Section 9: Safeguarding Children In Specific Circumstances (F-H)

Fabricated or induced illnesses
Family group conferences
Female genital mutilation
Fire setting
Forced marriage of a child
Foreign exchange visits
Foster care
Harbourers of missing children
Harming others - where children harm
Historical abuse
Honour based violence
Hospitals and receiving hospital services

9.16 Fabricated or induced illness

Government Guidance

Professionals are expected to work in line with ‘Safeguarding Children in Whom Illness is Fabricated or Induced' (DOH 2002), which includes:

Extensive guidance for inter-agency practice in handing individual cases;
Expected roles and responsibilities for a wide range of professionals working within health, Children's Social Care, police, education etc;
Key issues for working with families where fabricated or induced illness may be a feature.

Behaviours Associated with Fabricated/Induced Illness

There are three main ways, not mutually exclusive, of a parent/carer fabricating or inducing illness in a child.

Fabrication of signs and symptoms, for example, fabrication of past medical history;
Falsification of hospital charts, records, letters, documents and specimens of bodily fluids;
Induction of illness by a variety of means.

Behaviours include:

Deliberately inducing symptoms in children by administering medication or other substances, or by means of intentional suffocation;
Interfering with treatments by over dosing, not administering them or interfering with medical equipment such as infusion lines;
Claiming the child has symptoms which are unverifiable unless observed directly, such as pain, frequency of passing urine, vomiting, or fits;
Exaggerating symptoms, causing professionals to undertake investigations and treatments which may be invasive, are unnecessary and therefore are harmful and possibly dangerous;
Obtaining specialist treatments or equipment for children who do not require them;
Alleging psychological illness in a child.

Recognition of Fabricated/Induced Illness

Where illness is being fabricated or induced, extensive, unnecessary medical investigations may be carried out in order to establish the underlying causes for the reported signs and symptoms. The child may also have treatments prescribed or operations which are unnecessary. These investigations can result in children spending long periods of time in hospital and some, by their nature, may also place the child at risk of suffering harm or even death.

Carers exhibit a range of behaviours when they believe that their child is ill. A key professional task is to distinguish between the over anxious carer who may be responding in a reasonable way to a very sick child and those who exhibit abnormal behaviour. Such abnormal behaviour can be present in one or both parents/carers and often involves passive compliance of the child.

Many incidents of concern can be warning signs of fabricated or induced illness and practitioners should note the attached ‘Possible Warning Signs of Fabricated or Induced Illness Template'.

Referral

When a possible explanation for reported or actual signs and symptoms in a child is that they may have been fabricated or induced by a parent/carer, and as a consequence the child's health or development is or is likely to be impaired, a referral should be made to Children's Social Care.

The referral may, for example, follow an evaluation of the child's signs and symptoms whilst an in-patient or be due to concerns held by professionals working with the child or concerns held by a member of the public who knows the child.

In situations of possible induced or fabricated illness practitioners should not discuss their concerns with the parents/carers. This is because such discussion may increase the risk of significant harm to the child. Decisions about what discussions are to take place with the parents/carers are to be made on an inter-agency basis, following referral to Children's Social Care.

Response by Children's Social Care and Strategy Meeting

Child protection procedures are to be applied to referrals about possible fabricated/induced illness and an inter-agency Strategy Meeting is to be held. Staff attending the Strategy Meeting should be sufficiently senior to be able to contribute to the discussion of complex information and to make decisions on behalf of their agencies.

At a minimum agency/professional representation at the Strategy Meeting should include:

Children's Social Care
Police from the Protecting Vulnerable People's Unit
Medical Consultant responsible for the child's health
Senior Ward Nurse (if the child is an in-patient)
GP
Health Visitor
Education staff
School Nurse.

Consideration should be given to inviting:

A medical professional who has expertise in the branch of medicine which deals with the symptoms and illness processes caused by the suspected abuse;
The Legal Advisor to the local authority

All agencies/professionals involved should be asked to furnish a completed chronology for the Strategy Meeting.

Decisions about what discussions are to take place with the parents/carers, and by whom, are to be made at this Strategy Meeting (and the referrer should be advised).

Emergency Action

Sometimes it may be apparent at the point of referral to Children's Social Care that emergency action is necessary, for example, when a child's life is in danger, possibly through poisoning or toxic substances being introduced into the child's blood stream. Emergency action should normally be preceded by an immediate Strategy Discussion between the Police, Children's Social Care, Health and other agencies as appropriate and by the taking of legal advice. In the case of Re X (2006), the High Court has said that "cases of fabricated or induced illness, where there is no medical evidence of immediate risk of harm to the child, rarely warrant an EPO".

Responsibilities

From the point of referral, Children's Social Care the responsible Paediatric Consultant and Police, Protecting Vulnerable People's Unit are to work very closely together. Lead responsibilities are:

Children's Social Care for action to safeguard and promote the child's welfare;
The Paediatric Consultant for the child's health care and decisions pertaining to it.;
The Police for investigating any crime which may have been committed and the management of how investigations are to be conducted.

Chronologies and ‘Possible Warning Signs of Fabricated or Induced Illness Template'

The use of chronologies and the attached ‘Possible Warning Signs of Fabricated or Induced Illness Template' allows for systematic consideration of risk factors and risk assessment.

In compiling chronologies and using the attached template, the focus must be on:

Ensuring that all practitioners describe precisely what they have observed rather than using unfamiliar terminology;
Clarifying any concerns about medical information (treatments, expected findings, prognosis, etc) with an appropriate Doctor;
Focusing on the possible harm to the child, not the motivation of the parent/carer.

Professionals involved should formulate chronologies, as set out below, for discussion at the Strategy Meeting. Chronologies should not include every single contact, instead they should include any event that comes under any of the categories given in the attached ‘‘Possible Warning Signs of Fabricated or Induced Illness Template'.

Children's Social Care should then sort and merge the chronologies into one complete document, using this and the attached template to inform the risk assessment.

Any episode in which the parent/carer could be using the medical system to harm the child and all possible episodes of other forms of abuse must be included, including trivial injuries, which may be accidents or due to inflicted harm.

Chronology information should be set out on the following basis;

Date

Name

Source

Episode/event

Risk from a Member of Staff

There may be times when a member of staff is responsible for the unexplained or inexplicable signs and symptoms in a child. This should be borne in mind when considering how to manage the child's care. Any such concerns about a member of staff should be discussed with the relevant Named Professional for Child Protection.

Possible Warning Signs (Based on Cumbria Public Report 2004)

Reported signs and symptoms found on examination are not explained by any medical condition from which the child may be suffering. Here the doctor is attempting to put all the information together to make a diagnosis but the signs and symptoms do not correlate with any recognised disease or where there is a disease known to be present. A very simple example would be a skin rash which did not correlate with any known skin disease. An experienced doctor must be on their guard if something described is outside their previous experience.

Physical examination and results of medical investigations do not explain reported symptoms and signs. Physical examination and appropriate investigations do not confirm the reported clinical story. For example, it is reported a child turns yellow (has jaundice) but no jaundice is confirmed when the child is examined and a test for jaundice, if appropriate, is negative. A child with frequent convulsions every day has no abnormalities on a 24-hour video-telemetry (continuous video and EEG recording) even during a so-called ‘convulsion'.

There is an inexplicably poor response to prescribed medication and other treatment. The practitioner should be alerted when treatment for the agreed condition does not produce the expected effect. This can result in escalating drugs with no apparent response, using multiple medications to control a routine problem and multiple changes in medication due to either poor response or frequent reports of side effects. On investigation, toxic drug levels commonly occur but may be interspersed with low drug levels suggesting extremely variable administration of medication fluctuating from over- medication to withdrawal of medication. Another feature may be the welcoming of intrusive investigations and treatments by the parent.

New symptoms are reported on resolution of previous ones. New symptoms often bear no likely relationship to the previous set of symptoms. For example, in a child where the focus has been on diarrhoea and vomiting, when appropriate assessments fail to confirm this, the story changes to one of convulsions. Sometimes this is manifest by the parents transferring consultation behaviour to another child in the family.

Reported symptoms and found signs are not seen to begin in the absence of the carer, i.e. the perpetrator is the only witness of the signs and symptoms. For example, reported symptoms and signs are not observed at school or during admission to hospital. This should particularly raise anxiety of FII where the severity and/or frequency of symptoms reported are such that the lack of independent observation is remarkable. Caution should be exercised when accepting statements from non-medically qualified people that symptoms have been observed. In the case under review there was evidence that the school described episodes as ‘fits' because they were told that was the appropriate description of the behaviour they were seeing.

