Confidential Reporting

REGULATIONS AND STANDARDS

The Quality and Purpose of Care Standard

The Leadership and Management Standard

The Protection of Children Standard

SCOPE OF THIS CHAPTER

This chapter provides a policy framework for Confidentiality

NOTE: It is important that all staff read the whole of this chapter, not just sections of it; if in doubt; staff should consult their manager before taking action.

OTHER RELEVANT CHAPTERS

Whistleblowing Procedure

AMENDMENT

This chapter was slightly amended in May 2018 in regard to digital material.



Contents

1. Principles
2. Employees Duties
3. Written Information on Children
4. Information About Employees
5. Confidential Information
  5.1 Definition
  5.2 Public Interest
  5.3 Consent
6. Casual Disclosure of Information
7. Outside of the Work Environment
8. Meetings and Information Sharing within Childhood First
  8.1 Children
  8.2 Staff
9. The Professional Network
10. Recording Decision to Share or Not to Share
11. Circulation and Duplication of Confidential Information
  11.1 E-mail and the Internet
  11.2 Information by Phone
  11.3 Children's Phone Calls
  11.4 Responsible use of Phones
  11.5 Photocopies
  11.6 Information by Post
12. The Media


1. Principles

The care and treatment model at all Childhood First homes is relationship-based. Our daily care for children involves keeping them safe, showing them warmth and love, and providing the stimulation needed for their development and helping them achieve their full potential, within a stable environment where they experience consistent guidance and boundaries. Childhood First takes seriously our commitment to support children with a network of reliable and affectionate relationships and invests in Integrated Systemic Therapy (IST), a framework of group support, supervision, training and consultation designed to provide this. Staff members are required to use these forums openly, and to respect the confidentiality of each group as defined by its membership and the hierarchy within the community. In order to maximize the effectiveness of this network for children, and create a shared understanding, all members within the network must contribute to creating a culture of where information about each of them will be treated with respect, and can be used in the best interests of the children.

The majority of children placed in Childhood First homes have, historically, suffered the experience of an abusive invasion of their right to privacy and dignity. We recognise it to be an integral aspect of our work that we are experienced, by the children's group, as adults who will treat them, and each other, with respect; who will safeguard their right to privacy; and who will prove trustworthy in our protection of information pertinent to their physical and emotional welfare.

Evidence (Bullying Today, Children's Commissioners Report) suggests that staff should be aware of the additional risks of bullying faced by children and young people in Care and in Institutional settings. Stigma and lax attention to confidentiality are associated also with victimisation of children in care.


2. Employees Duties

All employees undertake within their contract of employment to treat as private and confidential and not at any time to disclose or permit to be disclosed, information:

  1. Relating to the children and young people in the care of Childhood First except in the interests of safeguarding and promoting their welfare;
  2. Relating to the business affairs or finances of Childhood First including the development of new projects when such knowledge or details were received during the period of this Agreement and are not in the public domain;
  3. Details of supporters and donors stored on any Childhood First databases;
  4. Personal details relating to any employee which may have been shared in a dynamics group etc.

All employees undertake within their contract of employment not to casually discuss or disclose matters relating to residents and others, including colleagues, to anyone in any way which would breach our duty of trust and confidence. Such information must not be used for any purpose other than in the appropriate exercise of an employee's duties.

An exception to this applies where you make a disclosure which is eligible for protection under the Public Interest Disclosure Act 1998, as detailed in the Confidential Reporting Procedure.

Upon termination of employment, all employees are contractually obliged to immediately deliver to Childhood First all correspondence, documents, papers and copies and digital information thereof or other material and property belonging to Childhood First which may be in their possession or under their control.


3. Written Information on Children

Also see the following chapters:

It is our joint responsibility to ensure the protection of written information pertaining to each child. Filing cabinets must be kept locked; files must never be removed from the premises and reports must not be removed from files.

All personal information recorded and retained about any child who receives a service from Childhood First or any adult who works for Childhood First will, in accordance with the Data Protection Act 1998, be:

  • Fairly and lawfully processed;
  • Processed for limited purposes;
  • Adequate, relevant and not excessive;
  • Accurate and up to date;
  • Not kept longer than necessary;
  • Processed in accordance with the individuals rights;
  • Secure;
  • Not be transferred to countries without adequate protection.

In addition any use or transfer of information, whether within or from Childhood First, which might identify a child, will comply with the Caldicott Principles.

