Safeguarding Children - Leeds
1. Scope and Development of Pathway
Quick info:
This pathway was developed to guide clinicians when managing suspected child safeguarding issues.
Author:
Yen Andersen, Named GP for Children's Safeguarding
Date of pathway development: December 2013
Date for review: June 2014
Updated October 2014
Updated December 2014
Updated February 2019-Mary Kearney Named Nurse for Safeguarding
Updated October 2020 - Sam Fuller, Specialist Safeguarding Practitioner – Children and Adult
2. Useful Contacts
Quick info:
CCG SAFEGUARDING TEAM: 0113 8431713 / – leeds.safeguarding@nhs.net
Contact Details-
If you believe a child is in immediate danger and at risk of harm call the police on 999
Children’s Duty & Advice Team Tel: 0113 3760336.
Emergency Duty Team (Mon – Fri 5pm – 8am, Friday 5pm – Mon 8am) Tel: 0113 5350600
3. Training and Further Resources
The Role of the Safeguarding Children Lead GP 
Training
Guidance on safeguarding children training requirements is set out in Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff intercollegiate document (2019) https://www.rcn.org.uk/professional-development/publications/007-366.
Guidance for adult safeguarding can be found in Adult Safeguarding: Roles and Competencies for Health Care Staff Intercollegiate document (2019) https://www.rcn.org.uk/professional-development/publications/pub-007366
It is the responsibility of the safeguarding lead GP to cascade safeguarding information and updates to the rest of the general practice.Evidence of participating in updates and clinical discussions can be used to support level 3 practitioners training requirements. The safeguarding lead GP should ensure the practice has a process for the implementation of learning from safeguarding case reviews and audit findings. All primary care practitioners can identify opportunities for arranging in-house safeguarding training, which can be done through the CCG safeguarding team. It is the responsibility of all primary care practitioners to manage and record their own safeguarding training compliance with regards to their role.
Resources to support practitioners in meeting their required safeguarding competencies include but are not limited to: accessing safeguarding training via E learning for health https://www.e-lfh.org.uk/ and by utilising a blended approach including the following:-
- Safeguarding Training Schedule - Provided by the CCGs Safeguarding Team.
- GP Team meetings
- GP Safeguarding meetings including peer group meetings
- Reflections on discussions
- Attendance at conferences/ safeguarding meetings
- Reflect on cases your working on/ patients you have discussed sought advice on – what do/ did you do differently
- eLearning
- Reading relevant research
- CCG Learning briefings
- CCG training schedule
- TARGET events – hot topics/ longer safeguarding sessions
The Prevent training and competencies framework https://www.england.nhs.uk/publication/prevent-training-and-competencies-framework/ provides specific guidance on the level of Prevent training required for healthcare workers and should be used to ensure that all healthcare practitioners meet the required training requirements.
In addition, the CCG safeguarding team offer primary care staff the opportunity to attend face to face and/or virtual safeguarding training sessions. The training schedule is circulated to all practice managers and safeguarding leads, as well as being available on the online booking system referenced below.
As of the 1st March 2021 we are now using an online booking system for all our training sessions. The new system can be found here: Primary Care Extranet – Online Training Booking.
If you do not have access to the Primary Care Extranet, please request an account from the CCG Comms Team, email: leedsccg.comms@nhs.net.
Alternatively contact the CCG SAFEGUARDING TEAM on: 0113 8431713/ leeds.safeguarding@nhs.net for more information.
Resources:
Health Visitor and Local Children's Team Locator can be found at Leeds (Family Information Service, Leeds)
https://familyinformation.leeds.gov.uk/early-start-search
Leeds Health Visitors and School Nursing teams have merged to become Leeds 0-19 Service and can be contacted on 0113 843 5683 - Professional line
Family Information Service, Leeds
The following link is for people who work with children and young people;
https://parentportal.leeds.gov.uk/Synergy/FamilyServices/
Leeds Safeguarding Children Partnership
Building a common understanding of different roles, responsibilities and services across the children’s workforce is an important part of helping us work together to achieve the best outcomes for children, young people and families in Leeds. Children and Families Service is a broad, varied and complex area of work and it can be difficult to make sense of the support available and know who does what.
To help with this, ‘One Minute Guides’ are available for everyone to use. There are already over 50 different ones and new guides are developed regularly and found at https://www.leedsscp.org.uk/News/One-Minute-Guides
A full list of all the guides can be found
https://www.leeds.gov.uk/docs/Glossary%20of%20One%20Minute%20Guides.pdf
Leeds Multi-agency Procedure and Local protocols for Professionals can be found at https://www.leedsscp.org.uk/Practitioners/Local-protocols
These include: FGM, Requesting Child Protection medicals, Neglect - Recognising, Responding and Assessing, Multi-agency Bruising Protocol for Children NIM (Not Independently Mobile) to name but a few.
Safeguarding Children Toolkit for General Practice
This toolkit is a series of practical workbooks for GPs and the primary healthcare team to recognise when a child, under the age of 18, may be at risk of abuse
https://www.rcgp.org.uk/clinical-and-research/resources/toolkits/child-safeguarding-toolkit.aspx
Template Policies-
Leeds safeguarding Children Partnership and Leeds safeguarding Adults Board have devised templates to support agencies developing an in house Safeguarding Policy and can be found at:
https://www.leedsscp.org.uk/Voluntary-Community-Faith-Third-Sector/safeguarding-pack/How-to-write-a-saefguarding-policy
Guidance On The Development Of Safeguarding Adults Policies And Procedures-
https://leedssafeguardingadults.org.uk/safeguarding-adults/multi-agency-policy-and-procedures
The CCG Safeguarding team have developed the Primary care template safeguarding policy template policy, which can be adopted fully as the practice Adult and Child safeguarding policy or in parts and added to your current policy.
