Welcome to the Professionals pages
Welcome to the LSCB Professionals pages. Here you will find key information, resources and links to support you in work to safeguard children.
Visit our Training tab to find out about courses and learning events available to you
Visit our resource pages for front line professionals or managers for tools and documents you are likely to need in your work with children and families
Have you seen the latest LSCB newsletter and bulletin?
Allegations Against Professionals
Making a referral to the Local Authority Designated Officer and Possible Outcomes
The LADO (Local Authority Designated Officer) provides advice and guidance to employers and other individuals/organisations who have concerns relating to an adult who works with children and young people (including volunteers, agency staff and foster carers) or who is in a position of authority and having regular contact with children (eg religious leaders or school governors).
There may be concerns about workers who 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 behaved in other ways that suggests they may be unsuitable to work with children
What should be referred to the LADO?
Any concern that meets the criteria above should be referred. Initially it may be unclear how serious the allegation is. If there's any doubt, the LADO or the designated safeguarding lead person in your agency should be contacted for advice.
What the LADO does:
The first step will be to offer an initial consultation about the concern. This may consist of advice and guidance regarding the most appropriate way of managing the allegation. The LADO will:
- help establish what the 'next steps' should be in terms of investigating the matter further
- liaise with the police and other agencies, and arrange for an allegations meeting to be held if required; if the case is complex there may be a series of meetings
- monitor and maintain an overview of cases to ensure they're dealt with as quickly as possible consistent with a thorough and fair process
- ensure child protection procedures are initiated where the child is considered to be at risk of significant harm
- ensure the appropriate agencies are involved in the investigation
- ensure advice is provided in relation to the adult's remaining in post over the course of the investigation
- ensure issues of sharing information with parents and other relevant individuals are considered
- assist an employer in decisions about a person's suitability to remain in the children's workforce, and whether a referral should be made to the Disclosure and Barring Service (DBS) or the appropriate regulatory or professional body
- In cases where the adult is unaware of the concern or allegation, it may not be appropriate to tell them immediately and may prejudice a potential police investigation. The LADO will provide advice.
The outcomes from a LADO referral may include:
- finding that the allegation is malicious
- finding that the allegation is unsubstantiated
- finding that the allegation is substantiated
- finding that the allegation is false
- finding that the allegation is unfounded
- internal investigation by the employer including consideration of disciplinary procedures
- a police investigation
- police prosecution
- Where the adult is reinstated there may be recommendations in relation to additional support, monitoring or training.
- Where an individual is dismissed from their post, a referral must be made to the DBS which makes decisions on whether individuals should be barred from working with children.
- Compromise agreements are not an acceptable resolution to a concern, and even if someone resigns it should not prevent a full and thorough investigation into the matter.
LADO Protocol & Procedure - April 2018
To make a referral to the Local Authority Designated Officer (LADO), please email a LADO Referral Form to LewishamLADO@Lewisham.gov.uk.
Current LADO Contact Details:
Finola Owens, London Borough of Lewisham, 1st Floor Laurence House, 1 Catford Road, SE6 4RU
Office Tel: 020 8314 3114
Quality Assurance Duty Desk: 020 8314 9177
Quality Assurance Team Manager: 020 8314 7280
London Child Protection Procedures
London Safeguarding Children's Board
Working Together to Safeguard Children 2015
Keeping Children Safe in Education
Child Not Brought to Appointments
The following animation is aimed at raising awareness about the consequences of missing appointments and to ensure that children and adults get the medical care that they need. This is a powerful reminder that children do not take themselves to appointments, and for practitioners to reflect on the impact of missed appointments on a child's wellbeing. With thanks to Nottingham City CCG & Safeguarding Children Board.
Child Not Brought (CNB): Child was not brought to the appointment without cancellation.
Did Not Attend (DNA): Did not attend appointment without cancellation
No Access Visit (NAV): Not available at home to be seen for appointment.
It is recognised that many children miss appointments in hospital and community settings, and are not available at home to be seen by staff working in different agencies.
Many Serious Child Safeguarding Practice Reviews (Serious Case Reviews) / Homicide Reviews both nationally and regionally have featured CNB, DNA and NAV as a precursor to serious child abuse and child death.
Key principles for Practice
- All agencies should have a policy and local guidance for managing CNB, DNA and NAVs which underpins both process and practice and reflects the differing needs of children and their families.
- Services provided should be child and young person friendly and work in partnership with parents and other practitioners.
- Practitioners should be child focussed and consider children and young people even when the CNB / DNA / NAV relates to the parent/carer, particularly when mental health or problematic substance misuse is featured.
- Practitioners should ensure they are appropriately trained in the identification of child maltreatment to ensure effective judgements are made as to whether the child or young person’s health and development are subject to impairment.
- Develop robust communication links with parents and other professionals or agencies working with the child and ensure that any outcome or consequence for the child or young person is explained.
- Know when and with whom to share information when there are concerns about a child or young person’s welfare and where to get advice.
- Document assessments, analysis, communications and actions taken in the child / young person or parent / carer record as relevant.
- Parents / Carers may disengage with any agencies caring for themselves or their children.
- Remember disengagement is a key risk factor for children and families and may be a precursor to something more serious happening.
- Following CNB / DNA / NAV the responsibility for any assessment of the situation rests with the practitioner to whom the child has been referred in conjunction with the referrer (Laming 2003).
- Consider the needs of the child and the parents / carers capacity to meet those needs.
- Consider environmental context of the child’s situation.
- Identify whether intervention is required to secure a child’s welfare.
- Verbal / written communication with the parents / referrer needs to outline consequence of CNB / DNA / NAV on the child.
- Where there are clear child protection concerns, discuss these with your line manager and make a referral to the Multi-Agency Safeguarding Hub (MASH) email@example.com in accordance with Lewisham’s procedures.
- Where there are concerns relating to children, information should be shared with the Line Manager, Named or Designated Safeguarding Lead / Lead Professional or other agency working with the family who can add to the information sharing process.
- The content of discussions should be clearly documented along with any actions and outcomes in the child or parent / carer record.
- Analysis and conclusion should also be documented ensuring that any referral letters and context of previous records have been considered.
- Consider arranging another appointment, check addresses and other details for accuracy.
- Ensure parents / carers are informed about the consequence(s) of further non-attendance for the child / young person and with whom information will be shared with should there be further CNB / DNA / NAV.
- Repeated CNB / DNA / NAV should result in a Team Around the Family (TAF) meeting to agree the best course of action.
- Unless there is a concern that a child / young person is likely to suffer significant harm then a referral should not be made to MASH until it is established the TAF has not worked. The referral will need to show what work has been attempted, by whom, and what is expected a referral to MASH will achieve.
- An immediate referral to MASH should be made if it is established urgent medical attention has not been sought or delayed for a child or young person by a parent / carer.
- Agencies should find ways to collect information in respect of CNB / DNA / NAV to increase the uptake of services in order to safeguard children and young people and improve their outcomes.
- Number of services CNB / DNA / NAVs under the age of 18 and include the outcome.
- Number of service CNB / DNA for mental health, drug and alcohol services including outcomes of the CNB / DNA.
- Number of NAVs including outcome of no access (all services).
- GP’s should audit outcomes of CNB / DNA / NAV and consider the consequence of non-engagement in order to work with families to improve engagement.
L&G NHS Trust – Child Not Brought Policy
Children & Adolescent Mental Health Services (CAMHS)
Mental Health and Emotional Well-Being Strategy for Children & Young People
Please click here for Self-Harm & Suicide Ideation in Children & Young People
Lewisham CAMHS is Tier 3 Service offering therapeutic interventions to children and young people up to the age of 18 who experience enduring moderate to serious/complex mental health concerns that impact on daily living. Professions represented within CAMHS include:
- Child and Adolescent Psychiatrists
- Clinical Psychologists
- Family Therapists
- Cognitive Behaviour Therapists
- Mental Health Nurses
- Occupational Therapists
- Therapeutic Social Workers
Lewisham CAMHS Services Summary and Contact Information
Services are located across three sites within the Lewisham Borough:
1. Kaleidoscope: Lewisham Centre for Children & Young People, 32 Rushey Green, Catford. SE6 4JF, Tel: 020 7138 1250
Generic team & Crisis Team
Children & young people up to the age of 18 living in Lewisham with a serious and enduring mental health problem, including presentations at Lewisham Hospital A&E
Neuro-Developmental Teams (NDT)
Children & young people up to the age of 18 with a diagnosed significant neurological condition including Autism Spectrum Disorder or moderate to more severe learning disability with a severe and enduring mental health problem.
Paediatric Liason Team
Children & young people with a medical condition, such as diabetes, where psychological support or treatment for the condition is required, physical complaints have been thoroughly investigated and there is continuing report of symptoms of illness
2. Lewisham Park: 78 Lewisham Park, London SE13 6QJ Tel: 020 3228 1000
Young people up to the age of 18 with acute mental health difficulties.
SYMBOL Team (Looked After Children)
Children and young people with serious and enduring mental health difficulties who are:
- looked after by the Lewisham Local Authority
- Looked after by other authorities but placed in Lewisham
- Adopted children / Children on Special Guardianship Orders
Functional Family Therapy Team (FFT)
Intensive outreach family therapy for young people and their families where the young person has persistent and significant conduct problems at home, school or in the community.
The Lewisham Functional Family Therapy team takes referrals from Lewisham CAMHS, Lewisham YOS, the Pupil Referral Units, plus Sedgehill and Prendergast Ladywell Schools.
3. Holbeach: 9 Holbeach, Catford, London SE6 4TW, Tel: 020 8314 9742
Adolescent Resource and Therapy Service (ART’S)
Young people up to the age of 18 who have offended or are at risk of offending and have serious and enduring mental health difficulties.
Please refer to the CAMHS Referral Criteria for full information on services and referrals.
When making a referral to Lewisham CAMHS please use our CAMHS Referral Form.
Non urgent referrals for CAMHS teams based at Kaleidoscope can be emailed to: LewishamCAMHSAdmin@slam.nhs.uk
If you have any urgent concerns about a child or young person’s mental health or a referral query please contact the CAMHS Duty Team at Kaleidoscope Tel: 020 7138 1250 (available Monday to Friday 9-5 excluding bank holidays)
Out of hours: Please advise the Parent/Carer to contact the child/young person’s G.P, or in an emergency, if it is felt that the child/young person is not able to be kept safe, send them to their local A&E.
South London and Maudsley NHS – Crisis Support Line Tel: 0800 731 2864 is available 24 hours a day if you need urgent help or advice.
Lewisham CAMHS Safeguarding Children Infrastructure and Contact Information:
Sophie Roberts is the Lead Nurse Safeguarding Children Lewisham CAMHS
Telephone: 0203 0491293 Lewisham CAMHS, Kaleidoscope, 32 Rushey Green, Catford, London SE6 4JF
Wendy Geraghty is the Lead Doctor Safeguarding Children Lewisham CAMHS
Telephone: 0203 2281000
Lewisham CAMHS, 78 Lewisham Park, London SE13 6QJ
Mark Perry is Service Manager Lewisham CAMHS
Telephone: 0207 138 1250
Lewisham CAMHS, Kaleidoscope, 32 Rushey Green, Catford, London SE6 4JF
Child & Adolescent Mental Health – Young Minds
Royal College of Psychiatrists
Kooth - free online service that offers emotional and mental health support for children and young people
MindEd - free educational resource on children and young people’s mental health for adults
Domestic Violence & Abuse
Domestic abuse is defined as “any incident or pattern of incidents of controlling, co-ercive, 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”. The abuse can encompass, but is not limited to:
Domestic abuse can also include forced marriage and so-called “honour crimes”.
