pose to children, the professional should make a referral to LA children's social care, in line with section 6. Referral and assessment.

5.21.6

The LA children's social worker receiving the referral should seek sufficient information to develop a chronology, and all records must be dated and the authorship made clear.

5.21.7

If information about the current whereabouts of the alleged abuser has not yet been gathered, LA children's social care should establish this as a matter of urgency.

5.21.8

The adult who has disclosed should be asked whether they want a police investigation and must be reassured that the police are able and willing to progress an investigation even for those adults who are vulnerable as a result of mental ill health or learning difficulties.

5.21.9

LA children's social care should reassure the adult that, even without their direct involvement, all reasonable efforts will be made to investigate the alleged abuse. LA children's social care should support the adult to access therapeutic or other services, as appropriate.

5.21.10

The LA children's social worker should:

• Inform the police at the earliest opportunity and establish if there is any information regarding the alleged abuser's current contact with children, irrespective of the wishes of the victim as to whether a police prosecution should take place;
• Inform the LA child protection adviser if the adult who has disclosed requests a police investigation or if the allegations involve organised and complex abuse (police involvement in an investigation will depend on a number of factors, including the victim's wishes and the public interest);
• Initiate a child protection enquiry if the alleged abuser is known to be currently caring for children or has access to children. This must include making a referral to LA children's social care in the area where the alleged abuser is currently living.

5.21.11

Where an adult alleges abuse in childhood in a different local authority area, the case should be transferred to agencies in the area where the abuse is alleged to have taken place. Parallel enquiries may be needed if the alleged abuser has contact with children elsewhere. The co-ordinating LA children's social care should be the one responsible for the geographical area where the abuse is alleged to have taken place.

5.21.12

Where the abuse is alleged in a former children's home or residential school, the responsible LA children's social care should be the one relating to the local authority responsible for running the establishment concerned, irrespective of where the children's home or residential / boarding school is / was located. It is important that there is effective communication about roles and responsibilities between agencies in such circumstances. See section 14. Organised and complex abuse; and consult the Government guidance Complex Child Abuse Investigations: Inter-Agency Issues (Home Office and DH, 2002).

5.21.13

The responsible police service for investigation will be the one covering the area where the alleged abuse is said to have taken place.

5.22.1

Honour based violence is the term used to describe murders in the name of so-called honour, sometimes called 'honour killings'. These are murders in which predominantly women are killed for perceived immoral behaviour, which is deemed to have breached the honour code of a family or community, causing shame.

The Metropolitan Police definition of so-called honour based violence is: 'a crime or incident, which has or may been committed to protect or defend the honour of the family and/or community'.

5.22.2

Professionals should respond in a similar way to cases of honour violence as with domestic violence and forced marriage (i.e. in facilitating disclosure, developing individual safety plans, ensuring the child's safety by according them confidentiality in relation to the rest of the family, completing individual risk assessments etc). See section 5.12. Domestic violence and section 5.16. Forced marriage of a child.

Recognition

5.22.3

A child who is at risk of honour based violence is at significant risk of physical harm (including being murdered) and/or neglect, and may also suffer significant emotional harm through the threat of violence or witnessing violence directed towards a sibling or other family member. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of physical harm which is such that it requires a compulsory intervention by child protection agencies into the life of the child and their family.

5.22.4

Honour based violence cuts across all cultures and communities, and cases encountered in the UK have involved families from Turkish, Kurdish, Afghani, South Asian, African, Middle Eastern, South and Eastern European communities. This is not an exhaustive list.

5.22.5

The perceived immoral behaviour which could precipitate a murder include:

• Inappropriate make-up or dress;
• The existence of a boyfriend;
• Kissing or intimacy in a public place;
• Rejecting a forced marriage;
• Pregnancy outside of marriage;
• Being a victim of rape;
• Inter-faith relationships;
• Leaving a spouse or seeking divorce.

5.22.6

Murders in the name of 'so-called honour' are often the culmination of a series of events over a period of time and are planned. There tends to be a degree of premeditation, family conspiracy and a belief that the victim deserved to die.

5.22.7

Incidents, in addition to those listed in 5.22.6 above, which may precede a murder include:

• Physical abuse;
• Emotional abuse, including:
  • house arrest and excessive restrictions
  • denial of access to the telephone, internet, passport and friends
  • threats to kill
• Pressure to go abroad. Victims are sometimes persuaded to return to their country of origin under false pretences, when in fact the intention could be to kill them.

5.22.8

Children sometimes truant from school to obtain relief from being policed at home by relatives. They can feel isolated from their family and social networks and become depressed, which can on some occasions lead to self-harm or suicide.

5.22.9

Families may feel shame long after the incident that brought about dishonour occurred, and therefore the risk of harm to a child can persist. This means that the young person's new boy/girlfriend, baby (if pregnancy caused the family to feel 'shame'), associates or siblings may be at risk of harm.

Disclosure and response

5.22.10

When receiving a disclosure from a child, professionals should recognise the seriousness / immediacy of the risk of harm.

5.22.11

For a child to report to any agency that they have fears of honour based violence in respect of themselves or a family member requires a lot of courage, and trust that the professional / agency they disclose to will respond appropriately. Specifically, under no circumstances should the agency allow the child's family or social network to find out about the disclosure, so as not to put the child at further risk of harm.

5.22.12

Authorities in some countries may support the practice of honour-based violence, and the child may be concerned that other agencies share this view, or that they will be returned to their family. The child may be carrying guilt about their rejection of cultural / family expectations. Furthermore, their immigration status may be dependent on their family, which could be used to dissuade them from seeking assistance.

5.22.13

Where a child discloses fear of honour based violence, professionals in all agencies should respond in line with section 5.12. Domestic violence and section 5.16. Forced marriage of a child; and the supplementary London procedure Safeguarding Children Abused Through Domestic Violence (London Board, 2007). The professional response should include:

• Seeing the child immediately in a secure and private place;
• Seeing the child on their own;
• Explaining to the child the limits of confidentiality;
• Asking direct questions to gather enough information to make a referral to LA children's social care and the police, including recording the child's wishes;
• Encouraging and/or helping the child to complete a personal risk assessment (see the proformas in the London procedure Safeguarding Children Abused through Domestic Violence);
• Developing an emergency safety plan with the child;
• Agreeing a means of discreet future contact with the child;
• Explaining that a referral to LA children's social care and the police will be made (see section 6. Referral and assessment);
• Record all discussions and decisions (including rationale if no decision is made to refer to LA children's social care).

See also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

5.22.14

LA children's social care should incorporate into their initial and core assessments the safety planning, self-assessment and risk assessment processes in Safeguarding Children Abused Through Domestic Violence (London Board, 2007).

5.22.15

Professionals should not approach the family or community leaders, share any information with them or attempt any form of mediation. In particular, members of the local community should not be used as interpreters.

5.22.16

All multi-agency discussions should recognise the police responsibility to initiate and undertake a criminal investigation as appropriate.

5.22.17

Multi-agency planning should consider the need for providing suitable safe accommodation for the child, as appropriate.

5.22.18

If a child is taken abroad, the Foreign and Commonwealth Office may assist in repatriating them to the UK. See also section 5.48 Accessing information from abroad.

5.23.1

This section should be read in conjunction with section 5.24 Hospitals (specialist) and, as appropriate, section 5.38 Psychiatric care for children.

5.23.2

The National Service Framework for children, young people and maternity services (Children's NSF) sets out standards for hospital services. It requires hospitals to have in place systems to ensure accountability for individual children's safety and well-being, including contemporaneous recording of concerns and discussions on a child's case and a safe discharge process.

5.23.3

Care must be provided in a safe environment which is child-friendly, healthy and well suited to the age and stage of development of the child/ren. Children should not be cared for on adult wards.  Wherever possible, children should be consulted about where they would prefer to stay in hospital and their views should be taken into account and respected.

Hospital admission data should include the age of children so hospitals can monitor whether they are being given appropriate care in appropriate wards.

5.23.4 

Hospitals are required to ensure their facilities are secure and that security arrangements are regularly reviewed. See National Service Framework for children, young people and maternity services.

5.23.5

For a child receiving a service from LA children's social care or Youth offending services prior to / during their stay in hospital, a lead professional (see section 1. Preface and introduction, 1.2.9 Lead professional) should be nominated to co-ordinate services for him/her.

5.23.6

When a child has been or is planned to be in hospital or accommodated by a Primary Care Trust (PCT) for more than three months, under s85 of the Children Act 1989 the hospital or PCT is required to notify the child's home authority, that is, the local authority for the area where the child is ordinarily resident, (see section 11. Mobile children and families, 11.9. Inter-borough arrangements for child protection enquiries). If it is unclear which authority that is, then the hospital should inform their own local authority or the local authority where their commissioning PCT is located.

5.23.7

LA children's social care in the home authority (see section 11. Mobile children and families, 11.9. Inter-borough arrangements for child protection enquiries) must assess the child's needs using the Assessment Framework (see section 6. Referral and assessment and appendix 5 for a summary and diagram of the Assessment Framework) and review the child's welfare using the Looking After Children materials. - [Looking After Children materials: assessment and action records (DH 1995), introduced in order to provide local authorities with a systematic means of gathering relevant information about children looked after away from home.]

Discharging children from hospital

5.23.8

Where professionals have concerns about a possible child protection issue, a multi-agency action plan to safeguard the child must be agreed and recorded before the child leaves hospital. - [The Inquiry into the death of Victoria Climbié (Lord Laming, 2003)]

5.23.9

As part of the plan:

• LA children's social care must assess and establish that the child's home environment is safe;
• The health professionals must ensure their concerns have been fully addressed and any plan for discharge of the child must be authorised by the child's consultant;
• The plan must provide for the ongoing promotion and safeguarding of that child's welfare;
• There must be follow-up arrangements to monitor compliance with the plan.

5.23.10

Particular attention is required in the discharge planning of newborns from neonatal intensive care units, since these babies are at high risk of re-admission to hospital. They need a properly co-ordinated programme of follow-up, with special attention to vision, hearing and developmental progress, as well as the co-ordinated input of services such as genetics.

Transition for children with long term conditions

5.23.11

Children with long term conditions need preparation for the move from children's to adult services.  All children with on-going health needs should have a plan developed with them for the transition of their care to adult services, which is coordinated by a named person.  If there are child protection concerns for such a child, the LA vulnerable adults service should be informed as part of the transition planning.

5.24.1

This section should be read in conjunction with section 5.23 Hospitals and, as appropriate, section 5.38 Psychiatric care for children.

5.24.2

There are a number of specialist hospitals in the London area. These provide specialist tertiary services, whether with a focus on paediatrics (e.g. Great Ormond Street Hospital) or in a particular health condition (e.g. the Royal Marsden Hospital). These hospitals have regional, national or international catchment areas. This means they are rarely a child's local hospital.

5.24.3

Children admitted to these hospitals can present with complex safeguarding and child protection issues. They may have sustained serious and life threatening non-accidental injuries or there may be concerns related to fabricated or induced illness (see section 5.13 Fabricated or induced illness). These children may have experienced, or be at risk of, significant harm through physical, sexual and emotional abuse and / or neglect (see section 4.3. Recognition of abuse and neglect). Furthermore, if there are lapses in the care provided for the child, s/he can suffer significant harm whilst in hospital.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.24.4

Most specialist hospitals have links with their local LA children's social care, who may be able, dependent upon local arrangements, to liaise with the child's home authority (see section 11. Mobile children and families, 11.9.2. Definition of home and host authorities) in child protection cases.

Some specialist hospitals offering tertiary care to children have children's social care teams on site, provided in partnership with the local children's social care service. In child protection cases, their role is to act as liaison with the home authority, except where they would be the lead agency - such as, when:

• The child is resident in the specialist hospital's local authority area;
• Incidents occur on the specialist hospital site;
• There are allegations against members of staff of the specialist hospital's Trust.

5.24.5

All Hospital Trusts should have in place protocols (which are in line with these London Child Protection Procedures), and which set out staff roles and responsibilities where child protection concerns are raised either prior to or subsequent to a child being admitted. Children in hospital must have appropriate protection, with referrals being made to LA children's social care in line with section 6. Referral and assessment. Failure to put immediate and appropriate safeguarding plans in place may leave a child at risk of harm.

5.24.6

Protocols should outline responsibilities and necessary actions in accordance with legal duties, procedures and accepted good practice:

• Case responsibility for the child rests with the home authority (see section 11. Mobile children and families, 11.9.2. Definition of home and host authorities), and the home authority should work in partnership with the Trust and with the host authority children's social care service. If a difference of opinion occurs, this should be resolved by discussion between managers (see section 18. LSCBs, quality assurance and conflict resolution);
• Where the child is already known to the home authority, and child protection concerns exist, the child should have an allocated social worker who should make contact with the relevant hospital social work department;
• Where a child protection concern which is already known to the home authority exists, relevant child protection plans (which also detail any action the relevant hospital trust staff may need to take to protect the child) should be immediately passed to the hospital social work department or, if out of hours, the Trust's out of hours lead for inclusion in hospital and social work records;
• Where a child protection concern arises, or a pre-existing concern changes on or after admission, the home authority should act immediately, in line with procedures for a s47 enquiry, to ensure the child is appropriately protected. Where necessary, a strategy meeting / discussion should be held in line with procedural timescales. This may be held at the hospital and chaired by a LA children's social care manager from the home authority;
• To ensure the safety of the child, members of the strategy meeting / discussion must consider and agree, in discussion with relevant Trust and social work management, the need for a legal framework to be put in place by the home authority. Any dispute should immediately be referred to senior management within the home authority and the Trust;
• A written care plan for the child must be immediately faxed or emailed to the hospital social work department. Similarly, strategy meeting / discussion minutes, any decisions (which must be in writing) and a copy of any legal orders must be sent to the relevant hospital trust (to the social work department during working hours and if there is one, or the Trust out-of-hours lead if out of hours) for inclusion in the child's records at the hospital;
• The care plan should be regularly reviewed, as appropriate, in a multi-agency / disciplinary meeting usually held at the hospital and chaired by the relevant person from the home authority;
• Where there are concerns about unauthorised removal of the child or unsupervised visiting by the parents to a child with injuries of a non-accidental nature, the senior hospital staff and senior staff from the home authority should discuss whether an immediate legal order is required to protect the child. If an order is required, the senior hospital staff and senior staff from the home authority should decide whether the home or host authority will make the application and on what grounds. If the risk to the child is potentially life threatening and the need for protection is immediate, the local police should be contacted to consider using their powers of police protection to ensure that the child is not removed from the hospital;
• The home authority needs to work in partnership with the specialist hospital;
• Where the child is admitted to the hospital from outside the UK, the child's home authority is the local authority in which the child has a temporary address (this could be an embassy address where an embassy has negotiated the contract with the hospital);
• A visiting non-UK citizen child should receive the same duty of care as a child resident in the UK (i.e. checks made, assessments completed, care plan initiated and reviewed).

Serious case reviews

5.24.7

Specialist Hospital Trusts may be involved in serious case reviews because of the nature of the services they offer. Such hospitals should contribute to serious case reviews in line with section 19. Serious case reviews.

5.24.8

Requests for a chronology and individual management reviews need to be made to the chief executive of the relevant Hospital Trust in cases where the specialist hospital is a non-local separate agency (in relation to the Local Safeguarding Children Board (LSCB) co-ordinating the review). The Chair of the LSCB in the local authority area for the specialist hospital should be informed of each request.

5.24.9

Depending on the level and nature of the relevant Hospital Trust's involvement in individual cases, they should be invited to send a representative to the serious case review panel meetings and given the opportunity to contribute to the terms of reference for the review.

5.24.10

Such hospitals should, where relevant, produce an individual management review, giving an holistic account of the hospital's involvement in the case and making recommendations.

5.24.11

The draft overview report should be circulated to the relevant hospital management board for consultation prior to completion.

5.25.1

Information and communication technology (ICT)-based forms of child physical, sexual and emotional abuse can include bullying via mobile telephones or online (internet) with verbal and visual messages. See also section 5.7. Bullying.

5.25.2

This section focuses on child sexual abuse. However, the procedure should be followed in other instances of ICT-based abuse e.g. physical abuse (such as, children being constrained to fight each other or filmed being assaulted).

Recognition and response

5.25.3

The impact on a child of ICT-based sexual abuse is similar to that for all sexually abused children (see section 4.3.19. Recognising sexual abuse). However, it has an additional dimension of there being a visual record of the abuse.

ICT-based sexual abuse of a child constitutes significant harm through sexual and emotional abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.25.4

Professionals in all agencies working with children, adults and families should be alert to the possibility that:

• A child may already have been / is being, abused and the images distributed on the internet or by mobile telephone;
• An adult or older child may be grooming a child for sexual abuse, including for involvement in making abusive images. This process can involve the child being shown abusive images;
• An adult or older child may be viewing and downloading child sexual abuse images.

Concern about particular child/ren

5.25.5

Where the concerns involve a particular child/ren, professionals considering / making a referral to LA children's social care should do so in line with section 6. Referral and assessment. See also section 6.4. Referral criteria, which provides guidance on the difference within LA children's social care between a s47 / core assessment and an initial assessment.

5.25.6

Professionals should be aware that, for the reasons outlined in sections 5.25.16 and 5.25.17 below, the child may not want to acknowledge their involvement or admit its abusive nature, and may resist efforts to offer protection. This should not be a deterrent and agencies will need to work together closely in order to continue to monitor and assess the nature and degree of any risk to the child.

5.25.7

The police should ensure that checks are made with regard to the subject adult and any other suspected adults, their contact with other children and other activities involving children. This is in order to identify the existence of organised and complex abuse or abuse of children through sexual exploitation. See section 5.43. Sexually exploited children and section 14. Organised and complex abuse.

