1.4.1 Child Protection Enquiries

SCOPE OF THIS CHAPTER

This chapter is based on Section 6 of the London Child Protection Procedures. It should be read in conjunction with the Initial and Core Assessment Guidance.

Note: These procedures describe arrangements in Bromley. They do not replace the London Child Protection Procedures.

Duty to Contact S.47 Enquiries
Integration with Assessment Framework
Threshold for S.47 Enquiries
Immediate Protection
Agency Checks
Strategy Discussion/or Meeting
CPU Criminal Investigations
Involving Parents, Family Members and Children
Meeting the Child
Paediatric Assessment
Risk Assessment
Outcome of Child Protection Enquiries
Time-Scales
Recording

1. Duty to Contact S.47 Enquiries

Children and Young People Division have the statutory duty to make, or cause to be made, enquiries when the circumstances defined in s.47 Children Act 1989 exist.

The responsibility for undertaking s.47 enquiries lies with the local authority in which the child lives or is found. Where this is a different authority to where the child lives (his / her home authority) this may usefully be described as the 'host' authority.

Where a child is living in another authority his / her 'home' authority should be informed as soon as possible and involved in strategy discussions / meetings. The 'home' authority may undertake the necessary enquiries on behalf of the host authority. This is likely to be appropriate in the case of a looked after child.

The 'home authority' should be informed as soon as possible and may be involved in strategy discussions. The home authority should take responsibility for further support of the child or family).

Obligations and Responsibilities of All Agencies

All agencies have a duty to assist and provide information in support of child protection enquiries.

2. Integration with Assessment Framework

Whenever the threshold criteria are met (see When S.47 Enquiries start) s.47 enquiries should be initiated, for all children in the household. This will usually follow an initial assessment, but may be justified at the point of referral, during the early consideration of a referral, the initial or core assessment or at any time in an open case when the threshold criteria are satisfied.

A core assessment should be commenced whenever an s.47 enquiry is initiated. The information and conclusions of the enquiry will inform the core assessment.

The s.47 enquiry should begin by focusing primarily on the information identified during the referral and initial assessment, which appears most important in relation to the risk of significant harm.

This will inform the core assessment, which should cover all relevant dimensions in the Assessment Framework, including the systematic gathering of information about the history of the child, family and household members, including any previous specialist assessments.

3. Threshold for S.47 Enquiries

A child's status - e.g. ' in need', or 'at risk of significant harm' must be ascribed in a flexible manner, which recognises the possibility of change and a consequent need to re-ascribe that status.

Initial or core assessments should be undertaken. If at any point the threshold for s.47 enquiries is met the procedures outlined in this module should additionally be followed.

S.47 enquiries start when:

There is reasonable cause to suspect that a child is suffering or likely to suffer significant harm in the form of physical, sexual, emotional abuse or neglect
Following an Emergency Protection Order or after a child is the subject of Police Protection
A child breaches curfew criteria in which case the response must be initiated within 48 hours of receipt of the information
s.47(1)(a)(iii) Children Act 1989 inserted by s.15(4) Crime and Disorder Act 1998]

The Children and Young People Division is the lead agency for child protection enquiries. In making a final decision about whether the threshold for an s.47 is met, The Children and Young People Division should consult CPU and other appropriate agencies so that relevant information can be taken into account.

Police must be informed at the earliest opportunity whenever a criminal offence appears to have been committed, or is suspected of having been committed, against a child. The police are responsible for undertaking the criminal investigation. Telephone referrals should be confirmed in writing using police form 87A .

A criminal investigation or further police involvement may not be required in every case. Among other factors, the police decision will take account of the best interests of the child.

Risk Assessment - S.47 Intervention Threshold

The Children and Young People Division' first line manager has the responsibility, on the basis of available information, to decide and authorise a child protection enquiry (s.47 enquiry. In undertaking the necessary assessment of risk, the manager must consider both the probability of the event or concern in question and its actual or likely consequence.

