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Respond to specific matters

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This page was updated on 09 May 2022. To view changes, please see page updates

This section provides guidance on how to investigate and assess a range of specific matters that are not covered elsewhere in this procedure.

Unborn child

The purpose of an investigation and assessment before the birth of a child is to assess concerns about the risk of significant harm that the unborn child may experience after he or she is born. If risk is identified, the pregnant woman will be offered help and support to increase the newborn baby’s safety. The role of Child Safety is to:

  • assess the likelihood that the unborn child will need protection after birth
  • decide what help and support can be offered to the pregnant woman and, if relevant, her partner or the father of the unborn child.

Any action taken by Child Safety to investigate and assess the safety of an unborn child after birth must not interfere with the rights and liberties of the pregnant woman.

Before commencing the investigation and assessment

Before commencing an investigation and assessment for an unborn child:

Delay having contact with the pregnant woman

Before having contact with the pregnant woman, the senior team leader will decide if it is necessary to delay contact with the pregnant woman until after the child is born.

The decision to delay having contact with the pregnant woman until after the child’s birth will only occur if there is a high probability that, if alerted to the concerns, the pregnant woman would relocate to avoid Child Safety intervention at the time of the birth, thus placing the newborn baby at increased risk of significant harm.

Note

The assessment about the likelihood of the woman relocating and the level of risk of harm to the newborn if this occurred, may be informed by information:

  • outlined in the notification
    or
  • gathered from an external agency when the investigation and assessment was commenced.

When the decision is made to delay contact with the pregnant woman:

  • The senior team leader will record the rationale and date of the decision to delay contact with the pregnant woman in the investigation and assessment event in ICMS.
  • Record an unborn child alert on the person records of the pregnant woman and the unborn child in ICMS.
  • Complete an unborn  child high risk alert. Refer to Complete an unborn child high risk alert.
  • Keep the investigation and assessment event open in ICMS until the child is born and the investigation and assessment is completed.
  • Seek information during the pregnancy from external agencies to inform the investigation and assessment.

If, following a decision to delay having contact with the pregnant woman, a subsequent decision is made to have contact with the pregnant woman due to new information being received about the family, the senior team leader will record in the Assessment and Outcome form in ICMS:

  • the rationale for the decision
  • the date before the child's birth that the decision was made to proceed with the investigation and assessment.

If Child Safety is contacted about additional concerns for an unborn child, refer to Respond to additional notified concerns.

Commence the investigation and assessment

An investigation and assessment for an unborn child is considered to have commenced when:

Note

Obtaining new information to commence the investigation and assessment does not require the consent of the pregnant woman. This information may be obtained under the authority of the Child Protection Act 1999, section 159MB(1)(c).

For further information, refer to the Information sharing guidelines.

Do not proceed with the investigation and assessment if, at the outset, the woman states that she:

  • was never pregnant or is no longer pregnant, due to a miscarriage or termination
    and
  • it appears from her physical presentation that she is not pregnant.

Practice prompt

Contact the woman’s health practitioner to verify that the woman is not pregnant. This information may be requested with or without the woman’s consent under the authority of the Child Protection Act 1999, section 159MB(1)(c)

For further information, refer to Information sharing guidelines.

Investigate and assess the concerns

Investigate and assess the likelihood that the  unborn child will be in need of protection after the child’s birth, including:

  • the level and type of risk to the child after the birth
  • the services that may assist the pregnant woman and, where relevant, her partner or the father of the unborn child, prior to the birth, to reduce the likelihood the child will be in need of protection.

Practice prompt

During the investigation and assessment, provide the pregnant woman with information about safe infant care to reduce the risk of sudden  unexpected death in infancy (SUDI). Understanding safe sleeping practices is particularly important when there is problematic alcohol and other drug use. (Refer to the Queensland Government website and the Red Nose Australia website for information and resources.)

Investigate and assess concerns about an Aboriginal or Torres Strait Islander unborn child

For an investigation and assessment in relation to an Aboriginal or Torres Strait Islander unborn child, advise the pregnant woman of her right to have an independent person help her participate in the investigation and assessment, including the decision about whether the unborn child will be in need of protection after he or she is born. 

If the pregnant woman agrees, arrange for an independent person to assist her to participate in the decision making. In addition, determine whether the pregnant woman agrees to:

  • the family’s participation in the investigation and assessment
    and
  • the involvement of an independent person to assist the family to participate.

Record whether an independent person helped facilitate the participation of the pregnant woman and the unborn child’s family in the investigation and assessment in the Independent person form in ICMS.

If the Family Participation Program has not accompanied Child Safety on the initial home visit during an investigation and assessment about an Aboriginal or Torres Strait Islander unborn child:

Refer to Engage the Family Participation Program.

