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The Protection of Children Standard
The Quality and Purpose of Care Standard
This chapter provides detailed guidance on the meaning and recognising of Significant Harm (Child Abuse), it also provides guidance on caring for/treating Children/young people and young people who have been abused.
For procedures regarding the reporting of child/young person welfare concerns, see Safeguarding Children and Young People and Referring Safeguarding Concerns Procedure.
Working Together to Safeguard Children
Safeguarding and Child Protection Policy
Allegations Against Staff Procedures
This chapter was amended in July 2022 to reflect Keeping Children/young people Safe in Education Statutory Guidance, the outcome of Ofsted’s thematic report, Review of sexual abuse in schools and colleges, and the Domestic Abuse Act 2021. See Section 7, Sexual Abuse and Section 9, Bullying.
Childhood First communities at present are all mixed gender - they cater for girls and boys living together and part of the treatment is to help them relate better together including across the genders. Many of the issues which arise in daily living and therefore are part of the group treatment programme concern the differences and difficulties between boys and girls.
Most children and young people who come to Childhood First facilities have suffered abuse and their experience of adults of the same or different genders to themselves has been difficult. At Childhood First we attempt, as far as we are able, to provide the children/young people with a good mix of people looking after them. Ideally we would provide men and women in equal numbers but this is not always possible - the residential sector has had difficulties recruiting and retaining men for some time. Teams are always mixed and where possible are led by a mixed gender pairing. Communities have a mixed gender leadership pairing where possible. Our treatment document (Integrated Systemic Therapy Policy- IST) explains more about this methodology.
The Children Act 1989 introduced the concept of 'Significant Harm' as the threshold that justifies compulsory intervention in family life in the best interests of children/young people; the act places a duty on local authorities to make enquiries to decide whether they should take action to safeguard or promote the welfare of a child/young person who is suffering, or is likely to suffer Significant Harm.
Harm is defined as the ill treatment or impairment of health and development. This definition was clarified in section 120 of the Adoption and Children Act 2002 (implemented on 31 January 2005) so that it may include, "for example, impairment suffered from seeing or hearing the ill treatment of another" (for example in the case of a child/young person who witnesses domestic abuse).
Physical Abuse, Sexual Abuse, Emotional Abuse and Neglect are all categories of Significant Harm.
There are no absolute criteria on which to rely when judging what constitutes significant harm. Sometimes a single violent episode may constitute significant harm but more often it is an accumulation of significant events, both acute and longstanding, which interrupt, damage or change the child's/young person's development.
In making your judgment about whether or not the concerns you have about a child/young person and their family meet the criteria for likely or actual suffering of significant harm, it is more than likely you will have some information but not the whole picture.
Abuse or neglect is not always easy to identify.
The first indications that a child/young person is being abused may not necessarily be the presence of a severe injury. Indicators can present in numerous ways to the public and professionals alike:
Initially, the situation may not seem serious but it should be remembered that prompt help to a family in trouble may prevent minor abuse escalating into something more serious.
There are four categories of child abuse, which are assumed to be forms of 'Significant Harm':
Somebody may abuse or neglect a child/young person by inflicting harm or by failing to act to prevent harm. Children/young people may be abused in a family or in an institution or community setting; by those known to them or, more rarely, by a stranger. They maybe abused by an adult or adults or another child/young person or children/young people.
Neglect is a form of Significant Harm which involves the persistent failure to meet a child's/young person's basic physical and/or psychological needs, likely to result in the serious impairment of the child's/young person's health or development.
Neglect may occur/involve:
Warning signs include:
Physical Abuse, is a form of Significant Harm which may include hitting, shaking, throwing, poisoning, burning or scalding, drowning, suffocating or otherwise causing physical harm to a child/young person, including fabricating the symptoms of, or deliberately causing, ill health, to a child/young person.