5.25.8

The police can draw upon powers to seize communications materials only in specified circumstances where the level of evidence would support an application to do so. The police Child Abuse Investigation Team (CAIT) will receive support from the Child Exploitation and Online Protection Centre (CEOP) as appropriate, to assist with enquiries of this kind. See section 2. Roles and responsibilities.

Concern about an adult

5.25.9

Professionals may identify a concern through a relationship with a child or an adult, from visits to the family home or from information shared by the victim's friends or family.

5.25.10

A professional who has a concern should discuss this with their line manager and / or their agency's nominated safeguarding children adviser.  See the London guidance for assessing children and families affected by adults viewing child sexual abuse images on the Internet (London Board 2010).

5.25.11

A concern about an adult should be shared even where there is no evidence to support it. A referral should be made to the police about the adult. The police must consider the possibility that the individual might also be involved in the active abuse of children and their access to children should be established, including family and work settings, and a referral made to LA children's social care.

Allegations against colleagues

5.25.12

Professionals in all agencies should be aware of alerting indicators amongst their subordinates and colleagues, and follow the procedures in section 17. Safer recruitment and section 15. Allegations against staff.

5.25.13

Human resources and IT professionals should be aware of the new legal framework created by the Sexual Offences Act 2003 (see sections 5.25.14 and 5.25.15 below).

Supplementary guidance

5.25.14

The making, distribution and viewing of child sexual abuse images is instrumental in the ongoing sexual abuse of children, within organised abuse (sexual exploitation, sex rings and trafficking), within and outside the family and with adults and children, both known and unknown. Online abuse cannot be separated from offline abuse.

5.25.15

The distribution of child abuse images continues to grow (a recent UK police operation seized over 750,000 images). Research shows that in the UK, over eight million children have access to the internet and a high proportion of these children (1 in 12), have met someone offline who they initially encountered in an online environment.

Impact on children

5.25.16

Children have great difficulty in talking about their abuse, some denying that it is their image even when there is categorical proof. The reasons for this include that children:

• Can experience intense feelings of powerlessness, knowing that there is nothing they can do about others viewing pornographic pictures / films of themselves (and sometimes their coerced sexual abuse of others) indefinitely;
• Express concerns over how pornography will be viewed (i.e. that they enjoyed it or were complicit in its production);
• Are aware that the sexual abuse they endured to produce the pornography can be distributed commercially or non-commercially for the arousal of others. They are also aware that it can be used to groom and abuse other children;
• Suffer in the knowledge that there is a permanent record of their sexual abuse and this knowledge has implications for the need for long-term support and treatment of the children to reflect the harm that indefinite circulation can cause.

5.25.17

Children may also be shown images of their own abuse by their abuser, and they typically hold a personal responsibility for not stopping their own abuse and that of others involved. All these aspects reflect the impact of the grooming process of the abusers, who endeavour to make the child feel that it is their fault and that they could have stopped the abuse.

Definition and legislation

5.25.18

The UK legislates against the production, distribution and possession of abusive images of children (also known as child pornography). It is an offence to take, permit to be taken, make, possess, distribute or advertise indecent images (photographs or pseudo-photographs) of children (Protection of Children Act 1978 [England and Wales) as amended by the Criminal Justice and Public Order Act 1994.

5.25.19

An indecent image of a child is a visual record of the sexual abuse of a child, either through sexual acts by adults, other children (or which involves bestiality), or children posed in a sexually provocative way.

5.25.20

It is a serious arrestable offence to seek out images of child abuse. The making of (this includes the voluntary downloading of) and possession of such images carry maximum sentences of ten and five years respectively.

5.25.21

The UK laws which relate to child abuse images are:

• Protection of Children Act 1978 (England and Wales) as amended by the Criminal Justice and Public Order Act 1994
• Civic Government Act, 1982 (Scotland)
• Sexual Offences Act 2003: Key Changes (England and Wales) 
• Memorandum of Understanding: Section 46 Sexual Offences Act 2003

Chat room grooming and offline abuse

5.25.22

Grooming of children online is a faster process than usual grooming, and totally anonymous. The abuser develops a 'special' relationship with the child online (often adopting a false identity), which remains a secret to enable an offline meeting to occur in order for the abuser to sexually harm the child. The abuser grooms online by finding out as much as they can about their potential victim, establishes the risk and likelihood of the child telling, finds out about the child's family and social networks and, if safe enough, will isolate their victim, usually through bribes or threats, and gain control.

5.25.23

Abusers may use child sexual abuse images to break down the child's barriers to sexual behaviour (and communicate to the child the abuser's sexual fantasies). Repeated exposure to abusive images is intended to diminish the child's inhibitions and give the impression that sex between adults and children is normal, acceptable and enjoyable.

5.25.24

There is an additional dimension to the silencing of children who have been groomed in chatrooms. Children's behaviour on the net is far less inhibited. They will talk about things and people and use language that they wouldn't in their everyday lives and they are fearful of those close to them finding out what they have said.

5.25.25

Children who have been 'duped' into believing that their online contact is a 'friend' have a serious concern of their own peer group finding out that they have been 'foolish' enough to be conned in this way. The majority say they would have told no one about their abusive experiences.

Child Exploitation and Online Protection Centre (CEOP)

5.25.26

The Child Exploitation and Online Protection Centre (CEOP) brings together law enforcement officers, specialists from children's charities and industry to tackle online child sexual abuse. CEOP provides a dedicated 24 hour online facility for reporting instances of online child sexual abuse. See also section 2. Roles and responsibilities, 2.12.13 Metropolitan Police Child Abuse Investigation Command.

Local Safeguarding Children Boards

5.25.27

Local Safeguarding Children Boards should support parents to ensure the safest possible use of the internet and mobile telephones for their children through public awareness campaigns and support for member agencies to communicate this message through the many varied environments where children may have access to the internet.

5.25.28

The primary concern for teachers with regard to the online environment is the safe and effective supervision of pupils using the internet in schools. However, because many children are using the internet at home for homework, socialising, and playing games, schools need to work with parents in educating children about the positive ways in which the internet can be used but also some of the associated risks.

5.25.29

Becta is the Government agency leading the national drive to improve learning through technology. As part of this remit, they are the key agency in supporting Local Safeguarding Children Boards to understand and respond to the issues and risks related to the use of ICT by children. See www.becta.org.uk

5.26.1

The law is not clear because it does not state an age when children can be left alone. However, parents can be prosecuted for wilful neglect if they leave a child unsupervised 'in a manner likely to cause unnecessary suffering or injury to health' (Children and Young Persons Act, 1933).

5.26.2

Nor does the law state an age when young people can baby-sit. However, where a baby-sitter is under the age of 16 years, parents remain legally responsible to ensure that their child comes to no harm.

5.26.3

This is, in part, in recognition that all children are different and demonstrate different levels of maturity and responsibility.

5.26.4

In any situation where a child is left alone, consideration should be given to the context (e.g. the ages, needs and maturity of the children, the length of time involved, the frequency of such incidents, the safety of the location and any other relevant factors). Having taken into account the circumstances above, the key question to ask is was the child left to their own fate?

Responses to situations

5.26.5 

If the child is already known to LA children's social care, professionals should check whether the case record indicates a plan of action to take if the child is found alone. It may be that the file indicates the need for police protection or an application for an emergency protection order in these circumstances.

5.26.6

In any case, if immediate protection of the child is assessed to be necessary, professionals should:

• Either under police protection or EPO, take the child to a suitable place and arrange a placement;
• If entry cannot be gained to an unsupervised child, obtain police assistance by contacting the police CAIT or the local police station:
  • when an emergency protection order is made, a warrant authorising any constable to assist in entering and searching the named premises can be obtained (Children Act 1989, s48)
  • in dire emergencies, the police can exercise their powers under s17(1)e of the Police and Criminal Evidence Act 1984 to enter and search premises without a warrant for the purposes of saving life and limb. If this action is taken, the police may consider it appropriate for the child/ren to be placed in police protection (Children Act 1989, s46)
• Leave a note for the parent or responsible adult, giving all information regarding the action to be taken and the reason, and advising them of what to do. If English is not the first language the note should be translated;
• Collect the child's immediate necessities and familiar toys. Ensure the child understands as far as is possible what is happening, recognising that being taken away from home by unknown adults (one of whom may be in uniform) may be understandably more frightening to the child than being left alone;

5.26.7 

If immediate protection is assessed as not necessary, professionals should:

• Establish the child's understanding of the whereabouts of the parent or responsible person and of the arrangements made;
• If the parent can be located, reunite parent and child and advise the parent of the dangers of leaving children alone;
• If the parent or responsible person seems likely to return shortly, wait with the child;
• If the parent or responsible adult has not returned within 30 minutes, either arrange for another responsible person to take responsibility for the child, or remove the child. A suitably responsible person could be a neighbour, relatives, someone with parental responsibility or a residence order, or friends known to and trusted by the child and professionals.

Subsequent action

5.26.8

On finding that a child has been left alone, it will be appropriate for consideration to be given to whether there needs to be further involvement with the family. An initial assessment of need, including the need for protection, should always be undertaken to see if there are identifiable needs within the family and for the child. The decision made and the reasons for this must be recorded.

Child left alone in a public place

5.26.9

A child inappropriately left alone in a public place will normally be dealt with in the first instance by the police.

Bed and breakfast accommodation

5.26.10

A child left alone in a room in bed and breakfast accommodation, where no suitable arrangements have been made by the parent/s to supervise the child, will be treated the same as a child left alone in a household, even where there are other adults present in the accommodation.

Messages for parents

5.26.11

For further information and advice for parents, see the NSPCC leaflet Home alone: guidance for parents, available at www.nspcc.org.uk.

5.27.1

Male circumcision is the surgical removal of the foreskin of the penis. The procedure is usually requested for social, cultural or religious reasons (e.g. by families who practice Judaism or Islam). There are parents who request circumcision for assumed medical benefits.

5.27.2

There is no requirement in law for professionals undertaking male circumcision to be medically trained or to have proven expertise. Traditionally, religious leaders or respected elders may conduct this practice.

Circumcision for therapeutic / medical purposes

5.27.3

The British Association of Paediatric Surgeons advises that there is rarely a clinical indication for circumcision. Doctors should be aware of this and reassure parents accordingly.

5.27.4

Where parents request circumcision for their son for assumed medical reasons, it is recommended that circumcision should be performed by or under the supervision of doctors trained in children's surgery in premises suitable for surgical procedures.

5.27.5

Doctors / health professionals should ensure that any parents seeking circumcision for their son in the belief that it confers health benefits are fully informed that there is a lack of professional consensus as to current evidence demonstrating any benefits . The risks / benefits to the child must be fully explained to the parents and to the young man himself, if Fraser competent.

5.27.6

The medical harms or benefits have not been unequivocally proven except to the extent that there are clear risks of harm if the procedure is done inexpertly.

Non-therapeutic circumcision

5.27.7

Male circumcision that is performed for any reason other than physical clinical need is termed non-therapeutic circumcision.

Legal position

5.27.8

The legal position on male circumcision is untested and therefore remains unclear. Nevertheless, professionals may assume that the procedure is lawful provided that:

• It is performed competently, in a suitable environment, reducing risks of infection, cross infection and contamination;
• It is believed to be in the child's best interests;
• There is valid consent from family / parents and the child, if old enough, is Fraser competent.

5.27.9

If doctors or other professionals are in any doubt about the legality of their actions, they should seek legal advice.

Principles of good practice

5.27.10

The welfare of the child should be paramount, and all professionals must act in the child's best interests. Children who are able to express views about circumcision should always be involved in the decision-making process:

• Even where they do not decide for themselves, the views that children express are important in determining what is in their best interests;
• Parental preference alone does not constitute sufficient grounds for performing a surgical procedure on a child unable to express his own view. Parental preference must be weighed in terms of the child's interests;
• When the courts have confirmed that the child's lifestyle and likely upbringing are relevant factors to take into account. Each individual case needs to be considered on its own merits.

5.27.11

An assessment of best interests in relation to non-therapeutic circumcision should include consideration of:

• The child's own ascertainable wishes, feelings and values;
• The child's ability to understand what is proposed and weigh up the alternatives;
• The child's potential to participate in the decision, if provided with additional support or explanations;
• The child's physical and emotional needs;
• The risk of harm or suffering for the child;
• The views of parents and family;
• The implications for the child and family of performing, and not performing, the procedure;
• Relevant information about the child and family's religious or cultural background.

5.27.12

Consent for circumcision is valid only where the people (or person) giving consent have the authority to do so and understand the implications (including that it is a non-reversible procedure) and risks. Where people with parental responsibility for a child disagree about whether he should be circumcised, the child should not be circumcised without the leave of a court.

Doctors' response

5.27.13

Doctors are under no obligation to comply with a request to circumcise a child and circumcision is not a service which is provided free of charge. Nevertheless, some doctors and hospitals are willing to provide circumcision without charge rather than risk the procedure being carried out in unhygienic conditions.

5.27.14

Poorly performed circumcisions have legal implications for the doctor responsible. In responding to requests to perform male circumcision, doctors should follow the guidance issued by the:

• General Medical Council: Guidance for doctors,
• British Medical Association: in respect of responding to requests to perform male circumcision,
• Royal College of Surgeons: Statement on Male Circumcision.

Recognition of harm

5.27.15

Circumcision may constitute significant harm to a child if the procedure was undertaken in such a way that he:

• Acquires an infection as a result of neglect;
• Sustains physical functional or cosmetic damage;
• Suffers emotional, physical or sexual harm from the way in which the procedure was carried out;
• Suffers emotional harm from not having been sufficiently informed and consulted, or not having his wishes taken into account.
  
  See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful there needs to be compulsory intervention by child protection agencies in the life of the child and their family.

5.27.16

Harm may stem from the fact that clinical practice was incompetent (including lack of anaesthesia) and / or that clinical equipment and facilities are inadequate, not hygienic etc.

5.27.17

The professionals most likely to become aware that a boy is at risk of, or has already suffered, harm from circumcision are health professionals (GPs, health visitors, A&E staff or school nurses) and childminding, day care and teaching staff.

Multi-agency response

5.27.18

If a professional in any agency becomes aware, through something a child discloses or another means, that the child has been or may be harmed through male circumcision, a referral must be made to LA children's social care in line with section 6. Referral and assessment. LA children's social care should assess the risk of harm to other male children in the same family, including unborn children.

Role of community / religious leaders

5.27.19

Community and religious leaders should take a lead in the absence of approved professionals and develop safeguards in practice. This could include setting standards around hygiene, advocating and promoting the practice in a medically controlled environment and outlining best practice if complications arise during the procedures.

Recognition and referral

5.28.1

Professionals in local agencies should be alert to the possibility that an expectant mother / family missing appointments or repeatedly being unavailable for home visits may indicate that a child or unborn child is at risk of, or is experiencing, significant harm. This could be physical, sexual or emotional abuse, and / or neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of physical harm which is such that it requires a compulsory intervention by child protection agencies into the life of the child and their family.

5.28.2

Professionals should take reasonable steps to reassure themselves as soon as possible that an expectant mother / family is not missing, whereabouts unknown.

5.28.3

Professionals should involve all the agencies with current or recent contact with the expectant mother / family to assess the child/ren's or unborn child's vulnerability. Professionals should consider questions such as:

• Is the mother a child herself, Is she subject to a child protection plan and/or is she a looked after child;
• Is there good reason to believe that the expectant mother / family may be the victim of a crime?
• Has there been a pre-birth conference for the child and is the unborn child subject to a pre-birth child protection assessment?
• Are any of the children the subject of child protection plans?
• Is the family currently subject to a s47 enquiry?
• Is the mother a child herself, or is she looked after by the local authority?
• Is there a person present in the household or visiting the mother with previous convictions for an offence against children, or other person who poses a risk of harm to children?
• Is it clear that the expectant mother / family is missing, whereabouts unknown?

5.28.4

If the answer to any of the above questions is yes, or an agency reaches the judgement that a child or unborn child is at risk of significant harm on the basis of the assessment, a referral should be made to LA children's social care, the mother / family's social worker or duty officer (in line with section 6. Referral and assessment), the police Child Abuse Investigation Team and, in the case of missing person's whose whereabouts are unknown, the police Missing Person's Unit.

5.28.5

If the expectant mother is a child, then section 5.29 Missing from care and home should be followed.

5.28.6

The assessment may have been very brief because the degree of concern for the child/ren or unborn child may have triggered an immediate referral to LA children's social care and the police.

Immediate action

5.28.7

The LA child protection adviser must be informed if a child subject of a child protection plan or an unborn child subject of a pre-birth child protection plan goes missing.

5.28.8

LA children's social care, the police Child Abuse Investigation Team and police Missing Person's Unit should exchange information and work together.

5.28.9

LA children's social care must complete the assessment of risk to the child / unborn child, and of their needs. The assessment will require LA children's social care to engage with all the agencies that have current or recent involvement with the child or expectant mother / family. Existing records in these agencies must be checked to obtain any information which may help to trace the mother / family (e.g. details of friends and relatives), and this information should be passed to the police officer undertaking enquiries to trace the mother.

5.28.10

LA children's social care should consider whether to notify members of the missing expectant mother / family's extended family, and if so how.

Strategy meeting / discussion

5.28.11

If, following the above procedures, the expectant mother / family has not been traced, a strategy meeting / discussion should be convened within five working days. See section 7. Child protection enquiries.

5.28.12

The strategy meeting / discussion should consider whether the details of the expectant mother / family should be circulated to other local authorities. If so, then the LA child protection adviser should notify other LA children's social care services and Local Safeguarding Children Boards using the notification proforma available at: www.londonscb.gov.uk/runaways. London local authorities should be notified electronically to the missing persons' mailbox in each London LA children's social care service. The strategy meeting / discussion should also consider whether other agencies could be notified (e.g. designated nurses in PCTs can be notified in writing, and they may circulate details to neighbouring maternity units and health visiting teams).

