Latest / Inside The Consulting Room - Understanding the Child Behind the Behaviour / Safeguarding When You Are Worried

Transcript

Safeguarding When You Are Worried · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello and welcome back to this third episode in the series concerned with the safeguarding of children.
• 0:08
  SPEAKER_00: This episode is really about what to do.
• 0:12
  SPEAKER_00: What to do when you are concerned.
• 0:15
  SPEAKER_00: See, and this is what we call safeguarding in practice.
• 0:18
  SPEAKER_00: Now, what you do and what I do might be different, but they are nonetheless actions that are underpinned by the same principles.
• 0:31
  SPEAKER_00: And that is to do with making others aware of or seeking advice on the concerns that we might have.
• 0:42
  SPEAKER_00: I'm going to write a companion series for this particular one, and this is partly due to the large numbers of downloads that have occurred in a very short period of time, which strongly suggests that people are fortunately concerned about this particular topic.
• 1:01
  SPEAKER_00: And so I want to add a companion series which looks at the ways in which children are affected and the sorts of things that you might very well see as a consequence of them possibly being at risk or experiencing harm.
• 1:23
  SPEAKER_00: But in this episode, I'm really looking at what to do.
• 1:28
  SPEAKER_00: What do you do when you are concerned?
• 1:32
  SPEAKER_00: Many years ago, child abuse was called incest, and nobody talked about it, and it was something of a dirty little secret.
• 1:43
  SPEAKER_00: And in the 80s, the explosion of awareness came about, and it was no longer called incest, it was called child abuse because it incorporated the knowledge and discovery of the fact that children who were being abused weren't always being abused by parents, but by many others.
• 2:09
  SPEAKER_00: And that of course opened up a whole series of investigations into historical cases, many of which were within the context of organizations, and everybody will be aware of how the Catholic Church, for example, has come under considerable scrutiny for the allegations and in some cases proven cases where abuse took place within the church system.
• 2:41
  SPEAKER_00: And this was not a standalone case.
• 2:44
  SPEAKER_00: There are many others that were publicized, one of which I was involved in years ago, and it was called Lockdown, Locking Down.
• 2:57
  SPEAKER_00: It was to do with how a particular childcare organization was systematically abusing its residents in a variety of ways, and it was a number one of a number.
• 3:12
  SPEAKER_00: And it was, of course, shocking, and these things informed the subsequent procedures that then emerged, and we now call safeguarding.
• 3:27
  SPEAKER_00: What I'm sort of interested in is there's a sort of comparison here with the denial that was taking place systemically and organizationally, and how these cases managed to be kept under the radar at least for a while, sometimes a long while.
• 3:49
  SPEAKER_00: But there's a parallel with, I think, members of the general public.
• 3:56
  SPEAKER_00: And please understand that when I say this, I'm not saying it with any hint of criticism.
• 4:02
  SPEAKER_00: I think there are times when people know that something is wrong, they just don't know what to do, and they they become almost frozen in that concern.
• 4:12
  SPEAKER_00: They may express it privately to friends, but whether or not they take action is something else.
• 4:19
  SPEAKER_00: Years ago, the NSPCC ran a campaign called Full Stop, and I was also involved in that in a different capacity, and that was to do entirely with the safeguarding of children and child protection, and they worked tirelessly and still do in the mission of trying to protect children.
• 4:47
  SPEAKER_00: So I think alongside this, I think there should be more to inform members of the public about what the options really are in terms of expressing concerns.
• 5:01
  SPEAKER_00: Because expressing a concern does no harm.
• 5:05
  SPEAKER_00: Not expressing a concern may very well be enabling the harm that is concerning and which is taking place.
• 5:16
  SPEAKER_00: Understand this, it is not your responsibility to determine risk, it is your responsibility to communicate concern.
• 5:24
  SPEAKER_00: Other people are very well positioned to assess that and to act accordingly.
• 5:29
  SPEAKER_00: And it's understandable that people don't know what to do.
• 5:32
  SPEAKER_00: They're concerned about a whole variety of things.
• 5:35
  SPEAKER_00: And I think safeguarding becomes most difficult at the point where concern turns into responsibility.
• 5:43
  SPEAKER_00: Not when we're learning about it, not when we're discussing it in principle, but when something is noticed.