The child's normal, daily life activities are being curtailed beyond that which might be expected for any medical disorder from which the child is known to suffer. The carer limits the child's activities to an unreasonable degree and often either without knowledge of medical professionals or against their advice. For example, confining a child to a wheelchair when there is no reason for this, insisting on restrictions of physical activity when not necessary, adherence to extremely strict diets when there is no medical reason for this, restricting child's school attendance.

Over time the child is repeatedly presented with a range of signs and symptoms. At its most extreme this has been referred to as ‘doctor shopping'. The extent and extraordinary nature of the additional consultations is orders of magnitude greater than any concerned parent would explore. Often consultations about the same or different problems are concealed in different medical facilities. Thus the patient might be being investigated in one hospital with one set of problems and the parent will initiate assessments elsewhere for a completely different set of problems (or even the same) without informing these various medical professionals about the other consultations.

History of unexplained illnesses or deaths or multiple surgery in parents or siblings of the family. The emphasis here is on the unexplained. Illness and deaths in parents or siblings can frequently be a clue to further investigation and hence a diagnosis in naturally occurring illness. In FII abuse, perpetrators frequently have had multiple unexplained medical problems themselves, ranging from frequent consultations with the general practitioner through to the extreme where there are multiple presentations with fabricated or induced illness resulting in multiple (unnecessary) operations. Self-harm, often multiple, and eating disorders are further common features in perpetrators. Additionally, other children either concurrently or sequentially might have been subject to FII abuse and their medical history should also be examined.

Once the perpetrator's access to the child is restricted, signs and symptoms fade and eventually disappear. This is a planned separation of perpetrator and child which it has been agreed will have a high likelihood of proving (or disproving) FII abuse. It can be difficult in practice, and appear heartless, to separate perpetrator and child. The perpetrator frequently insists on remaining at the child's bedside, is unusually close to the medical team and thrives in a hospital environment.

Exaggerated catastrophes or fabricated bereavements and other extended family problems are reported. On exploring reported illnesses or deaths in other family members (often very dramatic stories) no evidence is found to confirm these stories. They are largely or wholly fictitious.

Incongruity between the seriousness of the story and the actions of the parents. Given a concerning story, parents by and large will cooperate with medical efforts to resolve the problem. They will attend outpatients, attend for investigations and bring the child for review urgently when requested. Perpetrators of FII abuse, apparently paradoxically, can be extremely creative at avoiding contacts which would resolve the problem. There is incongruity between their expressed concerns and the actions they take. They repeatedly fail to attend for crucial investigations. They go to hospitals that do not have the background information. They repeatedly produce the flimsiest of excuses for failing to attend for crucial assessments (somebody else's birthday, thought the hospital was closed, went to outpatients at one o'clock in the morning, etc

Erroneous or misleading information provided by parent. These perpetrators are adept at spinning a web of misinformation which perpetuates and amplifies the illness story, increases access to interventions in the widest sense (more treatment, more investigations, more restrictions on the child or help, etc). An extreme example of this is spreading the idea that the child is going to die when in fact no one in the medical profession has ever suggested this. Changing or inconsistent stories should be recognised and challenged.

9.17 Family Group Conferences

Key Points

A family meeting, professionally facilitated, to agree safe plans to meet a child's needs
Complementary with Child Protection procedures which must still be instituted if appropriate

Supplementary information, including templates, about Family Group Conferences will be available on the Good Practice domain of the NYSCB website later in 2009.

General Principles of Operating FGCs

Children are generally best looked after within their own families/extended families.
Families are generally able to make good decisions about their children given the opportunity and the information to do so.
Families provide identity, roots and continuity to children.
Families have vital information that professionals cannot easily access.
Families' ability to care for their children will be encouraged by family decision-making.
Family problems can be helped by the involvement of friends and wider families.
Families can make plans sensitive to and reflective of their culture. Issues of race/culture/language/religion will be reflected throughout the process.

A Family Group Conference may be offered post assessment of need, which may have identified a need for protection. This procedure should be read in conjunction with LSCB Procedures Section 5, Section 6 and Section 8.

Throughout the FGC process the needs of the child shall remain paramount. If within the process it becomes apparent that that there are additional areas of risk to the child further to those initially identified, the social worker will be advised by the FGC co-ordinator. This may lead to a postponement of the FGC process depending on the exact nature of the information.

What is a Family Group Conference (FGC)?

A Family Group Conference (FGC) is a decision making and planning process whereby the family, including the wider family group, are empowered to make decisions for their children and young people, if they have been identified as being in need of a plan which will safeguard and promote their welfare.

FGCs are an approach to planning and decision-making, which uses the skills and experience of the wider family as well as professionals. The definition of who is in the family will come from the family itself and may include friends, neighbours and community members (subject to the need to exclude e.g., an alleged abuser).

A key issue before proceeding with the process is that the family has an understanding of what an FGC is. They must agree that such a meeting might be helpful in sorting out the problems/difficulties they are experiencing, and be able to make a clear and informed choice about whether to engage in the process.

The underlying principle of Family Group Conferences is that families are able to make good decisions about their children given the information and opportunity to do so. To support this principle it is vital that workers from all agencies work together.

Family members need to be able to understand what the issues are from the perspective of the professionals that need to be addressed.

The family and involved professionals should be clear:

Why are professionals involved;
What are the current views of the professionals, including any risks identified;
What issues the family need to address in order to ensure the welfare of the children;
What areas the family can make decisions on, and whether there are any decisions/issues that are not negotiable;
What resources are or might be available to implement any plan within this framework. Agencies should agree to work together to support the family plan, if it does not leave the child at risk of significant harm and if the resources requested can be provided.

Throughout the process the welfare of the child/ren remains paramount and any professional who holds concerns must discuss these with the case accountable social worker.

Examples of situations where a FGC may be considered are:

Where legal proceedings are being considered for a child;
Where children are due an Initial or Review Child Protection Conference or at any time when they are subject to a Child Protection Plan;
When children are subject to Interim Care Orders;
Where ongoing family support has been assessed as being needed;

The Four Part Family Group Conference Process: Referral, Preparation, the Meeting and after the Meeting.

Referral

In most cases the referrer will be the child's social worker (where child is in need or in need of protection) or another key professional for the child. This procedure will make note of these practitioners as Referrers.

The Referrer must contact the FGC Team. Contact details are outlined in Appendix 2, LSCB Procedures. Once it is agreed to pursue a FGC, the FGC Coordinator will allocate and arrange to meet with the referrer to complete the referral form and clarify:

Whether the family has a basic understanding of what an FGC is and agree that such a meeting might be helpful in sorting out the problems/difficulties they are experiencing;
Who might be the family/ friends participating in the meeting;
Which agencies are involved with the family and which staff may also participate in the process;
Discuss and clarify the different roles of the Facilitator and the Referrer (see below) ;
Consider whether there are any outstanding areas which need to be completed before the FGC can be progressed;

Role of the Referrer

The role of the Referrer should include the following:

Work together with other professionals to identify issues of concern;
Produce clear information for the FGC, which frames questions or issues for the family to address;
Liaise with the FGC Facilitator throughout the process;
Check out and negotiate resource-availability and funding for any family plan which potentially may emerge from the FGC.

Role of Professionals from other agencies

The role of any professional involved in the FGC process is to provide the essential information to the family that they will need in order to make good decisions for their children.

Consent will need to be gained from those with parental responsibility with regards to the sharing of the information with the wider family.

Concerns regarding sensitive information can be discussed with the Facilitator.

Referral Pathway

The parents and those with parental responsibility must have seen the referral and subsequent information provided by the Referrer so that they can comment on it, and agree to its contents being shared with everyone who will be invited to the FGC before the Facilitator can progress their work. The Facilitator will take responsibility for checking this out at the outset and informaing the referrer of whether family have agreed to progress.

In addition to the Referrer's report, professionals working with the family may well have important information to share. The Facilitator will liaise with professionals from all agencies to discuss and agree the process for providing information to the FGC in each individual case.

Preparation

Having received the referral the Facilitator will contact the referrer and then do the following:

Establish contact with the family;
Establish whom the family want at the meeting;
Meet the young person, if age appropriate, and establish their wishes and encourage and support their involvement in the process; Check whether an independent advocate will be involved.
Ensure information from all agencies working with the family has been fully considered and that workers who may be attending are fully briefed on the process and how the key information that they hold will be shared with the FGC;
Establish a date for the meeting and check that all parties can attend on that date;
Liaise frequently with the Referrer to report on progress;
Make contact with all relevant family members, immediate and extended, to discuss with them the content of the Referrer's report and to ensure that they are alerted to any concerns about the child's welfare;
Send out invitations confirming the date, time and venue of the meeting, to family and professionals;
Arrange for resources to be available to cover out of pocket expenses, e.g. travel expenses, for those attending the meeting.