When the expectant mother / family is found

5.28.13

When an expectant mother / family is found the police must be informed so that  they can cancel the missing person report.

5.28.14

When an expectant mother / family is found, there should, if practicable, be a strategy meeting / discussion between previously involved agencies within one working day, to consider:

• Immediate safety issues;
• Whether to instigate a s47 enquiry and any police investigation;
• Who will interview the expectant mother / family;
• Who needs to be informed of the expectant mother / family being found (locally and nationally).

5.29.1

This section is a summary of the supplementary London child protection procedure: Safeguarding Children Missing from Care and Home (London Board, 2006), and the two should be read in conjunction.

5.29.2

These London Child Protection Procedures define a child as 'missing' if their whereabouts are unknown, whatever the circumstances of their disappearance. Sometimes children stay out longer than agreed as a boundary testing activity which is well within the range of normal teenage behaviour. These children have taken 'unauthorised absence', and would not usually come within the definition of 'missing'. If a child's whereabouts are known then they cannot be 'missing'. Unauthorised absences should be carefully monitored as the child may subsequently go missing.

5.29.3

Children who are most vulnerable to going missing from care and home include those missing from school (see section 5.30. Not attending school), looked after children (see section 5.29.15 below) and asylum seeking children. The local authority, police and other agency response to an asylum seeking child going missing should be exactly the same as for all other children, whether they are looked after or living in the community.

5.29.4

When a child goes missing from care or home, they could be at risk of significant harm through physical or sexual abuse. The child may be missing from care or home because they are suffering physical, sexual or emotional abuse and / or neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect), which is so harmful that there needs to be intervention by child protection agencies into the life of the child and their family.

Prevention, recognition and response

5.29.5

The agency first alerted to the child's absence should (together with the child's parents), decide whether the child is having an 'unauthorised absence' or are 'missing'.

5.29.6

There is an expectation that parents will report their child is missing. Failure to do so may be a child protection issue and professionals should consider a referral to LA children's social care in line with section 6. Referral and assessment.

Referral and assessment

5.29.7

The police are the lead agency for the investigation of missing children.

5.29.8

Whenever a professional becomes concerned that a child is at risk of significant harm, a referral must be made to LA children's social care (verbal referral, followed by a written referral within 48 hours) in accordance with section 4. Recognition and response and section 6. Referral and assessment.

Strategy meeting / discussion

5.29.9

For any child who is missing from home, a strategy meeting / discussion should be held within 28 days, arranged by LA children's social care and the police invited (if the child is subject of a child protection plan, then officers from the Missing Person's Unit and the Child Abuse Investigation Team, or if not then the Missing Person's Unit only).

5.29.10

When a child is found, the risk indicators will be considered. For the critical few that are deemed at risk, a strategy meeting / discussion will be held between appropriate agencies and procedures followed as outlined in this protocol.

5.29.11

A police officer will interview all children upon their return, to establish what happened while the child was missing and whether there is any allegation of crime.

Independent interviews

5.29.12

Any child who is found following a period missing should, regardless of whether they are believed to have experienced, or be at risk of, significant harm, be offered an independent interview by an independent professional (e.g. social worker, teacher or police officer who does not usually work with the child); all reasonable efforts must be made to accommodate the child's wishes. This interview must take place within 72 hours of the child being located or returning from absence.

5.29.13

For children living in the community, the police and LA children's social care have responsibility for ensuring that the opportunity for an independent interview is offered.

5.29.14

This interview should provide a safe opportunity for the child to discuss any concerns regarding their care, including if they chose to run away from an abusive situation. If possible, the interview should take place without parents, foster carers or residential staff either present or in close proximity.

Looked after children

5.29.15

All looked after children must have an assessment, undertaken by LA children's social care staff, of the risks of the child absenting themselves using the social care pre-incident risk assessment form - see appendix 2 of the supplementary procedure Safeguarding Children Missing from Care and Home (London Board, 2006).

5.29.16

Where there is a high risk of a child going missing, residential unit staff / foster carers should prepare an information sharing form to help the police and other agencies to locate the child if they do go missing, see appendix 4 of Safeguarding Children Missing from Care and Home (London Board, 2006). This form should always be provided to the police at the time of reporting a looked after child missing.

5.29.17

On every occasion that a looked after child goes missing:

• A social care risk assessment record should be completed - see appendix 3 of Safeguarding Children Missing from Care and Home (London Board, 2006);
• The child's parents should be informed after taking in to consideration the reason the child is in care and whether there informing the family may put the child at further risk; and
• A police investigation must be initiated.

5.29.18

LA children's social care are responsible for children in their care at all times, and this responsibility is not absolved when a child is reported missing to the police.

5.29.19

LA children's social care must hold a discussion on the first available working day after a looked after child has been reported missing. This discussion should be clear about when and if a strategy meeting / discussion should be held, in line with sections 5.29.9 to 5.29.11 above.

5.29.20

A looked after child who is found following a period missing should be offered an independent interview as outlined in sections 5.29.12 to 5.29.14 above. For looked after children, it is the responsibility of the residential unit manager / supervising social worker and placing authority to ensure that this happens.

5.29.21

See section 7. Child protection enquiries, section 8. Child protection conferences and section 9. Implementation of child protection plans.

5.30.1

A minimum standard of safety should be afforded to children not attending school. This includes four groups of children:

• Children who are registered with schools and who are or go missing from school, and give rise to concern about their welfare (these children may be classified as missing, whereabouts unknown);
• Children who are poor attendees at school or who have interrupted school attendance;
• Children of school age who are not registered with a school;
• Children of school age who are educated at home but where there are concerns about their welfare.

5.30.2

This section should be read in conjunction with the supplementary London procedure: Safeguarding Children Missing from School (London Board 2006)

Child registered at school who goes missing

Initial response

5.30.3

On the first day a child is not in school without a valid reason (e.g. a telephone call or letter from the parent giving a valid explanation), a staff member trained to do so should telephone the child's parent / home to seek reasons for the absence and reassurance from a parent that the child is safe at home.

5.30.4

If contact is made with the parent and the child is missing, the staff member should advise the parent to contact all family and social contacts, the police and services such as the local accident and emergency departments and the child's GP.

5.30.5

If contact cannot be made with the parent or the staff member is concerned about the response they receive (e.g. the parent not informing the people listed above), the staff member should consider, with the school's nominated safeguarding children adviser, the degree of vulnerability of the child to decide on whether any further action is required at this stage (see section 5.30.10 below).  Any decision not to act should be reviewed on each subsequent day the child is absent.

Children with poor, irregular or interrupted school attendance

Initial response

5.30.6

On the first day a child is not in school, the procedures outlined in sections 5.30.3 to 5.30.5 above should be followed.

5.30.7

If contact is made with the parent and the child is not missing from home, the member of staff will follow their school procedures for children who are absent. However, if they are concerned about the welfare of the child (and this is likely to be the case if there is any reason to doubt the reason given by the parent for the child's absence from school), the staff member should discuss the case with the school's nominated safeguarding children adviser.

5.30.8

Schools must have systems for monitoring attendance, and where children are attending irregularly the LA education welfare or school attendance service should be notified to ensure the child is safe. The Government threshold for concern about school attendance is that 20 per cent plus non-school attendance raises concern about a child's education. Most LA education services therefore use this threshold for referral to education welfare and school attendance services. The local authority has a range of legal powers to enforce school attendance, including the prosecution of parents who fail to ensure that their children attend school regularly.

5.30.9

If a parent fails to comply with local authority efforts to ensure regular school attendance for a child, this must be viewed as a child welfare matter and a referral made to LA children's social care in line with section 6. Referral and assessment.

Children who are vulnerable or at risk of harm

5.30.10

When a child is absent or missing from school, they could be at risk of significant harm through physical or sexual abuse. The child may be absent or missing because they are suffering physical, sexual or emotional abuse and / or neglect. See section 4.3. Recognition of abuse and neglect. 

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful there needs to be intervention by child protection agencies into the life of the child and their family.

Children who are absent or missing from school may also be missing from care or home. See section 5.29. Missing from care and home.

5.30.11

Teachers, in consultation with the designated safeguarding children professional at the school, should make an immediate referral to LA children's social care in line with section 6. Referral and assessment, if:

• There is good reason to believe the child may be the victim of a crime;
• The child is subject of a child protection plan (see section 8. Child protection conferences and section 9. Implementation of child protection plans);
• The child is a looked after child (see section 5.18. Foster care and section 5.40. Residential care);
• The child is privately fostered child (see section 5.37 Private fostering);
• There is planned or current LA children's social care or adult social care involvement (e.g. a child protection [s47 enquiry] investigation);
• There is a person present in or visiting the family who poses a risk of harm to children.

5.30.12

The family may be avoiding contact and therefore the quicker the response the more likely they will be traced.  Delay may increase the risk of harm to the child.

5.30.13

Additional concerns may be caused if:

• There has been LA children's or adult's social care or criminal justice system involvement in the past;
• There is a history of mobility;
• There are immigration issues;
• The parents been subject to proceedings in relation to attendance;
• There is a history of poor attendance;
• There is information which suggests the child may be subject to:
  • a forced marriage (see section 5.16. Forced marriage of a child)
  • Honour based violence (see section 5.22. Honour based violence)
  • Female genital mutilation (see section 5.14. Female genital mutilation)
  • sexual exploitation (see section 5.43. Sexually exploited children) and / or trafficking (see section 5.46. Trafficked and exploited children).

5.30.14

Safeguarding Children Missing from School (London Board, 2006) lists further questions to assist a judgement about a child's vulnerability.

Reasonable enquiry

Day one

5.30.15

The process of 'reasonable enquiry' - [The Education (Pupil Registration) Regulations 1995 (S.I. 1995/2089), Regulation 9(1)(c) requires schools and local authorities to make 'reasonable enquiries' to locate pupils who have been absent for 4 weeks or more before they can be deleted from the register.] - starts with the questions above as soon as the child is discovered to be missing (i.e. on the first day). After school staff have exhausted the avenues of enquiry open to them, the LA education welfare or school attendance service should continue checking databases within the local authority and other databases (e.g. housing, health and the police) with agencies known to be involved with the family, with the local authority the child moved from originally, and with any local authority to which the child may have moved.

Days two to twenty-eight

5.30.16

If the judgement on the first day of absence is that there is no reason to believe the child is at risk of harm and the school delays further action, the process of reasonable enquiry should be repeated and enhanced, including reviewing the responses to the causes for concern listed in sections 5.28.11 and 5.28.13 above, for up to four weeks.  This should be undertaken jointly between the school and the local education welfare or school attendance service and / or the local authority designated person.

More than four weeks

5.30.17

If a child continues to be absent from school for four weeks and neither the school, the LA education welfare, school attendance nor children's social care service has been able to confirm any reason given for absence and there are concerns about the child's welfare, it is permissible under current regulations for the child's name to be removed from the school roll and for their details to be uploaded to the DCSF Lost Pupil Database.  However, this would be very unusual in these circumstances.

5.30.18

If concerns remain in relation to the welfare of the child, the education welfare service and / or LA children's social care should continue to pursue reasonable enquiries in accordance with section 5.29. Missing from care and home.

5.30.19

If the school, education welfare, school attendance or any other service or agency becomes aware that the child has moved to another school, that service should ensure all relevant agencies are informed in writing so arrangements can be made to forward records from the previous school.

Children of school age who are not registered with a school

5.30.20

Children of school age who are not registered with a school share the same vulnerabilities as those outlined in section 5.28.10 above.

5.30.21

Educational achievement contributes significantly to children's well-being and development; all children have a right to education and young children who reach school age or children already in education who move home should be supported to enrol in a new school as seamlessly as possible. This is particularly because children who move frequently are often already vulnerable through being looked after or in temporary accommodation.

5.30.22

Where parents appear not to have taken steps to ensure their child is registered with a school or receiving an appropriate education, the LA education welfare or school attendance service should make urgent enquiries about the child's welfare, and interview the child. If the parent fails to comply with LA efforts to place the child in school or to receive education in some other way and there are concerns that the child is suffering or is likely to suffer significant harm, this must be referred to LA children's social care as a child protection matter in line with section 6. Referral and assessment.

5.30.23

This process should be initiated for all children, including those who are likely to remain in a borough only temporarily or whose stay in the UK is intended to be temporary (other than if a child is visiting for a short holiday).

In particular, this process should be implemented for children whose stay may originally be temporary but where they are privately fostered. See section 5.37 Private fostering.

5.30.24

Local authority areas with high numbers of new arrivals from abroad should ensure that parents are aware they are required to enrol their children in school or to receive education in some other way. The local authority must assist parents to do so. All authorities must maintain effective systems for monitoring that any children from abroad living in their area are attending school.

5.30.25

Any professional encountering a child of school age who does not appear to be in a school should ask the parent about this and, if the child is not on a school roll or they are concerned that the parent may be evasive about this issue, they must contact their agency's nominated child protection advisor to discuss whether to make a referral to the LA education welfare or school attendance service.

Children of school age who are educated at home but where there are concerns about their welfare

5.30.26

The law allows parents of children in England and Wales to educate their child however they wish. The local authority has limited powers to intervene or even to be informed about this.

5.30.27

If a parent never registers their child at a school, they are not obliged to inform the local authority.

5.30.28

If a parent registers their child at an independent sector school and then withdraws their child from school to educate them at home, they are not obliged to inform the local authority.  Nor is the independent school obliged to inform the local authority.

5.30.29

If the parent registers their child at a state school and then withdraws their child to educate them at home, they are not obliged to inform the local authority. However, they are obliged to inform the state school, which in turn is obliged to inform the local authority within two weeks of removing the child from the school roll.

5.30.30

Where the local authority is informed of a parent's desire to educate their child at home, they have limited powers but the parent is required to assure them about the nature and quality of the education they are giving to the child.

5.30.31

However, there may be circumstances where the parent is seeking to avoid agency intervention in the child's life to conceal abuse or neglect or where, however well meaning, their desire to educate their child at home may give rise to general concerns about the child's welfare.

5.30.32

In these circumstances, it may be necessary for LA children's social care to conduct an assessment into whether the child's needs are being met or whether they are at risk of significant harm. See section 4. Recognition and response and section 6. Referral and assessment.

5.31.1

When children are brought to the attention of the police or the wider community because of their anti-social behaviour, this may reflect vulnerability due to their parents experiencing difficulties or being neglectful. These children may be at risk of, or experiencing, significant harm. This could be through physical, sexual or emotional abuse, and / or neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of harm which is such that it requires a compulsory intervention by child protection agencies into the life of the child and their family.

5.31.2  

These children's needs should be assessed and they should receive an appropriate multi-agency response. A range of powers should be used to engage families to improve the child's behaviour where engagement cannot be secured on a voluntary basis:

• Child safety order (CSO) - this is a compulsory intervention below the threshold of the child being at risk of significant harm. A local authority can apply for a CSO where a child has committed an act that would have been an offence if s/he were aged 10 or above, where it is necessary to prevent such an act, or where the child has caused harassment, distress or harm to others (i.e. behaved antisocially);
• A parenting order can be made alongside a CSO or when a CSO is breached - this provides an effective means of engaging with and supporting parents, while helping them develop their ability to undertake their parental responsibilities. A parenting order consists of two elements:
  • a requirement on the parent to attend counselling or guidance sessions (for example, parenting education or parenting support classes). This is the core of the parenting order and lasts for three months
  • a requirement on the parent to comply with such requirements as are determined necessary by the court. This element can last up to 12 months; and
• An education related parenting order - this is a civil court order which consists of the same two elements as standard parenting orders, except that they focus specifically on improving the behaviour and attendance of the child. Parent Support Advisers can be used instead of or as support for, an education related parenting order.

5.31.2

Arrangements should be in place for local community safety teams to seek help or advice about when antisocial behaviour by children should be regarded as evidence of need.

5.31.3

Children may participate in the neglect or mistreatment of a vulnerable adult within their family. Professionals in safeguarding adults' and children's teams should work together to protect both vulnerable adults and children.

5.32.1

Parental mental illness does not necessarily have an adverse impact on a child's developmental needs, but it is essential to always assess its implications for each child in the family. Many children whose parents have mental ill health may be seen as children with additional needs requiring professional support, and in these circumstances the need for a common assessment should be considered.

5.32.2

Where a parent has enduring and / or severe mental ill-health, children in the household are more likely to be at risk of, or experiencing, significant harm. This could be through physical, sexual or emotional abuse, and / or neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of physical harm which is such that it requires a compulsory intervention by child protection agencies into the life of the child and their family.

5.32.3

A child at risk of significant harm or whose well-being is affected, could be a child:

• Who features within parental delusions;
• Who is involved in his / her parent's obsessional compulsive behaviours;
• Who becomes a target for parental aggression or rejection;
• Who has caring responsibilities inappropriate to his / her age (see section 5.47 Young carers);
• Who may witness disturbing behaviour arising from the mental illness (e.g. self-harm, suicide, uninhibited behaviour, violence, homicide);
• Who is neglected physically and / or emotionally by an unwell parent;
• Who does not live with the unwell parent, but has contact (e.g. formal unsupervised contact sessions or the parent sees the child in visits to the home or on overnight stays);
• Who is at risk of severe injury, profound neglect or death;

Or s/he could be an unborn child:

• Of a pregnant woman with any previous major mental disorder, including disorders of schizophrenic, any affective or schizo-affective type; also, severe personality disorders involving known risk of harm to self and / or others.

