Safeguarding

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Introduction

Everybody has the right to live their lives in safety, free from abuse, neglect, violence and exploitation. By everybody, we mean babies, children, young people and adults.

People who work in healthcare have a duty to protect people from harm and promote wellbeing.

As an ICB we are committed to;

• Working with people and other organisations to ensure that the right to live free from abuse and neglect is protected. We do this by safeguarding our population.

• Enabling children in care and care experienced young people  to have the best experiences in life, from excellent parenting which promotes good health and educational attainment, to a wide range of opportunities to develop their talents and skills in order to have an enjoyable childhood and successful adult life. We do this by working with providers and other agencies all children who are looked after or care experienced

• Ensuring that we comply with the Mental Capacity Act 2005 for those people  who are unable to make decisions about their care and treatment or other aspects of their daily life.

We meet these commitments by working  in partnership with agencies across Cornwall and the Isles of Scilly through safeguarding boards and partnerships. There are 3 safeguarding boards and partnerships have oversight of safeguarding for the population in Cornwall and the Isles of Scilly. These are;

• Cornwall’s Safeguarding Adults Board
• Our Safeguarding Children Partnership
• Safer Cornwall (Kernow Salwa)
• Safer Isles of Scilly

The particular support for children in care and care experienced young people is overseen the Cornwall Corporate Parenting Board.

Safeguarding

Everybody has the right to live their lives in safety, free from abuse, neglect, violence and exploitation. By everybody, we mean babies, children, young people and adults.

Our Aims

To give due regard to the ICB safeguarding statutory duties as required by all safeguarding legislation, guidance and the joint forward plan.

To bring the NHS and other partners in Cornwall and the Isles of Scilly together so that  our integrated care system (ISC) will effectively address the particular needs of people affected by abuse or  those who lack mental capacity.

What we do

The ICB must carry out a number of safeguarding functions. These are mostly strategic responsibilities, which require us to work together with other partners to make sure we have an effective multi agency response to people experiencing abuse and neglect.

We set out how we do this in our safeguarding accountability and assurance framework

We set out our long-term plans of how we address the needs of people affected by abuse in our joint forward plan.

Our designated and lead professionals for safeguarding, children in care and mental capacity provide expert advice to the ICB, providers, other agencies and our safeguarding boards and partnerships. They also ensure that the safeguarding priorities of people in the ICB area are included and progressed in the joint forward plan.

How to contact us

To contact the ICB  about safeguarding, children in care and care experienced young people please e mail;
ciosicb.scatconcern@nhs.net

To contact the ICB about mental capacity and deprivation of liberty please e mail;

ciosicb.mentalcapacity@nhs.net

Adult Safeguarding

Adult safeguarding responsibilities arise from the Care Act 2014 which defines an adult as a person over the age of 18.

Adult safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about people and organisations working together to prevent and stop abuse and neglect, whilst promoting the wellbeing of the adult and having regard for their wishes, feelings and beliefs

If you have concerns about an adult or you are an adult experiencing abuse or neglect

If in danger or an emergency telephone the Police on 999.

If you are an adult experiencing abuse or neglect, or if you are concerned about an adult experiencing abuse or neglect and you would like to talk about referring for support, please contact the relevant below numbers.

For Cornwall

Contact tel. 0300 1234 131

This number can also be used for our of hours urgent contacts

Or you can make an online referral on the Cornwall Council website

For the Isles of Scilly

Contact tel. 01720 424 470

If you need to speak to someone outside of the hours of 9am – 5pm, phone 01720 422699.

Local help and Information

You can find advice and information on the websites below:

• Safeguarding adults Cornwall Council
• Safeguarding adults Isles of Scilly
• Cornwall and Isles of Scilly safeguarding adults board

Safeguarding Adult Policy for Cornwall and the Isles of Scilly

The Cornwall and Isles of Scilly multi agency adult safeguarding policy can be found on the Cornwall and Isles of Scilly safeguarding adults board website. It provides information on the different types of abuse and how to respond to abuse.

