4.4 Responding to concerns about a child

Responding to concerns about a child

Anyone who has concerns about a child’s welfare should make a referral to local authority 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. This includes professionals who work with children and their families but could also be the child themselves, family members or members of the public. Practitioners who make a referral should always follow up their concerns if they are not satisfied with the response.

The Children Act 1989 introduced the concept of significant harm as the threshold which justifies compulsory intervention in family life in the best interests of children. Section 47 of the Act places a duty on local authorities to make enquiries, or cause enquiries to be made, where it has reasonable cause to suspect that a child is suffering, or is likely to suffer significant harm.

It is therefore important that all professionals working with children and families understand the concept of significant harm and also what constitutes abuse and neglect.

Responding to risks of harm to an unborn child

In some circumstances, agencies or individuals are able to anticipate where an expected baby is likely to suffer significant harm (e.g. domestic violence, parental substance misuse or mental ill health).

These concerns should be addressed as early as possible before the birth so that a full assessment can be undertaken and support offered to enable the parent/s (wherever possible) to provide safe care. For more information, see the pre-birth procedures.

Responsibilities of agencies and organisations

Each organisation should have internal child protection procedures which are compliant with these regional procedures: each of the nine safeguarding partnerships within participating areas  are responsible for confirming agencies and organisations have these procedures in place.

Each organisation’s own internal child protection procedures must provide instruction to professionals in:

• identifying potential or actual harm to children
• discussing and recording concerns with a first line manager/in supervision
• analysing concerns by completing an assessment
• discussing concerns with the organisation’s designated safeguarding lead (who should be able to offer advice and decide upon the necessity for a referral to local authority children's social care).
• being aware of the requirement for children to have an Appropriate Adult. Further information can be found in the statutory guidance

Professionals in all organisations should be sufficiently knowledgeable and competent to contact local authority children's social care or the police about their concerns directly and to complete the appropriate referral form. Where advice is required, professionals should feel comfortable contacting their local authority children’s social care or Multi-Agency Safeguarding Hub (if one exists in the area) to discuss the case.

If it appears that the child is suffering, or likely to suffer, significant harm, a formal referral to local authority children's social care, the police or emergency services (for any urgent medical treatment) must not be delayed by the need for consultation with management or the designated safeguarding practitioner lead, or the completion of an assessment.  

Responsibilities of professionals

Professionals in all agencies and organisations (including public services, commissioned provider services and voluntary organisations; whether paid or a volunteer) who come into contact with children, who work with adult parents/carers or who gain knowledge about children through working with adults, should:

• be alert to potential indicators of abuse or neglect
• be aware that mental health problems can be an indicator that a child has suffered, or is at risk of suffering abuse, neglect or exploitation
• be alert to the risks which individual abusers, or potential abusers, may pose to children
• be alert to the impact on the child of any concerns of abuse or maltreatment
• be able to gather and analyse information as part of an assessment of the child’s needs.

The law empowers anyone who has care of a child to do all that is reasonable in the circumstances to safeguard their welfare. Accordingly, professionals in all agencies should take appropriate action wherever necessary to ensure that no child is left in immediate danger, e.g. a teacher, foster carer, childminder, a volunteer or any professional should take all reasonable steps to offer a child immediate protection (including from an aggressive parent).

Charity trustees are responsible for ensuring that those benefiting from, or working with, their charity, are not harmed in any way through contact with it.

Duty to co-operate and refer

All professionals in agencies with contact with children and members of their families must make a referral to local authority children's social care if there are signs that a child or an unborn baby:

• is suffering significant harm through abuse or neglect
• is likely to suffer significant harm in the future.

The timing of such referrals should reflect the level of perceived risk to the child or unborn baby and should be within one working day of identification or disclosure of the harm or risk of harm.

In urgent situations out of office hours the referral should be made to the local authority children's social care emergency duty team/out of hour’s team.

Where a child or unborn baby has an allocated social worker and a professional has new or additional information this must be documented and passed without delay to the allocated social worker or case manager for consideration by children's social care.  In the event the allocated social worker and/or case manager are unavailable the person holding information should follow the arrangements for passing on information to the relevant team.  As above, if it is outside of office hours the local authority children's social care emergency duty team/out of hours team should be contacted if the concern is high.  In emergencies, such as if a child is in immediate danger, the Police should be called for assistance.

Listening to the child

Whenever a child reports that they are suffering or have suffered significant harm through abuse or neglect, or have caused or are causing physical or sexual harm to others, the initial response from all professionals should be limited to listening carefully to what the child says to:

• clarify the concerns
• offer re-assurance about how the child will be kept safe
• explain what action will be taken and within what timeframe.

All professionals should be aware that children may not feel ready or know how to tell someone that they are being abused, exploited, or neglected, and/or they may not recognise their experiences as harmful. For example, children may feel embarrassed, humiliated, or being threatened.

