3.3 Strategy Discussions/Meetings and Section 47 Enquiries as Part of Social Work Assessment of Needs and Strengths
AMENDMENTThis chapter was updated in August 2014 to reflect the ‘Working Together 2013’ Single Assessment process in The Wirral.
- Strategy Discussions and Meetings
- Timescale of Strategy Discussion/Meeting
- Who Should be Involved?
- When a Face-to-Face Meeting is Required
- Chairing Strategy Meetings
- Venue for Strategy Meetings
- Recording of a Strategy Discussion/Meeting
- Duty to Undertake Section 47 Enquiries
- Obligations and Responsibilities of All Agencies
- Location of Responsibility for Section 47 Enquiries
- Purpose of Section 47 Enquiries
- Decision to Undertake Section 47 Enquiries
- Integration with Social Work Assessment of Need and Strengths and the Assessment Framework
- Single Agency or Joint Enquiry/Investigation
- Police Single Agency Investigations
- Joint Investigations
- Disagreements between Professionals
- Seeing and Interviewing the Child as part of Section 47 Enquiries
- Inability to Access the Child
- Achieving Best Evidence: Interviews of Children
- Child's Consent to the Video Recording of an Interview
- Parental Involvement and Consent
- Medical Assessments
- Outcome of the Section 47 Enquiries
- Children's Specialist Services Recording Requirements
- Resolving Professional Differences
|1.1||Whenever there is reasonable cause to suspect that a child is suffering, or is likely to suffer Significant Harm, there should be a Strategy Discussion/Meeting involving Children's Specialist Services and the Police, Health (Designated Nurse for LAC and/or Designated Doctor for LAC) and other bodies as appropriate (for example, Children's Centre/School, and in particular any referring Agency).|
|1.2||The Strategy Discussion/Meeting should be convened by Children's Specialist Services for immediate risk on the same day, or within 3 days for safeguarding concerns and those participating should be sufficiently senior and able, therefore, to contribute to the discussion of available information and to make decisions on behalf of their agencies.|
|1.3||A Strategy Discussion/Meeting may take place following a Referral and/or at any other time (for example, if concerns about Significant Harm emerge in respect of a Child in Need receiving support under Section 17 Children Act 1989).|
A Strategy Discussion/Meeting should be considered:
The Strategy Meeting/Discussion should be used to:
|1.6||The plan should reflect the requirement to convene an Initial Child Protection Conference within 15 working days of the Strategy Discussion/Meeting, which decided to initiate a section 47 Enquiry.|
|1.7||Children's Specialist Services should record information, which is consistent with the information set out in the Record of Strategy Discussion Any decisions about taking immediate action should be kept under constant review.|
|1.8||A Strategy Discussion may conclude that a Section 47 Enquiry is not required as there is insufficient evidence of risk of Significant Harm. This must be agreed by a Children's Specialist Services Manager, Detective Sergeant, Family Crime Investigation Unit and any other professionals involved in the discussion. The reasons for this decision must be fully recorded.|
In reaching a conclusion as to the justification for Section 47 Enquiries, the Strategy Discussion/Meeting must consider the following factors:
Strategy Discussions / Meetings should be held within a maximum of 3 working days of the Referral, incident of concern for a child known to Children's Specialist Services, or decision by a multi-agency network that the Child in Need Plan is not meeting the child's needs except in the following circumstances:
|3.1||The Strategy Discussion must involve at a minimum the Children's Specialist Services, Police and Health (specifically a Named Nurse or Paediatrician), as well as other agencies involved with the family, including the referring Agency or the child's Nursery/School.|
|3.2||In the case of a pre-birth Strategy Meeting (see Initial Child Protection Conferences Procedure, Pre-Birth Child Protection Conferences), this should involve the Midwifery Service.|
|3.3||When required, a legal adviser should be invited.|
|3.4||If the child is in a hospital setting (in-patient or out-patient) or receiving services from a child development team, the Paediatric Consultant responsible for the child's health should be involved, as should the senior ward nurse where the child is an in-patient. When a medical examination may be necessary, or has taken place, a senior Doctor from those providing services must also be involved.|
|3.5||Consideration must also be given to the need to seek advice from or invite a professional with expertise in the particular type of suspected Significant Harm. Where parents or adults in the household are experiencing problems such as domestic abuse, substance misuse or mental illness, it will also be important to consider involving the relevant adult services professionals.|
