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1.1.2 Recognising Abuse and Neglect

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Contents

1. Introduction

1.1

This chapter provides:

  • Definitions of Significant Harm, abuse and neglect;
  • Information to assist the general recognition of circumstances where a child may suffering or likely to suffer abuse or neglect;
  • Advice on the response to such recognition, including response to the child, parents or caregivers, the seeking of consultation and making a referral to the Multi Agency Safeguarding Hub (MASH).

2. Key Concepts

Significant Harm

2.1 The Children Act 1989 provides the legal framework for defining the situations in which local authorities have a duty to make enquiries about what, if any, action they should take to safeguard or promote the welfare of a child.
2.2 Section 47 of the Act requires that if a local authority has 'reasonable cause to suspect that a child who lives or is found in their area is suffering or is likely to suffer Significant Harm' the authority shall make, or cause to be made, such enquiries as they consider necessary.....'
2.3

Under s.31 (9) of the Children Act 1989 as amended by the Adoption and Children Act 2002:

  • 'Harm' means ill treatment, or the impairment of health or development, including, for example, impairment suffered from seeing or hearing the ill treatment of another;
  • 'Development' means physical, intellectual, emotional, social or behavioural development;
  • 'Health' includes physical and mental health;
  • 'Ill treatment' includes sexual abuse and forms of ill treatment, which are not physical.
2.4 Under s.31 (10) of the Act, where the question of whether harm suffered by the child is significant turns on the child's health and development, his/her health and development must be compared with that which could reasonably be expected of a similar child.
2.5 There are no absolute criteria on which to rely when judging what constitutes significant harm. It is the responsibility of Children's Social Care to make a judgement if a referral about abuse and / or neglect of a child satisfies the criteria for a Section 47 Enquiry (seeSection 3, Threshold for Section 47 Enquiries, of the Section 47 Enquiries Procedure.


Abuse & Neglect

2.6 'Child abuse and neglect' are forms of maltreatment of a child. These terms include serious physical and sexual assaults as well as cases where the standard of care does not adequately support the child's health or development.
2.7 Children may be abused or neglected through the infliction of harm, or through the failure to act to prevent harm.
2.8 Abuse can occur within the family or in an institution or community setting. Abuse can occur within all social groups regardless of religion, culture, social class or financial position.
2.9 Children may be abused by those known to them or, more rarely, by a stranger. They may be abused by an adult /s or another child/ren.
2.10

Four broad categories of abuse and neglect are used to determine if a child protection plan is required:

  • Physical abuse;
  • Emotional abuse;
  • Sexual abuse; and
  • Neglect.
2.11

These categories overlap and an abused child does frequently suffer more than one type of abuse. This chapter provides:

  • Definitions of these categories;
  • Information to help identify potential abuse and neglect;
  • Information about the required response (including referral to the Multi Agency Safeguarding Hub (MASH)).

3. Categories of Abuse and Neglect

Physical Abuse

3.1 Physical abuse may involve hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing physical harm to a child.
3.2 It may also be caused when a parent or carer fabricates the symptoms of, or deliberately induces illness in a child (see Fabricated or Induced Illness Procedure).


Emotional Abuse

3.3

Emotional abuse is a form of Significant Harm which involves 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 children 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 the 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 cyberbullying) 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.

3.4 Some level of emotional abuse is involved in most types of ill treatment of children, though emotional abuse may occur alone.


Sexual Abuse

3.5 Sexual abuse is a form of Significant Harm which 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. The 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). Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.
3.6 Children under 16 years of age cannot lawfully consent to any sexual activity occurring, although in practice young people may be involved in sexual contact to which, as individuals, they may have agreed (see Safeguarding Children and Young People from Sexual Exploitation Procedure and Sexually Active Children Procedure).


Neglect

3.9 Neglect involves 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 and development.
3.10 Neglect may occur during pregnancy as a result of maternal substance misuse (seeBrief Guides, Parental Substance Misuse).
3.11

Once the child is born, neglect may involve failure to:

  • Provide adequate food, clothing or shelter (including exclusion from home or abandonment);
  • Protect from physical and emotional harm or danger;
  • Meet or respond to basic emotional needs;
  • Ensure adequate supervision including the use of adequate care-takers;
  • Ensure access to appropriate medical care or treatment.

