Safeguarding is everybody’s business
On 19 July, the Trust held a safeguarding conference at The King’s Centre in Norwich. The aim of the event was to raise awareness of safeguarding and that it applies to everyone, regardless of profession, cultural background or setting. It is everybody’s business and if we don’t do something who will?
The Trust will use the additional knowledge and information gathered from the day to ensure safeguarding is continuously put at the core of any changes being made under the Radical Pathway Redesign (RPR) programme of work.
Maggie Wheeler, chair, said: “This is something the board takes very seriously. We have seen an increase in referrals and it is our duty to be ready, willing and able to respond. This is why we are placing safeguarding champions within each pathway being redesigned as part of RPR; safeguarding needs to be at the centre of any changes we make. We already have a focus on dignity and respect within our care services, but we also need to embed a culture of vigilance to become transparent and proactive when dealing with safeguarding issues.”
The event also provided a forum to bring together a wide range of professionals - from health care and public sectors as well as charitable and voluntary organisations - to share best practice.
Speaker: Dr Catherine Thomas, consultant child and adolescent psychiatrist
Dr Catherine Thomas, consultant child and adolescent psychiatrist for the Trust, opened the presentations by talking about the effect that neglect and abuse can have on infant attachment.
She explained that survival is part of the human condition and that our early experiences of attachment can help or hinder our ability to adapt to and cope with those dangers. Dr Thomas explained that our early experiences of parenting shape our ability to regulate our emotions later in life, and hence potentially impact on our ability to function optimally. A health visitor from Essex talked about how important it is to provide perinatal mental health support as there isn’t enough support at the initial attachment stages.
Dr Thomas responded by saying: “Our Trust RPR includes plans to develop a perinatal and infant mental health pathway.” She explained that the proposed new combined pathway between CAMHS and the Adult Mental Health Service, lead by Dr Rebecca Horne, will hopefully develop perinatal and infant parenting support and therapy, with plans for integrated work with children’s centres. The needs of the most vulnerable and complex parents and families would be targeted in this new pathway.
Speaker: Dr Rob Davey, consultant child and adolescent psychiatrist
Her presentation was followed by Dr Rob Davey, consultant child and adolescent psychiatrist, presented on the challenges of safeguarding teens and when/how a teenager should be protected. This guidance will be embedded into the CAMHS pathway being developed through RPR.
“Generally teenagers get a ‘bad press’,” he said. “They are more outspoken than younger children and are more mature than teenagers from previous generations.” He explained that it is because of this that society has developed a false idea that safeguarding adolescents is not needed. In actual fact, one third of people on the safeguarding register are teens.
During his presentation there was a lot of discussion around the internet and the emergence of new potential safeguarding issues such as cyber bullying, the online sharing of child pornography, grooming and children having access to inappropriate or criminal content.
One delegate who worked for the adoption agency raised the issue that parents are parents are not confident about social media, and highlighted the important role the Trust has to play in signposting parents to the appropriate agencies.
Dr Davey agreed, and talked about the various community parenting groups that the Trust recommends to parents. He added: “Ironically one of the best ways for parents to learn about this stuff is through the internet. The website www.kidscape.co.uk provides advice about the internet with sections for both children and parents.”
Speaker: Kae Donellan, inpatient manager for learning disability services
The next presentation was provided by Kae Donellan, inpatient manager for learning disability services, who talked about the implications of victims and perpetrators with learning disabilities. She said that in the 2173 referrals to the safeguarding board in Suffolk in 2010/11, 493 of those victims had learning disabilities – no small amount!
Kae brought up an example, which triggered a passionate debate among the delegates: a 25 year old woman with mild autism has unprotected sex because her boyfriend said she should have sex with his friends. She confided in her health care workers because she didn’t want to get pregnant and she feared that would have been raped if she had refused to do what her boyfriend asked.
The team made a safeguarding referral and after work with a psychologist and many capacity tests it was deemed she had the ability to consent and the case went no further.
A delegate from the Trust’s Carer’s Council raised the issue that if she thought she might be raped as a consequence of not doing what her boyfriend suggested then it wasn’t really a choice. Maggie Wheeler, Trust chair, said: “This raises an important issue that we have a duty to teach people with learning disabilities to safeguard themselves.” One attendee agreed, saying that there needs to be more focus on teaching about relationships and providing the right communication skills and vocabulary for adults with learning disabilities to better understand their situation.
