3.1 Referrals

AMENDMENT

In November 2015, Section 1, Duty to Refer, was revised for the purposes of clarity.

1. Duty to Refer

Professionals, employees, managers, helpers, carers and volunteers in all agencies must make a referral to Children’s Social Care Services if it is believed or suspected that:

When there are concerns about Significant Harm, then the referral must be made immediately. The greater the level of perceived risk, the more urgent the action should be. The suspicion or allegation may be based on information, which comes from different sources. It may arise in the context of the Family Support Process. It may come from a member of the public, the child concerned, another child, a family member or professional staff. It may relate to a single incident or an accumulation of lower level concerns.

The information may also relate to harm caused by another child, in which case both children, i.e. the suspected perpetrator and victim, must be referred – see also Abuse by Children and Young People who Display Sexually Harmful Behaviour Procedure.

The suspicion or allegation may relate to a parent, professional, volunteer or anyone caring for or working with the child – if so, see also Allegations Against Persons who Work with Children.

A referral must be made even if it is known that Children’s Social Care Services are already involved with the child/family. An NSCB1 referral form is not required on open cases. Referral co-ordinators in the MASH will alert the current social worker on new or recurring concerns made by the referrer.

If the case is open, the allocated social worker should be contacted to discuss new concerns arising. Alternatively advice may be sought from a Designated Senior Person or Named Professional from within the referrer’s own agency.

Where an agency, organisation, or worker has concern for the welfare or safety of a child they should make a telephone referral via the Customer Service Centre by telephone on 0344 800 8020. The referrer will be put through to the MASH (Multi-Agency Safeguarding Hub) workgroup, a team of specialist childcare workers, supported and managed by qualified and experienced childcare social workers.

Where there is a need to seek further information on the needs of the child to know whether a full safeguarding referral should be made, the MASH Triage workgroup will pass the enquiry to the MASH Operational Desk for further information gathering and analysis and, where appropriate, a referral will be made to the relevant Children’s Services teams for an assessment to be completed.

A telephone referral must then be confirmed in writing using the form marked NSCB1, within 24 hours. Completed NSCB1 can be e-mailed to MASH via mash@norfolk.gcsx.gov.uk but must only be sent from a secure email address. Alternatively, the referral be sent by:

  • Fax to the MASH Team on: 01603 762445
  • Post to: The MASH Team Manager, Floor 5, Vantage House, Fishers Lane, Norwich, Norfolk, NR2 1ET

WHEN IN DOUBT, CONCERNS MUST BE SHARED.

2. Urgent Medical Treatment

If the child is suffering from a serious injury or requires treatment, medical attention must be sought immediately by calling an ambulance or taking the child to the Accident and Emergency Department of the local hospital. The duty Consultant Paediatrician must be informed of the nature of the concerns and a referral must be made in accordance with this procedure as soon as practicably possible.

3. Ensuring Immediate Safety

The safety of children is paramount in all decisions relating to their welfare. Any action taken by staff should ensure that no child is left in immediate danger.

When considering whether immediate action is required to protect a child, all agencies should also consider whether action is required to safeguard and protect the welfare of any other children in the same household or related to the household or the household of an alleged perpetrator or elsewhere e.g. a work environment such as a school.

The law empowers anyone who has care of a child to do all that is reasonable in the circumstances to safeguard her/his welfare.

A teacher, foster carer, childminder or any professional should, for example, take all reasonable steps to offer a child immediate protection from an abusive parent.

Where abuse is alleged, suspected or confirmed in children admitted to hospital, they must not be discharged until a referral has been made via MASH in accordance with this procedure and a decision made as to the need for immediate protective action.

No child known to Children’s Social Care Services who is an inpatient in a hospital and about whom there are child protection concerns should be discharged home without a referral to establish that the home environment is safe, the concerns by medical staff are fully addressed and there is a plan in place for the ongoing promotion and safeguarding of the child’s welfare – for further information about children in hospital, see Section 6, Children in Hospital of Children Living Away from Home (including Children and Families living in Temporary Accommodation) Procedure.

4. Confidentiality

The safety and welfare of the child overrides all other considerations, including the following:

  • Confidentiality;
  • The gathering of evidence;
  • Commitment or loyalty to relatives, friends or colleagues.

For further details, see Information Sharing and Confidentiality Procedure.

The overriding consideration must be the protection of the child – for this reason, absolute confidentiality cannot and should not be promised to anyone.

For guidance in relation to making a referral relating to under-age sexual activity, see Allegations of Harm Arising from Under Age Sexual Activity Procedure.