4. Recognising Abuse and Neglect

The National Institute for Health and Care Excellence (NICE) has guidance on recognising child abuse and neglect.

4.1

The factors described in this section are frequently found in cases of child abuse. Their presence is not proof that abuse has occurred, but:

  • Must be regarded as indicators of possible Significant Harm;
  • Justify the need for careful assessment and discussion with designated / named / lead person, manager, (or in the absence of all those individuals, an experienced colleague);
  • May require consultation with and/or referral to the Multi Agency Safeguarding Hub (MASH).
4.2

Generally, in an abusive relationship the child may:

  • Appear frightened of the parent/s or other household members e.g. siblings or others outside of the home;
  • Act in a way that is inappropriate to her/his age and development (though full account needs to be taken of different patterns of development and different ethnic groups).
4.3 Staff should be aware of the potential risk to children when individuals, previously known or suspected to have abused children, move into or have contact with the household (see Management of Those Presenting a Risk to Children Procedure.)


Physical Abuse

4.4 This section provides information about the sites and characteristics of physical injuries which may be observed in abused children. It is intended primarily to assist non medical staff in the recognition of bruises, burns and bites which should be referred to Children's Social Care and / or require medical assessment. Further information for medical staff can be found on the Core Info website.
4.5

The following may be indicators of concern:

  • An explanation which is inconsistent with an injury;
  • Several different explanations provided for an injury;
  • Unexplained delay in seeking treatment;
  • Parents / carers are uninterested or undisturbed by an accident or injury;
  • Parents are absent without good reason when their child is presented for treatment;
  • Repeated presentation of minor injuries (which may represent a 'cry for help' and if ignored could lead to a more serious injury) or may represent fabricated or induced illness (see Fabricated or Induced Illness Procedure);
  • Repeated use of different doctors, hospital Emergency Departments and other forms of direct health provision;
  • Reluctance to give information or mention previous injuries.

Bruising

4.6

Children can have accidental bruising, but the following must be considered as highly suspicious of a non accidental injury unless there is an adequate explanation provided and experienced medical opinion sought:

  • Any bruising or other soft tissue injury to a pre-crawling or pre-walking infant or non mobile disabled child;
  • Bruising in or around the mouth, particularly in small babies which may indicate force feeding;
  • 2 simultaneous bruised eyes, without bruising to the forehead, (rarely accidental, though a single bruised eye can be accidental or abusive);
  • Repeated or multiple bruising on the head or on sites unlikely to be injured accidentally e.g. the back
  • The outline of an object used e.g. belt marks, hand prints or a hair brush (a pinch causes small double bruises, a punch or kick causes an irregular bruise with a paler centre, gripping causes ovals from fingertips or lines between fingers);
  • Linear pink marks, haemorrhages or pale scars may be caused by ligature, especially at wrists, ankles, neck, male genitalia;
  • Bruising or tears around, or behind, the earlobe/s indicating injury by pulling or twisting or slapping;
  • Bruising around the face;
  • Broken teeth and mouth injuries (a torn frenulum - the flap of tissue in the midline under the upper lip - is highly suspicious in non-mobile children, but frequently occurs accidentally in mobile children);
  • Grasp marks on small children;
  • Bruising on the arms, buttocks and thighs may be an indicator of sexual abuse.
4.7 Bruising may not be easily noticeable or distinguishable when children have darker skins (black / ethnic groups). Greater vigilance is required in noticing other possible indicators of injury e.g. wincing or demeanour of the child.
4.8 'Mongolian blue spots' closely resemble bruising. They are typically grey / blue pigmented areas over the lower back, trunk and limbs, which may be extensive. There is no over-lying damage or palpable swelling. They remain essentially unchanged in the first year of life and progressively disappear in childhood.


Bite marks

4.9 Bite marks can leave clear impressions of the teeth. Human bite marks are oval or crescent shaped. Those over 3cm in diameter are more likely to have been caused by an adult or older child.
4.10 A medical opinion from a forensic dentist / odontologist should be sought where there isany doubt over the origin of a bite. The police will have contact details.