Controlling and co-ercive behaviour
Domestic abuse is often thought of as physical, such as hitting, slapping or beating, but it can also be controlling or co-ercive behaviour. This is important as what might look like an isolated incident of violent abuse could be taking place in a context of controlling or co-ercive behaviour.
Controlling behaviour is a range of acts designed to make a person subordinate and/or independent 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.
Co-ercive 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.
We know that the first incident reported to the police or other agencies is rarely the first incident to occur; often people have been subject to violence and abuse on multiple occasions before they seek help.
Learning resources to support health and social work in situations of coercive control
A new set of learning resources for social workers, safeguarding leads, and health and social care practitioners, provides information and guidance on how to recognise and respond to coercive and controlling behaviour in intimate or family relationships.
Supporting the non-abusing parent in a holistic way that acknowledges the impacts of coercive control is important in achieving good outcomes for children. Research showed that children also experience the impacts of coercive control of a parent; for example, becoming isolated from family and friends, finding it difficult to gain independence, and feeling disempowered. The resources, which include five detailed case studies, will support practitioners to improve their understanding of the dynamics of power and control that underpin domestic abuse, enabling them to build trusting relationships with children and survivors.
The examples, tools and videos bring together evidence from research, practitioner experience, and the voice of people using services, to enable professionals to put the law into practice and improve support for people who are experiencing coercive control.
The Chief Social Worker’s Office at the Department of Health commissioned the materials, which were developed by Research in Practice for Adults and Women’s Aid. http://coercivecontrol.ripfa.org.uk/
Safeguarding children exposed to domestic abuse
Children who live in families where there is domestic abuse can suffer serious long-term emotional and psychological effects. Even if they are not physically harmed or do not witness acts of violence, they can pick up on the tensions and harmful interactions between adults. Children of any age are affected by domestic violence and abuse. At no age will they be unaffected by what is happening, even when they are in the womb.
The physical, psychological and emotional effects of domestic violence on children can be severe and long-lasting. Some children may become withdrawn and find it difficult to communicate. Others may act out the aggression they have witnessed, or blame themselves for the abuse. All children living with abuse are under stress.
- Consider the presence of domestic abuse as an indicator of the need to assess a child’s need for support and protection
Safe Lives, a national domestic abuse charity, has created a toolkit practitioners and front-line workers can use to identify high risk cases of domestic abuse, stalking and ‘honour’-based violence. The purpose of the checklist is to give a consistent and simple-to-use tool to practitioners who work with victims of domestic abuse in order to help them identify those who are at high risk of harm and whose cases should be referred to a MARAC meeting in order to manage the risk.
The toolkit has been endorsed by agencies such as the police (Association of Chief Police Officers), National Centre for Domestic Violence, and CAFCASS, who believe that the primary audience should be front line practitioners working with victims of domestic abuse who are represented at MARAC. This will include both domestic abuse specialists such as IDVAs and generic practitioners such as those working in a primary care health service or housing.
Locally, both the Adult’s and Children’s Safeguarding Board (LSAB / LSCB), as well as the Safer Lewisham Partnership (SLP) have agreed that all agencies in Lewisham working with, or supporting families at risk of domestic violence are expected to use the risk checklist. This is vitally important because using an evidence based risk identification tool increases the likelihood of the victim being responded to appropriately and therefore, of addressing the risks they face. The risk checklist gives practitioners common criteria and a common language of risk.
Safe Lives have produced an updated version of the RIC, which now includes comprehensive guidance explaining each risk question, how they can be asked, as well as practice points. There is also a frequently asked questions page with some useful tips on the checklist. The Safe Lives website has helpful resources about other ways your agency may access support, training or download the checklist in other languages. The Lewisham Safeguarding Children’s Board also offers annual training on the use of the checklist which is free for all professionals in the borough to attend, however, for more questions about the use of the RIC, access to training, and questions about domestic violence MARAC process, please visit www.lewisham.gov.uk/vawg or contact the Violence Against Women & Girls (VAWG) Programme Manager on firstname.lastname@example.org
Safeguarding high-risk victims of domestic violence and abuse – referring to the MARAC
The Lewisham Domestic Violence Multi-Agency Risk Assessment Conference (MARAC) is a risk management meeting where professionals share information on high and very high risk cases of domestic violence or abuse and put in place a risk management plan. The aim of the meeting is to address the safety of the victim, children and agency staff and to review and co-ordinate service provision in high risk domestic violence cases.
To be referred to the MARAC the individual must reside in the London Borough of Lewisham, be over the age of 16, be currently experiencing domestic violence or abuse (according to the cross Government definition of domestic violence) and be assessed as being at high or very high risk of harm of domestic violence or abuse in accordance with the Lewisham MARAC referral risk criteria. In order to assess whether a case meets the risk threshold, the Safe Lives DASH MARAC risk indicator checklist should be completed by the referring agency.
A tailored action plan will be developed at the MARAC to reduce the risk to the victim, children, other vulnerable parties and any staff and to ensure that the risk the perpetrator presents is managed appropriately. Examples of actions that will be agreed include flagging and tagging of files, referral to other appropriate multi-agency meetings, prioritising of agencies’ resources to MARAC cases.
Any service agency signed up to the MARAC Information Sharing Protocol may refer a case to the MARAC using the Lewisham MARAC Referral Form, and all agencies should be actively screening for domestic violence or abuse. Referrals should be submitted to each agency’s MARAC representative. Please contact your line manager to find out who your agency’s MARAC representative is.
For more questions about the use of the MARAC, access to training, and questions about the process, please visit www.lewisham.gov.uk/vawg or contact the Violence Against Women & Girls (VAWG) Programme Manager on email@example.com , or the MARAC Coordinator on firstname.lastname@example.org
For further information
Letter to partners on the use of the DV risk assessment
See the Domestic Violence information in our practice procedures
MOPAC VAWG Strategy 2018-2021
MOPAC Domestic and Sexual Violence Dashboard
Home Office Resources for Violence Against Women & Girls (VAWG)
Early Help & the Multi-Agency Safeguarding Hub (MASH)
The MASH is a consent-based model. Professionals dealing with suspected child neglect, abuse or need for support, will endeavour to work in partnership with parents. This means the professional will:
be open and honest with parents about the concerns they have about a child or children
explain to parents, before making a referral, how the MASH team will share information about the child and family to get the best possible picture about the child’s circumstances.
If the referring professional believes that seeking consent for sharing information with the MASH would place a child at further risk of harm or cause unnecessary delay, they may refer the child without parental consent, but must explain why this is the case. If in doubt please contact the MASH on 020 8314 6660 for further discussion.
The Multi-agency Safeguarding Hub (MASH) provides a single point of access for all professionals to report safeguarding concerns to children’s social care. Professionals can also request commissioned targeted family support through the multi-agency early help panel.
For urgent child protection referrals, contact the MASH on 020 8314 9181. If you think a child or young person may be in immediate danger, call 999 or contact your local police on 101.
Making a MASH request
If, as a professional, you have safeguarding concerns or are requesting commissioned family support for targeted early help, you can use the online MASH request form or the MASH Referral Form - Word Version, after reading the below information.
Please note that residents and other members of the public can still make referrals in person or over the phone.
All requests that come through the MASH will be triaged by the multi-agency team and you may be contacted by a professional representing your agency to discuss your request.
Before you make a request
The following information will help you determine if you need to make a MASH request, and which part of the MASH request form you need to use:
Our continuum of need document will help you assess the level of support needed or risks present. Professionals should refer to the Continuum of Need Document and it's Guidance before making a MASH request.
If you believe a child and their family need some additional support you should discuss this with the family first and agree who is best placed to provide that support. .
If you are a professional (e.g. CAFCASS, probation, housing conducting statutory safeguarding checks, assessments), working with a child and you require supporting information from children’s social care records use MASH Request Form - Online
or the MASH Referral Form - Word
Version the form to make a Statutory Request for Information.
If you are unsure about whether or not to make a MASH request, please contact the MASH Consultation Helpline on 020 8314 6660.
- If you are unsure about how to apply the levels of need for Early Help or you need support around the Early Help process and tools, please contact the Early Help Team Consultation Helpline on 020 8314 7333.
Opening hours are Monday-Friday, 9am to 5pm. If you have concerns about the welfare of a child outside of these hours, please contact the Emergency Duty Team on 020 8314 6000 and ask to speak to the out-of-hours duty social worker.
Early Help Strategy
Plan, Review & Closure Form
Early Help Leaflet for children and families.
Escalation Policy - Resolving Professional Differences / Escalation
Having different professional perspectives within safeguarding practice is a sign of a healthy and well-functioning partnership. These differences of opinion are usually resolved by discussion and negotiation between the professionals concerned. It is essential that where differences of opinion arise they do not adversely affect the outcomes for children and young people, and are resolved in a constructive and timely manner.
Differences could arise in a number of areas of multi-agency working as well as within single agency working. Differences are most likely to arise in relation to;
- Criteria for referrals
- Outcomes of assessments
- Roles and responsibilities of workers
- Service provision
- Timeliness of interventions
- Information sharing and communication
If you have difference of opinion with another professional, remember:
- Professional differences and disagreements can help us find better ways improve outcomes for children and young people
- All professionals are responsible for their own cases, and their actions in relation to case work
- Differences and disagreements should be resolved as simply and quickly as possible, in the first instance by individual practitioners and /or their line managers
- All practitioners should respect the views of others whatever the level of experience. Remember that challenging more senior or experienced practitioners can be hard
- Expect to be challenged; working together effectively depends on an open approach and honest relationships between agencies
- Professional differences are reduced by clarity about roles and responsibilities and the ability to discuss and share problems in networking forums
Where immediate resolution cannot be found, professionals should make accurate records of discussions and correspondence and follow the LSCB Escalation Policy. When making a referral to the LSCB please email email@example.com with a completed Resolving Professional Differences Record.
LSCB Escalation Policy Flowchart
Female Genital Mutilation / Cutting
Between April 2016 and March 2017 there were 1,065 newly recorded women and girls presenting at
Health settings in London,where FGM was identified or a procedure of FGM was undertaken.
NHS Digital FGM Annual Report 2016-2017
What is FGM?
FGM is a form of violence against women and girls (VAWG). It comprises of all procedures involving partial or total removal of the external female genitalia for non-medical reasons. It may be carried out at any time in a girls life, from baby to womanhood. It can be seen as a pathway to womanhood and can also be a condition of marriage. Some communities believe that if a girl has not had it done she is deemed unhealthy, unclean, or unworthy. Parents can have very strong beliefs, genuinely thinking they are doing the right thing for their daughter, and in communities where all females have the procedure it can seem normal, then making it very difficult for girls to challenge this tradition. However, not every mother who has had FGM will put their daughter(s) through the same procedure. Each case should be assessed carefully and sensitively.