In reaching his / her conclusion as to the justification for an s.47 enquiry, the manager must consider the following variables:

Seriousness of the concern(s)
Repetition or duration of concern(s)
Vulnerability of child (through age, developmental stage, disability or other pre-disposing factor -e.g. 'looked after')
Source of concern(s)
Accumulation of sufficient information
Context in which the child is living - e.g. a child in the household is already the subject of a Child Protection Plan
Any predisposing factors in the family that may suggest a higher level of risk e.g. mental health difficulties, substance misuse of parent / carer or domestic violence

An s.47 enquiry must always be commenced immediately when there is an indication (disclosure, allegation or evidence) that a child is suffering or likely to suffer significant harm. This applies equally to new, re-referred and open cases. For all new section 47 enquiries a 'Child Protection Checklist' must be completed.

A non-exhaustive list of examples distinguishing situations requiring an s.47 enquiry and those which first require an initial assessment are provided in the threshold response table.

A combination of any of the factors which taken individually would require only an initial assessment, when combined with domestic violence, parental mental illness, excessive drinking, or drug use may justify considering an immediate s.47 enquiry.

See London Child Protection Procedures (Section 6 Referral and Assessment) for threshold for pre-birth s.47 enquiries.

A police referral must be made whenever an allegation is made that may also constitute an allegation of crime, irrespective of the decision made by The Children and Young People Division about s.47 enquiries thresholds. Telephone referrals should be confirmed in writing within 48 hours, using police form 87A. The designated CPU referral manager will decide whether to investigate, following obligatory checks and information sharing (see Section 7, CPU Criminal Investigations).

Threshold Response Table

S.47	S.17
Any allegation of abuse or neglect or any suspicious injury in a pre or non mobile child	Allegation of physical assault with no visible or only minor injury (other than to a pre or non mobile child)
Allegations or suspicions about a serious injury to a child	Any incident / injury triggering concern e.g. a series of apparently accidental injuries or a minor non-accidental incident
Inconsistent explanations or an admission about a clear non-accidental injury
Repeated allegations or reasonable suspicions of non-accidental injury	Repeatedly expressed minor concerns from one or more sources
The child has been injured (even if inadvertently) during domestic violence	Allegations of one serious or three minor domestic violence incidents
Repeated allegations involving serious verbal threats and / or emotional abuse	Allegation concerning serious verbal threats Allegations of emotional abuse including that caused by minor domestic violence
Allegations/reasonable suspicions of serious neglect	Allegations of chronic or periodic neglect including insufficient supervision; poor hygiene, clothing or nutrition; failure to seek / attend treatment or appointments; age inappropriate domestic chores
Medical referral of non-organic failure to thrive in under fives
Direct allegation of sexual abuse made by child or abuser's confession to such abuse	Suspicions of sexual abuse e.g. sexualised behaviour, medical concerns or referral by concerned relative, neighbour, carer
Any allegation suggesting connections between sexually abused children in different families or more than one abuser
Schedule 1 offender moving into a household with under eighteen year olds
Any suspicious injury or allegation involving a child already the subject of a child protection plan or looked after by a local authority
No available parent / carer and child vulnerable to significant harm e.g. an abandoned baby
Suspicion that child has suffered or is at risk of significant harm due to fabricated / induced illness	No available parent / carer, child in need of accommodation and no specific risk if this need met e.g. unaccompanied asylum seeking child
Children subject of parental delusions which imply risk

4. Immediate Protection

Where there is a risk to the life of a child or the possibility of serious immediate harm, the police officer or social worker must act quickly to secure the safety of the child.

Emergency action may be necessary as soon as the referral is received or at any point during involvement with children, parents or carers.

Responsibility for immediate action rests with the authority where the child is found, but should be in consultation with any 'home' authority.

Immediate protection may be achieved by:

An alleged abuser agreeing to leave the home
The removal of the alleged abuser
Voluntary agreement for the child to move to a safer place with / without a protective person
Application for an Emergency Protection Order (EPO)
Removal of the child under police powers of protection
Gaining entry to the household under police powers

The social worker must seek the agreement of his / her first line manager and obtain legal advice before initiating legal action.

The Children and Young People Division should only seek the assistance of the police to use their 'powers of protection' in exceptional circumstances where there is insufficient time to seek an Emergency Protection Order or other reasons relating to the child's immediate safety.

