Unit 435 – Understand how to safeguard the well-being of children and young people 1 When working with children

Unit 435 – Understand how to safeguard the well-being of children and young people

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When working with children, safeguarding must be kept in mind at all times. It is very important that all staff members have an understanding of current legislation, guidelines, policies and procedures. The policies and procedures that I must adhere to in practice in line with my job role include informing the nurse in charge if a safeguarding issue arises, social care, safeguarding teams and school nurses/health visitors. They need to be informed immediately along with the relevant consultant in the speciality as per NUH policy. The procedures to follow for my trust include documenting all necessary safeguarding information on a specific pink documentation resource. The nurse in charge and all other relevant members of the MDT must be informed of any significant change and only information should be shared with the right people. Current legislation that is adhered to in practice includes the ‘Children and Young Persons Act 2008’ which outlines that children being treated should have an input from different members of the multi-disciplinary team throughout the stay in hospital up until the discharge planning meetings and support and guidance after discharge. The ‘Children Act 1989’ is referred to and used frequently in our department for parental responsibilities and the welfare of the child. Confidentiality, documentation, information sharing and consent are policies that all staff members must adhere too especially when handling safeguarding information in line with the NICE guidelines.

Child protection is part of the wider network that promotes and safeguards the welfare of children and young people. It refers to protecting specific children who are suffering from any form of abuse or neglect. Parents and or carers who fail to protect and care for their children could be taken to court and the child could potentially be removed from the family home and placed in to a temporary or permanent service of care. If there are suspicions that there may be abuse involved or if the story doesn’t match the mechanism of the injury, doctors can carry out a child protection medical examination which involved a full body examination and X-rays in some serious cases. This is to eliminate further injuries or to discover them. These examinations need to be performed by a safeguarding consultant, if any other specialities need to be involved for expert opinions, appropriate handovers should be done in line with safeguarding policies and procedures. Appropriate referrals need to be made by the doctors including social care and the police. It’s important that whilst performing these examinations, staff members are continually risk assessing to see if the child will be safe at home, children are in a safe environment outside of school, keeping in mind the trust policies and procedures and making decisions effectively. It is essential that all members of staff working with patients attend the safeguarding training appropriate to their training to keep up to date on current policies, legislation and support and guidance available.

All healthcare workers have a duty to protect and safeguard children but this also includes professionals in the community including schools, social care, borough councils and all other child service providers. Child care providers have a duty to protect and safeguard children at all times including day to day life. National guidelines refer back to the ‘Child Care Act 2006’ all providers must have a knowledge of this legislation in order to protect and safeguard the children in their care. Each provider will have different polices to another for example, a school will have a different policy to a council borough and they will have a different policy to a hospital. Anyone working with children should be able to recognise if a child is experiencing safeguarding issues. Schools must take in to account a child’s behaviour on a daily basis and recognise if there are any significant changes and then act upon them. Whether its behaviour, eating habits, personal hygiene or physical injuries, schools must follow their own policies and procedures when safeguarding and following what’s appropriate. For councils, they have their own safeguarding management team which includes social workers. They are responsible for promoting good practice and develop links in areas to support the safety and well-being of children. In order to protect and keep children safe from abuse the councils must adhere to policies. Any individual that works with children must have a recent DBS (Disclosure and Barring Service) check and they must have an awareness of how to protect children from harm and report abuse in the correct way.

According to the Local Safeguarding Board Regulations 2006, serious case reviews are undertaken by local safeguarding children boards (LSCB’s) when a child has died due to known or suspected abuse or neglect. Reviews may also be carried out when a child has been seriously harmed or have suffered from life threatening injuries. Most serious case reviews are listed on the NSPCC website once published and discussed in the court, they are available for everyone to read. Serious case reviews are used for agencies including nurses, doctors, social workers, GPs and other agencies so that they can have a discussion about current practices and how to improve and highlight when things went wrong and think of strategies on how professionals can work better in the future. In my personal experience working in the Children’s Burns Unit, we have had a case that went to court and a serious case review was published. We discussed the matter as a team and reflected on what we did well and what we could have done better. Support, extra training and safeguarding supervision was offered to the team. The report of the serious case review is published to the public so that recommendations can be made for future reference.

