National guidance for child protection in Scotland - Scottish ...

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Risk taking behaviours as a result of early abuse, e.g. drug taking, can then impact on parenting behaviours and the social environment, which can then lead to further abuse. Early interventions are thus crucial given the developing brain. However, it is important to note that intergenerational cycles of abuse are not inevitable, and there are many stages where decreasing risk factors and increasing protective factors can break this kind of cycle. Much can be learned from studies where individuals have encountered severe adversity and maltreatment in childhood, yet have not repeated this in their own parenting behaviours (Harris & Dersch, 2001). Domestic Abuse In the last national prevalence study, 26% of children and young people reported physical violence during their childhood (Cawson, Wattam, Booker, & Kelly, 2000). Results from the recent NSPCC prevalence study show that a quarter of children who live with domestic abuse experience are physically abused themselves (Radford, Corral, Bradley, Fisher, Bassett, Howat et al., 2010). It is important also to understand that the impact of domestic abuse can endure for children long after the measures have been taken to ensure their safety (Holt, Buckley, & Whelan, 2008). We know that the rates of child abuse and neglect are 15 times higher than the national average where domestic abuse is an issue, indeed in three out of five cases of maltreatment, domestic abuse is also an issue. Not only is there a link between domestic abuse and maltreatment, domestic abuse can impact on parenting abilities; it jeopardises the developmental progress and personal abilities of children, contributing to cycles of adversity; and it disrupts broader family functioning and the home environment (Buckley, Holt, & Whelan, 2007). The impact on their wellbeing can include a range of physical, emotional and behavioural consequences – low self esteem, depression, PTSD, aggression, running away from home and risk taking behaviour (Hester, Westmarland, Gangoli, Wilkinson, O’Kelly, Kent et al., 2006). The association between domestic abuse, harm to children’s health and use of health services is not straightforward but known adverse consequences include heightened risks of under immunisation and of risk taking behaviour in adolescence (Bair-Merritt, Blackstone, & Feudtner, 2006; Webb, Shankleman, Evans, & Brooks, 2001). Parental Mental Ill Health Approximately one in six adults in Britain has been diagnosed with a neurotic disorder such as depression, anxiety or phobias (Office of National Statistics, 2001). In addition, approximately five in 1,000 people surveyed were assessed as having a severe mental disorder such as schizophrenia or bipolar depression. It is hard to capture the effects of mental illness as it may vary and be perceived differently from case to case. Studies have shown some of the negative effects for children who have parents with mental illness (Aldridge, 2006; Stallard, Norman, Huline-Dickens, Salter, & Cribb, 2004; Tunnard, 2004). In addition, there have been studies that have linked parental mental illness to child abuse (Walsh, MacMillan, & Jamieson, 76
Children Under One Very young children particularly children under the age of two years are some of the most vulnerable in society. In statistics¹ published by the NSPCC in December 2011 nearly half of all serious case reviews are in relation to babies under one year of age and infants aged under one year are more at risk of being killed at the hands of another person than any other age group in England and Wales. (Over 6% of all children aged under 18 years in the UK were aged under one year (2010).) The proportion of child homicides in which the perpetrator is a parent is exceptionally high among infants. In Ofsted's numatic evaluation report of serious case reviews in England and Wales from 1 April 2007 to 31 March 2011 “Ages of concern; learning lessons from serious case reviews”² key findings and recurring messages regarding babies less than one year of age were that in too many cases: There were shortcomings in the timeliness and quality of pre-birth assessments. The risks resulting from the parents only were underestimated, particularly given the vulnerability of babies. There had been insufficient support for young parents. The role of the fathers had been marginalised. There was a need for improved assessment of and support for parenting capacity. There were particular lessons for both commissioning and provider health agencies whose practitioners are often the main or the only agencies involved with family in the early months. Practitioners underestimated the fragility of the baby. Of the 471 serious case reviews evaluated by Ofsted between 2007 and 2011 concerning 602 children, 210 (35%) children were babies under the age of one year. The report states that this has been a consistent pattern across the four year period. In Scotland, child protection figures i.e. children accessing the statutory child protection system is only available for the age category of 0-4 years old, but in Scotland in 2010 50% of all children on the child protection register were aged under four years. The Scottish Children’s Reporters Administration research report “Children aged under two years referred to the Children’s Reporter”³ is that in Scotland in recent years proportionately more children below the age of 2 years are being referred to the Reporter. In 2008 – 2009 this was almost one in 20 children under two years of age in Scotland (i.e. 5,651 children). In addition over the period of 2005 – 2009 more children under two years of age were needing to be placed on supervision requirements and on emergency measures (place of safety warrants 78
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CHILD PROTECTION GUIDANCE for Healt
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© Crown copyright 2013 You may re-
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MINISTERIAL FOREWORD Keeping Scotla
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affecting children, young people an
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and must be familiar with local pro
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experiencing difficulties in lookin
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Chapter 2 Roles and Responsibilitie
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Chapter 3 Sharing a Child Protectio
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Healthcare staff have a duty to co-
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Specific advice is provided below r
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Emergency and Urgent Care Medical S
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Specialist Child Protection Paediat
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PART 2 HEALTH SERVICES RESPONSIBILI
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NHS 24 NHS 24 is Scotland’s Natio
Page 30 and 31: Specification for a Child Protectio
Page 32 and 33: The Executive Director Lead Child P
Page 34 and 35: Provide advice and support on child
Page 36 and 37: Healthcare staff should seek advice
Page 38 and 39: individuals made through provisions
Page 40 and 41: All medical staff require both sing
Page 42 and 43: from the reporter or from an agent
Page 44 and 45: Appendix 1 Key Definitions and Conc
Page 46 and 47: Informal kinship care refers to car
Page 48 and 49: What is Harm and Significant Harm i
Page 50 and 51: Where a child is thought to be at r
Page 52 and 53: decision to remove a child's name w
Page 54 and 55: GIRFEC PRACTICE MODEL 51
Page 57 and 58: Proformas for Medical Assessment Ap
Page 59 and 60: 8. Reason for referral Briefing tak
Page 61 and 62: 11. Birth/Medical history 14. Devel
Page 63 and 64: 18. General examination Name(s) of
Page 65: Details of female genital findings
Page 68 and 69: Details of anal findings Natal fold
Page 70: Body diagrams Appendix A 67
Page 74 and 75: No access visit - when a visit has
Page 76 and 77: Missing Family Alert The purpose of
Page 78 and 79: High Risk Families High Risk Famili
Page 82 and 83: and child protection orders) to pro
Page 84 and 85: Children and Young People with Disa
Page 86 and 87: High Risk Families ACMD (2003). Hid
Page 88 and 89: Hester, M., Westmarland, N., Gangol
Page 90 and 91: Straus, M.A., Hamby, S.L., Finkelho
Page 92: © Crown copyright 2013 ISBN: 978-1
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