• 5:50
  SPEAKER_00: And the question then becomes, what do I do now?
• 5:54
  SPEAKER_00: Because it's at this point that uncertainty and hesitation and consequence begin to enter the picture.
• 6:03
  SPEAKER_00: In this episode, we're going to focus on practice.
• 6:08
  SPEAKER_00: What do you do in practice?
• 6:11
  SPEAKER_00: So, what safeguarding looks like when concern is no longer theoretical, and what options are available, how decisions are made, and how observations are translated into action in ways that may protect a child.
• 6:28
  SPEAKER_00: So safeguarding begins with noticing.
• 6:32
  SPEAKER_00: Noticing that something may not be as it should be.
• 6:36
  SPEAKER_00: And this doesn't require certainty, it simply requires attention.
• 6:42
  SPEAKER_00: Concern may arise from a change in behavior, a shift in mood or presentation, inconsistent or concerning accounts, patterns that just don't seem to align, and a sense that something is not right.
• 6:58
  SPEAKER_00: Now that's subjective, and that's okay.
• 7:02
  SPEAKER_00: Something is alerting us to the notion that something isn't right.
• 7:07
  SPEAKER_00: It's important to be clear, safeguarding doesn't require proof.
• 7:11
  SPEAKER_00: It begins with reasonable concern.
• 7:16
  SPEAKER_00: Sometimes when I see children in the consulting room, I might notice things like marks.
• 7:27
  SPEAKER_00: I might notice that there are marks on the child's legs, certainly more so with younger children.
• 7:34
  SPEAKER_00: Sometimes with older children, could be marks on their forearms, it could be on their knees, it could be just just somewhere that is visible.
• 7:48
  SPEAKER_00: And my immediate thought is how did that happen?
• 7:52
  SPEAKER_00: What I can't do is allow myself to make assumptions, but I ask questions.
• 7:57
  SPEAKER_00: And I might just ask simple questions and note the reaction.
• 8:02
  SPEAKER_00: And it may very well be the child says I was playing football or you know, or something else, perfectly innocent.
• 8:07
  SPEAKER_00: But if I see those marks again, I might begin to think, is there something happening here?
• 8:14
  SPEAKER_00: Most often I can tell very quickly if the mark is likely to be non-accidental.
• 8:22
  SPEAKER_00: And I see this not because of the nature of the mark, but because the way the child or young person reacts.
• 8:30
  SPEAKER_00: And it could very well be that the mark is self-inflicted.
• 8:36
  SPEAKER_00: So we're talking then about self-harm, another safeguarding concern, which may very well be attached to something else.
• 8:46
  SPEAKER_00: So in my work, I very alert to noticing risk factors.
• 8:55
  SPEAKER_00: But of course, the marks most visible are not physical.
• 9:01
  SPEAKER_00: They're ones which occur in other ways through disclosure, not disclosure of what's happened, but disclosure about maybe what is happening in a given environment.
• 9:15
  SPEAKER_00: And I have to thoughtfully put together the information that I have in order to try and establish whether or not there is a safeguarding risk alongside why why the child is there in the first place.
• 9:31
  SPEAKER_00: Now, one of the most uh common barriers at this stage, not so much for me, but for others, is the belief that I might be I might be wrong.
• 9:44
  SPEAKER_00: Well you might be, but safeguarding isn't based on certainty, it's based on responsible responses to concerns.
• 9:56
  SPEAKER_00: If we have a concern, the next step is to hold it carefully.
• 10:02
  SPEAKER_00: And what we have to be careful of, and in my work this is paramount, we have to be very careful not to ask leading questions.
• 10:12
  SPEAKER_00: I don't ask, is somebody hurting you?
• 10:15
  SPEAKER_00: I don't ask, is something bad happening?
• 10:18
  SPEAKER_00: And the reason I don't do this is for legal reasons, because in the event that a disclosure or a concern goes the distance, so to speak, it I might be required to give evidence in court.
• 10:34
  SPEAKER_00: And one of the things I can't be seen to do is to have behaved in a way towards the patient that indicates that I'm in some way leading them.
• 10:46
  SPEAKER_00: That can cause a case to collapse.
• 10:49
  SPEAKER_00: And so for those reasons, I have to gather evidential information carefully.
• 10:57
  SPEAKER_00: And sometimes that will result in a direct disclosure.
