An introduction to Safeguarding Children

1
An introduction to Safeguarding Children

• Training for pharmacists

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Safeguarding Children

• All health care professionals, including those
  who do not have a role specifically related to
  child protection, have a duty to safeguard and
  support the welfare of children.

3
Role of the pharmacist

• Identifying concerns about a child or young
  person and referring these to Childrens Social
  Care or the Police
• Responding to a request from Social Care for
  information about a child or their family
• Providing a professional pharmaceutical service
  to a child or family as part of an agreed child
  protection plan

4
Child abuse

• A person may abuse or neglect a child by
  inflicting harm or failing to act to prevent harm
• Children and young people may be abused
• in a family
• an institutional or community setting
• by those known to them or,
• more rarely, by a stranger

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Effect of child abuse

• All forms of cruelty are damaging
• The emotional impact can be harder to recover
  from than the physical effect
• Abuse can happen in any family but especially if
  there is
• Parental drug and alcohol misuse
• Domestic Abuse
• Parental mental ill health
• Parental Learning Disability

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Categories of abuse

• Physical abuse
• Sexual abuse
• Neglect
• Emotional abuse

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Physical abuse

• Physical abuse involves causing physical harm to
  a child or young person
• Hitting or shaking
• Throwing
• Burning or scalding
• Poisoning
• Drowning
• Suffocating
• Fabricated or induced illness

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Signs of Physical abuse - pharmacy staff

• Fabricated or induced illness
• Injuries for which pharmacy treatment is
  inappropriate
• Delay in presentation
• No clear history or conflicting/changing history
• Previous unexplained injuries
• Bruises which are
• Clustered
• On soft or unusual parts of the body
• Tattoo bruising
• Bruises as a result of defending themselves
• Not age appropriate

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Sexual abuse

• Age of consent for sexual activity in law is age
  16 years.
• Sexual abuse involves
• Direct or indirect sexual contact with a child or
  young person
• Corrupting children by involving them in
  inappropriate sexual activities

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Sexual abuse

• Majority of cases are victims of a cautious
  approach by someone known to the child - grooming
• Abuse of power
• Can be perpetrated by
• Adults
• Children
• Young People
• Any gender
• Involves the use of
• Threats
• Bribes
• Emotional manipulation
• Exploitation

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Signs of sexual abuse pharmacy staff

• Requests for treatment
• Injuries
• Sexually transmitted diseases
• Discharges
• Genital symptoms, often vague
• Urinary Tract Infections
• Contraception
• Pregnancy tests
• Disclosure

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Neglect

• Neglect is the persistent lack of care of a
  child. Failing to provide a child with
• Love
• Stimulation and opportunities for play or social
  activities
• A safe environment
• Nourishment
• Warmth
• Education
• Medical attention
• Clean clothing and hygiene
• Guidance and boundaries

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Neglect

• Neglect is usually
• Chronic
• The result of a culmination of factors
• Involving a long period of time
• Parent may have a learning disability or be a
  substance misuser or have mental health problems

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Signs of neglect - pharmacy staff

• Missed repeat essential prescriptions for a child
• Parents who are known substance misusers
• Observations regarding any children the adult is
  caring for.
• Signs of chaotic substance misuse in an adult who
  is caring for a child
• Children in the shop
• Dirty or hygiene problems
• Underweight/overweight
• Not attending school
• Behaviour problems
• Inappropriate clothing

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Emotional abuse

• Emotional abuse is repeatedly
• Rejecting a child
• Humiliating a child
• Denying the child their rights and a feeling of
  self worth
• High and inappropriate expectations
• Sustained repetitive and inappropriate parental
  responses which can harm and damage the child

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Emotional abuse

• Most complex form of abuse
• May be the most damaging form of abuse
• Constituent part of all other forms of abuse
• Has a potentially life long influence on the
  capacity to form successful relationships

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Signs of emotional abuse - pharmacy staff

• Domestic abuse
• Adult seeking treatment
• Disclosure
• Child Carer
• Parental mental health problems
• Exposure to self harm
• Exposure to parental mental health problems

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Reasons for concern

• A child tells you about a worry
• You see physical signs of abuse or neglect
• Someone else tells you about something they have
  seen or heard
• An adult or child tells you that they have hurt a
  child or are having difficulties with them
• You see worrying behaviour from a parent/carer
  towards a child
• You know something about an adult that causes you
  to be concerned about a child/childrens welfare
• A parent or carer tells you that they are having
  problems in meeting their childs needs

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Identifying concerns

• Try to sort out in your mind why you are worried,
  based on
• what you have seen
• what you have heard from others
• what has been said to you directly
• Try to be as clear as you can about why you are
  worried but do not be afraid to listen to your
  instinct that something just does not seem to be
  right.

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Information sharing.

• Even where sharing of confidential information is
  not authorised, you may lawfully share it if this
  can be justified in the public interest
• Protect children or other people from harm
• Promote the welfare of children
• Prevent crime or disorder
• The child has a right to be safe.
• Children may have tried to tell someone about the
  abuse but may not have been believed
• There may be more than one child who is being
  harmed.
• Your information may help to complete the picture
  of a childs life
• Children should not be expected to take
  responsibility for protecting themselves or
  others

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List of children subject to child protection plan

• Dont try to investigate this yourself.
• List of children who are the subject of a multi
  agency child protection plan held by Children and
  Young Peoples Social Care.
• Making an enquiry about whether a child has a
  child protection plan
• Verify your identity
• Share your concern
• Receive information
• Contact the child's allocated social worker
• Reassess the situation if there is no allocated
  social worker

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Making a referral

• Share your concerns with the parent or the young
  person if you feel this is safe.
• Contact Childrens Social Care or police if urgent
• Be prepared to share information with Social Care
  or the police
• Be prepared to be a part of multi agency child
  protection planning for a child.
• Seek advice if unsure from one of the Named or
  Designated Professionals

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Next steps

• Raise awareness
• Being there children and young people having the
  general feeling that you are approachable
• Taking the time to listen and acting
  appropriately
• The investigation and management of a case of
  possible deliberate harm to a child must be
  approached in the same systematic and rigorous
  manner as would be appropriate to the
  investigation and management of any other
  potentially fatal disease.

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References

• Children Act 1989 and 2004
• Working Together to Safeguard Children HM Govt
  2006
• What to do if youre worried a child is being
  abused. HM Govt 2007
• Information Sharing Practitioners guide.
  Integrated working to improve outcomes for
  children and young people. HM Govt 2007.
• Victoria Climbie Inquiry -
• www.victoria-climbie-inquiry.org.uk
• www.nspcc.org.uk
• Core info leaflets on bruising and burns and
  scalds