The Meeting

Part 1: Information sharing

This is the part of the meeting where the professionals provide the family with all the information that they need to make the Family Plan as well as advising about any assistance that they are able to give. The only workers who will attend the meeting are those who have important information to share.

Part 2: Private Family Time

When the family have all the information they need, the workers leave the meeting so that the family can talk things through in private and decide on their Family Plan. The family has three basic tasks:

To agree a plan;
To agree any contingency plans where a need is identified;
To agree how to review the plan.

The Facilitator will be available to the family during the family time, in case the family needs any help or additional information. It is very important that the CSC Referrer remains at the venue for the whole of the conference and may also be appropriate for other professionals to remain at the venue.

Part 3: Sharing the Family Plan

When the family have agreed their plan it is presented to the workers. The family and workers then discuss and clarify the plan, which will be written down so that everyone is clear what has been agreed.

A guiding principle within the family group conference process is that the plan made by the family will be accepted subject to the availability of the resources needed to implement it. Family plans should not place the child at increased risk of significant harm. See section below for where children are subject to Child Protection Plans.

After the Meeting

The family may feel that it would be helpful to have a further meeting to make sure that the plan is working, if so a further date will be agreed. The Facilitator will make sure that everyone is sent a record of the meeting and a copy of the Family Plan.

FGC and Child Protection

The following section is an extract from Working Together 2006 (10.2)

"Family Group Conferences (FGCs) may be appropriate in a number of contexts where there is a plan or decision to be made. FGCs do not replace or remove the need to convene Child Protection Conferences, which should always be held when the relevant criteria are met."

Where a social worker/ Deputy Service Manager considers that a referral for an FGC might be appropriate, and a Child Protection Conference is scheduled, the social worker should hold a consultation with the FGC Coordinator, who will be able to advise on the appropriateness of the referral and the timescale for allocating a FGC Facilitator. The Referrer must also consult with the responsible Independent Reviewing Officer.

Where an FGC is agreed by a Child Protection Conference it will become part of the child protection plan. The progress and effectiveness of the family plan will then be considered and reviewed by the Core Group, and by subsequent Review Child Protection Conferences.

Core Groups and Family Group Conferences

In some cases child protection conferences will recommend that a referral for a family group conference (FGC) is considered and in these situations the FGC will become a component action of the Child Protection Plan. Where this is the case it is important that the Core Group meets prior to the FGC referral to agree the remit and boundaries of this meeting.

As noted above a guiding principle within the process is that the plan made by the family will be accepted unless it should place the child at increased risk of significant harm.

Until the child protection plan is discontinued, LSCB child protection procedures will continue to be followed. The Core Group will continue to meet regularly and have responsibility to make sure the plan agreed by the family does not place the child at increased risk of significant harm. In most cases the Core Group will be able to endorse the Family Plan but where not, the FGC Facilitator will return to the family with the issues raised by the Core Group. The family will then have opportunity to review their plan. For this reason, the Core Group should be scheduled to be held shortly after the FGC.

Where issues remain, for example where the Core Group cannot endorse the reviewed family plan or the family is unable to change their original plan, an early Child Protection Review Conference should be called.

It is essential that any plan put forward by the family has sustainability. Therefore it would not be adequate to immediately call a Review Child Protection Conference to discontinue the child protection plan. This should only be considered after sufficient time has passed to prove the plan can be maintained.

9.18 Female genital mutilation

Female genital mutilation (FGM) is a collective term which includes the partial or total removal of the external female genital organs for cultural or other non-therapeutic reasons. FGM is very harmful. It is not like male circumcision. It causes long-term mental and physical suffering, difficulty in giving birth, infertility and death. It is also extremely painful.

FGM is much more common than realised. It is estimated that there are around 74,000 women in the UK who have undergone the procedure, and about 7,000 girls under 16 who are at risk. This estimate is based on the number of women and girls living in the UK who originate from countries where FGM is traditionally practiced, such as Yemen, Oman, Malaysia, Indonesia and the United Arab Emirates as well as 26 countries in Africa from Gambia to Somalia.

There are substantial populations from these countries in the big cities like London, Liverpool, Birmingham, Sheffield and Cardiff, but FGM is not necessarily confined to these areas.

FGM is illegal in this country and, through the ‘Female Genital Mutilation Act 2003' it is illegal to take girls abroad to have this procedure done.

Any medical provision for a pregnant woman who has herself been the subject of FGM provides the opportunity for recognition of risk and preventative work with parents.

A child may be considered to be at risk if it is known that older girls in the family have been subject to the procedure. Pre-pubescent girls of 7 to 10 are the main subjects, though the practice has been reported amongst babies.

A teacher or other professional may be alerted to a child being prepared for FGM to take place abroad in a number of ways, e.g. if a family belong to a community in which FGM is practised and are making preparations for the child to take a holiday, (planning absences from school, arranging vaccinations, etc) and/or the child may refer to a special procedure about to take place.

FGM must always be regarded as causing significant harm if:

There is suspicion that a girl or young woman, under the age of 18, is at risk of undergoing this procedure;
It is believed that a girl or young woman is at risk of being sent abroad for that purpose;
There are indications that a girl or young woman has suffered mutilation or circumcision.

Where a professional or agency believes a child is likely to suffer or has suffered FGM a child protection referral must be made to Children's Social Care. A Strategy Meeting is to be held within 24 hours to agree a course of action. In addition to normal attendance at the Strategy Meeting a professional with specific expertise should be invited and consideration should be given to inviting a legal adviser.

In planning any intervention it is important to consider the significance of cultural factors. Any intervention is more likely to be successful if it involves workers from, or with a detailed knowledge of the community concerned. FGM is a one-off event of physical abuse (albeit one that may have grave permanent sexual, physical, and emotional consequences), not an act of repeated abuse and organisational responses need to recognise this.

Under the Children Act 1989, possible legal proceedings could include a Prohibited Steps Order (s.8) with or without a Supervision Order (s.35), or use of the Inherent Jurisdiction of the High Court. Removal from home should be considered only as a last resort.

If the child has already suffered FGM the meeting will need to consider carefully whether to continue enquiries or whether to assess the need for support services. The meeting should consider any other children in the family or household who may be at risk of FGM in the future.

A second Strategy Meeting should take place within 10 working days of the referral, with the same Chair. This meeting must evaluate the information collected in the enquiry and recommend whether a Child Protection Conference is necessary.

A girl who has already been genitally mutilated should not normally be subject to a Child Protection Conference unless additional protection concerns exist. She should be offered counselling and medical help. Consideration must be given to any other female siblings at risk.

A girl believed to be in danger of genital mutilation may be made subject to a Child Protection Plan with the primary category of physical abuse. The Child Protection Plan should reflect an approach of awareness raising, education, support and persuasion.

For further guidance see Local Authority Social Services Letter LASSL (2004)4 available on www.dfes.gov.uk and contact the Foundation for Women's Health, Research & Development, 6th Floor, 50 Eastbourne Terrace, London W2 6LX, Tel. 0207 725 2606 or The African Well Woman Clinic at Central Middlesex Hospital, Acton Lane, Park Royal, NW10 7NS.

9.19 Fire setting

Fire play and fire setting behaviour by a child must always be taken seriously, because it can put a child at risk of significant harm:

There is a very real risk of possible death and injury; and
When a child sets fires, it may indicate that they are at risk of, or experiencing, serious mental or emotional harm

Consideration should be given to undertaking a common assessment and / or making a referral to Children's Social Care and the police.

Several factors may lead to fire setting:

Curiosity;
A cry for help;
Lack of parental control;
Serious emotional disturbance, which may be related to abuse and neglect.

Whilst all groups of children may become involved in fire setting, boys, children in one-parent families, and looked after children are overrepresented.

Issues for consideration in an assessment include the child's development needs, stressful environment factors, the degree of guidance and boundaries the child is receiving or is willing to accept, basic care and ensuring safety (e.g. where a young child can access matches and lighters).

All professionals should discuss their concerns with their line manager and their agency's nominated safeguarding children adviser.

The North Yorkshire Fire and Rescue Service is available by referral from the family or professionals to work with children. The scheme takes an educational approach with children and their parents, and can help identify the cause of the behaviour. It works across the spectrum from curiosity fire play in young children to arson in older children.

9.20 Forced marriage of a child

What Forced Marriage Means

In forced marriage, one or both spouses do not consent to the marriage and some element of duress is involved. Duress includes both physical and emotional pressure.

There is a distinction between a forced marriage and an arranged marriage. The tradition of arranged marriages has operated successfully within many communities and many countries for a very long time. In arranged marriages, the families of both spouses take a leading role in arranging the marriage but the choice of whether or not to accept the arrangement remains with the young people.

