1. Purpose

1. The purpose of a child protection policy and procedure is to ensure that appropriate action is taken when a young person, up to the age of 18 years, is suspected of either being abused or at risk from parents, guardians, carers, adult visitors, other responsible adults or other young people.

1. This Child Protection Policy recognises that the safety and protection of children is paramount and has priority over all other interests. The purpose of this policy is to protect any children or young adults who receive our services. It also includes the children or child relatives of adults who may be receiving our services. Whilst delivering services to children may not form part of our core business, we recognise that protecting children is everybody’s business and we have a statutory duty to ensure robust procedures are in place.

1. This policy refers to all children up to 18 years of age (including the unborn) regardless of nationality, culture or religion. If the child has ‘learning disabilities’ or is a care leaver, their needs may extend to their 21st birthday (Section 9 Children Act 2004). The term ‘children’ will be used throughout this policy to refer to children and young people.
2. To meet the legal requirements of the regulated activities that Epitome Home Care Agency is registered to provide:

• Children and Social Work Act 2017
• Female Genital Mutilation Act 2003
• Children and Young Persons Act 1933
• Serious Crime Act 2015
• Borders, Citizenship and Immigration Act 2009
• Adoption and Children’s Act 2002
• Digital Economy Act 2017
• Modern Slavery Act 2015
• United Nations Convention Rights of the Child 1989
• The Sexual Offences Act 2003
• The Police Act 1997
• Equality Act 2010
• Human Rights Act 1998
• Public Services Reform (Scotland) Act 2010
• The Regulation of Care (Requirements as to Care Services) (Scotland) Regulations 2002
• Children and Young People (Scotland) Act 2014

 2. Scope

1. The following roles may be affected by this policy:

• All staff
• Volunteers
• Anyone working on behalf of our organisation
• Senior Management including Directors
• Students, Trainees, Apprentices, Work Experience
• Contractors
• Agency Staff

1. The following people may be affected by this policy:

• Service Users
• Children

1. The following stakeholders may be affected by this policy:

• Family
• Commissioners
• External health professionals
• Local Authority
• NHS
  

 3. Objectives

1. To have a coordinated approach to child protection and to ensure Epitome Home Care Agency procedures dovetail with policies and procedures published by their Local Authority and whose contact details The Agency will append to this policy.
2. To ensure the voice of the child is heard.

• Policy

• Statement of Intent

Epitome Home Care Agency recognises the vulnerability of children and believes that it is always unacceptable for a child or young person to experience abuse of any kind. We wholly support the principle that the welfare of the child is paramount and accept the United Nations Declaration of the Rights of the Child. Children can be under threat, and/or abused by parents/family, other children and young people, care workers, staff and others.

We believe that all children, regardless of ethnicity, gender, culture, sexual orientation, disability, faith or religious belief, have a right to equal protection from all types of harm or abuse.

1. We recognise that deaf and disabled children and those with complex health needs are at increased risk of abuse. Additionally, we understand that some children have increased vulnerability because of the impact of previous experiences, level of dependency, communication needs, or other issues. All necessary steps will be taken to ensure that the rights of all children are respected and that opportunities for abuse to occur are minimised.

1. We will seek to keep children and young people safe by:

• Empowering children, listening, respecting and responding in a compassionate but effective way
• Ensuring a child-centred approach to service planning and delivery
• Ensuring that all staff read and understand this policy
• Providing child protection training to staff to enable them to recognise signs of abuse and follow appropriate procedures when dealing with child protection concerns
• Adopting safe staff recruitment, selection and vetting procedures
• Sharing information about child protection and good practice with staff, volunteers, parents, carers and relevant agencies
• Requiring all staff to follow the reporting and recording procedures in every case of suspected abuse or disclosed abuse
• Ensuring that all staff with responsibility for, or contact with children, will be provided with appropriate policies, guidance, training and support to enable them to implement this policy
• Providing effective management and support systems for all staff so that staff know who to contact within Epitome Home Care Agency in the event of child protection concerns arising
• Working within the relevant Local Authorities Child Protection Team guidance and procedures
• Ensuring policy and practice remains current and up to date and dovetails with local procedures

• Information Sharing and Confidentiality

Good communication is essential for any organisation. At Epitome Home Care Agency, every effort will be made to assure that, should individuals have concerns, they will be listened to and taken seriously.

It is the responsibility of the management staff to ensure that information is available to, and exchanged between, all those involved in this organisation and its activities.

Children and young people have a right to information, especially any information that could make life better and safer for them. Epitome Home Care Agency will act to ensure they have information about how, and with whom, they can share their concerns, complaints and anxieties.

When sharing information, staff will be sensitive to the level of understanding and maturity, as well as to the level of responsibility of the people with whom they are sharing.