|3.6||Those participating must be sufficiently senior to be able to contribute to the discussions of the available information and to make decisions on behalf of their own Agency.|
|4.1||A Strategy Discussion may take place at a meeting or by other means (for example, by telephone). In complex types of maltreatment a meeting is likely to be the most effective way of discussing the child's welfare and planning future action.|
Face-to-face meetings must be held when there:
|5.1||Strategy Meetings will be chaired by a Practice/Team Manager or Principal Team Manager.|
|6.1||Strategy Meetings should be held at various venues which are suitable for the Multi-agency Group and will be dependent on the availability of staff who may be non-mobile such as Hospital staff.|
|7.1||Agreed actions, the persons responsible and the agreed time scale must be recorded.|
|7.2||It is the responsibility of the Chair of the Strategy Meeting to ensure that these decisions are fully recorded and a copy should be made available immediately for all participants.|
|7.3||For telephone discussions, a copy of the Record of Strategy Discussion authorised by the Manager must be faxed/emailed to all participants.|
Children's Specialist Services has a statutory duty to undertake Section 47 Enquiries in any of the following circumstances:
|8.2||Responsibility for undertaking Section 47 Enquiries lies with the Children's Specialist Services for the area in which the child lives or is found, even though the child is ordinarily resident in another local authorities area.|
|8.3||Where a Strategy Discussion/Meeting is being convened in relation to a child who is ordinarily resident in the area of another Local Authority, her/his home authority must be informed as soon as possible, and be involved as appropriate in the Strategy Discussion/Meeting. In certain cases, it may be agreed that the home authority should undertake the enquiries e.g. if the child is Looked After, and in all cases, the home authority must take responsibility for any further support of the child or family identified as necessary. See also Children in Need Moving in and Out of Wirral Procedure.|
|9.1||All Agencies have a duty to assist and provide information in support of Section 47 Enquiries.|
|9.2||Any checks made by Children's Specialist Services and/or the Police with other agencies should be undertaken directly with involved professionals and not through messages with intermediaries.|
|9.3||Relevant Agencies should be informed of the reasons for the Section 47 Enquiries, whether parental consent has been obtained and asked for their assessment of the child in the light of information presented.|
|10.1||It is the responsibility of the Team to which the case is referred or the team which has case responsibility to assess what action is required and ensure that an investigation is undertaken.|
|If a child is in a Community Home, Foster Home or Boarding School in Wirral and a referral arises requiring investigation into circumstances in the placement, this will be the responsibility of the Assessment Team in whose area the placement is situated.|
|11.1||The purpose of the Section 47 Enquiries is to determine whether any further action is required to safeguard and promote the welfare of the child/ren who is/are the subject of the enquiry.|
|11.2||If a decision is made that a Section 47 Enquiry is necessary, it may be undertaken by the Children's Specialist Services alone or jointly with the Police - see Section 14, Single Agency or Joint Enquiry / Investigation.|
A decision to undertake such enquiries is usually taken following a Social Work Assessment of Needs and Strengths. However, a decision to undertake Section 47 Enquiries must be taken at any time whenever the criteria set out in Section 11, Purpose of Section 47 Enquiries and Timescale - see Section 2, Timescale of Strategy Discussion/Meeting are met, for example:
|12.2||The plan for Section 47 Enquiries must be developed at a Strategy Discussion or Meeting and reflect the requirement that, when further action is required to safeguard the child, an Initial Child Protection Conference must be convened within 15 working days of the Strategy Discussion/Meeting or, the Strategy Discussion/Meeting at which the Section 47 Enquiry was initiated if more than one was held.|
|13.1||A Social Work Assessment of Needs and Strengths is the means by which Section 47 Enquiries are carried out and must be commenced whenever the criteria for Section 47 Enquiries are satisfied. The Social Work Assessment of Needs and Strengths must be completed within 45 working days of the Strategy Discussion/Meeting or, the Strategy Discussion/Meeting at which the Section 47 Enquiry was initiated if more than one was held.|
|13.2||Section 47 Enquiries should begin by focusing primarily on the information identified during the Referral and any immediate Assessment information, which appears most important in relation to the risk of Significant Harm. This should be recorded on Record of Outcome of S47 Enquiries (ICSe - which is available on the children services intranet).|