The agency taking protective action must always consider whether action is also required to safeguard other children in the same household, in the household of an alleged perpetrator or elsewhere.

When Police Powers of Protection are used, an independent officer of at least inspector rank must act as the designated officer.

Planned immediate protection will normally take place following a strategy discussion (see Section 6, Strategy Discussion/or Meeting)

Where an agency - e.g. the police, has to act immediately to protect a child, a strategy discussion should take place, within 1 working day of the emergency action, to plan the next steps.

5. Agency Checks

The social work first line manager must make any decision that the threshold for s.47 enquiries has been met and consequently authorize the instigation of s.47 enquiries.

The social worker must consult with other agencies involved with the child and family in order to obtain a fuller picture of the circumstances of all children in the household, identifying parenting strengths and any risk factors.

Even when there has been a recent initial assessment, agencies should be informed that a child protection enquiry has been initiated and their views sought.

The social worker must consult his / her manager so that he / she can decide on the basis of available information, whether to seek consent to undertake inter-agency checks from a person with parental responsibility.

If the manager decides not to seek permission, he / she must record (a pro forma may be useful) the reasons - e.g.:

Prejudicial to the child's welfare
Serious concern about the behaviours of the adult
Concern that the child would be at risk of further significant harm

Where permission is sought and denied, the manager must determine whether to proceed, and if so, record the reasons.

The checks should be undertaken directly with involved professionals and not through messages with intermediaries.

The relevant agency should be informed of the reason for the enquiry, whether or not parental consent has been obtained and asked for their assessment of the child in the light of information presented.

Agency checks should include accessing any relevant information that may be held in one or more other countries.

6. Strategy Discussion/or Meeting

The discussion between Children and Young People Division and the CPU and relevant other agencies will have:

Shared information
Agreed whether to hold a strategy discussion or meeting to initiate an s.47 enquiry with or without a criminal investigation
Arranged (where necessary) either a strategy discussion or meeting, and which agencies to include
Allocated tasks if any immediate protective action is required

Strategy discussions by telephone will usually be adequate to plan an enquiry, but face-to-face meetings are likely to be more effective in complex types of maltreatment or neglect. Meetings should be held where:

There are allegations against staff, carers and volunteers or anyone professionally involved with the child
There is an allegation that a child has abused another child
There are ongoing, cumulative concerns about the child's welfare and a need to share concerns and agree a course of action
There are concerns about the future risk to an unborn child
Direct communication between more than two agencies is required for meaningful discussion

More than one strategy discussion and / or meeting may be required.

Both strategy discussions and meetings must:

Share and evaluate information and confirm the need for an enquiry
Agree the conduct and timing of any criminal investigation
Decide whether an s.47 enquiry and core assessment should be initiated (or continued if already commenced)

Where it is decided that there are grounds to initiate an s.47 enquiry, decisions, in the context of the racial, cultural and religious and linguistic background of the child and his / her family, should be made about:

Further information required and how it should be obtained
The scope of the enquiry, including other children at possible risk
The need for any paediatric or specialist assessment
How to meet the best interests of the child in the enquiry, taking account of any additional needs such as that arising from a disability or a need for an interpreter, speech and language therapist
When, how and who will undertake interviews with the child and if a video interview will be used
Any further action if consent is refused for interview or medical assessment
The needs of other children in contact with the alleged abuser(s), including all children in the household
Whether to interview referrer or anyone else
Agree what other actions may be needed to protect the child or provide interim services and support, including securing the safe discharge of a child in hospital
What information may be shared, with whom and when, taking into account the possibility of information sharing placing a child at risk of significant harm or jeopardising police investigations
Any implications for disciplinary action e.g. use of evidence statements
Any legal action required
The need for further strategy discussions and / or meetings
Timescales, agency and individual responsible for agreed actions, including the timing of police investigations and relevant methods of evidence gathering
Any need to reconvene the strategy discussion and/or meeting during the enquiry if the circumstances are particularly complex or unknown
The mechanism and date for reviewing the completion of agreed actions i.e. further strategy discussion/s, and /or meeting(s) in complex cases

Participants To Strategy Discussion/Meeting

The strategy discussion / meeting should ordinarily be coordinated and chaired by the Children and Young People Division first line manager.