Harm maybe caused to children/young people both by the abuse itself, and by the abuse taking place in a wider family or institutional context of conflict and aggression, including inappropriate or inexpert use of physical restraint. Physical abuse has been linked to aggressive behaviour in children/young people, emotional and behavioural problems, and educational difficulties. Violence is pervasive and the physical abuse of children/young people frequently coexists with domestic abuse. Physical Abuse may cause the following injuries:
Bruises
Symmetrically bruised eyes are rarely accidental, although they may occur where there is a fracture of the head or nose and blood seeps from the injury site to settle in the loose tissue around the eye. A single bruised eye may be the result of an accident or abuse. Careful consideration is required whenever there is an injury around the eye. It should be noted whether the lids are swollen and tender and if there is damage to the eye itself.
The following are uncommon sites for accidental bruising:
Babies or others who are not yet mobile, i.e. are developmentally unable to move on their own, should not get bruises or other injuries. If they have bruises or other injuries, these must be adequately explained before they are accepted as accidental.
Note Seemingly trivial injuries should not be ignored because abuse can and does sometimes escalate against a child/young person if it goes unchecked. They should be noted and collated in the child's/young person's records. Most falls or accidents produce one bruise on a single surface - usually on a bony protuberance. A child/young person who falls downstairs generally has only one or two bruises. Children/young people who fall usually fall forwards and therefore bruising is most often found on the front of the body. In addition, there may be marks on their hands if they have tried to break their fall. Bruising may be difficult to see on a dark skinned child/young person. Mongolian blue spots are natural pigmentation on the skin which may be mistaken for bruising. These purplish-blue skin markings are most commonly found on the backs of children/young people whose parents are darker skinned. |
Scars
Children/young people may have scars, but notice should be taken of a large number of differing age scars (especially if coupled with current bruising), unusual shaped scars (e.g. round ones from possible cigarette burns) or of large scars that are from burns or lacerations that did not receive medical treatment.
Fractures
These should be suspected if there is pain, swelling and discolouration over a bone or joint. Fractures should be suspected if the child/young person is not using a limb, especially in younger children/young people. The most common non-accidental fractures are to the long bones in the arms and legs, and to the ribs. It is very rare for a child under one year to sustain a fracture accidentally. Fractures also cause pain and it is very difficult for a parent to be unaware that a child/young person has been hurt.
Burns/Scalds
It can be very difficult to distinguish between accidental and non-accidental burns; however, burns or scalds with clear outlines are suspicious as are burns of uniform depth over a larger area.
Note
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Bites
These can leave clear impressions of the teeth. Human bites are oval or crescent shaped. If the impression of the bites is more than 3 cm across its width, they must have been caused by an adult or older child/young person with permanent teeth.
Other injuries which may be deliberately caused:
Injuries may also be caused as a result of a parent fabricating or inducing illness in a child/young person.
Childhood First believe children/young people and young people need a good experience of men and women working and relating well together. We are clear that children/young people and young people who have been damaged in the ways these children/young people have, including sexually, will have complex problems relating to adults, both adults of the gender who hurt/neglected them and adults of the opposite gender who may have been experienced as complicit or too weak to prevent the abuse/neglect. Children/young people with complex experiences may confuse sex and love, and when they feel an attachment are likely to sexualise it as this is what their experience has 'taught' them to do.
Sexual Abuse, involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child/young person is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children/young people in looking at, or in the production of, sexual images, watching sexual activities, encouraging children/young people to behave in sexually inappropriate ways, or grooming a child/young person in preparation for abuse.
Sexual abuse often takes place online, and can be in many forms including grooming, sexting (including sharing explicit photos / images) and social media. Creating or sharing explicit images of a child/young person is illegal, even if the person doing it is a child/young person. A young person is breaking the law if they:
However, if a young person is found creating or sharing images, the police can choose to record that a crime has been committed but that taking formal action is not in the public interest.
With effect from 29 June 2021, section 69 Domestic Abuse Act 2021 expanded so-called 'revenge porn' to include threats to disclose private sexual photographs and films with intent to cause distress.
Technology can be used to facilitate offline abuse. Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children/young people and young people.
Sexual abuse can have a long-term impact on emotional, social and educational development and is linked to the development of mental health issues in later life.
