Written by LGA
Child sexual exploitation (CSE) is a terrible crime with destructive and far reaching consequences for victims, their families, and society.
It is not limited to any particular geography, ethnic or social background, and all councils should assume that CSE is happening in their area and take proactive action to prevent it.
Recent events have shown that all areas need to be prepared to respond to this challenge robustly, and there are many good examples of effective work to be found around the country. The case studies in the report and online showcase some of the work that is already underway to improve local practice. These cover initiatives such as community engagement, regional work across local authority boundaries, building effective multi-agency partnerships and commissioning independent audits of local work.
Alongside these case studies, our 2015 resource pack contains a range of materials that councils may find useful when planning work locally. This includes an overview of key learning from recent reports and inquiries, a myth busting guide to common stereotypes around CSE, and advice for councillors on how to assess the effectiveness of local practice. Further resources, including training tools and advice on working with the media are available online, and will be updated regularly.
Tackling child sexual exploitation must be a priority for all of us, and the resources available in our 2015 report and this online resource highlight the very real difference that councils and their partners can make in preventing this awful crime – and the crucial role of councillors within this.
Councillor David Simmonds, Chair of the LGA Children and Young People Board
About this resource
This resource aims to help councils implement effective responses to child sexual exploitation within their own organisation, with their local partners and their communities.
Recognising that councils will have different approaches and circumstances, it does not set out a ‘one-size-fits-all’ resource that all councils should follow. Instead, it brings together and shares a set of resources, both new and existing, in order to provide councils with ideas and materials that can be adapted to suit local needs. It includes briefings, communications support, training materials and case studies.
What is child sexual exploitation?
Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people (or a third person or persons) receive ‘something’ (eg food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities. Child sexual exploitation can occur through the use of technology without the child’s immediate recognition, for example being persuaded to post sexual images on the internet or mobile phones without immediate payment or gain. In all cases, those exploiting the child or young person have power over them by virtue of their age, gender, intellect, physical strength and/or economic or other resources. Violence, coercion and intimidation are common, involvement in exploitative relationships being characterised in the main by the child or young person’s limited availability of choice resulting from their social, economic and/or emotional vulnerability.
Written by The International Federation of Social Work
This week IFSW organized a World Social Day event at the United Nations Head Quarters in New York. More than 500 social workers, educators, students and United Nations officials attended to celebrate the achievements of social workers worldwide.
Angelo McCain from The National Association of Social Workers USA spoke passionately about the importance of social workers upholding people’s dignity in their work and the impact that this has on the lives of people who attend social work services.
Ramu Damondaran, Chief of UN Academic Impact, highlighted the historical contributions that the social work profession has made to human rights. Rory Truell IFSW Secretary-General said, “We are very pleased that UN agencies and the social work profession can work effectively together to progress our common agendas”. He also noted, “That early drafts of the UN post-2015 agenda have not yet highlighted the need for all countries to have social protection systems which support all members of society. Nor does the post-2015 agenda address the global dynamics that drive inequality and poverty. As a profession that addresses not just the symptoms, but also the root-causes we will continue to advocate within our valued partnerships for community empowerment, transformational change and sustainability”.
IFSW wishes to thank the organizers: Michael Cronin, IFSW Main Representative and Co-Chair of the event, and the IFSW representatives Robin Mama, Co-Chair, Elaine Congress, Marica Wallace, and interns Mariam Elrazaz and Brittany Larkin for organizing the event. Also Lynne Healy IASSW Representative who concluded the event with the ‘Wrap-Up session’.
To learn more about the World Social Work Day at the UN in Geneva and to see images from celebrations around the world click here.
David Starkey attacks ‘victim status’ of ethnic minorities and disabled, accuses Baroness Lawrence of treating black people as victims
Source: NHS Choices
“Hundreds of deaths in mental health units ‘were avoidable’,” says a report on the front page of today’s Independent. The Guardian highlights 662 mentally ill detainee deaths from 2010 to 2013.
Both stories follow an inquiry by the Equality and Human Rights Commission (EHRC) into the deaths of people with mental health conditions while detained in police custody, prisons or psychiatric hospitals.
The inquiry looked at whether people who were detained had been treated correctly according to EHRC guidelines. The inquiry focused on two basic rights: the right to life and the right to non-discrimination.
What is the EHRC?
