Child & Vulnerable Adults Policy
Some of the text in this guide was adapted from material published by the Department of Health and Children (Ireland) and Comber.
About the Sexual Health Centre
The Sexual Health Centre is a Not for Profit, Voluntary Sector/Non-Governmental Organisation (NGO). It is situated at 16 Peter’s Street in Cork City and its charity number is CHY 19919. The Sexual Health Centre is now in its 30thyear. Its vision is for a society where (i) people are able to understand, acknowledge and express their sexuality, (ii) people are able to understand, acknowledge and respect the sexuality of others and (iii) fewer people experience STIs and crisis pregnancies. In achieving this, the mission defines the Sexual Health Centre as “an innovative and creative organisation that facilitates people’s need for clear and unambiguous information and support regarding their sexual health, while advocating for positive social change”. Our values include but are not limited to Equality, Dignity and Respect, Accountability, Quality, Inclusion and Transparency. We believe that (i) sexuality is an integral part of everyone, (ii) that everyone has the right to feel confident, assertive and safe to express their sexuality and (iii) that being listened to in confidence and accepted without prejudice can alleviate feelings of shame and isolation. The organisation team is focused on delivering health promotion workshops and interventions centred on education, support and facilitation. It works with a broad spectrum of society including but not limited to:
Intellectual disabilities,
LGBTI+ people,
People engaged with sex work,
Addiction service users,
Young adults,
Vulnerable adults and
Migrants
The Sexual Health Centre aims to safeguard children and vulnerable adults from abuse and exploitation in all that we do.
Our Policy
The Sexual Health Centre recognises the rights of children and vulnerable adults to protection from abuse, violence and exploitation. The Sexual Health Centre is committed to providing a safe environment for children and vulnerable adults who come into contact with representatives from the Sexual Health Centre.
The Board of Directors is responsible for ensuring that the organisation follows effective protection procedures which retain the ethos of the organisation and fit in with local statutory procedures.
The Sexual Health Centre is committed to ensuring that representatives of the organisation are aware of our policy in relation to protection of children and vulnerable adults. Children and vulnerable adults need protection for many reasons, including protection from the effects of poverty, disadvantage, exclusion and violence. This policy is specifically concerned with protecting children or vulnerable adults from abuse by a representative from the Sexual Health Centre. This policy will be reviewed every three years or as appropriate.
What is Abuse?
Defining abuse is a difficult and complex issue. A person may abuse by inflicting harm or by failing to prevent harm. Abuse of vulnerable adults can constitute the physical, psychological, emotional, financial or sexual maltreatment or neglect of a vulnerable adult by another person. The abuse may be a single act or repeated over a period of time, it may take one form or multiple forms. The lack of appropriate action can also be recognised as a form of abuse.
1 Children are defined as persons under 18 years of age as defined by UN Convention on the Rights of the Child.
2 A ‘Vulnerable Adult’ is a person aged 18 or older who, by reason of mental or other disability, age or illness is, or may be unable to take care of him or herself, or unable to protect him or herself against ‘significant harm’ or ‘exploitation’.
3 Representative means any person coming into contact with a child/ vulnerable adult while acting on behalf of the Sexual Health Centre. This includes staff, volunteers and board members.
– 2 – Irish guidelines recognise four categories of child abuse:
Physical Abuse: physical abuse is any form of non-accidental injury or injury which results from wilful or neglectful failure to protect a child. Examples include hurting or injuring a child, inflicting pain, poisoning, shaking or otherwise causing physical harm to the child.
Sexual Abuse: sexual abuse occurs when a child is used by another person for his or her gratification or sexual arousal, or for that of others. This includes direct or indirect sexual exploitation or corruption of children by involving them (or threatening to involve them) in inappropriate sexual activities.
Emotional abuse: emotional abuse is normally to be found in the relationship between a care-giver and a child rather than a specific event or pattern of events. It occurs when a child’s need for affection, approval, consistency and security are not met, for example repeatedly rejecting children, humiliating them, frightening them or denying their worth and rights as human beings.
Neglect: neglect is defined as the persistent failure to meet a child’s basic physical and physiological needs. This can be defined in terms of an omission, where a child’s health, safety, development or welfare is being avoidably impaired by being deprived of food, clothing, warmth, hygiene, intellectual stimulation, supervision and safety, attachment to and affection from adults or medical care.