Most child/young person victims are sexually abused by someone they know - either a member of their family or someone well known to them or their family. It can be the most secretive and difficult type of abuse for children and young people to disclose.
Both boys and girls of all ages are abused and the abuse may carry on for many years before it comes to light.
Initially children and young people may not recognise themselves as victims of sexual abuse - a child/young person may not understand what is happening and may not even understand that it is wrong especially as the perpetrator will seek to reduce the risk of disclosure by threatening them, telling them they will not be believed or holding them responsible for their own abuse.
Abusers may be both male and female.
It is important to note that children/young people are also capable of sexually abusive behaviour.
Recognition of sexual abuse generally follows either a direct statement from the child/young person (or very occasionally from the abuser), or more often, as a result of concerns about the child's/young person's behaviour, or because of physical symptoms or signs.
Indicators that a child/young person has been sexually abused include:
Child sexual exploitation is also a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child/young person or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology. See also: Safeguarding Children and Young People from Sexual Exploitation Procedure.
Emotional Abuse is a form of Significant Harm which involves the persistent emotional maltreatment of a child/young person such as to cause severe and persistent adverse effects on the child's/young person's emotional development. It may involve conveying to children/young people that they are worthless or unloved, inadequate, or valued only insofar as they meet the needs of another person. It may include not giving the child/young person opportunities to express their views, deliberately silencing them or 'making fun' of what they say or how they communicate. It may feature age or developmentally inappropriate expectations being imposed on children/young people. These may include interactions that are beyond the child's/young person's developmental capability, as well as overprotection and limitation of exploration and learning, or preventing the child/young person participating in normal social interaction. It may involve seeing or hearing the ill-treatment of another. It may involve serious bullying (including cyberbullying),causing children/young people frequently to feel frightened or in danger, or the exploitation or corruption of children/young people. Some level of emotional abuse is involved in all types of maltreatment of a child/young person, though it may occur alone.
It is not usually indicated by a specific incident, but is observed in the interaction with the child/young person. One child/young person may be scapegoated or treated completely differently to their siblings.
Parental behaviours associated with emotional abuse
The following may identify parental behaviours which, if persistent, may be emotionally abusive. What is inappropriate will often depend on the child's/young person's developmental stage:
Behavioural signs in children/young people
Behaviour in a child/young person which may indicate emotional abuse includes:
Also see: Countering Bullying Procedures.
Severe or persistent bullying can result in Significant Harm, which is why the Children's Homes Regulations require that the registered person must ensure that procedures for dealing with allegations of bullying are in place, and staff have the skills required to intervene, protect and address bullying behaviours effectively. Bullying is defined as 'behaviour by an individual or group, usually repeated over time, which intentionally hurts another individual or group either physically or emotionally' (DfE definition). Repeated bullying usually has a significant emotional component, where the anticipation and fear of being bullied seriously affects the behaviour of the victim.
It can be inflicted on a child/young person by another child/young person or an adult. Bullying can take many forms (for instance, cyberbullying or online bullying via text messages or the internet), and is often motivated by prejudice against particular groups, for example on grounds of race, religion, gender, sexual orientation, or can be because a child/young person is adopted or has caring responsibilities. It might be motivated by actual differences between children/young people, or perceived differences.
It can take many forms, but the three main types are:
An Ofsted thematic review (Review of Sexual Abuse in Schools and Colleges (Ofsted)) identified substantial levels of sexual harassment for both girls (90%) and boys (nearly 50%) – usually in unsupervised settings. Sexual harassment and sexual violence exist on a continuum and may overlap. Where the latter occurs, there could be a criminal offence committed (see also: Section 7, Sexual Abuse and Education Procedure, Safeguarding in Schools).
Cyberbullying is bullying that takes place using technology. Whether on social media sites, through a mobile phone, or gaming sites, the effects can be devastating for the young person involved. There are ways to help prevent a child/young person from being cyberbullied and to help them cope and stop the bullying if it does happen. It is another form of bullying which can happen at all times of the day, with a potentially bigger audience. By its very nature, cyberbullying tends to involve a number of online bystanders and can quickly spiral out of control. Children and young people who bully others online do not need to be physically stronger and their methods can often be hidden and subtle.
