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Thematic Learning from Case Reviews – Non-Accidental Injuries (NAI)

Date: Tuesday, 25th Jul 2023 | Category: Children

Dudley Safeguarding People Partnership are undertaking a monthly thematic learning dissemination, which provides an opportunity for staff and partner organisations in Dudley to be made aware of the key learning from our quality assurance activity and case reviews along with offering information in relation to this learning.

During July the focus has been on Non-Accidental Injuries (NAI) as this has been a recurring theme in our children’s reviews.

How do we review multi agency practice and share learning?

DSPP seeks to promote a culture of continuous learning and improvement across the organisations that work together to safeguard and promote the welfare of children and adults, identifying opportunities to draw on what works and promote good practice

Our thematic learning plan is one of the ways we share learning to improve practice.


We would like to share reviews that have links to the theme of NAI:

Helpful Resources

Bruising is the most common presenting feature of physical abuse in children. Recent DSPP Child Safeguarding Practice Reviews (CSPRs) and Serious Case Reviews (SCR’s) identified that children under the age of 1 year are presented in reviews as a result of a severe injury or death as a result of physical abuse. Please view the regional guidance on injuries in babies and children under 2 years of age.

Abusive Head Trauma (AHT) – also known as ‘shaken baby syndrome’ – causes catastrophic brain injuries, which can lead to death, or significant long term health and learning disabilities. AHT is not restricted to specific socio-economic groups – it can occur in any environment, when a parent or carer is on the edge due to infant crying.

The programme – ICON: Babies Cry, You Can Cope! – provides key messages and resources to let parents and carers know that infant crying is normal and there are methods which can be taken in order to cope.  Resources include leaflets, posters and video clips which can be shared with parents and carers at any contact had with midwives, health visitors, GPs, social workers, and other professionals working with families. 

View our ICON webpage for more information.

Download the ICON poster for a helpful resource

Informative videos regarding ICON are available from the ICON YouTube page

Child Protection Medicals

A Child Protection Medical is also known as a CP Medical, a Section 47 Medical or a Paediatric Medical Assessment. The Local Authority may request that a CP Medical is completed where there is suspicion or disclosure of child abuse and/or neglect or a referral has been made. The RCPCH Child Protection Companion recommends that children are seen for an assessment of possible physical abuse within 24 hours, though it may be clinically appropriate to be seen more urgently, depending on the context

Please see the medical examinations document for good practice service delivery standards for the management of children referred for child protection medical assessments

Prevention, early recognition and management of neglect is a priority in Dudley therefore DSPP has developed the Neglect Strategy which was revised and launched in November 2022.

Please view the Partnership Neglect Strategy here

A short video has been produced to explain the new DSPP Support Level Guidance and Framework, published in March 2023, watch the video here

and download the Guidance here

DSPP have designed a poster to help spot the signs of non-accidental injury and can be downloaded here

Neglect is the 2nd most common form of abuse in Dudley. Posters raising awareness of child neglect are available to download:

Training and Resources

The below DSPP courses are directly linked to the findings of our reviews:

ICON: ‘Babies cry, you can cope’

This training is designed to equip you with the knowledge, information and skills that you will need to discuss ICON with prospective parents.

Book on the eLearning course here

Child Abuse and Neglect eLearning

This level 1 package has been designed for multi-agency staff and volunteers who have contact with children and young people who July have safeguarding needs. It is important that everyone is able to recognise concerns around safeguarding and how to raise a concern so that appropriate actions can be taken.

Access the course here

Introduction to DSPP Support Level Guidance and Framework (Children's)

This course is linked to the ‘DSPP Support Level Guidance and Framework’ which provides the model of integrated working and gives practical guidance on making decisions across service thresholds for practitioners working in Dudley.

The DSPP Support Level Guidance and Framework is a vital tool that will support you in your delivery of targeted support services at the earliest opportunity – right through to specialist and statutory interventions when it is needed to promote the welfare and safety of vulnerable children and young people.