5.32.4

The following factors may impact upon parenting capacity and increase concerns that a child may have suffered or is at risk of suffering significant harm:

• History of mental health problems with an impact on the sufferer's functioning;
• Unmanaged mental health problems with an impact on  the sufferer's functioning;
• Maladaptive coping strategies;
• Misuse of drugs, alcohol, or medication;
• Severe eating disorders;
• Self-harming and suicidal behaviour;
• Lack of insight into illness and impact on child, or insight not applied;
• Non-compliance with treatment;
• Poor engagement with services;
• Previous or current compulsory admissions to mental health hospital;
• Disorder deemed long term 'untreatable', or untreatable within time scales compatible with child's best interests;
• Mental health problems combined with domestic abuse and / or relationship difficulties;
• Mental health problems combined with isolation and / or poor support networks;
• Mental health problems combined with criminal offending (forensic);
• Non-identification of the illness by professionals (e.g. untreated post-natal depression can lead to significant attachment problems);
• Previous referrals to LA children's social care for other children.

5.32.5

Adult mental health services should have named nurses / doctors / professionals for safeguarding children within their agency and seek advice from them if necessary.

Importance of working in partnership

5.32.6

Adult mental health professionals must identify those service users who are pregnant and those who are parents or who have regular access to children, whether they reside with children or not. Professionals should consider the needs of all children as part of their Care Programme Approach (CPA) assessments.

5.32.7

When adult mental health services and LA children's social care are both involved with a family, joint assessments should be carried out to assess the support parents need and the risk of harm to the child/ren, in line with section 6. Referral and assessment (section 6.4. Referral criteria and the indicator table at 6.4.4, provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment). Other agencies / services should be involved as appropriate (e.g. primary care).

5.32.8

Where appropriate, children should be given an opportunity to contribute to assessments as they often have good insight into the patterns and manifestations of their parent's mental ill-health.

5.32.9

CPA assessments and meetings for any adult who is a parent must include ongoing monitoring of the needs and risk factors for the children concerned. LA children's social care should be invited to contribute if they are involved with a family or where risks and needs have been identified that justify their involvement.

5.32.10

Mental health professionals must be included in strategy meetings, child protection conferences or associated meetings if a mental health service user is involved.

5.32.11

Mental health inpatient services should have written policies regarding the welfare of children and particularly the visiting of inpatients by children. See section 5.39. Psychiatric wards and facilities (children visiting).

5.32.12

Local Safeguarding Children Boards are responsible for taking full account of the challenges and complexities of work in this area by ensuring that inter-agency / disciplinary protocols are in place to clarify arrangements for co-ordination of assessment, support and collaboration.

5.33.1

Parental learning disabilities do not necessarily have an adverse impact on a child's developmental needs, but it is essential to always assess the implications for each child in the family. Learning disabled parents may need support to develop the understanding, resources, skills and experience to meet the needs of their children. Such support is particularly necessary where the parent/s experience the additional stressors of:

• Social exclusion;
• Having a disabled child (see section 5.11. Disabled children);
• Experiencing domestic violence (see section 5.12 Domestic violence);
• Having poor mental health (see section 5.32 Parental mental illness);
• Having substance misuse problems (see section 5.34 Parents who misuse substances);
• Having grown up in care (see section 5.18 Foster care and section 5.40 Residential care).

5.33.2

In most cases it is these additional stressors, when combined with a parent's learning disability, that are most likely to lead to concerns about the care their child/ren may receive. If a parent with learning difficulties appears to have difficulty meeting their child/ren's needs, a referral should be made to LA children's social care, who have a responsibility to assess the child's needs and offer supportive and protective services as appropriate.

5.33.3

Where a parent has enduring and / or severe learning disabilities, children in the household are more likely to be at risk of, or experiencing, significant harm through emotional abuse, and / or neglect, but also through physical and / or sexual abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.33.4

The following factors may contribute to a child having suffered or being at risk of suffering significant harm:

• Children of parents with learning disabilities are at increased risk from inherited learning disability and more vulnerable to psychiatric disorders and behavioural problems, including alcohol / substance misuse and self- harming behaviour;
• Children having caring responsibilities inappropriate to their years placed upon them, including looking after siblings (see section 5.47 Young carers);
• Neglect leading to impaired growth and development, physical ill health or problems in terms of being out of parental control;
• Mothers with learning disabilities may be targets for men who wish to gain access to children for the purpose of sexually abusing them.

5.33.5 

LA children's social care, vulnerable adult's services and other agency services must undertake a multi-disciplinary assessment using the Assessment Framework (see section 6. Referral and assessment and appendix 5 for a summary and diagram of the Assessment Framework), including specialist learning disability and other assessments, to determine whether or not parents with learning disabilities require support to enable them to care for their children. Such assessment will also assist in considering whether the level of learning disability is such that it may impair the health or development of the child for an adult with learning disabilities to be the primary carer.

5.33.6

All agencies must recognise that their primary duty is to ensure the promotion of the child's welfare, including their protection from any risk of harm.

5.33.7

Local Safeguarding Children Boards are responsible for taking full account of the challenges and complexities of work in this area by ensuring inter-disciplinary / agency protocols are in place for the co-ordination of assessment and support, and for close collaboration between all local children's and adult's services.

5.33.8

LA vulnerable adult's services should ensure eligibility criteria for service provision is such that parents with learning disabilities who need help in order to be able to care for their children can benefit from support provided under the NHS and Community Care Act 1990.

5.33.9

Group education combined with home-based support increases parenting capacity. Supported parenting should include:

• Accessible information;
• Advocacy;
• Peer support;
• Multi-agency and multi-disciplinary re/assessments;
• Long-term home-based and other support

5.33.10

For further information see Good practice guidance on working with parents with a learning disability (DH / DfES, 2007), available at www.dh.gov.uk.

5.34.1

Although there are some parents who are able to care for and safeguard their child/ren despite their dependence on drugs or alcohol, parental substance misuse can cause significant harm to children at all stages of development. A thorough assessment is required to determine the extent of need and level of risk of harm for each child in the family.

5.34.2

Where a parent has enduring and / or severe substance misuse problems, children in the household are likely to be at risk of, or experiencing, significant harm primarily through emotional abuse and neglect. The child/ren may also not be well protected from physical or sexual abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of physical harm which is such that it requires a compulsory intervention by child protection agencies into the life of the child and their family.

Maternal substance misuse in pregnancy

5.34.3

Maternal substance misuse in pregnancy can have serious effects on the health and development of the child before and after birth. Many factors affect pregnancy outcomes, including poverty, poor housing, poor maternal health and nutrition, domestic violence and mental health. Assessing the impact of parental substance misuse must take account of such factors. Pregnant women (and their partners) must be encouraged to seek early antenatal care and treatment to minimise the risks to themselves and their unborn child. See section 6.8. Pre-birth referral and assessment.

Newborn babies and children

5.34.4

Newborn babies may experience withdrawal symptoms (e.g. high pitched crying and difficulties feeding), which may interfere with the parent / child bonding process.  Babies may also experience a lack of basic health care, poor stimulation and be at risk of accidental injury.

5.34.5

The risk to child/ren may arise from:

• Substance misuse affecting their parent/s' practical caring skills: perceptions, attention to basic physical needs and supervision which may place the child in danger (e.g. getting out of the home unsupervised);
• Substance misuse may also affect control of emotion, judgement and quality of attachment to, or separation from, the child;
• Parents experiencing mental states or behaviour that put children at risk of injury, psychological distress (e.g. absence of consistent emotional and physical availability), inappropriate sexual and / or aggressive behaviour, or neglect (e.g. no stability and routine, lack of medical treatment or irregular school attendance);
• Children are particularly vulnerable when parents are withdrawing from drugs;
• The risk is also greater where there is evidence of mental ill health, domestic violence and when both parents are misusing substances;
• There being reduced money available to the household to meet basic needs (e.g. inadequate food, heat and clothing, problems with paying rent [that may lead to household instability and mobility of the family from one temporary home to another]);
• Exposing children to unsuitable friends, customers or dealers;
• Normalising substance use and offending behaviour, including children being introduced to using substances themselves;
• Unsafe storage of injecting equipment, drugs and alcohol (e.g. methadone stored in a fridge or in an infant feeding bottle). Where a child has been exposed to contaminated needles and syringes (see also section 5.5 Blood-borne viruses);
• Children having caring responsibilities inappropriate to their years placed upon them (see section 5.47 Young carers);
• Parents becoming involved in criminal activities, and children at possible risk of separation (e.g. parents receiving custodial sentences);
• Children experiencing loss and bereavement associated with parental ill health and death, parents attending inpatient hospital treatment and rehab programmes;
• Children being socially isolated (e.g. impact on friendships), and at risk of increased social exclusion (e.g. living in a drug using community);
• Children may be in danger if they are a passenger in a car whilst a drug / alcohol misusing carer is driving.

5.34.6

Children whose parent/s are misusing substances may suffer impaired growth and development or problems in terms of behaviour and / or mental / physical health, including alcohol / substance misuse and self-harming behaviour.

5.34.7

See the National Patient Safety Alert (November 2009) Preventing harm to children from parents with mental health needs.

Importance of working in partnership

5.34.8

Substance misuse professionals must identify those adults who are parents, or who have regular care giving access to children, and share the information with LA children's social care as early as possible.

5.34.9

LA children's social care, substance misuse services and other agency services must undertake a multi-disciplinary assessment using the Assessment Framework (see section 6. Referral and assessment and appendix 5 for a summary and diagram of the Assessment Framework), including specialist substance misuse and other assessments, to determine whether or not parents with substance misuse problems can care adequately for their child/ren. Such assessment should include whether they are willing and able to lower or cease their substance misuse, and what support they need to achieve this.

5.34.10

Professionals in all agencies must recognise that their primary duty is to safeguard and promote the welfare of the child/ren.

5.34.11

All care programme meetings for adults who are a parent must include ongoing assessment of the needs or risk factors for the child/ren concerned. LA children's social care should be invited to such meetings if appropriate and contribute.

5.34.12

Strategy meetings / discussions, child protection conferences and core group meetings, must include professionals from any drug and alcohol service involved with the subject child and their family.

5.34.13

Local Safeguarding Children Boards are responsible for taking full account of the challenges and complexities of work in this area by ensuring that inter-disciplinary / agency protocols and training are in place for the co-ordination of assessment and support and for close collaboration between all local children's and adult's services.

5.35.1

This section should be read in conjunction with section 5.42 Sexually active children and section 5.43. Sexually exploited children. Professionals should seek more detail, as appropriate, from the supplementary London child protection procedure Safeguarding Sexually Active Children (London Board, 2006).

5.35.2

Professionals have a responsibility to consider the welfare of both the prospective mother and her baby. However, the paramount concern must be for the welfare of the baby, and there should be no circumstances in which concerns about the baby are not shared and investigated for fear of damaging a relationship with a young parent.

5.35.3

Where a parent is herself a child, in the absence of support for her needs and responsibilities, her baby could be at risk of significant harm, primarily through neglect or emotional abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is likely to suffer a degree of physical harm which is such that it requires a compulsory intervention by child protection agencies into the life of the child and their family.

Mother under 16 years

5.35.4

Professionals in all agencies should be alert to situations where a teenage mother is not in contact with LA children's social care. If she is under 16, then a referral should be made to LA children's social care at the earliest opportunity, in line with section 6. Referral and assessment (see also section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment). See also section 5.42 Sexually active children.

Health and education professionals are most likely to have contact with pregnant teenagers.

5.35.5

LA children's social care should undertake an assessment of the unborn child's needs (see section 6.8. Pre-birth referral and assessment) and any potential risk of harm posed to them from the mother's needs and circumstances, including the mother's relationship with the father / current partner (including using the indicators in section 5.42 Sexually active children).

Mother over 16 years

5.35.6

If a young mother is over 16, professionals should:

• Make an assessment of the risk of harm to the baby, consulting their agency's child protection adviser as appropriate;
• Assess the risk of harm to the mother through her relationship with the father / current partner.

5.35.7

If, on the basis of these assessments, a professional has concerns about the ability of a young mother over the age of 16 to care for her baby without additional support, then a referral should be made to LA children's social care in line with section 6. Referral and assessment.

5.36.1

One or more assessment interview should be conducted in order to determine whether and in what way the child is emotionally disturbed, and also whether therapy treatment is needed. This could be as part of an assessment undertaken using the Assessment Framework (see section 6. Referral and assessment and appendix 5 for a summary and diagram of the Assessment Framework).

5.36.2

The decision about the need for therapeutic support (separate from formal court preparation of a child witness) should be considered:

• Keeping the child's interests paramount;
• Taking the child's wishes and feelings into account;
• On a multi-agency basis;
• In consultation with the child's parent/s;
• Taking the potential impact on criminal proceedings into account.

5.36.3

The decision should normally be made following a professional assessment of the child's need for therapy, and may be taken as part of a strategy meeting / discussion or in a child protection conference, or, if the child is not subject to child protection processes, in a multi-agency meeting arranged for this purpose.

5.36.4

If there is a demonstrable need for the provision of therapy and it is possible that the therapy will prejudice the criminal proceedings, consideration may need to be given to abandoning those proceedings in the interests of the child's wellbeing.

5.36.5

Alternatively, there may be some children for whom it will be preferable to delay therapy until after the criminal case has been heard, to avoid the benefits of the therapy being undone.

5.36.6

While some forms of therapy may undermine the evidence given by the witness, this will not automatically be the case. Multi-agency advice must be sought on the likely impact on the evidence of the child receiving therapy.

5.36.7

An assessment may be needed to inform a decision on whether a child with special needs (e.g. disabled children and those with learning disabilities, hearing and speech impairments etc) can, with the appropriate assistance, be a competent witness.

5.36.8

Therapeutic support may be sought / offered through a number of routes. Professionals who provide therapeutic support to children must be aware of the guidance Provision of Therapy for Child Witnesses (Home Office / CPS / DoH 2001, available at www.cps.gov.uk and the implications for the criminal process in terms of both disclosure and contamination of evidence.

5.36.9

The initial joint investigative interview with the child, including any visually recorded interview, should be undertaken prior to any new therapeutic work in order that the original disclosure is not undermined.

5.36.10

Where it becomes apparent that a child is already receiving therapeutic support at the point of the criminal investigations and child protection enquiries, there must be discussion as to how the work should proceed. The fact that therapeutic work is already underway will not necessarily prevent a case proceeding before a criminal court.

5.36.11

Prosecutors may need to be made aware of the contents of the therapy sessions, as well as other details specified in the above paragraph, when considering whether or not to prosecute and their duties of disclosure.

Crown Prosecution Service

5.36.12

The police should inform the Crown Prosecution Service as soon as therapeutic support is recommended, using a named contact point for the case relating to the child. Direct consultation between the professionals may be advisable in some cases and should be arranged through the police officer in the case.

5.36.13

The Crown Prosecution Service should advise the police of the potential impact of any proposed therapeutic support on criminal proceedings in each individual case.

5.36.14

It is the responsibility of the reviewing crown prosecution lawyer to seek confirmation from the police as to:

• Whether therapeutic work has been undertaken;
• If so, whether the witness said anything inconsistent with the disclosure to the police;
• What sort of therapeutic work was undertaken.

Therapeutic services

5.36.15

Professionals who provide therapeutic support to children must have appropriate training according to the level of work to be undertaken, as well as a thorough understanding of the effects of abuse. They must be a member of an appropriate professional body or have other recognised competence. They must also have a good understanding of how the rules of evidence for witnesses in criminal proceedings may require modification of techniques.

Pre-trial planning meeting

5.36.16

Where it is considered that therapeutic intervention is appropriate and has been commissioned, a pre-trial planning meeting should be convened.

5.36.17

Where LA children's social care is involved with the child, the team manager or service manager should convene and chair the meeting, and arrange for a formal record of it to be made.

5.36.18

Where LA children's social care is not involved, the therapeutic service commissioned to undertake work, or already involved with the child, should convene the meeting.

5.36.19

A formal record of the meeting should be made, and it should be noted that this may be disclosed in criminal proceedings.

5.36.20

Pre-trial planning meetings will involve relevant professionals from LA children's social care, police and the service offering therapeutic work. They may also include:

• Parents (unless implicated in the alleged abuse);
• The child, if of sufficient age and understanding;
• Other relevant professionals.

Considerations at the pre-trial therapy meeting

5.36.21

The purpose of the pre-trial meeting is to:

• Confirm that therapeutic intervention is in the best interests of the child (including taking into account the child's right to justice);
• Agree the parameters and nature of any proposed therapeutic support, ensuring that the process is subject to regular review;
• Agree lines of communication between the professional who will undertake the work and other professionals.

5.36.22

In deciding on what therapeutic support is appropriate to pursue pre-trial, the following considerations apply:

• Therapeutic support is on an individual basis (i.e. no joint or group sessions are normally acceptable because of the increased risk of contamination of evidence);
• Where joint or group sessions are already in progress, the implications for continuing must be considered, and in addition the particular implications for recording what takes place;
• Therapeutic support may be subject to challenge at court. Therefore, it is better that only one worker provides the support.

Therapy

5.36.23

The professional providing therapeutic support must be able to demonstrate professional competence or a sufficient level of supervision if called in a subsequent trial.

5.36.24

If, during a therapeutic session, a child refers to the abuse they have suffered, the worker should:

• Listen and acknowledge what has been said;
• Not seek clarification or ask probing or investigative questions;
• Consider whether there is new or additional allegations or information which require urgent discussion with the police / social worker.

5.36.25

The professional who will provide therapeutic support should be given sufficient information about the nature of the abuse alleged by the child to be able to judge if the child begins to make new or additional allegations within a session.

5.36.26

Care should be taken in the recording of therapeutic sessions (videos, tapes and written records). Immediate, factual, concise and accurate notes must be made for each session, which must be retained in their original format so that they can be produced at a later date if required. Any notes, visual or audio recordings, pictures etc. used during the therapeutic sessions must be similarly maintained.