The CPU designated referral manager must be involved in the initial strategy discussion if a decision to undertake a criminal investigation is being considered.

The discussion / meeting must generally involve, as a minimum, both Children and Young People Division and CPU with other agencies included as appropriate, in particular the referring agency, the child's nursery / school, health and (where relevant) registered owner of service and registration authority.

Where issues have significant medical implications, or a paediatric examination has taken place or may be necessary, a paediatrician should always be included.

If the child is receiving services from a hospital or child development team, the discussion should involve the responsible medical consultant and, in the case of in-patient treatment, a senior ward nurse.

The local authority solicitor's involvement may be appropriate.

Consideration should be given to the need to include a professional with expertise in particular cases of complex forms of alleged abuse and neglect.

The strategy meeting is essentially a meeting for professionals sufficiently senior to be able to contribute, although exceptional circumstances may arise when a non-professional may usefully contribute.

Notes of Discussion/Meeting

It is the responsibility of the chair of the meeting to ensure that the decisions and agreed actions are fully recorded using the ' Record of strategy discussion form a copy of which is at the end of this section.

For telephone discussions, a copy of the notes authorised by the first line manager should be faxed to all participants.

CPU officers attending strategy meetings or conducting strategy discussions will record the decisions and actions agreed on MPS strategy meeting record forms. The CPU will ensure that any discrepancies between Children and Young People Division and police records are resolved at the earliest opportunity.

Timing of Strategy Discussion/Meeting

Strategy meetings should be convened within 3 working days except in the following circumstances:

For allegations / concerns indicating a serious risk to the child (e.g. serious physical injury or serious neglect) the strategy discussion / meeting should be held on the same day as the receipt of the referral
For allegations of penetrative sexual abuse, the strategy discussion / meeting should be held on the same day as the receipt of the referral if this is required to ensure forensic evidence
Where immediate action was required by either agency, the strategy discussion / meeting must be held within 1 working day
Where the concerns are particularly complex e.g. organized abuse the strategy meeting must be held within a maximum of 5 working days, but sooner if there is a need to provide immediate protection to a child

The plan made at the strategy discussion/meeting should reflect the requirement to convene an initial child protection conference within 15 working days of the last strategy discussion (see 'What To Do If You're Worried A Child Is Being Abused').

Location of Strategy Meeting

Generally the strategy meeting should be held at the local Children and Young People Division, but can be convened elsewhere if appropriate.

If the child is an in-patient in hospital, the strategy meeting may need to be held at the hospital, to maximise input from hospital staff.

7. CPU Criminal Investigations

The primary responsibility of CPU staff is to undertake criminal investigations of suspected or actual crime. Children's Social Care Services have the statutory duty to make, or cause to be made; enquiries when the circumstances defined in s.47 Children Act 1989 exist.

Where both agencies have responsibilities with respect to a child, they must coordinate to ensure the parallel process of an s.47 enquiry and a criminal investigation is undertaken in the best interests of the child. This should primarily be achieved through the co-ordination of activities at strategy discussions and / or meetings.

Referral to CPU

Any suspected, alleged or actual crime must be referred to CPU. Telephone referrals should be followed up, within 48 hours, by faxed confirmation, on MPS form 87A .

The CPU referral manager will make a decision, based on MPS threshold policy, following checks and information sharing, whether to initiate a criminal investigation.

The following matters will always be investigated by police:

All sexual assaults
Physical abuse amounting to offences of actual bodily harm (s.47)
Offences Against the Person Act 1861) and more serious assaults
Serious neglect / cruelty offences
Minor offences where there are aggravating features

In respect of other offences of a minor nature the CPU referral manager will determine the necessity for a criminal investigation according to a number of criteria (threshold policy) which include whether the facts are clear and undisputed, known history and likely impact on child, etc.

If a minor crime, initially assessed by the referral manager as inappropriate of further investigation, is subsequently discovered to be more serious than originally perceived, then the case must be referred back to the CPU for further assessment.

Criminal investigation & strategy discussion/meeting

Where the CPU is undertaking a criminal investigation; the police are responsible for all the associated investigative activities e.g. conducting interviews of witnesses and suspects; visiting crime scenes and arranging medical examinations.

