Safeguarding children policy

Date: May 2024

Review date: March 2026

Version 3.0

Introduction

1.1 The Tavistock & Portman NHS Trust is required to fulfil its statutory duty under the Children’s Act (1989, 2004) to safeguard and promote the welfare of children.

1.2 The Children’s Act (1989, 2004) provides a comprehensive framework for the care and protection of children. The fundamental principle that underpins the Children’s Act is that the welfare of the child is paramount. Achieving positive outcomes for children requires all those with responsibility for assessment and provision of services for children and young people to work together according to an agreed plan of action.

1.3 Working Together to Safeguard Children (2018, 2023) requires organisations to:

Ensure staff are trained and supervised appropriately in respect of their roles and competencies as set out in Safeguarding Children Roles and Competencies for Healthcare Staff Intercollegiate Document’, (RCPCH 2019).
Be effective across agencies in establishing clear channels of communication and the development of collaborative working relationships.
Enhance professional development; ensuring staff have time for reflection on safeguarding cases.
Enable practitioners to deal with the stresses inherent in working within the safeguarding agenda.
Provide effective supervision for staff in line with the Trust’s Safeguarding Supervision Policy (Children and Young People 2022)

Purpose

This policy sets out the key principles intended to support all staff in their duty of safeguarding.
This policy sets out the roles and responsibilities of all staff with respect to keeping children safe and promoting their welfare.
The policy provides a framework that ensures robust and safe systems are in place to safeguard children, young people and vulnerable adults.
The policy aims to provide practical guidance to assist all staff working with children or their families. This includes all Tavistock & Portman NHS staff, and those who work in partnership with the above (e.g. agency staff, students and volunteers).
The policy aims to ensure that the Tavistock & Portman NHS Trust has a workforce who, whether they work directly with children or not, are aware of their responsibility to safeguard and promote the welfare of all children and young people.

Scope

3.1 This policy applies to all staff employed by the Tavistock and Portman NHS Foundation Trust. It is supplementary to national and regional guidance such as the London Multi-Agency Children Safeguarding Policy and Procedures (2019), our local Camden Safeguarding Children Partnership and that from other Safeguarding Children Board/Partnerships for areas where the Trust provides services.

3.2 This policy applies to all children/young people at risk of significant harm up to their 18^th birthday with whom the Trust is concerned.

3.3 This policy gives equal priority to keeping all children and young people safe regardless of their age, disability, gender reassignment, race, religion or belief, sex, or sexual orientation

Definitions

Safeguarding and promoting the welfare of children is defined as:Protecting children from maltreatment

Preventing impairment of children’s health or development
Ensuring that children are growing up in circumstances consistent with the provision of safe and effective care.
Undertaking that role so as to enable those children to have optimum life chances and to enter adulthood successfully.
Identifying risks within the environment/community that could impact on the safety and wellbeing of children and young people (e.g. sexual exploitation, gang cultures and contextual safeguarding).

Child protection is a part of safeguarding and promoting welfare. This refers to the activity that is undertaken to protect specific children who are suffering, or are likely to suffer, significant harm.

Children who are defined as being ‘in need’ under S.17 – The Children’s Act (2004), are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health and development will be significantly impaired, without the provision of services plus those who are disabled.

Some children are in need because they are suffering, or likely to suffer, significant harm. The Children’s Act 2004 introduced the concept of ‘significant harm’ as the threshold that justifies compulsory intervention in family life in the best interests of children and gives local authorities a duty to make enquiries to decide whether they should take action to safeguard or promote the welfare of a child who is suffering, or likely to suffer significant harm.

Children with protected characteristics such as being ‘Looked After’ or LGBTQ+ face the same risks as all children and young people, but are at greater risk of some types of abuse which needs to be considered. For example, they might experience homophobic, biphobic or transphobic bullying or hate crime. They might also be more vulnerable to or at greater risk of sexual abuse, online abuse or sexual exploitation (Barnardo’s and Fox (2016), McGeeney et al (2017), Xu and Zheng (2014).

Physical abuse

A form of abuse which may involve hitting, shaking, throwing, poisoning, burning, scalding, drowning, suffocating or otherwise causing physical harm to a child. Physical harm may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces, illness in a child.

Sexual abuse

Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening.

4.3.1 Activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet).

4.3.2 Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.

