Welcome


PCCSF is an independent professional organisation set up to
support doctors with an interest or involvement in protecting
and safeguarding children. At present, it is funded by membership subscription, run as a not-for-profit company. PCCSF is affiliated to the Alliance of Primary Care Societies from the Royal College of General Practitioners.

We welcome members from all four UK jurisdictions, representing doctors from Primary Care with an interest in
the protection and promotion of welfare of children and young people. Our membership is predominantly GPs but we welcome doctors from other specialties interested in this work.

The benefits of membership include:
· A secure email discussion group;
· A regular newsletter;
· An annual conference ( The 7th is at RCGP in 2014)

A special seminar was held in 2013 to help define the role on Named GPs for Safeguarding Children and prepare a position statement on primary care safeguarding. Membership has grown year by year from 24 in 2007 to 70 in 2014.

For details of membership contact: pccsfmembership@nhs.net

Danny Lang,
Vice Chair, PCCSF

Friday, 1 August 2008

Inspector's Report on Safeguarding Arrangements

Safeguarding children: the third joint chief inspectors’ report on arrangements to safeguard children
Published 8th July 2008

Assesses arrangements in 4 key areas:
  • overall effectiveness of systems
  • wider safeguarding role of public services
  • targeting vulnerable groups
  • response to child protection concerns

Overall effectiveness of systems

  • LSCB statutory partners [Connexions, CAFCASS, YOS] not yet involved everywhere
  • few LSCBs have prioritised specific vulnerable groups
    o looked-after children
    o privately fostered children
    o asylum seekers
    o children in mental health settings
    o children in secure and out of area placements
  • cannot show impact of their work
  • joint commissioning is underdeveloped
  • services constrained by time-limited funding
  • MAPPA arrangements are variable
  • variable updating of CRB checks
  • variable checking of staff in post prior to requirement for CRB

In terms of wider safeguarding role of public services

  • shared understanding of safeguarding lacking
  • lack of common approach across secure establishments
  • children still express concern for safety in care settings both secure and fostering
  • uncertain continuity funding preventive services [e.g. sex education]
  • dedicated programmes have failed to reduce rate of teen pregnancy
  • still significant substance misuse in offenders, substance misuse work not joined up on release
  • shortage of suitable mental health hospital beds
  • limited access to secure mental health beds
  • continuing lack of provision for learning difficulties and disability
  • 20% of LSCBs unable to demonstrate impact of strategies to deal with Domestic Violence
  • Probation response to children who offend, with background of DV, inadequate in 50%
  • significant variation in knowledge/understanding of DV in CAFCASS workers

Targeting Vulnerable Groups

  • 10% of children’s homes and fostering services inadequate in keeping children safe
  • children have limited say or choice in placement
  • educational attainment unacceptably lower for looked-after children
  • lack of continuity of social workers causes adverse effects in care plans
  • looked after children in custody have less contact with social worker than required
  • prison social workers doing well but uncertain funding
  • no agency has sole responsibility for children who go missing
  • processes for identifying young carers are underdeveloped
  • continuing concern about length of time children in court custody before secure placement
  • YOT assessments “lack rigour” and not informed by home visits
  • concerns remain about adequacy of health services for children who offend
  • treatment for young sexual offenders is limited
  • access/sustaining education is inconsistent
  • needs of children with learning difficulties who offend not well identified
  • restraint techniques still variable: previous report recommendations not implemented
  • inappropriate disciplinary/security measures applied: routine strip-searching etc
  • children in secure settings at distance from home less well monitored
  • concerns lack of priority given to children’s safeguarding by some NHS Trust and PCT boards
  • concerns extent health staff training
  • Concerns maintaining skills treating children by specialists [surgeons/anaesthetists]
  • access to specialist therapies [respite, speech/language/equipment, ADHD/Autism] limited
  • inadequate arrangements protection/care of children in airport holding facilities
  • some authorities provide less care to looked-after asylum seekers than others
  • continuing concern re effect on children’s wellbeing of detention in immigration removal centres
  • failure to address needs relating to ethnicity
  • no overall inspection of how children of armed forces personnel overseas kept safe

Response to child protection concerns

  • concerns that staff [in NHS, CAFCASS, YOT] have not received basic or intermediate child protection training
  • access to training is limited for schools, youth services, childrens homes, GPs, prison staff, YOT staff, nurses and hospital specialists
  • threshold for external investigation in response to allegation about use of force in prisons
  • lack of rigour & avoidable serious delay of serious case review
  • referral thresholds still not well understood by referring agencies
  • thresholds sometimes raised in response to workload, staff shortage and resources
  • identification of children at risk in criminal justice system poor
  • lines of accountability unclear
  • difficulties persist in parts of the NHS about sharing sensitive information


Recommendations

The Safeguarding Framework

All agencies
1. All agencies that have a statutory duty to cooperate (local authorities, district councils, police, primary care trusts, NHS trusts, Connexions, probation service, youth offending service, Children and Family Court Advisory Support Service, secure training centres and prisons) should ensure that they are fully compliant in respect of statutory membership of Local Safeguarding Children Boards by 1 September 2008.