Burns and scalds

4.11 It can be difficult to distinguish between accidental and non- accidental burns and scalds, and will always require experienced medical opinion.
4.12

Accidental scalds usually involve the upper front part of the body and have splash marks. Any burn with a clear outline may be suspicious e.g.:

  • Circular burns from cigarettes are characteristically punched out lesions 0.6 - 0.7 cm in diameter and healing usually leaves a scar;
  • Friction burns resulting from being dragged;
  • Linear burns from hot metal rods or electrical fire elements;
  • Burns of uniform depth over a large area;
  • Scalds that have a line indicating immersion or poured liquid (a child getting into hot water of its own accord will struggle to get out and cause splash marks);
  • Old scars indicating previous burns / scalds which did not have appropriate treatment or adequate explanation.
4.13 Scalds to the buttocks of a small child, particularly in the absence of burns to the feet, are indicative of dipping into a hot liquid or bath.


Fractures

4.14 Fractures may cause pain, swelling and discolouration over a bone or joint.
4.15 Non-mobile children rarely sustain fractures accidentally.
4.16

There are grounds for concern if:

  • The history provided is vague, non-existent or inconsistent with the fracture type;
  • There are multiple fractures or old fractures (in the absence of major trauma, birth injury or underlying bone disease);
  • Medical attention is sought after a period of delay when the fracture has caused symptoms such as swelling, pain or loss of movement;
  • There is an unexpected fracture in the first year of life.

Scars

4.17 A large number of scars or scars of different sizes or ages, or on different parts of the body, may suggest abuse.


Emotional Abuse

4.18 Emotional abuse may be difficult to recognise, as the signs are usually behavioural rather than physical. Manifestations of emotional abuse may also indicate the presence of other kinds of abuse.
4.19 The indicators of emotional abuse are often also associated with other forms of abuse.
4.20

Recognition of emotional abuse is usually based on observations over time and the following offer some associated indicators:

 


Parent / carer & child relationship factors 

 
  • Abnormal attachment between a child and parent / carer e.g. anxious, insecure or avoidant, indiscriminate or no attachment;
  • Indiscriminate attachment or failure to attach;
  • Conveying to children they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person e.g. persistent negative comments about the child or 'scapegoating' within the family;
  • Developmentally inappropriate or inconsistent expectations of the child which are outside what is considered reasonable and acceptable cultural / legal norms e.g. over-protection, limited exploration and learning, interactions beyond the child's developmental capability, prevention of normal social interaction;
  • Causing children to feel frightened or in danger e.g. witnessing domestic abuse, seeing or hearing the ill treatment of another.


Child presentation concerns 

 
  • Behavioural problems e.g. aggression, attention seeking, hyperactivity, poor attention;
  • Frozen watchfulness, particularly in pre-school children;
  • Low self esteem, lack of confidence, fearful, distressed, anxious;
  • Poor peer relationships including withdrawn or isolated behaviour.


Parent / carer related issues 

 
  • Dysfunctional family relationships including domestic abuse;
  • Parental problems that may lead to lack of awareness of child's needs e.g. mental illness, substance misuse, learning difficulties;
  • Parent or carer emotionally or psychologically distant from child.


Sexual Abuse

4.21 Boys and girls of all ages may be sexually abused and are frequently scared to say anything due to guilt and/or fear. The child may fear s/he will not be believed and/or fear repercussions due to possible threats that may have been made.
4.22 This form of abuse is particularly difficult for a child to talk about and full account should be taken of cultural sensitivities of individual child / family.
4.23 Recognition of sexual abuse can be difficult, unless the child tells others of the abuse, their account is believed and the suspected abuse referred to the Multi Agency Safeguarding Hub (MASH). There may be no physical signs and indications of sexual abuse are most likely to be emotional / behavioural.


Behavioural indicators

4.24

Behavioural indicators of sexual abuse may include:

  • Inappropriate sexualised conduct;
  • Sexually explicit behaviour, play or conversation, inappropriate to the child's age;
  • Continual and inappropriate or excessive masturbation;
  • Self-harm (including eating disorder), self mutilation and suicide attempts;
  • An anxious unwillingness to remove clothes for sports events (but this may be related to cultural norms or physical difficulties);
  • Running away.