Practice prompt

The Child Protection Act 1999, section 5C(2)(d) recognises the right of Aboriginal and Torres Strait Islander peoples to participate in significant decisions about their children (the participation principle). Make purposeful, timely and thorough efforts to ensure the pregnant woman and, where the pregnant woman agrees, the family of an Aboriginal or Torres Strait Islander unborn child have an opportunity to participate in significant decisions.

Structured Decision Making tools

Do not complete a safety assessment and family risk evaluation for the investigation and assessment of an unborn child unless the child is born before the approval of the investigation and assessment.

Use the following to inform the assessment:

  • the risk and protective factors relating to children, and in particular, those for high-risk infants. (Refer to the practice guide Infants at high-risk.) 
  • relevant information about cultural factors for Aboriginal and Torres Strait Islander children, gathered during the investigation and assessment.

Further reading

Investigate concerns about an unborn child and their siblings

If an unborn child and their siblings are listed as subject children in a notification, investigate and assess the concerns specific to the unborn child, in addition to those relating to the siblings.

If it becomes apparent, during an investigation and assessment for a child, that the mother is pregnant, decide whether the unborn child will be recorded as a 'subject child' or an 'other child' in ICMS. If it is decided that the unborn child is a subject child:

  • Investigate and assess the child protection concerns in relation to:
    • the unborn child after the child's birth
      and
    • the siblings.
  • Edit the approved notification to record the category as 'unborn’.

Take action when a pregnant woman cannot be interviewed

Where attempts to interview a pregnant woman have not been successful, other than when a pregnant woman cannot be located:

Practice prompt

It may assist a pregnant woman to read and understand a letter from Child Safety, if a professional working with the pregnant woman can offer to discuss it with her.

If a pregnant woman cannot be interviewed because:

  • she has exercised her right not to be interviewed after reasonable attempts have been made to engage her
    and
  • the differential pathway cannot be used
    or
  • the differential pathway was used, but the information provided by the other professional suggests increased risk to the unborn child after the child’s birth

take the following action:

  • Record an unborn child alert on the person records of the pregnant woman and the unborn child.
  • Complete an unborn child high risk alert. Refer to Complete an unborn child high risk alert.
  • Keep the investigation and assessment event open in ICMS until the child is born and the investigation and assessment is completed.
  • Seek information from external agencies during the pregnancy to inform the investigation and assessment.

Take action when a pregnant woman cannot be located

If the pregnant woman cannot be located after reasonable attempts have been made to locate her:

  • Seek information during the pregnancy from external agencies to inform the investigation and assessment, if possible.
  • Record an unborn child alert on the person records of the pregnant woman and the unborn child in ICMS.
  • Complete an unborn child high risk alert. Refer to Complete an unborn child high risk alert.
  • Keep the investigation and assessment event in ICMS open until either:
    • the child is born and the investigation and assessment is completed
    • 2 months have elapsed since the estimated date of delivery of the child and the woman has still not been located. In this circumstance:
      • complete a Record of actions—mobile family form in the investigation and assessment event in ICMS
      • record a no investigation and assessment outcome.

Complete an unborn child high risk alert

Complete an unborn child high risk alert when:

  • a decision has been made by a senior team leader to delay contact with a pregnant woman
  • a pregnant woman cannot be located after reasonable attempts have been made to locate her
  • the pregnant woman could not be interviewed by Child Safety or another professional using the differential pathway.

To complete an unborn child high risk alert:

  • Complete and forward:
  • In exceptional circumstances only, where the pregnant woman is highly mobile and it is not possible to identify the hospitals where she is likely to give birth:
    • complete an email with the title Statewide HRA (to ensure the email is activated), attach the  HRA Form 1 and send the email to Statewide_HRA@csyw.qld.gov.au (this will ensure that the email will be sent to public hospital child protection staff throughout Queensland, and to the Mater Hospital
      and
    • send a letter to the private or interstate hospital/s where the pregnant woman may be likely to give birth (see note below).
  • Telephone the hospitals to confirm receipt of the HRA Form 1 or letter and attach the form and letter to the investigation and assessment event in ICMS.
  • Provide the CSAHSC with a Child Safety After Hours Service Centre: After hours referral form and all relevant information, including the HRA Form 1 and letter.
  • Refer the matter to a SCAN team, if a coordinated multi-agency response is required. (Refer to the Consider a Suspected Child Abuse and Neglect team referral).
  • Record details of all actions taken in a case note in the investigation and assessment event.
  • Record a Member of a mobile family alert on all relevant person records, where there is information to suggest the pregnant woman is highly mobile.
  • Contact the pregnant woman's medical practitioner (if known) to:
    • discuss the concerns identified
    • request that information be shared with relevant health professionals, such as the midwife or hospital social work services
    • ask that Child Safety be advised when the child is born.