The CPU should through strategy discussions and / or meetings discuss with those involved, processes relevant to other agencies, in particular timing and methods of information gathering likely to impinge on an s.47 enquiry.

Some activities will be best undertaken collaboratively between Children and Young People Division and police e.g. interviews of child and parents / carers, unless this is prejudicial to the criminal investigation.

In urgent criminal cases (critical incidents) the police may need to act independently of partner agencies, however police will advise the appropriate agencies of the matter as soon as practicable.

Following a full assessment of the available facts the CPU may decide at any stage e.g. during or following a strategy meeting, to terminate a criminal investigation and will inform Children and Young People Division of the decision.

8. Involving Parents, Family Members and Children

The social worker has the prime responsibility to engage with family members in order to assess the overall capacity of the family to safeguard the child, as well as ascertain the facts of the situation causing concern.

Parents and those with parental responsibility must be informed at the earliest opportunity of concerns, unless to do so would place the child at risk of significant harm, or undermine a criminal investigation.

Parents should, in addition to being offered a verbal explanation of the child protection enquiry process, to be provided with an explanatory leaflet.

Due consideration must be given to the capacity of the parents to understand this information in a situation of significant anxiety and stress.

Consideration must be given to those for whom English is not their first language or who may have a physical / sensory / learning disability and may need the services of an appropriate interpreter.

It is also essential that factors such as race, culture, religion, gender and sexuality together with issues arising from disability and health are taken into account.

It may be necessary to provide the information in stages and this must be taken into account in planning the enquiry.

In planning any intervention with parent/s, the following points must be covered:

An explanation of the reason for concern and where appropriate the source of information
The procedures to be followed (this must include an explanation of the need for the child to be seen, interviewed and / or medically examined and seeking parental agreement for these aspects of the enquiry and / or investigation)
An explanation of their rights as parents including the need for support and guidance from an advocate whom they trust (advice should be given about the right to seek legal advice)
An explanation of the role of the various agencies involved in the enquiry and / or investigation and of the wish to work in partnership with them to secure the welfare of their child
The need to gather initial information on the history and structure of the family, the child and other relevant information to enable an assessment of the injuries and / or allegations and the continuing risk to the child to be made
In situations of domestic violence, the possibility of working with the parents separately
Assessment of evidential opportunities in a police investigation and recovery of evidence that may confirm or refute an allegation or suspicion of crime
The provision of an opportunity for parents to be able to ask questions and receive support and guidance

In the event of any conflict between the needs and wishes of the parents and those of the child, the child's welfare is the paramount consideration in any decision or action

Parents should be provided with an early opportunity to explain their perception of the concerns, recognising that there may be alternative accounts and disparities.

In the course of an enquiry it may be necessary for statutory agencies to make decisions or initiate actions to protect children, or require the parents to agree to such action.

The social worker must inform relevant agencies of any such decisions or actions and confirm them in writing without delay.

9. Meeting the Child

All children within the household must be directly communicated with during an enquiry. Those who are the focus of concern should be seen alone, subject to age and preferably with parental permission.

Working Together to Safeguard Children paragraph 5.37 states that 'exceptionally, a joint enquiries / investigation team may need to speak to a suspected child victim without the knowledge of the parent or carer. Relevant circumstances would include the possibility that a child would be threatened or coerced into silence; a strong likelihood that important evidence would be destroyed; or that the child in question did not wish the parent to be involved at that stage, and is competent to take that decision.'

Consideration must be given to child's developmental stage and cognitive ability.

Specialist help may be needed:

If the child's first language is not English (see London Child Protection Procedures)
He / she appears to have a degree of psychiatric disturbance but is deemed competent
He / she has a physical / sensory / learning disability (see London Child Protection Procedures Section 5.50)
Where interviewers do not have adequate knowledge and understanding of the child's racial religious and cultural background

Consideration should also be given to the gender of interviewers, particularly in cases of alleged sexual abuse.

It is also essential that factors such as race, culture, religion, gender and sexuality together with issues arising from disability and health are taken into account.

It may be necessary to provide the information in stages and this must be taken into account in planning the enquiry.

