Learning briefing: Thematic review – Physical Harm towards Infants and Children under 2

1. Learning Journey: What did we do?

We conducted an assessment to gauge how multi-agency partners identify and react to Physical Harm towards infants and children aged 0-2 years. The assessment centred on the expertise and knowledge of practitioners in dealing with men in their roles as fathers and primary caregivers, as well as the comprehension of agencies regarding pertinent pathways. The partnership aimed to track advancements in line with the recommendations from the 2020 Physical Harm Review and the following outcomes of the Partnership Improvement Plan:

1. Enhancing the results of pre-birth services and for infants
2. Strengthening collaborative efforts in adherence to Working Together, with a focus on shared responsibilities and multi-agency responses to families

How did we do that?

• Conducting an analysis of existing research, including pertinent Local Child Safeguarding Practice Reviews carried out by various partnerships across the country.
• Evaluating available data on both local and national levels
• A multi-agency tabletop audit activity to scrutinise the Strategy Meeting process and another tabletop audit to assess our responses to children under 2 years old who have experienced a physical injury
• A Practitioner survey to consider key lines of enquiry.
• Reviewing the existing training programs, their utilisation rate, and their impact.
• Senior Leaders’ interviews of key agency representatives about the key lines of enquiry
• Locality Partnership Feedback Meetings
• Undertaking an Appreciative Inquiry.
• Performing a Health Record Audit.

2. What good practice did we find?

• All agencies clearly strived to foster family relationships, with restorative practices evident in all partnerships. Child-focused work was apparent.
• Frontline practitioners are generally aware of their agency’s policies and responsibilities, and they are all expected to approach situations with professional curiosity, work in partnership (including information sharing) and identify risks.
• Face-to-face or verbal communication between agencies led to stronger professional relationships and better information sharing.
• Agencies are using a mix of face-to-face and online support in their interactions with colleagues and families offering wider scope for families to connect with professionals.
• Good recording practices were observed in Children’s Centres, with positive feedback on the HUGS programme.
• Strategy Discussions at the Front Door were often well-coordinated and attended.

3 What else did we find?

• Agencies inconsistently apply professional curiosity, often relying on self-reporting, this is further compounded by some services focusing mainly on the mother, neglecting a holistic family view.
• Not all practitioners are experienced or confident in working with neurodiverse parents impacting on the assessment and intervention work undertaken.
• Recruitment and retention issues affect information sharing due to a lack of continuity in staffing and understanding of partner organisation structures.
• There was a notable reduction in communication across partner agencies when statutory services became involved.
• Strategy discussions outside the Front Door e.g. children already open to children’s social care were less well organised and attended by partners. Multi agency attendance at Child Protection Conferences and Core Groups was also sometimes lacking with General Practitioner (GP) and Mental Health attendance at multi agency meetings noted to be poor.
• The right partners were not always invited to Strategy meetings, or if they were invited, they did not attend.
• There is inconsistency across agencies in understanding of key pathways or processes e.g. : Devon Pregnancy Support Pathway (Police), when bruises/marks in babies are found (Health) and safety plans for domestic abuse placing too much onus on the victim of domestic abuse to manage the perpetrator.
• Information about safe sleeping isn’t consistently shared.
• Opportunities to record Parental Responsibility are sometimes missed, especially in health services.
• Practitioners not dealing with safeguarding daily have reduced understanding of their responsibilities.

4. What can we learn?

Collaboration: Learn to build stronger relationships and shared objectives across the partnership underpinned by principals of restorative practice.

Information Sharing: Learn to improve robustness of information sharing and update organisational structures for sharing. Learn to prevent deterioration in communication and attendance at key meetings due to limited staffing capacity.

Communication: Learn to balance digital and face-to-face communication to prevent siloed working, promote collaboration with families and enhance opportunities for information sharing.

Restorative Practice: Learn from agencies further along their restorative journey to develop meaningful and collaborative relationships with families and partners to achieve sustainable positive outcomes.

Safety Plans: Learn from domestic abuse leads to develop better safety plans.

EDI: Learn from EDI teams to integrate considerations into practice and QA activity.

Cultural Barriers: Learn how to address barriers to working with males and differentiate between system change and individual practice within the agencies.

5. What are the recommendations?

Agencies working together effectively to reduce risk and harm

• Devon Safeguarding Children Partnership (SCP) to develop multi-agency training on professional curiosity.
• Devon SCP to collaborate with local NHS Devon ICB to improve GP engagement in child outcomes.
• Devon SCP to maintain and publicise a list of safeguarding leads.
• Consider co-locating services for better collaboration.

Responding to and including Key Male Figures/Primary Carers

• Record father’s identity for unborn children, if not shared, this should be stated on mother’s record.
• Ensure accurate recording of significant males connected to a child as well as those with parental responsibility.
• Ensure child’s voice is included within our recordings, including an analysis of what this might mean/be indicating.
• Action for Children to highlight good recording practices and share them.
• RDUH to create a “Good Practice Guide” for considering all family members within work with children and their families.

Offering the right support at the right time

• Children’s Social Care to quality assure compliance with timescales for the distribution of minutes and plans for children open to statutory social care services.
• Police and Children’s Social Care to collaborate to produce a “Good Practice Guide” on information sharing about Child Sexual Abuse offences.
• The Devon SCP to lead an activity to analysis and make recommendations on the level and impact of face-to-face and remote working within the partnership.

Compliance with Working Together 2023

• Devon SCP will link with the IG-BVA Board to share and disseminate messages and learning related to Domestic Abuse.
• Devon SCP to ensure a focus on Equality, Diversity, and Inclusion, including the views of children and their families throughout their work.

6. What can you do?

Read & Discuss: Devon Pregnancy Support Pathway, Southwest Bruising Procedures, Hospital Policy, Safe Sleeping Guidance and managing unexplained marks. ICON.  Devon Safeguarding Children Partnership.

Be Curious: Gather information and interact with families.

Avoid System Lead: Be professionally curious regardless of what your organisations systems and processes are prompting you to consider- be tenacious.

Training: Attend and maintain your safeguarding training.

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