• 11:03
  SPEAKER_00: Once a direct disclosure occurs, then immediate action follows.
• 11:09
  SPEAKER_00: That direct disclosure can be something to do with what's happening in the family environment.
• 11:15
  SPEAKER_00: It could very well be something that's historical.
• 11:18
  SPEAKER_00: Particularly this becomes more meaningful if the risk is still active.
• 11:24
  SPEAKER_00: So the personal persons concerned are part of the family system or part of the young person's contact.
• 11:32
  SPEAKER_00: And I've had lots of experience of that.
• 11:36
  SPEAKER_00: But primarily for all of us, the idea here is to hold the information carefully.
• 11:44
  SPEAKER_00: Don't ask questions, just be receptive to the fact that you're seeing something about which you're concerned.
• 11:53
  SPEAKER_00: Then the task is to decide what to do.
• 11:57
  SPEAKER_00: We have to be careful not to amplify it without thought, but we do need to ensure that we are allowing it to be considered.
• 12:08
  SPEAKER_00: Now, alongside this, it's important to record what's been observed.
• 12:13
  SPEAKER_00: Recording should be factual, clear, and free from interpretation where possible.
• 12:20
  SPEAKER_00: Because interpretation may be subjective.
• 12:25
  SPEAKER_00: It needs to be dated and termed.
• 12:28
  SPEAKER_00: This is not simply administrative, it creates a reliable account that can be shared, reviewed, and built upon.
• 12:36
  SPEAKER_00: One of the reasons why this is so helpful is that those who work in safeguarding are in a position to see a pattern.
• 12:45
  SPEAKER_00: It may very well be that they have received another safeguarding concern about the same child.
• 12:54
  SPEAKER_00: So if we see additional information being contributed, this then acts in a corroborative manner and demonstrates a pattern.
• 13:04
  SPEAKER_00: Think about this.
• 13:05
  SPEAKER_00: Somebody discloses historical abuse, they go to the police, because that's likely to be their first port of call if they're over the age of 18.
• 13:18
  SPEAKER_00: One of the first things the police will do once they've taken a full and thorough forensic statement is to then look at where is the corroborative evidence.
• 13:29
  SPEAKER_00: And they will approach people who the individual knew at around that time with permission and they will conduct inquiries because what they want to present to the Crown Prosecution Service is a pattern of behaviour that is evidenced by other individuals.
• 13:51
  SPEAKER_00: So this contribution may serve a wider purpose.
• 13:57
  SPEAKER_00: Something else that's important to consider is that if a child is a victim of harm, how do we know whether or not other children may be experiencing something similar?
• 14:14
  SPEAKER_00: So the next step here is to talk to an appropriate person.
• 14:20
  SPEAKER_00: Now who is an appropriate person?
• 14:23
  SPEAKER_00: Well, every school has what's called a designated safeguarding lead or a DSL within their organization, and they are specifically responsible for dealing with exactly this kind of thing.
• 14:39
  SPEAKER_00: If you're a clinician, you will know that a line manager or clinical supervisor is another option, or a safeguarding lead within any service.
• 14:53
  SPEAKER_00: It is also possible to contact your local authority safeguarding team.
• 15:00
  SPEAKER_00: Now, whilst this can be done anonymously, it is better if you can say who you are.
• 15:09
  SPEAKER_00: But once the even if it is an anonymous referral or an anonymous inquiry, it will be locked.
• 15:18
  SPEAKER_00: You will be required to give the name of the child for obvious reasons, and at the very least, the school they attend, and of course the nature of your concern.
• 15:28
  SPEAKER_00: And bear in mind, you're reporting a concern, you're not giving a conclusion.
• 15:34
  SPEAKER_00: So the purpose of sharing this concern is not necessarily just to transfer responsibility, you're passing the responsibility on to the right people, but it's also to extend the thinking.
• 15:50
  SPEAKER_00: Because one of the central risks in safeguarding is holding concern in isolation.
• 15:56
  SPEAKER_00: So where immediate risk is present, action shouldn't be delayed.
• 16:00
  SPEAKER_00: In my language, that's a level three or level four referral requiring immediate action.
• 16:05
  SPEAKER_00: That's not your responsibility.
• 16:08
  SPEAKER_00: But this may then include children's social care and the police.