We understand that some information is confidential and should only be shared on a strictly needtoknow basis. Epitome Home Care Agency will ensure that staff follow the guidelines: ‘Information sharing: Advice for

  practitioners providing safeguarding services to children, young people, parents and carers (2015)’.

• Safe Recruitment

Epitome Home Care Agency will adopt a consistent and thorough process of safe recruitment in order to ensure that those recruited are suitable. This includes ensuring that safe recruitment and selection procedures are adopted which deter, reject or identify people who might abuse children or are otherwise unsuitable to work with them. Epitome Home Care Agency will not sub-contract to any organisation which has not been part of a safe recruitment process.

Epitome Home Care Agency will ensure that the level of PVG Check required for the role will be confirmed. The recruiting manager shall ensure clearance is obtained before the applicant commences employment. As an employer of staff in a ‘regulated activity’, Epitome Home Care Agency has a responsibility to refer concerns to the Disclosure and Barring Service in accordance with the Protecting Vulnerable Groups. Managers must report concerns to their local protection team.

 5. Procedure

• Categories of Abuse

Working Together to Safeguard Children (2015) recognises 4 categories of abuse which are:

• Physical
• Emotional
• Neglect
• Sexual

Appendix 1 has these full definitions.

• Local Procedures

All staff, including contracted or agency staff working with children, will familiarise themselves with the local Child Safeguarding policies, procedures and guidelines and work within them. Epitome Home Care Agency will ensure that all staff within The Agency are aware and understand their local child protection policies and their localised reporting procedures. Copies of the local policy must be appended to this policy. Epitome Home Care Agency should identify a member of staff responsible for safeguarding.

• Responding When a Child Discloses Abuse

Keep the following considerations in mind when talking to a child who is disclosing abuse:

• Help the child feel comfortable
• Reassure the child that it is not their fault. Let them know that they have not done anything wrong
• Do not react with shock, anger, disgust. Be calm
• Do not force a child to talk. Give the child time. Let him/her talk to you at their own pace
• Do not force a child to show injuries
• Use terms and language that the child can understand
• Do not ‘interview’ the child
• Ask appropriate questions
• Do not ask ‘why’ questions
• Do not teach the child new terms or words. This is important in relation to the court and law
• Find out what the child wants from you
• Be honest with the child
• Confirm the child’s feelings. Be supportive
• Remember that the safety of the child is most important. Keep in mind that a child might be further abused if they report that they have spoken to someone about the abuse. If you feel that the child is in danger, you must act immediately

• Reporting Concerns

• If the child requires immediate medical attention, call an ambulance and inform the control room staff that there is a child protection concern
• Call 999 if in immediate danger
• Report incident/concerns to the relevant line manager who will support you to complete a report form
  
• Report to the Local Authority Child Protection Team

• Management of Allegations Against Staff

• If it is alleged that an employee of Epitome Home Care Agency may have caused harm to a child, it must be responded to and thoroughly addressed. There may be a concern that the member of staff may have:
  • Behaved in a way that has harmed or may have harmed a child
  • Possibly committed a criminal offence against or related to a child
  • Behaved towards a child or children in a way that indicates he or she is unsuitable to work with children

• Any allegation should be reported immediately to a Senior Manager within the organisation
• It is in everyone’s interest to resolve the case as quickly as possible, consistent with a fair and thorough investigation. Where it appears that a criminal offence may have been committed, the police should be contacted immediately by the appropriate Senior Manager
• The Local Authority Designated Officer (LADO) must be informed within one working day of all allegations that come to the attention of Epitome Home Care Agency or that are made to the police regarding an employee of Epitome Home Care Agency who may have caused harm to a child. It is the responsibility of the Registered Manager to ensure that the LADO is notified

• Protecting Disabled Children

Research 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. A child could be considered to be disabled if he or she has significant problems with communication, comprehension, vision, hearing or physical functioning. A failure to recognise disabled children’s human rights can lead to abusive situations and practices.

Organisational culture and ‘custom and practice’ can contribute to institutional abuse or harm.

• Epitome Home Care Agency should not underestimate how poor practice can become pervasive in influencing staff to behave inappropriately
• Carers should be given the opportunity to reflect on their practice and promote a positive risk-taking culture to enhance the quality of life for young people
• Epitome Home Care Agency will ensure that its services will readily seek the views of young people, parents and other professionals in reviewing their practice

Particular attention should be paid to promoting a high level of awareness of the risks of harm, to high standards of practice and strengthening the ability of children and families to help themselves.