The EHRC is an independent body working to challenge discrimination, and to protect and promote human rights in England, Scotland and Wales. In compliance with the Human Rights Act, it aims to help enforce equality legislation on grounds such as age, disability, race, religion, gender, sexual orientation, and marriage and civil partnership.
Over the period 2010 to 2013, there were 367 deaths from non-natural causes of adults with mental health conditions while detained in psychiatric wards and police custody. A further 295 adults died in prison, many of whom had mental health conditions.
The inquiry identified many areas of concern, including a lack of information sharing between professionals, insufficient involvement of family members, inappropriate use of restraint, and failure to learn from past incidents.
The Commission recommends that rigorous systems are put in place to ensure that any incidents are thoroughly and transparently investigated, and acted upon.
What did the EHRC investigate?
The Commission’s report looked into deaths in detention for those with mental health conditions. The inquiry looked at the period 2010 to 2013 in three detention areas:
Psychiatric hospitals. Detention in hospital means being held under the Mental Health Act, which is sometimes referred to as being “sectioned”. In 2012/13, there were said to be over 50,000 such detentions and the number has since been increasing.
Police custody. The Mental Health Act allows for a person “in crisis in a public space” to be held in police custody as a “place of safety” when there is insufficient other health-based support available. In 2012/13, there were reported to be 7,761 occasions when the Act was used to hold an individual in police cells.
Prisons. The prison service does not record the number of imprisoned people who have mental health conditions; however, they are likely to affect a large proportion of inmates. The most recent data – from 1997 – reported that 92% of male prisoners were suffering from psychosis, neurosis, personality disorder, alcohol misuse or drug dependence.
The Commission wanted to establish the extent to which there has been compliance with Article 2 (the right to life) and Article 14 (the right to non-discrimination) of the European Convention on Human Rights. It wanted to see whether improved compliance with these civil rights rules could reduce deaths in psychiatric hospitals, prisons and police custody.
What did the inquiry find about deaths in detention?
From 2010 to 2013, there were 367 deaths from non-natural causes of adults with mental health conditions while detained in psychiatric wards and police custody. A further 295 adults died in prison, many of whom had mental health conditions.
The inquiry found that the same mistakes are being repeated across prisons, police cells and psychiatric hospitals. This includes, for example, the failure to appropriately monitor patients and prisoners at serious risk of suicide, even in cases where their records recommend constant or frequent observation. It also includes failure to remove “ligature points” in psychiatric hospitals, which are known to be often used in suicide attempts.
According to the inquiry report, psychiatric hospitals are an “opaque system”. The Commission found it difficult to access information about non-natural deaths in psychiatric hospitals, such as individual investigation reports. This contrasts with prisons and police settings, where there is an independent body in charge of investigating deaths and ensuring that lessons are learnt.
The Commission also found misplaced concerns about data protection, leading to failures to share important information, such as concerns of other professionals about mental health, or suicidal tendencies not being passed on to prison staff. Similarly, failure to involve families to support the person being detained make it difficult for the family to pass on information that might have prevented deaths. Poor communication between staff, including lack of updates on risk assessments after self-harm or suicide attempts, was also highlighted.
Other significant findings included:
The availability of drugs, including “legal highs”, in prison.
Evidence of bullying and intimidation in prisons in the lead-up to someone talking their own life. This can result in a person being locked up alone in a cell for their own safety, because there is nowhere else for them to go. This can lead to deterioration of the person’s mental state.
Inappropriate use of restraint in people with mental health conditions, including “face-down” restraint. There were also increasing reports of police officers being called out to restrain people on psychiatric wards.
A high number of deaths occurred shortly after a person ended a period of detention, suggesting insufficient mental health support and follow-up.
What does the EHRC recommend?
The EHRC recommends:
Structured ways of learning from deaths and near misses in all settings where people with mental illness are detained, to ensure that improvements are made.
Individual prisons, hospitals and police settings should focus more strongly on meeting the basic responsibilities of keeping detainees safe. It recommends better staff training, and for the inspection regimes to explicitly monitor this.
The Commission wants more “transparency”, to allow services to be scrutinised and held to account. The Commission suggests that the “statutory duty of candour”, which is being introduced in April 2015 and applies to all NHS bodies in England, could help to achieve this.
What happens next?
