Joint Child Protection Protocol for Children Attending and Being Discharged from Hospital

Transcription

1 Joint Child Protection Protocol for Children Attending and Being Discharged from Hospital Introduction This protocol provides a framework for the exchange of information and collaborative decision-making between NHS D&G, Social Work and Police. It defines the points of contact, communication and decision-making both within and outwith 9am-5pm working hours. The protocol contains guidance which should be read in conjunction with single and inter-agency child protection guidelines. At all points consideration needs to be given, decisions made and recorded regarding the need to protect the child i.e. the need to admit the child or whether it is safe to discharge the child. 1. Children attending Hospital Settings within working hours When a child presents at Accident & Emergency (A&E), Ward 15 or any Minor Injuries Unit (MIU) a Child Protection Register check should always be undertaken within 2 hours. 1.1 Positive Child Protection Register Check In the event of the check being positive, the Senior Nurse in charge will inform the on call Consultant Paediatrician. 1.2 If there are no identified or new concerns, the Senior Nurse in charge will inform: Social Work (ask to speak to allocated social worker or their manager) NHS Child Protection Team Child's Health Visitor/School Nurse Liaison Nurse for Children in hospital 1.3 If there are identified or new concerns, e.g. about the presentation of the child (including delay); nature of the injury/illness; explanations inconsistent with injury/illness then the Consultant Paediatrician will contact the allocated Social Work Manager immediately. 1.4 This will then be followed by a discussion between the Social Work Manager, Consultant Paediatrician and a Supervisor within the Police Family Protection Unit (FPU). A decision will be made whether to progress under child protection procedures or not. 1

2 1.5 If the decision is to proceed under child protection procedures, a Strategy Meeting will be called to plan and co-ordinate the Child Protection Inquiry and Risk Assessment. If the child is a hospital patient the child's named Consultant Paediatrician and a member of the NHS Child Protection Team should be included in the meeting, with consideration to also involving the Senior Ward Nurse. Similarly, where a medical examination may be necessary or has already taken place, the child's named Consultant Paediatrician should be involved. 1.6 If the concerns are not to be progressed under child protection procedures, agreement should be reached as to how the child's needs can be met and the information fed into the next Core Group Meeting. 1.7 According to the circumstances, consideration should be given to the need for the Social Work Manager to convene an early Core Group Meeting. 1.8 Negative Child Protection Register Check When the child protection register check is negative but there are child protection concerns, the Senior Nurse in charge will inform the Consultant Paediatrician who will lead the process and in doing so s/he will contact the Social Work Duty Manager (Assessment & Referral Team) immediately. 1.9 This will then be followed by a discussion between the Social Work Duty Manager, Consultant Paediatrician and a Supervisor within the Police Family Protection Unit (FPU). A decision will be made whether to progress under child protection procedures or not If the decision is to proceed under child protection procedures, a Strategy Meeting will be called to plan and co-ordinate the Child Protection Inquiry and Risk Assessment as outlined above in If a decision is reached that a response is not required under child protection procedures but the child is in need of additional support or assessment, consideration should be given as to whether a single or multiagency response is required If a multi agency response is required and the child has been admitted to hospital a multi-agency meeting will be required prior to the child's discharge home If the child has not been admitted, a Child in Need multi-agency meeting should be convened within 5 working days by either the Consultant Paediatrician or the Social Work Duty Manager. 2