Safeguarding children

Safeguarding children responsibilities arise from the Children Act 1989 and amended in the Children Act 2004 and  Working Together to Safeguard Children 2018

They define safeguarding children as;

• Protecting children from maltreatment.
• Preventing impairment of children’s health or development.
• Ensuring that children are growing up in circumstances consistent with the provision of safe and effective care.
• Taking action to enable all children to have the best outcomes.

Safeguarding is a wider definition of ensuring a child’s safety than child protection alone;

The criteria for when a case should be referred to local authority children’s social care for assessment and for statutory services under:

• section 17 of the Children Act 1989 (children in need)
• section 47 of the Children Act 1989 (reasonable cause to suspect a child is suffering or likely to suffer significant harm)
• section 31 of the Children Act 1989 (care and supervision orders)
• section 20 of the Children Act 1989 (duty to accommodate a child)

If you have concerns about a child experiencing abuse or neglect

If in danger or an emergency telephone the Police on 999.

Anyone who has concerns about a child’s welfare should make a referral to children’s social care and should do so immediately if there is a concern that the child is suffering significant harm or is likely to do so.

Practitioners who make a referral should always follow up their concerns in writing and escalate if they are not satisfied with the response.

If you have immediate concerns or are worried about a child or young person’s safety, please telephone the Multi Agency Referral Unit (MARU) on 0300 123 1116

For out of hours support, please call 0300 1234 101

To make a child protection referral, contact the Multi-Agency referral Unit via health-and-social-care/childrens-services/child-protection-and-safeguarding

To make a contact for early help, please use the online portal to contact the hub. Information about all the services available through early help can also be found on the early help hub webpage.

Local help and Information

For more information about safeguarding children in Cornwall and the Isles of Scilly please visit south west child protection procedures

You can find more information on the Cornwall and Isles of Scilly Our Safeguarding Children Partnership website.

Domestic abuse and sexual violence

Some people who are experiencing domestic abuse and violence may not be able to protect themselves because of the coercion and control applied by a perpetrator to which they are personally connected.

Domestic abuse responsibilities arise from the Domestic Abuse Act 2021. The statutory guidance defines domestic abuse as;

Behaviour of a person (“a”) towards another person (“b”) is “domestic abuse” if both the following apply:

• a and b are each aged 16 or over and are personally connected to each other
• the behaviour is abusive

‘Personally connected’ includes people;

• who are or have been married or civil partner
• have agreed to marry or enter a civil partnership
• are in or have been in an intimate relationship
• they are or have been in a parental relationship in relation to the same child
• they are relatives

Anyone can be a victim of domestic abuse, regardless of sex, gender reassignment, age, ethnicity, socio-economic status, sexuality, or background.

The effects of domestic abuse on children can be both short and long term and  this impact on children is recognised in the  Domestic Abuse Act 2021.

How to get help or make a referral

If in danger or an emergency telephone the Police on 999.

If you are experiencing domestic abuse you can contact:

• Web: Safer Futures
• Tel: 0300 777 4777
• Online referral

The helpline is staffed between 09:00-17:00 on Mondays to Fridays.

Outside these hours you can email saferfutures@firstlight.org.uk or  call the National Domestic Abuse Helpline on 0808 2000 247

National help and advice  for domestic abuse

You can contact;

• National domestic abuse helpline
• Mankind for men who are victims of domestic abuse
• Galop for people who identify as LGBTQ+

Local help and information

Further information about domestic abuse can be found on the Safer Cornwall and Safer Scilly community safety partnership websites.

Prevent

Reporting possible extremist or terrorist activity can save lives.

Prevent is part of CONTEST, the Government’s counter-terrorism strategy. It aims to stop people being drawn into terrorism and provide help and support to those who are at risk of being radicalised and exploited. It operates in the pre criminal space and is about safeguarding children and adults by providing early intervention to protect and divert people away from being drawn into terrorist activity through the channel process.

Prevent is about recognising and supporting people who may be at risk of being drawn into terrorist activities.  A number of specified authorities have a duty do to this. This includes organisations providing healthcare. More information about these duties is described in the Prevent duty guidance.

If someone you know is at risk of being radicalised early support can be discussed and arranged via a Channel Panel. This is a panel of different relevant professionals who experienced in assessing and engaging services to support people.