Bullying often starts with apparently trivial events such as teasing and name calling which nevertheless rely on an abuse of power. Such abuses of power, if left unchallenged, can lead to more serious forms of abuse, such as domestic abuse, racial attacks, sexual offences and self-harm or suicide.
Bullying is a type of behaviour which needs to be defined by the impact on the child/young person being bullied rather than by the intention of the perpetrator.
The Home staff must ensure that children/young people in their care who attend the same schools, work together with educational establishments where bullying occurs between children/young people they both have responsibility for.
For procedures regarding the reporting of concerns, see: Safeguarding Children and Young People and Referring Safeguarding Concerns Procedures.
There is no 'typical' situation or environment in which child abuse may occur although many children/young people are abused by parents.
Parental responses to allegations of abuse which directly implicate them are very varied. The following do not indicate either that abuse has taken place or that no abuse has taken place, but should raise concern.
Children/young people may also be abused in an institution or community setting; by those known to them or, more rarely, by a stranger. For example, children and young people may be subject to ill treatment or abuse in the following settings:
This is generic guidance and advice for staff caring for children and young people who have been abused, it is not intended as being specific care management guidelines for individual children/young people. If children/young people have been abused or mistreated to the extent they require specific treatments or counselling, this should be addressed in their Placement Plans, agreed by the Placing Authority/Social Worker.
In the absence of such a plan, the following may be useful as general guidelines.
Children/young people who have suffered sexual abuse are survivors; not only have they experienced family, society, adult/child relationships being breached, but every taboo this society holds as a basic right to be safe.
Survivors should not be treated as 'victims of sexual abuse' but people and Children/young people in their own right. It is important to 'look past' any label which might have been placed on them.
That said, sexual abuse can be very psychologically damaging, as can any form of child abuse. Child sexual abuse is often linked to and involved the suffering of physical, emotional abuse and neglect too.
There is no definitive list of behaviours that suggest abuse may have taken place, but the following may be indicators (also see guidance above relating to specific forms of abuse e.g. Neglect or Physical Abuse).
Indeed, many more behaviours can also be connected to sexually abused children/young people, some of which involve stimulation of genitalia for self-gratification or solace (often not age appropriate), or exposing themselves to others.
Areas of the day such as meal times, evenings, bedtimes etc. may be associated with the time abuse was suffered. It is important to be sensitive to this and emphasize that their environment is now safe. Much reassurance might be required.
Children and young people can often be very worried about their physical health, not only in their genital region.
Children/young people who have been sexually abused might suffer from:
The above might cause the child/young person much distress, anxiety and worry. A medical check to prove 'everything's O.K.' is often ignored and it should not be assumed that this happened at investigation or disclosure stage.
Children and young people often suffer from a 'used goods syndrome'. They feel worthless, unwanted, unloved, cheap etc. Staff should praise and help children/young people 'find themselves' over time.
Often the child / adult relationship has been damaged. A feeling of mistrust, in that 'you are only being nice to me so you can abuse me' is evident.
Children and young people may never feel safe in adult company, which can be demonstrated in anti-social behaviours e.g. violence, abusive language, panic etc.
Trust might be very hard to achieve but only time and proof of security will facilitate this. Therefore it is very important that sexually abused children/young people are not 'let down' and promises are kept etc.
Additionally all children/young people who are Looked After elsewhere than with their birth mother or father will have feelings about mothering and fathering which they will work through using the men and women around them. Because of this our care is not gender neutral. We are clear that each child/young person will relate in a particular way to men and in a different way to women. Placement Plans may well outline in what ways children/young people need to be helped to relate better to a particular gender.