See below for further guidelines and indicators.
Appropriate Conduct for Representatives
The Sexual Health Centre is aware that children or adults it comes into contact with may be particularly vulnerable for a number of reasons including;
Intellectual or physical disability
Mental health problems
Dependence on State/NGO provision
Communication difficulties
Previous experience of abuse
Fear of not being believed
Fear and uncertainty regarding the future.
Representatives should be aware that many children and adults we come into contact with are vulnerable to abuse and may have been abused in the past. It is important that representatives of the Sexual Health Centre are aware of this and maintain appropriate standards of behaviour and conduct around children/ vulnerable adults, even if others do not expect it.
Children First Guidelines, published by the Department of Health and Children, Ireland (1999).
Having the right relationship within services is an essential foundation for ensuring people’s safety, protection and welfare. The right relationship is the behaviour or dynamic that should exist between the staff and volunteers in the organisation providing the service and the people who use the service. It involves people using the service being seen and treated with respect, dignity and value so the staff and volunteers can determine, as much as possible, the support required by the people who use the service and how they are to be supported.
Procedures
Disclosures and Suspicions made known to Representatives
A disclosure is defined as a specific allegation of abuse made against a named individual. A suspicion is when concern is expressed or raised about abuse that may have taken place or concern that abuse may take place. Through their work for the Sexual Health Centre, an allegation or suspicion of child or vulnerable adult abuse may be made known to a representative.
If this suspicion or allegation relates to a representative(s) of the Sexual Health Centre, procedures as outlined below should be followed.
Otherwise, representatives are advised to follow statutory regulations and refer to the complaint to the appropriate local partner organisation, authorities or child protection agencies. In these situations the Designated Person will be available to advise the representative.
The safety and protection of the child or vulnerable adult should be the paramount concern. This policy is specific to protecting children and vulnerable adults from representatives of the Sexual Health Centre.
Allegations against Representatives
The Sexual Health Centre has a Standard Referral Form (see Appendix 1) which should be used to report suspected or alleged abuse by a representative of the Sexual Health Centre. This form is available on our website and on request from the office. In making a report on suspected or actual abuse, the individual should ensure that the first priority is always for the safety and welfare of the child and/or vulnerable adult. Reports may be made by any concerned person who has reason to believe a representative of the Sexual Health Centre has abused a child or vulnerable adult; including co-workers or colleagues, parents, social workers, carers or stakeholders. Children or vulnerable adults can also disclose to an adult who may make a report on their behalf. The form should be completed and forwarded to the Designated Person at the Sexual Health Centre as soon as possible after the abuse is identified. The reporting procedure for dealing with disclosures, concerns or allegations of abuse within the Sexual Health Centre is outlined in the following steps:
The Sexual Health Centre representatives or third parties who have received a disclosure of abuse or who have concerns of abuse, should bring it to the attention of the Designated Person as soon as possible.
The Designated Person will assess and review the information that has been provided as quickly and effectively as possible. The DP may contact the HSE or other relevant authorities for informal advice relating to the allegation, concern or disclosure.
Any staff member/volunteer implicated in an investigation will be suspended from work without prejudice, pending the results of the investigation. It should be made clear that this suspension does not imply guilt but rather protects all parties whilst an investigation is undertaken.
Parents/guardians of the child or vulnerable adult will be informed of the allegation, concern or disclosure where possible, unless doing so is likely to endanger the child/ adult.
The Chairperson of the Board of Directors will be advised of the allegation, who will then communicate to the alleged perpetrator that an allegation has been made against him/her and the nature of the allegation. The representative about whom the allegation has been made will be offered the opportunity to respond to the allegations. This response should be documented, signed by both parties and retained.
