Bedfordshire Local Safeguarding Children Board

1
Bedfordshire Local Safeguarding Children Board

• LSCB Inter-Agency Protocol Summary
• Children, young people and parents / carers
  affected by substance misuse

2
This summary is provided to help safeguarding
children practitioners gain a quick understanding
of the protocol. The summary complements the
protocol which must still be read and understood
by all safeguarding children practitioners and
managers. The protocol itself is the source
document and must be referred to at all times.
3
Aim and Definitions

• Aim through partnership working, ensure safety
  and wellbeing where children are affected by
  problematic substance misuse
• Alcohol / Drug and substances any psychotropic
  substance
• Use can be harmful
• Misuse harmful use and dependence

4
Information sharing and consent

• Only by sharing information can professionals
  work together to safeguard and promote the
  welfare of children
• Children aged 16 can give their own consent to
  their personal information being shared
• Children under 16 can also give their own consent
  if deemed competent
• Competence is assessed using the Fraser
  guidelines

5
Information sharing without consent

• Is justifiable where
• Seeking consent may place the child at risk
• Where the duty to safeguard and promote welfare
  is greater than the duty of confidence
• Further guidance is available in WT and What to
  do if...
• Always record your decision and the reasons for
  sharing / not-sharing

6
Practice Guidance

• Working with parents
• Working with pregnant women
• Young carers
• Children and young people
• Assessment
• Competency and treatment
• Appendices

7
Working with Parents

• Focus on parents behaviour and impact on
  children, rather than the substance misuse
• Parents can provide adequate care whilst using
  substances
• Chaotic misuse is symptomatic of high risk
• Can cause emotional detachment, dangerous driving
  and children being poisoned or infected through
  contact with drug paraphernalia
• Safeguarding children and substance experts
  need to consult each other to understand risk

8
Working with ParentsDrugscope guidance

• Is there a substance free parent/carer,
  supportive partner or relative?
• Does the person move between different substance
  misuses?
• Are levels of child care different when a
  parent/carer misuses substances?
• Is there any evidence of co-existence of mental
  health problems alongside substance misuse?

9
Working with ParentsConsiderations

• Basic needs consistently provided?
• Health risks minimised?
• Supportive family and/or social networks?
• Responsible past behaviour?
• If not children are likely to be at risk of
  harm and/or neglect

10
Working with Pregnant Women

• Ensure antenatal care is being accessed
• Allocate key midwife to coordinate care
• Assess nature and extent of substance misuse,
  considering past behaviour
• Refer to specialist agencies as appropriate
• Refer to childrens social care if necessary
• Arrange M-A planning meeting or strategy meeting

11
Working with Pregnant Women

• Arrange meeting between parents and paediatrician
• Pre-birth planning meeting / CP conference 4-6
  weeks prior to expected date of confinement
• At birth, monitor for withdrawal / care
• Pre-discharge planning meeting / CP conference
• Implement / monitor effectiveness of discharge
  plan

12
Young Carers

• Children may take on a caring role for their
  parent / carer or siblings
• Children may be left home alone whilst
  parents/carers pursue activities related to their
  substance misuse (e.g. buying drugs)
• Children may feel more responsible when both
  parents/carers are misusing substances
• Supportive services can be accessed through
  Bedfordshire MAAG

13
Children and Young People

• Children who misuse substances should initially
  be assessed using the CAF
• Factors for assessment include
• Attitude, understanding and behaviour
• Nature and extent of misuse
• Awareness of risks, ability to stay safe
• Group or single activity misusing with whom
• Motivation for change

14
Children and Young People

• Factors for consideration include
• Age and maturity
• Degree of seriousness of misuse
• Whether harm/risk is continuing or increasing
• Context of misuse whether a child has multiple
  problems that require co-ordinated intervention
  (e.g. disability)
• Where needs remain unclear, consider referring
  for a specialist substance misuse assessment

15
Competency and Treatment

• Children under 16 need parental consent for
  treatment unless they are competent
• Factors to assess competency
• Age and ability
• Comprehension
• Understanding of proposed treatment
• Learning difficulty, level of intoxication or
  other factor (all factors may fluctuate)

16
Informing Parents

• Establish reasons for children not wanting
  parents to be informed
• Encourage under 16s to involve supportive parents
• Inform LA parent who will take responsibility
  for decision on whether to inform parents
• Respect young peoples (16-18) decision not to
  inform parents but encourage them to do so if
  appropriate

17
Where children are at risk of harm

• Refer to childrens social care
• Initial / core assessment undertaken
• Emergency action considered to protect child /
  other children
• Strategy meeting
• Child protection conference (if appropriate)
• Child non-compliance and at risk consider secure
  order

18
Appendices

• Useful contacts and reading
• Resilience matrix
• Criminal law and substance misuse
• MAAG
• Fraser guidelines