Note

The Queensland hospital email addresses are monitored during business hours only. In the rare situation where all public hospitals need to be urgently alerted to the HRA Form 1 outside business hours:

  • be aware that hospitals will not receive the emailed information until the next business day
  • consider whether to telephone each hospital (including the Mater Mothers’ Hospital and any private or interstate hospital) at which the pregnant woman may be likely to present. (For Queensland hospitals refer to the Queensland Health Unborn child high risk alert contact list).

Tip

If the pregnant woman presents for delivery at a hospital that has received the HRA Form 1, the hospital will send Child Safety the HRA Form 2 – unborn child high risk alert: notification that pregnant woman has presented for delivery.

Further reading

Practice guide Respond to an unborn child.

Record the investigation and assessment outcome

For an unborn child, one of the following outcomes may be recorded:

  • substantiated—child in need of protection, for an unborn child who is at risk of significant harm after birth and neither parent will be able and willing to protect the child from the harm
  • unsubstantiated—child not in need of protection, for an unborn child who will not be at risk of significant harm after birth
  • substantiated—ongoing intervention continues, for an unborn child who is already subject to ongoing intervention and will be at unacceptable risk of significant harm after birth
  • unsubstantiated—ongoing intervention continues, for an unborn child who is already subject to ongoing intervention and will not be at unacceptable risk of significant harm after birth
  • no investigation and assessment outcome, where a pregnant woman
    • advises she is no longer, or has never been pregnant and it has been confirmed with her medical practitioner (or reasonable attempts have been made to do so)
    • has not been located and two months have passed since the estimated date of delivery.

Practice prompt

Before the child’s birth, ensure the maternal health service has all relevant information about the unborn child’s safety and wellbeing needs at birth, including whether there are any assessed risks to the child’s safety, whether the pregnant woman is likely to have support needs while on the ward and the level of intervention or involvement (current or planned) by Child Safety.

Refer to the practice guide Respond to an unborn child.

Take action after the child's birth

Take action following the birth of the child, depending on the case circumstances:

  • Complete a safety assessment to determine whether the child is at immediate risk of harm. Refer to Carry out a safety assessment.
  • Proceed with other outstanding actions to complete the investigation and assessment where it was not finalised during pregnancy.
  • If an investigation and assessment completed prior to the birth had an outcome of substantiated—child in need of protection and a support service case is not currently open, either:
    • consult the senior team leader and the OCFOS lawyer and commence the most appropriate type of ongoing intervention
    • record a notification if it is decided that an up-to-date risk assessment is needed.
  • If there is an open support service case, review the support plan and decide how ongoing intervention will continue (if this did not occur before birth), either as intervention with parental agreement or as an application for a child protection order.

Note

If time allows, engage the Family Participation Program before contacting the parents of an Aboriginal or Torres Strait Islander newborn baby if:

  • a notification before the child’s birth was delayed until after the birth and is now to proceed
  • before the birth, the Family Participation Program was supporting the pregnant woman in her contact with Child Safety.

Refer to Engage the Family Participation Program.

Complete an HRA form 3 to cease an alert

Complete and forward an HRA Form 3: Cessation of unborn child high risk alert (HRA Form 3) to all relevant hospitals when either:

  • an HRA Form 1 has previously been sent to multiple hospitals and, following the baby's birth, the remaining hospitals need to be notified that an alert is no longer required
    or
  • Child Safety has been informed that the pregnant woman has had a miscarriage or termination and the relevant hospitals need to be notified that an alert is no longer required.

In circumstances where a statewide alert to Queensland Health’s maternity hospitals was required before the baby’s birth and the HRA Form 1 was sent to all public hospitals and the Mater Hospital, complete an HRA Form 3 and forward it to Statewide_HRA@csyw.qld.gov.au when the alert is no longer required.

Also notify any private or interstate hospitals informed of the alert when the alert is no longer required.

Transfer the investigation and assessment

The transfer of an investigation and assessment is to occur in a way that prioritises the safety of the child and provides continuous and planned service delivery to the child and family.

Transfer an investigation and assessment to the relevant CSSC if:

  • child protection concerns have been received and recorded by a RIS, CSAHSC or a CSSC in a different geographical area to where the child and their family reside
  • a child and their family relocate during the investigation and assessment, regardless of the reason.

If a child lives across two households, transfer the investigation and assessment to the CSSC in the geographical area of the household where the significant harm or risk of significant harm is alleged to have occurred. If concerns exist across both households:

  • two investigation and assessments will be completed
  • transfer the investigation and assessment event to the CSSC in the geographical area of each household.

Practice prompt

If the harm households are in different geographical areas, the CSSCs will collaborate to complete the investigation and assessments and minimise the impact on the family.

