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Abused or neglected children need support from consistent practitioners

NICE publishes draft quality statement on children and young people who have experienced abuse or neglect

Published on 13th September 2018

Children and young people who have experienced abuse or neglect should receive support from a consistent group of practitioners, a NICE draft quality standard has said.

Working with the same practitioners over time enables children and young people who have experienced abuse or neglect to build better relationships and protects them from being re-traumatised by having to re-tell their experiences, the National Institute of Health and Care Excellence said.

"Practitioners get to know the broader family context and any other agencies that work with that family. This helps practitioners from different agencies to work more effectively and protect children and young people from further harm," said the draft quality standard.

The draft child abuse and neglect NICE quality standard which is out for consultation covers recognising, assessing and responding to abuse and neglect of children and young people under 18. It describes high-quality care in priority areas for improvement.

Service providers, such as social services, sexual health services, drug and alcohol services, child and adolescent mental health services, youth offending services and primary and secondary care services that staff have an opportunity to build meaningful relationships by working with the same children and young people over time.

Social workers, mental health professionals, specialist drug services professionals, health visitors, GPs, community nurses, youth workers, police and probation officers should ensure that they build meaningful relationships with children and young people. They should also ensure they share information and build relationships with other practitioners working with that family and organise handovers if new staff members from their agency become involved.

As a result, children and young people who have experienced abuse or neglect will have opportunities to build stable, trusting relationships with practitioners who get to know them and their needs well.

The quality standard also states that children and young people who display marked changes in behaviour or emotional state are asked about anything that may be causing those changes in a private conversation.

"Children and young people can find it difficult to tell someone that they are being abused or neglected but they may communicate their experiences indirectly through their behaviour," said the standard. "Marked changes in children and young people’s behaviour or emotional state can be an indication of abuse or neglect."

"Practitioners who work with children and young people are in a position to consider whether changes in a child or young person’s behaviour or emotional state should be a prompt to explore concerns about possible abuse or neglect," it added.
Practitioners whose work brings them into contact with children and young people  need to be aware of their responsibilities in safeguarding children and young people and ensure that they take action as soon as they recognise risk factors or spot signs of abuse or neglect.

Furthermore practitioners need to stay alert to changes in behaviour or emotional state in the children and young people they work with and ask them about anything that may be causing those.

Children and young people talking to practitioners about abuse or neglect should have their experiences recorded in their own words to ensure that children and young people can be confident "that their voices are heard and their experiences truly captured".

Social workers and practitioners should ensure that all conversations with children and young people who experienced abuse or neglect are appropriate to age, developmental stage and language abilities. They should ensure all conversations are recorded and where possible written down as the exact words used by the child or young person.

"Where appropriate, they can also ask children and young people to check the record, indicate if they disagree with anything and sign it," the standard adds.

The standard also states that children and young people talking to practitioners about abuse or neglect agree with them how they will communicate with each other. It explains that children and young people may be living in circumstances where someone who may be abusing or neglecting them has access to their phone or email which could pose a safety risk and mean they would not be able to respond when practitioners try to contact them.

"Agreeing safe and effective arrangements to stay in touch is essential to ensure that children and young people are not put at additional risk. It will also help them to access and fully engage with the services supporting them," it said.

The quality standard concludes that children and young people who have experienced abuse or neglect are offered a choice of therapeutic interventions based on a detailed assessment.

Practitioners including social workers, mental health professionals, specialist drug services professionals, health visitors, GPs, community nurses, youth workers and probation officers should ensure they offer the most appropriate therapeutic interventions to children and young people who have experienced abuse or neglect based on a detailed assessment of their needs and wishes. They also ensure that they evaluate the effectiveness of the interventions provided.

NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements.

This is the draft quality standard for consultation running from 10 September to 8 October 2018. The final quality standard is expected to publish in February 2019.

Child abuse and neglect NICE  quality standard


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