It is sometimes also known as female circumcision. Other local terms are: Tahoor, Absum, Halalays, Khitan, Ibi, Sunna, Gudnii, Bondo, Kutairi. It is important to let the female refer to the term she understands it to be called. FGM is sometimes incorrectly believed to be an Islamic practice. This is not the case and the Islamic Shari’a Council, the Muslim College and the Muslim Council of Britain (MCB) have condemned the practice of FGM. The majority of cases of FGM are thought to take place between the ages of 5 and 8 and therefore girls within that age bracket are at a higher risk.
Mandatory Reporting Duty - What are ‘known cases?
Known cases are those where either a girl informs the person that an act of FGM – however described – has been carried out on her, or where the person observes physical signs on a girl appearing to show that an act of FGM has been carried out and the person has no reason to believe that the act was, or was part of, a surgical operation within section 1(2)(a) or (b) of the FGM Act 2003. The duty applies to all regulated professionals working within health or social care, and teachers. There is mandatory requirement to report to police cases of ‘visually identified’ or ‘verbally disclosed’ cases of FGM in girls under 18. The mandatory reporting does not apply to suspected cases or where a child might be ‘at risk’ of FGM. The mandatory reporting is for ‘known’ cases only.
It is Illegal
In the UK, anyone found guilty of an FGM offence or of helping somebody commit one, faces up to 14 years in prison, a fine, or both, regardless of where in the world the FGM takes place. Anyone found guilty of failing to protect a girl from risk of FGM faces up to 7 years in prison, a fine, or both. Lewisham has secured 1 FGM Protection Order.
Recognising Signs & Symptoms of Possible FGM Cases
A girl may;
- Say an older female relative is coming especially to see her.
- Say that she is being taken "home" for a special visit to become a woman (right of passage).
- become withdrawn following this "holiday" and/or there may be a change in her behavior.
- Run away from home, or start truanting from school.
- Have difficulty standing or sitting.
- Spend longer in the toilet than usual; because of bleeding and/or infection.
- Have frequent vaginal, urinal, or pelvic infections.
- Blood born infections, including Hepatitis B & C, and HIV.
- She may be reluctant to undergo any medical examinations.
- May ask for help, but not be explicit about the problem due to fear or embarrassment
- Develop emotional and mental health problems.
- Self harm, or be showing signs of child abuse.
Long Term Health Effects
Many girls and women are not aware of the lifetime effects FGM can have on them; with difficulty in child birth (sometimes ending in death), infertility, sexually difficulties, vaginal infections, painful periods, cysts and abscesses, and difficulty controlling her bladder. This is a procedure that cannot be reversed. FGM also involves a long term emotional impact including, anxiety, depression, and post traumatic stress disorder.
FGM is classified into four categories:
- Clitoridectomy: partial or total removal of the clitoris and, in very rare cases, only the prepuce
- Excision: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora
- Infibulation: narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, or outer, labia, with or without removal of the clitoris
- Other: all other harmful procedures to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area
Language & Image Guide - Please refer to the current language and image guidance to use when talking to survivors of FGM.
The following are terms used by different nationality's to describe FGM. You will need to consider that a survivor may not recognise FGM or Cutting to describe what they have experienced.
- Egypt: Thara / Khitan / Khifad
- Ethopia: Megrez / Absum
- Eritrea: Mekhnishab
- Kenya: Kutairi / Kutairi was ichana
- Nigeria: Ibi / Ugwu / Sumna
- Sierra Leone: Sunna / Bondo / Bondo Sonde
- Somalia: Gudiniin / Halalays / Qodiin
- Sudan: Khifad / Tahoor
- CHAD: Bagtne / Gadja
- Guinea-Bissau: Fanadu di Mindjer / Fanadu di Omi
- Gambia: Niaka / Kuyango / Musolula Karoola
Procedure in Lewisham
The LSCB Partnership has endorsed a local FGM Guidance to assist you with your responsibilities.
At-Risk Cases of FGM
Situations whereby the female child is at risk of FGM being performed, suspected of being performed, or suspected of having been performed, normal safeguarding procedures and existing pathways would apply. You should consult with your appointed safeguarding lead and you should report it to MASH on 020 8314 6660 and email firstname.lastname@example.org.
An FGM Protection Order offer a legal means to protect and safeguard victims and potential victims of FGM. Please see the Fact Sheet for more information.
Reporting Known Cases in Lewisham
In London the only reporting gateway for mandatory reports is via 101. You should also inform MASH and your appointed safeguarding lead of your report.
The duty applies to all regulated professionals working within health or social care, and teachers. There is mandatory requirement to report to police cases of ‘visually identified’ or ‘verbally disclosed’ cases of FGM in girls under 18. The mandatory reporting does not apply to suspected cases, or where another person (including the mother) discloses that FGM has taken place, or where a child might be ‘at risk’ of FGM. The mandatory reporting is for ‘known’ cases only, and this can be any girl of any nationality.
Home Office Mandatory Reporting Procedural Guidance
Multi-Agency Statutory Guidance FGM
Support is Available for Girls and Women at Risk
You can obtain a Statement Opposing Female Genital Mutilation for girls and women. It is in a variety of languages on the GOV.UK website. Girls and Women can also contact;
- Athena VAWG Service on 0800 112 4052, email email@example.com, website www.refuge.org.uk/Athena
- African Advocacy Foundation on 020 8698 447, website http://www.africadvocacy.org/
- NSPCC FGM Helpline on 0800 028 3550, email firstname.lastname@example.org
- FGM Every Bodys Biz website provides advice, support and a forum to hear the voice of the girl/woman. You can also obtain up-to-date information on FGM Health Specialists and organisations working on FGM, http://fgm-every-bodys-biz.co.uk/
- If a girl or woman has been taken abroad phone the Foreign & Commonwealth Office immediately on 020 7008 1500.
Specialist FGM Clinics for Survivors of FGM
African Well Women’s Clinic
Guy’s & St Thomas’ Hospital, 8th Floor, c/o Antenatal Clinic, Lambeth Palace Road, London SE1 7EH
Tel: 020 7188 6872
Open Monday-Friday, 9am to 4pm.
Contact: Confort Momoh MBE, FGM / Public Health Specialist 07956 542 576
Action African Well Women Centre
Self Referral for free confidential services
Contact: Julia Albert – Midwife or Hayat Arteh – Health Advocate
Tel: 020 8383 8761 or 07956 001 065
or 07730 970 738
Manor Gardens Clinic
The project works with volunteer FGM Community Champions, delivers training, provide workshops and 1:2:1 support through the Dahlia project (Specialist therapeutic service for women who have undergone FGM).
For further information on FGM we would encourage all professionals to view the excellent Home Office training package on FGM which can be found at: www.fgmelearning.co.uk/
Useful Links & Guidance:
NHS England Posters & Guidance
National FGM Centre
FGM Map by Country & Origin and their Practice
FGM Health Passport- Statement opposing FGM guidance in different languages.
Links to information about FGM Orders:-
National FGM Centre
Courts of Justice - Family Procedure Rules
What to do if you are worried about the Safety of a child – professionals
Female Genital Mutilation - An Overview (leaflet)
How to have difficult conversations with parents / carers
A guide for practitioners who work with children and their families.
The information in this guide is not exhaustive and it should be used as a reference alongside practitioners own safeguarding practices and in conjunction with appropriate supervision.
Four factors to consider when preparing for a difficult conversation with a parent or carer:
- Principles – that underpin safeguarding children.
- Planning – how to plan or be prepared
- The Conversation – things to consider when having a conversation
- Examples – open questions and suggestions
1. Principles – to support safeguarding discussions with parents / carers
- Always take time to plan the conversation before you speak to parents.
- Be open and honest, use basic language, avoid jargon.
- Ensure child protection policies are clear.
- Include child protection issues in information you give out to parents you are working with.
- Explain your statutory duty to safeguard children’s welfare, “duty of care” and requirement to report your concerns.
- Ensure parents / carers sign to acknowledge they have read and understood your safeguarding policy and offer them a copy.
- Use Early Help, refer to a children’s centre, or signpost to other support agencies, i.e. health visitor, parenting courses etc.
If you feel it’s too risky to talk to parents before speaking to Children’s Social Care, then don’t. Do not put yourself or a child at risk, e.g. if:-
- There is suspected sexual abuse.
- Parents could destroy evidence or hinder a police investigation.
- It is possible the child could be silenced.
Otherwise it’s good practice to discuss concerns with parents/carers and tell them you are going to make a referral. Before your conversation:-
- Plan how you are going to broach your concern and how to respond to different responses, e.g. anger, denial, emotional breakdown etc.
- Choose a time and place to give full privacy.
- Consider the timing of the meeting (e.g. a tired, crying baby, or collecting other children from school etc.) depending on the urgency of the concern.
- Adapt your style to the parent, consider language barriers or learning difficulties.
- Acknowledge your own anxiety about dealing with a difficult situation as it may affect your communication style.
- Have the child’s key worker with you or nearby for support and as a witness (and vice versa) or get support from Children’s Social Care.
- If previous experience of the parent/carer suggests they may pose a risk, make a full risk assessment and do not meet alone.
3. The Conversation
Make sure members of staff know where you are and what you are doing before a meeting. Tips and ideas for having a difficult conversation:-
- Consider your position in the room so nobody feels trapped.
- Ensure children cannot overhear you and are occupied (provide toys etc.)
- Frame the concern in a model of help and support.
- Be straight forward – Tell the parent/carer a referral to the Multi-Agency Safeguarding Hub is going to be or has been made.
- Tell them that “as a parent/carer they will want to get to the bottom of the matter”.
- Give clear explanations.
- Always remain confidential and professional.
- Words are sometimes really hard to find when approaching a parent – use ‘active listening’.
- Do not argue, interrupt, give advice, pass judgement, jump to conclusions or let the parent’s sentiment affect you.
- Avoid excessive reassurance, it may not be all right.
- Do encourage the parent to talk.
- Clarify what the parent means.
- Summarise what the parent has said.
- Consider your communication style: tone, pitch, speed of voice, body language (body slightly to the side, with an open stance or sit) be clam, make eye contact and appreciate they may need to talk.
- Consider the parents point of view which may be influenced by; bad experience of services, lack of trust, limited or distorted understanding of what is appropriate for children, learning difficulties, cultural and language barriers.
- Explain the nature of your concern using tact and diplomacy, but be direct and use factual information “Jodie was not brought to the last 2 appointments, what is the reason for this?”
- Do not use words such as child protection or child abuse, try words such as concerns, welfare, and duty of care.
Use your eyes and ears more than your mouth.
This is not an exhaustive list and you may want to use a technique of your own, following the general principle of open and probing questions:
- Avoid using “I think” which indicates it could be your own opinion.
- Avoid using jargon, try:-
- “I need to talk to you about the injury to XY’s face, can you tell me what happened?”
- “XY has been very lethargic today and says he has not slept, is there anything going on that might be troubling him?”
- “XY’s behaviour has changed dramatically over the last few weeks, (s)he has gone from being a happy, outgoing child to a very quiet, withdrawn child. Have you any idea what could have caused this?”