Safeguarding Children and Adults at Risk Policy
Resources
The LSCP has created an online questionnaire which enables you to do a safeguarding assessment of your organisation. The questionnaire is based on the standards set in Section 11 of The Children Act 2004 and is known as the Section 11 audit tool. Section 11 states that all organisations who work with children and young people should ensure that they have effective arrangements in place to safeguard and promote their welfare. Section 11 can be found at - https://www.leedsscp.org.uk/Voluntary-Community-Faith-Third-Sector/Section-11/Online-Section-11-audit
Further Information
Working Together to Safeguard Children. A guide to inter-agency working to safeguard and promote the welfare of children. July 2018
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/779401/Working_Together_to_Safeguard-Children.pdf
Information sharing Advice for practitioners providing safeguarding services to children, young people, parents and carers. July 2018
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/
attachment_data/file/721581/Information_sharing_advice_practitioners_safeguarding_services.pdf
4. Concerns about a Child
4a. MINDMATE
Leeds MindMate SPA is for professionals to refer into, when they are working with children and young people and identify they have a need for support with their emotional wellbeing or mental health. As from October 1st 2018, young people (13-17 years) or parents and carers of children (5-17 years) can now talk directly to the SPA team. They can call 0300 555 0324 during office hours.
Leeds MindMate SPA will work with all services available locally to find the right support for the child/young person.
Mindmate is for all children and young people who have a Leeds GP, up to the age of 18.
How to make a referral to MINDMATE-
You can refer over the phone by calling 0300 555 0324 between 9am and 5pm, Monday to Friday. Please remember to gain consent to make the referral from the young person/parent/carer (as appropriate)
To refer by email – Gain consent, fill out the referral form with as much information as you can from the young person and/or their family. Email the completed forms to leeds.mindmatespa@nhs.net. You must use a secure email address (e.g nhs.net, gov.uk) that is monitored regularly.
The referral form can be found at https://www.mindmate.org.uk/im-a-professional/leeds-mindmate-single-point-access/
4b. Early Help
See Early Help Learning Briefing 
Key to our approach to supporting children and young people in Leeds is a commitment to early help through a range of evidence based interventions. Early Help is a collaborative approach not a provision.
All children and young people will receive Universal Services, however, some children, either because of their needs or circumstances will require extra support to be healthy and safe and to achieve their potential. In Leeds we have recognised that a timely response is essential for families who need some support and to achieve this we have developed our Early Help Approach.
Early Help may be needed at any point in a child or young person’s life and we seek to offer support quickly to reduce the impact of problems that may have already emerged. Families are best supported by those who already work with them organising additional support with local partners as needed.
For children whose needs and circumstances make them more vulnerable, a coordinated multi-disciplinary approach is usually best, based on an Early Help Assessment, with a Lead Practitioner to work closely with the child and family to ensure they receive all the support they require. A range of Targeted Services are available through clusters to support these interventions.
Specialist Services will be provided where the needs of the child are such that statutory intervention is required to keep them safe or to ensure their continued development. By working together effectively we seek to reduce the number of children and young people requiring statutory interventions and reactive specialist services.
Services for adults play an essential role in our Early Help Approach. Many adults have additional needs e.g. substance use, mental health needs, parental learning disabilities and domestic violence which can impair their parenting capacity. Services which predominantly work with either children and young people or adults need to adopt a ‘Think Family, Work Family’ approach to secure better outcomes for children, young people and families with additional needs, through co-ordinating the support they provide.
For further information on Early Help: https://www.leedsscp.org.uk/Practitioners/Early-Help-Introduction
4c. Family Group Conference
All agencies in Leeds, through the Children and Young People’s Plan, have a clear commitment to restorative practice and putting families at the heart of decision making.
The restorative approach taken by partners in Leeds was endorsed by Ofsted in their inspection of Children’s Services and the Leeds Safeguarding Children Partnership (LSCP) in 2015.
As part of the commitment to working restoratively with families, Children’s Services have invested in expanding the Family Group Conference (FGC) service to enable a conference to be offered to more families, earlier in the lifetime of the issues they are experiencing. The long term ambition is to make the offer of a Family Group Conference an entitlement for all families experiencing difficulties. Due to the continued success of FGCs we have been granted permission by Department for Education to trial new practices in Leeds, which depart from the existing statutory guidance.
Further information can be found at https://www.leedsscp.org.uk/Practitioners/Family-Group-Conference
The LSCP One minute guide can be found at - https://www.leeds.gov.uk/docs/FGC%20Service%20-%20November%202016%20update.pdf
4d. Think Family, Work Family
simply means:
Think Family – people rarely live in isolation so you need to think about the needs of the whole family regardless of whether it is an adult or child that you are working with.
Work Family – you need to communicate with others working with different family members and coordinate your efforts for the best outcomes for the whole family, using Team Around the Family (TAF) approaches.
Think Family, Work Family is an approach whereby in their day to day roles, all practitioners across Adult and Children’s services are identifying, considering and appropriately responding to the safeguarding needs of all family members.
It places a responsibility on all practitioners to respond to identified issues from signposting and referral, through to providing services.
The principles of Think Family, Work Family
The Leeds Approach to Think Family, Work Family; Principles and Practice Guidance
Working with the whole family requires a co-ordinated approach to assessment and intervention, thus protecting both children and adults at risk from harm. Consideration of immediate risk should be prioritised as follows:
The welfare and safety of the child, including assessment and ensuring their views are sought (Paramount in law - Children Act 1989).
The welfare and safety of adults at risk who may be at risk from violence or abuse and who may or may not have capacity to make informed decisions. (No Secrets, HM Govt 2000; Mental Capacity Act, 2005).