How to make a referral

If you need to make a referral you can contact Devon and Cornwall Police.

You can also call 101 or the national police Prevent advice line 0800 011 3764, in confidence, to talk to specially trained Prevent officers.

The advice line is open 9.00am to 5.00pm every day.

Serious violence duty

In December 2022, the government published the statutory guidance for the serious violence duty. The ICB is now a responsible authority in delivering the requirements of the duty. This means that the ICB, in conjunction with its partners, is under duty to undertake a strategic needs assessment and produce a plan. Our responsibilities in relation to the Act are;

• facilitate the sharing of relevant health data and information to inform the problem profile or strategic needs assessment for the area (for example, number of knife crime injuries treated within NHS urgent care settings)
• support the development and implementation of a strategy
• facilitate appropriate commissioning (and co-commissioning) within the local health system to prevent, treat and manage serious violence as set out in the strategy
• where relevant, (co-) commission support services for those at risk of or involved in serious violence including from the voluntary and community sector

The guidance does not require the establishment of a new partnership to develop and implement the strategic plan, and instead confirms that the work can be completed as part of existing partnership arrangements such as community safety partnerships.

Modern slavery

Modern slavery encompasses slavery, servitude, forced and compulsory labour and human trafficking. Traffickers and slave drivers coerce, deceive and force individuals against their will into a life of abuse, servitude and inhumane treatment. The ICB has a duty to publish a modern slavery statement (PDF, 124 KB) in accordance with statutory guidance and as part of emergency preparedness, resilience and response to participate in the response to any large-scale modern slavery incident that occurs within the ICB area.

Hate crime

Crimes committed against someone because of their disability, transgender-identity, race, religion or belief, or sexual orientation are hate crimes and should be reported to the police.

Reporting hate crime

In an emergency call 999. If the crime is not an emergency, call 101.

You can also report  hate crime online.

More information

There is more information and resources on the police hate crime website.

Other NHS sources of information

See NHS advice  and the NHS England  Safeguarding children, young people and adults at risk in the NHS: Safeguarding accountability and assurance framework 2022.

Children in care and care experienced young people

The term “Looked after Child” (LAC) refers to a child who is in the care of the Local Authority. The term has a specific legal meaning based on the Children Act 1989. These children and young people may also be known as a Child in Care, (CIC).

Children can become looked after at any age from birth up to their 18^th birthday.

Children who are looked after fall into five main groups:

• children who are accommodated under a voluntary agreement with their parents (Section 20, Children Act 1989 status)
• children who are subject to a care order, interim care order or supervision order staying with birth family or other legal orders, (Section 31, Children Act 1989),
• children who are the subject of emergency orders for the protection of the child
• children who are compulsorily accommodated. This includes children remanded to the Local Authority or subject to a Youth Rehabilitation Order with a residence requirement
• children in respite/short breaks who are subject to the same statutory reviews as looked after children.

They may have been placed in care voluntarily by parents struggling to cope, or by Children’s Social Care who may have intervened because they were identified as being at significant risk of harm, neglect or exploitation. 

 Children who have been looked after by a Local Authority for at least 13 weeks since the age of 14 and have left care on or after their 16th birthday are known as Care Leavers up to their 25^th birthday and are entitled to additional services and prioritised support.

Children who are Looked After may be living:

• with foster parents
• at home with their parents under the supervision of Children’s Social Care
• in residential children’s homes
• in other residential settings, for example schools or secure units.
• away from home on a planned basis for short breaks or respite care
• with supported lodging carer’s if aged 16 years or older
• in semi-independent accommodation if aged 16 years or older
• in independent accommodation if aged 16 years or older

 What we do

NHS Kernow CCG is required, under Section 10 of the Children Act 2004 to ensure the timely and effective delivery of health services to Children Looked After and Care Leavers. .

In fulfilling those responsibilities, the NHS contributes to meeting the health needs of looked after children in three ways:

• commissioning effective services,
• delivering through provider organisations,
• and through individual practitioners providing coordinated care for each child

Commissioned Provider

The ICB commissions the specialist Children in Care Health Team through Royal Cornwall Hospitals Trust and mental health services through Cornwall Foundation Trust. Local Authority Public Health Nurses also provide services to looked after children.

