RESPONDING TO CONCERNS ABOUT CHILDREN
287. All staff who work and/or come into contact with children and their families have a role to play in child protection. That role will range from identifying and sharing concerns about a child or young person to making an active contribution to joint decision-making and/or planning an investigation to supporting the child or young person and their family (for further information, see Part 2 for more information on roles and responsibilities). Staff should be alert to signs that a child may be experiencing significant harm. When they recognise that a child's safety is compromised and/or that they are, or likely to experience, significant harm, they have a responsibility to follow local procedures for reporting and sharing these concerns.
288. There are a number of tasks for which specific agencies will take the lead role, including: the decision to undertake a child protection investigation; the planning of a joint investigation, including the need for a medical examination; and co-ordinating Child Protection Case Conferences and the Child Protection Plan. It should be noted, however, that where agencies have a specific role, they should still be making use of information from all relevant services and operating as part of a multi-agency response.
289. Formal child protection measures can be broadly divided into a number of different stages, which are discussed in detail in the sections below:
- recognising actual or potential harm to a child;
- sharing concerns and initial information-gathering;
- joint investigation/assessment;
- medical examination and assessment;
- Child Protection Case Conferences; and
- developing a Child Protection Plan.
290. At each stage, consideration must be given to whether emergency action is required to protect the child and to involving the child or young person and their family.
291. Investigating services are responsible for considering, at all stages, whether the child's safety is at risk. They should also look at the appropriateness of continuing to carry out a child protection investigation when it is clear that there are alternative explanations for the presenting concerns. Child protection investigations may highlight significant unmet needs for support and services among children and families. These should always be explicitly considered, even where concerns about significant harm are unsubstantiated.
Recognising actual or potential harm to a child
292. Concerns about actual or potential harm to a child or young person may arise over a period of time or in response to a particular incident. They may arise as a result of direct observation or disclosures from the child themselves, from a third party, or from concerns raised anonymously. Concerns may be relayed in the first instance through an intermediary service such as third sector helplines. Alternatively, an existing Child's Plan may act as the focus for a range of concerns.
293. A child who has been abused and/or neglected may show obvious physical signs of injury or maltreatment. However, an assessment of whether a child is experiencing, or likely to experience, harm should also look closely at the child's behaviour and/or development. Where staff are unsure about a child or young person's welfare, they should seek advice in line with local protocols. Any indicators of risk, such as domestic abuse or alcohol and/or drug misuse (as discussed in Part 4 of the guidance), do not in themselves mean that a child has or is experiencing, or is likely to experience, harm. However, they should act as prompts to practitioners to consider how the particular risk indicator or set of indicators is impacting on a child.
294. Concerns will also arise where a child is, or is likely to become, a member of the same household: as a child in respect of whom any of the offences mentioned in Schedule 1 of the Criminal Procedure (Scotland) Act 199510 has been committed; or as a person who has committed any of the offences mentioned in Schedule 1. In either case, the concerns should be shared with social work services without delay and in line with local guidelines, if this has not already happened.
295. Where concerns about a child's welfare come to the attention of any agency, staff will need to determine the nature of the concern and what the child may need. Any immediate risk should be considered at the outset, by whichever practitioner first comes into contact with the child and, thereafter, throughout the course of any subsequent investigation. Where immediate risk is not identified, practitioners should consider the five questions highlighted in the earlier chapter on identification of risk. This may result in other agencies being asked for information or for their view of a child's or family needs. Agencies should not make decisions about a child's needs without feeling confident that they have the necessary information to do so.
296. Where practitioners have concerns about possible harm to a child, it is vital that these are shared with social work services so that staff responsible for investigating the circumstances can determine whether that harm is significant. Concerns should be shared without delay as per local guidelines. Where a child is felt to be in immediate danger practitioners should report, without delay, direct to the police. Similarly, where a child is thought to require immediate medical assistance, this should be sought as a matter of urgency from the relevant health services.
Sharing concerns and initial information-gathering
297. All notofications of concerns about children should be taken seriously. Staff responsible for responding to these concerns should be aware that even apparently low-level concerns may point to more serious and significant harm. They should be sufficiently skilled in gathering information and carrying out initial risk assessments that children at risk of significant harm are not overlooked. Practitioners should consider all cases with an open mind and not make any assumptions about whether abuse has, or has not, occurred. Practitioners need to be alert to the possibility of abuse both of children they already know and in cases where concerns about child abuse or neglect are not stated at the outset.
298. Social work services and police have a clear statutory role in deciding whether an investigation should take place. Any service may receive a notification of concern about a child's safety and these should be shared with social work. When social work services are notified of concerns about a child's safety, they will need to form a view as to the nature of the child's needs and what response is needed, if any. All concerns, including those that do not require an immediate response, should be acknowledged quickly, indicating when a response will be made.
299. Before a decision can be taken as to whether a child protection investigation is required, it is essential that all relevant services are engaged. It is critical that:
- social work staff always confer with police officers when they believe a response under child protection may be required, ensuring that the police are in a position to consider carefully their role in investigating any crimes against children;
- health services are always centrally involved at this stage to ensure that key health information informs whether an investigation is required; and
- information-gathering involves all other key services as appropriate, including education, third sector and adult services.
300. Agency records should be checked and any previous agency involvement or any known relevant medical history, including that relating to parents/carers, should also be sought and considered. In addition, there will be circumstances where it will be essential for all relevant agencies and individuals to meet to consider the information in more detail before an investigation is launched. Any decision must be taken by managers with a designated responsibility.
301. Where a child or young person is believed to be at immediate risk, intervention should not be delayed pending receipt of information. Even in an emergency, the initial assessment of information should be discussed and endorsed by a designated manager. The need to gather information must always be balanced against the need to take any immediate protective action. At this stage, information gathered may only be enough to inform an initial assessment of the risk to the child or children. On the basis of the assessment of risk, social work services and police will need to decide whether any immediate action should be taken to protect the child and any others in the family or the wider community.