5.36.27

A pro-forma document will be completed following each session and will include:

• Date and location of session;
• Duration of session;
• Details of the professional undertaking the work with the child;
• Details of child;
• Details of other professionals present;
• Confirmation that records of the therapy sessions have been made.

5.36.28

The pro-forma documents will be copied prior to any criminal trial and the original document forwarded to the Crown Prosecution Service via the police.

Confidentiality not guaranteed

5.36.29

The professional undertaking therapeutic work needs to ensure that parents and any child of sufficient age and understanding are told that records are kept and that confidentiality cannot be guaranteed.

5.36.30

Any disclosure of new allegations by the child, or any material departure from or inconsistency with the original allegations, should be reported to the detective inspector of the police Child Abuse Investigation Team (CAIT) and to the social worker allocated to the child.

5.36.31

In newly arising allegations, therapy should not usually take place before a witness has provided a statement or, if appropriate, before a video-recorded interview has taken place. A further pre-trial planning meeting will be convened at the earliest opportunity to determine and agree the best course of action in the light of the new information or allegations.

Problem resolution

5.36.32

Any dissatisfaction should be resolved as simply as possible. This would normally be via discussion between the social worker, the professional providing the therapeutic support and the police officer in the criminal case.

5.36.33

Where disputes remain, a further pre-trial planning meeting should be convened with the Crown Prosecution Service, and involving appropriately senior agency representatives.

See also Provision of Therapy for Child Witnesses (Home Office/ CPS/ DoH 2001).

5.37.1

A private fostering arrangement is essentially an arrangement between families / households, without the involvement of a local authority, for the care of a child under the age of 16 (under 18 if disabled) by someone other than a parent or close relative (close relatives are parents, step-parents, siblings, siblings of a parent and grandparents) for 28 days or more. This could be an arrangement by mutual agreement between parents and the carers or a situation where a child has left home against their parent's wishes and is living with a friend and the friend's family.

The period for which the child is cared for and accommodated by the private foster carer should be continuous, but that continuity is not broken by the occasional short break.

5.37.2

Privately fostered children are a diverse, and sometimes vulnerable, group. Groups of privately fostered children include:

• Children sent from abroad to stay with another family, usually to improve their educational opportunities;
• Asylum seeking and refugee children;
• Teenagers who, having broken ties with their parents, are staying in short term arrangements with friends or other non-relatives;
• Children of prisoners placed with distant relatives;
• Language students living with host families;
• Trafficked children (see also section 5.46. Trafficked and exploited children).

5.37.3

Private foster carers and those with parental responsibility are required to notify LA children's social care of their intention to privately foster or to have a child privately fostered or where a child has been privately fostered in an emergency.

5.37.4

There will be circumstances in which a privately fostered child experiences physical, sexual or emotional abuse and / or neglect to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.37.5

Teachers, health and other staff working with children should make a referral to LA children's social care and the police if:

• They become aware of a private fostering arrangement which is not likely to be notified to the local authority; or
• They have doubts about whether a child's carers are actually their parents, and there is any evidence to support these doubts (including concerns about the child/ren's welfare (see also section 5.46. Trafficked and exploited children).     

It is likely that LA children's social care will not have been notified of most private fostering arrangements. See also section 6. Referral and assessment and section 7. Child protection enquiries.

5.37.6

When LA children's social care become aware of a privately fostered child, they must assess the suitability of the arrangement. They must make regular visits to the child and the private foster carer.

5.37.7

LA children's social care should visit and see the child alone unless this is inappropriate; they must visit the parent of the child when reasonably requested to do so. The child should be given contact details of the social worker who will be visiting him/her while s/he is being privately fostered.

5.37.8

The Children (Private Arrangements for Fostering) Regulations 2005 and the amended s67 of the Children Act 1989 strengthens the duties upon local authorities in relation to private fostering by requiring them to:

• Satisfy themselves that the welfare of children who are privately fostered within their area is being satisfactorily safeguarded and promoted;
• Ensure that such advice as appears to be required is given to private foster carers;
• Visit privately fostered children at regular six weekly intervals in the first year and 12 weekly in subsequent years;
• Satisfy themselves as to the suitability of the private foster carer, and the private foster carer's household and accommodation. The local authority has the power to impose requirements on the foster carer or, if there are serious concerns about the arrangement, to prohibit it;
• Promote awareness in the local authority area of the requirement to notify, advertise services to private foster carers and ensure that relevant advice is given to privately fostered children and their carers;
• Monitor their own compliance with all the duties and functions in relation to private fostering, and to appoint an officer for this purpose.

5.37.9

Private fostering can place a child in a vulnerable position because checks as to the safety of the placement will not have been carried out if the local authority is not advised in advance of a proposed placement. The carer may not provide the child with the protection that an ordinary parent might provide. In many cases, the child is also looked after away from a familiar environment in terms of region or country.

5.38.1

This section provides additional guidance to section 5.23 Hospitals and section 5.24 Hospitals (specialist), and the sections should be read in conjunction with each other.

See also the National Service Framework for children, young people and maternity services (Children's NSF) which sets out standards for hospital services in respect of individual children's safety and well-being.

5.38.2

Children who require treatment as an in-patient in a psychiatric setting will usually be admitted on a voluntary basis, otherwise the Mental Health Act 1983 or the Children Act 1989 will apply. The admission criteria will differ, such as acute (crisis or short term), for eating disorders or challenging behaviour. Age ranges can vary considerably and some children may be admitted to an adult psychiatric setting. Catchment areas for some hospitals may cover a regional or national area depending on the specialism.

5.38.3

Where consent for treatment is required, it should be clarified by the lead professional (e.g. LA children's social care, child and adolescent mental health services (CAMHS)) whether this is being carried out under the Mental Health Act 1983 or the Children Act 1989.

5.38.4

If any child who is considered to be Fraser competent is unwilling to remain as an informal patient consideration should be given to use the Mental Health Act 1983. For children under 16 where a Fraser competent child wishes to discharge him or herself as an informal patient from hospital, the contrary wishes of those with parental responsibility will ordinarily prevail. Where there is dispute consideration should be given to use the Act. Similarly if a 16 or 17 year old in unwilling to remain in hospital as an in-patient, consideration may need to be given whether he or she should be detained under the Act.

5.38.5

Children in psychiatric settings may need to be isolated from other patients or require control and restraint on occasions, and staff should be appropriately trained to meet their needs and safeguard their welfare. When a child is admitted to psychiatric settings where adults are inpatients, a risk assessment must be undertaken to avoid the child being placed in vulnerable situations.

5.38.6

Children admitted to psychiatric settings may disclose information about abuse or neglect concerning themselves or others. Disclosures may be made when the child feels it is safe to talk or when the child is angry, distressed or anxious. All allegations should be treated seriously and usual procedures followed.

See also section 5.20. Harming others.

5.39.1

Visits by children to psychiatric wards or hospitals should be undertaken to maintain a positive relationship for the child with the patient, who will usually be their parent or more rarely a family member such as a sibling. A visit by a child should only take place if it is in their best interest.

5.39.2

When a child visits a psychiatric ward or hospital, they could be at risk of significant harm through physical, sexual and/or emotional harm (see section 4.3. Recognition of abuse and neglect).

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and/or emotional harm through abuse or neglect, which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.39.3

This section applies to children visiting all patients receiving in-patient treatment and care from specialist psychiatric services, whether or not they are detained under the Mental Health Act 1983. This includes children visiting detained adolescent patients and adolescents who are being cared for in adult facilities.

Visiting patients in psychiatric wards

5.39.4

When children visit adult patients, all psychiatric in-patient settings should:

• Place child welfare at the heart of professional practice for all staff involved in the assessment, treatment and care of patients;
• Take account of the needs and wishes of children as well as patients;
• Address the whole process, including preadmission assessment, admission, care planning, discharge and aftercare;
• Assess the desirability of contact between the child and patient, identify concerns and assess the potential risks of harm to the child in a timely way;
• Establish an efficient procedure for dealing with requests for child visits in those cases where concerns exist;
• Establish a process for child visits which is:
  • not bureaucratic
  • supportive of both the child and the adult
  • does not cause delay in arranging contact
  • maximises the therapeutic value of the visit
  • ensures the child's welfare is safeguarded
• Set and maintain standards for the provision of facilities for child visiting;
• Ensure that staff are competent to manage the process of child visits.

5.39.5

See the Mental Health Act 1983 Code of Practice - [The Guidance on the Visiting of Psychiatric Patients by Children HSC 1999/222; and LAC (99) 32: Mental Health Act 1983 code of practice : guidance on the visiting of psychiatric patients by children].

Pre-visit arrangements

Compulsory admission

5.39.6

When a compulsory admission is planned for an adult who is a parent, the approved social worker must assess the child/ren's needs and the suitability of arrangements for their care. If there are concerns (see 5.36.16 and section 5.32. Parental mental illness) about the safety or care arrangements of the child/ren, the approved social worker must request that LA children's social care undertakes an assessment (see section 6. Referral and assessment). LA children's social care should make a recommendation to the hospital about the suitability of the children visiting their parent.

5.39.7

The approved social worker should, wherever possible, provide the hospital with the child/ren's assessment information. This may, as appropriate, include the recommendation made by LA children's social care when the patient was admitted, together with the views of those with parental responsibility about the child/ren visiting the patient in hospital.

Expected visit by a child

5.39.8

The ward manager/nurse in charge is responsible for the decision to allow a visit by a child. When a visit by a child is expected, the ward manager/nurse in charge should consider the available information about the child (as outlined in 5.39.6 and 5.39.7, above), alongside the assessment of the patient's needs for treatment and care and an assessment of the current state of the patient's mental health. The ward manager/nurse in charge should then make the decision in consultation with other members of the multi-disciplinary hospital team.

5.39.9

The ward manager/nurse in charge must make their decision on the basis of the interests of the child being paramount, superseding those of the adult patient.

Unexpected visit by a child

5.39.10

If a child visits unexpectedly, the ward manager/nurse in charge is responsible for deciding whether it is feasible, whilst they wait, to consider the available information about the child (as outlined in sections 5.39.6 and 5.39.7 above), alongside the assessment of the patient's needs for treatment and care and an assessment of the current state of the patient's mental health. The ward manager/nurse in charge should then make the decision in consultation with other members of the multi-disciplinary hospital team. If this is not feasible, the visit must be refused.

Patients admitted informally

5.39.11

Most patients are admitted informally. When a patient has been admitted on an informal basis, nursing staff should seek out information about children who may be visiting. When nursing staff are aware that a patient has a child, and there is a LA children's social worker or adult mental health care co-ordinator working with the patient, nursing staff should check with the social worker / care co-ordinator about the desirability of children visiting and the arrangements which have been made. Such discussions should be clearly documented.

5.39.12

If there are concerns about the safety or care arrangements of the child/ren (see section 5.39.16 below, and section 5.32. Parental mental illness) and there is no LA children's social worker involved, the ward manager/nurse in charge must request that LA children's social care undertake an assessment (see section 6. Referral and assessment). LA children's social care should make a recommendation to the hospital about the suitability of the child/ren visiting the patient.

5.39.13

Where LA children's social care has been asked to undertake such an assessment, their report should be sent back within one week of receipt of the written request / referral from the ward manager/nurse in charge (see section 5.39.12, above) in order to avoid delay in arrangements for the child.

5.39.14

The ward manager/nurse in charge is responsible for the decision to allow a visit by a child, and must follow the same decision making process for informal admissions and for compulsory admission (see sections 5.39.8 to 5.39.10 above).

5.39.15

In the vast majority of cases where no concerns have been identified, arrangements should be made to support the patient and child and to facilitate contact.

Identifying concerns

5.39.16

Concerns about the desirability of a child visiting may arise in a number of areas.  These could relate to:

• Consideration of the child's best interests;
• The patient's history and family situation;
• The patient's current mental state (which may differ from an assessment made immediately prior to or on admission);
• The response by the child to the patient's illness;
• The wishes and feelings of the child;
• The developmental age and emotional needs of the child;
• The views of those with parental responsibility;
• The nature of the service and the patient population as a whole;
• Availability of a suitable environment for contact.

See also section 5.32. Parental mental illness.

5.39.17

The hospital multi-disciplinary team may use the Framework for Assessing Children in Need and their Families (see appendix 5 for a summary of the Assessment Framework) to consider the best interests of the child in these situations.

5.39.18

A range of options may present themselves when concerns are identified in any of the areas above, and the concerns need not automatically result in a refusal of visiting. The hospital multi-disciplinary team must obtain a balance between the management of risk of harm and the interests of the child/ren and patients.

5.39.19

It may be helpful for the Hospital Trust and / or Local Safeguarding Children Board to consider whether or not to provide a service to facilitate contact. Research has highlighted the dangers of loss of contact with children for people who are psychiatric in-patients in hospital

Decisions to refuse a child's visits

5.39.20

The ward manager/nurse in charge may refuse to allow a child to visit if they have reason to believe it is not in the best interest of the child or patient.

5.39.21

The decision to prohibit a visit should be regarded as a serious interference with the rights of the patient and should only be taken in exceptional circumstances.

5.39.22

Decisions to refuse visits should be given verbally and confirmed in writing. They must be supported by clear evidence of concerns and the difficulties of managing them.

5.39.23

Policies should clearly set out the steps to be taken in making the decision to refuse visiting, including the process for:

• Consulting with the patient, the child (depending on age and understanding), those with parental responsibility and, if different, person/s with day to day care for the child, advocates and, where relevant, the LA children's social care;
• Communicating the decision to the patient, other family members, the child and those with parental responsibility;
• Reviewing any decision and the means of communicating this to the patient, advocate or other person or agency involved in the decision;
• Enabling a patient and others with parental responsibility to make representation against any decision not to visit, including access to assistance and independent advocacy. Such a system should be consistent with the Trust's overall complaints procedure and should contain an independent element.

Making arrangements for visits

5.39.24

The hospital or mental health trust providing the service must ensure that the hospital contains facilities for all patients to have contact with their children in a venue which is conducive to the child's safety and good quality contact for both child and patient.

5.39.25

Children should have appropriate supervision according to their age and need when they are visiting mental health service users. They should normally be accompanied by someone who has parental responsibility for their care and well being.

5.39.26

In some cases, it may be better for arrangements to be made for visiting away from the hospital. In the case of detained patients, this will require due consideration of the need for leave. Staff must be aware of the child protection and child welfare issues in granting leave of absence under s.17 of the Mental Health Act 1983.

Visiting patients in the special hospitals: Ashworth, Broadmoor and Rampton

5.39.27

Specialist hospitals must have procedures for child visiting that have been developed specifically for that service.  Decisions about whether to permit a child to visit a unit must always be based on:

• The interests of the child;
• The service user's offending history;
• The clinical history of the service user;
• The conditions under which the visit will take place.

5.39.28

A hospital may not allow a child to visit any patient unless the hospital's authority has approved the visit in accordance with the directions pertaining to the patient's admission (see 5.39.41 and The Directions and associated guidance to Ashworth, Broadmoor and Rampton Hospital Authorities (HSC 1999/160)) and in particular is satisfied that the visit is in the child's best interests.

The only exception to this is where there is a contact order made under the Children Act 1989 which specifies that the child may visit the patient in the special hospital. In such cases, visits should be allowed except where there are concerns about the patient's mental state at the time of the proposed visit, such that the nominated officer decides the visit would not be in the child's best interests (see 5.39.40).

Request for a child to visit

5.39.29

There may be cases where the patient has been:

• Convicted of murder or manslaughter, or an offence which leads to them being identified (by probation / youth offending services, police or health services, individually or via the Multi-Agency Public Protection Arrangements) as posing an ongoing risk to a child; or
• Found unfit to be tried or not guilty by reason of insanity, in respect of a charge of murder or manslaughter or an offence which leads to them being identified (by probation / youth offending services, police or health services, individually or via the Multi-Agency Public Protection Arrangements) as posing an ongoing risk to a child,

In these circumstance, the child must be within the permitted categories of relationship set out in The Directions and associated guidance to Ashworth, Broadmoor and Rampton Hospital Authorities (HSC 1999/160) (see 5.39.41, below).

5.39.30

If the patient's circumstances are not those in section 5.38.29, above or the child is within the permitted categories of relationship, the nominated officer should:

• Obtain written permission from the patient to contact those with parental responsibility for the child;
• Write to the person/s with parental responsibility for the child:
  • explaining that a request for a visit has been made
  • asking for confirmation of the relationship between the patient and the child
  • requesting consent for the child to visit the patient
  • explaining that before a visit can proceed, LA children's social care will be asked to assess whether the visit is in the child's best interests
• Write to any person/s without parental responsibility but with day-to-day care for the child (e.g. a grandparent), explaining that a request for a visit has been made and that the person with parental responsibility will be contacted.

5.39.31

In the case of a child who is looked after by the local authority and subject to a care order (with parental responsibility shared by the local authority and the parent/s), LA children's social care has responsibility for providing consent (following consultation with those with parental responsibility). Where a child is looked after by the local authority but not subject to a care order, the person with parental responsibility is required to give their consent.

5.39.32

If those with parental responsibility state that they are prepared to allow their child to visit the patient, the nominated officer should arrange for the patient's clinical team to undertake an assessment. This assessment is to judge the level of risk, if any, presented by the patient to children and to the particular child for whom the visit request has been made. Procedures for undertaking this type of assessment should be agreed with both the relevant LA children's social care service and Local Safeguarding Children Board for the hospital.

5.39.33

If the hospital's assessment of the risk of harm posed by the patient to the child does not rule out a visit, the nominated officer must:

• Contact the Director of Children's Services for the LA children's social care service where the child resides to request advice on whether the visit is in the best interests of the child;
• Include in the request a copy of the hospital's assessment and any other any relevant information about the patient, to assist LA children's social care to assess whether the proposed visit is in the child's best interests;
• Include in the request any information about other LA children's social care services which have relevant information about the child or the child's family;
• Inform the parents of the child that LA children's social care have been asked to make contact with the family.