• Make it common practice to enable disabled children to make their wishes and feelings known in respect of their care and treatment
• Ensure that disabled children receive appropriate personal, health and social education (including sex education)
• Make sure that all disabled children know how to raise concerns and give them access to a range of adults with whom they can communicate. This could mean using interpreters and facilitators who are skilled in using the child’s preferred method of communication
• Recognise and utilise key sources of support, including staff in schools such as support workers, friends and family members where appropriate
• Ensure that there is an explicit commitment to and understanding of disabled children’s safety and welfare among all providers of services used by disabled children
• Develop the safe support services that families want, and a culture of openness and joint working with parents and carers on the part of services
• Provide guidelines and training for staff on good practice in intimate care; working with children of the opposite sex; managing behaviour that challenges families and services; issues around consent to treatment; anti-bullying and inclusion strategies; sexuality and safe sexual behaviour among young people; monitoring and challenging placement arrangements for young people living away from home
• Where a child is unable to tell someone of the abuse, they may convey anxiety or distress in some other way, e.g. behaviour or symptoms, and Carers must be alert to this

• Child Sexual Exploitation (CSE)

As a result of recent nationwide cases CSE has become a national priority for health and social care. Staff have a significant contribution to make in identifying children and young people at risk of sexual exploitation. Where there are concerns about the welfare of a child, Epitome Home Care Agency should:

• Remember the child or young person’s welfare is of paramount importance
• Make sure Carers are alert to the signs of Child Sexual Exploitation
• Carers should seek immediate advice from their manager, and Epitome Home Care Agency should refer to children’s social care or the Police if there is a suspicion that that a child is at risk of harm or is in immediate danger
• Epitome Home Care Agency should ensure that staff know and understand the organisational and multi- agency safeguarding arrangements and processes
• Information should be shared on a need-to-know basis

• Domestic Violence and Abuse

There is a strong link between domestic abuse and all types of significant harm to children and young people. Witnessing domestic violence is a form of emotional abuse to a child/young person which may result in long- lasting implications for their future wellbeing.

Carers should follow local child protection reporting procedures if they are concerned that a child is witnessing domestic violence, is at risk of being harmed or is being harmed as a result of domestic violence or abuse.

• Forced Marriage and Honour Based Abuse/Violence

Children and young people can be subjected to domestic abuses perpetrated in order to force them into marriage or to ‘punish’ them for ‘bringing dishonour on the family’. Duress cannot be justified on religious or cultural grounds, and forced marriage is an abuse of human rights. Whilst honour based violence can culminate in the death of the victim, this is not always the case. The child or young person may be subjected, over a long period, to a variety of different abusive and controlling behaviours ranging in severity. The abuse is often carried out by several members of a family including mothers, and female relatives/community members and may, therefore, increase the child’s sense of powerlessness and be harder for professionals to identify and respond to. Forced marriages of children must be regarded as a child protection issue. Epitome Home Care Agency should not contact the parents in this situation and should make a referral direct to the safeguarding team and follow local reporting procedures. Further advice can be obtained from the Forced Marriage Unit (FMU) here: www.gov.uk/stop-forced-marriage.

If Someone Staff Know is at Risk

Contact the FMU if staff know someone who’s been taken abroad to be forced into marriage. Give as many details as possible, for example:

• Where the person has gone
• When they were due back
• When you last heard from them

The FMU will contact the relevant Embassy. If the person is a British national, the Embassy will try to contact the person and help them get back to the UK, if that is what they want.

• Female Genital Mutilation (FGM)

FGM is an illegal practice which affects a girl’s genital area and which can impact on their emotional or physical wellbeing. FGM is a criminal offence and carries a maximum penalty of 14 years imprisonment.

• If Carers are aware of any Service User who has had FGM or of any female children who are at risk of FGM, they must discuss this with their manager or safeguarding team
• Staff should understand their responsibilities to report concerns. Free E-Learning Training is available through the Home Office

• Whistleblowing

Safeguarding children is complex and can frequently be under review. It is important to remember that safeguarding is everyone’s responsibility, and a culture should be promoted where staff are able to raise concerns and whistleblow without fear, that there is an understanding of the need for staff support to achieve effective outcomes for children.

