Serious Case Reviews -

Serious Case Reviews -

Hampshire Safeguarding Children Board A briefing for SFYC Local Safeguarding Children Boards The key statutory mechanism for co-ordinating local authorities, policing, NHS, schools and others to protect children, and for ensuring that this work is effective. Created by: Children Act 2004

A statutory Board Members: LA, Social Care, Health, Education, Police, Probation, YOT, District Councils etc Includes: Lay members and community representation Aim: To improve how local organisations work together to ensure children stay safe

Who is part of Hampshire Safeguarding Children Board? The role of HSCB Safeguarding & Child Protection Procedures available on the HSCB website:

Multi-Agency training Quality Assurance: checking and scrutinising Communicating & raising awareness Commissioning and publishing Serious Case Reviews and incorporating learning into practice Abusive Head Trauma (AHT) A briefing for SFYC

Access to Serious Case Reviews All SCRs are required to be published in all but extenuating circumstance, these include significant risk to a sibling or parent/carer if the review were to be published. Local SCRs can be accessed via the HSCB website k National SCRs can be accessed on the NSPCCs national repository Thematic Reviews of SCRs and MARs

What is Abusive Head Trauma Shaken Baby Syndrome Child Abuse Catastrophic injuries: Bleeds in the brain and behind eyes Broken Bones Babies can be shaken, thrown or hit It affects approximately 24 of every 100,000 babies admitted to hospital each year Research suggests 1 in 9 mothers may have

shaken their baby and; up to 2 in 9 felt like doing so Injuries as a result of AHT Not all babies will die immediately as a result of abusive head trauma. Research suggests that two years after the injury 24.5% of babies with AHT will die and 40% will have significant disabilities. Children who survive may have significant brain injuries which result in long term care

needs Injuries as a result of AHT Associated features Apnoea stopped breathing 93% Broken Rib 77% Bleeds behind eyes 71% Fits 66%

Head & neck bruising 37% Triennial review of SCRs Risk of harm to a child increases when a number of identified vulnerabilities or risk factors are present in combination or over periods of time. This has been highlighted in previous national analyses of SCRs in relation to domestic abuse, substance misuse and parental mental health

problems. The latest report draws attention to some additional parental risk factors: Triennial review of SCRs domestic abuse,

parental mental health problems, drug and alcohol misuse, adverse childhood experiences, a history of criminality, particularly violent crime, patterns of multiple, consecutive partners, acrimonious separation. Triennial review of SCRs Of the 197 fatal case reviewed in the triennial

review 48 were due to physical abuse. This accounts for the largest single category of fatal SCRs. 73% of these cases were babies under the age of one. Case Study

What are you worried about? What are the risk factors? Who are you going to talk to? What are your processes? Known risk factors Kesler et al (2008) found that males represent 70% of perpetrators. Their study also provides strong evidence that, although AHT can occur in every socio-economic groups, there are significant demographic differences between the general population and those families in which AHT occurs.

Compared with the population of Pennsylvania, both mothers and fathers were more likely to be younger, less educated and unmarried. However, caution should be given to interpreting the statistics as these families are more likely to be reported for AHT (or conversely, that families conforming to other demographics are less likely to be reported). A previous study (Jenny et al 1999) found that missed cases of AHT more frequently involved intact and Caucasian families. Altman et al (2010) also concluded that Fathers and male surrogates are nearly 5 times as likely as mothers to shake an infant. Triggers Crying is considered the main trigger

Peak of crying is 6-8 weeks of age The parents or the mothers partner are responsible for AHT in 75% of babies A majority of perpetrators are male The most at risk groups are: Male baby

Below 6 months Low birth weight Regular contact with professionals Normal Crying Curve Identifying Risk factors If you identify a parent who is really struggling with their new baby take time to talk to them. Re-assure them that crying in babies is normal. Share with them the ICON messages

Discuss what options there are for rest / sleep / additional adult support Tell them to contact their health visitor/ Cry-sis for support Suggest they ask family/ friends for help to support them If you believe the child is at immediate risk of harm make a referral to Childrens Services following your settings protocol. ICON Safe Sleep

As part of the AHT campaign HSCB are including key messages in relation to safe sleep. This will be an area of focus during 2018/19. Babies should sleep in their own cot/ Moses basket in the same room as their parents. In a non smoking environment. Parents should not put the baby in their bed if they have been consuming alcohol or are under the influence of drugs Babies should be put to sleep on their backs The cost/ Moses basket should not contain sleeping aids/ additional bedding Babies can not regulate their temperature make sure the room

they sleep in is an appropriate temperature. HSCB Policies

4LSCB Procedures Bruising Protocol Unborn Baby Protocol Threshold Chart and guidance Escalation Policy FGM Family Engagement Policy (DNA) FII

Principles and Standards for Safeguarding Supervision Spotlight on How to refer to CRT Childrens Services Professionals; 01329 225379 Childrens Services Public; 0300 5551384 Interagency referral form Questions?

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