These grey areas are the exact reason for putting on the safeguarding conference and embedding best practice into the pathways being redesigned by the Trust’s clinicians. The idea is to promote discussion around these ‘grey areas’ and encourage problem solving and reflective practice among professionals across Norfolk and Suffolk.
Speaker: Amanda Murr from Norfolk Constabulary
Amanda Murr from Norfolk Constabulary, led an eye-opening presentation on honour-based violence (HBV) and abuse. She began by busting the myth that HBV only occurs in Asian families – it is prominent in African countries, the Middle East and in fact it occurs in all countries, including Britain. “Honour based crimes are difficult for people to discuss confidently,” Amanda said. “It is important to remember that you should never stereotype; it is only a minority of people that commit honour-based crimes. Don’t fall for the argument that ‘my culture allows me to do this’. It is our duty to ask questions.”
She reminded the delegates what Mike O'Brien said when he was Home Office minister: ‘Multicultural sensitivity is no excuse for moral blindness’.
“There are specialist police officers in both Norfolk and Suffolk,” Amanda said. “We want to get it right and get it right first time so use their knowledge and expertise.” She explained that the most important things to remember are:
• Always believe the victim,
• Always see the victim alone, and
• Never assume it is ‘cultural’ or ‘racial’.
One delegate asked whether there is a need for follow up with the victim to ensure they don’t return to the family. Amanda explained that there is no such thing as an exit strategy for HBV. The police work with the victims for a very long time.
Speaker: Dr Ian Newey, lead clinical psychologist in Central Norfolk Child and Adolescent Mental Health Services
The final presentation of the day was by Dr Ian Newey, lead clinical psychologist in Central Norfolk Child and Adolescent Mental Health Services, on the topic of sexual trauma and the mental health consequences it brings.
Dr Newey talked about his methods of therapy and what he described as the ‘process of tidying up memories’. Firstly he talked about Trauma Focused Cognitive Behavioural Therapy which includes making a trauma timeline to give a ‘zoomed out’ version of events. “This makes the traumatic memories more manageable. At this point you can then ‘zoom in’ to the specific trauma.”
He explained that by processing the trauma by thinking about and talking about the memories the distress is brought down by integrating the events into the person’s ‘normal’ autobiographical memories. This can be enhanced by following the trauma right through to a place of safety when creating a narrative about it i.e. asking “and what happened after that?”
“Developing a trusting relationship is essential when treating post-traumatic stress,” he said. “It is important to never do anything that you haven’t first explained. They need to know what they are consenting to. It is not a nice process to go through but if you can talk about it, it will get less distressing.”
Dr Newey also talked about eye movement desensitization and reprocessing (EMDR), a form of therapy devised by Francine Shapiro. This therapy involves repeatedly moving the eyes left and right, which can basically ‘unstick’ a memory in order for a person to process it. He explained that other bilateral movements (alternating taps on the table, for example) can work.
Close and feedback
The conference closed at 4:15pm giving delegates an opportunity to continue networking and visit the many information stalls on display at the event.
Saranna Burgess, safeguarding lead and named nurse for safeguarding children, concluded the day by saying: “I hope people here today have been able to build upon existing relationships and speak to people they wouldn’t have otherwise had the opportunity to meet.”
Feedback from the event was very positive. Below are just a few of the comments made by people during the day:
• Tessa Betts, from sexual assault support organisation The Harbour Centre said: “This event is very informative and of course relates to what we do. Dr Davey’s presentation about safeguarding adolescents was particularly relevant.”
• Her colleague Melanie Buttery agreed and added: “There are a lot of complexities being raised today - especially in relation to learning disabilities. Maybe it is a sign that something needs to be done.”
• Nurse therapist, Jane White, said: “This is an excellent opportunity to network and really questions the safeguarding issues that are around. It is an inspiring event.”
• Andrea Fiske, who works in the minor injuries unit at Cromer Hospital, added: “It is a good opportunity for networking and there has been a broad spectrum of speakers. There is a lot of information available and what I will take away from today is mainly a good list of contacts!”
• Clinical psychologist Catherine Spencer said: “It has been a really informative day with a good mix of people. There are agencies here today that I haven’t heard of so it is great to hear a wider view.”
Saranna added: “I hope we can build on this conference and go away with the message that safeguarding is everyone’s responsibility. If we don’t do something who will?”
Click here to download a PDF of the delegate brochure
Click here to download a PDF of the Trust safeguarding team and other exhibitors
Click here to download a PDF of the powerpoint presentation
Click here to download a PDF of the Carer involvement poster
Click here to download a PDF of the Service User involvement poster
Click here to download a PDF summary of the event