The objectives in seeing the child are to:

Record and evaluate his / her appearance, demeanour, mood state and behaviour
Hear the child's account of allegations or concerns
Observe and record the interactions of the child and his / her carers
See and record the circumstances in which the child is currently living and sleeping and, if different, his / her ordinary residence
Evaluate the physical safety of the environment including the storage of hazardous substances e.g. bleach, drugs
Ensure that any other children who need to be seen are identified
Assess the degree of risk and possible need for protective action
Meet the child's needs for information and re-assurance

The strategy discussion / meeting must decide where, when and how the child should be seen and if a video interview is required.

A child with a significant physical injury should be seen on the same working day as the referral is received.

In order to avoid undermining any subsequent criminal case, in any contact with a child prior to an interview, staff must:

Listen to the child rather than directly questioning him / her
Never stop the child freely recounting significant events
Fully record the discussion including timing, setting, presence of others as well as what was said

All subsequent events up to the time of the video interview must be fully recorded.

Visually Recorded Interviews

The conduct of and criteria for visually recorded interviews with children are clearly laid out in the current guidance - Achieving Best Evidence in Criminal Proceedings (HO 2001)

Video recorded interviews serve two primary purposes:

Evidence gathering for criminal proceedings
Examination in chief of a child witness

Relevant information from this process can also be used to inform s.47 enquiries, subsequent civil childcare proceedings or disciplinary proceedings against adult carers.

Criteria for video recording an interview

Video recorded interviews should be used for children giving evidence in sexual offence cases or in cases involving an offence of violence, abduction or neglect, unless the child objects and / or there are other difficulties e.g. abuse of the child has involved the use of video.

In other cases of children giving evidence the decision on whether or not to video should take account of the:

Individual child's needs and circumstances
Likelihood of maximising the quality of that particular child's evidence
Type and severity of offence
Circumstances of offence e.g. relationship to alleged abuser
Child's state of mind
Perceived fears regarding intimidation and recrimination

Consideration should be given to the:

The purpose and likely value of the specific video recorded interview
Competency, compellability and availability of child for cross-examination
Child's ability and willingness to talk in a formal interview setting

Inability to Access the Child

If a child's whereabouts are unknown, or they cannot be traced, by the social worker, within 24 hours the following action must be taken:

A strategy discussion /meeting with CPU
Agreement reached with the manager responsible as to what further action is required to locate and see the child and carry out the enquiry

If access to a child is refused or obstructed the social worker, in consultation with his / her manager, should have a strategy discussion with the police and seek legal advice as appropriate.

10. Paediatric Assessment

Where the child appears in urgent need of medical attention - e.g. suspected fractures, bleeding, loss of consciousness, he / she should be taken to the nearest A & E Department.

In other circumstances the strategy discussion or meeting will determine, in consultation with the paediatrician, the need and timing for a paediatric assessment.

A paediatric assessment involves a holistic approach to the child and considers the child's well being, including development, if under five years old and his / her cognitive ability if older (educational psychologists can offer further expertise).

This assessment should always be considered when there is a suspicion or disclosure of child abuse and / or neglect involving a suspicious or serious injury, suspected sexual abuse and serious neglect. Additional considerations are the need to:

Secure forensic evidence
Obtain medical documentation
Provide re-assurance for the child, parent and Children and Young People Division
Provide treatment follow up and review for the child (any injury, infection, new symptoms including psychological)

Only doctors may physically examine the whole child, but other staff should note any visible marks or injuries on a body map and document details in their recording.

Consent for Paediatric Assessment or Medical Treatment

The following may give consent to a paediatric assessment:

A child of sufficient age and understanding
Any person with parental responsibility
The local authority when the child is the subject of a Care Order (though the parent / carer should be informed)
The local authority when the child is accommodated under s.20 of the Children Act 1989, and the parent / carers have abandoned the child or are physically or mentally unable to give such authority
The High Court when the child is a ward of court
A Family Proceedings Court as part of a direction attached to an
Emergency Protection Order, an interim Care Order or a Child Assessment Order

When a child is looked after under s.20 and a parent / carer has given general consent authorising medical treatment for the child, legal advice must be taken about whether this provides consent for paediatric assessment for child protection purposes (the parent / carer still has full parental responsibility for the child)

A child of any age who has sufficient understanding (generally to be assessed by the doctor with advice from others as required) to make a fully informed decision can provide lawful consent to all or part of a paediatric assessment or emergency treatment.