• 16:15
  SPEAKER_00: Now, if we understand the options and pathways, we come to learn that once concern is shared, the decisions are made about the next steps.
• 16:25
  SPEAKER_00: And these are guided by thresholds, but they are guided by professional judgment.
• 16:31
  SPEAKER_00: Broadly, responses may include no further action with monitoring.
• 16:36
  SPEAKER_00: Now, this is quite important because even if there is, even if it's considered that no further action is required at this time, it is recorded, and if something else is reported, then that no further action will be informed and the case will be reopened.
• 16:55
  SPEAKER_00: This is really important.
• 16:58
  SPEAKER_00: Sometimes, as I've indicated, early help is considered to be the most appropriate response because it's it it's aware of the need for support for the family, but it's been determined that risk is not at the level of significant harm.
• 17:17
  SPEAKER_00: So this may involve family support services, uh, school-based intervention, community resources.
• 17:25
  SPEAKER_00: But this is then the I mentioned in a previous episode, TAF, team around the family.
• 17:32
  SPEAKER_00: Because fundamentally, what we're trying to do is not to punish families, we're trying to identify is there something we can do to minimize the risk and help this family?
• 17:44
  SPEAKER_00: Because this is not a family who wants to harm children, and I'm not suggesting there are families who specifically want to harm children, but we have to intervene in ways that are helpful, we have to alter the courses of things, but that isn't always the best option.
• 18:04
  SPEAKER_00: Because where there's a concern that a child might be at risk of harm or experiencing neglect or abuse, then referral to children's social care is required.
• 18:14
  SPEAKER_00: And under the Children Act of 1989, this may involve what I referred to earlier as Section 17, which is a support which is a support system for a child in need, or a section seven, uh section 47 investigation where significant harm is suspected.
• 18:35
  SPEAKER_00: Now these pathways aren't always linear, they require ongoing assessment and may change over time.
• 18:42
  SPEAKER_00: But one of the most important aspects of safeguarding is the ability to connect what is observed to what is done.
• 18:50
  SPEAKER_00: This involves asking, what have I seen?
• 18:53
  SPEAKER_00: What have I heard?
• 18:54
  SPEAKER_00: What might this indicate?
• 18:56
  SPEAKER_00: What level of concern does this represent?
• 19:00
  SPEAKER_00: Who needs to know?
• 19:01
  SPEAKER_00: And your answer might be I haven't got a clue.
• 19:04
  SPEAKER_00: So I'll ask.
• 19:06
  SPEAKER_00: That's all you have to do.
• 19:08
  SPEAKER_00: And crucially, when action is proportionate to this level of concern, uh then we start to think about what then what then happens next.
• 19:21
  SPEAKER_00: That bit is is not so easy because this is where safeguarding becomes most complex.
• 19:29
  SPEAKER_00: Because action isn't often taken without full certainty.
• 19:34
  SPEAKER_00: Now, in my view, that's not good enough.
• 19:38
  SPEAKER_00: If there is sufficient reason for concern, action of some kind needs to be taken.
• 19:48
  SPEAKER_00: And I would be very sure that my colleagues who work in safeguarding would say the same thing.
• 19:56
  SPEAKER_00: However, they work under certain protocols and restrictions.
• 20:14
  SPEAKER_00: And yet they're still acting responsibly, but they're to some extent their hands are tired, tired.
• 20:24
  SPEAKER_00: But you know, we go back to those terrible outcomes where failure to act has resulted in disaster.
• 20:34
  SPEAKER_00: I would say that it's unfair to assume that the situation with services is now as it was then, because that's certainly not true.
• 20:45
  SPEAKER_00: Now, there are common barriers to actions and there are predictable points at which safeguarding can falter.
• 20:52
  SPEAKER_00: And these include the fear of being wrong, and for some people, the concern about possible consequences.
• 21:02
  SPEAKER_00: Being something of an old hand, old hand at this, that isn't something that I'm particularly concerned about, but then this is my world.
• 21:13
  SPEAKER_00: That said, I do have to think, if I receive a disclosure, and I remember some years ago, a boy telling me that his father had a gun, and his father had threatened to use the gun, and that's the highest level of concern.
• 21:36
  SPEAKER_00: And whereas there are occasions most often, I will actually say, I am aware of the following, and for that reason I have to refer to this as a safeguarding concern.