Consideration should be given to additional support or advocacy for children with communication difficulties or disabilities and/or sexual orientation, vulnerabilities and those who do not speak English (particularly unaccompanied children, refugees or those trafficked from abroad). Children who identify as LGBT are recognised as being potentially at greater risk of harm. It is acknowledged that children who are perceived as being LGBT by other children are at a similar or at the same level of risk as children who identify as LGBT.

The child must not be pressed for information, led or cross-examined or given false assurances of absolute confidentiality, as this could prejudice police investigations, especially in cases of sexual abuse.

If the child can understand the significance and consequences of making a referral to local authority children's social care, they should be asked their view.

However, it should be explained to the child that, whilst their view will be taken into account, the professional has a responsibility to take whatever action is required to ensure the child's safety and the safety of other children.

Consulting parents  

Where practicable, concerns should be discussed with the parent and agreement sought for a referral to local authority children's social care unless seeking agreement is likely to:

• place the child at risk of significant harm through delay or the parent's actions or reactions
• lead to the risk of loss of evidential material. For example in circumstances where there are concerns or suspicions that a serious crime such as sexual abuse or induced illness has taken place.

Where a professional decides not to seek parental permission before making a referral to local authority children's social care, the decision must be recorded in the child's file with reasons, dated and signed and confirmed in the referral to local authority children's social care.

A child protection referral from a professional cannot be treated as anonymous, so the parent will ultimately become aware of the identity of the referrer. Where the parent refuses to give permission for the referral, unless it would cause undue delay, further advice should be sought from a manager or the nominated child protection adviser and the outcome fully recorded.

If, having taken full account of the parents' wishes, it is still considered that there is a need for referral:

• the reason for proceeding without parental agreement must be recorded
• the parent's withholding of permission must form part of the verbal and written referral to local authority children's social care
• the parent should be contacted to inform them that, after considering their wishes, a referral has been made.

Considering diversity

At all stages of the child protection process, consideration must be given to issues of diversity, taking into account:

• the impact of cultural expectations and obligations on the family
• the family's knowledge and understanding of UK law in relation to parenting and child welfare
• the impact on the family if recently arrived in the UK and their immigrant status
• the need to use safe and independent interpreters for discussions about parenting and child welfare, even though the family's day-to-day English may appear/be adequate.

The analysis of the child’s and families cultural needs must not result in a lowering of expectations when applying standards of good practice to safeguarding the child.

Seeking urgent medical attention

If the child is suffering from a serious injury, the professional must seek immediate medical attention from emergency services and must inform local authority children's social care, and the duty consultant paediatrician at the hospital.

Where abuse is alleged, suspected or confirmed in a child admitted to hospital, the child must not be discharged until:

• the local authority children's social care for the area where the hospital is located and for the child's home address are notified by telephone that there are child protection concerns. (This may be two different local authority children's social care teams)
• a strategy meeting/discussion has been held, if appropriate, which should include relevant hospital and other professionals.

Responding to concerns raised by members of the public

When a member of the public telephones or approaches any agency with concerns, about the welfare of a child or an unborn baby, the professional who receives the contact should always:

• Gather as much information as possible in order to make a judgement about the seriousness of the concerns.
• Take basic details:
• Name, address, gender and date of birth of child
• Name and contact details for parent/s, educational setting (e.g. nursery, school), primary medical practitioner (e.g. GP practice), professionals providing other services, a lead practitioner for the child.
• Discuss the case with their manager and the agency's designated safeguarding professional lead to decide whether to:
  • make a referral to local authority children's social care
  • make a referral to the lead practitioner, if the case is open and there is one
  • make a referral to a specialist agency or professional e.g. educational psychology or a speech and language therapist
  • undertake an assessment.
• Record the referral with the detail of information received and given, separating out fact from opinion as far as possible.
• Inform the referrer about what happens next.

The member of the public should also be given the number for their local authority children's social care and encouraged to contact them directly. The agency receiving the initial concern should always make a referral to local authority children's social care (and to the lead professional if there is one) in case the member of the public does not follow through (a common occurrence).

If there is a risk that the member of the public will disengage without giving sufficient information to enable agencies to investigate concerns about a child, the NSPCC national 24 hour Child Protection Helpline (0808 800 5000) and Childline (0800 1111) can be offered as an alternative means of reporting concerns.

Individuals may prefer not to give their name to local authority children's social care or the NSPCC. Alternatively they may disclose their identity, but not wish for it to be revealed to the parent/s of the child concerned. Wherever possible, professionals should respect the referrer's request for anonymity. However professionals should not give referrers any guarantees of confidentiality as there are certain limited circumstances in which the identity of a referrer may have to be given (e.g. the court arena).

Local publicity material should make the above position clear to potential referrers.

Local authority children's social care should offer the referrer the opportunity of an interview.