If a notification has been received and recorded, transfer the open investigation and assessment to the pending allocation tray of the relevant CSSC within the following timeframes:

  • immediately—for a notification with a 24-hour response timeframe and telephone the CSSC senior team leader to inform them
  • within 3 days—for an investigation and assessment with a 5-day response
  • within 5 days—for an investigation and assessment with a 10-day response.

Further reading

Refer to Procedure 1 Complete the response priority.

When the investigation and assessment is received by the receiving CSSC, it will be:

  • allocated to a CSO by the senior team leader
  • commenced within the required timeframe
  • completed within the specified timeframe.

If a family moves to another geographical area during an investigation and assessment without advising Child Safety, the transferring CSSC retains case responsibility until the transfer process is completed and will:

  • try to locate the family
  • decide if the investigation and assessment can be completed with the assistance of another CSSC.

If most of the investigation and assessment tasks are still to be completed, transfer the investigation and assessment, and:

  • immediately contact the senior team leader of the receiving CSSC to advise of:
    • the pending transfer
    • the outstanding tasks needed to complete the investigation and assessment
  • make sure all information gathered as part of the investigation and assessment is recorded in ICMS as soon as possible
  • reassign the investigation and assessment event to the receiving CSSC, including outstanding event tasks, so that any partially completed forms are also transferred
  • promptly transfer any paper files to the receiving CSSC.

The receiving CSSC must:

  • accept responsibility for completing the investigation and assessment during the first point of contact by the transferring CSSC
  • allocate the investigation and assessment immediately
  • ensure the investigation and assessment is commenced within the response priority timeframe―or if the investigation and assessment has already commenced, ensure the subject children are sighted within one week
  • complete a new safety assessment during the first contact with the family
  • complete the investigation and assessment.

CSSC managers are responsible for resolving disagreements that arise during the investigation and assessment transfer.

If the investigation and assessment is for a child or family who has moved to another jurisdiction, refer to Procedure 1 Information about a child in another jurisdiction.

Record an alert

An alert is recorded when significant information relevant to an alert type is identified during the investigation and assessment for a child, their family or carer family. The following alerts are available in ICMS:

  • Carer application refused
  • Carer certificate of authority cancelled/suspended
  • CCYPCG—Blue card declined. (This alert refers to a decision to refuse a person’s Blue Card application. The decision was previously the responsibility of the CCYPCG and is now the responsibility of Blue Card Services.  The name of the alert in ICMS has not yet been updated.)
  • Child death—result of harm
  • Child protection warrant
  • Child seriously injured—result of harm
  • Conflict based placement concern
  • Deceased—other (for example, as a result of accidental death, disability or illness)
  • Experienced detriment by department—Policy 634
  • Harm report
  • History of parents taking children without authority
  • Member of a family—child death—result of harm (for example, a member of a family where a child has died as a result of abuse or neglect)
  • Member of a family—child seriously injured—result of harm
  • Member of a mobile family
  • Missing child
  • Risk to staff
  • Self harm risk
  • Serious health condition
  • Significant DFV threat
  • Suicide risk
  • Unaccompanied humanitarian minor
  • Unborn child.

Practice prompt

If it is identified during the investigation and assessment that a subject child is at risk of self-harm or suicide, record the relevant alert. Refer to Procedure 5 Record a suicide risk alert or Procedure 5 Record a self-harm alert in ICMS.

Record an alert for significant domestic and family violence

Consider recording a ‘Significant DFV threat’ alert when one or more of the following domestic and family violence risk factors are identified within the family:

  • a victim believes their life is in danger
  • a perpetrator has caused serious injuries that require hospitalisation or assessment and treatment at a hospital emergency department
  • strangulation, stabbing or choking has been perpetrated
  • there has been an escalation of physical violence
  • the perpetrator has a history of incarceration for breach of a domestic violence order, physical assault, grievous bodily harm, torture or deprivation of liberty
  • the perpetrator has a history of breaches of domestic violence orders—failure to comply with a domestic violence order
  • there are previous or current threats by the perpetrator to kill the victim, a child, other family member or pets
  • the perpetrator has access to or possession of a firearm
  • the perpetrator has a history of stalking or obsessive behaviour
  • the perpetrator’s behaviour includes a pattern of coercion and control, for example, extreme isolation of the victim or the perpetrator accompanying the victim at all times when in public.

Attention

Also consider recording a ‘Significant DFV threat’ alert if a referral about the family has been made to a High Risk Team.

To record a Significant DFV threat alert:

  • Create an alert in the ICMS client profiles of the:
    • perpetrator
    • victim
      and
    • child.
  • Record the name and client profile number of the victim and child in the rationale field of the perpetrator’s alert.
  • Record the name and client profile number of the perpetrator in the rationale field of the victim’s and child’s alerts.
  • In each alert, also record either:
    • where to locate the assessment of the perpetrator’s pattern of behaviour, for example, the event number
      or
    • if there is no assessment, a brief summary of the coercive and controlling behaviours and the specific worries for the safety of the victim and child.