302. In circumstances where an allegation is made or concerns arise in relation to a child, serious consideration will always be given to the needs and potential risks to other children in the same household and children who are likely to become members of the same household. When it is decided to progress a concern raised about a child or young person as child protection, the child or young person needs to be seen by a social worker.
303. Many concerns raised over a child's welfare will not need a response under local child protection procedures. After making initial enquiries and gathering information on the child's circumstances, it may be decided that some other response is more appropriate, for example, offering advice, guidance, assistance or other services to the family. Particular consideration should be given to the health needs of the child.
304. The purpose of joint investigations is to establish the facts regarding a potential crime or offence against a child and to gather and share information to inform the assessment of risk and need for that child, and the need for any protective action.
305. In a joint investigation, key agencies such as social work services, the police and health services should plan and carry out their respective tasks in a co-ordinated way. This should not preclude any other agencies or individuals becoming involved. For example, education services or third sector organisations may be involved in supporting the child throughout the investigation and adult services may be involved in identifying risk factors. Within a joint investigation, agencies will have, at times, different responsibilities to fulfil, but associated activities should be planned together. This could include joint investigative interviews, forensic medical examinations, health assessments and identifying any relevant information agencies need to share about the child and their family. Local systems should be in place to facilitate early discussions between key agencies. It is critical that relevant services are consulted about any information they may hold on the child and family that might affect the child protection investigation, such as learning difficulties in the child and the need for augmented and alternative forms of communication, or significant mental health or alcohol misuse issues in a parent/carer. As much information as possible will be needed to inform the investigation and risk assessment.
306. Health staff need to be involved in planning all child protection investigations to ensure appropriate decisions about the wider health needs of the child and whether or not a medical examination is required are considered fully. Decisions about whether or not a medical examination is required should not be taken by police and social work staff without consulting a suitably qualified health professional as identified and agreed locally. In planning a medical assessment or forensic medical examination, discussion with Health staff colleagues is essential in order that the welfare needs of the child/young person are considered together with the need to collect forensic evidence. Decisions about the nature and timing of medical examinations should be made by appropriately trained paediatricians.
307. Children undergo fewer interviews and medical examinations when agencies act jointly, reducing disruption and distress to them and their families. Joint investigative interviews will be undertaken by suitably trained police officers and social work staff in accordance with the national guidance on interviewing child witnesses in Scotland. 11
308. Managers with a designated responsibility in social work services and police will be responsible for planning, co-ordinating and conducting any joint investigations and interviews in conjunction with all relevant agencies and individuals. At a minimum this should include appropriate health professionals with designated child protection responsibility. However, other agencies or services may also be involved depending on the circumstances of the individual child or young person and their parents/carers.
309. In planning any joint investigation, consideration should be given to: the child or young person's emotional state; whether an adult should be present to provide support and, if so, who this should be; any communication or interpreting facilities that may be required; any specialist input that may be needed; and any physical or mental health requirements. Additional details on planning a joint investigative interview can be found in the national guidance on interviewing child witnesses in Scotland. 12
310. Services need to designate staff with expertise, appropriate training and sufficient authority to act on their behalf and approach other agencies to initiate and review joint working. They should ensure that each agency will implement jointly agreed decisions and provide the resources needed to do so.
311. A core team of practitioners will carry out the investigation. This should include a social worker and a police officer; it may also include other staff from relevant agencies. Where appropriate, the role of the Lead Professional should be agreed.
312. Throughout the investigation, social services, following discussion with the relevant agencies, will consider the effectiveness of any protective or other action required and should record how the safety of the child has been ensured as well as any ongoing action necessary to protect the child. Any immediate actions required to protect the child should be carried out and feedback given to the person/agency who raised the concern. This information should be shared with key practitioners with responsibility for the child's well-being.
313. Where concerns about significant harm to the child are unsubstantiated, consideration needs still be given to any unmet needs and to the possible support required. This information should be recorded in the Child's Plan by the Lead Professional where appropriate. Where concerns exist about actual or likely significant harm to a child, social work services should convene a Child Protection Case Conference if this has not already been done.
314. Child Protection Committees should be satisfied that detailed arrangements are in place for joint investigations through local inter-agency procedures. These should describe local arrangements for access to interview facilities, specialist medical assessments (including forensic examinations and psychological or psychiatric advice) and the role of other agencies or specialist facilities. Local protocols for accessing and sharing information between agencies should be agreed and implemented.
Legal measures to protect children at risk
315. In some cases urgent action may be required to protect a child from actual or likely significant harm. At times, a child's parents or carers may agree to local authority social work services providing the child with accommodation and looking after them until concerns about the child's safety, or allegations of abuse or neglect, can be clarified. Social work services might also consider whether others in the child's extended family or social network could look after the child while agencies carry out further inquiries or assessment. There will, however, be cases where the risk of significant harm, or the possibility of the parents or carers removing the child without notice, makes it necessary for agencies to take legal action for their protection. Any person may apply to a Sheriff for a Child Protection Order or the local authority may apply for an Exclusion Order. The Child Protection Order authorises the applicant to remove a child from circumstances in which he or she is at risk, or retain him or her in a place of safety, while the Exclusion Order requires the removal of a person suspected of harming the child from the family home.
316. In exceptional circumstances, where a Sheriff is not available to grant a Child Protection Order or a child requires to be immediately removed from a source of danger, any person may apply to a Justice of the Peace for authorisation to remove or keep a child in a place of safety. In addition, a police constable may immediately remove a child to a place of safety where he or she has reasonable cause to believe that the conditions for making a Child Protection Order are satisfied, that it is not practicable to apply to a Sheriff for such an order and that the child requires to be removed to a place of safety to protect them from significant harm. In both cases, the child can only be kept in a place of safety for a period of 24 hours and further protective measures may have to be sought.