The assessment of risk will:
|13.4||This will inform the Assessment, which must cover all relevant dimensions in the Assessment Framework and be alert to the potential needs and safety of siblings or other children in the household or with whom the alleged offender may have had contact.|
|13.5||Section 47 Enquiries / Social Work Assessment of Needs and Strengths must be led by a qualified and experienced Social Worker from Children's Specialist Services, who will be responsible for its coordination and completion. The Social Worker must consult with other agencies involved with the child and family to obtain a fuller picture of the circumstances of all children in the household, identifying parenting strengths and any risk factors. All agencies consulted are responsible for providing information to assist.|
|13.6||At the same time, where there is a joint investigation, the Police will have to establish the facts about any offence that may have been committed against a child and collect evidence - see Section 14, Single Agency or Joint Enquiry/Investigation.|
|13.7||Enquiries and assessment should always involve separate interviews with the child and, in the majority of cases, the parents, and the observation of interaction between the parent and child. This will include interviews and observations of both parents, any other carers and the partners of the parents. Any discussions with children should be conducted in a way that minimises distress; leading or suggestive communication must be avoided and interviews during the process of a criminal investigation must follow the Achieving Best Evidence guidance - see also Section 18, Seeing and Interviewing the Child as part of Section 47 Enquiries and Section 22, Parental Involvement and Consent.|
|13.8||If the child is too young to be interviewed or communication is difficult for any reason, alternative means of understanding the child's wishes and feelings should be used.|
Children's Specialist Services - Single Agency Enquiry
Following a decision at the Strategy Meeting/Discussion Children's Specialist Services single agency enquiries will usually be those involving:
|14.2||During the Initial Strategy Discussion between Agencies when a decision has been taken to pursue Section 47 Enquiries on a Single Agency basis, the arrangements for each Agency to feed back to each other must be clarified at the outset.|
|14.3||If, at any point during the Single Agency Section 47 enquiries it becomes apparent that the joint investigation criteria are met, the Practice or Team Manager should contact the Police and a joint investigation commenced.|
Social Workers will therefore need to be aware of the need to:
Police Single Agency Investigations are usually appropriate when:
|15.2||When Police undertake a Single Agency criminal investigation, officers are responsible for all the associated investigative activities, e.g. conducting interviews of witnesses and suspects; visiting crime scenes and, in conjunction with the Social Worker, arranging medical assessments.|
|15.3||During a Police investigation, the investigating officer must assess the risks posed by the alleged offender, consider the ongoing needs of any child victim and her/his family and make a referral to Children's Specialist Services as appropriate, e.g. for Supportive and Therapeutic Services.|
|15.4||If during the course of a Police investigation, it emerges that parental deficiencies in the care of a child have significantly contributed to the alleged offence, Children's Specialist Services must be contacted, a Strategy Discussion held and a joint enquiry / investigation commenced if appropriate.|
|15.5||If during the course of a Police investigation, a risk to other children is identified, a Strategy Discussion must be held and the need for a joint enquiry / investigation must be considered.|
|15.6||When there has been an initial Strategy Discussion but a decision has been taken to pursue a Police single agency investigation, the arrangements for the Agencies to feed back to each other must be clarified at the outset.|
|15.7||On occasions, in urgent criminal cases (critical incidents), the Police may conduct a single agency investigation out of hours, in liaison with EDT, as a result of their duty to respond and take initial action to protect either a child or criminal evidence.|
|15.8||If this occurs, Children's Specialist Services must be informed as soon as possible and a Strategy Discussion held to consider the need for a joint investigation if appropriate.|
|16.1||Joint investigations are conducted by Children's Specialist Services and the Police.|
A joint investigation must always commence when there is an allegation or reasonable suspicion that one of the criminal offences described below has been committed:
A joint investigation must also be considered in cases of:
|16.4||Following a full assessment of the available facts, the Police and/or Crown Prosecution Service (CPS) may decide at any stage to terminate a criminal investigation and will inform the Social Worker of the decision in writing within 2 working days of the decision.|
|17.1||Disputes about the threshold for a joint enquiry must be resolved between Senior Managers of the Agencies involved and should result in the Wirral SCB Escalation Procedure being initiated.|
Seeing the Child
|18.1||Children who are the subject of Section 47 Enquiries should always be seen and communicated with alone by the Lead Social Worker. In addition all children within the household must be directly communicated with during the enquiries by either the Police or Children's Services or both agencies, so as to assess any risk to their safety.|
|18.2||The child subject to the enquiry must be spoken to alone within 24 hours of the referral being received, subject to their age and willingness, preferably with parental permission (see Section 22, Parental Involvement and Consent). Children are a key and sometimes the only source of information about what has happened to them especially in child sexual abuse cases but also in physical and other forms of abuse. Accurate and complete information is essential for taking action to promote the welfare of the child as well as for criminal proceedings that may be instigated concerning an alleged perpetrator of abuse.|
|18.3||When the child is the subject of ongoing Court Proceedings the Court must be notified. This is done by the Social Worker contacting Wirral Council's Legal Department to inform them that a Section 47 Enquiry investigation will be taking place. The social worker must also notify the Children's Guardian in CAFCASS;|
|18.4||When children are first approached, the nature and extent of any harm suffered by them may not be clear, nor whether a criminal offence has been committed. It is important that even initial discussions with children are conducted in a way that minimises any distress caused to them and maximises the likelihood that they will provide accurate and complete information. When a child is of an appropriate age and understanding, s/he should be told what is to happen and their agreement sought. Non-agreement should be respected.|
|18.5||Children's Services and the Police should ensure that appropriate arrangements are in place to support the child through the enquiry / joint investigation;|
Specialist help may be needed if:
|18.7||It is important wherever possible to have separate communication with a child. Leading or suggestive communication should always be avoided. It may be necessary to give the child some time and provide information to the child in stages, in order to develop sufficient trust to communicate any concerns they may have, especially if they have a communication impairment, learning difficulties are very young or are experiencing mental health problems. This must be taken into account in planning Section 47 Enquiries.|
|18.8||Explanations given to the child must be brought up to date as the Section 47 Enquiry/joint investigation progresses. In no circumstances should the child be left wondering what is happening and why.|
The objectives in seeing the child are to:
|18.10||The Strategy Discussion / Strategy Meeting must decide where, when and how the child or children should be seen and if a video interview is required (see Section 20.1, Criteria for Video Interviews).|
Seeing and interviewing the child is not a version of an Achieving Best Evidence Interview (ABE), undertaken under the evidence gathering for ABE interviews conducted under the Criminal Justice Act (2003). They may of course be used to inform these but are not replaced or a forerunner to ABE interviews. Staff should:
If efforts to see and communicate with the child or children within the time scales agreed at the Strategy Discussion are unsuccessful, then the Social Worker and, where relevant, the Police officer should:
|19.2||The Strategy Discussion must take place by the end of the working day on which the plan was to see the child, and must undertake a re-appraisal of the risks to the child and consequently the plan for completing Section 47 Enquiries in the light of not seeing the child.|
This must include agreement as to what further action is required to:
Criteria for Video Interviews
See "Achieving Best Evidence in Criminal Proceedings: Guidance on Interviewing Victims and Witnesses, and Using Special Measures 2011" for full and detailed Guidance.The police have lead responsibility for the criminal investigation and therefore the video interview process is managed by them and the Section 47 enquiry will run alongside the criminal investigation. However this does not mean that the police will always take the lead in the investigative interview. (Para 2.22 Ministry of Justice, Guidance on interviewing victims and witnesses, and guidance on using special measures (March 2011)). See also Achieving Best Evidence Guidance.