Record a separate alert each time the person has perpetrated domestic and family violence and been assessed as posing a significant threat to more than one victim. This will enable the perpetrator’s behaviour to be tracked over time and across multiple families.

Take action if a child and family cannot be located

Practice prompt

Take all reasonable steps to locate a family subject to a notification within the response priority timeframe.

If a family cannot be located, consider undertaking the following in an attempt to find information to locate them:

  • re-contact the notifier
  • check SCAN team records
  • contact any service providers known to be providing a service to the child or family 
  • search telephone directories
  • contact the QPS for information and assistance
  • search the electoral roll. (Refer to Australian Electoral Commission Roll)
  • request assistance from schools or the Department of Education  
  • request assistance from Centrelink
  • request assistance from Medicare Australia
  • request assistance from the Child Support Agency.

Note

The Information Sharing Protocol between the Commonwealth and Child Protection Agencies allows Australian Government agencies including Centrelink, Medicare Australia and the Child Support Agency to release a family's last known whereabouts to an authorised officer, in specific circumstances.

Requests must be made via Data Management Services only after all other attempts to locate a family have been exhausted. In most instances, Centrelink will have the most accurate up-to-date details, so contact Centrelink before Medicare Australia and the Child Support Agency.

Each agency has a separate disclosure requirement and request form.

Centrelink may disclose relevant information if it is necessary to prevent or lessen a threat to the life, health or welfare of a person. To request a family’s whereabouts from Centrelink:

Medicare Australia may disclose relevant information where it is necessary to prevent or lessen a serious or imminent threat to the life or health of an individual. To request information from Medicare Australia:

Before releasing information, the Child Support Agency needs to form a reasonable belief that:

  • the information is necessary to prevent or reduce the threat to the life, health or welfare of a person
    or
  • a reasonable belief that the threat may provide evidence that an offence has or may be committed against a person and the information will be used to prevent, investigate or prosecute the offence.

To request information from the Child Support Agency:

For assistance with making a request, contact Data Management Services. For specific information on what each agency can disclose, refer to the Information Sharing Protocol between the Commonwealth and Child Protection Agencies.

Record the outcome if the family cannot be located

If it has not been possible to commence an investigation and assessment and the senior team leader is satisfied that all reasonable attempts have been made to locate the family—taking into account the seriousness of the concerns, the potential risk of harm and the age and vulnerability of the child:

  • Record a member of a mobile family alert in ICMS on the person record of each relevant person, as soon as it is decided that the family are mobile, or will be difficult to locate.
  • Document all action taken to locate the child and family, in the Record of actions—mobile family form in the investigation and assessment event in ICMS, including:
    • attempts made to locate the family and carry out the investigation and assessment
    • the results of all action taken
    • relevant information received about the family from other parties
    • decisions made, and the rationale for decisions.
  • Finalise the investigation and assessment within 2 months and record a no investigation and assessment outcome for each subject child.

If a subsequent notification is recorded and the family has been located:

  • Do not reopen the original investigation and assessment event.
  • Assess the previous concerns along with the current concerns, as part of the investigation and assessment.
  • Record the previous concerns and the relevant outcomes in the current investigation and assessment event.

Take action if the parents do not allow contact with a child

If, during an investigation and assessment, a parent refuses entry to the home, or contact with the child:

  • Make every attempt to gain the parents’ consent to carry out the investigation and assessment.
  • Explain the legal obligation of Child Safety to investigate and assess the concerns under the Child Protection Act 1999, section 14.
  • Emphasise the responsibility of Child Safety to sight the child and speak to the child and the parents—to assess the concerns.
  • Explain that the investigation and assessment process provides an opportunity for the parents to respond to the concerns.
  • Acknowledge the parents’ reluctance and suggest options such as the use of a support person—refer to the practice guide The role of a support person.
    or
  • Before leaving the premises, arrange an appointment at another time—if no immediate danger is identified for the child, from:
    •  information in the notification
    •  observations made during contact with the parents.

If the parents continue to refuse contact, consult the senior team leader and the OCFOS lawyer about taking action under the Child Protection Act 1999  to enable the investigation and assessment to proceed, either:

Request assistance from another jurisdiction

Investigation and assessment - address known

Note

Assistance from another jurisdiction to complete an investigation and assessment is considered to be case work assistance under the Interstate Child Protection Protocol 2016.

Request assistance from another state, territory or New Zealand to complete the investigation and assessment, if the:

  • notification is for a child who currently resides in Queensland
  • parent who is the alleged person responsible for harm to a child resides at a known address in another jurisdiction.