317. The Children (Scotland) Act 1995 also makes provision for the local authority to apply for a Child Assessment Order if it has reasonable cause to suspect that a child may be suffering or is likely to suffer significant harm and that those with parental responsibility are preventing an assessment of the child being undertaken to confirm or refute that concern. The Child Assessment Order requires the parents or carers to produce the child and allow any assessment needed to take place so that practitioners can decide whether they should act to safeguard the child's welfare. The authority may ask, or the Sheriff may direct, someone such as a GP, paediatrician or psychiatrist to carry out all or any part of the assessment. Practitioners need to assist in carrying out these assessments when asked to do so and local procedures should make provision for this. Where the child is of sufficient age and understanding, they may refuse consent to a medical examination or treatment whether or not a Child Assessment Order is made. For further information, see the section on Health assessments.
Involving children and families
318. As with all activity with children and young people, children should be helped to understand how child protection procedures work, how they can be involved and how they can contribute to decisions about their future. Taking into account the age and maturity of the child or young person, they will often have a clear perception of what needs to be done to ensure their own safety and well-being. Children should be listened to at every stage of the child protection process and given appropriate information about the decisions being made. Where a child is deaf or hard of hearing, advice and support may be required to ensure that they are fully involved in what is happening.
319. Careful consideration needs to be given to the needs of the child or young person. They may have been groomed or controlled by explicit or implicit threats and violence and fear reprisals if they disclose. In some instances, a child or young person may be too distressed to speak to investigating agencies or they may believe that they are complicit in the abuse.
320. Immediate, therapeutic, practical and emotional support may be required; this will also start building trust. A thorough assessment should be made of the child or young person's needs and services provided to meet those needs. It is good practice to provide a confidential and independent counselling service for victims and families. Guidelines should be agreed with local Procurators Fiscal and counselling and welfare services on disclosure of information to avoid the contamination of evidence. Agencies who know the child or adult, including third sector organisations, may be involved in planning the investigation to ensure that it is managed in a child-centred way, taking care not to prejudice efforts to collect evidence for any criminal prosecution.
321. The use of an advocacy service for the child or young person, where available, should always be considered.
Family members and carers
322. When undertaking child protection investigations, the need to develop a co-operative working relationship should be given special attention. Working in partnership with parents/carers can be difficult to achieve at the point of investigation, when they may feel under intense scrutiny and suspicion. Parents/ carers should be treated with respect and, where possible and appropriate, given as much information as possible about the processes and outcomes of any investigation. Parents/ carers should feel confident that staff are being open and honest with them and in turn, feel confident about providing vital information about the child, themselves and their circumstances. Working in partnership with one or more family members is likely to have long-term beneficial outcomes for the child and staff must take account of a family's strengths as well as its weaknesses. Practitioners should ensure that the parents/carers understand that the first consideration is making sure the child is safe.
323. Parents, carers and family members can contribute valuable information, not only to the assessment and any subsequent actions, but also to decisions about how and when a child will be interviewed. Children and families need time to take in and understand concerns and processes. The views of parents/carers should always be recorded and taken into account. Decisions should also be made with their agreement, whenever possible, unless doing so would place the child at risk of suffering significant harm or impede any criminal investigation.
324. Parents/carers and children of sufficient age and understanding should be given a written record of decisions taken about the outcome of an investigation unless this is likely to impede any criminal investigation. In addition to receiving a copy of the decisions, they should be given the opportunity to discuss the decisions and their implications with a social worker or another relevant professional. This does not mean, however, that parents/carers should attend all meetings which are held in connection with their family. Sometimes, it will be appropriate and necessary for practitioners to meet without parents/carers in order to reflect on their own practice in a particular case, consider matters of a particularly sensitive or confidential nature, or deal with a matter which is likely to lead to criminal inquiries.
325. It is important that where there are child protection concerns and one of the parents/carers has learning difficulties, the use of an independent advocacy service, where available, is always considered. Professionals should be skilled or seek appropriate support in communicating with parents with learning difficulties. Practitioners need to take time when communicating and use simple language; they also need to make sure that the parents can read any written information or else provide that information in a different way.
326. In cases of familial abuse, practitioners should ensure the non-abusing parent or carer is involved as much as possible. Practitioners need to be wary of making judgements on parents and carers who are likely to be in a state of shock and experiencing great anxiety. While the priority should always be the protection and welfare of the child, practitioners should attempt to engage with the non-abusing parent/carer and determine what supports are necessary to help them care for the child. Equally, practitioners should be sensitive to the impact of abuse and the subsequent investigation on siblings and extended family members. Consideration should be given to their needs in such circumstances and to the likely impact on their ability to deal with the situation.
Health assessment and medical examination
The need for a health assessment
327. Discussion between medical, nursing, social work services and police should be encouraged at all stages to facilitate good liaison and the sharing of concerns. Understanding the expertise and roles of each group will ensure that all respect the contribution provided by each service and that the health needs of the child are not overlooked.
328. A thorough assessment of the child's health needs is an essential element in joint investigations. Although it may not provide evidence that a child has or has not been abused, a comprehensive assessment of a child and family's medical history and the child's health can assist the planning and management of any investigations and inform risk assessment. This assessment, alongside information from police, social work and other services, can help determine whether further investigation is necessary.
329. A medical examination for allegations of abuse, particularly sexual abuse can often reassure that no long-term physical damage or health risk has occurred and when conducted sensitively may be the start of a healing experience for both the child and their family. The health assessment should also aim to identify unmet health and welfare needs in a very vulnerable child and is integral to the child protection process. The decision on whether an actual medical examination is appropriate should be made during the planning stage with social work, police and with the involvement of relevant health staff.
Comprehensive medical assessment
330. A comprehensive medical assessment should be considered in cases of child abuse and neglect, even when information from other agencies show little or no obvious health needs. Accurate and comprehensive entries made in the health records are essential. In some cases of child abuse and neglect, there will be no obvious signs or symptoms and some children will require diagnostic procedures only available in a well-equipped hospital or clinic.