Access the course here

Child Neglect

By the end of the session, delegates will have:

  • Basic understanding of Neglect and the four models of Neglect
  • Understanding the concepts of purposeful Neglect or accidental Neglect
  • Knowledge of the impact of Neglect on a short and long-term basis
  • Awareness of Neglecting neglect and the barriers to practice
  • Key practice to ensure we are working to the best possible outcomes for children and families
  • Understanding of Disguised compliance and intergenerational Neglect and how to consider this in how we work with children and families
  • Considering Dudley’s practice around Neglect and what that means for their role

Book on the Neglect training here

Child Protection Conferences

This training is for all multi agency partners involved in Child Protection Conferences and will provide information for those taking part in Conferences.The training will cover:

  • Procedures and Processes for Child Protection Conferences
  • Planning for Conferences
  • Child and Parent Participation
  • Local Model for Conferences and Restorative Practice
  • Child Protection Plans and Core Groups

View dates for this training here

Professional Curiosity

This Multi-Agency training course will increase practitioner’s knowledge and confidence in practising ‘respectful uncertainty’ by thinking outside the box’, beyond their usual professional role, and considering individual’s and families’ circumstances holistically. It will also be an opportunity to explore how as professionals differences of opinion, concerns and issues that arise for practitioners at work and are resolved as effectively and swiftly as possible.

Book on the Professional Curiosity course through our booking system

Safer7 Briefings

Seven minute briefings are based on a technique borrowed from the FBI. It is based on research, which suggests that seven minutes is an ideal time span to concentrate and learn. Learning for seven minutes is manageable in most services, and learning is more memorable as it is simple and not clouded by other issues and pressures. 

As part of the Thematic Learning from reviews we have promoted our Safer7 briefings which are directly linked to the findings of our reviews:

Bruising is the most common presenting feature of physical abuse in children. Recent DSPP Child Safeguarding Practice Reviews (CSPRs) and Serious Case Reviews (SCR’s) identified that children under the age of 1 year are presented in reviews as a result of a severe injury or death as a result of physical abuse.

View the Safer7 on Non Accidental Injury here

ICON is a campaign to support parents / carers with ways of coping with a crying baby.

Similar to safer sleeping campaigns, ALL practitioners should take the opportunity, where they can, to be

professionally curious about parental stresses and coping with a newborn baby. It is important for parents to understand these messages.

Access the ICON Safer7 here

Neglect is the ongoing failure to meet a child’s basic needs. Neglect takes many forms. Neglected children July be left hungry or dirty, without adequate clothing, shelter, supervision, medical or health care. They July be put in danger or not protected from physical or emotional harm. They July not get the love, care, and attention they need from their parents or carers.

This safer7 gives an overview of Child Neglect

A child protection medical is a medical assessment which is undertaken either at the request of social care or police, or when a referral has been or is about to be made by a clinician to social care in the context of concerns for the wellbeing of a child already receiving clinical care.

The assessment includes the clinical history and examination and detailed information i.e. line drawings and photos.  The assessment includes obtaining any relevant investigations, arranging any necessary aftercare and writing a report with an opinion.(RCPCH 2020)

View the Safer7 briefing here

All professionals that encounter children, parents and carers in their role need to be aware of their safeguarding responsibilities and alert to the needs of vulnerable children and young people. This requires professionals to be curious so that they can effectively identify vulnerabilities and potential or actual risks of harm. Children rarely disclose abuse and neglect directly to practitioners and, if they do, it will often be through unusual behaviour or comments. Which makes identifying abuse and neglect difficult for professionals across agencies. The first step in keeping children safe is to be professionally curious and to engage with children and their families at the earliest opportunity before problems escalate into crisis

Access the Professional Curiosity Safer7 here

Sharing information is crucial to safeguarding children – poor information sharing is repeatedly highlighted as an issue in CSPRs and SARs.

The most important consideration is whether sharing information is likely to safeguard and protect the child or adult with care and support needs.

View the Information Sharing Safer7

Disguised Compliance involves parents and carers appearing to co-operate with professionals to allay concerns and stop professional engagement (Reder et al, 1993). This can mean that social workers and other practitioners may be unaware of what is happening in a child’s or adult’s life and the risks they face may be unknown to authorities

View the Safer7 on disguised compliance