Greater Manchester Doulas Community Interest Company (GMD CIC) is committed to safeguarding and promoting the welfare of all individuals involved in supporting women in the childbearing year and beyond.
Our policy aims to incorporate statutory reports and guidance into our practice. In formulating our policy we have referred to key documents such as Statement of Government Policy on Adult Safeguarding (DoH May 2013); No secrets: Guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse (2015); Safeguarding and child protection standards for the voluntary and community sector (NSPCC 2019).
- Definition of a vulnerable adult
We define an adult as anyone over 18 years of age and we use the broad definition of a ‘vulnerable adult’ as a person “who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation”.
- Signs and definitions of abuse
Abuse can be defined as “a violation of an individual’s human and civil rights by any other person or persons.” This may consist of single or repeated acts, it may occur in any relationship and lead to the significant harm, or exploitation of a person. The main forms of abuse are:
- financial or material
- neglect and acts of omission
2.1 What is child abuse?
Abuse happens when a person – adult or child – harms another. It can be physical, sexual or emotional, but can also involve a lack of love, care and attention.Neglect can be just as damaging to a child as physical or sexual abuse.
Children and vulnerable adults may be abused by:
- family members
- people working or volunteering in organisational or community settings
- people they know
- strangers, albeit much less commonly.
Children and vulnerable adults suffering abuse often experience more than one type of abuse. The abuse usually happens over a period of time, rather than being a single, isolated incident.
Increasingly, abuse happens online.
2.1.1 Physical abuse
Physical abuse happens when a child or vulnerable adult is deliberately hurt, causing injuries such as cuts, bruises, burns and broken bones. It can involve hitting, kicking, shaking, throwing, poisoning, burning or suffocating.
It’s also physical abuse if a parent or carer makes up or causes the symptoms of illness in children. For example, they may give them medicine they don’t need, making them unwell. This is known as fabricated or induced illness.
Neglect is persistently failing to meet a child or vulnerable adult’s basic physical and/or psychological needs usually resulting in serious damage to their health and development. Neglect may involve a parent or carer’s failure to:
- provide adequate food, clothing or shelter
- supervise a child (including leaving them with unsuitable carers) or keep them safe from harm or danger
- make sure the child receives appropriate health and/or dental care
- make sure the child receives a suitable education
- meet the child’s basic emotional needs – parents may ignore their children when they are distressed or even when they are happy or excited. This is known as emotional neglect.
Neglect is the most common type of child abuse. It often happens at the same time as other types of abuse.
2.1.3 Sexual abuse
Sexual abuse is forcing or enticing a child or vulnerable adult to take part in sexual activities. It doesn’t necessarily involve violence, and the child may not be aware that what is happening is abuse. Child sexual abuse can involve contact abuse and/or non-contact abuse.
Contact abuse happens when the abuser makes physical contact with the child. It includes:
- sexual touching of any part of the body, whether the child is wearing clothes or not
- rape or penetration by putting an object or body part inside a child’s mouth, vagina or anus
- forcing or encouraging a child to take part in sexual activity
- making a child take their clothes off, touch someone else’s genitals or masturbate.
Non-contact abuse involves non-touching activities. It can happen online or in person and includes:
- encouraging a child to watch or hear sexual acts
- not taking proper measures to prevent a child being exposed to sexual activities by others
- showing pornography to a child
- making, viewing or distributing child abuse images
- allowing someone else to make, view or distribute child abuse images.
Online sexual abuse includes:
- persuading or forcing a child to send or post sexually explicit images of themselves (sometimes referred to as “sexting”)
- persuading or forcing a child to take part in sexual activities via a webcam or smartphone
- having sexual conversations with a child by text or online
- meeting a child following online sexual grooming with the intent of abusing them.
Abusers may threaten to send sexually explicit images, video or copies of sexual conversations to the young person’s friends and family unless they take part in other sexual activity. Images or videos may continue to be shared long after the abuse has stopped. Abusers will often try to build an emotional connection with a child in order to gain their trust for the purposes of sexual abuse. This is known as grooming.