331. The comprehensive medical assessment has five purposes:
- to establish what immediate treatment the child may need;
- to provide information that may or may not support a diagnosis of child abuse when taken in conjunction with other assessments, so that agencies can initiate further investigations, if appropriate;
- to provide information or evidence, if appropriate, to sustain criminal proceedings or care plans;
- to secure any ongoing health care (including mental health), monitoring and treatment that the child may require; and
- to reassure the child and the family as far as possible that no long-term physical damage or health risk has occurred.
332. In order to make the most effective contribution, the examining doctor must have all the relevant information about the cause for concern and the known background of the family or other relevant adults, including previous instances of abuse/neglect or suspected abuse/neglect. Wherever possible, information from the joint investigative interview should be made available to the examining doctor(s).
Arranging a medical examination
333. The number of examinations to which a child is subjected must be kept to a minimum. Careful planning of the medical component of the examination by experienced medical staff will facilitate this. In planning the medical investigation, it is important to remember that it is the duty of the police to provide best evidence, including medical evidence, to the Procurator Fiscal and the Children's Reporter in appropriate cases.
334. Appropriate advice must be available on a 24-hour basis from suitably trained and experienced paediatricians. In some remote areas, GPs with additional training will take on this role. The paediatrician (or exceptionally the GP) involved in the planning discussion should take responsibility for taking the medical assessment forward, agreeing with police and social work colleagues the nature, timing and venue for the examination. In situations where the child is brought initially to the attention of Health and where there are concerns regarding the welfare or safety of a child, the paediatrician should contact social work services or the police before carrying out any medical assessment. Where information is unclear or uncertain, a comprehensive medical assessment may be undertaken to determine the need for a specialist paediatric or joint paediatric/forensic examination. Where it is clear that a forensic opinion will be required - for example, where there is an allegation or observation of serious physical assault or injury or a disclosure of sexual abuse - the forensic examination should also include a comprehensive medical assessment.
Specialist paediatric or joint paediatric/forensic examination
335. A specialist paediatric or joint paediatric/forensic examination may need to be carried out under the following circumstances:
- the child urgently requires more specialist assessment or treatment at a paediatric department (for example, if they have a head injury or suspected fractures);
- the account of the injuries provided by the carer does not provide an acceptable explanation of the child's condition;
- the result of the initial assessment is inconclusive and a specialist's opinion is needed to establish the diagnosis;
- lack of corroboration of the allegation, such as a clear statement from another child or adult witness, indicates that forensic examination, including the taking of photographs, may be necessary to support criminal proceedings against a perpetrator and legal remedies to protect the child;
- the child's condition (for example, repeated episodes of unexplained bruising) requires further investigation; and
- in cases of suspected child sexual abuse, as the medical examination has to be carried out by medical practitioners with specialist skills using specialist equipment.
336. In some cases, the information gathered from an earlier comprehensive medical assessment may be sufficient together with other supportive evidence (for example, corroboration of the incident from an eyewitness) to enable a conclusion to be reached regarding the allegation. In such cases, there will be no need for further examination. Photographic evidence may be obtained by the police or medical photographer as part of their investigative procedures, but the examining doctors should assist by ensuring that all significant injuries are recorded.
337. The decision whether a joint paediatric/forensic examination or an examination by a single paediatric examiner is appropriate should be made during the discussion with social work services and police. Relevant health staff should also be involved. Where there is a lack of consensus, this should be resolved by the examining doctor referring the child for a second opinion to a senior paediatric colleague with specialist experience in child protection.
338. The specialist paediatric examination provides a comprehensive assessment of the child, establishing the need for immediate treatment and ongoing health care as well as providing a high standard of forensic evidence to sustain any criminal or care proceedings and offering reassurance and advice to the child and carers. The examination is intended to encompass both the child's need for medical care and the legal requirement for evidence in a single examination.
339. The joint paediatric/forensic examination combines a comprehensive medical assessment with the need for corroboration of forensic findings and the taking of appropriate specimens for trace evidence including, for example, semen, blood or transferred fibres. While the paediatrician is responsible for assessing the child's health and development and ensuring that appropriate arrangements are made for further medical investigation, treatment and follow-up, the forensic physician (also known as forensic medical examiner, child medical examiner, or police casualty surgeon) is responsible for the forensic element of the examination and fulfils the legal requirements in terms of, for example, preserving the chain of evidence. The presence of two doctors in the joint paediatric/forensic examination is important for the corroboration of medical evidence in any subsequent criminal proceeding and is also good medical practice.
340. The type of medical examination, the venue and the timing should be fully discussed with police and social workers. Social work services or the police should ensure that the child and parent(s) (and/or any other trusted adult accompanying the child) are fully informed of the arrangements and likely timescale of the investigation as soon as possible.
Timing of medical examinations
341. The timing of the medical examination should be agreed jointly by the medical examiners and the other agencies involved. It may not be in the child's best interests to rush to an immediate examination. It may be more appropriate to wait until the child has had time to rest and prepare; this may also allow for more information to become available. It is expected that in the great majority of cases arising in working hours, a comprehensive medical assessment will be carried out locally and quickly by a doctor who knows the child and/or the family and is competent to carry out such an assessment. If an assessment cannot be arranged through normal local contacts, the paediatrician responsible for child protection should be contacted. The decision on how best to proceed should always be made in discussion with the other agencies involved.
342. In cases of alleged sexual abuse where the incident has taken place some time previously, the examination must be carefully planned to take place during working hours when skilled personnel and specialist staff are available. Where the incident is believed to have taken place more recently, care must be taken to ensure that forensic trace evidence is not lost. Particular care should be taken to retain clothing and bedding, and to avoid bathing.