3 2. Children attending Hospital Settings outwith working hours 2.1 When a child presents at Accident & Emergency (A&E), Ward 15 or any Minor Injuries Unit (MIU) a Child Protection Register check should always be undertaken within 2 hours. 2.2 Positive Child Protection Register Check In the event of the check being positive, the Senior Nurse in charge will inform the Middle Grade on call Paediatrician who will inform the Consultant Paediatrician as appropriate. 2.3 If there are no identified or new concerns, the Senior Nurse in Charge will inform: Social Work - West of Scotland Standby Service (WSSS) and the next working day will inform: NHS Child Protection Team and Consultant Paediatrician Child's Health Visitor/School Nurse Liaison Nurse for Children in Hospital 2.4 If the check is positive and there are new or identified concerns, the on call Paediatrician will telephone social work (WSSS) and agreement reached as to whether there are child protection concerns. 2.5 If it is agreed that the concerns are of a child protection nature, child protection procedures should be followed. 2.6 If it is agreed that a child protection inquiry is needed immediately then the appropriate Police Manager and the Senior Social Worker from WSSS must agree the outline of the inquiry with the detail to be agreed by the investigating officers. 2.7 If it is agreed that a Child Protection Inquiry may be needed but can wait until the availability of the local area team and Family Protection Unit or if it is not clear from the available information/more information is needed, a strategy meeting will take place the next working day. 2.8 If the concerns are not to be progressed under child protection procedures, agreement should be reached as to how the child's needs can be met and the information fed into the next Core Group Meeting. 2.9 In both circumstances consideration should be given to the need for the Social Work Manager to convene an early Core Group Meeting Negative Child Protection Register Check When the child protection register check is negative but there are child protection concerns, the Senior Nurse in Charge will discuss this with the Middle Grade on call Paediatrician who will then inform the on call Consultant Paediatrician. 3

4 2.11 The on call Paediatrician will telephone social work (WSSS) and agreement reached as to whether there are child protection concerns If it is agreed that the concerns are of a child protection nature, this should be followed by a discussion between the On- Call Paediatrician, Social Work (WSSS) and the Police. 4

5 CHILD PROTECTION WITHIN HOURS Child presents at A&E, Ward 15, Minor Injuries Unit (MIU) Child Protection Register (CPR) Check within 2 hours CPR Check Negative but Concerns CPR Check Positive Senior Nurse in Charge informs on- call Consultant Paediatrician who will lead process Senior Nurse will inform on call Paediatrician Identified Concerns Consultant Paediatrician contacts local Social Work Office (Social Work Duty Manager) No Concerns Consultant Paediatrician contacts local Social Work Office (Duty / Team Manager) Discussion Consultant Paediatrician (to be named) Duty/Team Manager FPU Supervisor Senior Nurse in Charge Informs: Social Work (WSSS) NHS Child Protection Team Child s HV/SN, Liaison Nurse Discussion Consultant Paediatrician Duty / Team Manager FPU Supervisor Child Protection Procedures Child in Need Child Protection Procedures Multi Agency Response Needed Single Agency Response If Child Has Been Admitted: Multi-agency Meeting prior to discharge If Child Has Not Been Admitted: Multi Agency Meeting within 5 working days 5

6 CHILD PROTECTION OUT OF HOURS Child Presents at A&E, Ward 15, Minor Injuries Unit (MIU) Child Protection Register (CPR) Check within 2 hours CPR Negative but Concerns CPR Positive Inform On-Call Middle Grade Paediatrician * Discussion: On-Call Paediatrician Social Work (West of Scotland Standby Service) Police (Force Communication Centre) Child Protection New Concern Child in Need Senior Nurse in Charge will inform On- Call Paediatrician Middle Grade No Identified or New Concerns Senior Nurse in Charge Informs: Social Work (WSSS) Next working day; NHS Child Protection Team Child s HV/SN, Liaison Nurse Child Protection Inquiry needed immediately CPI needed but can wait until next working day or if more information is needed Strategy Meeting * Discussion between Senior Social worker WSSS & appropriate Police Manager FPU & Co-ordinate a Child Protection Inquiry & Initial Risk Assessment Child Protection Multi Agency Response Needed Child in Need Single Agency Response Needed * If Child Has Been Admitted: Multi Agency Meeting Prior to Discharge If Child Has Not Been Admitted: Multi Agency Meeting Within 5 Working Days * At all these points, consideration must be given to and decisions reached regarding the child s discharge at this stage of the process. 6