2.1.4 Child sexual exploitation (CSE)
Child sexual exploitation (CSE) is a type of sexual abuse. Young people in exploitative situations and relationships receive things such as gifts, money, drugs, alcohol, status or affection in exchange for taking part in sexual activities. Young people may be tricked into believing they’re in a loving, consensual relationship. They often trust their abuser and don’t understand that they’re being abused. They may depend on their abuser or be too scared to tell anyone what’s happening. They might be invited to parties and given drugs and alcohol before being sexually exploited. They can also be groomed and exploited online. Some children and young people are trafficked into or within the UK for the purpose of sexual exploitation. Sexual exploitation can also happen to young people in gangs (Berelowitz et al, 2013). Child sexual exploitation can involve violent, humiliating and degrading sexual assaults and involve multiple perpetrators.
2.1.5 Harmful sexual behaviour
Children and young people who develop harmful sexual behaviour harm themselves and others. Harmful sexual behaviour can include:
- using sexually explicit words and phrases
- inappropriate touching
- using sexual violence or threats
- full penetrative sex with other children or adults.
Sexual behaviour between children is also considered harmful if one of the children is much older – particularly if there is more than two years’ difference in age or if one of the children is pre-pubescent and the other isn’t (Davies, 2012). However, a younger child can abuse an older child, particularly if they have power over them – for example, if the older child is disabled (Rich, 2011).
2.1.6 Emotional abuse
Emotional abuse is persistent and, over time, it severely damages a person’s emotional health and development. It involves:
- humiliating, putting down or constantly criticising
- shouting at, making threats or calling names
- mocking a child or vulnerable adult or making them perform degrading acts
- constantly blaming or scapegoating for things which are not their fault
- trying to control their life and not recognising their individuality
- not allowing them to have friends or develop socially
- pushing them too hard or not recognising their limitations
- manipulating a child or vulnerable adult
- exposing a child to distressing events or interactions such as drug taking, heavy drinking or domestic abuse
- persistently ignoring them
- being cold and emotionally unavailable during interactions
- never saying anything kind, positive or encouraging, and failing to praise their achievements and successes.
2.1.7 Domestic abuse
Domestic abuse is any type of controlling, bullying, threatening or violent behaviour between people who are or were in an intimate relationship. There are many different types of abusive behaviours that can occur within intimate relationships, including emotional, sexual, financial, psychological and physical abuse. Domestic abuse can be underpinned by an on-going pattern of psychologically abusive behaviour (coercive control) that is used by one partner to control or intimidate the other. Research by the NSPCC has indicated that many young people experience domestic abuse in their own intimate relationships (Barter, 2009). The UK’s cross-government definition of domestic abuse also covers relationships between young people aged 16 and 17 (Home Office, 2013). Children’s exposure to domestic abuse between parents and carers is child abuse. Children can be directly involved in incidents of domestic abuse or they may be harmed by seeing or hearing abuse happening. The developmental and behavioural impact of witnessing domestic abuse is similar to experiencing direct abuse. Children in homes where there is domestic abuse are also at risk of other types of abuse or neglect.
2.1.8 Bullying and cyberbullying
Bullying is behaviour that hurts someone else. It usually happens over a lengthy period of time and can harm a child or vulnerable adult both physically and emotionally.
- verbal abuse, such as name calling
- non-verbal abuse, such as hand signs or glaring
- emotional abuse, such as threatening, intimidating or humiliating someone
- exclusion, such as ignoring or isolating someone
- undermining, by constant criticism or spreading rumours
- controlling or manipulating someone
- racial, sexual, ableist or homophobic bullying
- physical assaults, such as hitting and pushing
- making silent, hoax or abusive calls.
Bullying can happen anywhere – at school, at home or online. When bullying happens online (cyberbullying) it can involve social networks, games and mobile devices. It includes:
- sending threatening or abusive text messages
- creating and sharing embarrassing images or videos
- ‘trolling’ – sending menacing or upsetting messages on social networks, chat rooms or online games
- excluding children from online games, activities or friendship groups
- setting up hate sites or groups about a particular child
- encouraging young people to self-harm
- voting for or against someone in an abusive poll
- creating fake accounts, hijacking or stealing online identities to embarrass a young person or cause trouble using their name.
2.1.9 Child trafficking
Child trafficking is child abuse. It involves recruiting and moving children who are then exploited. Many children are trafficked into the UK from overseas, but children can also be trafficked from one part of the UK to another. Children are trafficked for:
- child sexual exploitation
- benefit fraud
- forced marriage
- domestic servitude such as cleaning, childcare, cooking
- forced labour in factories or agriculture
- criminal exploitation such as pickpocketing, begging, transporting, drugs, selling pirated DVDs and bag theft.