Mark Hammond, the EHRC’s chief executive says: “This Inquiry reveals serious cracks in our systems of care for those with serious mental health conditions. We need urgent action and a fundamental culture shift to tackle the unacceptable and inadequate support for vulnerable detainees.
“The improvements we recommend aren’t necessarily complicated or costly: openness and transparency, and learning from mistakes are just about getting the basics right. In particular, by listening and responding to individuals and their families, organisations can improve the care and protection they provide.”
The Commission says it is now going to follow up its recommendations with the relevant organisations.
More than 280,000 elderly patients were stuck in hospital this winter after Tory budget cuts triggered an “unprecedented” social care crisis.
A damning report today exposes the growing problem of delayed transfers of care – or bed blocking – which is up 30% on the same period last year.
Almost 70% of nurses admitted they were “frequently” delaying discharging older patients because there was no one to care for them at home or in the community.
Nearly all of the NHS staff described it as a “serious” problem and 82% said it had got worse in the past year.
Older persons’ charity the Royal Voluntary Service, which provided the figures, said more than 4,000 patients were blocking beds every day.
Bed blocking – up 30% in a year
Its head David McCullough said: “This winter we’ve seen delays in hospital discharge reach unprecedented levels, with lack of support for older people after hospital a root cause.
“While additional funding has been allocated in some areas to address the crisis, many authorities and hospital trusts are still facing budget cuts.”
The Tory-led Coalition has slashed £1billion from social care budgets, leaving hospitals struggling to arrange support from care workers and district nurses. In total there were 281,982 delayed discharges this winter.
That was up 30% from the 216,797 in the same period last year.
Older patients languishing when fit to be discharged
Number blocking beds every day
Nurses ‘frequently’ delaying elderly discharges
The Government insisted it had given the NHS an extra £700million this winter to fund extra staff and beds.
Yet today’s report found 40% of older patients ended up languishing in hospital when they were fit to discharged. Experts said being left in limbo in such a way was extremely distressing.
Another cause of the problem is older people’s families demanding staff keep them in hospital for longer – even when their relative is well enough to leave.
More than half of nurses said they had experienced such pressure.
One in 10 nurses said their hospital had resorted to eviction notices on patients and families to free up beds.
The scandal is also having a huge impact on A&E waiting times because there are fewer beds for new admissions.
David Buck, of health think-tank The King’s Fund, said: “Delayed discharges are a key indicator of the performance of not only hospitals, but how our overall health and care systems are working.”
Labour wants to integrate health and social care if it wins the general election. It has also vowed to recruit at least 5,000 NHS staff to care for patients at home.
Dr Eileen Vizard
Dr Eileen Vizard is a Consultant Child & Adolescent Psychiatrist.
She is also former clinical director of the National Clinical Assessment and Treatment Service (NCATS) – a national service run by the NSPCC in partnership with NHS trusts to help children and young people exhibiting harmful sexual behaviour.
If we can stop a child offending and developing into an adult sex offender, we can save dozens of potential victims from being abused.
Fortunately, in our experience it’s rare any young person who sexually abuses is ‘beyond help’.
Alongside suitable punishment where appropriate, treatment that may be both intensive and long term can help them understand the impact of their behaviour and turn their lives around.
But it’s a difficult process, and the earlier we can intervene, the better. So we would ask parents to come forward and call the NSPCC as soon as they suspect something isn’t right.
We then have to interrupt the thought process that leads them to offend and help them to develop non-abusive responses to these thoughts.
It’s similar to what we all do if we are about to lose our temper or say something we know we’ll regret.
But here the consequences are far greater. Increasingly we are seeing the impact easy access to pornography can have on young people.
Being exposed to it at a young age can warp children’s views of what is normal sexual behaviour.
Some children will act out things they may have seen in porn.
It can be hard for children to understand the impact their behaviour has on others and also the consequences for their own lives. So these are things we focus on in treatment sessions.
A small number of older children may not have had help early enough and may have entrenched sexual interest in children.
This group needs specialist mental health treatment. In most cases, we can turn this behaviour around and protect other children.
It’s not easy and there are no quick fixes. But through specialist services, such as NCATS we can, and do, prevent more abuse.
Dr Linda Papadopoulos
A psychologist who wrote a report for the Home Office in 2010 on ways to protect children from exposure to sexual imagery says not enough is being done.
Her findings said boys were becoming fixated on being macho and dominant, while girls presented themselves as sexually available.