Public protection – consider whether the situation presents a risk to the wider public e.g. risk of sexual offences, risk of terrorism, risk of violence (MAPPA, 2010; Prevent Strategy; HM Government, 2011).
Why are we taking this approach?
Think Family works. Research suggests that a multi-agency, ‘Think Family’ approach can be effective in helping families, even for those who have not benefited from traditional service approaches. A new approach is needed for working with children and families in Leeds for four main reasons:
- Think Family works
- High levels of need
- Shared legal duties
- The high cost of failure to the individuals and society
A different approach is needed because we know that to improve the lives of those children facing the biggest challenges, we need to identify, understand and resolve the problems of the adult parents. A small minority of families struggle with a long, intergenerational history of linked and complex problems such as mental illness, abuse, learning disabilities, domestic violence or substance misuse and the evidence shows that traditional approaches cannot make the difference – a joined up approach that helps both the children and adults is needed.
Further information can be found at https://www.leedsscp.org.uk/Practitioners/Think-Family-Intro
5. Child at Risk of Harm
If you suspect that a child or young person is being, or is at risk of being significantly harmed as a result of abuse or neglect, you must report this immediately.
Practitioners working with children, young people and families should:
- Discuss your concerns in the first instance with your Safeguarding Lead or line manager if you are unsure if they are suffering significant harm
- Inform the parents and / or gain their consent for you to make this contact unless doing so would put the child at risk
- Gather information using the Contact Form as guidance
The Contact Form to refer a child to Children Social Work Services can be found on EMIS and SystmOne Child templates or by accessing the following link:-
https://www.leedsscp.org.uk/Concerned-about-a-child
Attendance of GPs at child protection conferences
The independent chairs of child protection conferences in Leeds screen GP conference attendance/invitations. GPs will only be invited to attend child protection conferences under certain circumstances, such as:
- If the GP made the initial referral to social care.
- If there are concerns in relation to possible Fabricated or Induced Illness.
- A child has significant health needs where the GP is a lead health professional
- Or if the independent chair/social worker feels that the GP has integral information which may require clarity during the conference.
The reason for the request for GP attendance at the child protection conference will be included within the invitation.
GPs where possible will need to prioritise attendance at the conference when requested to ensure the safeguarding process is effective. If they are unable to attend then a conversation with the independent chair prior to the conference should be held.
To aid GP attendance at conference where possible the independent chair may consider an alternative venue for the meeting, such as a General Practice if the family are agreeable.
Processes in place within General Practice
Each General Practice should have clear processes in place to effectively manage requests for child protection reports and attendance at conferences.
Reports which are written should form part of the clinical record.
Outcomes of child protection conferences should be clearly recorded in clinical records, including any health related actions and those for the GP.
Communication with other professionals is key to safeguarding children and each GP practice should have a system in place in relation to communicating with other health professionals, such as midwives and health visitors.
Each Practice is responsible for being able to identify any children registered at their practice who are currently or have been subject to a child protection plan.
All forms for Initial Child Protection and Review Child protection reports can be found in the Child Template on EMIS and SystmOne Child and Young person’s template.
- Initial Child Protection Review (ICP) Report
- Review Child Protection (RCP) Report
For additional support for writing Child Protection reports see-
Guidance for GPs preparing reports for child protection conference
Sample GP Report Initial Child Protection Conference
Self assessment audit tool for GP reports
6. Types of abuse
Physical Abuse
The possible hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing physical harm to a child. Physical harm may be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.
Emotional Abuse
The persistent emotional maltreatment of a child such to cause severe and reoccurring adverse effects on the child’s emotional development.
Psychological or Emotional Abuse includes threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
Sexual Abuse
The forcing or enticing of a child or young person to take part in sexual activities whether or not the child is aware of what is happening. This may not necessarily involve a high level of violence.
This includes rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts including violent acts, to which the adult has not consented or was pressured into consenting.
Neglect
The persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in serious impairment of the child’s health or development.
Neglect or Acts of Omission includes ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, care and support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating.
Neglect Strategy
Neglect is the most common type of abuse experienced by children and young people in England. Launched in July 2017, the five year Neglect Strategy links together objectives in order to improve our ability to quantify the extent of neglect in Leeds, and ensuring that all agencies and practitioners are better able to recognise and respond to neglect. Find out more here. https://www.leedsscp.org.uk/LSCB/media/Images/pdfs/Neglect-strategy2017.pdf
Learning Briefing – Neglect in Childhood
7. Factors to consider when making a judgement
- Child’s development Needs
- Parenting Capacity
- Family & Environmental Factors
Information can be found in the Child & young person safeguarding template on EMIS and Systmone
8. Information Sharing
All staff have a responsibility to adhere to “The Seven Golden Rules for Information Sharing” -
GDPR and Data Protection Act - Seven golden rules for information sharing
- Remember that the Data Protection Act 1998 and human rights law are not barriers to justified information sharing, but provide a framework to ensure that personal information about living individuals is shared appropriately.
- Be open and honest with the individual (and/or their family where appropriate) from the outset about why, what, how and with whom information will, or could be shared, and seek their agreement, unless it is unsafe or inappropriate to do so.
- Seek advice from other practitioners if you are in any doubt about sharing the information concerned, without disclosing the identity of the individual where possible.
- Share with informed consent where appropriate and, where possible, respect the wishes of those who do not consent to share confidential information. You may still share information without consent if, in your judgement, there is good reason to do so, such as where safety may be at risk. You will need to base your judgement on the facts of the case. When you are sharing or requesting personal information from someone, be certain of the basis upon which you are doing so. Where you have consent, be mindful that an individual might not expect information to be shared.
- Consider safety and well-being: Base your information sharing decisions on considerations of the safety and well-being of the individual and others who may be affected by their actions.