LA children's social care response

5.39.34

On receipt of the request from the hospital (see section 5.39.33, above), LA children's social care should contact those with parental responsibility (and those caring for the child if they are different) to arrange to undertake an assessment to establish:

• The child's legal relationship with the named patient;
• The quality of the child's relationship with the named patient, prior to hospitalisation and currently;
• Whether there has been past abuse of the child, alleged or confirmed, by the patient;
• The likelihood of future risks of significant harm to the child if the visits took place;
• The child's wishes and feelings about the visit, taking account of their age and understanding;
• The views of those with parental responsibility and, if different, person/s with day-to-day care for the child;
• If it is known the child has lived in other LA children's social care areas, what other relevant information is known about the child and family;
• The frequency of contact that would be appropriate.

5.39.35

LA children's social care should send the completed assessment report to the nominated officer, advising whether the visit would be in the best interests of the child.

5.39.36

If LA children's social care advises that a visit would be in the child's best interests, the nominated officer should discuss this with LA children's social care and make a decision about the visit, taking account of any potential risk posed by the patient and the potential risk of significant harm being suffered by the child.

5.39.37

If the person/s with parental responsibility refuses to co-operate with the LA children's social care assessment, LA children's social care should consider its legal position:

• If the child is known to LA children's social care, it could make its report on the basis of the information it has already but make clear that the information is not up to date and does not take account of the wishes and feelings of the child;
• If LA children's social care holds no information about the child, it should inform the hospital that it is unable to make any report.

The visit

5.39.38

Any visits by children must:

• Take place in an appropriate atmosphere and setting (i.e. child-centred and child-friendly), taking account of the age of the children (as advised by the LA children's social care service local to the hospital) whilst maintaining the required level of security;
• Be properly supervised throughout the visit, with sufficient staff present (of an appropriate grade and with requisite knowledge and understanding and enhanced Criminal Record Bureau checks - for children, not just vulnerable adults) to supervise the children's visits at all times and to prevent unauthorised contacts;
• Allow the child contact with only the named patient for whom a visit has been approved. No children are to visit on the ward areas.

5.39.39

The nominated officer must ensure that a child's contact with a patient within the hospital takes place at a frequency which is in the child's best interests, taking account of advice from LA children's social care. All visits by children shall be specifically authorised by the nominated officer.

Refusing a visit

5.39.40

There are five circumstances in which the nominated officer must refuse to allow a child to visit. These are if:

• The relationship between the patient and the child is not within the permitted categories of relationship as set out in paragraph 2(2)(b) of the Directions (see section 5.39.41 below). The nominated officer must notify the patient of the decision and reasons for it in writing. However, the patient has no right to make representations against this decision.
• The person/s with parental responsibility responds to the nominated officer stating that they do not agree to the child visiting the patient. The decision and the reasons for the decision must be put in writing to the patient.
• The hospital's assessment indicates that the patient's mental health state and/or risk to children is such (in the immediate or longer-term) that it would not be appropriate for the child to visit the patient. The decision to refuse the visit must be put in writing to the patient and the person with parental responsibility and include details of the complaints procedure.
• The relevant LA children's social care service concludes that a visit is not or may not be in the child's best interests. The decision to refuse the visit must be put in writing to the patient, the child (if appropriate), those with parental responsibility, person/s with day to day care for the child, if different, and LA children's social care. Details of the review procedure should be given.
• There are concerns about the patient's mental state at the time of the visit. The reasons for the refusal should be explained to the patient, those with parental responsibility, person/s with day to day care for the child, if different, and, if appropriate, the child.

5.39.41

The Directions and associated guidance to Ashworth, Broadmoor and Rampton Hospital Authorities (HSC 1999/160) sets out the assessment process to be followed when deciding whether a child can visit a named patient in these hospitals; and LAC(99)23 sets out local authority duties and responsibilities assist the hospital by assessing whether it is in the interests of the child to visit the patient.

5.40.1

A child in residential care is vulnerable to physical, sexual or emotional abuse and / or neglect.  If there are lapses in the care provided, the child can suffer to such a degree that it constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

Good quality planning and care

5.40.2

The welfare and safety of children living in residential care should be promoted and provided for at a minimum, in line with the relevant National Minimum Standards (see www.ofsted.gov.uk), in all residential care settings.

5.40.3

All commissioners and providers of residential care services for children are responsible for ensuring that children are safeguarded. Commissioner contracts and provider procedures should be comprehensive and unambiguous in setting out the responsibilities and processes for safeguarding and promoting children's welfare.  Local Safeguarding Children Boards should monitor the welfare of children living in residential care. See section 18. LSCBs, quality assurance and conflict resolution.

5.40.4

Local authorities placing children in another local authority area are required to notify the host authority prior to placement.

5.40.5

As part of their statutory responsibilities for planning children's care, social workers are required to maintain a regular up to date assessment of child's needs, see looked after children in foster care on their own and take appropriate account of the child's wishes and feelings. Evidence of their engagement with the child must be recorded so that the plan for the child's care is kept up to date, with the child being offered the right services to respond to the full range of their needs.

5.40.6

Independent Reviewing Officers (IROs) are responsible for chairing meetings that must be scheduled at prescribed intervals to review the child's care plan. IROs have specific responsibilities to ensure that the plan has taken the child's wishes and feelings into account and that their care plan remains appropriate in view of the child's needs, including their need to be effectively safeguarded.

5.40.7

The standards for children living in residential care include that:

• Children feel valued and respected and their self-esteem is promoted;
• There is an openness on the part of the residential care service to the external world and external scrutiny, including contact with families and the wider community;
• Residential care and support staff are trained in all aspects of safeguarding children, are alert to children's vulnerabilities and risks of harm, and are knowledgeable about how to implement safeguarding children procedures;
• Children who live in residential care are listened to and their views and concerns responded to;
• Children have ready access to a trusted adult outside the residential care setting (e.g. a family member, the child's social worker, independent visitor, children's advocate). Children should be made aware of the help they could receive from independent advocacy services, external mentors, and ChildLine (see section 2. Roles and responsibilities, 2.25.12 NSPCC);
• Residential care and support staff recognise the importance of ascertaining the wishes and feelings of children and understand how individual children communicate by verbal or non-verbal means;
• here are clear procedures for referring safeguarding concerns about a child to the relevant LA children's social care service;
• In relation to complaints:
  • complaints procedures should be clear, effective, user friendly and readily accessible to children and young people, including those with disabilities and those for whom English is not their preferred language
  • procedures should address all expressions of concern, including formal complaints. Systems that do not promote open communication about 'minor' complaints will not be responsive to major ones, and a pattern of 'minor' complaints may indicate more deeply seated problems in management and culture which need to be addressed
  • records of complaints should be kept by providers of children's services (e.g. there should be a complaints register in every boarding school which records all representations including complaints, the action taken to address them, and the outcomes)
  • children should be genuinely able to raise concerns and make suggestions for changes and improvements, which are taken seriously
    
    See section 18. LSCBs, quality assurance and conflict resolution.
• Bullying is effectively countered (see section 5.7. Bullying);
• Recruitment and selection procedures are rigorous and create a high threshold of entry to deter abusers (see section 17. Safer recruitment);
• There is effective supervision and support, which extends to temporary staff and volunteers (see section 16. Supervision and training);
• The residential care service contract staff are effectively checked and supervised when on site or in contact with children;
• Clear procedures and support systems are in place for dealing with expressions of concern by residential care and support staff about other staff or carers (see section 15. Allegations against staff);
• Organisations have a code of conduct instructing residential care and support staff on their duty to their employer and their professional obligation to raise legitimate concerns about the conduct of colleagues or managers. There should be a guarantee that procedures can be invoked in ways which do not prejudice the 'whistle-blower's' own position and prospects;
• There is respect for diversity and sensitivity to race, culture, religion, gender, sexuality and disability;
• Residential care and support staff are alert to the risks of harm to children in the external environment from people prepared to exploit the additional vulnerability of children living away from home.

Promoting and protecting a child's welfare

5.40.8

It is important that children have a voice outside the residential unit. Social workers are required to see children in residential units on their own (taking appropriate account of the child's wishes and feelings) at regular intervals and evidence of this should be recorded.

5.40.9

Residential carers should be provided with full information about the child and their family, including details of abuse or possible abuse and whether the child has harmed others, both in the interests of the child and of the staff and other children in the residential unit.

5.40.10

Residential carers should monitor the whereabouts of the children, including their patterns of absence and contacts. Residential carers should follow the recognised procedure of their agency on sharing general concerns about a child, and whenever a child is missing from the unit. This will involve notifying the placing authority and, where necessary, the police of any unauthorised absence by a child. See section 5.29. Missing from care and home.

5.40.11

Residential carers should have guidance on sharing more general concerns (e.g. alerting other professionals, considering child behaviour around contact, absences, school, moods etc.).

5.40.12

The local authority's duty to undertake s47 enquiries, when there is reasonable cause to suspect that a child is suffering, or is likely to suffer, significant harm, applies on the same basis to children in residential care as it does to children who live with their own families.

5.40.13

Such enquiries will consider the safety of any other children living in the residential unit. If child protection concerns are raised about the care in a residential unit, the local authority in which the child is living has the responsibility to convene a strategy meeting / discussion, which should include representatives from the responsible local authority which placed the child; a representative from Ofsted should also be invited. At the strategy meeting / discussion, it should be decided which local authority should take responsibility for the next steps, which may include a s47 investigation. If the case appears to be a complex one, see section 14. Organised and complex abuse.

For further details on this see section 15. Allegations against staff, section 6. Referral and assessment, including section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment; and section 7. Child protection enquiries.

5.40.14

See also section 8. Child protection conferences.

5.41.1

Self-harm and suicide threats and gestures by a child put the child at risk of significant harm, and should always be taken seriously. They may also be indicative of psychological or emotional disturbance triggered by physical, sexual and / or emotional abuse or chronic neglect which may also constitute significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.41.2

Professionals should also consider the circumstances of a serious eating disorder or extreme risk-taking as a threat or attempt at self-harm or suicide by a child.

5.41.3

Children can be particularly vulnerable at times of transition, when any emotional difficulties they may be experiencing are compounded by changes which they may find stressful or frightening (e.g. leaving home or care, transferring to adult services, facing or being in custody, experiencing a family break-up).

5.41.4

Professionals may be able to reduce or prevent self-harming behaviours by planning for transitional support for children already receiving care services, and being alert to children becoming stressed and isolated in universal settings.

5.41.5

Professionals in all agencies who become aware, through disclosure or otherwise, that a child has self-harmed or threatened or attempted suicide, should discuss this with their line manager and their agency's nominated safeguarding children adviser.

5.41.6 

Whenever a child is known to have deliberately harmed themselves, a parent should be contacted urgently. Either they or, if unavailable, a responsible adult should go with the child to the accident and emergency department (A&E) to obtain a physical and psychological assessment of his / her needs and the risk of further harm.

Professionals should base the assessment on the Assessment Framework (see section 6. Referral and assessment and appendix 5 for a summary and diagram of the Assessment Framework).

5.41.7

Children under 16 should be admitted to a children's ward under the care of a paediatrician. Irrespective of whether the child requires physical monitoring or treatment, s/he should receive the necessary assessment of mental health need and risk, together with support, from child and adolescent mental health services (CAMHS). See section 5.23 Hospitals, section 5.24 Hospitals (specialist) and section 5.38 Psychiatric care for children.

5.41.8

If the assessment indicates that there are child protection concerns, the hospital staff should consult with their nominated safeguarding children adviser and / or, as appropriate, make a referral to LA children's social care in line with section 6. Referral and assessment.

5.41.9

Any discharge should involve co-ordinated planning with community health services, CAMHS, LA children's social care and the police where appropriate.

5.42.1

This section is a summary of the supplementary London child protection procedure Safeguarding Sexually Active Children (London Board, 2006), and the two should be read in conjunction. See also the Sexual Offences Act 2003 and section 5.43 Sexually exploited children.

5.42.2

Underage sexual activity which presents cause for concern is likely to raise difficult issues and should be handled particularly sensitively.

Recognition and referral

5.42.3

A sexual relationship can present a risk of significant harm to a child if one of the intimate partners is coercive or abusive. The abuse can include physical, sexual abuse and emotional abuse. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

Children under 13 years

5.42.4

A child under 13 is not legally capable of consenting to sexual activity, accordingly under the Sexual Offences Act 2003 penetrative sex with a child under 13 years old is classed as rape.

5.42.5

Where a professional is concerned that a child is involved with penetrative sex or other intimate sexual activity, there would always be reasonable cause to suspect that a child, whether girl or boy, is suffering, or is likely to suffer, significant harm. There should be a presumption that the case will be referred to LA children's social care, in line with section 6. Referral and assessment and that a strategy discussion will be held in accordance with section 7. Child protection enquiries to discuss appropriate next steps.

5.42.6

Cases involving children under 13 should always be discussed with the agency's nominated safeguarding children adviser.

5.42.7

All cases involving under 13s should be fully documented, including giving detailed reasons if a decision is taken not to share information. These decisions should be exceptional and only made with the documented approval of a senior manager.

Children 13 to 16 years

5.42.8

Sexual activity with a child under 16 is also an offence. Where it is consensual it may be less serious than if the child were under 13, but may nevertheless have serious consequences for the child's welfare. In every case of sexual activity involving a child aged 13 to 15, professionals should consider, with their agency's nominated safeguarding children adviser, whether they should initiate a discussion with other agencies about the risk of harm to the child and whether a referral should be made to LA children's social care. Professionals should base this judgement on an assessment using the considerations in sections 5.42.11 and 5.42.12 below.

5.42.9

Where there is reasonable cause to suspect that a child is at risk of, or is suffering significant harm, there is a presumption that  professionals in all agencies will make a referral to LA children's social care in line with section 6. Referral and assessment. See section 6.4. Referral criteria and the indicator table at 6.4.4, for guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

5.42.10

All cases should be carefully documented, including where a decision is taken not to share information, and the reasons for not referring the case given.

Assessment of risk

5.42.11

Sexual abuse and exploitation of a child/ren involves an imbalance of power. The assessment should seek to identify possible power imbalances within a relationship. These can result from differences in size, age, material wealth and / or psychological, social and physical development. In addition, gender, sexuality, race and levels of sexual knowledge can be used to exert power.

5.42.12

In order to determine whether a relationship presents a risk of harm to a child, the following indicators should be considered:

• Whether the child is competent to understand, and consent to, the sexual activity they are involved in (children under 13 are not legally capable of consenting to sexual activity);
• What the child/ren in the relationship's living circumstances are, whether they are attending school, whether they or their siblings are receiving services from LA children's social care or another social care agency etc;
• The nature of the relationship between those involved, particularly if there are age or power imbalances;
• Whether overt aggression, coercion or bribery was or is involved, including misuse of alcohol or other substances as a disinhibitor;
• Whether the child's own behaviour (e.g. through misuse of alcohol or other substances) places them in a position where they are unable to make an informed choice about the activity;
• Any attempts to secure secrecy by the sexual partner beyond what would be considered usual in a teenage relationship;
• Whether methods used to secure a child's compliance, trust and / or secrecy by the sexual partner are consistent with grooming for sexual exploitation. Grooming is likely to involve efforts by a sexual predator (usually older than the child) to befriend a child by indulging or coercing them with gifts / treats (i.e. money or drugs), developing a trusting relationship with the child's family, developing a relationship with the child through the internet etc in order to abuse the child;
• Whether the sexual partner is known by one of the agencies as having, or previously having had, other concerning relationships with children (which presupposes that checks will be made with the police);
• Whether the child denies, minimises or accepts the concerns held by professionals.

Requests for police information

5.42.13

In cases where an agency requests information from the police for the purposes of a risk assessment, the police will:

• Receive the information;
• Search relevant indices and pass the results to legitimate enquirers;
• Only record the request and details provided for intelligence purposes (such requests will not be treated as allegations of crime referrals);

Depending on the result, the enquirer may then make a subsequent referral.

5.42.14

In situations where asking the police for information is deemed inappropriate due to the confidential nature of an agency's relationship with the client, the agency making the decision not to check with the police must take responsibility for conducting a risk assessment without relevant police information. This decision must be made within the agency's supervision arrangements, at a managerial level.

5.42.15

On each occasion that a professional in any agency has contact with a child (by telephone or a meeting) or receives information about them, the professional should consider whether the child's circumstances (in relation to the indicators in sections 5.42.11 and 5.42.12 above) have changed in a way which may require referral (or re-referral) to LA children's social care and the police.

LA management decision

5.42.16

There may be cases where LA children's social care staff receive a referral or become aware of a sexually active child aged 13 to 16, and decide not to make a referral to the police. This decision must be made at a managerial level, after an initial assessment, including checking police indices and with clear evidence that the child is not being abused or exploited through the sexual relationship. The decision, and the reasons for it, must be recorded contemporaneously in the child's LA children's social care record.

Criminal action against a child

5.42.17

Whilst it is an offence for any child to engage in a sexual relationship under the age of 16, in the majority of cases it will not be in the best interests of the child for criminal proceedings to be instigated against them.

5.42.18

The decision as to whether or not to proceed with criminal action against a child who has been referred to the police will be made by the Crown Prosecution Service, acting upon the advice of the police. The best interests of the child concerned will be one factor in informing this decision.

Disabled children

5.42.19

Disabled children are more likely to be abused than non-disabled children, and they are especially at risk of harm when they are living away from home. They may be particularly vulnerable to coercion due to physical dependency or because a learning disability or a communication difficulty means that it is not easy for them to communicate their wishes to another person. This increases the risk that a sexual relationship may not be consensual.