If suspicions or allegations are about relatives, friends or colleagues, professional or otherwise, the concerns must not be discussed with them before making the referral.

Individual members of the public who make a referral may prefer not to give their name or alternatively they may disclose their identity, but not wish for it to be revealed to the parents/carers of the child concerned.

Wherever possible, Children’s Social Care Services workers receiving referrals from members of the public should respect the referrer’s request for anonymity. However, referrers should not be given 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 Criminal or Family Court arena. The referrer’s request for anonymity must be recorded.

NB – Referrals made by professionals can never be anonymous.

5. Listening to the Child

If the child makes an allegation or discloses information which raises concern about Significant Harm, the initial response should be limited to listening carefully to what the child says so as to:

  • Clarify the concerns;
  • Offer reassurance about how s/he will be kept safe; and
  • Explain that the information will be passed to Children’s Social Care Services and/or the Police.

If a child is freely recalling events, the response should be to listen, rather than stop the child; however, it is important that the child should not be asked to repeat the information to a colleague or asked to write the information down.

If the child has an injury but no explanation is volunteered, it is acceptable to enquire how the injury was sustained.

However, the child must not be pressed for information, led or cross-examined or given false assurances of absolute confidentiality. Such well-intentioned actions could prejudice police investigations, especially in cases of Sexual Abuse.

A record of all conversations, (including the timings, the setting, those present, as well as what was said by all parties) and actions must be kept.

No enquiries or investigations may be initiated without the authority of the Children’s Social Care Services or the Police.

If the child can understand the significance and consequences of making a referral, he/she should be asked her/his views by the referring professional.

Whilst the child’s views should be considered, it remains the responsibility of the professional to take whatever action is required to ensure the safety of that child and any other children.

6.Parental Consultation

Professionals should seek, in general, to discuss concerns with the family and, where possible seek the family’s agreement to making a referral unless this may, either by delay or the behavioural response it prompts or for any other reason, place the child at increased risk of suffering or likely to suffer Significant Harm.

See also Information Sharing and Confidentiality Procedure.

A decision by any professional not to seek parental permission before making a referral to Children’s Social Care Services must be approved by their manager, recorded and the reasons given.

Where a parent has agreed to a referral, this must be recorded and confirmed on the relevant Referral Form.

Where the parent is consulted and refuses to give permission for the referral, further advice and approval should be sought from a manager or the Designated Senior Person or Named Professional, unless to do so would cause undue delay. The outcome of the consultation and any further advice should be fully recorded.

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

  • The reason for proceeding without parental agreement must be recorded;
  • The Children’s Social Care Services team should be told that the parent has withheld her/his permission;
  • The parent should be contacted by the referring professional to inform her/him that after considering their wishes, a referral has been made.

7. Making a Referral

All Referrals for children living or found in Norfolk can be made by calling the Customer Service Centre on 0344 800 8020. During working hours the call will be put through to the MASH.

Calls can also be made in an emergency outside of office hours using the same number. The call will be put through to the Emergency Duty Team. Alternatively, in an emergency, the Police should be contacted.

All professionals must confirm telephone referrals in writing within 24 hours using form NSCB1.

In the event that an agency does not agree with the response and decisions about the referral by the Children’s Social Care Services, the referring agency should discuss their concerns directly with the line manager of the social worker, in the first instance to seek resolution. See also Resolving Professional Disagreements Procedure, Resolution Process.

If the child is known to have an allocated social worker, referrals should be made directly to the allocated worker or, in her/his absence, the manager or a duty worker in that team.

If the concern arises out of office hours, the referral must be made to the Emergency Duty Team. Any work undertaken by the Emergency Duty Team will be completed by the regular office hours’ Children’s Social Care Services.

If it is not possible to contact the MASH or relevant Children’s Social Care Services office, the concern must be reported via the Police. If the Police receive a referral prior to the Children’s Social Care Services, they must consult with Children’s Social Care Services as soon as practicable and prior to taking any action. The Police Child Abuse Investigation Unit is based alongside Children’s Social care within the MASH and they work closely together.

Professionals in most agencies should have internal procedures, which identify Designated Senior Persons or Named Professionals – managers or staff, who are able to offer advice on child protection matters and decide upon the necessity for a referral. Consultation may also be required directly with the MASH or the allocated social worker in Children’s Social Care Services.

Arrangements within an agency may be that a designated person makes the referral. However, if the designated or named person is not available, the referral must still be made without delay.

A referral or any urgent medical treatment must not be delayed by the unavailability of designated or named professionals.