 6. Definitions

• Domestic Violence and Abuse

• The UK’s cross-government definition of domestic abuse is:

Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This abuse can encompass but is not limited to:

• Psychological
• Physical
• Sexual
• Financial
• Emotional

• Controlling behaviour is: A range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour
• Coercive behaviour is: An act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim. This definition, which is not a legal definition, includes so called ‘honour’ based violence, female genital mutilation (FGM) and forced marriage, and is clear that victims are not confined to one gender or ethnic group

• Protection

• Protection is a term which relates to the action taken to promote the welfare of children and protect them from harm. Child Protection is everyone’s responsibility

• Protecting children from maltreatment
• Preventing impairment of children’s health or development
• Ensuring that children are growing up in circumstances consistent with the provision of safe and effective care
• Taking action to enable all children to have the best outcomes

• Child or Young Person

• Under the Children Acts 1989 and 2004 respectively, a child (or young person) is anyone who has not yet reached their 18th birthday. The fact that a child has reached 16 years of age, is living independently or is in further education, is a member of the armed forces, is in hospital, in prison or in a Young Offenders Institution does not change his or her status or entitlement to services or protection under the Children Act 1989

• Staff

• Employment context: A person working under the control or direction of another, under a contract of employment in return for a wage or salary

• Volunteer

• The Disclosure and Barring Service (DBS) defines a ‘volunteer’ as: “A person who is engaged in any activity which involves spending time, unpaid (except for travelling and other approved out of pocket expenses), doing something which aims to benefit someone (individuals or groups) other than, or in addition to close relatives

• Child Sexual Exploitation

• Child sexual exploitation is a form of child sexual abuse

• It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the
  

victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator

• The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology

 Key Facts – Professionals

Professionals providing this service should be aware of the following:

• The welfare of the child is paramount, with safeguarding being everyone’s business
• Whether you deliver children’s services or not you must ensure that your staff have received child protection training and understand local reporting procedures
• Epitome Home Care Agency should promote a culture where staff can freely raise concerns

Key Facts – People Affected by The Service

People affected by this service should be aware of the following:

• You have a right to equal protection from all types of harm or abuse
• Epitome Home Care Agency will seek your consent to share information about you. However, if we think you are at risk we will respond in your best interests. We will only share information on a need-to-know basis

Further Reading

There is no further reading for this policy, but we recommend the ‘Underpinning Knowledge’ section of the review sheet to increase your knowledge and understanding.

Excellent Practice

To be ‘Excellent’ in this policy area you could provide evidence that:

• There is evidence that staff working with children have received supervision which gives them the opportunity to reflect on their practice
• Epitome Home Care Agency works in partnership with other agencies to promote the welfare of the child
• Epitome Home Care Agency has a robust procedure in place for undertaking root cause analysis of all incidents, understanding lessons learnt and applying them so incidents don’t arise again
• The wide understanding of the policy is enabled by proactive use of the QCS App

Forms

The following forms are included as part of this policy:

Title of form	When would the form be used?	Created by
Appendix 1: Categories of Abuse	When seeking further guidance	QCS
Appendix 2: Child Sexual Exploitation	When further guidance is needed	QCS

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Appendix 1: Categories and Indicators of Child Abuse and Neglect

The following definitions from ‘Working Together to Safeguard Children (HM Government 2015)’ will assist staff to recognise whether a child is suffering, or is likely to suffer significant harm. Where abuse is suspected, a referral    should always be made to Local Authority Child Protection Team using local reporting procedures.

Physical Abuse: Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating, or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms or, deliberately induces illness in a child.

Emotional Abuse: Emotional abuse is the persistent emotional maltreatment of a child such as to cause severe and persistent effects on the child’s emotional development, and may involve: Conveying to children that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person; Imposing age or developmentally inappropriate expectations on children. These may include interactions that are beyond the child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction; Seeing or hearing the ill-treatment of another e.g. where there is domestic violence and abuse; Serious bullying, causing children frequently to feel frightened or in danger;  Exploiting and  corrupting children. Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone.

Sexual Abuse: Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (e.g. rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. Sexual abuse includes non-contact activities, such as involving children in looking at, including online and with mobile phones, or in the production of pornographic materials, watching sexual activities or encouraging children to behave in sexually inappropriate ways or grooming a child in preparation for abuse (including via the internet). Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.

In addition, sexual abuse includes abuse of children through sexual exploitation. Penetrative sex, where one of the partners is under the age of 16, is illegal although prosecution of similar-age, consenting partners is not usual.       However, where a child is under the age of 13 it is classified as rape under s5 Sexual Offences Act 2003.

Neglect: Neglect is the persistent failure to meet a child’s basic physical and/or psychological needs, likely to result in the serious impairment of the child’s health or development.

Neglect may occur during pregnancy as a result of maternal substance misuse, maternal mental ill health or learning difficulties or a cluster of such issues. Where there is domestic abuse and violence towards a carer the needs of the child may be neglected. Once a child is born, neglect may involve a parent failing to:

• Provide adequate food, clothing and shelter (including exclusion from home or abandonment)
• Protect a child from physical and emotional harm or danger
• Ensure adequate supervision (including the use of inadequate care-givers)
• Ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to a child’s basic emotional, social and educational needs

Domestic Abuse: Included in the four categories of child abuse and neglect above, are a number of factors relating to the behaviour of the parents and carers which have significant impact on children, such as domestic violence.       Research analysing Serious Case Reviews has demonstrated a significant prevalence of domestic abuse in the       history of families with children who are the subject of Child Protection Plans. Children can be affected by seeing, hearing and living with domestic violence and abuse as well as being caught up in any incidents directly, whether to protect someone or as a target. It should also be noted that the age group of 16 and 17 year olds have been found in recent studies to be increasingly affected by domestic violence in their peer relationships.