Children who are trafficked experience many forms of abuse and neglect. Physical, sexual and emotional abuse is often used to control them, and they’re also likely to suffer physical and emotional neglect. Child trafficking can require a network of organised criminals who recruit, transport and exploit children and young people. Some people in the network might not be directly involved in trafficking a child but play a part in other ways, such as falsifying documents, bribery, owning or renting premises or money laundering. Child trafficking can also be organised by individuals and the children’s own families. Traffickers trick, force or persuade children to leave their homes. They use grooming techniques to gain the trust of a child, family or community. Although these are methods used by traffickers, coercion, violence or threats don’t need to be proven in cases of child trafficking – a child cannot legally consent to their exploitation so child trafficking only requires evidence of movement and exploitation. Modern slavery is another term which may be used in relation to child trafficking. Modern slavery encompasses slavery, servitude, forced and compulsory labour and human trafficking (HM Government, 2014). The Modern Slavery Act passed in 2015 in England and Wales categorises offences of slavery, servitude, forced or compulsory labour and human trafficking (NCA, 2017).
2.1.10 Female genital mutilation (FGM)
Female genital mutilation (FGM) is the partial or total removal of external female genitalia for non-medical reasons. It’s also known as female circumcision or cutting. The age at which FGM is carried out varies. It may be carried out when a girl is newborn, during childhood or adolescence, just before marriage or during pregnancy (Home Office et al, 2016). Religious, social or cultural reasons are sometimes given for FGM. However, FGM is child abuse. It’s dangerous and a criminal offence. There are no medical reasons to carry out FGM. It’s used to control female sexuality and can cause severe and long-lasting damage to physical and emotional health.
2.2 Signs of abuse
Children and vulnerable adults who suffer abuse may be afraid to tell anybody about the abuse. They may struggle with feelings of guilt, shame or confusion – particularly if the abuser is a parent, caregiver or other close family member or friend. Many of the signs that a person is being abused are the same regardless of the type of abuse. Anyone working with children or vulnerable adults needs to be vigilant to the signs listed below:
- regular flinching in response to sudden but harmless actions eg someone raising a hand quickly
- showing an inexplicable fear of particular places or making excuses to avoid particular people
- knowledge of ‘adult issues’ for example alcohol, drugs and/or sexual behaviour which is inappropriate for their age or stage of development
- angry outbursts or behaving aggressively towards children, adults, animals or toys
- becoming withdrawn or appearing anxious, clingy or depressed
- self-harming or thoughts about suicide
- changes in eating habits or developing eating disorders
- regularly experiencing nightmares or sleep problems
- regularly wetting the bed or soiling their clothes
- in older children, risky behaviour such as substance misuse or criminal activity
- running away or regularly going missing from home or care
- not receiving adequate medical attention after injuries.
These signs do not necessarily mean that person is being abused. There may well be other reasons for changes behaviour such as a bereavement or relationship problems between parents/carers. In assessing whether signs are related to abuse or not, they need to be considered in the context of their development and situation.
2.2.1 Signs of physical abuse
All children have trips, falls and accidents which may cause cuts, bumps and bruises. These injuries tend to affect bony areas of their body such as elbows, knees and shins and are not usually a cause for concern.
Injuries that are more likely to indicate physical abuse include:
- bruises on babies who are not yet crawling or walking
- bruises on the cheeks, ears, palms, arms and feet
- bruises on the back, buttocks, tummy, hips and backs of legs
- multiple bruises in clusters, usually on the upper arms or outer thighs
- bruising which looks like it has been caused by fingers, a hand or an object, like a belt or shoe
- large oval-shaped bite marks.
Burns or scalds
- any burns which have a clear shape of an object, for example cigarette burns
- burns to the backs of hands, feet, legs, genitals or buttocks.
Other signs of physical abuse include multiple injuries (such as bruising, fractures) inflicted at different times.
If a person is frequently injured, and if the bruises or injuries are unexplained or the explanation doesn’t match the injury, this should be investigated. It’s also concerning if there is a delay in seeking medical help for a person who has been injured.
2.2.2 Signs of neglect
Neglect can be difficult to identify. Isolated signs may not mean that a child or vulnerable adult is suffering neglect, but multiple and persistent signs over time could indicate a serious problem.