It is essential in reporting any case of alleged/suspected abuse that the principle of confidentiality applies. The information should only be shared on a ‘need to know’ basis and the number of people that need to be informed should be kept to a minimum. After consultation with the Chairperson of the Board of Directors and relevant authorities, the Designated Person will then take one of two options:
On the basis that there are reasonable grounds for concern (as outlined in Appendix 3), report the allegation, concern or disclosure to the relevant statutory authorities or not make a formal report to the authorities but keep a record of the concerns on file. The reasons for not reporting the allegation, concern or disclosure will be clearly recorded. The representative or third party who made the initial report will be informed if a formal report is not being made to the authorities and it is open to him/her to make a formal report themselves, directly to the relevant authority if they feel this is necessary.
Where, following an initial investigation, the representative is not reported to the authorities but is found to have been engaged in poor practice (e.g. shouting at a child/ vulnerable adult), the representative should be warned about the poor practice and it may constitute grounds for termination of the relationship. This will be decided by the Board of Directors. In an emergency a report should be made directly to the Police. The Designated Person will retain up-to-date contact details of appropriate referral authorities. In Ireland, concerns should be referred to the HSE Child Protection Social Work Services in the relevant area.
Designated Person
The Designated Person is responsible for being familiar with the principles of good practice for the protection of children and vulnerable adults and the implementation and monitoring of the Child and Vulnerable Adults Protection Policy of the Sexual Health Centre. The Designated Person is responsible for co-ordinating action within the organisation when a concern arises and reporting any suspicion or disclosure of abuse to the appropriate services. The Designated Person is responsible for recording and retaining all relevant documentation in relation to protection issues that arise. The Designated Person should receive appropriate Child Protection training and support for his/her role if required. If there is an allegation or suspicion in relation to the Designated Person, the Chairperson of the Board of Directors will deal with all aspects of the case, including the reporting procedure.
The Designated Person/s for the Sexual Health Centre is:
Name: Dr. Martin Davoren,
Title: Executive Director, The Sexual Health Centre
Tel: 021 427 5837
Record Keeping
The Designated Person is responsible for keeping the records related to Child and Vulnerable Adult Protection in secure storage and in accordance with GDPR, such as:
Any disclosures, concerns or allegations of abuse.
The follow up to any complaints, disclosure, concerns or allegations, including informal advice from the relevant authorities or agencies, official reports and the minutes of any meetings in relation to reports.
Signed acceptance forms of the Sexual Health Centre Child and Vulnerable Adult Protection Policy by staff, volunteers and directors.
All Garda Vetting Forms and related correspondence. Other staff / Directors may access files as appropriate to their role, though this will be kept to a minimum.
Prevention
The Sexual Health Centre will select volunteers, staff and directors based on their suitability for the role available. Checks for suitability may include CV; Interview; References; Garda Vetting; Evidence of professional qualifications. Where appropriate to their role, volunteers, staff and director should sign a declaration stating that they comply with the Sexual Health Centre’s Child and Vulnerable Adults Protection Policy and that there is no reason that they cannot work with children (see Appendix 2).
Communication and Implementation
The policy is also available on the organisation website (www.sexualhealthcentre.com). The Sexual Health Centre will support its partner organisations to develop appropriate child protection policies and procedures where required. The Sexual Health Centre will review and evaluate its Child Protection policy every three years or as appropriate. Amendments and additions to the policy will be recorded.
THE SEXUAL HEALTH CENTRE CHILD & VULNERABLE ADULT PROTECTION REFERRAL FORM
Your name:
Email address:
Telephone number:
Your relationship to the Sexual Health Centre – if relevant:
Your relationship to the child/ adult concerned – if relevant:
Name of child/ adult:
Age and date of birth of child/ adult:
Who does the child/ adult live with?
Address/place of residence of child/ adult (and telephone no. if available):
Are you reporting your own concerns or passing on those of somebody else? Give details.
Brief description of what has prompted the concerns (include dates and times of any specific incidents):
Observations made by you: Physical signs? Behavioural signs? Indirect signs?
Have you spoken to the child/adult? If so, what was said?
Has anybody been alleged to be the abuser? If so, give details.
Have you consulted an external agency or reported this to anyone else?
Give details (name of person, name of organisation, date and time).
Does the child/adult require medical attention?