Government
2. The Department for Children, Schools and Families, the Home Office and the Ministry of Justice should clarify the roles, functions and responsibilities of agencies contributing to multi-agency public protection arrangements (MAPPA) and ensure that relevant agencies meet them fully.

Local Safeguarding Children Boards
3. Local Safeguarding Children Boards should ensure that robust quality assurance processes are in place to monitor compliance by relevant agencies within their area with requirements to support safe recruitment practices. These processes should include regular audits of vetting practice and random sampling of compliance with checks with the Criminal Records Bureau.

The wider safeguarding role of public services

Government
4. The Department for Children, Schools and Families, the Department of Health and the Ministry of Justice should increase and better target child and adolescent mental health services in order to improve access to these services for children and young people with learning difficulties and/or disabilities and those who are in the criminal justice system.

Government, agencies providing services to children and young people and relevant inspectorates
5. All government departments, agencies and relevant inspectorates should specifi cally include the impact of domestic violence on children and young people within their risk assessments for planning, delivering, evaluating or inspecting safeguarding services.

Safeguarding groups of vulnerable children

Local authorities
6. Local authorities should make adequate provision of safe, sustainable and supported accommodation and stop the use of bed and breakfast accommodation for care leavers and young people both at risk of custodial remand or returning to communities from custodial settings.

Government
7. The Department for Children, Schools and Families and the Home Office should monitor at a national level the incidence of children missing from home.
8. The Department for Children, Schools and Families and the Youth Justice Board* should provide guidance to staff working in custodial and residential settings on the behaviour management of children and young people. Such guidance should include a model behaviour management strategy and emphasise that restraint should only be used as a last resort and should not be used solely to gain compliance. The guidance should make clear that methods of restraint should not rely on pain compliance.
9. The Department for Children, Schools and Families and the Youth Justice Board should issue a requirement that all incidences when restraint is used in custodial settings and which result in an injury to a young person are notified to, and monitored and publicly reported by, the Local Safeguarding Children Board.
10. The Department for Children, Schools and Families and the Youth Justice Board should issue a requirement that all incidents of strip-searching of young people in custodial settings are risk-assessed and recorded and that this data should be monitored by prison safeguarding committees. The Youth Justice Board should monitor the aggregated data nationally across the secure estate.
11. The Department for Children, Schools and Families and the Ministry of Justice/Youth Justice Board should provide long-term funding for social work input into youth offender institutions.
12. The Department for Children, Schools and Families, Department of Health and the Youth Justice Board should make the necessary provision to ensure that all children who display, or are convicted of, sexually harmful behaviours are assessed and that their needs for treatment are met.
13. The Department for Children, Schools and Families, the Department of Health and the Ministry of Justice/ Youth Justice Board should ensure continuity in the provision of mainstream services, particularly health and education, when young people return from a secure setting into the community.
14. The UK Border Agency should ensure that children are detained only in exceptional circumstances and for no more than a few days. The individual welfare needs of children should be taken into account, and that process documented, in any decision to detain and throughout the detention process.
15. The Department for Children, Schools and Families should issue guidance to local councils to ensure that children whose detention continues for more than seven days are subject to an independent welfare assessment of their health, welfare, educational and developmental needs and have an individual care plan. The welfare assessment and care plan should inform weekly reviews of the continued detention of children.

Child protection

Government and Local Safeguarding Children Boards
16. The Department for Children, Schools and Families and Local Safeguarding Children Boards should ensure greater consistency in decision-making about when a serious case review should be commissioned.

Government and Inspectorates
17. Ofsted should report annually on the outcome of evaluations of serious case reviews.
18. The Department for Children, Schools and Families should ensure that the national dissemination of biennial reports on the lessons learned is timely.

Government
19. The Department for Children, Schools and Families and the Youth Justice Board should ensure that the assessment tools used within the youth offending service and secure settings are robust in addressing the safeguarding needs of children and young people.
20. The Department for Children, Schools and Families, the Department of Health, the Home Office and the Ministry of Justice should ensure that information-sharing arrangements between healthcare professionals and other professionals providing services for children are in place and monitored to ensure informed and coordinated service provision.
21. The Department for Children, Schools and Families, supported by other relevant government departments, should provide an annual update of progress made on the recommendations in this report.

All agencies providing services to children and young people
22. All agencies that have a statutory duty to cooperate (local authority children’s services, district councils, police, primary care trusts, NHS trusts, Connexions, probation, Youth Offending Service, Cafcass, secure training centres and prisons) should clarify the chain of accountability and responsibilities for child protection from the front line through to their most senior level.

Full report can be downloaded from:
http://www.safeguardingchildren.org.uk/

Andrew Mowat
July 2008

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