- Necessary, proportionate, relevant, adequate, accurate, timely and secure: Ensure that the information you share is necessary for the purpose for which you are sharing it, is shared only with those individuals who need to have it, is accurate and up-to-date, is shared in a timely fashion, and is shared securely.
- Keep a record of your decision and the reasons for it – whether it is to share information or not. If you decide to share, then record what you have shared, with whom and for what purpose.
Further information is available at
“Information sharing Advice for practitioners providing safeguarding services to children, young people, parents and carers.”(July 2018)
Managing an allegation against a member of staff
In order to manage allegations against child care professionals, every Local Authority appoints a Local Authority Designated Officer (LADO). The LADO works within Children’s Services and should be alerted to all cases in which it is alleged that a person who works with children has: behaved in a way that has harmed, or may have harmed, a child, possibly committed a criminal offence against children, or related to a child, or behaved towards a child or children in a way that indicates s/he may pose a risk to children
The Local Authority Designated Officers (LADO) in Leeds can be contacted Monday to Friday on: 0113 3789687, between them they operate a duty system for LADO notifications.
If you think that a professional has harmed a child:
- Complete the notification form- found at https://www.leedsscp.org.uk/Practitioners/Managing-allegations
- Email the form to: LADO@leeds.gov.uk
9. Further information relating to Safeguarding
Domestic Violence-
Refer to Domestic Violence Leeds Health Pathway
Domestic abuse is any type of controlling, bullying, threatening or violent behaviour between people in a relationship. But it isn’t just physical violence – domestic abuse includes emotional, physical, sexual, financial or psychological abuse.
Abusive behaviour can occur in any relationship. It can continue even after the relationship has ended. Both men and women can be abused or abusers.
Domestic abuse can seriously harm children and young people. Witnessing domestic abuse is child abuse and local safeguarding procedures should be followed. Young people can also be victims of domestic abuse in their own relationships.
Domestic violence makes up the majority of violence against women, children and men locally and nationally and includes physical, psychological, coercive and controlling behaviour, sexual violence, emotional abuse, financial exploitation and stalking. It is best understood as a pattern of behaviour characterised by the misuse of power and control and often escalates over time.
How Are Children and Young People Affected by Domestic Abuse?
Children living with domestic abuse are denied their right to a safe and stable home environment and can experience significant risk and disruption to their lives.
The harm caused through witnessing domestic abuse is formally acknowledged in UK legislation, as are the rights of children and young people to be kept safe from abuse. See:
NSPCC - What the law says about children and domestic abuse- https://learning.nspcc.org.uk/child-abuse-and-neglect/domestic-abuse/
In 2013 the government definition of domestic violence changed to include people aged 16 and 17 years old. Extending the definition increased awareness that young people experience domestic violence and abuse and encouraged more young people to come forward and access support. When talking about young people in abusive relationships, the term used is ‘Interpersonal Violence and Abuse’ (IPVA).
For any child under 18 years local safeguarding procedures should be followed and a referral to Children’s Social Care Services should be considered. Practitioners can consider using the young people’s version of the DASH risk identification checklist. Guidance along with the checklist can be found via the Safelives website: https://safelives.org.uk/practice-support/resources-identifying-risk-victims-face.
Domestic abuse as a predictor of harm for children and young people
Children and young people are at significant risk from domestic abuse in the home. Alongside mental health and substance misuse, the presence of domestic abuse is frequently a key aggravating factor when a child has been killed or seriously injured in the home.
The Adoption and Children Act 2002 (section 120) extended the definition of "harm" as stated in the Children Act 1989, to include "impairment suffered from seeing or hearing the ill treatment of another". This came into effect in January 2005.
Children suffer harm from domestic abuse; whether or not they are present in the room when an incident occurs.
Domestic abuse is known to pose the following risks to children and young people:
- There is a direct correlation between the presence of domestic abuse and child abuse, which means professionals, should always consider the possibility of both forms of abuse where one is identified. The presence of domestic abuse increases the risk of abuse toward children, including of emotional abuse and neglect.
- Children may be at risk from physical abuse from the victimised parent in efforts to reduce the severity of punishment from the perpetrator.
- Domestic abuse is an aggravating factor in cases of child sexual abuse, with coercion and violence used as a tool to obtain and maintain compliance.
- Parents experiencing domestic abuse are at significant risk of mental health difficulties, which may impact their ability to nurture and care for children in the short term.
- Research has shown that unborn children are subject to physical harm and emotional distress from domestic abuse, causing damage to foetal development and increasing risk of miscarriage.
Immediate impact of domestic abuse on children and young people
Domestic abuse has wide ranging effects on the physical and emotional wellbeing of children and young people, including:
- Distress caused by witnessing (seeing or hearing) the physical and emotional suffering of a parent.
- Children may be pressurised into concealing assaults, and experience the fear and anxiety of living in an environment where abuse occurs.
- Children may be drawn into the abuse of a parent, or may themselves become victims of physical abuse and experience injury and serious harm.
Child/adolescent to parent abuse
Domestic violence and abuse can be experienced between family members regardless of gender or relationship. Child/adolescent to parent abuse is a common and often hidden form of family violence and abuse.
Child/adolescent to parent domestic abuse can be understood as a harmful act which is designed to gain power and control over a parent. The abuse can be physical, psychological, or financial.
Child to parent violence is an abuse of power through which the child or adolescent attempts to use coercive control and dominate others in the family and should not be confused with childhood testing of boundaries.
Parents may report the following:
- Threatening or using violence when their demands are not met. This may include damage to possessions and house fittings.
- Using psychological and emotional abuse to wear parents down - this might include attempts to degrade, humiliate or embarrass parents and other family members.
- Threatening they will leave home if you do not do what they want.