In my place of work, confidentiality is a very serious matter. Information regarding patients should only be shared with healthcare professionals that are involved in the patient’s care. All staff members should have relevant training in safeguarding which has a module containing the correct policies and procedures when handling and sharing information that’s relevant to the job role of the professional. This training is mandatory for all staff as part of legislation rules, all professionals working to safeguard children must have the relevant training. Sharing information is a solution to providing the most efficient way to ensure that children are protected and safeguarded against abuse and neglect. All information, medical notes and child protection records in my work setting should be kept secure at all times in line with the Data Protection Act 1998. When information sharing with outside agencies including social care, the information should only be disclosed after obtaining consent from the family but in some cases when child protection is involved this is not possible therefore legal precautions must be taken which is organised by social services. In these cases, confidentiality policies should be followed in the same instance as all patients ensuring computers are locked, notes are locked away and discussions regarding patients are taken place in a confidential room.

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All professionals that work in a children and young person work force have a duty to safeguard and protect the children they work with. Children cannot protect themselves and they are more vulnerable to abuse and neglect than adults are. Professionals have a duty to identify signs and abuse and neglect in the early stages in order to prevent it from happening further. Children who suffer abuse vary as there are many different types that include physical abuse, emotional abuse, verbal abuse, sexual abuse and neglect. It’s important that staff can understand the early signs of abuse. An example is if a child has a change in behaviour and they become very shy and withdrawn, they may also avoid interacting with others including staff or parents/friends this highlights that they may be suffering from verbal abuse. Safeguarding is massively important and we must as professionals try and identify the early signs of harm or abuse before it ends in a serious or fatal injury. If a staff member begins to see signs of abuse or neglect or even see physical harm to the child, the appropriate services must be informed including social care, police and any other multi agency workers. It is essential that staff stay up to date with relevant training to safeguard children as it’s our duty of care.

It’s important that everyone who works in a children and young person work force understands that every child is different and they all have individual needs. In my place of work, children sometimes don’t know what to expect when they come in to the clinic. They are faced with an unfamiliar environment and unfamiliar people. Each professional need to take in to account that the child may have fears and to be mindful of this. When a child first attends the clinic, it’s important that we document any specific needs or conditions the child may have, also we document what the child likes and dislikes so we can prepare for future appointments. By the staff members having an awareness of any specific needs the child may have it allows the staff to adapt the way of working to ensure the child feels as comfortable as possible. In the clinic that I work in, we have many different techniques to explain procedures to children. For example, we have resources such as books, toys and videos, we have hospital play specialists who are trained to distract and work cognitively to help the child adapt to what’s happening. This is why it’s essential to gain information from parents/carers for any specific needs they might have to ensure their time in hospital is as comfortable as possible. Each child’s wishes should be taken in to account when decision making about their own care. Parents and practitioners should listen and communicate in a sensitive manner to ensure the child feels listened to and supported.

Safeguarding children doesn’t just involve one organisation, many organisations including hospitals, GP’s, health visiting, schools, social care, police, NSPCC and more. All of these professionals have a responsibility to keep children safe which involves sharing information, identifying concerns and taking necessary actions if needed. It is essential that organisations work closely in order to safeguard children in the most effective and professional way. When organisations work in partnership together it involves everyone listening, communicating, supporting and protecting each child who is at risk of neglect or abuse or who have been through it. By organisations working together, their own professional roles and responsibilities ensuring they work to the full potential will ensure the child is safe and protected. When a child is in hospital and requires other input from other professionals, a meeting is arranged so that all professionals can discuss the cases and give opinions. It is essential that organisations work together closely to ensure nothing is missed from cases. In previous safeguarding events across the UK, failure to communicate and information share has led to serious harm and in some cases death. It’s important that organisations continue to work in partnership and to stay up to date with relevant training and current legislation rules.