The person making the referral should provide the following information if available – note – absence of information must not delay a referral:

  • Full name, any aliases, date of birth and gender of child/children;
  • Full family address and any known previous addresses;
  • Identity of those with parental responsibility;
  • Names, date of birth and information about all household members, including any other children in the family, and significant people who live outside the child’s household;
  • Ethnicity, first language and religion of children and parents/carers;
  • Any need for an interpreter, signer or other communication aid;
  • Any special needs of the child/ren;
  • Is the child registered at a school or regularly attending a school? If so, identify the school;
  • Any significant/important recent or historical events/incidents in the child or family’s life;
  • Has the child recently spent time abroad or recently arrived in the area?
  • Cause for concern including details of any allegations, their sources, timing and location;
  • The identity and current whereabouts of the suspected/alleged perpetrator;
  • The child’s current location and emotional and physical condition;
  • Whether the child is currently safe or is in need of immediate protection because of any approaching deadlines (e.g. child about to be collected by alleged abuser);
  • The child’s account and the parents’ response to the concerns if known. The parents response must be sought unless there are concerns that this would place the child at risk;
  • The referrer’s relationship and knowledge of the child and parents/carers;
  • Known current or previous involvement of other agencies/professionals;
  • Information regarding parental knowledge of, and agreement to, the referral.

8. How Referrals will be Received

Children’s Social Care Services will ensure that all child protection referrals are responded to by the MASH within normal working hours. Further details on MASH procedures my be viewed in the Norfolk Children’s Services Procedures Manual, Initial Contacts and Referrals Procedure. Outside normal working hours, the Emergency Duty Team will receive referrals.

9. Where there is or may be a Crime Committed

If the referral relates to a situation in which a crime has or may have been committed, including sexual or physical assault or physical injury caused by neglect, it will be discussed in the MASH by the multi-agency partners co-located there (Police, Children’s Social Care and Health). The Police Children’s Social Care Services, Health and any other agencies involved with the child, will have a strategy meeting to consider whether there should be a criminal investigation and/or a Children’s Social Care Services led intervention. If the situation relates to a child who has an allocated social worker, they will need to make contact with the Police based in the MASH to have a Strategy Discussion.

Whilst the responsibility to instigate criminal proceedings rests with the Police, they should consider the view expressed by other agencies. In some circumstances with less serious cases, it may be agreed that the best interests of the child would be served by a Children’s Social Care Services led intervention rather than a full police investigation.

This will need to be discussed carefully and a decision made at a Strategy Discussion.

See also Allegations of Harm Arising from Under Age Sexual Activity Procedure.

10. The Outcome of a Referral and Feedback

The Children’s Social Care Services team will decide upon and record their next steps of action within one working day of receiving a referral.

The decision about future action will take account of the discussion with the referrer, consideration of information held in existing records and discussion with any other professionals or services as necessary (including the Police where a crime against a child may have been committed – see Section 9, Where there is or may be a Crime Committed).

The outcome of the referral will be:

  • That the child appears to be a Child in Need and there are concerns about the child’s health and development or concerns of Significant Harm which justify a Social Work Assessment; and/or
  • That emergency protective action should be taken to safeguard the child or children – see Section 11, Emergency Protective Action – (this will usually be determined by an immediate Strategy Discussion); or
  • Where the child is already known and new information suggests that the child is or may be suffering harm, that a Section 47 Enquiry and/or a new or updated Assessment is required; or
  • That an offer of early help or referral to another agency should be made; or
  • That no further action is required.

Where the Significant Harm has been caused by a person who was not previously known to the child or by another child, the decision whether to take further action under these procedures will depend on the following:

  • Is the alleged perpetrator likely to pose a risk of suffering or likely to suffer Significant Harm to this or any other children?
  • Did the parent or carer by omission or commission contribute to the abuse?

Feedback on the outcome of a referral should be provided to the referrer, including where no further action is to be taken.

In the case of a referral by a member of the public, feedback should be provided in a way which will respect the confidentiality of the child.

11. Emergency Protective Action

Also see Flowchart 2: Immediate Protection (Working Together 2015).

Where there is a risk to the life of a child or the possibility of immediate harm, the Police officer or social worker must act with urgency to secure the safety of the child.

Immediate protection may be achieved by:

  • An alleged abuser agreeing to leave the home;
  • The removal of the alleged abuser;
  • A voluntary agreement for the child to move to a safer place;
  • Application for an Emergency Protection Order;
  • Removal of the child under powers of Police Protection;
  • Gaining entry to the household under Police powers.

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

Children’s Social Care Services should only seek the assistance of the police to use their powers of Police 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.

Planned immediate protection will normally take place following a Strategy Discussion.