Confidentiality in the Context of Forced Marriage

Confidentiality is an extremely important issue for any child/young person threatened with, or already in, a forced marriage.

Very careful consideration must be given in relation to who is to be given what information, which must be on a ‘need to know' basis only. This applies to practitioners as well as members of the family or the community. Any disclosure, which could lead to the child/young person being traced, could put her or him at considerable risk of harm, including death from family or others.

Approaches must not be made to the child/young person's family, friends or those with influence within the community, without the express consent of the child/young person.

Information is not to be shared with anyone, without the express consent of the child/young person, unless it is necessary to do so in order to protect her or him. The best interests of the child/young person must be the paramount consideration.

In order to trace the whereabouts of a child/young person, sometimes families use organised networks, which can include family and community members, bounty hunters, taxi drivers, shop keepers and people who have access to records such as staff from Benefits Offices, GP Surgeries and Housing Departments. Information on case files and database files should be kept strictly confidential and preferably restricted to named members of staff only, in all involved agencies. All professionals and particularly those in Children's Social Care, should very carefully consider, in these special circumstances, what information is placed on accessible computer systems, own agency records, and reports to, and records of, inter-agency discussions/meetings.

Social Workers and other practitioners may be placed under pressure from relatives, councillors, MPs and those with influence within the community to say where a young person is. Under no circumstances is this information to be divulged.

Referral to Children's Social Care or Police

Information about a possible or actual forced marriage may come from the child/young person concerned or a friend or relative. It may also become apparent in relation to other family issues, such as domestic violence, self-harm, teenage pregnancy, child abuse or neglect, family conflict or when a child/young person has gone missing.

Any practitioner from any agency who has reason to believe that a child/young person may be at risk of forced marriage, or has been subject to forced marriage, whether or not the child/young person is thought currently to be in this country, must immediately refer to Children's Social Care or the Police.

Where the Police are the first to be informed, they are to refer to Children's Social Care without delay.

Children's Social Care Response

Social Workers and their managers, dealing with cases of possible forced marriage, are expected to be familiar with, and work to, the comprehensive guidance set out in ‘Young People and Vulnerable Adults Facing Forced Marriage: Practice Guidance for Social Workers ‘ DfES, Foreign & Commonwealth Office, ADSS, DOH 2004.

Forced marriage places children and young people at considerable risk of rape and possible physical harm, including murder. Due to the complex and sensitive issues involved in relation to forced marriage, such referrals are to be brought to the attention of the Children's Social Care Child Protection Manager (or equivalent) without delay

If the first contact to Children's Social Care is by the child/young person, or a friend on their behalf, every effort is to be made to obtain as much information as possible at that point, as there may not be another opportunity.

If the child/young person attends Children's Social Care, s/he is to:

Be seen immediately in a secure and private place.
Be seen alone, even if they attend the office with others.
Have all the options explained to them and have their wishes recognised and respected.
Be reassured of confidentiality by Children's Social Care.
Be considered for immediate protection and placement away from home.

Wherever possible the following should be obtained:

Details of the person making the report and their relationship with the young person
Details of the young person concerned, including:
- Nationality
- Date and place of birth
- Passport details
- School details
- Employment details
- Name and address of parents;
Full details of the allegation;
Friends and family members who the young person can trust:;
Any background information such as schools attended, involvement by Police, Doctors or other health services;
Recent photograph or other identifying documents;
Whether there is a family history of forced marriage and abuse and whether any other family member is at risk of forced marriage;
Whether the young person is pregnant or has a secret boyfriend/girlfriend, is already secretly married or is self-harming.

Additional factors in all cases are:

Information should be kept strictly confidential and be restricted to named members of staff only.
Where possible, the young person should have the choice of gender and race of the Social Worker who deals with their case.
The young person should be:
- involved in discussion, together with the Police and other relevant professionals
- given personal safety advice (which is detailed within the national guidance)
- informed of their right to seek legal advice and representation
- given contact details for their Social Worker/Manager.
There should be liaison with the Children's Social Care legal representatives.
Any injuries should be documented and a medical examination undertaken where appropriate.
A code word should be established to ensure that the Social Worker is speaking to the right person.

The national guidance stresses that the following must not happen:

The matter being treated as a domestic issue, with the young person being sent back to the family home;
Ignoring what has been said or dismissing the need for immediate protection.
Approaching the young person's family, friends or those with influence within the community, unless there is the express consent of the young person;
Contacting the family in advance of any enquiries, either by telephone or letter;
Sharing information outside child protection processes without the express consent of the young person;
Breaching confidentiality except where this is to ensure the young person's safety;
Placing the child/young person with extended family;
An attempt at mediation or reconciliation (which can be extremely dangerous to the child/young person).

All referrals about possible/actual forced marriage are to initially be dealt with under child protection processes and an inter-agency Strategy Meeting/Discussion held.

Strategy Meeting Regarding Forced Marriage

A Strategy Meeting must be held within one working day. The need for immediate protection and placement away from home must be considered. If the young person is in immediate danger, then protective action must be taken, either through Police Protection or an Emergency Protection Order. Extended family are not an option for placement and it may be that placement needs to be out of the local authority area, in order to protect the child/young person. It may also be necessary to place a child in a racially unmatched foster placement to avoid the child being traced.

Decisions are to be made in relation to legal proceedings and advice sought, from the local authority Legal Adviser, as to the most appropriate legal steps to be taken.

Where the professionals involved in the Strategy Meeting/Discussion consider that the child/young person is not in immediate danger, arrangements should be made for an initial or core assessment, as per the ‘Framework for Assessment of Children and their Families' (DOH 2000) also for the child/young person to be provided with information on rights, choices and support services in relation to forced marriage.

Parents should be informed of actions, unless to do so would place the young person at risk. If protective action has been taken, parents are not to be informed of a young person's whereabouts.

Where the child/young person concerned is not in the United Kingdom, the professionals at the Strategy Meeting/Discussion are to make arrangements for as much information as possible to be discretely gathered and for the Community Liaison Unit at the Foreign and Commonwealth Office to be contacted.

Further Planning

Wherever there is protective action, or a core assessment, there is to be a multi-agency professional meeting to plan the future for the child/young person. This should be held at the earliest opportunity. The child/young person is to be fully involved in the planning.

Parents should be informed of actions, unless to do so would place the young person at risk.

Medical Examination

If it is necessary to arrange a medical examination for emotional or physical illness or to give attention to injuries, this should be undertaken in accordance with local child protection procedures. There must however be consideration as to whether using any medical practitioner from the local ethnic community may jeopardise or threaten the security of the young person. If there is seen to be a risk, then medical assistance is to be sought through another route.

Interpreters

Where necessary, the services of an Interpreter should be sought. Careful consideration needs to be given as to the choice of the Interpreter and to the information to which s/he is to be made party. There must be consideration as to whether using an Interpreter from the local ethnic community may jeopardise or threaten the security of the young person. If there is seen to be a risk, then interpreting services should be sought elsewhere.

Further advice

Young people and vulnerable adults facing forced marriage: practical guidance for social workers and for education staff (July 2009). Click here for guidance thats offers step by step advice for frontline workers »

9.21 Foreign exchange visits

Children on foreign exchange visits and in some language schools stay with families selected by the school (or hosting organisation) in the host country and are vulnerable for reasons comparable to others living away from home. If there are lapses in the care provided for them, the child can suffer to such a degree that it constitutes significant harm.

Recognition of abuse and neglect

Children may be at additional risk as the assessment and supervision that would apply if the child was privately fostered are not applicable because most exchanges last less than 28 days. It is unlikely the school (or hosting organisation) selecting the host family will have been able to conduct a thorough assessment of the suitability of the host family.

Advice and assistance can be given by the Children's Social Care to schools wishing to conduct more thorough assessments, for example the host family could be asked to give consent for checks of the local children and family social care service database, and also for checks with other local agencies (for example with GPs).

In the event that a pupil's host family has been the subject of s47 enquiries, unless or until there is a satisfactory resolution of concerns, the family should be regarded by the UK school as unsuitable to receive or continue hosting a pupil from an overseas school.

UK schools and agencies should take reasonable steps to ensure that a comparable approach is taken by relevant schools abroad.

9.22 Foster care

When a child is being placed with foster carers, prior to placement (or as soon as possible) foster carers should be provided with full information about the foster child and his/her family, including details of abuse or possible abuse, in order to allow them to make informed decisions about the appropriateness of the placement.

Social Workers are required to see children in foster care on their own (taking appropriate account of the child's wishes and feelings).

Managing Allegations Against Staff (Section 10, LSCB Procedures) outlines the process to be followed where there are allegations of harm to a child by foster carers or other members of their household.

Where there are concerns about significant harm to a foster child, Section 47 Enquiries must consider the safety of any other children living in the household, including the foster carers' own children.