7 3. Guidelines for Discharge Planning Meeting for Ward 15 and Cresswell Wing 3.1 In all cases where children need a support plan, there should be adequate planning for discharge. Discharge Planning Meetings should only be held when there are no identified child protection concerns and when a decision has already been reached that the child will be discharged. If there are child protection concerns, or the child is on the Child Protection Register, the Named Paediatric Consultant must discuss these with the Social Work Duty Manager (Please refer to Section 1 or 2 of this document). 3.2 If there is a need for multi-agency involvement, e.g. medical complex needs with social work support, this should be discussed with the Duty or allocated Social Worker and a multi-agency referral form completed. In these circumstances, the named Paediatric Consultant or Deputy will convene, chair and arrange minuting of the Discharge Planning Meeting. If there is no need for multi-agency involvement, e.g. home oxygen, the Named Paediatric Consultant will convene, chair and arrange minuting of the Discharge Planning Meeting. The outcome from all meetings will be to identify: The child s needs How these needs can be met By whom Timescales Outcomes Parents/Carers will always be invited to these meetings. In all cases, the need for a Key/Lead Professional should be considered along with reviewing arrangements. 7

8 In all cases, the need for a Key/Lead Professional should be considered along with reviewing arrangements. Guidance for the Chair 1. In advance of the meeting ensure you are aware of the important issues, clinical details, purpose and expected outcome of the meeting. 2. If unexpectedly unable to attend, find a replacement or telephone the organiser to arrange a replacement. 3. Suggested format of meeting: a) Make parents welcome b) Apologies/Round the table introductions c) Give the reason for the meeting, a resume of clinical details, issues to be addressed and decisions/arrangements to be made d) Invite information sharing from each professional present e) Invite information sharing/comments from parents f) Formulate child s plan (see Appendix 1) g) Draw the meeting to a close h) When minutes are typed, check for accuracy and ensure copies are sent to all attendees including a copy of the child s plan (appendix 1). When convening a Discharge Planning Meeting, the Chair should: a) Discuss with and explain to parents b) Draw up a list of invitees (CP Team should always be invited if there are social/child protection concerns) c) Identify a suitable Chair person from Health and check on availability and willingness d) Arrange clerical/admin support for minute taking and typing e) Arrange suitable time and venue after telephone consultation with key individuals f) Complete all invitations by telephone/ /letter g) If time permits, follow telephone invitation with written confirmation. In all cases the Senior Nurse in Charge should be consulted with regard to an appropriate time if ward staff are to attend. 4 Failures to arrive at agreement 4.1 Within this area of work differences of opinion and judgement will exist. It is important these are openly shared and acknowledged. Parents and children should not be subject to unwarranted child protection enquiries, nor have their rights to family life unnecessarily compromised. It is equally important to act in a focused and collaborative manner, being clear about particular responsibilities, when there is good reason to believe a child s welfare is, or is likely to be, significantly harmed. 8

9 4.2 Where agreement cannot be reached between health and social work, or with the police, second opinions and decisions must be sought as soon as possible. In social work and police those involved should refer to their own line management. In NHS this will be to the Director of Public Health. 9

10 DISCHARGE PLANNING FOR A CHILD/CHILDREN DOES CHILD NEED SUPPORT PLAN? ARE OTHER AGENCIES INVOLVED? DOES THE PLAN NEED TO BE MULTI AGENCY? NO YES Interagency Is it Child Protection? Named Consultant would convene, chair and minute the meeting NO e.g. child in need. Discuss with Social Work and complete referral form YES Child Protection Procedures Discharge planning meeting needed 10

11 APPENDIX 1 5. Child s Plan NAME: DOB: ADDRESS: (SMART Objectives Specific / Measurable / Achievable / Realistic / Timescales Date Made / Amended : Child s Need How Can This Be Met By Whom (Who Is The Best Person To Do This) Outcome (How Will We Know This Has Been Achieved) Timescale (When Do We Want This To Be Achieved By) Signature of Chair.. Cc All Attendees 11