Just a handful of the 36 recommendations made by Dr Linda Papadopoulos in 2010 were acted on – including the introduction of new age ratings for music videos. She says:
Some of the things I suggested were acted on, but I feel strongly that the Government could absolutely be doing more to tackle this problem.
A fundamental thing we need to be doing is to teach children in schools the difference between pornography and normal sexual behaviour.
They are two very different things and sadly a lot of children are learning about sex and relationships from pornography and getting a very warped view.
I think politicians do recognise the importance of the issue, but sadly what tends to happen is that other things take precedence with regard to budgets.
And unless you shout loud enough – and for long enough – things just don’t happen. There is not just one thing you can do to fix this.
There are many factors that need to be dealt with. Finding a way of stopping under-18s accessing online pornography should be made a priority.
I think clicking a button on adult websites to say you are 18 isn’t good enough and there are ways around that.
There are people talking about the use of credit cards to do that. Something as simple as that would keep a lot of kids away from online porn.
- The Guardian,
A hospital doctor carried out female genital mutilation on a young mother after the birth of her first child in a London hospital, a court has heard .
Mounting the first prosecution against someone for carrying out FGM in England and Wales, the Crown alleged that Dr Dhanuson Dharmasena, a junior registrar in obstetrics and gynaecology at the Whittington hospital, had mutilated a 24-year-old mother by the manner in which he had sewn her up after childbirth.
The woman had undergone type 3 FGM – in which part of the labia are sewn together – as a child in Africa, and during labour the doctor had made two cuts to her vaginal opening to ensure the safe delivery of her baby. When Dharmasena sewed her up, a midwife warned him that what he had done was illegal. He asked a consultant for advice, and the more senior doctor said it would be “painful and humiliating” to remove the stitch he had made, and it remained in place, the court heard.
“It is the stitching back together by Dr Dharmasena which the prosecution says is an offence under the act,” Kate Bex, prosecuting, told Southwark crown court.
Dharmasena, 32, is charged alongside another man, Hasan Mohamed, 41, who is accused of aiding and abetting the doctor. Both men deny the charges.
The doctor, who qualified in 2005, and began specialising in obstetrics and gynaecology in 2008, had been at the Whittington for a month when the events took place in 2012.
Under the 2003 Female Genital Mutilation Act, a doctor does not commit an offence if his actions involve a surgical operation on a woman in any stage of labour, or immediately after birth, for purposes connected with the labour or birth.
Bex told the jury of seven women and five men: “It will be for you to decide if Dr Dharmasena’s admitted act of sewing [her] labia together was necessary for her physical health or was for purposes connected with the labour or birth.”
She said the case was not what might be expected of an FGM prosecution. “If you do know a little about FGM you may be expecting to hear that the offence took place in a back-street clinic by an unqualified and uncaring person on a young child. This trial is quite different but it nevertheless involves FGM.”
She said the woman, who is known as AB to protect her identity, had been subjected to type 3 female genital mutilation aged six in Somalia.
Around 130 million women, according to the World Health Organisation, have undergone FGM, and the Crown said the practice could be dangerous and could cause haemorrhaging, shock, infection, ulceration and death.
Bex said she was not alleging Dharmasena’s actions exposed AB to the risk of any such side effects. “But a woman’s labia should not be sewn together at all unless medically necessary,” she said. The woman refused to provide a witness statement to the police, the court heard.
Pregnant with her first child, the woman had been seen in antenatal appointments by midwives at the hospital, the jury was told. When asked standard questions about whether she had been subjected to FGM, she told the midwife, “It’s fine, it’s opened”, referring to a revision of her circumcision which had taken place in February 2011.
The midwife should have organised a birth plan for her which would have involved deinfibulation – reopening the vaginal opening – well in advance of going into labour. This was not done. Instead, AB arrived in labour at 8.55am, where her FGM was discovered.
Dharmasena arrived in the delivery room at 10.10am and saw the woman was progressing fast. Concerned about the baby, he made two cuts to facilitate the birth, one of which involved cutting through the scar tissue from the FGM.
In half an hour he delivered the baby. A senior house officer stitched up the mother, but at the insistence of Mohamed, Dharmasena followed up by sewing up the labia with a single continuous stitch around 1.5cm to 2cm long, the Crown said.