A young person aged sixteen or seventeen has an explicit right (s.8 Family Law Reform Act 1969) to provide consent to surgical, medical or dental treatment and unless grounds exist for doubting his / her mental health, no further consent is required.

A child who is of sufficient age and understanding may refuse some or all of the paediatric assessment though refusal can potentially be overridden by a court.

Wherever possible the permission of a parent should be sought for children under sixteen prior to any paediatric assessment and / or other medical treatment.

Where circumstances do not allow permission to be obtained and the child needs emergency medical treatment then:

The medical practitioner may regard the child to be of an age and level of understanding to give his / her own consent
The medical practitioner may decide to proceed without consent

In these circumstances, parents must be informed as soon as possible and a full record must be made at the time.

In non-emergency situations, when parental permission is not obtained, the social worker and manager must consider whether it is in the child's best interests to seek a court order.

Arranging the Paediatric Assessments

In the course of s.47 enquiries, appropriately trained and experienced practitioners must undertake all paediatric assessments.

Referrals for child protection paediatric assessments from a social worker should be made via the Phoenix Centre on 020 8466 8800.

The paediatrician may arrange to examine the child him / herself, or arrange for the child to be seen by a member of the paediatric team in the hospital or community.

In cases of suspected sexual abuse GPs must not perform a detailed examination.

The assessment may be carried out jointly by a forensic medical examiner (FME) and a paediatrician. If a FME is not available, two paediatricians may carry out the assessment provided one has received forensic training.

In these cases, a CPU officer should directly brief the doctors and take possession of evidential items.

Single examinations should only be undertaken if the person has the requisite skills and equipment. For further guidance for paediatricians and FMEs see the Royal College of Paediatrics and Association of Police Surgeons Child Health Guidelines (2002).

In cases of severe neglect, physical injury or penetrative sexual abuse, the assessment should be undertaken on the day of referral, where compatible with the welfare of the child.

The social worker should, (unless this would cause undue delay) consult parents about the gender of the medical practitioner prior to the examination being conducted.

The need for a specialist assessment by a child psychiatrist or psychologist should be considered.

In planning the examination, the social worker, the manager responsible, the CPU and relevant doctor must consider whether it might be necessary to take photographic evidence for use in care or criminal proceedings.

Where such arrangements are necessary, the child and parents must be informed and prepared and careful consideration given to the impact on the child.

Recording of Paediatric Assessment

The paediatrician should supply a report to the social worker, GP and where appropriate the CPU. The timing of a letter to parents should be determined in consultation with Children and Young People Division and CPU.

The report should include:

A verbatim record of the carer's and child's accounts of injuries and concerns noting any discrepancies or changes of story
Documentary findings in both words and diagrams
Site, size, shape and where possible age of any marks or injuries
Date, time and place of examination
Those present
Who gave consent and how (child / parent, written / verbal)
Other findings relevant to the child e.g. squint, learning or speech problems etc.
Confirmation of the child's developmental progress (especially important in cases of neglect)
Time examination ended

All reports and diagrams should be signed and dated by the doctor undertaking the examination.

11. Risk Assessment

The scope and focus of the assessment during the enquiry will be that of a risk assessment which:

Identifies the cause for concern
Evaluates the strengths of the family
Evaluates the risks to the child
Considers the child's needs for protection
Evaluates information from all other sources (see Section 5 - London Child Protection Procedures)
Considers the ability of parents and wider family and social networks to safeguard and promote the child's welfare

S.47 paperwork should provide for two specific risk assessment phases to determine the level of subsequent intervention:

Immediately following checks and information gathering to determine if an s.47 enquiry should be progressed
At the conclusion of the enquiry to determine the outcome and subsequent levels of intervention to be offered

Where the child's circumstances are about to change the risk assessment must include an assessment of the safety of the new environment e.g. where a child is to be discharged from hospital to home the assessment must have established the safety of the home environment and implemented any support plan required to meet the child's needs.