To request assistance in completing the investigation and assessment:

  • contact the Interstate Liaison (IL) team to obtain the appropriate form to make the request of the other jurisdiction
  • Attach the notification and any other relevant information gathered.
  • Provide information about attempts already made to contact the parent or why this has not occurred.
  • Specify the tasks requested of the other jurisdiction.
  • Scan and email all relevant documentation to the IL team at ILO@csyw.qld.gov.au.

The IL team will:

  • forward the documentation to the IL team in the jurisdiction where the parent lives and request that the jurisdiction assists with interviewing the identified parties  
  • follow up with the IL team in the other jurisdiction, to find out whether they have decided to conduct the interviews, as requested.

If the other jurisdiction agrees to assist, the IL team will obtain from them a record of the interviews conducted. If the other jurisdiction does not agree to assist, the IL team will consult with the CSSC manager about whether to respond in line with the dispute resolution process.

If a family relocates to another jurisdiction before or during the investigation and assessment:

Investigation and assessment - address unknown

If the whereabouts of the family in another jurisdiction is unknown, forward a request for an interstate alert to the IL team (Refer to Procedure 1 Information about a child in another jurisdiction.) If information is subsequently received about the family or the family’s whereabouts, notify the IL team immediately.

Respond to a request for assistance from another jurisdiction

If another state, territory or New Zealand requests case work assistance from Queensland to complete an investigation and assessment being conducted by that jurisdiction, the IL team will:

  • ensure the relevant documentation is received, including the current Queensland address, history checks and notification information from the other jurisdiction
  • ensure that the other jurisdiction has specified the tasks to be completed
  • forward all relevant documentation to the relevant CSSC for action.

The receiving CSSC will:

  • allocate the matter
  • seek clarification, as necessary, with the requesting office in the other jurisdiction
  • complete the tasks as requested
  • send a written report to the IL team for forwarding to the other jurisdiction.

Concerns about a child’s discharge from a hospital

Respond to a doctor’s concerns about a child’s immediate safety upon discharge from a hospital

If a child is subject to an open investigation and assessment and a Queensland Health doctor contacts the CSSC with concerns about the immediate safety of a child upon discharge:

  • seek as much information as possible about the reasons for the doctor’s concern
  • collaborate with the doctor to decide what action is required to ensure the safe discharge of the child
  • carry out a safety assessment for the child, or review the current safety assessment, if applicable.

Practice prompt

If the doctor provides new concerns that were previously unknown, record them as additional notified concerns. Refer to Respond to additional notified concerns.

If, after consultation with RIS or CSSC staff, the doctor remains concerned about Child Safety’s response and the immediate safety of a child upon discharge, they may initiate the discharge escalation pathway for a child at risk.

Advise the CSSC manager immediately if the doctor indicates the discharge escalation pathway is likely to be initiated.

The discharge escalation pathway consists of two steps:

  • an emergency case conference to enable a coordinated response to the immediate safety needs of the child upon discharge, and
  • a formal escalation when the emergency case conference is unable to resolve the concerns.

For more information refer to the practice guide Queensland Health discharge escalation pathway.

Tip

Prior to initiating the discharge escalation pathway, the doctor must follow all existing Queensland Health legislative and procedural requirements and guidelines for assessing and responding to a child’s protection needs.

Respond when the discharge escalation pathway is initiated

To initiate the discharge escalation pathway, the doctor will contact the senior team leader and advise that there will be an emergency case conference to coordinate a response to the immediate safety needs of the child upon discharge. 

The senior team leader will immediately advise the CSSC manager that the discharge escalation pathway has been initiated.

The emergency case conference may be either:

  • an emergency SCAN team meeting, when the criteria for a SCAN referral is met, or
  • an inter-agency meeting, when the criteria for a referral to the SCAN Team is not met, or an after hours response is required.

The emergency case conference will occur as soon as practicable and within 24 hours, to discuss:

  • the doctor’s concern for the child’s immediate safety
  • the Child Safety assessment and response to the child’s immediate safety needs
  • where the child will be going when they are discharged from hospital and what arrangements may have been made to ensure the child’s immediate safety
  • how long the child will be staying in hospital
  • professional visiting arrangements and
  • whether a further review is required.

Attention

A doctor has 24 hours to convene the emergency case conference (emergency SCAN team meeting or inter-agency meeting). This 24 hour timeframe commences at the time the doctor initiates contact with Child Safety, either by a phone call or by leaving a message for a call back.

If the doctor does not receive a response from Child Safety within 24 hours, they will contact the CSSC manager for appropriate action.

In circumstances when the 24 hours has passed and the CSSC manager has not responded or actioned the request, the medical officer can commence a formal escalation of their concerns. Refer to Respond to a formal escalation.

Request to attend an emergency SCAN team meeting

A Queensland Health SCAN team core member representative may request an emergency SCAN team meeting for the purposes of initiating the discharge escalation pathway.

