The Children Act 2004 s.11 sets out a legal duty on all health care organisations and contractors to safeguard and promote the welfare of children and young people, and to co-operate with other agencies to protect individual children and young people from harm. Staff working primarily with adults who have dependent children that may be at risk because of their parent/carers′ health or behaviour share this responsibility. The responsibilities of individual organisations are set out in Chapter 2 of ‘Working Together to Safeguard Children’ (2015) which states that all staff should receive training to ensure they attain the competences appropriate to their role and follow the relevant professional guidance.
In order to be registered with the CQC, Independent Health Contractors have to meet the core standards. Core Standard (C2) states, ‘Health care organisations protect children by following national child protection guidance within their own activities and in their dealings with other organisations.’
Safeguarding Children and Young People: Roles and Competencies for Health Care Staff – Intercollegiate Document 2014 outlines the knowledge and skills framework to assist in the identification, planning and delivery of training and education needs across the range of healthcare employees. It identifies five levels of competence as follows:
• Level 1: All staff including non-clinical managers and staff working in health care settings
• Level 2: Non-clinical and clinical staff who have some degree of contact with children and young people and/or parents/carers
• Level 3: Clinical staff working with children, young people and/or their parents/carers and who could potentially contribute to assessing, planning, intervening and evaluating the needs of a child or young person and parenting capacity where there are safeguarding/child protection concerns
• Level 4: Named professionals
• Level 5: Designated professionals
Safeguarding Adults at risk
The term Adults at risk has replaced the term Vulnerable adults, as it was felt to imply some culpability. The Care Act 2014 s 6(7) places a duty on health professionals to ”cooperate with each of their relevant partners, … in the exercise of their functions relevant to care and support including those to protect adults. Relevant partners of a local authority include:
• NHS England;
• Clinical Commissioning Groups (CCGs);
• NHS trusts and NHS Foundation Trusts;
• Department for Work and Pensions;
• the Police; Prisons and Probation services;”
The Care Act 2014 introduced some significant changes to the categories of abuse.
Physical abuse – including assault, hitting, slapping, pushing, misuse of medication, restraint or inappropriate physical sanctions.
Domestic violence – including psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence.
Sexual abuse – including rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.
Psychological abuse – including emotional abuse, threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, cyber bullying, isolation or unreasonable and unjustified withdrawal of services or supportive networks.
Financial or material abuse – including theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.
Modern slavery – encompasses slavery, human trafficking, forced labour and domestic servitude. Traffickers and slave masters use whatever means they have at their disposal to coerce, deceive and force individuals into a life of abuse, servitude and inhumane treatment.
Discriminatory abuse – including forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion.
Organisational abuse – including neglect and poor care practice within an institution or specific care setting such as a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to on-going ill-treatment. It can be through neglect or poor professional practice as a result of the structure, policies, processes and practices within an organisation.