9.23: Harbourers of Missing Children and Young People

Certain individuals allow young people to stay at their homes without informing the parent or carer of the young person. They either directly or indirectly encourage them to go missing and to stay away from their carers. This can lead to an increase in the number of individuals who are reported as missing.

Some of these individuals actually target these young people for the purpose of grooming or involving them in prostitution. Serious offences are usually difficult to prove due to the lack of co-operation of the young person.

These procedures aim to identify, warn and where necessary prosecute these individuals for harbouring or abduction in order to disrupt this activity.

Discretion - Advice or Warning

If the harbourer has no malicious intent, officers should seek the co-operation of the harbourer wherever possible. Officers should use their discretion to decide whether advice or a formal warning will be more effective in changing the behaviour of the harbourer.
Officers must also use their discretion as to the number of warnings that should be issued.

If the harbourer is suspected of sexual exploitation or other abuse, consideration should be given to securing sufficient evidence to prosecute at the earliest opportunity.
However if the harbourer has no malicious intent, the primary aim is to ensure the warnings are effective so that a prosecution is not necessary.

Investigation Procedure

Gain access to the premises.
Remove the child/ young person to a place of safety.
Secure and preserve evidence.
Ascertain whether the suspect has been previously warned for harbouring in respect of this child/ young person.
Consider issuing a standard/ final warning.
If previously issued a final warning, then consider arrest/ interview and prosecution of the suspect.

Gaining access to Premises- S17(1)(e) Police and Criminal Evidence Act 1984

A constable may enter and search any premises to save life or limb or prevent serious damage to property.

Emergency Protection Order

The Emergency Protection Order may authorise the applicant to enter specified premises to search for the child. The Court may also issue a warrant authorising a Constable to assist the applicant mentioned above and use reasonable force if necessary.

Recovery Order

Where the child is subject to a care order, an emergency protection order or is in police protection, a Recovery Order can be sought if entry is refused.

Remove the Child/ Young Person

If a child/ young person is located at the home of a suspected harbourer then:

A constable should remove the child and any other children at risk to a place of safety if the constable has reasonable cause to believe that the child/ children would otherwise be likely to suffer significant harm.
Consider contacting the Police Protecting Vulnerable Person's Unit and arranging medical examinations and video interviews.
There is an implied power to use reasonable force to take a child/ young person into Police Protection.

On the first occasion that a child is located in the company of a person not connected with the child, the officer must use their judgement to decide if the circumstances indicate that the individual is inducing, assisting or inciting the child to runaway or stay away from their carer. Officers should use their discretion as to whether or not a formal warning is appropriate.

Secure and Preserve Evidence

Obtain as much evidence from the scene as possible:

Record any admissions made by the child or defendant.
Record any hearsay evidence from other witnesses or children present.
Look for objective indications of a sexual element to the relationship between the child and defendant:
Videos or magazines with sexual content that are clearly visible.
Inappropriate photographs taken of the child.
Inappropriate photographs taken of the defendant that the child has access to.
Computers turned on connected to inappropriate chat rooms.
Signs that the child and defendant were both sleeping in the same room/ bed.
Condoms or sex toys visible in the room.
Over familiar contact between the child and defendant.
Inappropriate text messages sent between the child and defendant.
The child or defendant being inappropriately dressed in each others company.
Excessive gifts being bought by the defendant for the child.
The child and defendant having pet names for each other.

Seize any evidence immediately under S19 Police and Criminal Evidence Act 1984 whether or not you make an arrest.

Ascertain whether the suspect has been previously warned for harbouring in respect of this child/ young person.

Standard Warning

The Standard Warning is only appropriate where it is believed the suspect has no malicious intent. If the suspect is suspected of grooming or sexually exploiting the child/ young person then officers should go straight to the Final Warning or in serious cases arrest.

Officers should use their discretion as to the number of Standard Warnings that should be issued taking into account the stated aims of this investigation strategy.

The Officer/PCSO should:

verbally warn the suspect that:
- the carer has not given their permission for this child to stay with the suspect or be in the suspects company;
- if the child should return again they should not let them into their house;
- that the child is under 16 and/or in the care of the Local Authority; and
- if they do not co-operate then they will be liable to being prosecuted under S2 Child Abduction Act 1984 or S49 Children Act 1989;
record details of this warning;
inform the NY Police Missing Person Coordinator of the action that has been taken.

The NY Police Missing Person Coordinator should then:

liaise with Children's Social Care to discuss whether a written warning should be sent or alternatively whether it would be more advantageous to seek the co-operation of the harbourer;
if it is decided that a written warning should be sent, ensure a follow up letter is sent to the suspect on behalf of the Police confirming the Standard Warning (the letter should clearly state the age of the child, the date of birth of the child if aged 15 and that the child is in the care of the Local Authority if applicable);
retain a copy of the warning letter;
instruct the parent/ carer to tell their child that they are absolutely banned outright, with no exceptions, from visiting the address or associating with the suspect;
liaise with the Local Authority Housing Department or Housing Association to ascertain whether the harbourer is in breach of any term of their tenancy agreement and if so encourage the other agency to consider appropriate enforcement action.

Final Warning

Should the child or young person be found again in the company of the suspect or at any address that the suspect is residing or at, the officer/ PCSO should:

issue a final verbal warning;
record details of the final warning in their Pocket Notebook;
submit a Form A Intelligence report;
inform the Divisional Missing Person Coordinator of the action taken;

The Divisional Missing Person Coordinator should then;

obtain a statement from the parent/ carer that confirms;
- that they are the parent of the child;
- the name and date of birth of the child;
- that they "have absolutely banned outright, with no exceptions (name of child) from visiting any address at which (name of suspect) is residing or at and/ or from associating with (name of suspect) at any place whatsoever";
- that they "are the person with lawful control over (name of child) and can say that (name of suspect) has no lawful authority to take, remove, keep or detain (name of child) from (their) lawful control";
- that they "believe that by making this statement (they are) acting in the best interest of (name of child) and support police action";
- that they consent to the use of a photograph of (name of child) when the police issue a "Final Warning" to (name of suspect)";
obtain a photograph from the parent/ carer;
visit the suspect with the relevant Social Worker (wherever possible) to verbally warn the suspect, show the photograph and hand deliver the warning letter (Misper 3 or 3a);
request statements from all officers/ PCSOs who have issued the verbal warnings;
prepare a briefing item for operational briefings.

The purpose of the Final Warning is to prevent the defendant successfully raising the defence that s/he:

did not know the age or identity of the child/ young person; and
did not know that s/he did not have permission to allow the child/ young person to stay with them or be in their company.

Arrest/ Interview

If the defendant is again found in the company of the child/ young person

If the child is under 16:

the defendant should be arrested for an offence of abduction contrary to S2 Child Abduction Act 1984;
the defendant should be interviewed for offences contrary to S2 Child Abduction Act 1984 and S49 Children Act 1989 if the child is in care;
if there is sufficient evidence, the defendant should be charged with the most appropriate offence.

If the child is over 16 but in care:

the defendant should be invited to attend the police station for interview;
if there is sufficient evidence the defendant should be reported for summons for an offence contrary to S49 of the Children Act 1989 after interview, or if the defendant refuses to be interviewed.

Legislation

1. Section 49 Children Act 1989: Abduction of Children in Care

This offence applies to any child/ young person subject to a care order, emergency protection order or in police protection. This applies even if the child/ young person is 16 or over.

A person is guilty of an offence if, knowingly and without lawful authority or reasonable excuse, he:

takes a child to whom this section applies away from the responsible person;
keeps such a child away from the responsible person; or
induces, assists, or incites such a child to run away or stay away from the responsible person.

2. Section 2 Child Abduction Act 1984: Abduction of Child

This offence applies to any child under 16. This applies even if the child is not subject to a care order, emergency protection order or in police protection.

A person not connected with the child is guilty of an offence if, without lawful authority or reasonable excuse, he takes or detains a child under the age of 16:

so as to remove him from the lawful control of any person having lawful control of the child; or
so as to keep him out of the lawful control of any person entitled to lawful control of the child.

3. Section 46 Children Act 1989: Power to Remove to Place of Safety or Prevent Removal from Place of Safety

Where a Constable has reasonable cause to believe that a child would otherwise be likely to suffer significant harm, he may:

remove the child to suitable accommodation and keep him there; or
take such steps as are reasonable to ensure that the child's removal from any hospital, or other place, in which he is then being accommodated is prevented.

This is the primary power for the police in emergency situations.

4. Recovery Order S50 Children Act 1989: Order to Produce Child on Request and Remove Child

A Recovery Order allows a court to order the recovery of a child who has been prevented from returning to his/her lawful guardian or has run away.