When this occurs, follow existing SCAN team processes. Refer to the Suspected Child Abuse and Neglect (SCAN) Team System Manual

The CSSC manager is required to attend this meeting, in addition to the nominated Child Safety SCAN team core member representative.

Attention

When a SCAN team meeting is convened for the purpose of initiating the discharge escalation pathway, and the SCAN team is unable to reach consensus on recommendations regarding the multi-agency actions required, the discharge escalation process for a child at risk will override the SCAN team system escalation process. The decision to initiate a formal escalation is made by a Queensland Health doctor.

Request to attend an inter-agency meeting

When the matter does not meet the criteria for a referral to the SCAN team, or an after-hours response is required, the Queensland Health doctor will contact the relevant senior team leader to invite the senior team leader and CSSC manager to attend an inter-agency meeting. 

The senior team leader and CSSC manager must attend this meeting and may invite other Child Safety staff or service providers engaged with the child and family to contribute to the discussion.

When an inter-agency meeting is scheduled outside of business hours, the CSAHSC senior team leader will attend.

Queensland Health will invite stakeholders who are engaged with the child’s care and discharge planning, such as the doctor, child protection liaison officer, child protection advisor and other relevant allied health staff.

The inter-agency meeting will be chaired by a Queensland Health representative and formal minutes will be recorded.

The CSSC manager will advise the regional director immediately if the doctor indicates a formal escalation is likely to be initiated.

Respond to a formal escalation

A formal escalation may occur when a child is medically fit for discharge and either:

  • an emergency case conference has occurred, and the doctor is still concerned about Child Safety’s decision making and the immediate safety of a child upon discharge from a hospital

or

  • the CSSC manager has not responded within the 24 hour timeframe to a request for an emergency case conference.

To initiate a formal escalation, the doctor’s line manager (or a nominated escalation position within the relevant hospital and health service) will contact the Child Safety regional director to:

  • discuss the immediate safety concerns for the child and the Child Safety response and
  • consider further actions and make decisions as required.

If this occurs outside of business hours, Queensland Health will contact the CSAHSC senior team leader to formally escalate the concerns, consider further actions and make decisions as required. If they are unable to contact the senior team leader by phone, they will send an email to CSAHSC (csahscintake@cyjma.qld.gov.au) requesting an urgent call back advising:

  • a formal escalation has been initiated
  • contact details for a return phone call, and
  • a summary of the presenting issues.

The nominated escalation position and the regional director or CSAHSC senior team leader have the authority to consider further actions and make decisions as required.

End the escalation process

If a child is discharged by the Queensland Health treating team or self-discharges at any point during the process, the discharge escalation pathway ceases.

If a child is discharged, the doctor must advise Child Safety of:

  • the date and time the child was discharged
  • the name and address of the person the child has been discharged to, if known
  • the discharge summary, recommended follow up and risks relevant to the child’s safety and wellbeing needs, and
  • any other information relevant to the safety and best interests of the child.

When advised that a child has been discharged from hospital, take action to ensure the child’s immediate safety.

Respond if a person may have been a victim of violence

If information is gathered during the investigation and assessment that indicates a child or family member may have been injured as a result of an act of violence, give them one or more of the following, in line with Child Safety’s responsibility under the Victims of Crime Assistance Act 2009:

After giving the information record the following in a ‘victim of crime’ case note in the investigation and assessment event in ICMS:

  • that the child or family member has been identified as possibly being a victim of an act of violence
  • that information about how to contact Victim Assist Queensland has been provided.

Attention

A parent who has been identified as a person responsible for an act of violence against their child is unable to make an application to Victim Assist Queensland on behalf of the child.

If the perpetrator remains with the family, make sure that the process of sharing the information about Victim Assist Queensland is carried out sensitively and in a way that ensures the safety of the child or family member.

Further reading

Procedure 5 Victims of Crime.

Young person in contact with the youth justice system

When investigating and assessing concerns about a child who is also in contact with the youth justice system, contact the youth justice case worker to:

  • gather information to inform the assessment
  • verify information provided by the child and parents during interviews
  • share relevant information, for the purpose of coordinating service delivery
  • advise that the child has been placed in care, if applicable.

A youth justice case worker may act as a support person for the child during an interview or investigation and assessment process, if requested by the child or their family. If a request is made, contact the relevant Youth Justice Service Centre to advise them of the request and discuss whether it is appropriate for a youth justice officer to participate in the process.

Any involvement by youth justice in the implementation or monitoring of an immediate safety plan for a child is to be negotiated by Child Safety with the youth justice case worker or their line manager.