- “Whenever there is a worry about any child, or they something about being hurt we legally have to pass on that information to children’s services – you may have read this in the parent’s information/handbook when XY started?”
- “XY told a member of staff he is slapped every night, and, because of what he has said I have informed Children’s Social Care. All settings are expected to talk to Children’s Social Care when children say things like this, and Children’s Social Care have asked me to talk to you about this. Can you tell me what happened?”
Questions can start with the following:-
- “is there any reason why……….”
- “we need to have a chat………..”
- “XY has said……………………..”
- “I have noticed XY has seemed hungry in the mornings, is (s)he managing to have breakfast before he comes to school?”
- XY has a bruise on his face but he can’t remember how it happened, do you know how he did it?”
Once you have had a conversation or a series of discussions with the parent or carer, you may need to consider what actions, if any, you need to take. Consider the following:-
- Professional curiosity – have you confirmed the response you have received from other agencies? Do you need to make further enquiries?
- Trust your instincts – You have spoken to the parent/carer and you know the child – trust your instincts if you still have concerns.
- Follow safeguarding procedures – ensure you check your agency safeguarding procedures and seek guidance from an appropriate person.
- Pre and Post Supervision – agencies have varying supervision procedures; be sure to raise your concerns and get guidance and support before and after you have had a conversation with a parent/carer as this will give you a chance to reflect on what happened and discuss what needs to happen next (reflective practice).
- Escalation – If you are still concerned about a decision or practice you can escalate your concerns; the LSCB recommend you follow our Resolving Professional Differences / Escalation Policy.
- Referral – Following any discussion, if you are concerned about the safety of a child or you believe they are at risk of immediate danger – contact the police. If you believe the child is at risk of significant harm – seek guidance from the MASH team.
- Early Help – You may want to contact Early Help or create a Team Around the Family.
|What are we worried about?
||What’s working well?
||What needs to happen?
What words would you use to talk about this problem so that parents/carers understand?
Use plain language and avoid jargon.
Consider any problems the family might be having which are making this problem harder to deal with e.g. housing, finances, isolation, or family breakdown.
- I need to talk to you about the mark XY’s face, (s)he can’t remember how it happened, and do you know how (s)he did this?
- XY’s behaviour has changed a lot in the last few weeks. (S)he has gone from being happy and outgoing to quiet and withdrawn – have you any idea what might have caused this this?
- We are having a lot of problems with XY, (s)he seems angry. Is there anything happening at home which would help us to understand this?
- I know we have talked about this before but I am still worried because XY is still quite dirty when she comes to school and other children have commented that (s)he smells. Do you have everything you need at home to wash clothes and to have a bath regularly?
Who are the people who care for the child? And what are the best things about how they care for them?
Who would the child say are the most important people in their lives? And how do they help them grow up well?
- It sounds like things are a bit difficult at the moment, is anyone supporting you?
- What would XY say are the best things about his life?
- You have been doing well to get XY to school with all that is happening, is there anything we can do to support you further?
- Have you noticed this problem before? How was it sorted out in the past?
Now you have explored this more, how worried are you about this child? 10 is not worried; 0 is so worried you need to make a referral for support or safeguarding.
- What would you need to see for it to be 10?
- What do you think is the next step to getting this worry sorted out?
- Have you done any direct work with the child?
- Curiosity – verify any information with professionals or other family members.
- Supervision – seek guidance before and after interaction with parents/carers to reflect on the information gathered.
- Procedures – follow your agency safeguarding procedures.
- Referral – If you are concerned about the safety of the child or young person.
- Escalation – If you are not satisfied with the outcome of the referral and still have concerns.
Information Sharing & Consent
In every Serious Case Review that has ever been undertaken, information sharing has been a key theme. It is essential that all professionals gain consent and share information appropriately within the network of those working with a child and their family. If you do not have consent and are unsure about whether to share information, discuss it with your line manager in the first instance. We recommend you undertake the LSCB E-Learning courses and read the guidance and legislation detailed below.
LSCB Training Programme
The LSCB recommends all professionals undertake the E-Learning courses as follows:-
- Information Sharing & Consent
- Data Protection Act
Missing, Exploitation and Trafficking Information Sharing Guidance
Successful partnership working depends substantially on effective communications and information sharing between agencies. MET Information Sharing Guidance document.
Working Together 2015 Extracts
- Effective sharing of information between professionals and local agencies is essential for effective identification, assessment and service provision.
- Early sharing of information is the key to providing effective early help where there are emerging problems. At the other end of the continuum, sharing information can be essential to put in place effective child protection services. Serious Case Reviews (SCRs) have shown how poor information sharing has contributed to the deaths or serious injuries of children.
- Fears about sharing information cannot be allowed to stand in the way of the need to promote the welfare and protect the safety of children. To ensure effective safeguarding arrangements:
- all organisations should have arrangements in place which set out clearly the processes and the principles for sharing information between each other, with other professionals and with the LSCB; and
- no professional should assume that someone else will pass on information which they think may be critical to keeping a child safe. If a professional has concerns about a child’s welfare and believes they are suffering or likely to suffer harm, then they should share the information with local authority children’s social care.
- Information Sharing: Advice for practitioners providing safeguarding services to children, young people, parents and carers (2015) supports frontline practitioners, working in child or adult services, who have to make decisions about sharing personal information on a case by case basis.6 The advice includes the seven golden rules for sharing information effectively and can be used to supplement local guidance and encourage good practice in information sharing.
The seven golden rules to sharing information
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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 (see principles).
7. 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.
Gillick / Fraser Competence - NSPCC
When we are trying to decide whether a child is mature enough to make decisions, people often talk about whether a child is 'Gillick competent' or whether they meet the 'Fraser guidelines'.
The Gillick competency and Fraser guidelines help us all to balance children’s rights and wishes with our responsibility to keep children safe from harm
Data Protection Act
The Data Protection Act controls how personal information is used by organisations, businesses or the government.
Everyone responsible for using data has to follow strict rules called ‘data protection principles’. They must make sure the information is:
- used fairly and lawfully
- used for limited, specifically stated purposes
- used in a way that is adequate, relevant and not excessive
- kept for no longer than is absolutely necessary
- handled according to people’s data protection rights
- kept safe and secure
- not transferred outside the European Economic Area without adequate protection
There is stronger legal protection for more sensitive information, such as:
- ethnic background
- political opinions
- religious beliefs
- sexual health
- criminal records
Missing, Exploited (CSE) & Trafficking
Lewisham Safeguarding Children Board:
Child sexual exploitation is on of Lewisham Safeguarding Children Board’s (LSCB) key priorities. The LSCB therefore endeavours to prevent children and young people being sexually exploited by understanding the issues associated with the activity and raising community awareness so to equip our neighbourhoods, schools and workforce with the knowledge, skills and tools to tackle this and associated need. We will continue to identify those children and young people who are at risk of sexual exploitation and will intervene robustly to minimise the potential for harm, disrupt the problematic behaviours and use criminal procedures as appropriate.
LSCB MET Strategy:
The LSCB has overall responsibility for ensuring there is a coordinated, multi-agency response to children who are at risk of sexual exploitation. The full operating framework is set out in the LSCB Missing, Exploitation and Trafficking (MET) strategy which can be accessed via the link listed below.
There are 3 different levels of risk indicators for CSE as explained in the CSE toolkit:
- Low level risk indicators
- Medium level risk indicators
- High level risk indicators
The MASH referral process can be found here: http://www.safeguardinglewisham.org.uk/lscb/lscb/professionals/early-help
The LSCB strongly promotes the use of the CSE risk assessment toolkit by all professionals to assist them in assessing the risks and early indicators of CSE. It is everyone’s responsibility to prevent children and young people being sexually exploited.
The Lewisham LSCB MET strategy needs to be read in conjunction with the following documents:
- London Child Protection Procedures
- Working Together to Safeguard Children (DFE, 2015)
- Safeguarding children and young people from sexual exploitation (DCSF 2009)
- Tackling child sexual exploitation action plan (DFE, 2011) and Tackling child sexual exploitation action plan; progress report (DFE, 2012)
- Pan London CSE Protocol (revised 2015)
- Statutory Guidance on children who run away and go missing from home or care (DSCF, 2009)
- Safeguarding children who may have been trafficked; practice guidance (DFE & HO, 2011)
- Victims of Human Trafficking – guidance for frontline staff (UKBA & HO, 2013)
Missing, Exploited & Trafficked (MET) Strategy
Appendix A - National and Local Context
Appendix B - Harmful Sexual Behaviour
Appendix C - Child Sexual Exploitation Risk Assessment & Toolkit
Appendix D - Emerging Best Practice: Learning from Serious Case Reviews and Studies of Current Practice
Appendix E - Children Who Run Away or Go Missing From Home or Care
Appendix F - Navigate Project Online Safety
Appendix G - Lewisham Child Sexual Exploitation and Missing Sub Group & MET Board Terms of Reference
DfE CSE Definition Guide February 2017
Modern Slavery & Child Trafficking
The Modern Day Slavery Act 2015 came into force in October 2015.
Part 1. Consolidates and clarifies the existing offences of slavery and human trafficking whilst increasing the maximum penalty for such offences. For offences of slavery, servitude and forced or compulsory labour, or for offences of human trafficking any person found guilty is liable to life imprisonment.
Part 2. Provides for two new civil preventative orders, the Slavery & Trafficking Prevention Order, and the Slavery & Trafficking Risk Order. Request of a Chief Officer of Police, Immigration Officer, or NCA can prevent foreign travel, protect potential victims, and prevent further offences.
Part 3. Provides for new maritime enforcement powers in relation to ships.
Part 4. Establishes the office of Independent Anti-Slavery Commissioner and sets out the functions of the Commissioner. To encourage good practice in investigation / victim care.
Part 5. Introduces a number of measures focussed on supporting and protecting victims, including a statutory defence for slavery or trafficking victims and special measures for witnesses in criminal proceedings. Child trafficking advocates, non prosecution of victims compelled to commit crime, presumption of under 18 until appropriate age assessment. Public body has a duty to notify suspected victim of trafficking.
Part 6. Requires certain businesses to disclose what activity they are undertaking to eliminate slavery and trafficking from their supply chains and their own business.
Part 7. Requires the Secretary of State to publish a paper on the role of the Gangmasters Licensing Authority and otherwise relates to general matters such as consequential provision and commencement.
The typology of 17 types of modern slavery offences in the UK
Victims exploited for multiple purposes in isolated environments
Victims who are often highly vulnerable are exploited for labour in multiple ways in isolated rural locations. Victims live on offenders' property in squalid conditions, are subject to repeated abuse and are very rarely paid.
Victims work for offenders
Victims are forced to work directly for offenders in businesses or sites that they own or control (some offenders may be gangmasters). The main method of exploitation is not paying or illegally underpaying victims.
Victims work for someone other than offenders
Victims are employed in a legitimate and often low-skilled job, with legal working conditions, by an employer unrelated to the offenders. Most or all wages are taken by offenders often through control of the victims' bank accounts.
Exploited by partner
Victims are forced to undertake household chores for their partner and often their partner's relatives. If married, the marriage may have been arranged or forced and the servitude often occurs alongside domestic abuse and sexual exploitation.
