Health and Social Care

The duty to safeguard children overrides any responsibilities to provide a health and/or social care service to adults.

All Staff

All of those employed by the Committee for Health and Social Care to work (and volunteer to work) directly or indirectly with children must ensure that protection of children and promoting their welfare forms an integral part of their practice. All these health and social care professionals must be able to:

understand the risk factors and recognise children in need of support and/or protection
recognise the needs of parents who may need extra help in bringing up their children, and know where to refer for help
recognise the risks of abuse to an unborn child
assess the needs of children and the capacity of parents/carers to meet their children's needs including the needs of children who display sexually harmful behaviours
contribute to child protection conferences, family group conferences and strategy discussions
play an active part, through the child protection plan, in safeguarding children from significant harm
contribute to serious case reviews and their implementation
All health and social care staff must have access to advice and support from a designated person responsible for child protection. All employees must undertake regular safeguarding training and updating.

Early years

Day Childcare Services Childcare services include family and children's centres, day nurseries, childminders, pre-schools, playgroups, and holiday/out of school schemes and crèches.

Private and voluntary providers caring for children up to 5 years of age must be registered by Health and Social Services Department, Early Years Service and have a written statement, based on the procedures laid out in the booklet ' What To Do If You Are Worried A Child Is Being Abused ' (HM Government, Every Child Matters, (December 2006)). This statement must clearly set out staff responsibilities for reporting suspected abuse or negligence in accordance with the Guernsey and Alderney Child Protection Guidelines. The statement must include contact and telephone numbers for Services for Children and Young People's, Assessment and Intervention social work team and the police. It must also include procedures to be followed in the event of an allegation being made against a member of staff or volunteer.

Designated Person Responsible for Child Protection - Health

This professional has a specifically defined role and responsibilities for protection of children.The Designated Person Responsible for Child Protection provides advice and support on protection of children, when this is needed. This designated person plays an important roles in developing training and in reviewing and evaluating practice and learning following serious case reviews

Paediatricians

The Paediatricians roles are:

To take a history, examine and investigate children where child abuse or neglect is suspected.
Make an evidence based diagnosis of child abuse or neglect on the balance of probability.
To be aware of the family structure and identify other children who may be at risk of abuse or neglect and require assessment. To participate in strategy meetings and child protection conferences.
To work with the interagency child protection team in the assessment and management of children where child abuse is suspected.
To write reports for child protection conferences, statements for the police and reports for court.
To be prepared to attend child protection conferences or reviews and court to give evidence as requested. It is recognized that there are difficulties in attending at short notice.
To participate in assessing the needs of the child, the planning and provision of support for vulnerable children and families.
To play a part, through implementation of the child protection plan, in safeguarding children from significant harm.
To contribute to serious case reviews where a child has died as a result of abuse or suffered serious abuse.
To contribute to reviewing child deaths.

Maternity Service Staff

All health professionals working with pregnant women should be alert to the strong links between adult domestic abuse and child abuse, and must understand that women vulnerable to domestic violence will tend to minimise abuse and be more likely to delay seeking care and fail to attend antenatal clinics regularly.

The midwife plays an important role in routine antenatal enquiry of domestic violence. This is known to lead to a higher rate of disclosure of abuse. Women will not disclose abuse without being asked directly. They report wanting to be asked. The routine antenatal enquiry ensures that women are informed of the availability of local support, and liaison with multi agency services in the antenatal and postnatal period if appropriate can be instigated. The enquiry can occur at the first booking interview; however it is more commonly asked when the woman attends a future antenatal appointment alone. This information is documented on the patient tracker which remains on Loveridge Ward.

It is important that health professionals provide a supportive and enabling environment, where the issue of abuse and the availability of specialist support are raised with every pregnant woman.

In known cases where women appear more vulnerable, or require additional support (for example: previous child in care, teenage pregnancy) the maternity services is able to offer a named midwife in the antenatal period. This ensures that there is continuity of care at this crucial time to increase identification of any potential problems that may arise during pregnancy. This may indicate additional parenting support that may be required in the postnatal period. The opportunity to liaise with a variety of members of the multi agency team can then be increased.

During the postnatal period (either on Loveridge or in the Community), if the midwife has concerns regarding mothering or parenting of the neonate, or domestic violence she will liaise with Health Visitors and Social Workers as appropriate.

Ref: Home Office Development and Practice Report Tackling Domestic Violence: the role of health care professionals (2nd edn)

Health Visitors and School Nurses; Roles and Responsibilities

Health visitors have a key role to play in the identification of children who may be being abused and also in the interventions to protect children. As visitors to the home as part of a universal service, health visitors are in a position to understand and identify the risk factors and recognise when children are in need of support or protection.

School nurses have contact with school age children through their direct work in schools.

Both health visitors and school nurses have an in-depth knowledge of child health and development. Their work with children and families in promoting, assessing and monitoring health and development means they have an important role to play in all the stages of the child protection process. Their view of children across a broad spectrum of health, social, economic and educational circumstances puts them in an ideal position to identify normal limits for children and assess when children fall outside these parameters.

As part of this role they must be able to:

Understand and identify the risk factors in families and be able to recognise when children are in need of support or protection
Identify the indicators of abuse or neglect
Be familiar with the process of referral onto the appropriate agency for support or protection of the child
Share and help analyse information so an informed assessment can be made of the child's needs and circumstances
Contribute to case conferences and core groups by attending and providing written reports
Take and active part in the child protection plan along with other professionals working in partnership with children and families
Keep themselves updated with regard to child protection theory and practice
Access child protection supervision and advice

Children's Social Care

Children's social care services are committed to the principle of promoting a child's right to be brought up in safety and security by his/her birth family. The welfare and safety of the child, however, is the paramount consideration.

Children's social care services will always take seriously any information received regarding the welfare of a child. Action taken will be informed and sympathetic, and in the best interests of the child. Children's social care services are committed to working closely with other agencies in all aspects of safeguarding children.

Children's services have a legal responsibility to enquire into the circumstances of children and young people who may require compulsory intervention. This is when there is information that suggests they may have been abused or be at risk of being abused. Children's services have to take all reasonable measures to protect them from further harm. This responsibility extends to all children and young people, whether they are living with their parents, in the care of others or being looked after by the States of Guernsey or Alderney. These measures may include referring concerns about the child to the Children's Convenor where there is reason to believe that the child may be in need of compulsory intervention, or to the Juvenile Court.

In every case children's services will actively seek to involve parents, carers, and the child (where appropriate) in discussions and decisions that may affect their lives. Children's services social workers will also consult with other professions and agencies involved with the family.

The responsibilities of children's social care services include:-

the investigation, identification and assessment of risk and abuse;
the monitoring and support of children and young people at risk of abuse.