During the sad cases when a child has been abused or harmed, there are many different organisations that need to be informed. Each professional has different roles and responsibilities. For example;

• Nurses and hospital staff – To provide on-going care whilst treated as a patient in hospital but being vigilant for signs of neglect and harm, to act upon signs and symptoms of neglect or harm by informing the correct agencies quickly and efficiently. Hospital staff including doctors and nurses will give opinions on injuries which are non-accidental and caused by abuse.
• Social services – To provide support for vulnerable children and families, act as parental responsibility for children who have been removed from their families, work with the courts and follow through herrings when children have been exposed to immediate danger, be responsible for carrying out assessments with families to test parent’s capacity to see how safe children are in the care at home and make arrangements and support families during contact sessions.
• GP’s – Know how to make relevant referrals to appropriate agencies if safeguarding situations arise, attend child protection meetings and be able to give information about the child and family, information share when enquires are being made to relevant organisations, ensure all the staff that work in the practice have relevant safe guarding training including child protection.
• Midwives and health visitors – to conduct risk assessments and carry out assessments that outline risk factors to a child during pregnancy, birth and early years, to monitor children’s development and identify and act upon if there is a reason that the child has a developmental delay or failure to thrive, support parents and children and offer advice and guidance if needed and to notify and notify social services if they have the need to if a child is at risk or harm of abuse or neglect.
• Schools and education services – have correct and relevant policies and procedures or safeguarding children and young people, create and maintain a safe environment for children, ensure all staff have relevant and up to date safeguarding training, monitor children’s development and assess when a child isn’t performing to their normal standard and offer support, report to social care when identified that children are suffering or likely to suffer from harm or abuse and refer any concerns to the designated child protection officer in the school and they will escalate as needed to the relevant services.
• Police – all police staff have a duty to investigate criminal offences committed against children and young people, ensure that all investigations are handled with sensitivity, have specially trained officers to obtain evidence if needed, liaise with social care and attend child protection meetings to provide input of information if needed, use emergency authorities to enter premises to ensure the immediate protection of children and young people believed to be suffering or at risk of suffering immediate harm and to have a good understanding knowledge of current legislation and relevant safeguarding training.
• Psychologists – provide support and therapy sessions to children who have been harmed or neglected to help them overcome the trauma they have faces, a chance to open up and discuss thoughts and feelings of what’s happened and to make relevant referrals if needed.

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In my work setting, children’s safety is at the heart of everything we practice. Staff members have policies and procedures to follow at all times to ensure we practice safely at all times. All staff members must continuously risk assess to ensure the environment is safe for children, the floor is clear and no hazards are in place where an accident could happen. parents and carers have to give their trust to the professional to ensure that their child is safe and well cared for. For all staff who work in a children and young person work setting must have a DBS (Disclosure and Barring Service) check to ensure they have a clear criminal background this is to ensure the ultimate safety of the child. All staff members who work with children have to complete mandatory training yearly about current safeguarding legislation and policies the trust must follow when this happens. Children do not have the knowledge or know how to protect themselves so all hospital staff have a duty of care to do this.

In my place of work, there are policies and procedures that we have to follow, these are in place to protect ourselves and children and young people. Legislation applies in the policies and procedures we must follow at work including Children Act 2004, Human Rights 1998 and Data Protection Act 1998. In my place of work, we have a confidentiality policy which means that all medical information relating to the child should be kept secured either in a locked cabinet or a locked computer device. All child protection paper work should be documented on the correct paperwork and secured away and only accessed by staff involved and have relevant authority. My place of work also has a policy to make a social care referral if a professional has concerns of abuse or at risk of abuse. The policy includes being honest with the family and explaining the reasons of concerns. All information needs to be documented clearly and precisely and information needs to be shared with the relevant people including the hospitals safeguarding team who must have an input and can offer advice and guidance to staff and to also inform the nurse in charge and the patients consultant as this is per trust policy and is the correct procedure to deal with a safeguarding case. In my trust, there is a policy to follow when information sharing, this must only happen with the correct professionals who are involved and who need to be involved. This is in line with the confidentiality policy. In my place of work, we also have a whistleblowing policy, this is a confidential phone line that staff members can call if they are experiencing suspected misconduct, illegal acts or failure to act in line with the trusts policies and procedures. It is important that all staff members are aware of this policy as its important to raise and discuss these concerns for the patient’s safety and the staff members safety.