Where removal of files is required by law, a request must be made in writing to the Director/Registered Manager. A personal undertaking in writing will be required, that any information contained in the file will only be used for the purpose specified within the written request. The consent of the child and those holding "parental responsibility" for the child will normally be required. Any such requests will normally go through the child's Social Worker in the first instance. On leaving Childhood First young people's files will be rationalised with reports, documents, logs, correspondence and data retained, shredded or forwarded on as appropriate and in accordance with the Data Protection Act 1998.

The Case Recording Policy and Staff Guidance, Records must usually be retained after closure details how long written information on children should be stored for. Most records should be kept in the home for the period the child is placed and for three months afterwards. After this they should be centrally archived. In implementing central archiving records are scanned and stored on the central server, and then paper records are destroyed.


4. Information About Employees

Also see: Case Recording Policy and Staff Guidance.

Childhood First holds personal data about all employees. In employment contracts, employees consent to data being used as set out. If this information changes, employees should let appropriate record keepers in their workplace know so that records can be updated. All personal information, records and data retained on any member of Childhood First will be kept secure, with access only for those staff with legitimate business, permission or responsibility for such information.

Under the regulations of the Data Protection Act 1998, employees may request to view information held on their personnel files, including references from former employers. These may be disclosed with the consent of the writer or the organisation. Accessing another employee's records without authority will be treated as gross misconduct and is a criminal offence under the Data Protection Act 1998, section 55.

Retention of records: Childhood First follows the retention periods recommended by the Information Commissioner in the Employment Practices Data Protection Code. However, on the instructions of our Insurers, some personal data, particularly in relation to the recruitment and vetting process, will be retained indefinitely.

If Childhood First sells all or part of its business it may provide personal data about employees to any prospective purchaser but will only do so in accordance within the terms of the Transfer of Undertakings (Protection of Employment) Regulations 1981.


5. Confidential Information

All staff have access to personal information relating to children placed at Childhood First. Children have the right to have their personal life kept as private as possible. Within the community it will be necessary to share information across the various staff groups according to the Childhood First treatment methodology, to ensure children are safeguarded and their welfare promoted. It will also be necessary to share information with those who are corporate parents alongside us in the spirit of this arrangement. All information must be managed sensitively, giving paramount consideration to the welfare and safeguarding needs of the child. No member of staff can assure confidentiality regarding information disclosed to them by children and colleagues. There are circumstances in which it is incumbent upon a staff member to pass information on in the interests of protecting children, for example:

  • Where professionals are undertaking a Child Protection Enquiry or Complaints investigation in relation to a child;
  • Where the Police are investigating a criminal offence or require information to help them find an absent or missing child;
  • Where information is requested in the furtherance of an inquiry or tribunal, or for the purposes of a Serious Case Review;
  • Where the information is required by colleagues engaged in caring for the child or the information may reduce or prevent harm to the child at some time in the predictable future.

Information may also be disclosed to persons who have a statutory right of access to the information; for example:

  • Where the Court directs that records be produced or a Children's Guardian is appointed;
  • Where information is requested by Inspectors of the Regulatory Authority e.g. Ofsted or CSSIW (who have specific statutory powers that permit access to records);
  • Many children who come to us will have had boundaries broken and will consequently be sensitive to the feeling of being public property, or perhaps too open in relation to others. Judgements about enabling children to appropriately share personal information and to recognise what is private are fine ones, and need to be discussed with colleagues, seniors and consultants. Children will be helped in their relationships with each other to respect each other's privacy without unhelpfully colluding in holding secrets or dangerous information. Staff must take care as to how personal information relating to one child is divulged to other children.

5.1 Definition

In our communities it is understood from the beginning by children and adults that information to do with relating to others is to be shared with others. This is the essence of a relationship based group treatment and therefore is not confidential. However some of the information is of course sensitive and must be treated sensitively and not shared with those outside the community or the child's network.

The relationship between staff and children includes both a formal confidential relationship (like for instance between a doctor and patient or social worker and client) and an informal relationship where a whole range of information is told and only some of it is to be treated confidentially. There is a duty on staff to treat case files confidentially.

Confidence is only breached where the sharing of confidential information is not authorised by the person who provided it or to whom it relates. If the information was provided on the understanding that it would be shared with a limited range of people or for limited purposes, then sharing in accordance with that understanding will not be a breach of confidence. Similarly, there will not be breach of confidence where there is explicit consent to the sharing. Even where sharing of confidential information is not authorised, you may lawfully share it if this can be justified in the public interest. Therefore, where there is a concern about a child or young person, refusal of consent should not necessarily be regarded as precluding the sharing of confidential information. Seeking consent should be the first option, if appropriate.