Consent to medical treatment
343. Consent is required for medical treatment and examination. Parental consent should be sought if the parents have parental rights and responsibilities and the child is under 16, unless this is clearly contrary to the safety and best interests of the child (for example, in urgent circumstances). However, the Age of Legal Capacity (Scotland) Act 1991 allows that a child under the age 16 can consent to any medical procedure or practice if in the opinion of the attending qualified medical practitioner they are capable of understanding the possible consequences of the proposed examination or procedure. Children who are judged of sufficient capacity to consent can withhold their consent to any part of the medical examination (for example, the taking of blood or a video recording). Clear notes should be taken of which parts of the process have been consented to and by whom.
344. In order to ensure that children and their families give properly informed consent to medical examinations, the examining doctor, assisted if necessary by the social worker or police officer, should provide information about any aspect of the procedure and how the results may be used. Where a medical examination is thought necessary for the purposes of obtaining evidence in criminal proceedings but the parents/carers refuse their consent, the Procurator Fiscal may consider obtaining a warrant for this purpose. However, where a child who has legal capacity to consent declines to do so, the Procurator Fiscal will not seek a warrant. If the local authority believes that a medical examination is required to find out whether concerns about a child's safety or welfare are justified, and parents refuse consent, the local authority may apply to a Sheriff for a Child Assessment Order or a Child Protection Order with a condition of medical examination. A child subject to a Child Protection or Assessment Order may still withhold their consent to examination or assessment if they are deemed to have legal capacity . For further information on Child Protection and Assessment Orders, see the section on Legal measures.
Mental health assessments
345. Physical signs or symptoms may be inconclusive when viewed in isolation, but can provide a clearer picture of abuse or neglect when seen in conjunction with other information. A psychiatric or psychological examination can highlight emotional or behavioural signs of abuse and/or symptoms of mental distress or illness. In all cases during the investigation stage, staff in all agencies working with children and families must be alert to behaviours that indicate possible abuse. There may be a need for close liaison with child and adolescent mental health services during the investigation.
346. More detailed information about the roles and responsibilities of medical practitioners and child protection can be found in Protecting Children - A Shared Responsibility - Guidance for Health Professionals in Scotland. 13 This document will shortly be reviewed in light of the National Child Protection Guidance.
Child Protection Case Conferences
347. A core component of GIRFEC is the Child's Plan. Within the context of child protection activity, where the plan includes action to address the risk of significant harm, it is known as a Child Protection Plan and any meeting to consider such a plan is known as a Child Protection Case Conference ( CPCC).
348. CPCCs are a core feature of inter-agency co-operation to protect children and young people. Their primary purpose is to consider whether the child - including an unborn child - is at risk of significant harm and if so, to review an existing Child's Plan and/or consider a multi-agency action plan to reduce the risk of significant harm. CPCCs are formal multi-agency meetings that enable services and agencies to share information, assessments and chronologies in circumstances where there are suspicions or allegations of child abuse and neglect. The need for a conference should be discussed with other services and agencies at an early stage in investigations. Any agency can request a CPCC. National timescales have been introduced for CPCCs as well as for the production of minutes and Child Protection Plans. Every effort should be made to meet the timescales within the national guidance but it is recognised that this may not always be possible. The reasons for not complying with the timescales should be recorded, along with a proposed future date for completion.
349. Local inter-agency child protection procedures should contain detailed information about arrangements for CPCCs and the importance of ensuring that an effective interim risk management plan is in place, covering the time from the notification of concern to the initial CPCC. Local procedures should also address details of any core group arrangements, templates (such as Child Protection Plans), dispute resolution processes and minute-taking arrangements.
350. Where a child is believed to be at actual or potential risk of significant harm, their name should be placed on the Child Protection Register. Social work services are responsible for the Child Protection Register and, as such, for arrangements in respect of registration. Even where a child is not felt to be at risk of significant harm, there will still often be a need to develop a co-ordinated Child's Plan and identify a Lead Professional.
351. The function of all CPCCs is to share information in order to identify risks to the child collectively and the actions by which those risks can be reduced. The participants should maintain an outcome-focused approach:
- ensuring that all relevant information held by each service or agency has been shared and analysed on an inter-agency basis;
- assessing the degree of existing and likely future risk to the child;
- considering the views of the child/parents/carers;
- identifying the child's needs and how these can be met by services and agencies;
- developing and reviewing the Child Protection Plan;
- identifying a Lead Professional;
- deciding whether to place or retain a child's name on the Child Protection Register; and
- considering whether a referral to the Reporter to the Children's Hearing is needed if this has not already been done.
There are four types of CPCC: initial; pre-birth; review; and transfer.
352. The purpose of an initial CPCC is to allow representatives from across services to share information about a child for whom there are child protection concerns, jointly assess that information and the risk to the child and determine whether there is a likelihood of significant harm through abuse or neglect that needs to be addressed through a multi-agency Child Protection Plan.
353. Where it is agreed that a child is at risk of significant harm and that their name should be placed on the Child Protection Register, those attending the CPCC are responsible for developing and agreeing a Child Protection Plan and identifying the core group of staff responsible for implementing, monitoring and reviewing the plan. The participants need to take account of the circumstances leading to the CPCC and the initial risk assessment. Due to the timescales for calling an initial CPCC, there may only be time for an interim risk management plan; a more comprehensive risk assessment may still need to be carried out after the CPCC. In some instances, there will already be a multi-agency Child's Plan in place and this will need to be considered in light of the concerns about the child.
354. The initial CPCC should be held as soon as possible and no later than 21 calendar days from the notification of concern being received. Where possible, participants should be given a minimum of five days' notice of the decision to convene a CPCC. Local guidelines should ensure there are clear arrangements in place for sharing information held by schools and ensuring education representation at meetings during school holidays. These arrangements need to be communicated effectively to staff within and across services.
355. The purpose of a pre-birth CPCC is to decide whether serious professional concerns exist about the likelihood of harm through abuse or neglect of an unborn child when they are born. The participants need to prepare an inter-agency plan in advance of the child's birth.