Given the variety of children's backgrounds and the different circumstances leading to suspicion of abuse there are no hard and fast rules or unequivocal criteria that apply to the video recording of interviews Agreement needs to be obtained between the Police and Children's Specialist Services on whether it is in the best interests of the child to conduct a full criminal investigation. However among the considerations to be taken into account at the Strategy Meeting/Discussion before proceeding with any video -recorded interview with the child are the following:
Any video recorded interview serves two primary purposes:
In addition any relevant information gained during the interview can be used to:
Conduct of Joint Video Interviews
|20.5||In all cases where it is agreed to conduct a video recorded interview of a child, "Achieving Best Evidence in Criminal Proceedings: Guidance on Interviewing Victims and Witnesses, and Using Special Measures 2011" must be followed and staff conducting the interview must have had appropriate training.|
|20.6||The video interview must only be undertaken following and within the parameters agreed at a Strategy Discussion / Meeting.|
|20.7||Those conducting the interview must meet to agree and record a plan for the interview.|
|20.8||Following the interview a reconvened Strategy Meeting must take place within a week.|
|21.1||The video recording of interviews of children may only be carried out with the consent of the child her/himself. The interviewers are responsible for ensuring that, as far as possible, the child is freely participating in the interview, and not merely complying with a request from adult authority figures.|
|21.2||See Achieving Best Evidence in Criminal Proceedings: Guidance on Interviewing Victims and Witnesses, and Using Special Measures 2011.|
|22.1||If the parent or other family member is implicated in the alleged abuse and there is a joint investigation with the police, firm agreement needs to be gained on who should and what can be discussed with them prior to any direct contact with Children's Social Care. The police may want to interview parents/family member under caution or any other police investigative process. This must be agreed beforehand when there are joint investigations as the Section 47 Enquiry must also ascertain as far as possible the need to safeguard the child/ren.|
|22.2||The Social Worker has the prime responsibility to engage with parents and other family members to ascertain the facts of the situation causing concern and to assess the capacity of the family to safeguard the child.|
|22.3||The assessment of the parents must include both parents, any other carers and the partners of the parents.|
|22.4||In most cases, parents should be enabled to participate fully in the assessment and enquiry process, which must be explained to them verbally. If a parent has a specific communication difficulty or English is not their first language, an interpreter should be provided.|
|22.5||Consideration should be given to the capacity of the parents to understand the information in a situation of anxiety and stress.|
|22.6||Parents must be involved at the earliest opportunity unless to do so would prejudice the safety of the child. The needs and safety of the child will be paramount when determining at what point parents or carers are given information. Parents must be kept informed throughout about the enquiry, its outcome and any subsequent action unless this would jeopardise the welfare of the child.|
In explaining the process of Section 47 Enquiries to parents, the following points should be covered:
|22.8||The Social Worker must consult her/his Manager so that s/he can decide on the basis of available information, whether to seek parental consent to undertake Inter-Agency checks. Parental consent is not necessary when there are concerns raised about the welfare of a child, See Information Sharing and Confidentiality Procedure. This will usually have already been discussed during the Assessment and at the Strategy Discussion.|
|22.9||In addition, the Social Worker must consult her/his manager about whether parental consent should be sought for an interview with and/or medical assessment of a child.|
If a decision is made not to seek parental permission, the reasons must be recorded and this may include:
|22.11||When it is decided to interview and/or arrange a medical assessment of the child without seeking the consent of the parents, the decision must be endorsed by a line manager. Legal advice must be taken as to whether any legal action is required before an interview and/or medical assessment can take place, for example, an application for a Child Assessment Order or in more urgent cases, an Emergency Protection Order.|
The parent or carer must be informed as soon as practicable and consistent with the best interests of the child.