Emotional abuse

The persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development.

It may involve conveying to a child that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child opportunities to express their views, deliberately silencing them or ‘making fun’ of what they say or how they communicate.
It may feature age or developmentally inappropriate expectations being imposed on children. These may include interactions that are beyond a child’s developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child participating in normal social interaction.
It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying (including cyber bullying), causing children frequently to feel frightened or in danger, or the exploitation or corruption of children.
Some level of emotional abuse is involved in all types of maltreatment of a child, though it may occur alone.

4.5 Neglect

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 and 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. (Working Together to Safeguard Children, 2018)

4.6 Contextualised Safeguarding

Contextualised safeguarding looks at how we engage with risks outside of the family, (extra familial harm). There is a recognition that children and young people (particularly adolescents) can be harmed in the community. Examples include sexual exploitation, gang affiliation, County Lines and episodes of ‘missing’.

Policy statements

5.1 All safeguarding children activity aims to protect a child’s right to live in safety, free from abuse and neglect.

It involves people & organisations working together to

prevent and stop risks and experience of abuse or neglect.
promote a child’s wellbeing.

5.2 Safeguarding Children activity at The Tavistock and Portman NHS Foundation Trust (‘the Trust’) takes place within the context of:

Duties and responsibilities

The Chief Executive is the accountable officer with overall responsibility for ensuring the implementation of effective safeguarding adults at risk procedures

The Chief Nurse: is the Executive Lead for Safeguarding and has a responsibility to ensure the safeguarding agenda is embedded across organisational practice. As the Trust Board Lead for Safeguarding, this post holds accountability, with responsibility delegated to the Named Professional Leads.

The Safeguarding Children Lead provides clinical leadership on safeguarding children services within the organisation. They will ensure that a co-ordinated and integrated safeguarding service is provided and that services are delivered in accordance with the Safeguarding Children policy and procedures with safe systems and processes in place for their staff to adhere to.

The Named Professional will have specific expertise in children’s health and development, child maltreatment and local arrangements for safeguarding and promoting the welfare of children.

The Named Professionals are responsible for promoting good professional practice and providing specialist advice and support to health professionals within their organisation on any issues where there are concerns about the well-being and/or safety to children.

The Named Professional will ensure child protection supervision and training is provided for all staff. They have a key role in ensuring a safeguarding training strategy is in place and is delivered within their organisation.

Named professionals have a responsibility to work closely with the Designated professionals for Safeguarding within the Integrated Care Boards (ICB’s).

The Divisional Heads of Departments have a responsibility to ensure staff members have the time to participate in the safeguarding training and supervision. They must ensure staff members are supported and have access to appropriate safeguarding support.

All Employees must be alert to the possibility of significant harm to a child resulting from abuse or neglect, or to a child who is ‘in need’. All staff should be able to recognise indicators and know how to act upon concerns, their depth of knowledge being commensurate with their roles and responsibilities.

All staff must be aware of the vulnerabilities of certain groups of children such as those who are disabled, ‘looked after’ or privately fostered.

All staff must be aware of the vulnerabilities of certain groups of adults who may find parenting difficult, for example, those experiencing domestic abuse, unstable mental health problems, uncontrolled substance or alcohol misuse or severe learning disabilities.

All staff working primarily with adults who are parents or carers should always consider the effects on parenting capacity and subsequent implications for children of the adult’s illness or behaviour.

All staff must recognise that sharing information is vital for early intervention to ensure that children are protected from abuse and neglect and that the safeguarding of children is paramount and must override any duty of confidence. Under these circumstances staff have a responsibility to share appropriate information about a child or young person with other professionals / agencies in accordance with Information Sharing Guidance for Practitioners and Managers (HM Government 2008) and any local guidance.

All staff must be aware that when they have child protection concerns, they can discuss their concerns with a named safeguarding professional, line manager or supervisor as required, and must know how to access this support. However, these discussions must never delay any emergency action that needs to be taken to protect a child.

All staff must uphold the rights of the child to be able to communicate, be heard and safeguarded from harm and exploitation irrespective of their:

Race, belief, first language and ethnicity
Gender and sexuality
Age
Health or disability
Residence
Criminal behaviour
Political or immigration status

All staff must be familiar with and know where to access this policy and any locally agreed procedures that support this policy.