The Home Office definition of Domestic violence and abuse was updated in March 2013 as: “Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence and abuse between those aged 16 or over, who are or have been intimate partners or family members regardless of gender and sexuality. This can encompass, but is not limited to, the following types of abuse:

• Psychological
• Physical
• Sexual
• Financial
  
• Emotional

Controlling behaviour: A range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour. Coercive behaviour is an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.”

Signs of Abuse

Recognising child abuse is not easy. It is not your responsibility to decide whether child abuse has taken place or if a child is at risk of harm from someone. You do however, have both a responsibility and duty to act in order that the appropriate agencies can investigate and take any necessary action to protect a child. The following information should help you to be more alert to the signs of possible abuse:

Physical Abuse

Most children will collect cuts and bruises as part of the rough and tumble of daily life. Injuries should always be interpreted considering the child’s medical and social history, developmental stage and the explanation given. Most accidental bruises are seen over bony parts of the body e.g. elbows, knees, skins, and are often on the front of the body. Some children, however, will have bruising that is more than likely inflicted rather than accidental.

Important indicators of physical abuse are bruises or injuries that are either unexplained or inconsistent with the explanation given, or visible on the ‘soft’ parts of the body where accidental injuries are unlikely e.g. cheeks, abdomen, back and buttocks. A delay in seeking medical treatment when it is obviously necessary is also a cause for concern, although this can be more complicated with burns, as these are often delayed in presentation due to blistering taking place. The physical signs of abuse may include:

• Unexplained bruising, marks or injuries on any part of the body
• Multiple bruises – in clusters, often on the upper arm, outside of the thigh
• Unexplained bruising in babies or non-mobile children
• Cigarette burns
• Human bite marks
• Scalds, with upward splash marks
• Multiple burns with a clearly demarcated edge

Changes in behaviour which can also indicate physical abuse:

• Fear of parents being approached for an explanation
• Aggressive behaviour or severe temper outbursts
• Flinching when approached or touched
• Reluctance to get changed, for example in hot weather
• Depression
• Withdrawn behaviour
• Running away from home
• Fear of medical help or examination

Emotional Abuse

Emotional abuse can be difficult to measure, as there are often no outward physical signs. There may be a          developmental delay due to a failure to thrive or grow, although this will usually only be evident if the child puts on weight in other circumstances, for example when hospitalised or away from their parents’ care. Even so, children who appear well-cared for may nevertheless be emotionally abused by being taunted, put down or belittled. They may receive little or no love, affection or attention from their parents or carers. Emotional abuse can also take the form of children not being allowed to mix or play with other children. Changes in behaviour which can indicate emotional abuse include:

• Neurotic behaviour e.g. sulking, hair twisting, rocking
• Sudden speech disorders
• Fear of making mistakes
• Being unable to play
• Self-harm
• Fear of parent being approached regarding their behaviour
• Developmental delay in terms of emotional progress
  
• Extremes of passivity or aggression
  

Sexual Abuse

Adults or other children who use children to meet their own sexual needs, abuse both girls and boys of all ages,   including infants and toddlers. Usually, in cases of sexual abuse, it is the child’s behaviour that may cause you to become concerned, although physical signs can also be present. In all cases, children who tell about sexual abuse do so because they want it to stop. It is important, therefore, that they are listened to and taken seriously.

The physical signs of sexual abuse may include:

• Pain or itching in the genital area
• Bruising or bleeding near the genital area
• Sexually transmitted disease
• Vaginal discharge or infection
• Stomach pains
• Discomfort when walking or sitting down
• Pregnancy

Changes in behaviour which can also indicate sexual abuse include:

• Sudden or unexplained changes in behaviour e.g. becoming aggressive or withdrawn
• Fear of being left with a specific person or group of people
• Having nightmares
• Running away from home
• Sexual knowledge which is beyond their age, or developmental level
• Sexual drawings or language
• Bedwetting/daytime  soiling
• Sudden loss of appetite or compulsive eating
• Self-harm or mutilation, sometimes leading to suicide attempts
• Saying they have secrets they cannot tell anyone about
• Substance or drug misuse
• Suddenly having unexplained sources of money or gifts
• Not allowed to have friends (particularly in adolescence)
• Acting in a sexually explicit way towards adults or other children/peers