If permission is sought but refused the Manager must determine whether to proceed, and if so, record the reasons. When there are reasonable grounds to believe that a child is suffering, or is likely to suffer, Significant Harm, and access is refused, Children's Specialist Services has a duty, unless it is satisfied that the child's welfare can be safeguarded without doing so to apply for:
When a Medical Assessment is Necessary
|23.1||Strategy Discussions or Meetings must consider, in consultation with the Designated Doctor for LAC/ Paediatrician (if not part of the Strategy Discussion or Meeting), the need for and timing of a Medical Assessment.|
|23.2||Medical Assessments should always be considered necessary where there has been a disclosure or there is a suspicion of any form of abuse to a child.|
Additional considerations are the need to:
|23.4||In cases of severe neglect, physical injury or penetrative sexual abuse, the assessment should be undertaken on the day of the Referral, where compatible with the welfare of the child.|
Medical Assessments in Child Protection Cases
When enquiring into incidents/allegations or suspicions of child abuse the Social Work Practitioner and/or Investigating Police Officer has to make a decision about whether to request a medical assessment by an appropriate doctor (this will probably be a paediatrician) in respect of the child and their siblings.
It is important to remember that medical evidence and opinion is only a contribution to the information gathered to make an assessment about the existence of risk or Significant Harm.
Whilst the medical assessment MAY provide a clear indication of abuse it will often only indicate a number of possibilities and it should be remembered that the absence of medical evidence does not, of itself, prove that no abuse has taken place.
The purpose of the medical assessment is:
- To assess whether the child has been injured and/or whether there are any other medical or developmental concerns;
- To provide treatment for the child;
- To provide an opinion in writing about the possible causes.
Consideration about the necessity for A Medical Assessment
Medical assessment WILL usually be necessary if ANY of the following apply:
- Any injuries to babies;
- There is reasonable suspicion of Significant Harm to a child;
- There is reasonable suspicion of Significant Harm to any child with a disability and the disability "impairs" his/her ability to communicate;
- There are inconsistencies in the explanations given regarding the cause of the injury or harm;
- There are suspicions or indications of detectable previous injury;
- There are signs of serious Neglect and/or signs of serious Emotional Abuse;
- There is reason to believe that forensic evidence of abuse may be present.
Medical assessments will NOT usually be necessary if ALL of the following apply:
- The injury is of a minor nature and does not need medical attention;
- The child is of an age and understanding to give an AUTHENTIC account of what has taken place;
- The child does not have a disability which would make it difficult to communicate that he/she is suffering abuse;
- The explanation given by the child and the parent/carer is consistent both with each other and with the injury or harm;
- There are no other indications of previous injury or current neglect.
In the context of joint enquiries involving the Police and Specialist Services, a joint decision should be taken about the need for a medical assessment at the Strategy Discussion/Meeting stage and the reasons behind the decision recorded.
Following an enquiry about abuse involving a child which strongly indicates that abuse has occurred, immediate consideration should be given to the need for the child's siblings or other children of the household to be medically assessed.General Practitioners may already have seen children prior to Social Workers/Police becoming involved. In this event their advice and the advice of a Paediatrician should be sought on the appropriateness of any further medical assessment. Further assessment will only take place if it is considered necessary, not as a matter of routine.
Medicals for Physical Abuse
|Consultant Paediatricians and Senior Paediatricians provide an on-call system for medical examinations on request by Children's Specialist Services. There should always be a discussion between the Social Worker and Paediatrician as to the most appropriate time for examination.