A Recovery Order can be made in respect of any child/ young person subject to a care order, emergency protection order or in police protection.

A court can make a Recovery Order where it appears to the court that there is reason to believe that a child to whom this section applies:

has been unlawfully taken away or is being unlawfully kept away from the responsible person;
has run away or is staying away from the responsible person; or
is missing,

5. Risk of Sexual Harm Orders S123 Sexual Offences Act 2003: Order to Protect Child by Prohibiting Defendant doing certain specified acts

This is a civil preventative order for which the police can apply to a Magistrates' Court. It can be granted on the balance of probabilities rather than beyond reasonable doubt. The child or children to be protected must be under 16. The offender must be over 18.

An application can be made if:

there is evidence that the person has on at least two occasions engaged in sexually explicit conduct or communication with a child or children.
there is reasonable cause to believe that the order is necessary to protect a child or children from harm arising out of future such acts by him.

6. Sexual Offences Prevention Order S104 Sexual Offences Act 2003: Order to Protect Public from Serious Sexual Harm by Prohibiting Convicted Defendant from doing certain specified acts

Sexual Offences Prevention Orders are civil preventative orders. An application can be made if:

the defendant has been convicted of an offence listed in Schedule 3 or Schedule 5 of the Sexual Offences Act 2003; and
his subsequent behaviour gives rise to reasonable cause to believe that it is necessary for such an order to be made to protect the public from serious sexual harm.

7. S24 Police and Criminal Evidence Act 1984

In relation to a "non-arrestable" offence such as an offence under s49 Children Act 1989, in order to make an arrest a constable must have reasonable grounds for believing that the persons arrest is necessary to:

obtain/ verify the name of the person;
obtain/ verify the address of the person;
prevent physical injury to the suspect or any other person;
prevent loss or damage to property;
prevent an offence against public decency;
prevent unlawful obstruction of a highway;
protect child/ vulnerable person;
allow prompt and effective investigation of the offence/ conduct of the suspect;
prevent any prosecution being hindered by the disappearance of the suspect

9.24 Harming Others

The harm caused to children by the harmful and bullying behaviour of other children can be significant. This may involve single incidents or ongoing physical, sexual or emotional (including verbal) harm perpetrated by a single child or by groups / gangs of children.

In addition, children of both genders can direct physical, sexual or emotional violence towards their parents, siblings and / or partner.

Such abuse should be subject to the same safeguarding children procedures as apply in respect of children being abused by an adult. Children who harm others should be held responsible for their harmful behaviour and professionals responding to them should be alert to the fact that they are likely to pose a risk to children other than the current victim.

Children who harm others are likely to have considerable needs themselves. Evidence suggests these children may have suffered significant disruption in their lives, been exposed to violence within the family, may have witnessed or been subject to physical or sexual abuse, have problems in their educational development and may have committed other offences.

Recognition and referral of abuse

Professionals must base their decision on whether behaviour directed at another child should be categorised as harmful or not on the circumstances of each case. It will be helpful to consider the following factors:

The relative chronological and developmental age of the two children (the greater the difference, the more likely the behaviour should be defined as abusive);
Whether the alleged abuser is supported or joined by other children;
A differential in power or authority (e.g. related to race, gender, physical, emotional or intellectual vulnerability of the victim);
The actual behaviour (both physical and verbal factors must be considered);
Whether the behaviour could be described as age appropriate or involves inappropriate sexual knowledge or motivation;
The degree of physical aggression, intimidation or bribery;
The victim's experience of the behaviour and the impact it is having on their routines and lifestyle (e.g. not attending school);
Attempts to ensure secrecy;
Duration and frequency of behaviour.

All professionals should make a referral to Children's Social Care when there is a suspicion or an allegation of a child:

Having been seriously physically abused or being likely to seriously physically abuse another child or an adult;
Having been seriously emotionally abused or being likely to seriously emotionally abuse another child or an adult;
Having harmed another child or an adult.

Sexual abuse and serious physical and emotional abuse

These procedures are written with particular reference to sexually harmful behaviour, though when there are serious child protection concerns as a result of serious non-sexual violence or serious emotional abuse by a child or children, these procedures should also be followed.

Whenever a child may have harmed another, all agencies must be aware of their responsibilities to both children and multi-agency management of both cases must reflect this.

The interests of the identified victim must always be the paramount consideration.

It is possible that the child with harmful behaviours may pose a significant risk of harm to their own siblings, other children and / or adults. The child will have considerable needs themselves, and may also be or have been the victim of abuse.

Strategy meeting

When any agency makes a referral to Children's Social Care about a child who has been or is a victim of abuse, an initial strategy meeting must take place between Children's Social Care, the police and other relevant agencies to share the information and determine whether the threshold for s47 enquiries has been reached.

Child protection enquiries

Where the suspected abuser is a child, a similar strategy meeting should be convened involving the police and Children's Social Care.

When the children concerned are the responsibility of different Children's Social Care services, each local authority service must be represented at the strategy meeting which will usually be convened and chaired by the Children's Social Care for the local authority in which the victim lives.

Different social workers should be allocated for the child who is the victim and the child who has harmed, even when they remain living in the same household, to ensure both are supported through the process of the enquiry and that each child's needs are fully assessed and met.

The strategy meeting should be convened and chaired by Children's Social Care and a record made. The following individuals should be invited to the meeting:

Social worker for the child who is suspected or alleged to have harmed another child / adult;
Social worker for the child/ren alleged to have been abused;
Social workers' first line manager;
Police;
School representative/s (particularly if the concerns suggest that other children in the school setting have been or may be at risk of being abused);
School nurse or other health services staff, as required;
Child and adolescent mental health services (CAMHS) representative;
Representatives of fostering or residential care, as applicable;
Consideration should also be given to inviting a local specialist voluntary agency and any other professional or agency involved with the child alleged to have caused the harm.

The meeting must plan in detail the respective roles of those involved in the enquiries and ensure the following objectives are met:

The safety of all children concerned, with particular attention needing to be paid to living and contact arrangements while concerns are being investigated;
Information relevant to the protection needs of the alleged victim is gathered;
Any criminal aspects of the abuse are investigated;
Any information relevant to abusive experiences and protection needs of the child who has harmed is gathered.

In planning the investigation, the following factors should be considered:

Age of all children and adults who may be involved (both victims and children who have harmed);
Whether the child who harmed was/is supported by other children;
Seriousness of the alleged incident;
Effect on the victim/s and their own view of their safety;
The victim's parents' attitude and ability to protect their child/ren;
The abuser's parents' response to their child's behaviour;
Whether there is a suspicion that the child who is alleged to have harmed has also been abused;
Whether there is reason to suspect that adults are also involved;
The likelihood and desirability of criminal prosecutions taking place;
The level of ability of the child and any communication problems that they may have;
The mental state of the child and their capacity to be interviewed.

Where there is a suspicion that the child is both an abuser and a victim of abuse, the strategy meeting must decide the order in which any interviews will take place.

Criminal investigation

The police will decide whether an alleged offence should be subject to criminal investigation. Such allegations may not be the responsibility of the Police Protecting Vulnerable Person's Unit.

From the perspective of the criminal investigation, when a child aged ten or over is alleged to have committed an offence, the first interview with them must be undertaken by the police (i.e. it will be a recorded interview held in a police station, under caution and with parent or another appropriate adult present).

On occasion, this approach may not be in the best interests of the overall management of the investigation or of the welfare of the children involved. In these circumstances, the police may agree that it would be preferable for a Children's Social Care social worker (and other professionals as appropriate) to interview the child as a potential victim of abuse. This should only be the case where explicit police agreement has been obtained to this course of action.

Where police decide to conduct a separate ‘offender' interview, a social worker or other agency professional should be involved in the interview, to perform the statutory responsibility to the child/ren of an appropriate adult.

If during the course of being interviewed as a victim of, or witness to, alleged abuse, a child discloses offences that they have committed or been subjected to, these incidents should normally be the subject of a separate interview as detailed in Achieving Best Evidence, Section 6, LSCB Procedures.

Throughout the enquiry, the immediate protection of all child/ren involved must be ensured.

Where a decision is reached that the alleged behaviour does not constitute abuse and there is no need for further enquiry or criminal investigation, the details of the referral and the reasons for the decision must be recorded. In each case and in respect of each child involved or potentially involved, Children's Social Care will determine whether or not an initial or core assessment of need is warranted.

Outcome of enquiries

The outcome of enquiries is as described in Child Protection Enquiries (Section 6, LSCB Procedures). However, the position of the alleged victim and the alleged abuser must be considered separately.

If the information gathered in the course of the enquiries suggests that the abuser is also a victim or potential victim of abuse (including neglect), a separate child protection conference must be convened for him or her.