356. They will also need to consider actions that may be required at birth, including:
- whether it is safe for the child to go home at birth;
- whether there is a need to apply for a Child Protection Order at birth;
- whether the child's name should be placed on the Child Protection Register. It should be noted that as the Register is not regulated by statute, an unborn child can be placed on the Register. Where an unborn child is felt to require a Child Protection Plan, their name should be placed on the Register; and
- whether there should be a discharge meeting and a handover to community- based supports.
357. The pre-birth CPCC should take place no later than at 28 weeks pregnancy or, in the case of late notification of pregnancy, as soon as possible from the concern being raised but always within 21 calendar days of the concern being raised. There may be exceptions to this where the pregnancy is in the very early stages. However, concerns may still be sufficient to warrant an inter-agency assessment.
358. The purpose of a review CPCC is to review the decision to place a child's name on the Child Protection Register or where there are significant changes in the child or family's circumstances. The participants will review the progress of the Child Protection Plan, consider all new information available and decide whether the child's name should remain on the Child Protection Register.
359. The first review CPCC should be held within three months of the initial CPCC. Thereafter, reviews should take place six-monthly, or earlier if circumstances change. Where a child is no longer considered to be at risk of significant harm and the Child Protection Plan has been converted into a Child's Plan, their name should be removed from the Child Protection Register by the review CPCC. The child and their family/carers may still require ongoing support and this should be managed through the Child's Plan.
360. Transfer CPCCs specifically cover the transfer of information about a child where a Child Protection Plan is currently in place. Only a review CPCC can de-register a child from the Child Protection Register. Where a child and/or their family move permanently to another local authority area, the original local authority will notify the receiving local authority immediately, then follow up the notification in writing.
361. Where the child moves to another authority the originating authority needs to assess this change in circumstances. If there is felt to be a reduction in risk the originating authority should arrange a review CPCC to consider the need for ongoing registration, or, if appropriate, de-registration. In such circumstances it would be best practice for an appropriate member of staff from the receiving authority to attend the review. Where the original authority considers that the risk is ongoing or even increased by the move, the receiving local authority is responsible for convening the transfer CPCC. This should be held within the timescales of the receiving local authority's initial CPCC arrangements but within a maximum of 21 calendar days.
362. Where a child and their family move from one Scottish authority to another then:
- if the child has a Child Protection Plan, the case records and/or file needs to go with the child; or
- if the child is subject to a Supervision Requirement, the case records and/or file needs to go with child.
Where a child was on the Child Protection Register previously in another area, the receiving authority should request the child's file from the previous authority (if still available).
363. At the transfer CPCC, the minimum requirement for attendance will be the original local authority's allocated social worker and the receiving local authority social worker, plus the appropriate managers as well as representatives from appropriate services including health and education.
364. The number of people involved in a CPCC should be limited to those with a need to know or those who have a relevant contribution to make. All persons invited to a CPCC need to understand its purpose, functions and the relevance of their particular contribution. This may include a support person or advocate for the child and or family.
365. CPCCs will be chaired by senior staff members, experienced in child protection, who are competent, confident and capable. It is critical that the chair has a sufficient level of seniority/authority within their own organisation and is suitably skilled and qualified to carry out the functions of the chair. The chair, wherever possible, should not have any direct involvement with or supervisory function in relation to any practitioner who is involved in the case. They should be sufficiently objective to challenge contributing services on the lack of progress of any agreed action, including their own. While the chair will in the majority of instances be from social work services, where an individual could fulfil the required criteria, it is possible for a senior staff member from a different agency or service to undertake the role. The chair should be able to access suitable training and peer support.
366. The chair's role is to:
- agree who to invite, who cannot be invited and who should be excluded in discussion with the Lead Professional and any other relevant agency;
- meet with parents/carers and explain the nature of the meeting and possible outcomes;
- facilitate information-sharing and analysis;
- identify the risks and protective factors;
- ensure that the parents/carers and child's views are taken into account;
- facilitate decision-making;
- determine the final decision in cases where there is disagreement;
- wherever possible, chair review CPCCs to maintain a level of consistency;
- where a child's name is placed on the Register, outline decisions that will help shape the initial Child Protection Plan (to be developed at the first core group meeting);
- identify the Lead Professional;
- advise parents/carers about local dispute resolution processes;
- facilitate the identification of risks, needs and protective factors;
- facilitate the identification of a core group of staff responsible for implementing and monitoring the Child Protection Plan;
- agree review dates;
- challenge any delays in action being taken by staff or agencies;
- ensure that national timescales are adhered to, including review dates, distribution of minutes and copies of the Child Protection Plan and changes to plans; and
- ensure that any member of staff forming part of the core group who was not present at the case conference is informed immediately about the outcome of the case conference and the decisions made, and that a copy of the Child Protection Plan is sent to them.
367. Minutes are an integral and essential part of the meeting and should be noted by a suitably trained clerical worker and agreed by the chair before being circulated to the participants. Participants should receive the minutes within 15 calendar days of the CPCC. To avoid any unnecessary delay in actions and tasks identified, the chair should produce a record of key decisions and agreed tasks for circulation within one day of the meeting. This should be distributed to invitees who were unable to attend and members of the core group, as well as CPCC attendees.
368. Minutes need to be clearly laid out and should as a minimum, record:
- those invited, attendees and absentees;
- reasons for child/parents/carers non-attendance;
- reports received;
- a summary of the information shared;
- the risks and protective factors identified;
- the views of the child and parents/carers;
- the decisions, reasons for the decisions and note of any dissent;
- the outline of the Child Protection Plan agreed at the meeting, detailing the required outcomes, timescales and contingency plans;
- the name of the Lead Professional; and
- membership of the core group.
369. CPCC participants need to include:
- local authority social worker(s);
- education staff where any of the children in the family are of school age or attending pre-five establishments;
- NHS staff, health visitor/school nurse/ GP as appropriate, depending on the child's age, and the children's paediatrician where applicable; and
- police where there has been involvement with the child and/or parents/carers.