Where a child/ is or children are afforded immediate protection by an Emergency Protection Order or Police Protection the local authority has a duty to initiate Section 47 Enquiry.

12. Cross Boundary Referrals

If the referral relates to a child who is temporarily visiting the area of another local authority or in a hospital or Looked After outside of the local area, the local authority/Police for the area where the child actually is at the time have prime responsibility for an initial response to the referral.

The referral should be passed to that authority immediately for them to follow the necessary procedures and to undertake a Section 47 Enquiry and/or take any immediate protective action that is necessary. They will be responsible for liaising with any other Children’s Social Care Services as necessary.

Before undertaking such enquiries, the child’s home authority must be consulted and agreement sought on who is best placed to undertake the enquiries. Where this is consistent with the child’s immediate protection needs, it may be agreed that the child’s home authority will respond to the referral.

For those children from other local authority areas, who are the subject of Child Protection Plans, there must be consultation with the responsible Lead Social Worker.

Any relevant personnel from another local authority or agency should be consulted and invited to attend the Strategy Meeting or invited to contribute to the Strategy Discussion.

Comprehensive enquiries must be undertaken with the host local authority and any agencies to which the child is known. This must include checking whether the child has a Child Protection Plan.

All enquiries should be confirmed in writing.

The Strategy Discussion/Meeting, clarifying roles, responsibilities and timescales for actions, must be recorded on the relevant forms and copies of the record distributed within ONE working day, to all relevant parties.

13. Pre-Birth Referrals

Where agencies or individuals anticipate that prospective parents may need support services to care for their baby or that the baby may be suffering or likely to suffer Significant Harm, a referral to Children’s Social Care Services must be made as soon as the concerns are recognised, via the MASH. See also Pre-Birth Protocol.

Where the concerns centre around an aspect of parenting behaviour, for example substance misuse, the referrer must make clear how this is likely to impact on the baby and what risks are predicted.

A pre-birth referral should always be considered where:

  • There has been a previous unexplained death of a child whilst in the care of either parent;
  • A parent or other adult in the household has been convicted for violent conduct;
  • The mother, father or a sibling in the household has a Child Protection Plan;
  • The mother, father or a sibling has previously been removed from the household by court order or Accommodated as a result of concerns regarding Significant Harm;
  • The degree of domestic violence known to have occurred is likely to significantly impact on the babies safety or development;
  • The degree of parental substance misuse is likely to significantly impact on the babies safety or development;
  • The degree of parental mental illness/impairment is likely to significantly impact on the babies safety or development;
  • There are serious concerns about the prospective parents’ ability to care for themselves and/or to care for the child, for example where the parent has no support and/or has learning disabilities;
  • Any other concern exists that the baby may be suffering or likely to suffer Significant Harm, including a parent previously suspected of having Fabricated or Induced Illness in a child, or a prospective parent who has been the subject of fabricated or induced illness as a child themselves.

Delay must be avoided when making referrals in order to:

  • Provide sufficient time to make adequate plans for the babies protection;
  • Provide sufficient time for a full and informed assessment;
  • Avoid initial approaches to parents in the last stages of pregnancy, at what is already an emotionally charged time;
  • Enable parents to have more time to contribute their own ideas and solutions to concerns and increase the likelihood of a positive outcome to assessments;
  • Enable the early provision of support services so as to facilitate optimum home circumstances prior to the birth.

Concerns should be shared with prospective parent/s and consent obtained to refer to Children’s Social Care Services unless this action in itself may place the welfare of the unborn child at risk e.g. if there are concerns that the parent/s may move to avoid contact with social workers or other professionals.

See also Information Sharing and Confidentiality Procedure.

Where the outcome of the referral is that the child is in need of support services rather than safeguarding, the child should be referred to the appropriate service using Norfolk Family Support Form the with the parents’/carers’ involvement and agreement.

14. Recording

The referrer should keep a written record of:

  • The child’s account;
  • Discussions with the parent;
  • Discussions with managers;
  • Information provided to MASH or the local Children’s Services office;
  • Decisions taken (clearly timed, dated and signed);
  • Records should be reviewed with regular intervals to ensure that decisions taken are followed through.

The referrer should confirm verbal and telephone referrals in writing, within 24 hours, using the NSCB1.

The MASH worker receiving the referral should keep a written record of:

  • Discussions with the referrer;
  • Discussions with any other professionals or agencies involved (including the Police where a crime against a child may have been committed);
  • Any other relevant information which was taken into account;
  • Discussions with managers;
  • Decisions taken (clearly timed, dated and signed);
  • Records should be reviewed with regular intervals to ensure that decisions are followed through.
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