1. www.virgincare.co.ukPrivate and confidential1 Clinical Case By Paul Wright Named Doctor Safeguarding Virgin Care

2. www.virgincare.co.uk Private and confidential 2 Introduction Child BA Referred in May 2010 – Aged 13 years 6 months BA had disclosed to a teacher that she had been beaten over a long period at home School referred to Social Care and Police They visited her but although had been happening for over a year – no acute injuries 2 days later was kicked in the morning and medical requested

3. www.virgincare.co.uk History of Presenting Problem BA recalls many incidents of physical beating and injury 2 years previously she had been hit with a metal mop which had caused her to break the middle finger of right hand Present Carers have hit her many times Sometimes has to kneel on the floor with her hands above her head; if they drop she is beaten Private and confidential 3

4. www.virgincare.co.uk History of Presenting Problem She has to do a lot of chores at home including looking after the other 2 children (they are natural children of the carers) She runs their baths, sweeps the floor, does the food shopping and cooking for the family She has to eat different food from the rest of the family Private and confidential 4

5. www.virgincare.co.uk History of Presenting Problem On the previous evening she had had little sleep and had not got up to do her chores Carer had woken her up and kicked repeatedly on her legs Private and confidential 5

6. www.virgincare.co.uk Past History Born and spent early childhood in Nigeria Family ethnically Yoruba Father was Muslim and Mother Christian Father died when BA 3 years of age, and Mother died when BA 8 years of age BA told that father had died in a car accident, and mother following robbery and rape However both died of AIDS related illnesses Private and confidential 6

7. www.virgincare.co.uk Past History BA has two older siblings in Nigeria When her Mother died all went to live with different relatives BA’s current carers are her Paternal Grandfather’s Brother’s son and his wife Mr SA (adoptive father) was granted temporary residence in UK under the Highly Skilled Migration Programme Private and confidential 7

8. www.virgincare.co.uk Past History In March 2009 BA arrived in the UK with her adoptive parents and their 2 children Papers prepared for immigration state BA born in 1997, whereas BA stated she was born in 1996 As part of adoption BA’s name was completely changed September 1999 started at Secondary School Private and confidential 8

9. www.virgincare.co.uk Medical History in UK Taken to see GP within 2 weeks of arriving in the UK History of bedwetting every night 2 older siblings described as “bedwetters” Referred to Enuresis Clinic No appointments were kept Private and confidential 9

10. www.virgincare.co.uk School Progress Adoptive parents refer to major behaviour problems These are not substantiated by her school Form tutor states BA an exemplary student, her only problem being her persistent late arrival Academic progress has been excellent but adoptive mother has never congratulated her, and has hidden her good reports from adoptive father Private and confidential 10

11. www.virgincare.co.uk School Progress April 2010 – Adoptive Father contacted School Pastoral Care Coordinator about comments BA had been writing in her diary He said he would punish her with a cane Told that an inappropriate method of punishment and reported to Social Care BA later disclosed to Social worker that had been punched on back, legs and arms Private and confidential 11

12. www.virgincare.co.uk School Progress May 2010 – BA disclosed to school that she was being punished at home and do housework in the mornings Had been hit across back with a stick and had to hold her hands up to protect her head Disclosed that she was adopted and fearful of reprisals School contacted Social Care Private and confidential 12

13. www.virgincare.co.uk School Progress Next Day – Interviewed by Social Worker and Police 2 Days Later – BA arrived at school very distressed as mother had reportedly kicked her 7 times that morning BA kicked on thighs and legs and noted to be unable to sit down comfortably Social Care informed and Medical arranged Private and confidential 13

14. www.virgincare.co.uk Medical Numerous old scars noted –Back at least 6 –Right leg at least 12 including a large one which was reported to be a burn from a motorbike accident –Left leg at least 5 –Left Elbow 2 All injuries consistent with being hit by a hard object over a prolonged period of time 2 injuries consistent with accidental burns Private and confidential 14

15. www.virgincare.co.uk Follow up from Medical Following Medical, Police took out an Police Protection Order and BA placed in Foster Care Following day – Meeting between Foster Mother and Social Care Foster Mother informed that LA seeking to take out an Emergency Protection Order in respect of BA Section 47 Investigation to be conducted into 2 other children Private and confidential 15

16. www.virgincare.co.uk Follow up from Medical EPO obtained that day 3 days later Home Visit – Foster Mother very distressed and pleading that BA returned to her care 2 days later – Final strategy discussion and decision that an Initial Child Protection Conference be convened on 2 younger children LA obtained an Interim Care Order Private and confidential 16

17. www.virgincare.co.uk ABE Interview Domestic Chores worse when adoptive father away Persistently verbally denigrated by adoptive mother to visitors to house and to family in Nigeria Beaten by cane anywhere on her body Palms a common site as did not show marks Hand beaten by a metal mop by adoptive father which had led to a fracture and resultant trigger finger Private and confidential 17

18. www.virgincare.co.uk Investigation into 2 other Children No concerns raised re physical abuse other than emotional impact of what they had witnessed Both made subject to CP Plans under Emotional Abuse Private and confidential 18

19. www.virgincare.co.uk Further History BA remains in Foster Care BA made an allegation that she was raped aged 9 years in Nigeria HIV and STD screening negative Seen in Enuresis clinic – Secondary Enuresis following Mother’s Death On Desmopressin for a year – Now stopped Private and confidential 19

20. www.virgincare.co.uk Points Cultural Differences – Safeguarding follows UK law and is Culturally blind Falsification of Age Children brought to UK by “Family Members” and placed in servitude Private and confidential 20