370. Other participants might include other health practitioners (including mental health services), adult services, housing staff, addiction services, educational psychologists, relevant third sector organisations, representatives of the Procurator Fiscal and armed services staff where children of service personnel are involved (for further information on proceedings involving the armed services, see Appendix D). On occasion, a Children's Reporter may be invited to attend although their legal position means they can only act as an observer and cannot be involved in the decision-making.
371. Participants attending are there to represent their agency/service and share information to ensure that risks can be identified and addressed. They have a responsibility to share information and clarify other information shared as necessary.
372. There may be occasions when it is appropriate to invite foster carers, home carers, childminders, volunteers or others working with the child or family to the CPCC. The practitioner most closely involved with the person to be invited should brief him or her carefully beforehand. This should include providing information about the purpose of the CPCC and their contribution, the need to keep information shared confidential and advice about the primacy of the child's interests over that of the parents/carers where these conflict.
373. Parents, carers or other with parental responsibilities should be invited to the CPCC. They need clear information about practitioners' concerns if they are to change behaviour which puts the child at risk.
374. In exceptional circumstances, the chair may determine that a parent/carer should not be invited to or be excluded from attending the CPCC (for example, where bail conditions preclude contact or there are concerns that they present a significant risk to others attending, including the child or young person). The reasons for such a decision need to be clearly documented. Their views should still be obtained and shared at the meeting and the chair should identify who will notify them of the outcome and the timescale for carrying this out. This should be recorded in the minutes.
375. The chair should encourage the parent/carer to express their views, while bearing in mind that they may have negative feelings regarding practitioners' intervention in their family. The chair should make certain that parents/carers are informed in advance about how information and discussion will be presented and managed. Parents/ carers may need to bring someone to support them when they attend a CPCC. This may be a friend or another family member, at the discretion of the chair, or an advocacy worker. This person is there solely to support the parent/carer and has no other role within the CPCC.
376. Information about CPCCs should be made available to children and parents/carers. This may be in the form of local leaflets or national public information. Guidance on parents/carers attendance at CPCCs should be contained in local inter-agency child protection procedures.
377. Consideration should be given to inviting children and young people to CPCCs. CPCCs can be uncomfortable for children to attend and the child or young person's age and the emotional impact of attending a meeting must be considered. A decision not to invite the child or young person should be verbally communicated to them, unless there are reasons not to do so. Children and young people attending should be prepared beforehand so that they can participate in a meaningful way, and thought should be given to making the meeting as child- and family-friendly as possible. Consideration should also be given to the use of an advocate for the child or young person. It is crucial that the child's or young person's views are obtained, presented, considered and recorded during the meeting, regardless of whether or not they are present. Where the child is disabled, consideration should be given to whether they will need support to express their views. Where appropriate and agreed the child should be part of the core group.
378. Reasons for agreeing that older children and young people should or should not attend a CPCC or core group meeting should be noted, along with details of the factors that lead to the decision. This should be recorded in the minutes.
Provision of reports
379. Reports should be produced and co-ordinated to ensure that relevant information is effectively shared with conference participants and supports good decision-making. Where possible, composite reports should be produced - either in advance of the CPCC meeting or soon afterwards - with the Lead Professional collating information and all relevant participants (particularly the child(ren) and family) contributing. These arrangements should be covered by local protocols.
380. The report/s should include all relevant information and a chronology, to be completed by the Lead Professional. They should also include information pertaining to significant adults in the child's life and provide a clear overview of the risks, vulnerabilities, protective factors and the child's views. Other children in the household or extended family should also be considered.
381. Invitees have a responsibility to share the content of the report(s) with the child and family in an accessible, comprehensible way. Particularly prior to an initial CPCC, consideration needs to be given as to the most appropriate means of sharing reports with the child and family and to when it should be done
Restricted access information
382. Restricted access information is information that, by its nature, cannot be shared freely with the child, parent/carer and anyone supporting them. The information will be shared with the other participants at the CPCC. Such information may not be shared with any other person without the explicit permission of the provider.
383. Restricted information includes:
- Sub-judice information that forms part of legal proceedings and which could compromise those proceedings;
- information from a third party that could identify them if shared;
- information about an individual that may not be known to others, even close family members, such as medical history and intelligence reports; and
- information that, if shared, could place any individual(s) at risk, such as a home address or school which is unknown to an ex-partner.
384. All participants at a CPCC with significant involvement with the child/family have a responsibility to contribute to the decision as to whether or not to place the child's name on the Child Protection Register. Where there is no clear consensus in the discussion, the Chair will use his or her professional judgement to make the final decision, based on an analysis of the issues raised. In these circumstances, the decision-making needs to be subjected to independent scrutiny from a senior member of staff with no involvement in the case. The local inter-agency child protection procedures should give details as to how this will be achieved, including timescales. Local guidelines should provide clear pathways for any escalation of issues and dispute resolutions.
385. Dispute resolution is a way of managing:
- challenges about the inter-agency process;
- challenges about the decision-making and outcomes;
- challenges by children/young people or their parents/carers about the CPCC decisions; and
- complaints about practitioner behaviour.
386. Pending the completion of the dispute resolution process all protective actions should continue, the child's name be added to Child Protection Register and the Child Protection Plan developed as required.
387. The agencies and services involved in child protection work have clear complaints procedures, which should be followed where there is a complaint about an individual practitioner. There should be clearly defined local arrangements for challenging inter-agency CPCC processes:
- Agency representatives - where a member of staff wishes to raise an issue about the process or disagrees with CPCC decisions, they should go through their normal line management processes.
- Parent/carer - where they wish to challenge the decisions of the CPCC, they should follow the process contained within local inter-agency child protection procedures. If the complaint is about a specific practitioner, they should follow that agency's complaints procedures.
- Child - children and young people should be able to access child- and family-friendly information on how to challenge a decision or make a complaint from any of the practitioners with whom they have contact.