• 21:52
  SPEAKER_00: I couldn't do that in that particular case because it may place the child at further risk.
• 21:59
  SPEAKER_00: The outcome.
• 22:00
  SPEAKER_00: Some of that was that although the father's gun wasn't something which could be used as an active weapon, the fact that he was threatening to use it was regarded as serious enough to have him removed from the family home.
• 22:20
  SPEAKER_00: Sometimes people believe it's okay, someone else will act.
• 22:24
  SPEAKER_00: Well, probably no they won't.
• 22:26
  SPEAKER_00: Sometimes people are uncertain about thresholds, and sometimes people don't know what to do and feel concerned about raising a concern with an organization.
• 22:40
  SPEAKER_00: Understanding this is important because it's common and it's human, but the truth is that safeguarding depends on the ability to move beyond those concerns.
• 22:52
  SPEAKER_00: It is better to take action and report rather than take no action.
• 23:01
  SPEAKER_00: Your concerns might be completely wrong.
• 23:05
  SPEAKER_00: It could be that you've completely misinterpreted what you've heard.
• 23:10
  SPEAKER_00: It could be that you have made a number of assumptions which are entirely wrong.
• 23:18
  SPEAKER_00: It doesn't matter.
• 23:19
  SPEAKER_00: Communicate them anyway.
• 23:21
  SPEAKER_00: You can't make conclusions, but you can report your concerns.
• 23:25
  SPEAKER_00: You can say, look, I've heard this or I've seen this and I don't know what to do.
• 23:30
  SPEAKER_00: That's responsible.
• 23:32
  SPEAKER_00: That's the right thing to do.
• 23:35
  SPEAKER_00: And if you don't do that, and then you find out that something bad has happened, it's too late by that time.
• 23:44
  SPEAKER_00: And I I say this not because not to provoke guilt, but I wouldn't want anybody to be in a situation where they knew something, it didn't communicate it, and then there was an outcome which was perhaps preventable.
• 24:02
  SPEAKER_00: That's a horrible thing to have to live with.
• 24:05
  SPEAKER_00: Safeguarding isn't about certainty, it's about responsibility.
• 24:10
  SPEAKER_00: It begins with noticing, and it develops through thinking and sharing what you know.
• 24:19
  SPEAKER_00: And then it can be realized through action.
• 24:22
  SPEAKER_00: And at each stage, the question isn't, am I completely sure?
• 24:26
  SPEAKER_00: But is there enough concern here or confusion to justify taking this forward?
• 24:34
  SPEAKER_00: Because when it comes to children, waiting for certainty could mean waiting for too long.
• 24:40
  SPEAKER_00: Safeguarding asks something difficult, sorry, dear, difficult of us.
• 24:45
  SPEAKER_00: It's we have to remain attentive, we have to remain thoughtful, and when necessary to act, even in the presence of uncertainty.
• 24:54
  SPEAKER_00: And it's this capacity more than any individual procedure that protects children.
• 25:02
  SPEAKER_00: As you listen to this podcast, there are children in the UK and the rest of the world.
• 25:09
  SPEAKER_00: Right now, there are children who are experiencing harm.
• 25:13
  SPEAKER_00: That is a fact.
• 25:16
  SPEAKER_00: It may be that nobody knows.
• 25:19
  SPEAKER_00: It may be that tomorrow morning, when children go back to school Monday morning, it could be that that harm is visible or apparent.
• 25:32
  SPEAKER_00: This could be a child who is a friend of yours, a friend of your children.
• 25:37
  SPEAKER_00: This could be not necessarily your child, but this could be a child who slipped under the radar, and a child about whom the concerns haven't necessarily been realized.
• 25:53
  SPEAKER_00: Think of it then as were it your child, what would you do?
• 26:01
  SPEAKER_00: What would you want others to do?
• 26:04
  SPEAKER_00: It's a responsibility that we as grown-ups and parents have.
• 26:10
  SPEAKER_00: And helping children in this way has life-changing possibilities.
• 26:18
  SPEAKER_00: I do realize that this has been something of a tough series because I'm not pulling punches, and because I believe that over and above everything, we have to do the right thing for children because they're not equipped to do it for themselves.
• 26:40
  SPEAKER_00: Thank you for listening.
• 26:41
  SPEAKER_00: I will be offering the compassion.