As a rule it is better for Medical Assessments to be done within working hours by the Community Paediatricians. There are several reasons for this:
|Monday to Friday 9.00am to 5.00pm - Examinations can be booked directly at the Rainbow Centre by telephoning 0151-252-5609.|
Outside Working HoursExaminations can be booked by telephoning 228-4811. The caller then has to ask for a long range bleep or a phone call to be made to the 1st doctor on call for child protection.
Medicals for Sexual Abuse
|The Police coordinate examinations for Sexual Abuse. Ideally joint examinations should take place within working hours by the Community Paediatrician and the Forensic Medical Examiner (FME). Police and social care representatives will attend to provide background information and support to families. The Police will need to contact the FME to agree a mutually convenient time for the DR and FME to undertake the examination.|
|Monday to Friday 9.00am to 5.00pm - Examinations can be booked directly at the Rainbow Centre by telephoning 0151-252-5609.|
Outside Working HoursExaminations can be booked by telephoning 228-4811. The caller then has to ask for a long range bleep or a phone call to be made to the 1st doctor on call for child protection.
Attendance at Child Protection Medicals
The child subject to a child protection medical should always be accompanied by:
- Their primary carer(usually parent(s)).
This allows for formal consent and collection of detailed family and past medical history. It is also important to ask carers how injuries may have occurred;
- The Social Worker who knows the family best.
This allows sharing of all relevant background and good communication about the outcome of the assessment;
- The police officer involved(where appropriate).
Consent to a Medical Assessment
The Doctor will request written consent from the child and/or carer for history taking, medical examination, appropriate investigations and sharing of information with other agencies.
Children may give or refuse consent to a medical assessment if they are deemed to have sufficient understanding to make an informed decision.
Children of sufficient age and understanding CANNOT BE MEDICALLY ASSESSED WITHOUT THEIR CONSENT EVEN WHERE AN EMERGENCY PROTECTION ORDER HAS BEEN MADE.
It is the Doctor's decision whether a child under 16 years has sufficient understanding to make an informed decision.
To enable consent to be given, sufficient information should be provided to allow an informed choice to be made. How this is discussed will depend on the age and understanding of the child. Where a child is mature enough, he or she should be given an explanation of the purpose of the medical assessment, of their right to give or refuse consent and of the consequences of the decision. The doctor should discuss this with the child prior to the medical assessment.
If any doubt remains about the validity of the child giving or withholding consent OR if a child of sufficient age and understanding gives consent but his/her parents do NOT agree to a medical assessment, legal advice should be sought.
If the child is not of sufficient age and understanding to give informed consent, consent must be obtained from the person with Parental Responsibility before the medical assessment can be carried out. In the case of a child already the subject of an EPO or an Interim Care Order, advice from Legal Section should be sought. However, the doctor will need to use their own judgement, even when there is valid consent, in exceptional circumstances, e.g. the young child who is very distressed.
If consent is refused by the person with Parental Responsibility, legal advice should be sought. Where the Local Authority holds a Care Order under section 31 Children Act 1989 for the child, the Local Authority has Parental Responsibility and can give consent to the assessment. Where the child is subject to an Interim Care Order, leave of court will first need to be obtained.
The Medical Assessment
The Doctor will usually discuss the background details with the Social Worker without the child and carer present.
The medical history and examination will usually take place without the social worker being present.
Medical information will be collected using standard forms. Any investigations such as blood tests, x-rays or photographs will be arranged at Arrowe Park Hospital.
Following the assessment the doctor should discuss the findings firstly with the child and carer and secondly with the Social Worker.
The Medical Report
The examining doctor will prepare a report as soon as possible after the examination. This report will follow a standard format. The report will outline the relevant history and findings on examination. It will give a view as to the causes of any injuries or other physical signs.
Any recommendations should be listed at the end of the report and make it clear who is responsible.
The medical report will be sent to the child's GP with copies to:
- The Social Worker attending;
- The Police Officer attending(where appropriate);
- The child's Health Visitor(for pre-school children);
- The child's School Nurse (for children attending School).