The presence of child/adolescent to parent abuse may indicate a host of other risks including harm, trauma and dysfunction prompted by:
- Domestic abuse in the home – whether current or in the past
- Mental health difficulties for parent or child/adolescent
- Substance misuse issues amongst members of the household, including the adolescent
- Children having been forced to participate in abuse by the perpetrator, whether as witnesses or having been encouraged to participate with the perpetrator
- Negative external peer influence
How should professionals respond to child/adolescent to parent domestic abuse?
Where child/adolescent to parent abuse is disclosed, there are a number of immediate actions which should be considered. It is recommended that families are referred to the Children Social Work Services, which can assess the immediate risk to all family members, which includes any siblings in the home.
Workers may identify separate safeguarding risks for adults in the family, which may prompt a specific safeguarding adult's referral. Effective safeguarding is achieved when agencies share information to obtain an accurate picture of the risk and then work together to ensure that the safety of the adult at risk is prioritised. In high-risk situations it may be relevant to access the multi-agency risk assessment conference (MARAC) process
Children and adolescents using dominant and coercive behaviours may be experiencing a range of challenges and anxieties, which left unaddressed, may impact upon the immediate safety and wellbeing of parents and children in the household. Left unchecked, behaviours may also escalate in future to intimate partner violence, continuing the cycle of abuse.
Referral and support options should be made available for the parent, including referral to specialist domestic abuse assistance. Parents experiencing this form of abuse may however be reluctant to seek help, fearing judgement from agencies or negative consequences for their child. Parents may also feel out of options or when they have attempted to reach out in the past, agencies may have offered unhelpful or contradictory advice.
Domestic violence and abuse in any context can escalate swiftly, leading to immediate harm and lifelong consequences for all concerned. Practical measures must always be taken to minimise harm and manage risk.
For further information on Children and young people-
Leeds Domestic Violence Service -
https://www.leeds.gov.uk/domesticviolence/children-and-young-people
Leeds One minute guide – https://www.leeds.gov.uk/docs/164%20-%20Domestic%20abuse%20in%20young%20peoples%20relationships.pdf
Domestic violence and abuse – the impact on children and adolescents
NSPCC- Contact our trained helpline counsellors for help, advice and support.
help@nspcc.org.uk or Tel 0808 800 5000
Womens Aid- The impact of domestic abuse on children and young people
Child Exploitation
Child Exploitation risk identification tool
Child exploitation practice guidance
Child Sexual Exploitation (CSE)
Frontline practitioners should be aware of the key indicators of children being sexually exploited which can include:
- going missing for periods of time or regularly coming home late;
- regularly missing school or education or not taking part in education;
- appearing with unexplained gifts or new possessions;
- associating with other young people involved in exploitation;
- having older boyfriends or girlfriends;
- suffering from sexually transmitted infections;
- mood swings or changes in emotional wellbeing;
- drug and alcohol misuse; and
- Displaying inappropriate sexualised behaviour.
Practitioners should also be aware that many children and young people who are victims of sexual exploitation do not recognise themselves as such. Further information about Child Sexual Exploitation is available at Leeds Safeguarding Children Partnership (https://www.leeds.gov.uk/docs/Child%20Sexual%20Exploitation%20-%20November%202013.pdf)
The Barnardo’s definition of child sexual exploitation:
- Inappropriate relationships: Usually involving one perpetrator who has inappropriate power or control over a young person (physical, emotional or financial). One indicator maybe a significant age gap. The young person may believe they are in a loving relationship.
- ‘Boyfriend’ model of exploitation and peer exploitation: The perpetrator befriends and grooms a young person into a ‘relationship’ and then coerces or forces them to have sex with friends or associates. Barnardo’s have reported a rise in peer exploitation where young people are forced or coerced into sexual activity by peers and associates. Sometimes this can be associated with gang activity but not always.
- Organised/networked sexual exploitation or trafficking: Young people (often connected) are passed through networks, possibly over geographical distances, between towns and cities where they may be forced/ coerced into sexual activity with multiple men. Often this occurs at ‘sex parties’ and young people who are involved may be used as agents to recruit others into the network. Some of this activity is described as serious organised crime and can involve the organised ‘buying and selling’ of young people by perpetrators.
CSE is a form of sexual abuse. Act on your concerns in the same way as you would for other safeguarding concerns by seeking advice and contacting Duty & Advice team on 0113 3760336
Resources for CSE
Leeds CSE Resource list can be found at-
https://www.leedsscp.org.uk/Practitioners/Child-Exploitation-and-Children-Missing-from-Home/CSE-protocols
Child sexual Exploitation, Definition and Guide for Practitioners-
https://www.gov.uk/government/publications/child-sexual-exploitation-definition-and-guide-for-practitioners
“Key messages from research on child sexual exploitation: Staff working in health settings”
https://www.csacentre.org.uk/research-publications/key-messages/staff-working-in-health-settings/
NHS England has produced a short video to increase awareness and understanding of the issues surrounding identifying and responding to child sexual exploitation. https://www.youtube.com/watch?v=Wm1bEWvDHCg&feature=youtu.be
Child Criminal Exploitation
Child Criminal Exploitation (CCE) can be understood as: the exploitation of children and young people aged less than 18 years in the storage, distribution and selling of illegal drugs, under violent coercion or exploited through the use of debt, or promise of cash or drugs. Patterns of grooming behaviour by adults can be seen to be similar to those associated with sexual exploitation (CSE). There will be a power imbalance and children and young people should not be viewed as at fault, ‘choosing a lifestyle’ or making an informed choice.
Criminal exploitation is not restricted to drugs; some children are transporters of cash as well as firearms and weapons, and are coerced into carrying out theft and burglaries. Many children and young people subject to CCE are exploited by criminal gangs. A gang is considered to be a relatively durable, predominantly street-based group of young people who:
(1) see themselves (and are seen by others) as a discernible group,
(2) engage in a range of criminal activity and violence,
(3) identify with or lay claim over territory,
(4) have some form of identifying structural feature, and
(5) are in conflict with other, similar, gangs.