Exploited by relatives
Victims live with and exploited for household chores and childcare by family members, usually extended family. Many victims are children.
Exploiters not related to victims
Victims live with offenders who are often strangers. Victims are forced to undertake household chores and are mostly confined to the house.
Child sexual exploitation – group exploitation
Children are sexually exploited by groups of offenders. This is usually for personal gratification, but sometimes the exploitation involves forced sex work in fixed or changing locations and will include characteristics of types 9 and 10. Offenders frequently transport victims to different locations to abuse them.
Child sexual exploitation – single exploiter
Similar to type 7, often involves the grooming of children and transporting them for the purposes of sexual exploitation, although the offending is carried out by one individual.
Forced sex work in fixed location
Victims are trafficked and exploited in established locations set up specifically for sex work. This can include brothels or rooms in legitimate business premises (e.g. massage parlour).
Forced sex work in changing location
Victims are forced into sex work where the location of exploitation frequently changes. Locations include streets, clients' residence, hotels or 'pop-up' brothels in short-term rented property. Victims are frequently advertised online.
Trafficking for personal gratification
Victims are trafficked to residential sites controlled by offenders and sexually exploited for the offenders' own gratification. Some victims may be confined to the site for a long period of time.
Forced gang-related criminality
Victims are forced to undertake gang related criminal activities, most commonly relating to drug networks. Victims are often children who are forced by gangs to transport drugs and money to and from urban areas to suburban areas and market and coastal towns.
Forced labour in illegal activities
Victims are forced to provide labour to offenders for illegal purposes. The most common example is victims forced to cultivate cannabis in private residences.
Forced acquisitive crime
Victims are forced by offenders to carry out acquisitive crimes such as shoplifting and pickpocketing. Offenders may provide food and accommodation to victims but rarely pay them.
Victims are transported by offenders to locations to beg on the streets for money, which is then taken by offenders. Victims are often children vulnerable adults.
Trafficking for forced sham marriage
Traffickers transport EU national victims to the UK and sell these victims to an exploiter in a one-off transaction. Exploiters marry victims to gain immigration advantages and often sexually abuse them.
Financial fraud (including benefit fraud)
Victims are exploited financially; most commonly their identity documents are taken and used to claim benefits. This type often occurs alongside other types.
Possible Risk Indicators
A child cannot give consent to being exploited, even if they have agreed to being moved/believe they have consented, it is not "informed consent". Any child transported for exploitative reasons is considered to be a trafficking victim. All practitioners should use professional curiosity to support your ability to identify the risk factors.
- Physical symptoms, i.e. pregnant, STI's, sexual or physical assault, poor dental health. May show signs of physical or psychological abuse, look malnourished or unkempt, or appear withdrawn.
- Victims may rarely be able to travel on their own, seem under the control or influence of others, rarely interact, or appear unfamiliar with their neighborhood or where they work.
- Involved in criminal activity, i.e. cannabis factory, begging, pick pocketing.
- Foreign national child. Brought or moved from another country. Has false documentation, or no passport or ID.
- With an adult, but unclear what the relationship is.
- Concerns about the relationship between the parent and child.
- With an adult who speaks for the child.
- Orphaned or separated from family or main carers.
- Possesses money or goods not accounted for.
- Has not been registered with a GP.
- May or may not be enrolled at a school.
- Homeless child.
- An unrelated or new child discovered at an address.
- Found in a brothel or sauna.
- May be working in catering, nail bars, caring for children, cleaning etc.
- Links to adult(s) with offending history.
- Missing child. There is a strong possibility the child will be re-trafficked within 24-48 hours of being placed in care.
Procedure in Lewisham
Child Trafficking and Slavery are Child Protection issues and the normal procedures apply. You can make a referral to the Multi-Agency Safeguarding Hub by telephone 020 8314 6660 or by email email@example.com or complete a MASH Referral Form.
- Athena Service firstname.lastname@example.org 0800 112 4052
- NSPCC Child Trafficking Advice Centre (CTAC): 0808 800 5000 email@example.com
- UK Human Trafficking Centre: 0844 778 2406, UKHTC@nca.x.gsi.gov.uk
- Refugee Council Advice Line: 020 7346 1134
- ECPAT UK: 020 7233 9887 ecpat.org.uk
- Coram Legal Centre: www.childrenslegalcentre.com
- Children and Families Across Boarders (CFAB) 020 7735 8941 cfab.uk.net
- Foreign & Commonwealth Office: 020 7008 1500
- CEOP 020 7238 2320/2307 ceop.gov.uk
- Home Office http://www.crimereduction.homeoffice.gov.uk/toolkits/tp01.htm
Resources & Publications
A typology of modern slavery offences in the UK October 2017
Home Secretary Amber Rudd announces new measures to improve identification and support for victims of modern slavery. October 2017
Home Office Resources
Human Trafficking Strategy
London Safeguarding Children Board - Trafficked Children toolkit and guidance
Safeguarding Children who may have been trafficked (2011) DfE
Home Office UK Border Code of Practice for Keeping Children Safe from Harm
There are many factors that influence and shape the development of a child. Some are within the child, such as genetic factors, and others are from external sources such as physical, psychological and family influences, as well as the wider neighbourhood and cultural aspects.
Neglect is therefore often complex and not always immediately recognised. The impact will vary according to type, severity and length of time, making it difficult for those working with children and families to manage. Professional uncertainty, differences of opinion or undue optimism regarding levels of need and the criteria for significant harm can lead to long term exposure which substantially increase the risk to children.
Neglect of children remains one of the Lewisham Safeguarding Children Board’s (LSCB) key priorities. This strategy has been developed with multi-agency partners to set out Lewisham’s approach to child neglect.
This strategy should be viewed alongside the following key strategies, policies and procedures and government guidance in relation to neglect:
Working Together to Safeguard Children (2015) describes neglect as:
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 abuse. Once a child is born, neglect may involve a parent or carer failing to:
- Provide adequate food, clothing or 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 caregivers)
- Ensure access to appropriate medical care or treatment
It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.
In addition the London Child Protection Procedures say:
1.38 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. www.londoncp.co.uk/chapters/responding_concerns.html
Neglect is the ongoing failure to meet a child’s basic needs. Some of the signs of neglect include:
- Poor physical appearance – a child who is dirty, hungry, has a lack of appropriate clothing, bad hygiene, not having access to medical care and treatment
- Absence of supervision/boundaries – a child who is put in danger or not protected from physical or emotional harm, use of inadequate care givers, chaotic family environment with no boundaries or routines
- A child not getting the love, care and attention they need from their parents or carers
A child who’s neglected will often suffer from other forms of abuse as well. Neglect can cause serious, long-term damage to the child’s emotional, social and physical development having a profound impact on their future outcomes and in some cases can result in death.
It happens when parents or carers can’t or won’t meet a child’s needs. Sometimes this is because they don’t have the skills or support needed, and sometimes it’s due to other problems such as mental health issues, drug and alcohol problems or poverty.
Why is this important in Lewisham?
Neglect is the most common reason for a child to be the subject of a child protection plan in the UK. In Lewisham, approximately 70% of children subject to a plan are suffering from neglect.
What do professionals need to do?
Although you may be worried about a child, it’s not always easy for professionals to identify neglect. There’s often no single sign or incident that a child or family need help. It is more likely that there will be a series of concerns over a period of time that, taken together, demonstrate the child is at risk. If you think a child may be experiencing neglect, don’t wait:
- Gather all relevant information about the child, including the parenting capacity and family and environmental factors in order to form a professional judgment on strengths, risks and harmful factors
- Regularly review progress using the Toolkit below and update the multi-agency plan accordingly
Of course professional judgement has to be exercised in determining the harm or potential harm caused to a child by neglect but you should always consult with your agency safeguarding lead and refer to the Lewisham Continuum of Need document which will help you determine what sort of professional intervention will best meet the needs of the child and family.
Lewisham Neglect Strategy & Toolkit (January 2018)
Lewisham Neglect Toolkit (January 2018) (WORD DOCUMENT) & Graded Care Profile
LSCB Safeguarding Briefing - May 2018 - Neglect
The internet is a great way for children and young people to connect with others and learn new things. As interactions between people are increasingly taking place on-line it is essential that we safeguard children as robustly in the virtual world as we do in the real one. We can do this through:
- Promoting safe on-line behaviour to children, young people and their families
- Taking children, young people and their families’ on-line actions and networks into account when providing support
Children, young people and their families go online for a variety of reasons, including:
- To search for information or content on search engines
- Share images and watch videos through websites or mobile apps
- Use social networking websites
- Write or reply to messages on forums and message boards
- Play games along or with others through websites, apps or games consoles
- Chat with other people through on-line, games, messenger apps, games consoles, webcams, social network, and other instant communication tools
- Find new friends and partners
There are lots of benefits in going on-line, and also some risks. These include:
- Exposure to and sharing of explicit material (including sexting)
- Identity theft
It’s important that as professionals you are confident in talking with children, young people and their families about their on-line choices and interactions. This includes tablets, lap-tops, phones etc, for example:
- Personal information shared on-line: checking privacy settings, sharing contact details, geotagging
- Images shared and online communication: on-line support networks, inappropriate images (e.g. sexting), online bullying or harassment
- On-line relationships: safe online friendships, meeting up with on-line friends or potential partners
LSCB E-Safety Guidance - June 2017
Advice and resources
CEOP Thinkuknow provides advice for parents and carers, children and young people, and those that work with them.
NSPCC Online Safety has further advice and tools.
Child Exploitation & Online Protection (CEOP)
CEOP is there to support young people, parents and carers while surfing online, and offers help and advice on topics such as:
- harmful content
It also enables people to immediately report anything on-line which they find concerning, such as harmful or inappropriate content, or possible grooming behaviour.
For more information, or to report concerns, simply click on the CEOP Icon
What is it?
Prevent forms one part of the Governments Counter Terrorism Strategy – CONTEST. This aims to
- Protect: Strengthen our protection against terrorist attack.
- Prepare: Mitigate the impact of an attack.
- Pursue: Stop terrorist attack.
- Prevent: Stop people from becoming terrorists or supporting terrorism by:-
- responding to the ideological challenge of terrorism and the threat we face from those who promote it,
- preventing people from being drawn into terrorism and ensuring that they are given appropriate advice and support,
- working with sectors and institutions where there are risks of radicalisation that we need to address
What does this mean for Statutory Organisations in Lewisham?
Since 2015, statutory agencies have a duty under the Counter Terrorism & Security Act “to have due regard to the need to prevent people from being drawn into terrorism”. These agencies should:
- Establish strategic and operational links with other specified authorities.
- Facilitate the assessment of risk for specified authorities, including providing advice and sharing threat assessments based on the Counter Terrorism Local Profiles (CTLP).
- Provide a range of training products (including but not limited to Workshops to Raise Awareness of Prevent - WRAP) to all specified authorities.
- Understand the full range of bodies affected by the new duties, and ensure they understand their responsibilities.
- Embed Prevent into commissioning, procurement and grant funding processes.
- Embed Prevent into Safeguarding Policies and ensure all providers are signed up to local Safeguarding arrangements.