Signature
Date
Please return this form in strict confidence to: Dr. Martin Davoren, Executive Director, The Sexual Health Centre, 16 Peters Street, Cork, Ireland, T12 DX73 or email to martindavoren@sexualhealthcentre.com
Recognising Child Abuse Definition and Possible Physical and Behavioural Indicators of Child Abuse Neglect
Neglect
Neglect can be defined in terms of an omission, where the child suffers significant harm or impairment of development by being deprived of food, clothing, warmth, hygiene, intellectual stimulation, supervision and safety, attachment to and affection from adults, medical care. Neglect generally becomes apparent in different ways over a period of time rather than at one specific point. Possible indicators of this type of abuse are:
Frequent minor or serious injuries
Untreated illness
Hunger, lack of nutrition
Tiredness
Inadequate and inappropriate clothing
Lack of supervision
Low self esteem
Lack of peer relationships
Emotional
Emotional abuse is normally to be found in the relationship between a care-giver and a child rather than in a specific event or pattern of events. It occurs when a child’s need for affection, approval, consistency and security are not met. Unless other forms of abuse are present, it is rarely manifested in terms of physical signs or symptoms. Possible indicators of this type of abuse are:
Unreasonable mood and/or behavioural changes;
Aggression, withdrawal or an ‘I don’t care attitude’;
Lack of attachment;
Low self esteem;
Attention seeking;
Depression or suicide attempts;
Suicidal ideation
Persistent nightmares, disturbed sleep, bedwetting, reluctance to go to bed;
A fear of adults or particular individuals e.g. family member, baby-sitter or indeed excessive clinginess to parents/carers;
Panic attacks.
Physical
Physical abuse is any form of non-accidental injury or injury which results from wilful or neglectful failure to protect a child. Possible indicators of this type of abuse are:
Frequent bruising, fractures, cuts, burns and other injuries;
Torn clothing;
Bite marks burns or welts;
Bruises in places difficult to mark e.g. behind ears, groin;
Undue or unnecessary fear;
Aggressiveness or appearing withdrawn;
Absconding frequently from home.
Sexual
Sexual abuse occurs when a child is used by another person for his or her gratification or sexual arousal or for that of others. Possible indicators of this type of abuse are:
Over affectionate or inappropriate sexual behaviour;
Age inappropriate sexual knowledge given the child’s age, which is often demonstrated in language, play or drawings;
Fondling or exposure of genital areas;
Hints about sexual activity;
Unusual reluctance to join in normal activities which involve undressing, e.g. games/swimming.
Indicators of Abuse are Not Facts
It is important to stress that no one indicator should be seen as conclusive in itself of abuse; it may indeed indicate conditions other than child abuse. A cluster or pattern of signs is likely to be more indicative of abuse. Signs must also be considered in the child’s social and family context as child abuse is not restricted to any socio economic group, gender or culture. It is important to always be open to alternative explanations for possible physical or behavioural signs of abuse.
Reasonable Grounds for Concern
The ability to recognise child abuse depends as much on a person’s willingness to accept the possibility of its existence as it does on their knowledge and information. Child abuse can often be difficult to identify and may present in many forms. It is important to stress that no one indicator should be seen as conclusive in itself of abuse. All signs and symptoms must be examined in the total context of the child’s situation. The statutory authorities should always be informed when a person has reasonable grounds for concern that a child may have been abused, or is being abused, or is at risk of abuse. A suspicion that is not supported by any objective indicator of abuse or neglect would not constitute reasonable grounds of for concern.
The following examples would constitute reasonable grounds for concern:
specific indication from the child that s/he was abused;
an account by the person who saw the child being abused;
evidence such as injury or behaviour which is consistent with abuse and unlikely to be caused in any other way;
an injury or behaviour, which is consistent both with abuse and with an innocent explanation but where there are corroborative indicators supporting the concern that it may be a case of abuse. An example of this would be a pattern of injuries, an implausible explanation, other indications of abuse, dysfunctional behaviour;
consistent indication, over a period of time, that a child is suffering from emotional or physical neglect.