Children and young people involved in criminal exploitation are often sent to differing locations within the United Kingdom to carry out tasks for gangs, such as supplying drugs to suburban areas, market and coastal towns. Gangs are usually based in cities. This criminal activity is known as ‘county lines’ – a term that is used by the police. This type of movement of children falls within the legal definition of trafficking in the Modern Slavery Act 2015. Child trafficking is defined as the ‘recruitment, transportation, transfer, harbouring or receipt’ of a child for the purpose of exploitation.
CCE needs to be viewed in the context of broader vulnerabilities and other forms of exploitation and abuse. This could be within families, communities or more sophisticated organised crime groups. There needs to be consideration around the overlap and links between familial violence and/or criminality, trauma, peer to peer abuse, CSE, gang violence, going missing, and (as above) trafficking and modern day slavery.
For further information see the One Minute Guide on Child Criminal Exploitation (CCE). https://www.leeds.gov.uk/one-minute-guides
Female Genital Mutilation (FGM)
Female genital mutilation is any procedure which involves the partial or complete removal of the external female genitalia, or other injury to the female genital organs for no medical reason. Many believe that FGM is necessary to ensure acceptance by their community, however this custom is against the law in the UK and many other countries. All types of FGM are illegal in the UK; it is an offence to take a female out of the UK for FGM or for anyone to circumcise women or children for cultural or non-medical reasons here in the UK.
Potential health consequences of Female Genital Mutilation
If women in the family have already undergone FGM then there is an increased risk to other girls in the family. Girls who have had the procedure performed will often avoid exercise on their return to school, ask to go to the toilet more often, find it hard to sit still for long periods or may have further time off school due to problems related to the procedure. It is essential that teachers, doctors and other professionals learn the warning signs that a girl might be at risk.
Multi-Agency Statuary Guidance has been published to provide information on FGM, including: the law, provide strategic guidance along with advice and support to front-line staff. Please see link below.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/912996/6-1914-HO-Multi_Agency_Statutory_Guidance_on_FGM__-_MASTER_V7_-_FINAL__July_2020.pdf
Reporting FGM
A new mandatory reporting duty for FGM has been introduced via the Serious Crime Act 2015, following a public consultation. The duty requires regulated health and social care professionals and teachers in England and Wales to report known cases of FGM in under 18-year-olds to the police. The mandatory reporting duty came into force on the 31st October 2015. Please see https://www.leedsscp.org.uk/Practitioners/FGM
If concerns are raised that a child is at risk in Leeds the Safeguarding Practice Lead or Deputy should contact the Duty & Advice Team for assessment consideration.
Recording FGM-Department of health and NHS England FGM Enhanced Dataset
Following publication of the Data Standard on 2nd April 2014, it became mandatory for any NHS healthcare professional to record (write down) within a patient’s clinical record if they identify through the delivery of healthcare services that a woman or girl has had FGM.
Health and Social Care Information Centre (HSCIC) is collecting data on FGM within England on behalf of the Department of Health (DH) and NHS England (NHSE). This is to support the DH and NHSE FGM Prevention Programme. The data is collected to improve the NHS response to FGM and to help commission the services to support women who have experienced FGM as well as safeguarding women and girls at risk of FGM.
There is no requirement to ask every girl and woman whether they have had FGM. The requirement is to record FGM in a patient’s healthcare record only if and when it is identified during the delivery of any NHS healthcare. Professionals are reminded to be aware of the risk factors, including country of origin (see multi-agency guidelines for list of countries), and to use their professional judgement to decide when to ask the patient if they have had FGM.
It remains best practice to share information between healthcare professionals to support the ongoing provision of care and efforts to safeguard women and girls against FGM. For example, after a woman has given birth, it is best practice to include information about her FGM status in the discharge summary record sent to the GP and Health Visitor, and to include that there is a family history of FGM within the Personal Child Health Record (PCHR), and Electronic patient record.
Training:
NHS England have produced a training package on FGM for health professionals, which includes information on statuary duty, resources and information.
There is now ONE website from which you can link to all the NHS programme outputs. This should be your first point of call for the NHS work on FGM, and it links to partner organisations including Department of Health and Social Care, NHS Digital and others.
www.england.nhs.uk/ourwork/safeguarding/our-work/fgm/
E- Learning for all professionals to recognise and prevent FGM can be accessed at
www.fgmlearning.co.uk
www.e-lfh.org.uk/programmes/female-genital-mutilation/
Leeds have produced a One Minute Guide in relation to FGM
The Leeds Safeguarding Children Partnership have developed a flow chart to advice on the management of an FGM case
NHS England has produced a short video to increase awareness and understanding of the issues surrounding safeguarding and female genital mutilation. Link: https://www.youtube.com/watch?v=1SLeFxz8GQw
The Leeds Safeguarding Children Partnership have developed a flow chart to advice on the management of a FGM case and further training can be accessed via E- Learning for all professionals to recognise and prevent FGM can be accessed at - www.fgmlearning.co.uk & www.e-lfh.org.uk/programmes/female-genital-mutilation/
NHS England has produced a short video to increase awareness and understanding of the issues surrounding safeguarding and female genital mutilation.
https://www.youtube.com/watch?v=1SLeFxz8GQw
Organisations that can help:
NSPCC FGM helpline: 0800 028 3550
www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/female-genital-mutilation-fgm
For a list of other organisations who can provide advice and support on FGM see the ‘Contact, helplines and clinics’ section of the FGM resource pack:
www.gov.uk/government/publications/female-genital-mutilation-resource-pack/female-genital-mutilation-resource-pack#contacts-helplines-and-clinics
Enter a postcode to find local organisations
www.gov.uk/female-genital-mutilation-help-advice
CONTEST and PREVENT
What is radicalisation?