5.42.20

In assessing whether a relationship presents a risk of harm to a disabled child or young person, professionals need to consider the indicators listed in sections 5.42.11 and 5.42.12 above in the light of these potential additional vulnerabilities.

Children 16 and 17 years

5.42.21

Sexual activity involving a 16 or 17 year old, though unlikely to involve an offence, may still involve harm or the risk of harm. Professionals should still bear in mind the considerations and processes outlined in this guidance in assessing that risk, and should share information as appropriate. It is an offence for a person to have a sexual relationship with a 16 or 17 year old if they hold a position of trust or authority in relation to them (see the Sexual Offences Act 2003).

5.43.1

This section is a summary of the supplementary London child protection procedure Safeguarding Children Abused Through Sexual Exploitation (London Board, 2006), and the two should be read in conjunction. See also the Sexual Offences Act 2003 and section 5.42. Sexually active children.

5.43.2

The sexual exploitation of children is a form of child sexual abuse which includes some combination of:

• Pull factors: children exchanging sex for attention, accommodation, food, gifts or drugs;
• Push factors: children escaping from situations where their needs are neglected and there is exposure to unsafe individuals;
• Control, brain washing, violence and threats of violence by those exploiting the child.

5.43.3 

Sexually exploited children also suffer physical and emotional abuse and, often, neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.43.4 

Boys and girls may be drawn into sexual exploitation by peers who are already involved. Girls in particular are frequently coerced into sexual exploitation by an older man, posing as and viewed by them as their boyfriend. The girl is physically and emotionally dependent upon him, which may be reinforced by the use of alcohol and drugs. Over time, access to friends and family becomes curtailed and the child becomes alienated from agencies which may be able to identify and interrupt the abuse.

5.43.5

Sexually exploited children are rarely visible on the streets, and grooming children for abuse via the internet has contributed to the invisibility of the sexual exploitation of children (see section 5.25. ICT-based forms of abuse).

5.43.6

Increasingly, victims are identified under 16 years of age, across all cultures. Many children are exploited in the community, although the behaviours associated with exploitation may bring them into care and a significant number of children are targeted whilst being looked after by LA children's social care.

5.43.7

Sexually exploited children commonly have low self-esteem and have experiences which include the following signs and symptoms:

• Going missing frequently and / or from a young age;
• Bullying in or out of school;
• Previous and sometimes current sexual abuse, neglect and physical abuse, and domestic violence within the family;
• Family involvement in sexual exploitation, drugs or alcohol;
• Drug and alcohol use themselves;
• Emotional symptoms, including eating disorders, mood swings and self harm (sometimes very extreme, e.g. genital cutting);
• Involvement in theft, shoplifting, deception etc. often organised by the person exploiting them;
• A preoccupation with their mobile phone which indicates the child is being controlled (e.g. possession of multiple phones, extreme distress when one is lost or not working);
• Having limited freedom of movement;
• Showing signs of sexual activity / abuse, including STDs, terminations and pregnancy scares;
• Possession of money and goods not accounted for;
• Having an older "boyfriend" - in some cases the "boyfriend" drives them about.

Referral and assessment

Risk Assessment Framework

5.43.8 

Professionals in all agencies should be alert to the possibility that a child for whom they have concerns may be sexually exploited. They should discuss their concerns with their agency's nominated safeguarding children adviser and they should use the risk assessment framework (see Safeguarding Children Abused through Sexual Exploitation [London Board, 2006]) to make a judgement about the risk of harm to the child.

5.43.9

The framework groups indicators of risk of harm into categories:

• Category 1 (at risk): a vulnerable child who is at risk of being targeted and groomed for sexual exploitation;
• Category 2 (medium risk): a child who is targeted for opportunistic abuse through the exchange of sex for attention, accommodation, food, gifts and drugs. The likelihood of coercion and control is significant;
• Category 3 (high risk): a child whose sexual exploitation is habitual, often self defined and where coercion / control is implicit.

5.43.10

These categories also include situations where:

• A child is at immediate risk of significant harm and has other additional vulnerabilities;
• The sexual exploitation may be being facilitated by a child's parent;
• The sexual exploitation may be being facilitated by a child's parent failing to protect;
• A related or unrelated adult in a position of trust or responsibility to a child may be organising or encouraging the sexual exploitation.

Response

5.43.11

Category 1: a professional, together with their agency's safeguarding children adviser, should consider whether the agency can provide focused early intervention and diversion to meet the child's needs as a single agency, and how to proceed if not.

5.43.12

A professional or agency view that a child is at risk (category 1) may be inaccurate. Sharing information about that child may reveal them to be at medium or high risk and in need of immediate protection. See Safeguarding Sexually Active Children (London Board, 2006), which describes the process for gathering information from the Metropolitan Police.

5.43.13

If a single agency cannot meet the child's needs, they should call a network meeting of the agencies currently involved with the child, or ask LA children's social care to do so.

5.43.14

Category 2 and 3: professionals in all agencies should make a referral to LA children's social care in line with section 6. Referral and assessment.

5.43.15

Children and their families should be made aware of the concerns and engaged in developing the diversion plans. However, this should be approached with a high level of sensitivity, and attendance at network and multi-agency planning (MAP) meetings is not normally recommended as the children concerned are often subject to significant threats, bribes and conflicted loyalties. They may feel impelled to tell their abusers what is being planned and in turn become more isolated from services. Similarly, families may be unable to promote the child's best interests.

Multi-agency planning (MAP) meeting

5.43.16

LA children's social care should consider initiating s47 enquiries (see section 6. Referral and assessment, including section 6.4. Referral criteria and the indicator table at 6.4.4, which provides guidance on the difference in LA children's social care between s47 / core assessment and an initial assessment.

5.43.17

MAP meetings may run alongside other planning meetings, child protection conferences, or looked after children reviews. However, they may be the sole form of planning for the child.

5.43.18

The aim of MAP meetings is to develop a plan to enable the child to protect themselves, to recognise and avoid risky behaviours and people, and to engage in positive activities and relationships.

5.43.19

Plans should also consider:

• The risks to other children in the household or placement;
• Whether the child should remain at home or in their present placement; and
• The feasibility of controlling the child's movements, and the likely effects of doing so.

5.43.20

The child's parents, including staff in residential units and foster carers, should be asked to take positive action to clarify and record suspicions and minimise the child's involvement in sexual exploitation.

5.43.21

The safeguarding and support plan should specify who is responsible for undertaking the work. A copy of the plan and minutes should be sent to all the agencies involved with the child and a date for a review meeting should be agreed, to take place no later than three months after the initial meeting.

5.43.22

The LA children's social care child protection adviser should advise on the diversion plan for category 1 cases and agree MAP meetings for category 2 and 3 cases.

5.43.23

Implementing effective diversionary and safeguarding and support plans for children may require professionals to be extremely persistent in continuing to offer support and services. It may be that a non-LA children's social care professional may best be able to provide a direct service.

Looked after children

5.43.24

Staff in residential units should also be aware that more than one child in a unit may be being targeted, or that the abuser has previously been involved with children at the unit.

5.43.25

When a referral is received regarding a looked after child, the child's social worker must inform their team manager and the lead professional. For a description of a lead professional see section 1. Preface and introduction, 1.2.9 Lead professional and 1.6. Glossary.

5.43.26

If the child is in foster care, the social worker and fostering link worker should meet with the foster carer to decide which of the above steps could reasonably be taken by the foster carer. This needs to take place in consultation with the fostering team manager.

Role of the police

5.43.27

If there are suspicions that a child is involved in sexual exploitation, but there is no immediate or direct evidence, the police officer noting the concern should complete a coming to notice (PAC) form on the Merlin system. The Borough Public Protection Desk(PPD) will risk assess the form and share the information with LA children's social care.

5.43.28

LA children's social care and the police should put in place arrangements for deciding which officers will be responsible for investigating whether a crime has been committed.

5.43.29

Criminal action in respect of the child will not be instigated until the matter has been discussed within a MAP meeting, and then only in very limited circumstances, when it is established that all attempts at diversion have failed. Particular attention should be paid to the following:

• The age and vulnerability of the child;
• The return to sexual exploitation must be considered genuinely voluntary, with no evidence of physical, mental or emotional coercion;
• The child has been told, and understands, that criminal proceedings may take place, and the implications of this for them now and in the future.

5.43.30

See section 7. Child protection enquiries, section 8. Child protection conferences and section 9. Implementation of child protection plans, and also Safeguarding Children and Young People from Sexual Exploitation (DCSF, 2009).

5.44.1

Current guidelines for praying for children and engaging with them in a faith context are available in the 'Safe and Secure' booklet, available at: www.ccpas.co.uk, produced by the Churches' Child Protection Advisory Service (CCPAS) and the Metropolitan Police. Whilst the booklet is specifically for Christian communities, the principles it sets out for safeguarding children are the same across all faith communities and can be adapted accordingly.

See also section 2. Roles and responsibilities, 2.25.22 Faith communities.

5.44.2

Where parents, families and the child themselves believe that an evil force has entered a child and is controlling them, the belief includes the child being able to use the evil force to harm others. This evil is variously known as black magic, kindoki, ndoki, the evil eye, djinns, voodoo, obeah. Children are called witches or sorcerers.

5.44.3

Parents can be initiated into and / or supported in the belief that their child is possessed by an evil spirit by a privately contacted spiritualist / indigenous healer or by a local community faith leader. The task of exorcism or deliverance is often undertaken by a faith leader, or by the parents or other family members.

5.44.4

A child may suffer emotional abuse if they are labelled and treated as being possessed with an evil spirit. In addition, significant harm to a child may occur when an attempt is made to 'exorcise' or 'deliver' the evil spirit from the child. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.44.5

The forms the abuse can take include:

• Physical abuse: beating, burning, cutting, stabbing, semi-strangulating, tying up the child, or rubbing chilli peppers or other substances on the child's genitals or eyes;
• Emotional abuse: in the form of isolation (e.g. not allowing a child to eat or share a room with family members or threatening to abandon them). The child may also be persuaded that they are possessed;
• Neglect: failure to ensure appropriate medical care, supervision, school attendance, good hygiene, nourishment, clothing or warmth;
• Sexual abuse: within the family or community, children abused in this way may be particularly vulnerable to sexual exploitation.

Reasons for the abuse

5.44.6

A belief in spirit possession is not confined to particular countries, cultures, religions or communities. Common factors that put a child at risk of harm include:

• Belief in evil spirits: this is commonly accompanied by a belief that the child could 'infect' others with such 'evil'. The explanation for how a child becomes possessed varies widely, but includes through food that they have been given or through spirits that have flown around them;
• Scapegoating because of a difference: it may be that the child is being looked after by adults who are not their parents (i.e. privately fostered), and who do not have the same affection for the child as their own children.
• Rationalising misfortune by attributing it to spiritual forces and when a carer views a child as being 'different' because of disobedience, rebelliousness, over-independence, bedwetting, nightmares, illness or because they have a perceived or physical abnormality or a disability;
  
  Disabilities involved in documented cases included learning disabilities, mental ill health, epilepsy, autism, a stammer and deafness;
• Changes and / or complexity in family structure or dynamics: there is research evidence (see Stobart, Child Abuse linked to Accusations of Spirit Possession [DfES 2006]) that children become more vulnerable to accusations of spirit possession following a change in family structure (e.g. a parent or carer having a new partner or transient or several partners). The family structure also tended to be complex so that exact relationships to the child were not immediately apparent. This may mean the child is living with extended family or in a private fostering arrangement (see section 5.34 Private fostering). In some cases, this may even take on a form of servitude;
• Change of family circumstances for the worse: a spiritual explanation is sought in order to rationalise misfortune and the child is identified as the source of the problem because they have become possessed by evil spirits. Research evidence is that the family's disillusionment very often had its roots in negative experiences of migration:
  • in the vast majority of identified cases in the UK to date, the families were first or second generation migrants suffering from isolation from extended family, a sense of not belonging or feeling threatened or misunderstood. These families can also have significantly unfulfilled expectations of quality of life in the UK;
• Parental difficulties: a parent's mental ill health appears to be attributed to a child being possessed in a significant minority of cases. Illnesses typically involved include post-traumatic stress disorder, depression and schizophrenia.

Recognising child abuse or neglect linked to spirit possession

5.44.7

Indicators of abuse include:

• A child's body showing signs or marks, such as bruises or burns, from physical abuse;
• A child becoming noticeably confused, withdrawn, disorientated or isolated and appearing alone amongst other children;
• A child's personal care deteriorating, for example through a loss of weight, being hungry, turning up to school without food or food money or being unkempt with dirty clothes and even faeces smeared on to them;
• It may also be directly evident that the child's parent does not show concern for or a close bond with them;
• A child's attendance at school becoming irregular, or being taken out of school all together without another school place having been organised;
• A child reporting that they are or have been accused of being evil, and / or that they are having the devil beaten out of them.

5.44.8 

Professionals who are best placed to recognise when a child has been labelled as spirit possessed are those who have regular contact with children - teachers and school nurses, health professionals, community groups and churches, and in some instances LA children's social care professionals. Professionals working with parents may also become aware that a parent has come to believe that an evil spirit has entered their child.

Professional response

5.44.9

Faith based abuse may challenge a professional's own faith and / or belief, or the professional may have little or no knowledge on the issues that may arise. This makes it difficult for the professional to identify what they might be dealing with and affect their judgement. It will often take a number of contacts with the child or pieces of information to recognise the abuse.

5.44.10

Professionals should consider:

• How to build a relationship of trust with the child, and whether there is another professional who already has a trusting relationship with the child;
• Whether to involve the family. A belief that the child is possessed may mean they are stigmatised in their family. If the child has been labelled as possessed, professionals should find out how this affects the child's relationship with others in the extended family and community;
• What the beliefs of the family are;
• Where to obtain expert advice about cultures or beliefs that are not their own;
• What pressures the family are under. These cases of abuse will sometimes relate to blaming the child for something that has gone wrong in the family. Professionals should consider whether there is anything that can or should be done to address relevant pressures on the family;
• That the abuser may have a deeply held belief that they are delivering the child of evil spirits and that they are not harming the child but actually helping them. Holding such a belief is no defence or mitigation should a child be abused.

5.44.11

Professionals should consider:

• Whether these beliefs are supported by others in the family or in the community, and whether this is an isolated case or if other children from the same community are being treated in a similar manner;
• Whether there is a faith community and leader which the family and the child adhere to:
  • as a minimum, the full details of the faith leader and faith community to which the family and child adhere to should be obtained
  • the exact address of the premises where worship or meetings take place should be obtained
  • further information should be obtained about the belief of the adherents and whether they are aligned to a larger organisation in the UK or abroad (websites are particularly revealing in terms of statements of faith and organisational structures);
• The family structure:
  •   the roles of the adults in the household should be clarified (e.g. who the child's main carer is, whether the child is being privately fostered)
  • whether the abuse relates to the arrival of a new adult into the household or the arrival of the child, perhaps from abroad
  • If the child has recently arrived, what their care structure in their country of origin was. What the child's immigration status is
  • the identities and relationships of all members of the household. These should be confirmed with documentation; it may be appropriate to consider DNA testing;
• Whether there are reasons for the child to be scapegoated (e.g. the child's behaviour or physical appearance may be different from other children in the family or community, the child may be disabled or their parents labelled as possessed);
• Whether an interpreter is required. If working with a very small community, the professional should assure themselves that the interpreter and the family are not part of the same social network.

5.44.12

Professionals should ensure that all the agencies in the child's network understand the situation so that they are in a position to support the child appropriately. The child can themselves come to hold the belief that they are possessed and this can significantly complicate their rehabilitation.

5.44.13

To dismiss the belief may be harmful to the child involved.  With careful and appropriate engagement and adequate support, harm can be reduced or in some cases totally removed.

Working with places of worship and faith organisations

5.44.14

In some circumstances, it may be appropriate to work in partnership with a responsible leader/s from a faith community or to assist a community in terms of safeguarding children through education and training. Such training provides preventative and parenting opportunities.

5.44.15

Before embarking on this course of action, a risk assessment should be conducted to ensure that the child/ren, professionals and others involved in the engagement can do so safely. This strategy is best conducted utilising agencies such as the police and trusted community partners. There are charities and statutory bodies who can access faith communities to assist in this training.    

5.44.16

Concerns about a place of worship may emerge where:

• A lack of priority is given to the protection of children and there is a reluctance of some leaders to get to grips with the challenges of implementing sound safeguarding policies or practices;
• Assumptions exist that 'people in our community' would not abuse children or that a display of repentance for an act of abuse is seen to mean that an adult no longer poses a risk of harm;
• There is a denial or minimisation of the rights of the child or the demonisation of individuals;
• There is a promotion of mistrust of secular authorities.

5.44.17

Professionals should consult with their agency's nominated safeguarding children adviser and make a referral to LA children's social care, in line with section 6. Referral and assessment.

Children being taken out of the UK

5.44.18

If a professional is concerned that a child who is being abused or neglected is being taken out of the country, it is relevant to consider:

• Why the child is being taken out of the UK;
• Whether the care arrangements for the child in the UK allow the local authority to discharge its safeguarding duties;
• What the child's immigration status is. Professionals should also consider whether the child recently arrived in the UK, and how they arrived;
• What the proposed arrangements are for the child in their country of destination, and whether it is possible to check these arrangements;
• Whether the arrangements appear likely to safeguard and promote the child's welfare;
• That taking a child outside of the UK for exorcism or deliverance type procedures is likely to cause significant harm.

See section 5.46 trafficked and exploited children.

5.44.19

See also Safeguarding Children from Abuse Linked to a Belief in Spirit Possession (DfES, 2007).

5.45.1

Surrogacy is legal in the UK, with reasonable expenses only being paid to the surrogate mother. Surrogacy arrangements are not legally enforceable.