5.2 Public Interest

A public interest can arise in a wide range of circumstances, for example: to protect children or other people from harm, to promote the welfare of children or to prevent crime and disorder. There are also public interests, which in some circumstances may weigh against sharing, including the public interest in maintaining public confidence in the confidentiality of certain services. The key factor in deciding whether or not to share confidential information is proportionality, i.e. whether the proposed sharing is a proportionate response to the need to protect the public interest in question. In making the decision you must weigh up what might happen if the information is shared against what might happen if it is not, and make a decision based on a reasonable judgment.

Staff must make a judgement on the facts of the individual case. However, sharing confidential information will normally be justified in the public interest where there is evidence that the child is suffering or is at risk of suffering significant harm (most if not all of our children) or where there is reasonable cause to believe a child may be suffering or at risk of suffering significant harm and to prevent significant harm to children or serious harm to adults.

5.3 Consent

"Consent issues can be complex, and lack of clarity about them can sometimes lead practitioners to incorrect assumptions that no information can be shared." Consent must be informed. This means that the person giving consent needs to understand why information needs to be shared, who will see their information, the purpose to which it will be put and the implications of sharing that information. Consent can be explicit - expressed in writing or orally. This is often preferable as it reduces scope for subsequent dispute. Implicit consent can also be valid in many circumstances. Consent can legitimately be implied if the context is such that information sharing is intrinsic to the activity, and especially if that has been explained at the outset. Such implicit consent would apply to particular community meetings for example.

Children need to have sufficient understanding to give consent. Children 12 and over can generally be considered to have sufficient understanding - though some we work with may not. Younger children may also have sufficient understanding. The issues must be explained to them in a way which is suitable for their age, language and likely understanding.

Useful questions to consider in assessing whether a particular child on a particular occasion has sufficient understanding to consent, or refuse consent, to sharing of information about them:

  • Can the child understand the question being asked of them?
  • Does the child have a reasonable understanding of:
    • What information might be shared?
    • The main reason or reasons for sharing the information?
    • The implications of sharing that information, and of not sharing it?
  • Can the child or young person:
    • Appreciate and consider the alternative courses of action open to them?
    • Weigh up one aspect of the situation against another?
    • Express a clear personal view on the matter, as distinct from repeating what someone else thinks they should do?
    • Be reasonably consistent in their view on the matter, or are they constantly changing their mind?

In most cases, where a child cannot consent or where you have judged that they are not competent to consent, a person with parental responsibility should be asked to consent on behalf of the child. Where parental consent is required, the consent of one such person is sufficient. In situations where family members are in conflict you will need to consider carefully whose consent should be sought. If you judge a child or young person to be competent to give consent, then their consent or refusal to consent is the one to consider even if a parent or carer disagrees.

Childhood First services proactively inform children, young people and families, when they first engage with the service about our approach to information sharing so that consent is obtained for this kind of treatment (see Admission Policy). All children who come into Childhood First services meet with the Director or Deputy Director of the service or community and are told openly and honestly about the nature of our group relationship based treatment. Similarly all staff understand through the recruitment process that they will be required to share personal information and participate in relationship based group work. Staff share all information openly and honestly with children's social workers and seek also to discuss concerns with families "where such discussion and agreement-seeking will not place a child at increased risk of significant harm or lead to interference with any potential investigation. The child's interests must be the overriding consideration in making any such decisions." (WTSC 2006 Appendix 3).

There is a duty to report any suspicion of Significant Harm involving any child to Child Protection services, to the child's own social worker and others. This includes disclosures made as part of a therapeutic intervention. However, staff may discuss their concerns with a manager, before reporting the disclosure to the Child protection agencies - unless the Director is implicated, in which case, the report should be made to an independent senior manager, the relevant social worker or directly to the Child Protection agencies (for more details, see Child Protection Referrals Procedure).

When not to seek consent

There will be some circumstances where you should not seek consent, for example, where to do so would:

  • Place a child or young person at increased risk of significant harm; or
  • Place an adult at risk of serious harm; or
  • Prejudice the prevention or detection of a serious crime; or
  • Lead to unjustified delay in making enquiries about allegations of significant harm.


6. Casual Disclosure of Information

The safety and welfare of children is always of paramount importance. Childhood First employees are provided with a variety of professional group forums to reflect on their work.

These cover the clinical progress of children including functioning within peer, adult and group relationships; team-working and relationships amongst staff members within the communities.

In the interests of the welfare of the children, staff members are required to ensure that children do not overhear such discussions.


7. Outside of the Work Environment

Childhood First staff are prohibited from discussing issues of care relating to children or their families outside of the professional workplace particularly in public places or at social gatherings. Gross disregard for this guidance may result in disciplinary action.