Some of these signs include:
- children who appear hungry – they may come to school without lunch money or even try to steal food
- children or vulnerable adults who appear dirty or smelly and whose clothes are unwashed or inadequate for the weather conditions
- children who are left alone or unsupervised
- children or vulnerable adults who fail to thrive or who have untreated injuries, health or dental problems
- children or vulnerable adults with poor language, communication or social skills for their stage of development
- children or vulnerable adults who live in an unsuitable home environment, for example the house is very dirty and unsafe, perhaps with evidence of substance misuse or violence
- children or vulnerable adults who have taken on the role of carer for other family members.
2.2.3 Signs of sexual abuse
There may be physical signs that a child or vulnerable adult has suffered sexual abuse. These include:
- anal or vaginal soreness or itching
- bruising or bleeding near the genital area
- discomfort when walking or sitting down
- an unusual discharge
- sexually transmitted infections (STI)
Changes in their mood or behaviour may also cause concern. They may want to avoid spending time with specific people. In particular, they may show sexual behaviour that is inappropriate for their age. For example:
- they could use sexual language or know things about sex that you wouldn’t expect them to
- a child might become sexually active at a young age
- they might be promiscuous.
2.2.4 Signs of child sexual exploitation (CSE)
Sexual exploitation can be very difficult to identify. Warning signs can easily be mistaken for ‘normal’ teenage behaviour. Young people who are being sexually exploited may:
- go missing from home, care or education
- be involved in abusive relationships, appearing intimidated and fearful of certain people or situations
- hang out with groups of older people, or anti-social groups, or with other vulnerable peers
- get involved in gangs, gang fights, gang membership
- have older boyfriends or girlfriends
- spend time at places of concern, such as hotels or known brothels
- not know where they are, because they have been moved around the country
- be involved in petty crime such as shoplifting
- have access to drugs and alcohol
- have new things such as clothes and mobile phones which they can’t or won’t explain
- have unexplained physical injuries.
2.2.5 Signs of harmful sexual behaviour
It’s normal for children to show signs of sexual behaviour at each stage in their development. Children also develop at different rates and some may be slightly more or less advanced than other children in their age group. Behaviours which might be concerning depend on the child’s age and the situation. If you’re unsure whether a child’s sexual behaviour is healthy, Brook provides a helpful, easy-to-use traffic light tool. The traffic light system is used to describe healthy (green), potentially unhealthy (amber) and unhealthy (red) sexual behaviours.
2.2.6 Signs of emotional abuse
There aren’t usually any obvious physical signs of emotional abuse but you may spot signs in a child’s actions or emotions. It’s important to remember that some people are naturally quiet and self-contained whilst others are more open and affectionate. Mood swings and challenging behaviour are also a normal part of growing up for teenagers and children going through puberty. Be alert to behaviours which appear to be out of character for the individual child or are particularly unusual for their stage of development.
Babies and pre-school children who are being emotionally abused may:
- be overly-affectionate towards strangers or people they haven’t known for very long not appear to have a close relationship with their parent, eg when being taken to or collected from nursery
- lack confidence or become wary or anxious
- be aggressive or nasty towards other children and animals.
Older children and vulnerable adults may:
- use language, act in a way or know about things that you wouldn’t expect for their age
- struggle to control strong emotions or have extreme outbursts
- seem isolated from their parents
- lack social skills or have few, if any, friends
- fear making mistakes
- fear their parent being approached regarding their behaviour
2.2.7 Signs of domestic abuse
It can be difficult to tell if domestic abuse is happening, because it usually takes place in the family home and abusers can act very differently when other people are around. Children or vulnerable adults who witness domestic abuse may:
- become aggressive
- display anti-social behaviour
- suffer from depression or anxiety
- not do as well at school – due to difficulties at home or disruption of moving to and from refuges.
2.2.8 Signs of bullying and cyberbullying
It can be hard to know whether or not someone is being bullied. They might not tell anyone because they’re scared the bullying will get worse. They might also think that the bullying is their fault. No single sign indicates for certain that a child or vulnerable adult is being bullied, but you should look out for:
- belongings getting ‘lost’ or damaged
- physical injuries such as unexplained bruises
- being afraid to go to school, being mysteriously ‘ill’ each morning, or skipping school
- not doing as well at school
- asking for – or stealing – money (to give to a bully)
- being nervous, losing confidence or becoming distressed and withdrawn
- problems with eating or sleeping
- bullying others.