Radicalisation refers to the process by which a person comes to support terrorism and forms of extremism leading to terrorism. Radicalisation is usually a process not an event. During this process, there will inevitably be opportunities to intervene in order to reduce the risk of the individual being attracted to extremist ideology and causes and safeguard him/her from the risk of radicalisation. It is important to be able to recognise the factors that might contribute towards the radicalisation of an individual. Indeed, some of the factors that lead an individual to becoming radicalised are no different to those that might lead individuals towards involvement with or being vulnerable to other activity such as gangs, drugs and sexual exploitation.
Those involved in extremist activity come from a range of backgrounds and experiences. There is no single profile of what an extremist looks like or what might drive a young person towards becoming radicalised. It can affect impressionable young boys and men and also impressionable young girls and women.
What factors might contribute towards radicalisation?
Below are some of the factors that might contribute towards an individual becoming radicalised. These are included in the Channel Vulnerability Assessment Framework. This is not an exhaustive list and the presence of any of these factors does not necessarily mean that he/she will be involved in extremist activity. However, a combination of many of these factors may increase the vulnerability to extremist activity:
- A need for identity, meaning and belonging
- Feelings of grievance and injustice
- A desire for excitement and adventure
- Susceptibility to indoctrination
- A need to dominate and control others
- A desire for political or moral change
- Family or friends’ involvement in extremism
- Being at a transitional time of life
- Being influenced and controlled by a group
- Relevant mental health issues
- Over-identification with a group or ideology
- ‘Them and Us’ thinking
- Dehumanisation of the enemy
- Feeling under threat
- A desire for status
- Opportunistic involvement
- Attitudes that justify offending
- Harmful means to an end
- Harmful objectives
Contest is the Government's Counter Terrorism Strategy, which aims to reduce the risk from terrorism, so that people can go about their lives freely and with confidence.
Contest has four strands which encompass:-
- PREVENT; to stop people becoming terrorists or supporting violent extremism
- PURSUE; to stop terrorist attacks through disruption, investigation and detection
- PREPARE; where an attack cannot be stopped, to mitigate its impact
- PROTECT; to strengthen against terrorist attack, including borders, utilities, transport infrastructure and crowded places
Prevent focuses on preventing people becoming involved in terrorism, supporting extreme violence or becoming susceptible to radicalisation. Alongside other agencies, such as education services, local authorities and the police, healthcare services have been identified as a key strategic partner in supporting this strategy.
Healthcare professionals may meet and treat people who are at risk of being radicalised, such as people with mental health issues or learning disabilities, which may have a heightened susceptibility to being influenced by others.
Practice staff who have concerns about that someone may be becoming radicalised must seek advice and support from the dedicated PREVENT Lead.
Please contact the GGG safeguarding team on 0113 8431713 / leeds.safeguarding@nhs.net for further information.
Guidance can be found at
Revised Prevent Duty Guidance: for England and Wales
https://www.gov.uk/government/publications/prevent-duty-guidance/revised-prevent-duty-guidance-for-england-and-wales
Information Sharing and Governance Guidance for Prevent-
https://www.england.nhs.uk/publication/practical-guidance-on-the-sharing-of-information-and-information-governance-for-all-nhs-organisations-specifically-for-prevent-and-the-channel-process/
Leeds Safeguarding Children Partnership-One Minute Guide-
https://www.leeds.gov.uk/one-minute-guides
Links to NHSE/ Home office Prevent e learning resources:
https://www.elearning.prevent.homeoffice.gov.uk/edu/screen1.html
https://www.elearning.prevent.homeoffice.gov.uk/preventreferrals
https://www.elearning.prevent.homeoffice.gov.uk/channelawareness
If you believe someone is at risk of radicalisation you should first speak to your line manager who will liaise with the PREVENT lead in the CCG. They can support you in making a referral to the local authority via the usual safeguarding procedures.
If you believe the individual may already be involved in terrorism or extremist activities, you should also contact the Anti-Terrorism hotline on 0800 789 321.
If the concern is urgent then use 999.
Other useful contact details for advice: CCG PREVENT Lead – Belinda Sharratt, Designated Nurse for Safeguarding Children and Adults 0113 8431713/leeds.safeguarding@nhs.net or email the Prevent team: prevent@leeds.co.uk.
Forced Marriage and Honour Based Violence
If any professional has a concern regarding forced marriage or honour based violence they must seek advice and act upon it.
A forced marriage-
There is a clear distinction between a forced marriage and an arranged marriage. In arranged marriages, the families of both spouses take a leading role in arranging the marriage, but the choice of whether or not to accept the arrangement still remains with the prospective spouses. However, in forced marriage, one or both spouses do not consent to the marriage but are coerced into it.
Duress can include physical, psychological, financial, sexual and emotional pressure. In the cases of vulnerable adults who lack the capacity to consent to marriage, coercion is not required for a marriage to be forced.
The provision of consent is essential within all marriages – only the spouses themselves will know if they their consent is provided freely.
Forcing someone to marry is a criminal offence. It is child abuse, domestic abuse and a form of violence against women and men; it should form part of existing child and adult protection structures, policies and procedures.
Further information can be found at Forced Marriage One Minute Guide- https://www.leeds.gov.uk/docs/46%20-%20Forced%20Marriage%20-%20June%202014.pdf
https://www.gov.uk/guidance/forced-marriage
Call: 020 7008 0151 (Mon-Fri: 09.00-17.00) Email: fmu@fco.gov.uk
Address: Forced Marriage Unit, Foreign & Commonwealth Office, King Charles Street, London, SW1A 2AH
For all out of hours emergencies, please telephone 020 7008 1500 and ask to speak to the Global Response Centre.