8. Meetings and Information Sharing within Childhood First

8.1 Children

The Childhood First treatment methodology - Integrated Systemic Therapy (IST) - consists of a complex network of meetings. These meetings are for a variety of purposes and include different sets of people. More information about them can be found in the Childhood First treatment methodology document, 'Integrated Systemic Therapy for Traumatised Children and Young People' The nature of group work is that the group is needed to process difficult and sensitive information so the boundaries using IST may be different from other work places The purpose of many meetings is to think about relationship issues; others concern the business of running the community. Some involve children and staff, others are for staff only. The general rule of thumb concerning confidentiality is that the contents of a meeting should be shared only with those who are members of the group. For example the Community Meeting involves all children and all the staff who work with children so the contents of it can be shared with any of these people even if they are not present at every meeting. Specific details may be shared with other people, for example parents or ancillary staff, at the discretion of those running the meeting and with the guiding principle of all decisions to share being information needed to promote the welfare of the child. The contents of all clinical forums are liable to be shared with Clinical Consultants and Line Managers as necessary. The hierarchical nature of IST requires that all staff and children understand that children and staff will share the contents of meetings with their key/link workers, and managers even if these people are not members of the specific group.

Part of the essence of relationship based work is to help children to understand what sort of information should be kept private and shared with those closest, and what sort of information it is useful to share. Because of their experiences children are often in a muddle about this. Due to the nature of the work the issues can also become confusing for staff, and every member of staff must share information with their line manager in order to think about how much more widely it should be shared. Adults must be very careful to ensure that sensitive information about children is conveyed to them in a planned and organised way, by the right person. It is important in working with these particular children who have been subject to unhealthy and collusive relationships that everyone understands that staff will not keep secrets and will discuss all matters relating to their work with children with their line managers and clinical supervisors. It is also our job to help children in relation to other confidential relationships e.g. doctors.

Children and families using Childhood First facilities and services will be made aware from the very beginning that group work is about sharing, and that staff will as a matter of course discuss the details of children's cases with their clinical supervisors and line managers. The IST methodology and training consists of many forums including case discussions, work discussions and group supervisions where details of children's lives are shared. These forums and other supervisions will also discuss how best to share information more widely. Such issues should also be discussed with children in community meetings, small groups and individually.

8.2 Staff

IST provides a variety of professional forums to discuss the practice of colleagues as well as the behaviour of children including opportunities provided during formal supervision. Adults are encouraged to make the most of these opportunities as part of maintaining high standards of therapeutic practice. The principles of IST are that staff are expected to 'bring themselves' to work; the tool for working psychodynamically is our way of relating and our emotional responses to each other. To be effective staff must be engaged in discussing these aspects of themselves with each other in individual and group supervisions. This is quite different from other workplaces where there is a strong differentiation between the personal self and the professional self and demands great skill trust and respect.


9. The Professional Network

Improving information sharing practice is a cornerstone of the Government's Every Child Matters strategy to improve outcomes for children, because sharing information is vital to ensure children with additional needs gain access to the services they require and also because it is essential to protect children and young people from suffering harm from abuse and to prevent them from offending. This is to prevent problems escalating and to increase the chances of a child or young person achieving positive outcomes. Research and experience show that success in helping children and young people depends upon effective partnerships sharing relevant information. It should be acknowledged that inquiry after inquiry has shown that serious harm has come to children where professionals have not shared concerns properly. It is recognised that the children Childhood First works with often have a large network of professionals who work with them inside and outside the community. In deciding when to share information outside of the community, staff members need to consider not only legal obligations but also the balance of duty of confidentiality of the child with public interest. The public interest test will almost certainly be satisfied where there is a clear risk of significant harm to a child. Such matters should always be discussed with line managers and Directors.

Key points on information sharing:

  • Explain to children how information will be shared and why and seek their agreement where possible;
  • The child's welfare and safety must always be the over-riding consideration;
  • Where possible respect the wishes of children and their families about sharing information, but if you judge there is sufficient need in the public interest to override lack of consent you may do so. This would be where maintaining confidentiality would put the child or others at increased risk of significant harm, or undermine the prevention, detection or prosecution of a serious crime;
  • When in doubt, seek advice;
  • Ensure all information shared is up-to-date, accurate and necessary for the purpose for which you are sharing it.

Sharing confidential information outside our own agency is often necessary as we work jointly with other agencies to protect and safeguard the welfare of children. To inform decision making around the sharing of confidential information outside of Childhood First, the following key questions/principles should be applied:

  1. Is there a legitimate purpose for you or Childhood First to share the information?
  2. Does the information enable a person to be identified?
  3. Is the information confidential?
  4. If the information is confidential, do you have consent to share?
  5. Is there a statutory duty or court order to share the information?
  6. If consent is refused, or there are good reasons not to seek consent to share confidential information, is there a sufficient public interest to share information?
  7. If the decision is to share, are you sharing the right information in the right way?
  8. Have you properly recorded your decision?