Neglect

Neglect can be a difficult form of abuse to recognise, yet has some of the most lasting and damaging effects on    children. The physical signs of neglect may include:

• Constant hunger, sometimes stealing food from other children
• Poor personal hygiene – constantly dirty or ‘smelly’
• Loss of weight, or being constantly underweight
• Inappropriate clothing for the conditions
• Poor parental engagement for school/health needs

Changes in behaviour which can also indicate neglect may include:

• Complaining of being tired all the time
• Not requesting medical assistance and/or failing to attend appointments
• Having few friends
• Mentioning being left alone or unsupervised

NB: These definitions and indicators are not meant to be definitive, but only serve as a guide to assist you. It is     important too, to remember that many children may exhibit some of these indicators at some time, and that the     presence of one or more should not be taken as proof that abuse is occurring. There may well be other reasons for changes in behaviour such as a death, or the birth of a new baby in the family or relationship problems between parents/carers. In assessing whether indicators are related to abuse or not, the authorities will always want to      understand them in relation to the child’s development and context.

Abuse and Neglect – General Indicators:

The risk of maltreatment is recognised as being increased when there is:

• Parental or carer drug or alcohol abuse
• Parental or carer mental ill health
• Intra-familial violence or history of violent offending
• Previous child maltreatment in members of the family
• Known maltreatment of animals by the parent or carer
• Vulnerable and unsupported parents or carers
• Pre-existing disability in the child

(NICE CG89: When to suspect Child Maltreatment, July 2009)

Babies Under 1 Year

All babies need to be safe, nurtured and able to thrive. The early care they receive provides the essential foundations for all future physical, social and emotional development. Whilst most parents do provide the love and care their babies need, sadly too many babies suffer abuse and neglect. The emotional abuse, neglect or physical harm of babies is particularly shocking both because babies are totally dependent on others and because of the relative prevalence of such maltreatment.

• 45 per cent of serious case reviews in England relate to babies under the age of 1 year

In England and Wales, babies are eight times more likely to be killed than older children. Original analysis conducted for this report estimates, for the first time, the numbers of babies living in vulnerable and complex family situations:

• 19,500 babies under 1 year old are living with a parent who has used Class A drugs in the last year
• 39,000 babies under 1 year old live in households affected by domestic violence in the last year
• 93,500 babies under 1 year old live with a parent who is a problem drinker
• 144,000 babies under 1 year old live with a parent who has a common mental health problem (All babies count campaign, NSPCC, executive summary. Nov 2011).

‘Working Together to Safeguard Children’ was first published in 2013 and updated in 2015 with minor amendment to the guidance in 2017 to add the definition of child sexual exploitation and can be found

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What is Child Sexual Exploitation?

Sexual exploitation of children and young people has been identified throughout the UK, in both rural and urban areas, and in all parts of the world. It affects boys and young men as well as girls and young women from any background and of any ethnicity. It is a type of Sexual Abuse and can have a serious impact on every aspect of the lives of children involved. Child sexual exploitation (CSE) is the organised and deliberate exploitation of a child purely for the sexual gratification of adults.

The sexual exploitation of children is described in the government guidance as “involving exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) because of their performing, and/or another or others performing on them, sexual activities. It can occur using technology without the child’s immediate recognition;

1. being persuaded to post sexual images on the internet/mobile phones without immediate payment or gain. In all cases, those exploiting the child have power over them by their age, gender, intellect, physical strength and/or economic or other resources. Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child’s limited availability of choice resulting from their social/economic and/or emotional vulnerability.”

Sexual exploitation results in children and young people suffering harm, and causes significant damage to their physical and mental health. It can also have profound and damaging consequences for the child’s family. Parents and carers are often traumatised and under severe stress. Siblings can feel alienated and their self-esteem affected.

Family members can themselves suffer serious threats of abuse, intimidation and assault at the hands of perpetrators.

There are strong links between children involved in sexual exploitation and other behaviours such as running away from home or care, bullying, self-harm, teenage pregnancy, truancy and substance misuse. In addition, some children are particularly vulnerable, for example, children with special needs, those in residential or foster care, those leaving care, migrant children, unaccompanied asylum-seeking children, forced marriage and those involved in gangs.

Many sexually exploited children are hidden from public view. They are unlikely to be loitering or soliciting on the streets. Research and practice has helped to move the understanding away from a narrow view of seeing sexual exploitation as a young person standing on a street corner selling sex.

There is also often a presumption that children are sexually exploited by people they do not know. However, evidence shows that this is often not the case and children are often sexually exploited by people with whom they feel they have a relationship, e.g. a boyfriend/girlfriend.