All staff must ensure that they update their child protection skills and knowledge at a level commensurate with the post for which they are employed by undertaking further refresher training as appropriate and in line with level of competence defined by “Safeguarding Children and Young People; Roles and Competencies for Health Care Staff“(RCPCH 2019).

All staff working directly with children and young people must ensure that safeguarding and promoting the welfare of children and young people forms an integral part of all elements of the care they offer.

All staff share a responsibility to work effectively with other agencies as outlined in Working Together to Safeguard Children (2023) when concerns have been identified about the welfare of a child or young person.

Working together to safeguard children 2023: statutory guidance (publishing.service.gov.uk)

Support

Support and Supervision is provided for all health professionals working with children and their families and can be accessed through Safeguarding Children Lead.

Service managers will ensure that protected time is available to enable staff to receive child protection supervision as is required and is provided in addition to, and separately from clinical supervision and management supervision.

Allegations against staff

The Tavistock and Portman NHS Foundation Trust has a Managing Allegations Against Staff Policy

If a member of staff becomes aware of any information regarding another member of staff which identifies that a child either may or has been at risk of significant harm (including the member of staff’s own children), they must refer to the Chief Nurse in accordance with the London Child Protection Procedures (2022) or the NHSE Managing Safeguarding Allegations Against Staff Policy & Procedure (2020).

Training requirements

9.1 Awareness of the safeguarding children policy is covered within the induction programme of all new employees or volunteers and their understanding should be checked within supervision meetings.

9.2 All staff will receive training on safeguarding adults at a level commensurate with their roles, and in accordance with the Intercollegiate Document – Roles and Responsibilities for Health Care Professionals (2019)

9.3 The Trust has conducted a training needs analysis and details of training arrangements for staff working with children at risk of significant harm are contained in the Staff Training Procedure.

Process for monitoring compliance with this policy

10.1 The Trust will monitor compliance with this policy and procedure in the following way:

The Trust’s Integrated Safeguarding Group will monitor all safeguarding children activity including the number of concerns being recorded and where/whether concerns are being reported to the relevant local authority.
The Integrated Safeguarding Group and the Quality and Safety Committee will monitor the uptake of safeguarding children training as part of their continual monitoring of mandatory training, Compliance of this, will be reported to the People and Organisational Development committee. The group will refer training issues to the respective director for action as
The Trust Children Safeguarding Lead will provide an annual report to the Integrated Safeguarding Group and to the Quality and Safety Committee containing information on the delivery and uptake of training in line with the requirements set out in the policy

The Children Safeguarding Lead will review any incidents relating to Safeguarding and report concerns/ investigations/ lessons learned to the Patient Safety Lead.

The Children Safeguarding Lead will be responsible for adding any specific safeguarding children risks to the Operational Risk Register as they arise, and this Risk Register will be monitored through the Trust’s Risk Management

The Trust’s Safeguarding Team will undertake spot check audits of cases with safeguarding adults concerns to ensure that the records show that all relevant procedures have been followed. If this audit raises concerns the relevant lead will make recommendations to the Patient Safety Lead and an action plan will be developed and followed. Any action plan will be monitored by the Risk and Safety Sub-Committee.

References

Children Act (1989, 2004)
Working Together to Safeguard Children (2018, 2023)
Safeguarding Children – Roles and Competencies for Healthcare Staff Intercollegiate Document’, (RCPCH 2019)
The London Multi-Agency Children Safeguarding Policy and Procedures (2019)
Human Rights Act (1998)
Mental Capacity Act (2005)
Tavistock & Portman Supervision Policy (2022)
Information Sharing Guidance for Practitioners and Managers (HM Government 2008)
The NHSE Managing Safeguarding Allegations Against Staff Policy & Procedure (2020).
Barnardo’s and Fox (2016), McGeeney et al (2017), Xu and Zheng (2014) in NSPCC (2024). https://learning.nspcc.org.uk/safeguarding-child-protection/lgbtq-children-young-people

Other resources

Whistleblowing helpline (to report Organisational Abuse/Neglect concern)

Voiceability: Advocacy in Camden

Care Quality Commission

Forced Marriage

Domestic Violence Services/Resources in Camden

Safeguarding Resources and Services Links

Modern Slavery & Human Trafficking Guidance