5.45.2

It is illegal to advertise for a surrogate in the UK. Most people have a family member or friend willing to carry the child, others join a surrogacy organisation.

5.45.3

Partial surrogacy uses the egg of the surrogate mother and the sperm of the intended father, thus the baby is biologically related to the intended father and the surrogate mother. This can make it difficult for the surrogate mother to give up her own biological child, but also for the intended mother to accept a child which her husband has fathered with another woman.

5.45.4

Total surrogacy uses the egg of the intended mother combined with the sperm of her husband or donor sperm. A baby conceived by this method has no biological connection to the surrogate mother, making it easier for her to give up the child she is carrying.

5.45.5

A professional in any agency may become aware of the surrogacy arrangement and have concerns about:

• The suitability of the intended parents to care for the child;
• Conflict between the adults in a surrogacy arrangement e.g. that the surrogate mother is under pressure to relinquish the child against her will (see, as appropriate, section 5.12. Domestic violence); and / or
• The amount being paid for the child.

5.45.6

An unborn or newborn child in these circumstances could be at risk of physical and emotional abuse and / or neglect. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.45.7

In these circumstances, all staff have a responsibility to safeguard and promote the welfare of the unborn or newborn child, and professionals should follow the procedures for referral to LA children's social care set out in section 6. Referral and assessment.

5.45.8

LA children's social care responses should be proportionate to what are likely to be very individual circumstances, and legal advice should be sought.

5.46.1

This section is a summary of the supplementary London child protection procedure Safeguarding Trafficked and Exploited Children (London Board, 2006) and the two should be read in conjunction. See also section 5.43. Sexually exploited children and section 5.44. Spirit possession or witchcraft.

5.46.2

A trafficked child is coerced or deceived by the adult who brings them into the country or moved within the UK. When the child arrives in the UK or is moved within the country, they are denied their human rights and are forced into exploitation by the trafficker or the adult/s into whose control the child is delivered. The UK is a transit and a destination country for trafficked children.

5.46.3

Exploitation may include domestic servitude, sexual exploitation, forced marriage, criminal activity such as street robbery or credit card fraud, begging, benefit fraud, acting as a drug mule or decoy for adult traffickers, sweatshop or restaurant work. A child may be exploited by more than one of these means at once. There is evidence that some UK resident children, mainly young girls, are being groomed, coerced and moved around between towns and cities within the UK for the purposes of sexual exploitation.

5.46.4

The physical, sexual and / or emotional abuse, and neglect, a trafficked child may suffer constitutes significant harm. See section 4.3. Recognition of abuse and neglect.

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful that there needs to be compulsory intervention by child protection agencies into the life of the child and their family.

5.46.5

Rarely, children may be used for ritual killing or exorcism. Children in this country are not currently thought to be to be trafficked as part of the trade in human organs.

Recognition

5.46.6

Even children who understand that they are being trafficked and exploited may still appear to submit willingly, through fear for themselves or their family, or because they believe their parents have agreed to the situation, or sometimes also because of bribes.

5.46.7

Recognition of trafficked and exploited children will normal rely on a combination of general signs of abuse and neglect, signs associated with exploitation and issues concerned with the child's immigration status:

5.46.8

Signs and symptoms associated with sexual or other exploitation can be found in section 5.40  Sexually exploited children (5.40.8).

5.46.9 

Signs and symptoms specific to trafficking include children who are:

• Not in possession of their own travel documents;
• Excessively afraid of being deported;
• Known to have had their journey or visa arranged by someone other than themselves or their family;
• In possession of false papers, and these have been provided by another person;
• Unable to confirm which adult is going to accept responsibility for them;
• Accompanied / controlled by a person who has applied for visas on behalf of many others, or acts as guarantor for other visa applications;
• Travelling on a visa application that has been guaranteed by a person who has acted for other visitors who have not returned to their countries of origin on the expiry of the visa;
• Being cared for by adult/s who are not their parents (see section 5.37 Private fostering), or the quality of the relationship between the child and their adult carers is not good;
• Scantily dressed, or have the labels cut out of their clothes;
• Required to earn a minimum amount of money every day;
• Required to pay off an exorbitant debt, perhaps for the travel costs, before being able to have control over their own earnings;
• Handing over a large part of their earnings to another person;
• Presenting a history with missing links and unexplained moves;
• Working in various locations;
• Known to beg for money.

5.43.10

For more information see:

• Section 10.1 of the supplementary guidance Safeguarding Trafficked and Exploited Children (London Board, 2006) for an expanded list of signs and symptoms;
• Safeguarding children who may have been trafficked (DCSF and the Home Office, 2007); and
• The child trafficking assessment toolkit designed to help front line staff identify children who may have potentially been trafficked as part of a new National Referral Mechanism.

National Referral Mechanism

5.46.11

The National Referral Mechanism (NRM) is a multi-agency framework designed to enable frontline practitioners to work together to identify and support victims of trafficking. Designated expert 'Competent Authorities' within the UK Human Trafficking Centre (UKHTC) and the UK Border Agency (UKBA) are responsible for determining, from the evidence gathered, but in particular on the basis of advice from children's services, whether a child meets the Council of Europe Convention on Action Against Trafficking in Human Beings ('the Convention') definition of trafficking. It was launched on 1 April 2009 and will ensure consistency of approach across all relevant agencies.

5.46.12

Decisions about who is a victim of trafficking are made by trained specialists in designated 'Competent Authorities'. The UKHTC hosts one such Competent Authority. The UKHTC Competent Authority deals with cases referred by all external agencies such as the police, local authorities etc where the person is a UK or EEA national, or where there is an immigration issue but the person is not yet known to UKBA. A linked but separate Competent Authority sits in UKBA for situations where trafficking is raised as part of an asylum claim or in the context of another immigration process.

5.46.13

An integral part of the NRM is the provision of accommodation and support to victims, and local authorities will continue to take the lead in providing appropriate services for vulnerable children (including trafficked children). Further details of the NRM process, including the trafficking toolkit, can be found on the Home Office crime reduction website.

Children at port of entry

5.46.11

Immigration officers are empowered to refer children to LA children's social care in the area the port is located, if a child's immigration documentation is incorrect or if the officer has concerns about the child's welfare. However, officers have a very limited opportunity to assess the child's welfare, and adults bringing children into the country illegally are adept at concealing irregularities in their relationship with the child, including using threats to ensure that the child presents appropriately.

Children already in the UK

5.46.12

Most trafficked children are invisible to statutory services.

5.46.13

As most trafficked children are not aware of their rights or that they can claim asylum, they are unlikely to come to the notice of asylum or immigration services once they are in the UK.

5.46.15

Many trafficked and exploited children are not registered at school or with a GP. These children do not come into contact with the statutory services who could raise concerns about their welfare, although younger children may be known to LA housing services or the benefits service.

5.46.15

Professionals in all agencies should be alert to the possibility that a newly immigrant child could be living with adults who are exploiting the child (i.e. that the child is trafficked). A child may be presented at accident and emergency services, walk-in centres, minor injury units or GUM clinics, or could be registered at school for a short period only. See also section 5.30. Not attending school.

5.46.16

A child in this situation is being privately fostered, and professionals should check with LA children's social care to establish whether the arrangement has been notified to them (see section 5.37. Private fostering).

Responding to concerns

5.46.17

LA children's social care should urgently:

• Obtain as much information as possible from the referrer (see also section 5.48. Accessing information from abroad);
• Verify that the child is living at the address;
• In the case of a referral from a school or education department, obtain the list of documentation provided at admission;
• Complete a Home Office check to clarify the status of the child/ren and the adult/s caring for them.

5.46.18

On completion of the initial information gathering, LA children's social care should plan one of four ways forward:

• An initial assessment to gather more information (see section 6. Referral and assessment);
• Accommodation of the child under s20 Children Act 1989, e.g. if:
  • the child is lost or abandoned, or there is no person with parental responsibility for the child (i.e. the child is an unaccompanied minor)
  • the person who has been accommodating the child is prevented, for whatever reason, from providing suitable accommodation or care
  • there is reasonable cause to believe that the child is suffering or likely to suffer significant harm, an emergency protection order may be sought. Consideration should be given to police powers of protection in an emergency;
• A s47 and a core assessment of need in line with section 6. Referral and assessment. See also section 6.4. Referral criteria, which provides guidance on the difference within LA children's social care between a s47 / core assessment and an initial assessment;
• No further action.

LA children's social care should advise the referrer which plan is in place.

Interviewing the child and adults

5.46.19

Once information has been gathered, LA children's social care and the police should decide whether to conduct joint interviews with the Child Abuse Investigation Team or borough police and / or the immigration service.

5.46.20

Where it is decided that the family should be visited and interviewed, standard social work practice should be followed. The child should be seen alone, preferably in a safe environment. Ensure that carers are not in the proximity. Children will usually stick to their account and not speak until they feel comfortable.

5.46.21

Professional interpreters who have a clear Criminal Records Bureau check should be used; it is not acceptable to use a family member or friend. See section 5.50. Working with interpreters / communications facilitators.

5.46.22

The adults in the family should be interviewed (separately if possible) on the same basis, using the same questions. A comparison can then be made between the answers to ensure they match.

5.46.23

All documentation should be seen and checked. This includes Home Office documentation, passports, visas, utility bills, tenancy agreements, birth certificates. Particular attention should be given to the documentation presented to the school at point of admission. It is not acceptable to be told 'the passport is missing' or 'I can't find the paperwork right now'. It is extremely unlikely that a person does not know where their paperwork / official documentation is kept.

5.46.24

On completion of the assessment, a meeting should be held with the social worker, their supervising manager, the referring agency (as appropriate), the police and any other professionals involved to decide on future action. Further action should not be taken until this meeting has been held and multi agency agreement obtained.

Issues to consider when working with trafficked children

5.46.25

The child is likely to need:

• Safe accommodation if they are victims of an organised trafficking operation;
• Legal advice about their rights and immigration status;
• Their whereabouts to be kept confidential;
• Discretion and caution to be used in tracing their families;
• A risk assessment to be made into the danger they face if they are repatriated;
• Support and protection against reprisals if acting as a witness.

Criminal prosecution

5.46.26

The police and the Home Office are responsible for any action regarding fraud, trafficking, deception and illegal entry to the country.

Local Safeguarding Children Boards

5.46.27

Local Safeguarding Children Boards should offer training to improve:

• Professionals' and volunteers' ability to recognise a trafficked and exploited child;
• Multi-agency working to protect and promote the welfare of such children.

5.46.28

Local Safeguarding Children Boards should:

• Maintain close links with community groups and have a strategy in place for raising awareness within the local community of the possibility that children are trafficked and exploited, and how to raise a concern;
• At ports of entry, they should maintain close relationships with local immigration services;
• Be aware of the child trafficking agenda within their local authority and ensure all suspected child victims of trafficking are referred through the NRM using the correct procedure; and
• Identify trafficking co-ordinators who can ensure a co-ordinated campaign of information-sharing to support the safeguarding agenda between local authorities, police and the NRM competent authorities to ensure a full picture is provided on child NRM referrals and secure the best safeguarding outcome for the child.

5.46.29

For those requiring more information on the nature and scale of child trafficking in the UK, please refer to the Child Trafficking Strategic Threat Assessment 2008/09 produced by the Child Exploitation and Online Protection (CEOP) Centre - [This and other related documents is available from www.ceop.police.uk/publications.]

5.47.1

In many families, children contribute to family care and well-being as a part of normal family life. A young carer is a child who is responsible for caring on a regular basis for a relative (usually a parent, grandparent, sometimes a sibling or very occasionally a friend) who has an illness or disability. This can be primary or secondary caring.

5.47.2

Caring responsibilities can significantly impact upon a child's health and development. Many young carers experience:

• Social isolation;
• A low level of school attendance;
• Some educational difficulties;
• Impaired development of their identity and potential;
• Low self-esteem;
• Emotional and physical neglect;
• Conflict between loyalty to their family and their wish to have their own needs met.

5.47.3

Professionals in all agencies should be alert to a child being a young carer. Where a young carer is identified, professionals should consider the child's support needs using the Common Assessment Framework.

5.47.4

There are circumstances in which a young carer can be suffering, or at risk of suffering, significant harm through emotional abuse and / or neglect. See section 4.3. Recognition of abuse and neglect. 

Significant harm is defined in section 4. Recognition and response as a situation where a child is suffering, or is likely to suffer, a degree of physical, sexual and / or emotional harm (through abuse or neglect) which is so harmful there needs to be intervention by child protection agencies into the life of the child and their family.

5.47.5

A referral should be made to LA children's social care, in line with section 6. Referral and assessment, where a young carer is:

• Unlikely to achieve or maintain a reasonable standard of health or development because of their caring responsibilities;
• At serious risk of harm through abuse or  neglect;
• Providing intimate body care.

5.47.6

Unless there is reason to believe that it would put the child at risk of harm, young carers should be told if there is a need to make a referral, in order that their trust in a professional is retained.

5.47.7

Wherever possible, the young carer's consent and the consent of their parent should be sought, through a discussion of why the referral must be made and the possible outcomes.

5.47.8

Where a young carer or parent does not give consent, but it is still considered necessary to initiate a child protection enquiry, both the child and parent should be kept informed of all decisions made and offered support throughout (see section 6. Referral and assessment).

5.47.9

Professionals in all agencies should enquire, from LA adult social care, whether the family is receiving all their entitlements under the provisions of the Carers (Recognition and Services) Act 1995.

5.47.10

Where a young carer is caring for another child, each individual child should be assessed using the Common Assessment Framework, except if the child/ren are at risk of significant harm. Professionals should consult with their agency's nominated safeguarding children adviser and make referral to LA children's social care in line with section 6. Referral and assessment, for an assessment of each child's needs using the Assessment Framework (see section 6. Referral and assessment and appendix 5 for a summary and diagram of the Assessment Framework).

5.47.11

Agencies that work with young carers such as schools, should implement policies outlining the support services available to these children.

5.47.12

Young carers may not meet some agencies thresholds for referral and may need to be referred to young carers' projects where appropriate.

5.47.13

See the National Strategy for Carers (chapter 8 Young Carers) (DH, 1999), available at www.dh.gov.uk.

Additional guidance

5.48.1

A child for whom significant relevant information may be held abroad includes a child who may:

• Be recently immigrant into the UK, with or without their parents, and for whom there are concerns of harm, including through accusations of spirit possession or witchcraft (see section 5.44 Spirit possession or witchcraft);
• Have been, or is suspected to have been, trafficked into or out of the UK for sexual exploitation, domestic servitude, benefit fraud etc (see section 5.46 Trafficked and exploited children);
• Be at risk of abuse or has already been abused, through, female genital mutilation (see section 5.14 Female genital mutilation);
• Threatened with forced marriage or at risk of honour based violence (see section 5.16. Forced marriage of a child and 5.20 Honour based violence).

5.48.2

Professionals contributing to a multi-agency assessment (in line with section 6. Referral and assessment) of a child for whom relevant information is likely to be held abroad, should seek information from their respective counterpart agencies abroad (i.e. health professionals in the UK are responsible for retrieving health information from health professionals abroad, etc).

5.48.3

Where an assessment is required of family or relatives' circumstances abroad, LA children's social care should contact an organisation such as International Social Services (UK), whose details are available at: www.cfab.uk.net.

5.48.4

Professionals should contact national embassies and consulates in London for the countries concerned. Embassy and consulate details are available on the Foreign and Commonwealth Office website, at: www.fco.gov.uk.

5.48.5

Where local agencies abroad cannot assist in divulging information about a child and their family, UK professionals should seek assistance from International Social Services (UK).

Eligibility

5.49.1

All children who are victims of offences of violence, committed within or outside the family, may be entitled to criminal injuries compensation, whether or not there has been a prosecution or conviction, including where there is no visible physical injury (e.g. sexual assault).

Criminal Injuries Compensation Authority (CICA)

5.49.2

The Criminal Injuries Compensation Authority (CICA) has a duty to compensate fairly all those who suffer personal injuries directly attributable to a crime of violence (legal aid may be available to assist in submitting applications and deciding whether or not to accept awards).

5.49.3

Conditions CICA operates are:

• There is a minimum award and the injury must be serious enough to award this minimum compensation payment;
• The incident should have been reported to the police. CICA may withhold or reduce compensation if an applicant did not take, without delay, all reasonable steps to inform the police or another appropriate authority of the circumstances of the injury;
• There is a two year limitation period on making a claim after the incident, unless CICA exercises its discretion to 'allow an application out of time' (in the case of child abuse, CICA may be sympathetic to applications no matter how long ago the incident occurred);
• CICA is concerned always to make awards which take into account the best interests of the victim;
• Where a child and the person causing the injuries are living in the same household (e.g. as members of the same family) at the time of the injuries, compensation will only be paid where the person responsible has been prosecuted (unless there are good reasons why not), and CICA is assured that the offender will not benefit from the award;
• Following from this, CICA may appoint trustees to hold the compensation for the benefit of the child making such provisions for maintenance and education as necessary.

Conducting claims by children

Looked after children

5.49.4

Where the local authority holds parental responsibility, LA children's social care should help the child make the claim or should initiate the claim on the child's behalf. The form should be completed by the child's social worker and approved by the LA children's social care manager.

5.49.5

The local authority's power to make a claim on behalf of a child is limited to children who are subject to a care order.

5.49.6

Where a child is looked after but the local authority does not have parental responsibility, the child's social worker should approach the person with parental responsibility, if it is appropriate to do so, and inform them of their right to make a claim for the child and assist them in doing so.

5.49.7

If this is inappropriate (e.g. because the person with parental responsibility caused the injuries, or is cohabiting with the person who did, or the person with parental responsibility does not initiate the claim), LA children's social care should refer the child to a solicitor or to Victim Support.