2.2.9 Signs of child trafficking
Signs that a child has been trafficked may not be obvious but you might notice unusual behaviour or events. These include a child who:
- spends a lot of time doing household chores
- rarely leaves their house, has no freedom of movement and no time for playing
- is orphaned or living apart from their family, often in unregulated private foster care
- lives in substandard accommodation
- isn’t sure which country, city or town they’re in
- is unable or reluctant to give details of accommodation or personal details
- might not be registered with a school or a GP practice
- has no documents or has falsified documents
- has no access to their parents or guardians
- is seen in inappropriate places such as brothels or factories
- possesses unaccounted for money or goods
- is permanently deprived of a large part of their earnings, required to earn a minimum amount of money every day or pay off an exorbitant debt
- has injuries from workplace accidents
- gives a prepared story which is very similar to stories given by other children.
There are also signs that an adult is involved in child trafficking, such as:
- making multiple visa applications for different children
- acting as a guarantor for multiple visa applications for children
- travelling with different children who they’re not related to or responsible for
- insisting on remaining with and speaking for the child
- living with unrelated or newly arrived children
- abandoning a child or claiming not to know a child they were previously with.
2.2.10 Signs of FGM
A girl at immediate risk of FGM may not know what’s going to happen. But she might talk about or you may become aware of:
- a long holiday abroad or going ‘home’ to visit family
- relative or cutter visiting from abroad
- a special occasion or ceremony to ‘become a woman’ or get ready for marriage
- a female relative being cut – a sister, cousin or an older female relative such as a mother or aunt
- missing school repeatedly or running away from home.
A girl who has had FGM may:
- have difficulty walking, standing or sitting
- spend longer in the bathroom or toilet
- appear withdrawn, anxious or depressed
- have unusual behaviour after an absence from school or college
- be particularly reluctant to undergo normal medical examinations
- ask for help, but may not be explicit about the problem due to embarrassment or fear.
Reporting requirements It is a mandatory duty for a regulated healthcare professional to report any concerns they have about a female under 18 years and record when FGM is disclosed or identified as part of NHS healthcare. As FGM is illegal this should be reported to the Police via the 101 non-emergency number.
- GMD CIC’s safeguarding responsibilities
3.1 We acknowledge our duty to:
- help directors, staff and volunteers recognise their responsibilities (through guidance, support and training)
- be respectful, aware and diligent in all our interactions and relationships
- promote personal safety and minimise risk to staff, volunteers, clients and their families and our colleagues from other agencies
- act quickly, with respect and consideration for all involved, where there a serious causes for concern.
3.2 GMD CIC’s safeguarding officer Gemma Aitchison is designated to hold safeguarding responsibilities which include:
- a leadership and coordination role
- policy review and implementation
- the decision to contact relevant agencies.
3.3 GMD CIC believes that everyone has rights as individuals and should be treated with dignity and respect. GMD CIC will strive to provide a safe environment for anyone participating in events and training or when receiving support.
3.4 GMD CIC will carry out risk assessments, and make reasonable, proportionate adaptations to their activities, if required.
3.5 GMD CIC reserves the right to refuse to admit vulnerable adults to GMD CIC programmes if it judges that the adaptation necessary to safeguard that individual’s wellbeing goes beyond what is reasonable and proportionate.
3.6 All members of staff working closely with vulnerable adults have to be alert to possibilities of abuse and any concerns about the behaviour of any adult should be reported in accordance with procedures.
3.7 Volunteers and staff working directly with clients are required to abide by the GMD CIC Code of Conduct.
3.8 GMD CIC reserves the right to deny employment to individuals where permitted criminal records checks suggest they might pose a danger. GMD CIC also reserves the right to suspend and/or dismiss staff members, in accordance with its employment procedures, from employment or from undertaking a specific role. This may apply if information was withheld about their criminal record at the point of employment, or one is acquired during employment.
3.0 Any staff member who considers that they themselves may be a vulnerable adult, are encouraged to seek support.
- Procedures to be followed when abuse is suspected
4.1 All members of staff working closely with children and/or vulnerable adults have to be alert to possibilities of abuse. Any concerns should be logged appropriately and reported to the safeguarding officer who will decide what further action to take.
4.2 It is the duty of staff to inform only, not to investigate – this is the role of the police and social services.
4.3 If staff, in the course of their work, have a safeguarding issue brought to their notice, this must be treated as a priority over all work.
4.4 In situations where inappropriate behaviour has been reported, ‘whistleblowers’ will be respected and supported while investigations are carried out.
4.5 Guidance with regard to a specific incident may be obtained from the lead safeguarding officer.
- Key Contacts
Gemma Aitchison, Lead Safeguarding Officer
Reviewed 14 December 2022