A suspicion, not supported by any objective indication of abuse or neglect, does not constitute a reasonable suspicion or reasonable grounds for concern. Reacting in the immediate aftermath of a disclosure of abuse:
Keep calm and do not appear shocked;
Do not promise not to tell anyone, explain that you will need to tell someone who can take appropriate action but that it will be dealt with confidentiality; – Never ask leading questions, instead repeat the last words the child has said in a questioning manner; – Reassure the child that they are not to blame;
Reassure the child that they were right to tell you;
Let the child know what you are going to do next. (Children First 1999, 4.3.2 and 4.3.3)
Recognising abuse of Vulnerable Adults: Types of Abuse, Definitions and Indicators Physical Abuse
Definition: Physical abuse is the control by violence or battery of another person or threat to use such means. It includes hitting, slapping, pushing, kicking, misuse of medication, restraint or inappropriate sanctions. Indicators of these include:
Bruises
Dislocations
Lacerations
Marks left by a gag
Abrasions
Hair loss
Scratches
Missing teeth
Burns
Eye injuries
Sprains
Fractures
Sexual Abuse
Definition: Sexual abuse is the domination and control of the body of the victim. It includes rape and sexual assault, or sexual acts to which the vulnerable adult has not consented, or could not consent to, or where he/she was compelled to consent. Indicators include:
Sexually transmitted infections and human bite marks
Non physical indicators include:
Noticeable and uncharacteristic change in behaviour
Hints about sexual activity
Inappropriate seductive behaviour
Sexually aggressive towards others
Unusual reluctance to join in activities involving undressing
Clinging
Isolation
Nightmares
Phobias
Depression
Eating and sleeping disorders
Fear of being left alone with a particular person (family, staff, others)
Psychological Abuse (including emotional abuse)
Definition: This includes threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling intimidation, coercion, harassment, verbal abuse, isolation or withdrawal of services or supportive networks. Indicators include:
Demoralisation
Depression
Feelings of helplessness/hopelessness
Disrupted appetite/sleeping patterns
Tearfulness
Excessive fears
Agitation
Resignation
Confusion
Unexplained paranoia
Strong ambivalent feelings towards someone
Financial or Material Abuse
Definition: This includes theft, fraud, exploitation, pressures in connection with wills, property, inheritance or financial transactions or the misuse or misappropriation of property, possessions or benefits. Indicators include:
Unexplained or sudden inability to pay bills;
Unexplained or sudden withdrawal of money from accounts;
Funds diverted to someone else’s use;
Damage to property;
Unexplained disappearance of possessions;
No funds for food, clothes or services;
Refusal to spend money;
Disparity between living conditions and assets;
Extraordinary interest by family member in older person’s assets;
Making dramatic financial decisions.
Neglect and Acts of Omission
Definition: This includes ignoring medical or physical needs, failure to provide access to appropriate health, social care or educational services, or withholding the necessities of life, such as medication, adequate nutrition and heating. Indicators include:
Dehydration
Malnutrition
Inappropriate clothing
Poor hygiene
Unkempt appearance
Under or over medicated
Unattended medical needs
Exposure to danger and/or lack of supervision
Absence of required aids e.g. glasses or dentures
Pressure sores
Institutional Abuse
Definition: Inappropriate practices or systems employed by or within the organisation which deny people using the service, their right to choice, privacy and independence. Indicators include:
Staff become desensitised through lack of management and supervision and accept as reasonable, practices which could be deemed inappropriate outside the organisation;
Staff and management do not listen to, hear and/or respond appropriately to views of people using the service;
The organisation cannot respond within a reasonable timeframe or appropriately to complaints made;
People using the service are treated collectively rather than as individuals;
The person’s right to privacy and choice are not respected e.g. the practice of entering a person’s room without knocking and getting a response;
Talking about an individual’s personal or intimate details in a manner that does not respect a person’s right to privacy. These also include:
Poor record keeping i.e. reports /records unavailable;
Failure to account for incidents/accidents and falls etc.;
Unsatisfactory response to complaints;
Service users appearing frightened/depressed/ anxious;
Staff ordering people around or shouting at them;
Poor moving and handling practices;
Lack of stimulation in daily activity;
Service users reluctant to talk about their care, visitors/visiting professionals made to feel uncomfortable and unwelcome and lack of opportunity to see service user alone;
Locks/ties on the outside doors, ties on chairs;
Furniture in rooms positioned to restrict movement;
Clothing dirty;
Poor drug administration
If you have any questions or queries please contact us on 021 427 58 37 or info@sexualhealthcentre.com.