12. Outcome of Child Protection Enquiries

At the completion of the planned enquiry, a strategy discussion / meeting should be held to share information and agree the outcome of the enquiry or plan any further enquiries. These should be recorded on the record of child protection / initial assessment form.

When the outcome is agreed, the original concerns may be:

Unsubstantiated
Substantiated, but assessed as posing no continuing risk of significant harm
Substantiated and at continuing risk of significant harm

Where the concerns are not substantiated or are substantiated but the situation assessed as no continuing risk of significant harm the manager must authorise the decision, having ensured that the child, any other children in the household and the child's carers have been seen and spoken with.

In these circumstances, consideration must be given to completion of the core assessment (if incomplete) and provision of services. Some boroughs provide a system of family support or network meetings to provide multi-agency coordination of service delivery.

Where concerns are substantiated and the child is assessed to be at continuing risk of significant harm the first line manager / child protection adviser must authorise the convening of an initial child protection conference and completion of the core assessment, having ensured the child, any other children in the household and the child's carers have been seen and spoken with.

Feedback from Enquiries

Outcomes of enquiries must be clearly recorded by the social worker, with the reasons for decisions clearly stated and signed off by his / her manager.

Feedback about outcomes should be provided to non-professional referrers in a manner that respects the confidentiality and welfare of the child.

Parents, children (depending on level of understanding), professionals and other agencies who have had significant involvement, should be provided with a copy of the written record of the outcome of the enquiry.

If there are ongoing criminal investigations, the content of the social workers feedback should be agreed with the CPU.

Disputed Decisions

Where Children and Young People Division have concluded that an initial child protection conference is not required but professionals in other agencies remain seriously concerned about the safety of a child, they should seek further discussion with the social worker, his / her manager and / or the child protection advisor. The concerns, discussion and any agreements made should be recorded in each agencies file.

If concerns remain, the professional should discuss with a designated / named / lead person or senior manager in their agency. If concerns remain the agency may formally request that Children and Young People Division convene an initial child protection conference. Children and Young People Division should convene a conference where one or more professionals, supported by a senior manager / named or designated professional requests one.

If this approach fails to achieve agreement, the procedures for resolution of conflicts (see Section 18.5 - London Child Protection Procedures) should be followed.

13. Time-Scales

Routine

The initial strategy discussion / meeting instigates the s.47 enquiry.

The core assessment must be completed within 35 working days from the date of the strategy discussion/meeting (see the Framework for the Assessment of Children in Need and their Families p.32, paragraph 3.11).

The maximum period from the strategy discussion (or last discussion if more than one held) of an enquiry to the date of the initial child protection conference is 15 working days, which means that initial conferences may be held prior to the completion of the core assessment.

Exceptions

The time-scales above are the minimum standards required by Working Together. Where the welfare of the child requires shorter time-scales these must be achieved.

There may be exceptional circumstances where it is not in the child's interests to work to the above time-scales. The circumstances which may lead to an alternative time-scale include:

The need to engage interpreters, translators etc.
Pre-birth assessments
Complex cases e.g. fabricated or induced illness, those involving suspected organised or institutional abuse, cases where paid or voluntary carers are involved and cases which require coordination with other local authorities because the child is found outside the borough

Any proposal to justify variation of routine time scales must be authorised by the service manager following the line manager's consultations with the CPU and any relevant agencies.

Reasons for diverging from these time-scales must be fully recorded together with a plan of action detailing alternative arrangements.

14. Recording

A full written record must be completed by each agency involved in an s.47 enquiry, using the required agency pro-formas, (legibly) signed and dated by the staff.

The responsible manager must countersign social services s.47 recording and forms.

Practitioners should, wherever possible, be retained signed and dated rough notes until the completion of anticipated legal proceedings.

Children and Young People Division recording of enquiries should include:

Agency checks
Content of contact cross referenced with any specific forms used
Strategy discussion / meeting notes
Details of the enquiry
Body maps (where applicable)
Assessment including identification of risks and how they may be managed
Decision making processes
Outcome / Further Action Planned

At the completion of the enquiry the social work manager should ensure that the concern and outcome have been entered on a chronology kept at the front of each file

End