If a child in contact with the youth justice system is taken into the custody of the chief executive, contact the youth justice case worker and:

  • tell them who has custody and guardianship rights and responsibilities for the child
  • explain the implications for decision making about custody and guardianship matters. (Refer to Procedure 5 Decision making for a child.)
  • explain that an Aboriginal or Torres Strait Islander child has the right to have an independent person to help facilitate their participation in significant decisions made by Child Safety, if relevant.  (Refer to Procedure 5 Decision making for Aboriginal and Torres Strait Islander children.)
  • coordinate service delivery for the period that the young person is in care.

If the matter is referred to the SCAN team, the youth justice case worker may be invited by the SCAN team to participate in the meeting as an invited stakeholder.  Refer to the Suspected Child Abuse and Neglect (SCAN) Team System Manual for how to make a referral to a SCAN team and how to invite a stakeholder.

If youth justice remains involved with the child when the investigation and assessment is completed, contact the youth justice case worker and provide the following information:

  • the outcome of the investigation and assessment
  • whether the child is in the care of the parents
  • the nature of any ongoing intervention by Child Safety.

Fabricated or induced illness

Tip

Fabricated or induced illness, previously known as Munchausen’s Syndrome by Proxy, is a specific pattern of abuse where an individual fabricates or induces illness or injury in a person in their care. In child protection matters, illness or injury may be fabricated or induced in a child by a parent, or someone in a parental role.

If concerns about fabricated or induced illness are identified during the investigation and assessment:

  • immediately give the information to the QPS (Child Protection Act 1999, sections 14(2) and (3))
    and
  • consult the QPS before taking further action to complete the investigation and assessment. 

Adopted child

If it is identified that the child is adopted, at the completion of the investigation and assessment, consider referring the family to either Adoption and Permanent Care Services or Post Adoption Support Queensland (PASQ), if the child or their family may benefit from specialised counselling.  Refer to Post Adoption Support Queensland (PASQ).

Animal welfare issues

Discuss any animal welfare issues identified during the investigation and assessment with the family as part of a holistic assessment.

Attention

The confidentiality provisions of the Child Protection Act 1999 significantly limit the information that can be shared with the Royal Society for the Prevention of Cruelty to Animals (RSPCA).

The Memorandum of Understanding between The State of Queensland, through Department of Communities (Child Safety) and The Royal Society for the Prevention of Cruelty to Animals, Queensland 2012–2014 includes information about when Child Safety will:

  • give families information about the RSPCA
  • contact the RSPCA directly with the family’s consent.

If it becomes apparent that an animal has harmed a child or presents a risk to the safety or wellbeing of a child:

  • Advocate and promote the RSPCA to the parents.
  • Encourage the family to:
    • use the RSPCA as a support service to reduce the risks that the animal poses to the child
    • consent to Child Safety contacting the RSPCA on behalf of the family
    • inform the RSPCA of the animal welfare concerns, but only if the family does not take steps to address animal welfare concerns that pose a safety risk to the child. If requested, the RSPCA will re-contact Child Safety and advise if they took action.

If referring the family to a support service, seek the parents’ consent to include information about the animal welfare issues in the referral.

If animal welfare issues are identified that are not related to child protection concerns:

  • give the family information about the RSPCA and encourage them to seek support
  • do not give information to the RSPCA without the family’s consent.

If a family is not able to provide care and accommodation for their animals:

  • provide the family with information about the RSPCA
  • encourage the family to use the RSPCA as a support service.

Note

The RSPCA is committed to providing temporary emergency care and accommodation for the animals of families who are involved with Child Safety.

Breaches of pool fencing requirements

If obvious or blatant breaches of pool fencing requirements are noticed during the investigation and assessment (for example, unfenced access points or a broken fence or gate):

  • Discuss the safety risks and water safety strategies with the parents.
  • Report the issue to the relevant local authority responsible for assessing pool fencing compliance, providing only:
    • the property address
    • the nature of the issue relating to the pool fence.

Practice prompt

Do not provide the family’s name or other identifying family details.

Family subject to the Witness Protection Program

At times, families subject to a Witness Protection Program through any one of the state or territory police services may reside in Queensland and be the subject of a notification. These families have a heightened need for confidentiality, due to the importance of protecting their identity, whereabouts and personal safety.

Witness protection in Queensland is administered by the Crime and Corruption Commission, but is operationalised by the QPS Witness Protection Unit.

If it becomes known during an investigation and assessment that a family is subject to witness protection:

  • Liaise with the QPS to ensure the best response to these complex and sensitive matters. Contact the Communications Room, QPS on telephone (07) 3360 6325 and ask to speak to either:
    • the Officer in Charge, QPS Witness Protection Unit
    • the Operations Coordinator, QPS Witness Protection Unit.
  • Ensure Child Safety meets the legislative responsibility to investigate the child protection concerns.
  • Consider whether sensitivity needs to be applied to the relevant person profiles or events in ICMS. (Refer to the ICMS Manual sensitivity overview.)

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