When she saw his stitch, the midwife, Aimma Ali, said it was illegal and spoke privately to Dharmasena. He consulted the on-call consultant, Vibha Ruparelia, and explained that he did not know the stitch was illegal.
The consultant said it would be too painful and humiliating to remove the stitch, and it was left in. In his notes, Dharmasena wrote: “Had discussion with consultant post delivery. In hindsight should not have closed stitches. Decision made not to reopen sutures.”
The doctor’s actions were against hospital policy which is written and available and Dharmasena was expected to be aware of it, said Bex.
“The … published policy is that the cut edges should not be stitched back together and that they should be over-sewn with absorbable stitches so that they heal apart,” she said.
In a statement as part of an internal hospital investigation, Dharmasena said: “I was not entirely sure how to repair the anterior midline incision. The cut edges were very small containing scar tissue and had minimal bleeding.”
When he was arrested in August 2013, however, the prosecution say he changed tack, raising for the first time the defence that the stitch was medically justified, writing: “A single suture was appropriate … in an FGM case where there is bleeding.”
Mohamed is also charged alternately with intentionally encouraging or assisting the commission of an offence contrary to section 44(1) of the Serious Crime Act 2007.
The case continues.
Janet Low: The HPC – Democracy at Work
Taxpayers fork out more than £250,000 to support ONE problem family with parenting advice and debt management
Lord Hunt of Kings Heath (Labour)
My Lords, we now move on to another group on the regulation of healthcare workers, and social care workers as well. In debate in Committee, I made it clear that I was concerned about the decision of the Government to abolish the General Social Care Council and to transfer responsibility for regulation of social care workers to the Health Professions Council. I am concerned for two reasons. First, I know that the General Social Care Council had rather a bumpy ride to start with and was the subject of a review, which was critical of the way in which it performed. However, it is right to pay tribute to the tremendous work undertaken in the last two years under its current leadership and the chairmanship of Mrs Rosie Varley to improve and enhance the quality of the regulation by the council. It is very disappointing that the Government have decided that, just at the time when the GSCC is starting to prove itself, the whole thing is to be dismantled and the function transferred to the Health Professions Council.
I also do not understand why the Health Professions Council is considered to be the right regulator for social workers. There is a difference between social work and health work. We touched on that in the last debate. I agree with what the noble Earl, Lord Howe, said in response to the noble Baroness when he reflected on the value of social care workers but also on the difference in role. The Health Professions Council regulates a number of bodies, but they all have a health basis in the main. Therefore, it stretches the imagination to see how this body will effectively regulate social care workers in the future. The profession of social work is pretty fragile and having its own regulator is one of the building blocks for boosting the status, confidence and quality of the social work profession.
I oppose the abolition of the GSCC and the transfer of social worker regulation to the HPC in principle. If I am unsuccessful in persuading the Government, even at this stage, to change their mind, I suggest that a number of issues would help to reassure me and many social workers about the way in which the HPC will perform. This is why I have a number of amendments, which seek to ensure that there is an appropriate definition of “social worker”. I think that it would be appropriate, inside the HPC, to establish an office of chief social worker. I also think that the name of the HPC should recognise that it is regulating the social work profession. I have not yet had any rational answer as to why “Social Work”, or something of the sort, should not appear in the title of the HPC. We know that the reason is that the HPC has refused to have it. I think that the department is finding it difficult to tell the HPC that it is subject to parliamentary provision and that it is not enough, simply because it does not want “Social Work” in its title, not to agree to it. I refer the noble Earl, Lord Howe, to the Bill before us. It refers, in these clauses, to a number of orders, including health and social work orders. Therefore, there clearly cannot be an objection in principle to the use of “Social Work” in the title. It is totemic, but it is at least a way of showing the 100,000 individuals in the social work profession to be covered that in fact the HPC is not going to continue with a medical model of regulation.
My final point is this. I invite the noble Earl to state clearly that it is not his department’s intention that the HPC should eventually take over the regulation of nurses and doctors. He will know that a review is being undertaken of the Nursing and Midwifery Council and I gather that there are also proposals to change the governance of the General Medical Council. A number of people in the health service have told me that they think the eventual aim is for the HPC to regulate all the healthcare professions. The noble Earl would provide a great deal of reassurance if he would say that it is not his department’s long-term ambition to turn the HPC into the sole regulator of all the health and social care professions. I for one would be very concerned about that. I beg to move.