BACKGROUND
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This review examined the
circumstances around the
life of a teenager who
took his own life. Child
E suffered a troubled childhood
and adolescence, and several
agencies had had involvement.
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THE PROCESS
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The review has been commissioned
by the Leeds Area Child
Protection Committee (ACPC)
under Part 8 of "Working
Together to Safeguard Children - A
Guide to Inter-Agency Working
to Safeguard and Promote
the Welfare of Children" (Department
of Health, Home Office,
Department for Education
and Employment 1999).
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The purpose of the review
is:
To establish whether there
are lessons to be learned
in the way in which local
professionals and agencies
working together;
To identify those lessons,
how they will be acted
upon, and what is expected
to change as a result and
to improve inter-agency
working and better safeguard
children.
The report was written
by a panel convened by
Leeds ACPC, and it was
informed by the internal
management reviews of West
Yorkshire Police, Education
Leeds, Leeds Health Trusts,
Leeds Mental Health Trust,
Children & Adolescent
Mental Health Services,
East Leeds Primary Care
Trust, Leeds Social Services,
the Youth Offending Team
at Leeds and the Probation
Service, West Yorkshire.
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RECOMMENDATIONS
FOR INDIVIDUAL AGENCIES
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Recommendations for West
Yorkshire Police
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There are no recommendations
for West Yorkshire Police.
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Recommendations for Education
Leeds
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To
introduce an effective
system for pupil tracking
in relation to vulnerable
pupils. This should include
clear protocols on roles
and responsibilities for
admission and transfer
between mainstream and
alternative specialist
provision, to ensure that
a pupil remains on the
role of the referring school
until appropriate transfer
procedures are agreed.
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-
To
review practice and
establish clear procedures
in relation
to exclusion policies
for pupils from LEA
provision. This
should include the
convening of multi-agency
meetings,
particularly in the
case of vulnerable
children, to ensure
that child
protection
considerations have
been fully explored.
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-
To
establish written procedures
between schools, statutory
and supporting agencies,
that will improve educational
access and attainment for
vulnerable children.
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Recommendations for the
Health Service
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To
reiterate through
training for all Health
staff
the need for holistic
assessments
of children which
take into consideration
their home environment. Further,
that such assessments
are not an end in themselves
and clear responsibility
must be taken for
implementing any intervention
strategies
by Health professionals
following such an
assessment.
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-
To
consider the potential
for Child Health
Services to be more
actively
involved in monitoring
ongoing need
as indicated by the
boy's
behaviour and circumstances
out of school, rather
than just by child
protection registration.
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-
To
bring the recommendations
of the Serious Case Review
to the attention of senior
Adult Mental Health professionals
within the context of Clinical
Governance.
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The
need for practice development
that addresses the recognition
of the seriousness of long-term
neglect and emotional abuse
and the dangers of disguised
compliance should be explored.
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Recommendations for the
Social Services Department
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-
Where
there are repeated
presentations of a
child on the CPR at
Hospital A & E
Departments, the
reasons and motivation
for these should
be
explored by the keyworker,
even
if these are not
identified as suspicious
by the
Hospital.
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-
Where
the emotional health of
young people is identified
as a major issue in child
protection cases, it is
essential that this is
identified through the
child protection plan,
and actually addressed.
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-
Where
there is evidence of parental
substance misuse impacting
on the care of children
in a child protection case,
all possible attempts should
be made to engage adult
substance misuse workers
in the process of assessment
and planning for the children.
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Where
there is evidence of adult
mental health on the care
of children in a child
protection case, all possible
attempts should be made
to engage adult mental
health workers in the process
of assessment and planning
for the children.
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-
Where,
in the management of a
child protection case,
active consideration is
being given to the appropriateness
of children remaining with
their current carer, but
removal by legal intervention
is felt likely to be counterproductive,
it is essential that alternative
care arrangements with
the extended family should
be explored.
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Recommendations for the
Youth Offending Team
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-
That
the YOT review their procedures
to highlight child protection
concerns where an individual
expresses intentions of
self-harm or suicide.
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That
YOT review their procedures
to ensure that an appropriate
agency continues to be
involved with a child in
cases where YOT have withdrawn.
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Recommendations
for the Probation Service
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-
The
Probation Service should
ensure that staff are
conscious of child protection
concerns when dealing
with clients who have
responsibility for caring
for children.
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Recommendations
for ACPC
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-
That
ACPC consider their procedures
in relation to child
protection conferences
to include relevant education
agencies.
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-
That
ACPC raise with the Department
of Health the importance
of GP co-operation with
Serious Case Reviews.
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