Physical indicators

 
  • Sexually transmitted infections;
  • Vaginal soreness or bleeding;
  • Pregnancy.


Neglect

4.25 Evidence of neglect is built up over a period of time and can cover different aspects of parenting e.g. neglect of the child's physical needs possibly causing non-organic failure to thrive; neglect of the child's developmental emotional needs which may contribute to cognitive delay; neglect of the child's emotional needs resulting in behavioural markers.


Child related indicators

 
  • Non -organic failure to thrive / faltering growth;
  • Delay in achieving developmental, cognitive and / or other educational milestones;
  • A child who is unkempt or inadequately clothed or dirty or smells;
  • A child who is frequently perceived to be hungry;
  • Behavioural signs may include a child seen to be listless, apathetic and unresponsive with no apparent medical cause, anxious attachment; aggression; indiscriminate friendliness;
  • Failure of child to grow or develop within normal expected pattern, with accompanying weight loss or speech / language delay;
  • Recurrent / untreated infections or skin conditions e.g. severe nappy rash, eczema or persistent head lice / scabies;
  • Unmanaged / untreated health / medical conditions including poor dental health;
  • Frequent accidents or injuries;
  • Child frequently absent or late at school;
  • Poor self esteem;
  • Child thrives away from home environment.


Indicators in the care provided

 
  • Failure by parents or carers to meet the basic essential needs e.g. adequate food, clothes, warmth, hygiene;
  • Failure by parents or carers to meet the child's health and medical needs e.g. poor dental health; failure to attend or keep appointments with health visitor, GP or hospital; lack of GP registration; failure to seek or comply with appropriate medical treatment; failure to address parental substance misuse during pregnancy;
  • A dangerous or hazardous home environment including failure to use home safety equipment; risk from animals;
  • Poor state of home environment e.g. unhygienic facilities, lack of appropriate sleeping arrangements, inadequate ventilation (including passive smoking) and lack of adequate heating;
  • Lack of opportunities for child to play and learn;
  • Child left with adults who are intoxicated or violent;
  • Child abandoned or left alone for excessive periods.

5. Professional Response

Being Alert to Children's Welfare

5.1 Everybody who works or has contact with children (or pregnant women) should be able to recognise, and know how to act upon, evidence that a child's health or development (or that of the unborn baby) is or may be being impaired and especially when they are suffering or likely to suffer Significant Harm.
5.2

Whenever practitioners are concerned about the welfare or safety of a child they should follow these procedures. These concerns may arise during:

  • Day to day contact with the child or an isolated contact;
  • The process or outcome of an Early Help Assessment.

If the member of staff who has made the referral to the Multi Agency Safeguarding Hub (MASH) does not feel the response has been appropriate and concerns remain, then the member of staff should share this view with Children's Social Care Managers and, if problems persist, discuss with their line manager about escalating the issue through their management line - see Complaints, Non-Compliance and Conflict Resolution Procedure


Early Help Assessment

5.3 The Early Help Assessment (formerly CAF) is an assessment of the needs of a child or young person and deciding how those should be met.
5.4 The Early Help Assessment is intended for use by practitioners across all agencies and is designed to facilitate communication and more effective work. The Early Help Assessment enables contribution by children and parents/carers to the assessment, planning and review processes. Click here for further information about the Early Help process in Milton Keynes.
5.5 Those working with children and those working with adults who are parents/carers need to be aware of their duties to share information (with informed consent) about children with additional needs, and need to be aware how they can complete or contribute to an Early Help Assessment.
5.6 Use of an Early Help Assessment should not delay referral to the Multi Agency Safeguarding Hub if there are concerns that a child is at risk of being abused or neglected (see Quick Referral flowchart).
5.7 If an Early Help Assessment has already been completed (or is in progress) when child protection concerns are identified, it should inform the assessment completed by Children's Social Care (see Quick Referral flowchart).
5.8

If, following an assessment by Children's Social Care, a child does not meet the criteria for services, undertaking an Early Help Assessment to respond to the child's additional needs may be recommended.