There an obvious difference between espousing radical and extreme views and acting on them, and practitioners should ensure that assessments place behaviour in the family and social context of the young person and include information about the young person’s peer group and conduct and behaviour at school. Holding radical or extreme views is not illegal, but inciting a person to commit an act in the name of any belief is in itself an offence.
Compliance in Lewisham
In Lewisham, work has been taking place to ensure that all relevant agencies are complying with their obligations under the 2015 Counter Terrorism & Security Act. This includes delivering briefings, training, and the development of a Risk Assessment Tool for Children’s Social Care.
Prevent in Lewisham operates a Strategic Board – the Prevent Delivery Group – and a Multi-Agency Safeguarding Panel – Channel.
- If you see or hear anything that could be terrorist-related, trust your instincts and call the Anti-Terrorist Hotline on 0800 789 321.
- If you think you have seen a person acting suspiciously, or if you see a vehicle, unattended package or bag which might be an immediate threat, move away and call 999.
- If you are involved in an incident follow police advice to: ‘RUN, HIDE AND TELL’
- Download the citizenAID App which provides safety and medical advice from Google Play, Apple App or the Windows store, for free.
Lewisham Prevent Service
LBL Prevent are available to assist agencies in complying with their Counter Terrorism Act duties. The support offer includes:
- The provision of Workshops to Raise Awareness of Prevent (WRAP training for frontline staff),
- Management briefings regarding Prevent Duty compliance,
- Coordination of strategic and operational groups,
- The provision of Prevent-related resources and dissemination of relevant information.
If you have any questions regarding Prevent in Lewisham you can contact the Prevent Manager by email firstname.lastname@example.org.
Make a Referral
Judges have issued Care or Wardship Proceedings where there are allegations of children being taken abroad to strongholds of so called ISIS. If you are worried about a child or a young person you should follow child protection procedures without delay.
If a child is in immediate risk call 999, otherwise contact the MASH Team by telephone and follow up your referral in writing within 24 hours.
MASH Team Telephone: 020 8314 6660 Email email@example.com
Lewisham Prevent Team firstname.lastname@example.org
Lunchtime Briefing or in-depth Half Day Course
Prevent awareness eLearning
The Prevent awareness eLearning has recently been refreshed. This includes updates to reflect the recommendations from the Parsons Green review, updated information following the change in threat and attacks of 2017, and new case studies. A link to the training is below.
The training is for anyone who has been through the Prevent awareness eLearning or a Workshop to Raise Awareness of Prevent (WRAP), and so already has an understanding of Prevent and of their role in safeguarding vulnerable people.
The training follows on from the Prevent awareness training which introduces users to the NOTICE-CHECK-SHARE procedure for evaluating and sharing concerns relating to radicalisation. The package shares best practice on how to articulate concerns about an individual, and ensure that they are robust and considered. It is aimed at anyone who may be in a position to notice signs of vulnerability to radicalisation and aims to give them confidence in referring on for help if appropriate. It is also designed for those (for example line managers) who may receive these referrals and have to consider how to respond, whether that be establishing more context, or reaching out to partner agencies for support. A link to the training is below.
This training package is for anyone who may be asked to contribute to, sit on, or even run a Channel Panel. It is aimed at all levels, from a professional asked to input and attend for the first time, to a member of staff new to their role and organising a panel meeting. It covers both an introduction to what Channel is, how it operates in the user’s region, and how to organise a Channel Panel for the first time. In response to feedback, it also covers information sharing, including how, when and with whom to share information of a Channel case. A link to the Channel Panel training is below.
If your department would like bespoke training please contact email@example.com
Professional Curiosity & Challenge
Nurturing professional curiosity and challenge are a fundamental aspect of working together to keep children and young people safe.
In this resource we will raise awareness of the need for respectful uncertainty; help practitioners spot the signs of when a parent or carer may be using disguised compliance; and advise where and how to access help and services.
What is professional curiosity?
Professional curiosity is the capacity and communication skill to explore and understand what is happening within a family rather than making assumptions or accepting things at face value.
This has been described at the need for practitioners to practice ‘respectful uncertainty’ – applying critical evaluation to any information they receive and maintaining an open mind. In safeguarding the term ‘safe uncertainty’ is used to describe an approach which is focused on safety but that takes into account changing information, different perspectives and acknowledges that certainty may not be achievable.
Professional curiosity can require practitioners to think ‘outside the box’, beyond their usual professional role, and consider families’ circumstances holistically.
Professional curiosity and a real willingness to engage with children, adults and their families or carers are vital to promoting safety and stability for everyone.
Much has been written about the importance of curiosity during home visits and the need for authentic, close relationships of the kind where we see, hear and touch the truth of their experience of ‘daily life’ and are able to act on it and to achieve similar closeness with parents or carers.
Practitioners will often come into contact with a child, young person, adult or their family when they are in crisis or vulnerable to harm. These interactions present crucial opportunities for protection. Responding to these opportunities requires the ability to recognise (or see the signs of) vulnerabilities and potential or actual risks of harm, maintaining an open stance of professional curiosity (or enquiring deeper), and understanding one’s own responsibility and knowing how to take action.
Children in particular, but also some adults, rarely disclose abuse and neglect directly to practitioners and, if they do, it will often be through unusual behaviour or comments. This makes identifying abuse and neglect difficult for professionals across agencies. We know that it is better to help as early as possible, before issues get worse. That means that all agencies and practitioners need to work together – the first step is to be professionally curious.
Curious professionals will spend time engaging with families on visits. They will know that talk, play and touch can all be important to observe and consider. Do not presume you know what is happening in the family home – ask questions and seek clarity if you are not certain. Do not be afraid to ask questions of families, and do so in an open way so they know that you are asking to keep the child or adult safe, not to judge or criticise. Be open to the unexpected, and incorporate information that does not support your initial assumptions into your assessment of what life is like for the child or adult in the family.
Thinking the unthinkable
Safeguarding is everyone’s responsibility, and where practitioners are concerned each and every agency has a role to play in safeguarding and protecting children.
The following factors highlight the need for all of us to strive to improve professional curiosity and professional courage:
- the views and feelings of children and some adults are actually very difficult to ascertain
- practitioners do not always listen to adults who tried to speak on behalf of a child or another adult and who may have important information to contribute
- parents or carers can easily prevent practitioners from seeing and listening to a child or another adult
- practitioners can be fooled with stories we want to believe are true
- effective multi-agency work needs to be coordinated
- challenging parents or carers (and colleagues) requires expertise, confidence, time and a considerable amount of emotional energy.
What is disguised compliance?
Professional curiosity or respectful uncertainty is needed when working with families who are displaying disguised compliance. Disguised compliance involves parents or carers giving the appearance of co-operating with agencies to avoid raising suspicions and allay concerns.
There is a continuum of behaviours from parents or carers on a sliding scale, with full co-operation at end of the scale, and planned and effective resistance at the other. Showing your best side or ‘saving face’ may be viewed as ‘normal’ behaviour and therefore we can expect a degree of disguised compliance in all families; but at its worst superficial cooperation may be to conceal deliberate abuse; and many case reviews highlight that professionals can sometimes delay or avoid interventions due to parental disguised compliance.
The following principles will help front line practitioners deal with disguised compliance more effectively:
- focus on the needs, voice and ‘lived experience’ of the child, young person or adult
- avoid being encouraged to focus to extensively on the needs and presentation of the adults or carers – whether aggressive argumentative or apparently compliant
- think carefully about the ‘engagement’ of the adult or carers and the impact of this behaviour on the practitioners view of risk
- focus on change in the family dynamic and the impact this will have on the life and well-being of the child or adult – this is a more reliable measure than the agreement of adults or carers in the professionals plan
- there is some evidence that an empathetic approach by professionals may result in an increased level of trust and a more open family response leading to greater disclosure by adults and children
- practitioners need to build close partnership style relationships with families whilst being constantly aware of the child needs and the degree to which they are met
- there is no magic way of spotting disguised compliance other than the discrepancy between an adult or carer’s accounts and observations of the needs and accounts of the child. The latter must always take precedent.
Communication - the key to good multi-agency working
- speak to other practitioners on a regular basis – don’t wait for meetings
- when assessing and managing a case, input from two, three or four sources is better than one
- sometimes the most important relationship to trust is yourself – if you feel there is a risk that is not being managed and no one is hearing you what do you do, how do you escalate this?
- try to be flexible with meetings to fit around all involved practitioners availability
- don’t use jargon – talk to colleagues and families using language they understand and relate to
- include families in decisions about their own lives
- be mindful of personal optimistic bias (wishful thinking) when reviewing the families’ progress
- make sure care plans are multi-agency and SMART
- self-assessments tools can promote honest discussion
- team managers should attend training for providing effective supervision and reflective practice in managing safeguarding
- use quality assurance and audit framework such as quality standards to review case records to support good practice that keeps children safe and aids staff continuous professional development (CPD).
- to support good communication, a formal information sharing arrangement should be in place between all agencies with the purpose and content about requesting and sharing information explicitly agreed
- fears about jeopardising the relationship with the family should not be a barrier to the sharing of information
- principles from "the seven golden rules for information sharing" should be followed
- information should be shared in a timely manner and the family included where it does not increase risk
- all involved agencies should be given ample notice when invited to case review meetings to enable them to provide reports and feedback to contribute to ongoing assessment and review of family progress
- a group of practitioners should maintain contact with each other and make the times of meetings flexible to enable optimal attendance of practitioners.
Difficult conversations with parents and carers
Open discussion with parents and carers when there are welfare concerns about a child often provokes anxiety in practitioners. Professional challenge is part of good child protection practice.
To increase practitioners’ confidence we have published a "How to have difficult conversations with parents/carers" guide.
The information in this guide is not exhaustive and it should be used as a reference tool alongside practitioners own safeguarding practices and in conjunction with appropriate supervision.
Four factors to consider when preparing for a difficult conversation with a parent or carer are:
- Principles – that underpin safeguarding children
- Planning – how to plan or be prepared
- The conversation – things to consider when having a conversation
- Examples – open questions and suggestions.
Professional challenge - having different perspectives
Differences of opinion, concerns and issues can arise for practitioners at work and it is important they are resolved as effectively and swiftly as possible.
Having different professional perspectives within safeguarding practice is a sign of a healthy and well-functioning partnership. These differences of opinion are usually resolved by discussion and negotiation between the practitioners concerned. It is essential that where differences of opinion arise they do not adversely affect the outcomes for children and young people and are resolved in a constructive and timely manner.
Differences could arise in a number of areas of multi-agency working as well as within single agency working. Differences are most likely to arise in relation to:
- criteria for referrals
- outcomes of assessments
- roles and responsibilities of workers
- service provision
- timeliness of interventions
- information sharing and communication.
If you have difference of opinion with another practitioner, remember:
- professional differences and disagreements can help us find better ways improve outcomes for children, adults and families
- all professionals are responsible for their own cases and their actions in relation to case work
- differences and disagreements should be resolved as simply and quickly as possible, in the first instance by individual practitioners and /or their line managers
- all practitioners should respect the views of others whatever the level of experience – remember that challenging more senior or experienced practitioners can be hard
- expect to be challenged; working together effectively depends on an open approach and honest relationships between agencies
- professional differences are reduced by clarity about roles and responsibilities and the ability to discuss and share problems in networking forums.