Due to the nature of the grooming methods used by their abusers, it is very common for children and young people who are sexually exploited not to recognise that they are being abused. Staff should be aware that, particularly young people aged 17 and 18, may believe themselves to be acting voluntarily and will need support to work with them so they can recognise that they are being sexually exploited.

Types of CSE

There are three main types of CSE:

• Inappropriate relationships – this usually involves one perpetrator who has inappropriate power or control over a young person. There is often a significant age gap and the victim may believe they are in a loving relationship
• ‘Boyfriend’ model – the perpetrator befriends and grooms the young person into a ‘relationship’ and then convinces or forces them to have sex with friends or associates. This is sometimes associated with gang activity
• Organised sexual exploitation – young people are passed through networks where they are forced into sexual activity with multiple men. This often occurs at ‘sex parties’ and the young people may be used to recruit others into the network

Child Sexual Exploitation (CSE) can also take place over the internet.

Know the Signs

Even something that seems like normal teenage behaviour could be a sign that a child is being sexually exploited. Some of the visible signs include:

• Change in physical appearance- new clothes, more/less makeup, poor self-image, weight gain/loss
• Having increased health/sexual health related problems
  
• Having marks or scars on their body which they try to conceal by refusing to undress or uncover parts of their body
• Expressions of despair (self-harm, overdose, eating disorder, challenging behaviour, aggression, appearing drunk or under the influence of drugs/alcohol, suicidal tendencies, looking tired or ill, sleeping during the day)
• Sexually transmitted infections/ pregnancy
• Multiple miscarriages or terminations
• Indicators of CSE in conjunction with chronic alcohol and drug use
• Indicators of CSE alongside serious self-harming behaviour
• Being defensive about where they have been and what they have been doing
• Volatile/criminal behaviour
• Use of the internet that causes concern including possible use of webcam
• Becoming involved in criminality/repeat offending
• Exclusion and/or unexplained absences from school or not engaged in education or training. Non-school attendance or excluded due to behaviour
• Sexualised risk taking including on Internet and mobile phone
• Sexting’ (the act of sending sexually explicit messages or photographs, primarily between mobile phones)
• Increased use of online gaming including Xbox
• Association with gangs
• Removed from known ‘red light’ district by professionals due to suspected CSE
• Child under 16 meeting different adults and exchanging or selling sexual activity
• Being hostile or physically aggressive in their relationship with parents/carers or other family members
• Getting into cars with unknown adults or associating with known CSE adults
• Child under 13 engaging in penetrative sex with another over 15 years
• Associating/developing a sexual relationship with older men or women
• Reports of being involved in CSE through being seen in hotspots (i.e. in certain flats, recruiting grounds, cars or houses and maybe in company of known CSE adults)
• Becoming disruptive at home or school or using offensive language
• Being secretive or withdrawn
• Older ‘boyfriend/girlfriend’ or relationship with a controlling adult
• Physical or emotional abuse by that ‘boyfriend/girlfriend’ or controlling adult
• Associating with other sexually exploited children
• Regularly coming home late or going missing overnight or longer
• Returning home after long intervals but appearing well cared for
• Being a victim of honour based violence
• Unsuitable or inappropriate accommodation (including street homelessness, staying with adults known to be involved in CSE and living in a place where needs are not met)
• Being involved in witchcraft
• Isolated from peers and social networks; not mixing with their usual friends
• Lack of positive relationship with a protective, nurturing adult
• Living independently and failing to respond to attempts by workers to keep in touch.
• Unusual association with taxi drivers/firms
• Breakdown of residential placements due to behaviour
• Having money, mobile phones, credit for mobile phones, sim cards, clothes, jewellery or other items without plausible explanation and not given by parents/carers
• Having multiple mobile phones, sim cards or use of a mobile phone that causes concern; multiple callers, more texts than usual
• Overtly sexualised dress
• Disclosure of physical/ sexual assault and then refusing to make or withdrawing a complaint
• Having possession of hotel keys/key cards or keys to unknown premises
• Receiving rewards of money or goods for recruiting peers into CSE or just introducing peers to known adults
• Receiving rewards of money or goods for recruiting peers into CSE or just introducing peers to known adults
• Knowledge of towns and cities they have no previous connection with
• Being taken to clubs and hotels by adults and engaging in sexual activity
• Disappearing from the ‘system’ with no contact or support
• Being taken abroad by family members (forced marriage)
• Abduction and forced imprisonment
• Being bought/sold for sexual acts

Possible Indicators Specific to Boys and Young Men are:

• Health – physical symptoms (e.g. bruising or sexually transmitted infections); drug or alcohol misuse; self-harm or eating disorders
• Education – truancy, deterioration of school work or part-time timetable
  
• Emotional and behavioural development – secretive e.g. about internet use; anti-social behaviour; sexualised language; sexually offending behaviour
• Family and social relationships – associating with other children and young people at risk of sexual exploitation; missing from home or staying out late; getting into cars of unknown people; contact with adults outside normal social group
• Identity – low self-esteem, poor self-image or lack of confidence
• Social presentation – wearing an unusual amount of clothing
• Income – social activities with no explanation of how funded; possession of abnormal amounts of money, gifts, new mobile phones, credit on mobile phone, number of SIM cards
• Social integration – frequenting known high-risk areas or going to addresses of concern; seen at public toilets known for cottaging; seen at adult venues

What are the Vulnerabilities?