Additionally, children/young people (especially towards adolescence, but often before) naturally have sexual feelings about staff members - these may be about either gender, but are more often than not expressed towards the opposite gender. Adults need to be aware of this, and very sensitive about the issues which emerge. Often children/young people from these circumstances may be adept at relating sexually. Adults should enlist the help of their supervisors and peers to ensure that a child/young person is helped to manage their feelings and the adult is helped to manage the situation appropriately. It is of course never appropriate for staff members to reciprocate sexual feelings.
It is recognised that adults may on occasion have sexual feelings towards children/young people. This is problematic as the role of staff is to be there to meet the children's/young people’s needs, not their own. Such feelings must never be acted on, and must be talked about immediately.
It is important the child/young person can be encouraged to protect themselves. There is no 'standard format' of attempting this self-protection work but needs to be specific to the particular child/young person, perhaps using examples from their own experiences/ behaviour. Specialist advice should be sought as appropriate.
Child abuse doesn't go away. The more knowledge a child/young person obtains about sexual relationships and society values in general the more a child/young person realises just what has happened to them. Therefore at some stage in their development it might appear not to be a big issue, whereas later difficulties may again come to the fore. Sensitivity and compassion are needed to cushion these hurtful rationalisations and honesty of reply and interaction are needed. Someone available to listen will be very valuable and specialist help should be sought.
Consistent development monitoring should be an integral part of any treatment programme. Paediatric care, speech therapy, physical and / or occupational therapy, special educational help and various forms of therapy or individual psychotherapy are many of the therapies often indicated for abused children/young people.
When a child/young person discloses abuse it can be likened to a balloon. If the situation is handled carefully the balloon deflates at a steady pace but sometimes the balloon will burst if the situation is not handled with care and sensitivity. Likewise disclosure is a traumatic experience for a child / young person as they are sharing their most private sexual experience with someone.
After disclosure children/young people can be told, often in anger, such things as:
Often, therefore, many children/young people who are looked after suffer remorse, guilt etc. Not only because of seeing the traumatic consequences of their disclosure, but also being 'cast out' by their families, the ones who should (and perhaps still do) love them the most. Again, sensitivity and compassion to help bridge building (if possible) into broken relationships might be appropriate at some stage, but only at the child's/young person's pace.
Some children/young people recreate the dynamics of their families and invite harm by 'playing the victim' often incurring further abuse from peers or rejecting carers. Where possible therefore, specific provisions for children/young people should be offered in the context of a carefully devised intervention plan for the whole family.
Child abuse is very difficult to prove in Court, especially sexual abuse. Often before disclosure children/young people are involved in offending, excluded from school and are disruptive at home. This scenario can be 'set up' by abusers. "Oh this is the next thing s/he's done, look how s/he behaves usually!" Abusers organise a mantle of protection around themselves. They might appear to be very respectable people in their own community e.g. church attendants, fund raisers, youth club helpers etc. "How could anyone say such a thing about Mr. or Mrs. Bloggs, they're so nice!"
Abusive families and people continue to place responsibility for disclosure on the child/young person. Even when they are in care, in prison or even dead! The 'mantle' of we or I'm a safe person continues to occur and breaking this cycle of 'closed awareness' is often impossible. Staff should always try to actively be aware of this e.g. by stopping distressing phone calls etc.
In conclusion, as in many areas of social work there are no 'quick fixes' in this area. The most important factor must always be to support the child/young person, emphasise the positives and keep the child's/young person's welfare as paramount.
This guide is just that, a guide, not an answer but hopefully will it provide staff with landmarks to help children/young people whilst they are in the organisation's care.
As touched on in other policies it is quite possible for children/young people to falsely accuse adults of having sexual feelings and acting on sexual feelings. To protect themselves and the community all staff members must ensure they never act in a sexualised manner towards children/young people, and that if they observe others doing so they discuss it with a senior member of staff in supervision. Staff should avoid leaving themselves in isolated situations with children/young people who may be prone to such allegations (There are clear and comprehensive policies to protect children/young people from real abuse). It is essential that the policy about allegations about staff members is followed on all occasions.
See: Allegations Against Staff Procedure.
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