Please see our Resolving Professional Differences / Escalation Policy
Professional curiosity and culturally competent safeguarding practice
The issue of safeguarding within BAME communities is widely debated among policy makers and practitioners.
BME/BAME – Black and Minority Ethnic, or Black, Asian and Minority Ethnic is the terminology normally used in the UK to describe people of non-white descent (according to the www.irr.org.uk)
There is evidence that culturally competent safeguarding practice enhances children’s and adults well being and an understanding of how variations in child rearing and caring practices are understood by BAME families and practitioners could contribute to prevention and early intervention.
Interventions have the potential to be as a result of stereotyping, lack of awareness among practitioners of how various categories of abuse are manifested in BAME communities, coupled with a general lack of awareness of cultural practices.
It is important therefore that practioners are sensitive to differing family patterns and lifestyles and to child rearing and caring patterns that vary across different racial, ethnic and cultural groups. At the same time they must be clear that child or adult abuse cannot be condoned for religious or cultural reasons.
All practitioners working with children, young people, vulnerable adults and their parents, carers or families whose faith, culture, nationality and possibly recent history differs significantly from that of the majority culture, must be professionally curious and take personal responsibility for informing their work with sufficient knowledge (or seeking advice) on the particular culture and/or faith by which the child, young person, adult and their family or carers lives their daily life.
Practitioners should be curious about situations or information arising in the course of their work, allowing the family to give their account as well as researching such things by discussion with other practitioners, or by researching the evidence base. Examples of this might be around attitudes towards, and acceptance of, services e.g. health; dietary choices; education provision or school attendance.
In some instances reluctance to access support stems from a desire to keep family life private. In many communities there is a prevalent fear that social work practitioners will ‘take your children away’. There may be a poor view of support services arising from initial contact through the immigration system, and, for some communities – particularly those with insecure immigration status – an instinctive distrust of the state arising from experiences in their country of origin.
Practitioners must take personal responsibility for utilising specialist services’ knowledge. Knowing about and using services available locally to provide relevant cultural and faith-related input to prevention, support and rehabilitation services for the child, young people or adults (and their family) will support practice.
- knowing which agencies are available to access
- having contact details to hand
- timing requests for expert support and information appropriately to ensure that assessments, care planning and review are sound and holistic.
Often for BAME communities, accessing appropriate services is a consistent barrier to them fully participating in society, increasing their exclusion and potential for victimisation.
The Safeguarding Lead in your agency should be able to signpost you to appropriate support available within your organisation.
Supervision, curiosity and understanding families
For many agencies, the use of effective supervision is a means of improving decision-making, accountability, and supporting professional development among practitioners. Supervision is also an opportunity to question and explore an understanding of a case.
Group supervision and Reflective Practice Groups can be even more effective in promoting curiosity and safe uncertainty, as practitioners can use these spaces to think about their own judgments and observations. It also allows teams to learn from one another’s experiences, and the issues considered in one case may have echoes in other workloads.
Tips for practice:
- present alternative hypotheses
- present cases from the child, young person, adult or another family member’s perspective.
Care and activity settings - sensitivity, curiosity and persistence
Care setting practitioners are perhaps best placed to notice how children are because they have contact with the same child on a regular basis. Practitioners can see changes in appearance, behaviour, alertness or appetite and provide a degree of monitoring of the child’s welfare; in effect, they can be the ‘eyes’ for other professionals working with them. This will also apply to volunteers and workers who run groups and clubs for children, young people or adults.
There are many examples of good practice in care staff where alert to concerns and were able to demonstrate professional curiosity and awareness of possible maltreatment and cumulative risk.
Being professionally curious enables practitioners to challenge a child’s vulnerability or risk while maintaining an objective, in a professional and supportive manner. This is not an easy balance.
Domestic Violence & Abuse and professional curiosity
Many Domestic Homicide Reviews and Serious Case Reviews refer to a lack of professional curiosity or respectful uncertainty. Practitioners need to demonstrate a non-discriminatory approach and explore the issues to formulate judgments that translate into effective actions in their dealings with families.
In particular it is vital that professionals understand the complexity of domestic abuse and are curious about what is happening in the child, adult and perpetrator’s life.
Professional curiosity is much more likely to flourish when practitioners:
- are supported by good quality training to help them develop
- have access to good management, support and supervision
- ‘walk in the shoes’ (have empathy) of the child and/or adult to consider the situation from their lived experience
- remain diligent in working with the family and developing the professional relationships to understand what has happened and its impact on all family members
- always try to see all parties separately.
Working with families where there is domestic violence & abuse can be very challenging and practitioners should not take everything they are told at face value. This is particularly so when a victim is not being seen alone and we should also be alert to the following behaviours which should provoke our professional curiosity:
- the victim waits for her/his partner to speak first
- the victim glances at her/his partner each time they speak, checking her/his reaction
- the victim smooths over any conflict
- the suspected perpetrator speaks for most of the time
- the suspected perpetrator sends clear signals to the victim, by eye/body movement, facial expression or verbally, to warn them
- the suspected perpetrator has a range of complaints about the victim, which they do not defend.
If these signals are present, the practitioner should find a way of seeing the suspected victim alone. Practitioners must be mindful to the needs of young people who may be experiencing inequality and/or violence in their relationships. Practitioners, however curious, cannot protect children and adults by working in isolation. Domestic abuse requires a multi-agency response and families and communities also have a vital role to play in protecting children and adults.
Education settings - curiosity and listening
Education staff are perhaps best placed to notice how children and young people are because they have contact with them on an almost daily basis. School staff can see changes – such as in appearance, behaviour, alertness or appetite – and provide a degree of monitoring of the child’s welfare; in effect, they can be the ‘eyes’ for other practitioners working with the young person.
There are many examples of good practice in education where staff were alert to concerns and were able to demonstrate professional curiosity and awareness of possible maltreatment and cumulative risk.
Being professionally curious enables practitioners to challenge parents and explore a child’s vulnerability or risk while maintaining an objective, professional and supportive manner. This is not an easy balance.
It can be difficult for children to express concerns about their own well being, so practitioners have a responsibility to create an environment in which they can do so. Schools should be careful of ‘organisational deafness’ which minimises the chances of really hearing what young people are saying, for example in relation to concerns about their friends.
Professionals (particularly school staff) should be curious and give sufficient credence to occasions when information is shared by young people.
Health practitioners - authoritative practice and professional curiosity
Authoritative practice and professional curiosity are vital in responding to the often highly complex cases that are characteristic of Reviews, where multiple risks and vulnerabilities may extend over considerable periods of time.
An important aspect of authoritative practice is that every practitioner ‘takes responsibility for their role in the safeguarding process’. Authoritative practice needs to be underpinned by a culture of supportive supervision and service leads and managers have a responsibility to foster such cultures and model authoritative practice in their own leadership by:
- encouraging all health practitioners to take responsibility for their role in safeguarding process, while respecting and valuing the role of others
- allowing practitioners to exercise their professional judgement in the light of the circumstances of a particular case
- encouraging a stance of professional curiosity and challenge from a supportive base.
Example: Supporting engagement – moving from Did Not Attend (DNA) to Child Not Brought (CNB)
In a large number of reviews there was evidence of poor engagement with health and social care services. Parents or carers who do not engage present a challenge to practitioners, but this challenge also provides an opportunity for protection.
When working with vulnerable people and families, health practitioners and services should maintain ‘consistent support for the family’ and curiosity and vigilance towards meeting the vulnerable child’s needs – and be persistent in pursuing non-engagement.
Non-compliance may be a parent/carer’s choice, but it is not the vulnerable child’s. Health service administrators and practitioners should treat repeated cancellations and rescheduling of appointments with curiosity and with the same degree of concern as repeated non- attendance. In doing so, it is essential to recognise families’ vulnerabilities and be flexible in accommodating their needs.
A shift away from the term DNA (did not attend) to CNB (child not brought) would help ‘maintain a focus on the child’s ongoing vulnerability and dependence, and the carers’ responsibilities to prioritise the child’s needs’.
Tips for health professionals to Be Curious!
- know who the named professionals are for your area and that you fully understand their roles – promoting good professional practice and providing advice and expertise for fellow professionals
- ensure that safeguarding is addressed within your clinical supervision
- be aware of the relevant Lewisham safeguarding procedures
- be aware of the need to always have ‘professional curiosity’
- be prepared to be both challenged and challenging within your own professional sphere
- ensure you know how to escalate safeguarding concerns.
Police & Criminal Justice Agencies - "don't take things at face value"
Developing and maintaining an open stance of professional curiosity supports police (and other staff) to consider the possibility of maltreatment, and to challenge and explore issues while maintaining an objective and supportive approach.
Given that criminal justice agencies often deal with specific incidents, supervising individual offenders or investigating stand-alone crimes, there is a risk of seeing an individual or a family only through one lens. Protecting children, young people or vulnerable young adults involves understanding their lives and experiences and making professional judgments.
Children, young people are unlikely to readily disclosure abuse or neglect, this means practitioners have to be able to spot the signs and create a suitably safe and trusting listening environment.
There are examples of police and other professionals focusing on offenders behaviours and not their underlying vulnerabilities.
Children or vulnerable young adults repeatedly going missing should trigger police officers’ professional curiosity, it is vital to consider what is motivating their behaviour.
Practitioners and managers need to be curious, to be sceptical, to think critically and systematically but to act compassionately.
Physical Abuse of Children & Young People
Dfe campaign website
To use physical force that results in an injury, physical pain, or impairment. This may include hitting, beating, pushing, shoving, throwing, shaking, slapping that leaves a mark, kicking, pinching, punching, suffocation, pulling hair out, burning, or striking with an object, hands, or feet. Being made to swallow something that hurts or causes illness, i.e. forcing the taking of medicine when a child is not ill - Also known as Fabricated Induced Illness. Being made to sit or stand in uncomfortable positions or locked in small spaces.
What is the Law?
In the UK it is unlawful for a parent or carer to smack their child, except where this amounts to "reasonable punishment". This defence is laid down in Section 58 of the Children Act 2004.
Whether a smack amounts to reasonable punishment will depend on the circumstances of each case, taking into consideration factors like the age of the child and the nature of the smack. There are strict guidelines covering the use of reasonable punishment and the Director of Public Prosecutions for England and Wales has produced a charging standard of categorisation in order to assist prosecutors to determine the appropriate charging offence. It will not be possible for a parent/carer to rely on this defence if the physical punishment amounts to wounding, actual bodily harm, grievous bodily harm or child cruelty.
Cultural tradition or adults perceived ideas of parental rights to use physical force as a way of discipline must not stand in the way of protecting a child from physical abuse.
The NSPCC report that although exact numbers of physical abuse are not known, it is estimated that 1 in 4 children have been physically abused. Disabled children are 3 times more likely to be abused than non-disabled children. In 2016-17 over 6,800 children were identified as needing protection from physical abuse, with 11,000 children contacting help lines for support - 22% of those cases were referred to the Police. In 2017 7,000 ChildLine counselling sessions were about physical abuse.