Where there are no grounds for a child protection conference, but concerns remain regarding the child's sexually / physically / emotionally harmful behaviour, they should be considered as a child in need. In such cases, a multi-agency planning meeting should be held and a plan for the provision of services for the child and his / her family agreed. Service provision should:

Be informed by an assessment of the child's needs and the risk they pose to others;
Set out who will have responsibility for what actions, including what course of action should be followed if the plan is not being successfully implemented; and
Include a timescale for review of progress against planned outcomes.

Family Group Conferences may have a role to play in fulfilling these tasks. For information refer to Family Group Conferences (Section 9.17, LSCB Procedures) or the practice guidance in Good Practice section of the LSCB website.

Child protection conference

In addition to carrying out the usual functions, the child protection conference must consider how to respond to the child's needs as a possible abuser.

Where the alleged abuser is not deemed to require a protection plan to protect them, consideration should be given to the need for services to address any abusive behaviour and the multi-agency responsibility to manage any risk, through the use of multi-agency planning meetings.

Criminal proceedings

The decision as to how to proceed with the criminal aspects of a case will be made by the police and the Crown Prosecution Service. The police must operate in accordance with the duty to seek to investigate and prosecute all crimes. Agencies working with young offenders should ensure that actions by staff do not undermine the need to ensure a criminal conviction if the substance of the allegation so warrants it.

Multi-agency planning meetings

Children who are victims and those who are abusers are likely to have complex needs requiring a multi-agency response. Therefore, in cases where there are no grounds for holding a child protection conference, or where one has been held but a protection plan did not result, a multi-agency meeting should be convened to plan multi-agency services for a child in need.

It is not envisaged that universal services would be able to deal with such a degree of complexity through the processes associated with the Common Assessment Framework (CAF).

These multi-agency meetings should not be confused with the borough Multi-Agency Public Protection Arrangements (MAPPA), in which arrangements are made to protect the community from known potentially dangerous offenders. However, the local co-ordinator for the MAPPA in either the police or probation service must be advised of concerns posed by young abusers, especially where the abuser has been cautioned or convicted, in which latter case the local Youth Justice Service Team will also become involved. See Section 12.1, LSCB Procedures for risk management of adult sexual and violent offenders under the MAPPA.

For each child (the victim and the child with harmful behaviours), a multiagency planning meeting should be convened by Children's Social Care to:

Share information;
Agree to undertake;
- An assessment of the needs of the victim/s;
- An assessment of the needs and risks posed by the child with harmful behaviours;
Agree to refer for a specialist assessment for either child, as required;
Set a timetable for both assessments;
Co-ordinate interim:
- Support for the victim/s;
- Risk management for the child with harmful behaviours;
Allocate agency and professional roles, including which agency will take responsibility for the interim risk management plan.

Those invited should include participants of the strategy meeting / discussion and representatives from health, including child and adolescent mental health services (CAMHS), the school and any other professionals with relevant knowledge of the child and their parent/s.

On completion of the assessments, the multi-agency meeting should be reconvened for each child to consider the outcome, and to review and coordinate the roles of relevant agencies in providing identified interventions, including a risk management plan and specialist input for children with special needs.

It should be clear which agency is responsible for the risk management plan for a child with harmful behaviours. The plan should always address the risk to other children wherever the child spends time, including at school and within or near to the home address or placement whenever a child is looked after by a local authority. A plan must be in place to minimise risk of future offending.

Both the risk management plan and support for a child who is the victim should be reviewed at regular multi-agency meetings. The Chair of the multiagency meeting should decide the frequency of the review meetings according to each child's needs / risk. At the point of closure, the review must consider the possible need for long term monitoring and the availability of advice and other services.

Children moving into or re-entering a local authority area

Children with inappropriate sexual or very violent behaviour who are re-entering the community following a custodial sentence or time in secure accommodation, or who move into an area from another local authority, require the multi-agency response (assessment / intervention) described above. The response should be initiated at the earliest opportunity.

Where a child who has been convicted of sexual offences involving the abuse of other children is released into the community, the Multi-Agency Public Protection Arrangements (MAPPA) must be invoked to ensure the safety of the community, in line with Section 12, LSCB Procedures.

Carrying of offensive weapons and gangs

Offensive weapons are defined in the Prevention of Crime Act 1953 as ‘any article made or adapted for causing injury to the person; or intended by the person having it with him for such use by him'. S139 and s139A of the Criminal Justice Act 1988 refer to ‘any article which has a blade or point or is sharply pointed'. The only exceptions are small folding pocket knives where the blade is less than 3 inches long. But this exception does not of course prevent schools from imposing their own bans on pupils carrying such weapons. There are three categories of offensive weapons:

‘Made' could include a dagger or gun;
‘Adapted' could include a broken bottle; and
‘Intended' for such use could include a rock or stone.

Clearly many articles are capable of being an offensive weapon, but in the latter category there would need to be evidence of an intention to use that particular article as a weapon.

Behavioural problems by a group of young people can impact upon a neighbourhood but does not necessarily mean that they are a gang. It is common practice for groups of young people to gather together in public places to socialise. Groups of young people can be disorderly and / or antisocial but not engage in criminal activity.

There are specific organised gangs who engage in criminal activity. Problems between gangs can be further enhanced by the use of ‘gangs' websites where they publicise themselves.

Children who carry offensive weapons and / or are members of specific gangs (who engage in criminal activities) could place themselves and others at risk of significant harm. Preventative work in relation to offensive weapons and gangs should be a key part of each LSCB's strategy, establishing safer environment by engaging with young people, challenging unacceptable behaviour, and helping young people develop respect for themselves and their community. Police, schools, Youth Offending Teams and other appropriate local agencies should mutually establish and develop strong partnerships and policies.

In 2007, the Department for Education and Skills (DfES) provided new guidance to schools on screening for offensive weapons, following the enactment of s45 of the Violent Crime Reduction Act 2006. See www.teachernet.gov.uk

Children moving into or re-entering a local authority area

9.25 Historical abuse

Historical Abuse Allegations from an Adult

This procedure links to Complex Abuse (LSCB Procedures, Section 12.3)

When an adult makes a disclosure to a professional that s/he suffered abuse as a child, the professional to whom the disclosure is made should:

Clarify whether there are any child/ren who may currently be at risk from the alleged perpetrator;
Ascertain whether the adult is aware of the alleged perpetrator's recent or current whereabouts and any contact the alleged perpetrator may have with children;
Advise the adult to make a formal complaint to the police, explaining that there is a significant likelihood that a person who has previously abused a child will have continued and may still be doing so;
Offer the adult support in making a formal complaint to the police;
Provide information about relevant services.

Where it is believed that the alleged perpetrator has contact with a child a referral should be made to Children's Social Care so that information can be gathered and a decision can be made whether to apply child protection procedures in respect of the child/ren with whom the alleged perpetrator has contact.

Where an adult making a disclosure chooses not to make a formal complaint to the police, the adult should be advised of the possible to risk to children. The adult should be advised that the information will be shared and a referral made to Children's Social Care. If the adult wishes for his/her identity to remain anonymous this must be respected, however, they should also be asked if they would be willing to talk with a representative of Children's Social Care to enable them to seek to safeguard any other child who may be at risk.

Where the professional remains concerned about issues in relation of consent and confidentiality s/he should liaise with his/her Manager or Named Person for Child Protection.

Historical Abuse Allegations from a Child/Young Person

Any historical abuse allegation from a child/young person is to be treated as if it is recent in terms of appropriate response to the child and their needs.

In relation to the alleged perpetrator and other children who may be at risk, the same principles as above apply.

9.26 Honour based violence

Honour based violence

Honour based violence is the term used to describe murders in the name of so-called honour, sometimes called ‘honour killings'. These are murders in which predominantly women are killed for perceived immoral behaviour, which is deemed to have breached the honour code of a family or community, causing shame.

Professionals should respond in a similar way to cases of honour violence as with domestic violence and forced marriage (i.e. in facilitating disclosure, developing individual safety plans, ensuring the child's safety by according them confidentiality in relation to the rest of the family, completing individual risk assessments etc). See Domestic Abuse (LSCB Procedures, Section 9.14) and also practice guidance available of the LSCB website – www.safeguardingchildren.co.uk.

Honour based violence cuts across all cultures and communities, and cases encountered in the UK have involved families from Turkish, Kurdish, Afghani, South Asian, African, Middle Eastern, South and Eastern European communities. This is not an exhaustive list.

The perceived immoral behaviour which could precipitate a murder include:

Inappropriate make-up or dress;
The existence of a boyfriend;
Kissing or intimacy in a public place;
Rejecting a forced marriage;
Pregnancy outside of marriage;
Being a victim of rape;
Inter-faith relationships;
Leaving a spouse or seeking divorce.