10. Recording Decision to Share or Not to Share

You should record your decision and the reasons for it whether or not you decide to share information. If the decision is to share, you should record what information was shared and with whom.


11. Circulation and Duplication of Confidential Information

All employees must pay particular attention to the risks of transmitting confidential information by e-mail or fax:

  • Transmit information between locations only if a secure network or comparable arrangements are in place or if, in the case of e-mail, password protection or encryption is used;
  • Consider the identity and relevance of the authority requesting such information;
  • Ensure that all copies of e-mail and fax messages received are held securely;
  • Use systems to expunge from the system e-mails received or sent;
  • Do not transfer employee data to countries outside the European Economic Area (EEA) without reference to the Chief Executive.

Care will be taken to restrict visitors to areas of the community where there can be no access to records, documents or children's case files. All case files should be locked away unless being used by staff. They should always be locked away at night.

11.1 E-mail and the Internet

Special consideration must be given to the transmission of confidential information to external sources by staff. The preferred method of sharing information is via a LAN with shared drives. Where no LAN is in operation another form of communication or password protected files must be used. Passwords must be stored safely and only communicated to colleagues as necessary in a separate communication from the document. No personal information regarding children will ever be recorded on external networks, bulletin boards or websites.

11.2 Information by Phone

Anyone requesting information regarding a child by phone must be cleared before any disclosures of the whereabouts of a child or sensitive information can be made. The following procedure must be adhered to:

  • The name of the enquirer must be recorded;
  • The name and phone number must be checked against the list of people authorised to gain access to information, and those who are not permitted to do so;
  • The caller should be called back on the number provided to check veracity;
  • Any attempt, or suspected attempt, to obtain information by a person who is not permitted to do so must be recorded, and the Director, key/ link worker and Social Worker notified. All therapeutic and administrative staff at the centre must be advised to prevent a further attempt being successful. The Director and Social Worker will decide whether anyone else should be informed (e.g. Police) and risk assessments will be updated accordingly.

11.3 Children's Phone Calls

Children have a right to make phone calls without reference to staff members. In many cases sensitive phone calls are negotiated with the key/link worker and are deemed confidential, but sometimes a child may need support to make or receive a difficult call.

11.4 Responsible use of Phones

If children are misusing phone calls in a way which endangers themselves or others (for example to summon drug dealers or pimps to the community, or to organise violent or bullying events) their calls will be supervised. Where they have their own mobile phone, this will be removed from them explaining why. All significant adults will be made aware of instances where children's mobile phones have been removed or where their phone calls are being supervised. This will be detailed in the Placement Plan. Social workers will be encouraged to call and visit the child more often than usual to compensate for the child's inability to call out as freely as usual. Regulation 44 visitors will also be made aware of this situation. Unsupervised calls will resume and mobile phones returned to the child after proper discussion with all concerned and when the Director feels that the child is in the right frame of mind to try again to manage the phone responsibly. Responsible use of phones will be a subject for discussion in community meetings so that everyone understands and can support each other in learning to use phones safely.

11.5 Photocopies

Handouts about specific children should only be used in exceptional circumstances. They must be numbered, collected and any spare copies destroyed following review meetings. In those specific cases where a child's information may be used for training purposes or as part of research being undertaken, care must be taken to mask names, circumstances, and situations that could identify the child.

11.6 Information by Post

Mail that arrives for staff (and not marked personal) may be opened in particular circumstances when that member of staff is on annual leave, long term sick or has left the community. This is to ensure that information relating to children is not delayed. Care will be taken not to open personal mail, and where this happens inadvertently, it will not be read but re-sealed.

Letters to children are deemed private to the child and children's mail will not be opened unless there are specific reasons detailed in the Placement Plan which clearly relate to the safety of that child or other children in the home. It will be important for staff to encourage children to divulge important information such as court correspondence and review dates received by post, which may be photocopied and kept on file. However this is not a requirement and the child may choose not to divulge such information. A child will be encouraged to open parcels and packages in the presence of a staff member if there are specific reasons identified which relate to the safety and protection of the child or others living at Childhood First. Such requirements will be detailed in the Risk Assessment attached to the Placement Plan.


12. The Media

Special attention must be given to any contact with the media. Under no circumstances must any staff member converse with the media on any matter relating to his/ her work with Childhood First or on any matter relating to any client or his/her family either during or beyond his/her period of employment. They are also prohibited from using identifiable examples of children's case histories in any case presentations or studies.