The Warning Signs and Vulnerabilities are indicated below:

Once engaged offenders are likely to employ a series of sequential steps to erode the free will of the victim and trap them into a lifestyle which is not a choice but to which they can see no alternative as it has become all they know. These incremental steps may take the form of:

• Chilling – Generally associating with the child, supplying them with drink or drugs, listening to them, making them feel good and appearing to be the only one who understands them. Commonly this phase may extend for a protracted period e.g. 12 months
• Presents – The victim will be provided with gifts e.g. jewellery, electronic items or money
• Physical – The offender will begin to ask for them to enter a sexual relationship
• Pestering – Whether they have had a sexual relationship to date the pressure to do so or to expand it will be increased
• Threats – To the victim and/or other people e.g. their family
• Orders – The victim is essentially challenged to refuse what is being demanded of them
• Force – Whether they consent the victim is physically forced to engage in sexual acts

The Significance of Attachment

Victims often do not see themselves as such and may defend their abuser. Some will avoid contact with the police and can be the hardest victims to gain the confidence of and protect. If a child or a young person presents with an indicator of CSE, action is required; the earlier the intervention, the better the chances for success.

Attachment between the victim and offender is the key to CSE occurring and continuing and breaking that attachment is the most effective way to tackle the issue, safeguard the victim and deal with the offender. Attachment arises from the grooming/indoctrination process as the offender creates the cognitive distortions of the victim. They erode pre- existing relationships and bonds and replace them with their own, making them the single most important person in the victim’s life. In doing so they create a position whereby the victim is more likely to give in to their demands and less likely to report them due to the natural processes of the brain. Attachment also explains why the victim will repeatedly return to the offender even after making complaints about them; refuse to pursue complaints that have been made and give false details about persons involved or acts that have occurred.

Important Information About CSE

Sexual exploitation can take many forms from the seemingly ‘consensual’ relationship where sex is exchanged for attention, accommodation or gifts, to serious organised crime and child trafficking.

What marks out exploitation is an imbalance of power within the relationship. The perpetrator always holds power over the victim, increasing the dependence of the victim as the exploitative relationship develops.

Technology can play a part in sexual abuse, for example, through its use to record abuse and share it with other like- minded individuals or as a medium to access children and young people to groom them. A common factor in all cases is the lack of free economic or moral choice.

Sexual exploitation has strong links with other forms of ‘crime’, for example, domestic violence and abuse, online and offline grooming, the distribution of abusive images of children and child trafficking. Many adults involved in prostitution describe difficult childhood experiences that include domestic violence and abuse, neglect, emotional abuse, disrupted schooling and low educational attainment.

The perpetrators of sexual exploitation are often well organised and use sophisticated tactics. They are known to target

areas where children and young people gather without much adult supervision, e.g. parks or shopping centres or sites on the Internet.

Referral

As in all cases, concerns that a child may be at risk of sexual exploitation should be discussed with a manager and/or designated professional for safeguarding, and a decision made as to whether there should be a referral to Children’s Social Care.

The wishes and feelings of the child or young person should be obtained when deciding how to proceed, but Staff should be aware that perpetrators may have groomed the child’s responses and that the child may be denying what is happening.

Where a Staff is fearful of losing the engagement of a child or young person by reporting their concern to Children’s Social Care, the manager should discuss this with Children’s Social Care to agree a way forward. Any decision not to share information or refer a child should be recorded with a full explanation of the rationale behind that decision and the prevailing circumstances at that time. This will assist in future if there is a review of the case and the decision-making processes.

A child or young person who is suspected of suffering or being at risk of suffering sexual exploitation will be a child who may be a Child in Need under the Children Act 1989 and should be referred to Children’s Social Care using the relevant local child protection referral procedures.

Children’s Social Care and the Police will consult and share information concerning incidents or suspicions of sexual exploitation within 24 hours. A decision should be made whether a criminal offence has been committed against a child or young person.

The child’s individual needs and circumstances must be carefully assessed, including issues of ethnicity, gender, culture, disability, religion and sexual orientation.