19.12 Visits by a Child to High Secure Hospitals and Prisons

High secure (formerly known as special) hospitals have a duty to implement child protection policies, liaise with their local safeguarding partnership, provide safe venues for children’s visits and provide nominated officers to oversee the assessment of whether visits by specific children would be in their best interests.

Many prisons now operate a similar system in relation to sex offenders and other dangerous offenders.

Children’s social care must assist staff in high secure hospitals to carry out their responsibilities in relation to the assessment (LAC (99) 23 amended by LAC (2000)18).

With respect to visits by children to patients who have mental health difficulties and are in local non-special hospitals (including those detained under the Mental Health Act 1983), the onus for risk assessments lies with the Mental Health Trust.

Patients who are found unfit to be tried, or not guilty by reasons of insanity, in respect of murder, manslaughter or those who pose a risk to children will only be eligible for a visit if within the permitted categories of relationship.

The nominated officer of the relevant hospital must contact a person with parental responsibility for the child to:

• Seek her/his consent for the visit;
• Confirm the relationship of the child to the patient;
• Clarify who will accompany the child on the visit (must be a parent, relative, foster carer or employee of children’s social care);
• Inform them of the requirement for an assessment by Children’s social care.

A clinical assessment of the patient must be undertaken by the hospital.

If the clinical findings are supportive of the visit and the person with parental responsibility is in agreement, the local authority must be asked to undertake an assessment about whether the visit is in the child’s best interests. The clinical assessment will be provided to the local authority.

Assessment with Respect to High Secure Hospitals

On receiving the request for an assessment, the social worker must:

• Contact a person with parental responsibility for the child to gain consent for the assessment.

The children’s social care assessment provided should establish:

• The child’s legal relationship with the named patient (only children in specified categories of relationship may visit);
• The quality of the child’s relationship with the named patient, both currently and prior to hospital admission;
• Whether there has been past, suspected, alleged or confirmed, abuse of the child by the patient;
• Future risks of significant harm to the child if the visits take place;
• The child’s wishes and feelings about the proposed visit, taking into account her/his age and understanding;
• The views of those with parental responsibility and, if different, those with day to day care of the child;
• If it is known that the child lived in other local authority areas, what other information is known about the child and the family;
• The frequency of contact that would be appropriate;
• Who would accompany the child on visits, and the type and nature - e.g. quality and duration of relationship with the child.

Report

The assessment must be completed within 1 month of the referral and the report sent to the nominated officer at the high secure hospital stating whether, in the opinion of children’s social care, the visit would be in the best interests of the child.

The decision should take account of the:

• Nature (e.g. quality and duration) of the child’s attachment to the patient;
• Past abuse and /or risk of significant harm to the child from the named patient;
• Views of the child, those with parental responsibility and those with day to day care of the child;
• Opinions of professionals who have knowledge of the child;
• Hospital’s assessment;
• Whether the visit is, overall, in the child’s best interests;
• Who will accompany the child on her/his visits to the high secure hospital.

If the person with parental responsibility refuses to co-operate with the assessment and no information is known about the child, the nominated officer must be informed that a report cannot be provided.

Where the child is known to children’s social care, information from records may be supplied with the agreement of the person with parental responsibility.

If the social worker concludes that the visit would not, or may not, be in the child’s best interests then the hospital must not allow the visit.

If the social worker advises that the visit would be in the child’s best interests, then the hospital nominated officer should make the decision, following discussion with the social worker and after taking account of all available information.

Any approval for a visit is valid for a period of 12 months from the date on which it is given and may only be withdrawn in that period if the nominated officer is satisfied that there has been a relevant change of circumstances. If the period of 12 months has elapsed and the patient wishes to continue to have visits, the nominated officer must review the permission in accordance with their responsibilities