Child Protection Plan
388. When a Child's Plan is converted into a Child Protection Plan or when a new Child Protection Plan is developed for the first time, the plans should set out in detail:
- the perceived risks and needs;
- what is required to reduce these risks and meet those needs; and
- who is expected to take any tasks forward including parents/carers and the child themselves.
Children and their families need to clearly understand what is being done to support them and why.
389. In addition, Child Protection Plans need to clearly identify:
- key people involved and their responsibilities, including the Lead Professional and named practitioners;
- supports and resources required (in particular, access to specialist assistance);
- the agreed outcomes for the child or young person;
- the longer terms needs of the child and young person;
- the process of monitoring and review; and
- any contingency plans.
390. Responsibility is shared for the Child Protection Plan. Each person involved should be clearly identified, and their role and responsibilities set out. To preserve continuity for the child and their parent(s)/carer(s), arrangements should be made to cover the absence through sickness or holidays of key people. All Child Protection Plans where there are current risks should have specific cover arrangements built in to make sure that work continues to protect the child. As part of this continuity, children and young people who are on the Child Protection Register should not be excluded from school unless there is a multi-agency discussion to identify risk factors and strategies to address these.
391. Any interventions should be proportionate and clearly linked to a desired outcome for the child. Progress can only be meaningfully measured if the action or activity has had a positive impact on the child.
392. Participants should receive a copy of the agreed Child Protection Plan within five calendar days of the CPCC. It is recognised that a full comprehensive risk assessment may not be achievable within the timescales of the initial CPCC or the first core group. Therefore, it should be recognised that the early Child Protection Plan may need to be provisional until a fuller assessment can be undertaken.
393. A core group is a group of identified individuals, including the Lead Professional, the child and their parents/carers, who have a crucial role to play in implementing and reviewing the Child Protection Plan. The core group is responsible for ensuring that the plan remains focused on achieving better outcomes for the child by reducing the known risks. The initial core group meeting should be held within 15 calendar days of the initial CPCC.
394. The functions of a core group include:
- ensuring ongoing assessment of the needs of, and risks to, a child or young person who has a Child Protection Plan;
- implementing, monitoring and reviewing the Child Protection Plan so that the focus remains on improving outcomes for the child. This will include evaluating the impact of work done and/or changes within the family in order to decide whether risks have increased or decreased;
- maintaining effective communication between all services and agencies involved with the child and parents/carers;
- activating contingency plans promptly when progress is not made or circumstances deteriorate;
- reporting to review CPCCs on progress; and
- referring any significant changes in the Child Protection Plan, including non-engagement of the family, to the CPCC chair.
395. Consideration of the involvement of the child should take cognisance of their age and the emotional impact of attending a meeting to discuss the risks they have been placed at. Children attending must be prepared beforehand to allow them to participate in a meaningful way. It is crucial that their views are obtained, presented and considered during the meeting. This group should provide a less formal way for children, parents and carers to interact with agency and service providers.
396. The core group will report back to the CPCC on progress on the Child Protection Plan. Where a core group identifies a need to make significant changes to the Child Protection Plan, they should notify the CPCC chair within three calendar days.
397. Consideration should be given to the most appropriate and effective ways of engaging with parents and carers to promote the safety of their child or children. Family group conferences are a useful mechanism for promoting child-centred family involvement in a plan to keep the child safe and meet their needs. However, it is essential that families and children are not confused by a multiplicity of parallel planning meetings. Consideration should be given to how meetings can be organised to avoid duplication. For further information on family group conferences, see the Children 1 st and NSPCC websites.
Criminal prosecution of alleged perpetrators of abuse or neglect
398. Decisions regarding any criminal prosecution or gathering of further evidence will be taken by the Procurator Fiscal and the police. When a decision is taken to raise criminal proceedings in which the child or children will be cited as witnesses and asked to give evidence, the relevant social worker should discuss the case with the police. The police will then advise the Procurator Fiscal accordingly, highlighting any concerns about the risk of further abuse of or interference with witnesses in the case and with any other children to whom the alleged perpetrator has access. This information is vital to assist Procurators Fiscal and the court to make informed decisions about bail and any additional special conditions which may be required. The initial CPCC may provide, in some instances, an opportunity for social work services, the Reporter and the Procurator Fiscal to discuss recommendations about bail and any necessary conditions. The Sheriff will decide whether to grant bail or not.
399. If an alleged perpetrator of abuse is to be prosecuted, child witnesses should always be given information and support to prepare them for the experience of being a witness in court. Local authorities and other agencies must consider a range of issues, including whether the child needs counselling or therapy before criminal proceedings are concluded. The needs of the child take priority and counselling should not be withheld solely on the basis of a forthcoming prosecution. There is a Code of Practice aimed at facilitating the provision of therapeutic support to child witnesses in court proceedings. Agencies should consider the potential impact of an unsuccessful prosecution or hostile cross-examination of a child and the implications for the future protection of that child and others.
400. Where counselling does take place, the person(s) offering counselling may be called as witnesses to explain the nature, extent and reasons for the counselling. Welfare agencies should discuss therapeutic intervention with the Procurator Fiscal so that they are aware of the potential impact of such counselling on any criminal proceedings.
401. Special measures for all child witnesses cited to attend court should include: having a support person present; screens so that the child cannot see the accused; a CCTV link from within the court building or from a remote site, as appropriate; prior statements treated as evidence in chief (criminal cases only); and evidence taken by a commissioner.
402. Consideration should be given as to who may act as a support person for the child, particularly in cases where that person may also be called upon as a witness. In all cases, the person citing the witness ( e.g. the Procurator Fiscal or defence lawyer) will make an application to the court with whom the final decision on which option is the most appropriate rests. The child's own views should also feed into the decision-making process.
403. More detailed information about the support available to child witnesses can be found below:
404. The process of responding to child protection concerns in diagrammatic form can be represented in the following way. However, it should be noted that at any stage, the process may be stopped if it is felt emergency measures are required to protect the child or no further response under child protection is necessary.