Professional Consultation

5.9 Professionals in most agencies should have internal procedures, which identify child protection designated / named managers /staff able to offer advice and decide upon the necessity for a referral.
5.10 Consultation, without giving case details, may also be accomplished directly with Children's Social Care via the child protection co-ordinators or in her/his absence the Multi Agency Safeguarding Hub (MASH). There should be no delay in obtaining advice e.g. by waiting to speak to the co-ordinator, so that any decision to refer can be followed up immediately.
5.11 A formal referral or any urgent medical treatment must not be delayed by the need for consultation.


Listening to the Child

5.12 Responsibility for making enquiries and investigating allegations rests with Children's Social Care and Police Child Abuse Investigation Units (CAIUs), along with other relevant agencies (see Referral and Assessment Procedure and Section 47 Enquiries Procedure.)
5.13

Where abuse is alleged, the initial response by professionals should be limited to listening carefully to what the child says so as to:

  • Clarify the concerns;
  • Offer re-assurance about how s/he will be kept safe; and
  • Explain what action will be taken.
5.14 The child must not be pressed for information, led, cross-examined or given false assurances of absolute confidentiality. Such well-intentioned actions could prejudice police investigations, especially in cases of sexual abuse.
5.15 If the child can understand the significance and consequences of making a referral to the Multi Agency Safeguarding Hub (MASH), s/he should be informed that the referral is being made.
5.16 Regardless of the child's view, it remains the responsibility of the professional to take whatever action is required to ensure the safety of that child and any other children.


Parental Consultation

5.17

Where practicable, concerns should be discussed with the family and agreement sought for a referral to the MASH unless this may:

  • Increase the likelihood of the child suffering Significant Harm e.g. by the behavioural response it prompts or by leading to an unreasonable delay;
  • Place a member of staff at risk by the behavioural response it may prompt;
  • Lead to the risk of loss of evidential material.
5.18 Professional consultation (see Section 5.9, Professional Consultation) should be sought if in doubt about the advisability of informing the parents of the concerns or if there are concerns about the safety of any member of staff.


Decision not to seek parental permission

5.19 A decision by any professional not to seek parental permission before making a referral to the Multi Agency Safeguarding Hub must be recorded and the reasons given.
5.20 Formal referrals from named professionals cannot be treated as anonymous, so the parent will ultimately become aware of the identity of the referrer.


Parental permission given

5.21 Where a parent has agreed to a referral, this must be recorded and confirmed in the referral to Multi Agency Safeguarding Hub (MASH).


Parental refusal of permission

5.22 Where the parent refuses to give permission for the referral, further advice should, unless this would cause undue delay, be sought from a manager or the nominated child protection officer and the outcome fully recorded.
5.23

If, having taken full account of the parent's wishes, it is still considered that there is a need for a referral:

  • The reason for proceeding without parental agreement must be recorded;
  • The MASH should be told that the parent has withheld her/his permission;
  • The parent should be contacted to inform her/him that after considering their wishes a referral has been made (unless this action might increase the risk of harm to the child).
5.24 For a full discussion about information sharing and confidentiality, see Information Sharing and Confidentiality Procedure.


Urgent Medical Attention

5.25 If the child is suffering from a serious injury, medical attention must be sought immediately from the hospital Emergency Department.
5.26 If abuse is suspected, the Multi Agency Safeguarding Hub (MASH) and the duty consultant paediatrician must be informed.
5.27 Except in cases where emergency treatment is needed, Children's Social Care and the CAIU are responsible for ensuring any medical examinations required are initiated as part of a Section 47 Enquiry.


Report to Child Health

5.28 In all cases of injury presented at the Emergency Department or walk in service, the emergency service must inform the GP, health visitor and/or school nurse.


Duty to Refer to Children's Social Care

5.29

Staff in LSCB member agencies and contracted service providers must make a referral to the Multi Agency Safeguarding Hub (MASH) if there are signs that a child under the age of 18 years or an unborn baby:

  • Is suffering or has suffered Significant Harm;
  • Is likely to suffer Significant Harm; or
  • (With agreement of a person with Parental Responsibility) would be likely to benefit from family support services.
5.30 The timing of such referrals must reflect the level of perceived risk, but should usually be within 1 working day of the recognition of risk.
5.31 In urgent situations, out of office hours, the referral should be made to the Emergency Social Work Team 01908 265545.