Signs & Symptoms of Physical Abuse
The child may have:-
- Regular bruising anywhere on the body, including defensive bruises to the arms or bruises shaped like an instrument or hand.
- Bruises with dots of blood under the skin.
- A bruised scalp and swollen eyes from the hair being pulled violently.
- Broken bones or fractures.
- Burns or scalds, including small round burns from a cigarette or sharp edged burns.
- Bite marks usually round or oval shaped.
You may notice:-
- The child may regularly avoid taking part in sports activities or reluctant to get changed in front of others.
- Becomes withdrawn, flinches, is anxious, clingy, or suddenly behaves differently.
- May be depressed, or develop obsessive behaviour.
- Have problems sleeping, frequent nightmares, bed wetting, or soils clothes.
- There may be changes in the child's eating habits or the child may develop an eating disorder.
- The child may bully or hurt other children and become aggressive.
- They may develop risky behaviours, i.e. taking drugs, alcohol, self-harm, or have thoughts about suicide.
- The child may regularly miss nursery or school. Children have accidents, trips and falls. However, if a child regularly has injuries, you notice a pattern, or the explanation does not match the injury you should use professional curiosity and investigate to ascertain if a child is being physically abused and make a referral to Children's Social Care. Adults who physically abuse children may have emotional or behavioural problems such as difficulty controlling their anger. They may have family or relationship problems or have experienced abuse as a child. They may have parenting difficulties including unrealistic expectations of children, they may not have an understanding of a child’s needs, or have no idea how to respond to a child.
Effects of Shaking a Baby
If a baby is shaken or thrown, they may suffer non-accidental head injuries. Shaking a baby can cause fractures, internal injuries, long-term disabilities and even death.
The most serious consequence of a non-accidental head injury (NAHI) is a brain injury which can lead to learning problems, seizures, hearing and speech impairment, visual impairment or blindness, behaviour problems or changes in personality, severe brain damage, long-term disability, or even death. Babies may suffer other injuries from the abuse such as broken bones or fractures.
Good Advice to Parents/Carers on How to Discipline Without Smacking
- Provide love and emotional warmth as much as possible.
- Have clear simple rules, boundaries and explain actions to the child so they understand what is expected of them.
- Be a good role model.
- Praise good behaviour so it will increase, and ignore behaviour which is not to be repeated.
- Criticise behaviours and not the child.
- Reward good behaviour with hugs and kisses.
- Distract young children or use humour.
- Young children often respond well to a wall chart marking good behaviour, setting targets and agree on a small reward.
- Allow children some control, make joint decisions and give choices.
- If punishment is necessary, remove privileges, or take time out.
- Have a strategy in place and think about your reactions before feelings escalate.
- Seek support from the local Children's Centre or Parent Support Group.
Long Term Effects of Physical Abuse
The long term impact of child abuse is far reaching, some studies indicate that without the right support, the effects of childhood abuse can last a lifetime. These effects can be characterised by frequent crisis, failed relationships or difficulty maintaining family relationships, chaotic lifestyles, and are highly likely to have a psychiatric disorder such as depression, anxiety, personality disorders, or eating disorders.
Procedure in Lewisham
If you become aware or suspect a child is being physically abused, has an injury that is not consistent with the explanation provided, or a disclosure is made by a child, you must immediately contact the MASH Team on:-
Telephone Number: 020 8314 6660
If a child is in immediate danger call 999.
You have a duty of care to seek medical attention for the child if necessary.
Children’s Centres are able to offer a range of support for parent(s) who may be struggling to cope. You can contact your local Children’s Centre for any one of the services below:-
- Family and parenting support, including family learning and parenting courses.
- Advice on early-years education and childcare, including eligibility for free education and childcare for 2–4-year-olds.
- Child and family health services, including baby hubs and breastfeeding support.
- Volunteering and employment support, including links to Jobcentre Plus.
- Information and advice about children’s services and schools.
- Drop-in services covering health, education and a range of other areas such as debt management, counselling and SENDIASS.
- DfE, Together we can tackle child abuse
Self-Harm & Suicide Ideation in Young People
Mental health problems affect around 1 in 10 children and young people. This includes depression, anxiety, and conduct disorder, and are often a direct response to what is happening in their lives.
Self-harm is when someone hurts themselves on purpose and is a way of expressing deep distress, a way of communicating what cannot be put into words, with very difficult feelings that could build up inside. It is not attention seeking behaviour.
Self-Harm is a very common behaviour in young people and affects around one in 12 young people.
Warning signs of Self-Harm
- People who self-harm may suffer mood swings and become withdrawn.
- Unexplained wounds.
- Have a lack of motivation.
- There may be changes in their eating habits.
- They may cover up their body (even in warm weather).
Warning signs of Suicide Ideation
They may be:
- Quiet, brooding, or withdrawn.
- Feeling exhausted and distant.
- Feeling cut off from those around them.
- Not making eye contact.
- Agitated, irritable or rude.
- Talking about suicide or saying it’s all hopeless.
- Desperate for help but afraid to ask.
They may also:
- Be busy, chirpy, laughing and joking, talking about future plans, and telling you not to worry about them.
The safest way to know if someone is thinking about suicide is to ask them. If a person is suicidal the idea is already there. If they aren’t suicidal it won’t do any harm. Saying something is safer than saying nothing.
Risk Factors of Self-Harm & Suicide Ideation
- Stressful life events.
- Low self-esteem.
- On-going family relationship problems.
- Being bullied at school.
- Mental health problems – depression and delusional thoughts.
- Substance and alcohol misuse.
- Family circumstances.
- Stress and worry – academic pressure.
- Experience of abuse – physical, emotional, sexual abuse, sexual exploitation, and forced marriage.
- Feelings of being rejected in their lives.
Types of Self-Harm
- Cutting of the skin with objects (e.g. razor blades, scissors, pens, bottle tops etc.)
- Scratching the skin.
- Picking wounds or interfering with healing.
- Ingesting toxic substances.
- Excessive drug or alcohol intake.
- Hitting or punching themselves.
- Head banging or biting themselves.
- Pulling hair out.
- Swallowing or inserting objects.
- Taking an overdose.
- Staying in an abusive relationship.
- Taking risks too easily.
- Restricting their eating.Young people can self-harm in a variety of body locations, i.e. arms, legs, abdomen, etc.
Responding to Self-Harm in Lewisham
If a child or young person overdoses or there is a serious self-harm incidence they should be taken to A&E in the first instance. An assessment will be undertaken which may involve a referral to the Children & Adolescent Mental Health Service (CAMHS).
If you become aware of a young person who is self-harming or having suicidal thoughts. Explore their feelings with them and talk about the help available:-
Share what you know with the child’s parents / carers.
Tips for Talking with Young People - Print The Poster!
- Parents Helpline 0808 802 55 44
- Advice for professionals
- Ask the parent / carer to make an appointment.
- Online chat support for young people
Work it Out Lewisham
- Information on services and support available in Lewisham.
Papyrus Hopeline 0800 068 41 41
- Confidential advice for young people
- Advice for parents / carers.
- Advice for professionals
ChildLine – 0800 11 11
- Confidential advice for young people
- Advice for professionals
- Individual one to one, drop in counselling for children and young people experiencing emotional wellbeing issues at 10 schools in Lewisham
Lewisham Mind Kit
- Online resources for range of mental health/ wellbeing issues and peer mentoring support
National Self-Harm Network
- UK charity offering moderated support forum for self-harm
NHS Choices - Moodzone
- Online and audio resources to improve mental wellbeing and information about available treatments
- Online training for anyone working with 0-18 year olds
Coping with Self-Harm, A Guide for Parents & Carers
Calm Harm App.
Down load this from your AppStore or GooglePlay. The app offers activities to comfort, distract, express yourself, Release, Random and Breathe.
Free LSCB Training Offer - Self Harm & Suicide Ideation
Health Improvement Training Offer - Youth Mental Health First Aid
Worried about a child suffering from harm?
What to do if you are worried about a child suffering from harm
If you are concerned that a child has suffered harm, neglect or abuse, please contact Lewisham Multi Agency Safeguarding Hub (MASH) who can discuss this with you:
- During office hours (Monday – Friday):
Lewisham’s MASH 020 8314 6660
- Out of Office hours:
Emergency Duty Team – 020 8314 6000
If a child is at immediate risk of harm, call the Police on 999.
The MASH is multi agency and brings together services such as from social care, education, health, police and children centres. The MASH aims to work together to offer the right help at an early stage to families who need support.
Consent to share
You should seek, in general, to discuss concerns with the family and, where possible seek the family’s agreement to making a referral unless this may, either by delay or the behavioural response it prompts or for any other reason, place the child at increased risk of Significant Harm.
- A decision by any professional not to seek parental permission before making a referral to Children’s Social Care Services must be approved by their manager, recorded and the reasons given
- Where a parent has agreed to a referral, this must be recorded and confirmed on the relevant referral form
- Where the parent is consulted and refuses to give permission for the referral, further advice and approval should be sought from a manager or the Designated Senior Person or Named Professional, unless to do so would cause undue delay. The outcome of the consultation and any further advice should be fully recorded
All recording with regards to consent to share information should be included in the inter-agency referral form and kept on individual organisation’s record systems.
Protocol for the management of actual or suspected bruising in infants who are not independently mobile
Please see the London Child Protection Procedures
Child Exploitation & Online Protection (CEOP)
CEOP is there to support, help and advise young people, parents and carers and the professionals who work with them
It also enables people to immediately report anything online which they find concerning, such as harmful or inappropriate content, or possible grooming behaviour. See our On-line safety page to find out more
For more information, or to report concerns, simply click on the CEOP Icon
GUIDELINES FOR PROFESSIONALS / AGENCIES / PARENTS
These guidelines are intended for any parent, professional or agency wishing to make a referral to Lewisham Young Carers Service on behalf of a child or young person within a caring role. Please read these guidelines carefully before completing the attached referral forms.
Who can you make a referral for?
Any Young Carer between the ages of 5 and 18 can be referred to our services that are residents or their cared for is someone who lives within the borough of Lewisham:
- Providing care or support for someone with a physical disability, long term illness, mental ill health or substance misuse.
- Is affected by the condition of their cared for.
We will prioritise the service to young carers with the highest need as a result of the significant impact of the caring role and level of caring responsibilities.
The level of priority for each Young Carers may fluctuant throughout the lifetime of their involvement in the service due to sudden changes in their caring situation.
How to make a referral?
Please complete all the pages of our Referral Form and send to:
Waldram Place, Forest Hill
London, SE23 2LB
Tel: 0208 699 8686 | Fax: 0208 699 0634
What happens now?
On receipt of the referral we will look at the information you have given us and prioritise the need for assessment. The outcome will be either:
- Young carer does not meet the criteria for a young carer and no assessment will take place.
- Young carer is allocated to a member of the young carers team for a home visit.
- Further information is needed from the referrer before processing any further.
Referrers will be informed of the outcome via telephone or email within 4 weeks. If you have not heard from us please contact us on 0208 699 8686.
If allocated for assessment, a young carers support officer will make contact with the family to arrange a home visit to gain better understanding about the young carer’s family’s situation and decide on what support services they will be offered.
If you have any questions throughout the referral or assessment process, please do not hesitate to contact us.