Police 101 ask for SPOC for HBV or main safeguarding office at Elland Road – 0113 3859590.
Multi-agency practice guidelines: Handling cases of Forced Marriage
These practice guidelines have been developed alongside the statutory guidance “The Right to Choose” issued in November 2008, Forced Marriage (Civil Protection) Act 2007. The statutory guidance sets out the responsibilities of Chief Executives, Directors and Senior Managers within agencies involved with handling cases of forced marriage. It covers issues such as staff training, developing inter-agency policies and procedures, raising awareness and developing prevention programmes through outreach work.
This document seeks to supplement the statutory guidance with advice and support for front line practitioners who have responsibilities to safeguard children and protect adults from the abuse associated with forced marriage. As it is unlikely that any single agency will be able to meet all the needs of someone affected by forced marriage, this document sets out a multi-agency response and encourages agencies to cooperate and work together closely to protect victims.
For information refer to –Forced Marriage- One Minute Guide
https://www.leeds.gov.uk/docs/46%20-%20Forced%20Marriage%20-%20June%202014.pdf
Learning Briefing – Forced Marriage
Honour-based violence
The terms “honour crime” or “honour-based violence” or “izzat” embrace a variety of crimes of violence (mainly but not exclusively against women), including assault, imprisonment and murder where the person is being punished by their family or their community.
They are being punished for actually, or allegedly, undermining what the family or community believes to be the correct code of behaviour.
In transgressing this correct code of behaviour, the person shows that they have not been properly controlled to conform by their family and this is to the “shame” or “dishonour” of the family. It can be distinguished from other forms of abuse, as it is often committed with some degree of approval and/or collusion from family and/ community members. Victims will have multiple perpetrators not only in the UK; honour based violence can be a trigger for a forced marriage.
For information refer to -Honour Based Violence One Minute Guide https://www.leeds.gov.uk/docs/
47%20-%20Honour%20Based%20Violence%20-%20June%202014.pdf
Karma Nirvana
Karma Nirvana is an award-winning British human rights charity supporting victims of honour-based abuse and forced marriage. Honour crimes are not determined by age, faith, gender or sexuality. They run a national helpline offering direct support and guidance to victims and professionals.
Karma Nirvana provides training to the Police, NHS and Social Services. They act as expert witnesses in court, speak out in schools and attend awareness raising events nationally and internationally. In addition, our team lobby government and after ten years of campaigning, forced marriage became a criminal offence in 2014.
UK Helpline: 0800 5999 247 Monday - Friday: 9am - 5pm.
info@karmanirvana.org.uk
If you are in immediate danger call 999
A referral form can be found on https://karmanirvana.org.uk/advocacy-project/
Learning Briefing- Honour Based Violence
Advocacy flyer
Karma Nirvana advocate referral form
Human Trafficking
Human trafficking is the recruitment, movement, harbouring or receiving of children, women or men through the use of force, coercion, abuse or vulnerability, deception or other means for the purpose of exploitation.
Anyone can be a victim of trafficking, women, men and children, British and foreign nationals. A person does not have to be transported across borders to trafficked.
People are trafficked for a number or reasons:
- Sexual exploitation
- Domestic servitude
- Forced labour including in the agricultural, construction, food processing, hospitality industries and in factories
- Criminal activity including cannabis cultivation, street crime, forced begging and benefit fraud
- Organ harvesting
Duty to notify the Home Office of potential victim of modern slavery
From 1 November 2015, specified public authorities have a duty to notify the Secretary of State of any individual identified in England and Wales as a suspected victim of slavery or human trafficking, via the National Reporting Mechanism (NRM). This duty is intended to improve the identification of victims and help build a more comprehensive picture of the nature and scale of modern slavery, to improve victim identification and the law enforcement response.
The “duty to notify” is set out in Section 52 of the Modern Slavery Act 2015
The information that must be provided within a notification has been set out in the Modern Slavery Act 2015 (Duty to Notify) Regulations 2015. Where an adult has not consented to the referral, then the notification must not include information that identifies the person, or enables the person to be identified (either by itself or in combination with other information). The form must be signed to indicate an adult’s consent to being identified.
A specified public authority which includes information in accordance with the Regulations does not breach any obligation of confidence owed by the public authority in relation to that information.
Notification of child victims:
Although the duty to notify applies to both children and adults, as children do not need to consent to enter the NRM, specified public authorities agencies should generally complete a full NRM referral, rather than a notification. This enables fuller information gathering and assessment of the case to be completed.
Hope for Justice
Is an organisation which provides support to and identification and rescue of victims, including advocacy and restoration, to help victims become survivors and then ‘over-comers’ with a renewed sense of hope and purpose for their future. They also provide training and information to professionals, and have a useful website.
Find out more at www.modernslaveryhelpline.org or to seek help or to report slavery call the helpline on: 0800 1212700
Further information can be found at https://www.stopthetraffik.org/
Learning Briefing- Modern Slavery and Human Trafficking
Advocacy
Advonet
This referral form is for all types of advocacy. You can complete this form on your own behalf (self-referral) or on behalf of someone else. Part 1 must be completed and depending on the advocacy required please complete other relevant parts. Incomplete forms may result in delays in allocating an advocate.
10. Advice and support available should you identify a safeguarding concern
Quick info:
CCG SAFEGUARDING TEAM: 0113 8431713 / leeds.safeguarding@nhs.net
Contact Details-
If you believe a child is in immediate danger and at risk of harm call the police on 999
Children’s Duty & Advice Team Tel: 0113 3760336.
Emergency Duty Team (Mon – Fri 5pm – 8am, Friday 5pm – Mon 8am) Tel: 0113 5350600
Following a verbal referral to children’s social care duty and advice a written referral should be submitted within 48 hours. The form can be found on either S1 or EMIS and must be sent by secure email.