Any concerns about clarity of reports must be discussed with the Doctor involved as soon as possible.
|24.1||Section 47 Enquiries are concluded at the point when an informed decision is made taking account of all information available as to whether the child is at continuing risk of Significant Harm or not.|
|24.2||When a joint investigation has been held, a Strategy Discussion or Meeting should be held to agree the outcome and recorded on ICS.|
Section 47 Enquiries will result in one of 4 possible outcomes:
|24.4||In all cases, the outcome must be authorised by a Practice or Team manager who must decide if the Social Work Assessment of Needs and Strengths should be or has been completed or should be continued. If the outcome of a Section 47 Enquiry is that the concerns are substantiated but the child is judged not to be at continuing risk of Significant Harm, this decision must be endorsed by a suitably experienced and qualified social work manager.|
|24.5||Before the Practice or Team manager comes to a decision s/he must consult all agencies that have participated in the Section 47 Enquiries.|
|24.6||Where concerns are substantiated but the child is not judged to be at continuing risk of Significant Harm, a meeting, of involved professionals and family members may be convened at the end of the enquiries / Assessment to agree what actions should be undertaken by whom and with what outcomes for the child's health and development. This Child in Need planning meeting must include whether a plan for ensuring the child's future safety and welfare should be developed and implemented, whether a Family Group Conference (FGC) should be held and/or whether services should be provided under the Team Around the Family process (see the Wirral Guide for Integrated Working).|
|24.7||Such a meeting is also important to inform parents about the nature of any on-going concerns.|
|24.8||Whatever process is used to plan future action, the resulting plan should be informed by the Section 47 Enquiries / Social Work Assessment of Needs and Strengths findings. It should set out who will have responsibility for what action, including a time scale for review of progress against planned outcomes.
Discontinuing Section 47 Enquiries
|24.9||If it is clear that the criteria for Section 47 Enquiries are not / no longer satisfied, any decision to cease Section 47 enquiries must be taken in consultation with the Police and other involved Agencies, in particular the referring Agency after checks have been completed and recorded as such on ICS. This decision must be authorised by a Manager who must record whether the Social Work Assessment of Needs and Strengths should be completed.
Recording Section 47 Enquiries
|24.10||A full written record must be completed by each agency involved in Section 47 Enquiries, using the Agency's internal pro-formas, signed and dated by staff.|
|24.11||Rough notes must be retained by practitioners until the completion of any anticipated legal proceedings.|
|24.12||Strategy discussions and outcomes must be recorded directly onto ICS. The dates that the child was seen, if they were seen alone and the reason for the visit must be recorded.|
|24.13||If, following consultation with the Police during the investigation and planning stage, it appears that criminal or other legal proceedings are likely this must be recorded in the strategy record by the Practice/Team Manager's contemporaneous notes within 24 hours of contact.|
A record of legal advice must be produced by the solicitor within 48 hours of the meeting.
Children's Specialist Services recording of Section 47 Enquiries should include:
Typed records should:
|25.3||File must be checked and countersigned by a Team Manager or Practice Team Manager at the conclusion of investigations. These are minimum standards The Practice or Team Manager must record on ICS profile notes.|
Within /ICS, the Social Worker must be mindful of the purposes of the record as follows:
Feedback on Outcome of Section 47 Enquiries
|25.5||Feedback on the outcome of the enquiries must be provided to non-professional referrers in a manner that respects the confidentiality and welfare of the child.|
|25.6||Children's Specialist Service must ensure that parents, children (depending on their level of understanding), professionals and other agencies which have involvement are notified in writing of the outcome within 48 hours of the decision on the outcome being made.|
|25.7||If there are ongoing criminal investigations, the content of the notification must be agreed with the Police.|
Where there are differences of views amongst professionals, such as a decision to have an Initial Child Protection Conference, the Wirral SCB Escalation Procedures (see Escalation Procedure - Within Children's Specialist Services and Escalation Procedure - Children's Specialist and Targeted Preventative Services and Other Agencies) must be followed.