The Children in Care Health Team facilitates the delivery of relevant health services to all Cornwall and Isles of Scilly looked after children and young people and those children and young people who are living in Cornwall and the Isles of Scilly from other Local Authority areas in accordance with their Health Care Plan.  This team also provides statutory Initial and Review Health Assessments and arranges Initial and Review Statutory Health Assessments when required from providers outside of Cornwall and the Isles of Scilly.

Royal Cornwall Hospitals Trust also provides the Designated Doctor and medical adviser adoption and fostering and medical services to deliver both Statutory Initial Health Assessment and Statutory Adoption Medical Reviews.  They also provide the Adoption Medical Adviser to the Statutory Adoption Panel.

If you need to contact a health service about a child in care

The Children in Care Health Team can be contacted Monday – Friday 9am – 5pm. 

Email: rch-tr.Cornwallchildrenincarehealthteam@nhs.net

• Telephone:  01872 245590

All children in care living in Cornwall should be registered with a:

• local GP – to find a GP  Find a GP – NHS (www.nhs.uk)
• dentist – telephone 03330063300 for advice about how to access dental care
• and optician

All children in care will have access to public health nursing services, Health Visiting and School Nursing (if attending a local school).

All requests for Health Assessments should be emailed to rch-tr.cornwallchildrenincarehealthteam@nhs.net. Please do not send any requests for Health Assessments direct to individual practitioners.

Cornwall provides a range of health and other services to support children with additional needs Find out more on the Local Offer website.

And for children in care placed into Cornwall.

Children placed in Cornwall by other Local Authorities – Cornwall Council

Mental Capacity and deprivation of liberty

The responsibilities in relation to mental capacity and deprivation of liberty arise from the Mental Capacity Act  2005.

The Mental Capacity Act (MCA) 2005 applies to people who are aged 16 or over.

Mental capacity is the ability to make a decision.

If a person lacks capacity, it means they cannot make a decision if they cannot do any one of the following:

• understand the decision
• retain the information
• weigh up the information relating to the decision
• communicate the decision

People may not be able to make a decision because they have an impairment of the brain or mind. The impairment may affect their ability to understand, retain, weigh up and communicate information about the decision. Such an impairment may arise from, for example a learning disability, dementia or a brain injury. It is important to remember that an impairment on its own does not mean the person lacks capacity, A person must also not be able to understand or retain or weigh up or communicate information. The Act is also clear that capacity is decision specific which means that a person may be able to make 1 decision but not another.

The Mental Capacity Act is built upon five key statutory principles that guide and inform decision-making for those who may lack capacity in certain aspects of life including health and wellbeing.

The MCA 2005 Key Principles are:

 A presumption of capacity – “A person must be assumed to have capacity unless it is established that they lack capacity”.

Support individuals to make their own decisions – “A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success”.

Right to make an unwise decision – “A person is not to be treated as unable to make a decision merely because he makes an unwise decision”.

Best interest – “An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in his best interests”.

Least restrictive option – “Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action”.

The Mental Capacity Act  2005 provides a legal framework to enable decisions to be made for people. This is important for health services, because to give care or treatment to someone, for example to take a sample of blood, the person must give their consent, If the person cannot consent, the Act allows the health worker to undertake that action in the person’s ‘best interest’.

It ensures that those who lack capacity are able to access treatment and that professionals giving the treatment are protected from liability in doing so if they apply the act correctly.

Our aims

• To protect the rights of individuals regarding their health, welfare, financial affairs, and property.
• To enhance awareness of the roles and responsibility of those involved in mental capacity and deprivation of liberty
• To maintain professional relationships and engagement with providers to enhance the care and rights of individuals that require complex care

What we do

For people for whom we commission a package of care we;

ensure individuals’ rights are upheld and that they remain safe from harm

Provide support with deprivation of liberty enquiries, community deprivation of liberty applications and court of protection applications

provide education and training with the development of LPS (Liberty Protection Safeguards).

Liaise directly with other parties and the court through our legal services provider regarding legal matters relating to the Court of Protection

Please contact the team directly for all MCA to LPS information and updates.