Making the Referral

5.32 Referrals should be made to the Children's Social Care office where the child is living or is found.
5.33 If the child is known to have an allocated social worker, referrals should be made to her/him, or, in her/his absence to the manager or a duty officer. In other circumstances, referral should be to the MASH 01908 253169 or 01908 253170 by emailchildren@milton-keynes.gov.uk.
5.34

Where available, the following information should be provided with the referral (but absence of information must not delay referral):

  • Cause for concern including details of any allegations, the source/s of these, timing and location of incident/s;
  • Child's current location and emotional and physical condition;
  • Whether the child needs immediate protection;
  • Full names, date of birth and gender of child/ren;
  • Family address (current and previous);
  • Identity of those with parental responsibility;
  • Names and date of birth of all household members and any known regular visitors to the household;
  • Details of child's extended family or community who are significant for the child;
  • Ethnicity, first language and religion of children, parents / carers;
  • Any need for an interpreter, signer or other communication aid;
  • Any special needs of child/ren and other household members;
  • Any significant / important recent or historical events / incidents in child or family's life, including previous concerns;
  • Details of any alleged perpetrators (if relevant);
  • Background information relevant to referral e.g. positive aspects of parents care, previous concerns, pertinent parental issues e.g. mental health, domestic abuse, drug or alcohol abuse, threats and violence towards professionals;
  • Referrer's relationship and knowledge of child and parents / carers;
  • Known current or previous involvement of other agencies / professionals e.g. schools, GPs;
  • Information regarding parental knowledge of, and agreement to, the referral.
5.35 The referrer must confirm verbal and telephone referrals in writing, within 48 hours, using a multi-agency referral form. Any Early Help Assessment that has been undertaken should be attached to the referral.
5.36 Referrals must be acknowledged, in writing, within 1 working day of receipt. Where no acknowledgement is received within 3 working days, the referrer must contact the MASH again.


Ensuring immediate safety

5.37 The safety of children is paramount in all decisions relating to their welfare. Any action taken by members of staff from an LSCB agency should ensure that no child is left in immediate danger.
5.38 The law (s.3 (5) Children Act 1989) empowers anyone who has actual care of a child to do all that is reasonable in the circumstances to safeguard her/his welfare.
5.39 A teacher, foster carer, childminder or any professional should for example, take all reasonable steps to offer a child immediate protection from an aggressive parent.
5.40

Where abuse is alleged, suspected or confirmed in a child presented at the Emergency Department / admitted to hospital, s/he must not be discharged until:

  • Children's Social Care are notified by phone that there are child protection concerns;
  • Written confirmation is provided within 48 hours on an inter-agency referral form;
  • A Strategy Discussion/Meeting has been held including relevant hospital staff.


Recording

5.41

The referrer should keep a written record of:

  • Discussions with child;
  • Discussions with parent;
  • Discussions with managers;
  • Information provided to the Multi Agency Safeguarding Hub (MASH);
  • Decisions taken (clearly timed, dated and signed).

 

6. Referral by Members of the Public

6.1 When members of the public are concerned about the welfare of a child or an unborn baby, they should the Multi Agency Safeguarding Hub (MASH).
6.2

Any professional from another agency receiving a child protection referral from a member of the public must:

  • Advise the member of public to refer directly to the MASH;
  • Inform the MASH of the details of the concern;
  • Note the details of the concern and the communication with the MASH.
6.3 Referrers should have an opportunity to discuss their concerns with a qualified social worker.
6.4 Referrers should be asked specifically if they hold any information about difficulties being experienced by the family/household due to domestic abuse, mental illness, substance misuse, criminal behaviour/convictions and/or learning difficulties.
6.4 The NSPCC help line offers an alternative means of reporting concerns.
6.5 Individuals may prefer not to give their name to Children's Social Care or NSPCC. Alternatively they may disclose their identity, but not wish for it to be revealed to the parents / carers of the child concerned.
6.6 Where possible, staff should respect a referrer's request for anonymity. There are however, certain limited circumstances in which her/his identity may have to be given e.g. to a court.
6.7 Local publicity material should make the above position clear to potential referrers.


This page is correct as printed on Sunday 22nd of July 2018 11:48:32 PM please refer back to this website (http://mkscb.procedures.org.uk) for updates.
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