Murders in the name of ‘so-called honour' are often the culmination of a series of events over a period of time and are planned. There tends to be a degree of premeditation, family conspiracy and a belief that the victim deserved to die.

Incidents which may precede a murder include:

Physical abuse;
Emotional abuse, including:
- house arrest and excessive restrictions;
- denial of access to the telephone, internet, passport and friends;
- threats to kill;

Pressure to go abroad. Victims are sometimes persuaded to return to their country of origin under false pretences, when in fact the intention could be to kill them.

Children sometimes truant from school to obtain relief from being policed at home by relatives. They can feel isolated from their family and social networks and become depressed, which can on some occasions lead to self-harm or suicide.

Families may feel shame long after the incident that brought about dishonour occurred, and therefore the risk of harm to a child can persist. This means that the young person's new boy/girlfriend, baby (if pregnancy caused the family to feel ‘shame'), associates or siblings may be at risk of harm.

Disclosure and response

When receiving a disclosure from a child, professionals should recognise the seriousness / immediacy of the risk of harm.

For a child to report to any agency that they have fears of honour based violence in respect of themselves or a family member requires a lot of courage, and trust that the professional / agency they disclose to will respond appropriately. Specifically, under no circumstances should the agency allow the child's family or social network to find out about the disclosure, so as not to put the child at further risk of harm.

Authorities in some countries may support the practice of honour-based violence, and the child may be concerned that other agencies share this view, or that they will be returned to their family. The child may be carrying guilt about their rejection of cultural / family expectations. Furthermore, their immigration status may be dependent on their family, which could be used to dissuade them from seeking assistance.

Where a child discloses fear of honour based violence the professional response should include:

Seeing the child immediately in a secure and private place;
Seeing the child on their own;
Explaining to the child the limits of confidentiality;
Asking direct questions to gather enough information to make a referral to Children's Social Care and the police, including recording the child's wishes;
Encouraging and/or helping the child to complete a personal risk assessment
Developing an emergency safety plan with the child;
Agreeing a means of discreet future contact with the child;
Explaining that a referral to Children's Social Care and the police will be made
Record all discussions and decisions (including rationale if no decision is made to refer to Children's Social Care).

Children's Social Care should incorporate into their initial and core assessments the safety planning, self-assessment and risk assessment processes in Safeguarding Children Abused Through Domestic Violence.

Professionals should not approach the family or community leaders, share any information with them or attempt any form of mediation. In particular, members of the local community should not be used as interpreters.

All multi-agency discussions should recognise the police responsibility to initiate and undertake a criminal investigation as appropriate.

Multi-agency planning should consider the need for providing suitable safe accommodation for the child, as appropriate.

If a child is taken abroad, the Foreign and Commonwealth Office may assist in repatriating them to the UK.

9.27 Children in hospital or receiving hospital services

Children who are in hospital or receiving other hospital services should have their overall welfare safeguarded and promoted in the same manner as all other children. Hospitals should take all reasonable steps to ensure that children are cared for in secure children's wards and are provided with suitable adult supervision and care. Wherever possible, children should be consulted about where they would prefer to stay in hospital and their views should be taken into account and respected.

Child likely to be Hospital over three months

Where it is believed that a child will remain in hospital or be accommodated by a Health Trust for longer than three months, Children's Social Care are to be informed so that they can assess the child's needs and decide whether services are required under the Children Act 1989.

Child where there are concerns for child's care on discharge

No child known to Children's Social Care who is an inpatient in hospital, and about whom there are concerns over his/her safety and welfare, is to be allowed to leave hospital until it has been established by Children's Social Care that the home environment is safe, the concerns of the medical and nursing staff have been fully addressed, and there is a social work plan in place for the ongoing promotion and safeguarding of the child's welfare.

Communication by Doctors

All doctors involved in the care of a child, about whom there are concerns about possible deliberate harm, must provide Children's Social Care with a written statement of the nature and extent of their concerns. If misunderstandings of a medical diagnosis occur, these must be corrected at the earliest opportunity in writing. It is the responsibility of the doctor to ensure that his or her concerns are properly understood.

Child with Child Protection Plan who has an Unplanned Admission to Hospital

If a child, who is subject to a Child Protection Plan, has an unplanned admission to hospital, Children's Social Care should be notified without delay by the ward senior staff member.

The Social Worker should seek as much clarity as possible regarding the reasons for the unplanned hospital admission. Unless it can clearly be shown that the admission was not due to a lack of care or to inflicted harm, a Core Group meeting is to be held prior to the child's discharge. This meeting should be chaired by the Deputy Service Manager/ Service Manager.

Child who Ingests Illegal/Prescribed Substances

Where a child requires hospital treatment due to an ingested illegal/prescribed substance e.g. Methadone, an immediate referral is to be made to Children's Social Care, who in turn are to contact the Police Protecting Vulnerable Person's Unit without delay. The need for urgency of response in terms of the child's welfare, the safety of other children in the house, initial assessment of the care by the parents and the home conditions and obtaining forensic evidence is of paramount importance.

Refusal by Child of Medical Assessment/ Treatment

Any staff faced with a situation where a child/young person's life may be in danger because of his/her refusal to accept medical assessment and/or treatment, should contact Children's Social Care as a matter of urgency.

The Team Manager should, without delay, liaise with Legal Services and determine whether an application should be made to the Court for an order to obtain the medical assessment and/or treatment.

Non-medical Supervision

Where a child is in hospital and the child requires supervision on non-medical grounds, it is the responsibility of Children's Social Care to arrange that supervision.

What to do if you are worried about a child?

Information for young people

Information for families

Elearning Basic Awareness Course and Child Protection

Section 9: Safeguarding Children In Specific Circumstances (F-H)

9.16 Fabricated or induced illness

Government Guidance

Behaviours Associated with Fabricated/Induced Illness

Recognition of Fabricated/Induced Illness

Referral

Response by Children's Social Care and Strategy Meeting

Emergency Action

Responsibilities

Chronologies and ‘Possible Warning Signs of Fabricated or Induced Illness Template'

Risk from a Member of Staff

Possible Warning Signs (Based on Cumbria Public Report 2004)

9.17 Family Group Conferences

Key Points

General Principles of Operating FGCs

What is a Family Group Conference (FGC)?

The Four Part Family Group Conference Process: Referral, Preparation, the Meeting and after the Meeting.

Role of the Referrer

Role of Professionals from other agencies

Referral Pathway

Part 1: Information sharing

Part 2: Private Family Time

Part 3: Sharing the Family Plan

FGC and Child Protection

Core Groups and Family Group Conferences

9.18 Female genital mutilation

9.19 Fire setting

9.20 Forced marriage of a child

What Forced Marriage Means

Confidentiality in the Context of Forced Marriage

Referral to Children's Social Care or Police

Children's Social Care Response

Strategy Meeting Regarding Forced Marriage

Further Planning

Medical Examination

Interpreters

Further advice

9.21 Foreign exchange visits

Recognition of abuse and neglect

9.22 Foster care

9.23: Harbourers of Missing Children and Young People

Discretion - Advice or Warning

Investigation Procedure

Gaining access to Premises- S17(1)(e) Police and Criminal Evidence Act 1984

Emergency Protection Order

Recovery Order

Remove the Child/ Young Person

Secure and Preserve Evidence

Standard Warning

Final Warning

Arrest/ Interview

Legislation

1. Section 49 Children Act 1989: Abduction of Children in Care

2. Section 2 Child Abduction Act 1984: Abduction of Child

3. Section 46 Children Act 1989: Power to Remove to Place of Safety or Prevent Removal from Place of Safety

4. Recovery Order S50 Children Act 1989: Order to Produce Child on Request and Remove Child

5. Risk of Sexual Harm Orders S123 Sexual Offences Act 2003: Order to Protect Child by Prohibiting Defendant doing certain specified acts

6. Sexual Offences Prevention Order S104 Sexual Offences Act 2003: Order to Protect Public from Serious Sexual Harm by Prohibiting Convicted Defendant from doing certain specified acts

7. S24 Police and Criminal Evidence Act 1984

9.24 Harming Others

Recognition and referral of abuse

Sexual abuse and serious physical and emotional abuse

Strategy meeting

Child protection enquiries

Criminal investigation

Outcome of enquiries

Child protection conference

Criminal proceedings

Multi-agency planning meetings

Children moving into or re-entering a local authority area

Carrying of offensive weapons and gangs

Children moving into or re-entering a local authority area

9.25 Historical abuse

Historical Abuse Allegations from an Adult

Historical Abuse Allegations from a Child/Young Person

9.26 Honour based violence

Child protection and safeguarding
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