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NURS 60271 Social Work Intervention and Service Users

Essay Topic: ,

Introduction

This essay is based around a children and families case study and will first set out the significant issues for the individuals involved before outlining the policy and legislative mandates and frameworks that would provide the basis for informed assessment and intervention. It will then highlight the most effective interventions, designed to improve the situation, using practice theories and approaches. Finally it will detail the interdisciplinary and multi-agency context and provide the framework and guidance to ensure it was completed in an anti-discriminatory and anti-oppressive way.

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A significant issue, common to many families dealing with social services departments, is that they often feel a lack of control and autonomy (Harwath, 2002). As social work professionals it is essential that we engage with Josie and her family, establishing their views and opinions, (Thompson, 2002). An initial assessment of Josie’s situation has taken place and this has progressed through enquires under Section 47 of the 1989 Children Act, to the decision to hold a child protection conference. At this conference a recommendation was made to speak to legal services about initiating Care Proceedings in relation to both Michael and baby Perdita.

One must consider that the family and professionals may have different perceptions of the current situation and this becomes problematic when assessments focus on family weaknesses and disadvantages (Milner & O’Byrne, 1998). There are contradictory reports about Josie’s parenting skills, which could have a significant impact on any decisions taken. Mary, her foster mother, reports that Josie is trying hard with Perdita, demonstrating good levels of affection, whilst staff at the family centre state they have, “grave doubts” about her ability to parent. Josie is considered to have learning disabilities, however a key issue is the fact that no adequate assessment has taken place to assess the level, if any, of her learning difficulties. Adult services state that they consider Josie to have ‘only has mild to moderate, not severe learning difficulties,’ and if this is the case, then there could very limited impact on her potential parental capacity, however, it must be noted that single parents that have learning difficulties often face prejudice, (Thomas & Woods, 2003).

Josie’s first child, Michael, has lived with his grandparents since he was just a few months old, but returned to live with her, as a result of his grandmother’s recent death. It must be confusing and disorientating for him to be temporarily placed back with his mother, and then almost immediately removed again into foster care. Equally it must have placed an additional strain and burden on Josie when Michael was first returned, but then removed, affecting her ability to cope during Perdita’s birth and immediate aftercare.

At birth, Perdita’s father was registered on the birth certificate, and through this action he has parental responsibility. However, when he last visited the police had to be called, after he struck Josie, and therefore extreme sensitivity and care will need to be taken in decisions and agreements made over his future involvement with the family due to the potential problem of domestic violence.

The legal position over Emma, Josie’s middle child, who was adopted at age two, needs to be fully established. It is possible that it was agreed as a condition for Josie to have some form of limited contact visits and agreed letterbox contact, and if so then the possibility of restoring this contact should be investigated.

The family’s economic status is not clear. The nature of Josie’s potential work and the effect of any employment on the family as a whole is currently unknown but could be viewed as a risk factor by some. The core key issues become whether Josie is currently able to provide best care for Perdita and Michael, whether this can be achieved with further support or whether Perdita and Michael need to be removed from Josie’s care and placed elsewhere.

There are a wide number of policy and legislative mandates that would provide guidance and inform the assessment process and potential interventions in this case study, however, due to the limits of the word count they will be listed and their relevance outlined in brief.

The four principal pieces of legislation relevant to this case study are the Children Act 1989, the Protection of Children Act 1999, the Adoption and Children Act 2002 and the Children Act 2004.

The Children Act 1989 sought to carry into legislation the belief that where possible:

‘children are generally best looked after within the family, with both parents playing a full part and without resort to legal proceedings. The welfare of the children is the paramount consideration,’ (Children Act, 1989).

Thus the Children Act sought, where possible, to protect children within a family environment. Sections 27 and 47 of the Act – significantly titled ‘Co-operation Between Authorities’ and ‘Local Authority’s Duty to Investigate‘ – sets out the Governments demands for closer agency communication. The main themes of the Children Act 2004 were an emphasis upon ‘integrated planning’, ‘delivery of services’, ‘multi-disciplinary working’, ‘increased accountability’ and, especially, more provision for those children with ‘special needs.’

The core legislation relating to children and their families in England and Wales is the Children Act 1989, (Warman,2003). Section 17 states that it is a duty of every local authority to “safeguard and promote the welfare of children within their area who are in need”. Whilst Section 47 lays a specific duty to “make enquires or cause enquiries to be made and to take action in response to reported concerns of significant harm”. Being placed with a foster mother indicates that the family is currently subject to an interim care and supervision order under Section 38, which provides the court with the power to make interim care and supervision orders, which place the children in the care of the local authority on an interim basis, whilst the family is assessed, and until the court can make a final decision. The interim care order has the same effect as a final care order in giving the local authority parental responsibility (Children Act 1989).

In fulfilling these duties agencies are assisted by guidance published by the Department of Health . Working Together to Safeguard Families (DoH,1999), directs inter-professional practice where children may be experiencing risk of significant harm, whilst Framework for the Assessment of Children in Need and Their Families (DoH, 2000), provides broad guidance on the conduct of various types of assessment, including the level and nature of the need, the type of appropriate services to meet the assessed need, and how, when, and by whom, such services will be delivered,(Harwarth,2002). To date such interim assessments have seen Josie and Perdita placed with a specialist Mother and baby foster carer, however, it

is questionable as to whether the local authority have fully complied with the Children and Young Person Act 2008, as it is possible to argue that suitable accommodation for Michael to reside with his mother and sister, should have been sought and provided. In addition, in circumstances where the authority intends to accommodate a child with a parent or someone with parental responsibility, the authority must first review the proposed arrangements according to regulations made under Section 26 of the Children Act 1989, that is a review by an Independent Reviewing Officer.

A sensitive balance needs to be struck by reviewing the placement whilst also promoting a sense of permanence and stability for the child and carers, (Warman, 2003). Looked after children’s reviews are meetings were identified needs are tailored in light of the care plan and status of the placement. Integral to the review is the Every Child Matters ethos, whereby the government seeks to guarantee equal opportunities for all children. Adding further weight, Article 8 of The Humans Rights Act 1998 outlines a persons right to respect for their private life and family, whilst the Mental Capacity Act 2005, provides a statutory framework to empower and protect people who may lack capacity to make some decisions for themselves (HMG, 2005). In Josie’s case this would include people recognised as having some learning difficulties which may affect their capacity to make some decisions. The act makes it clear who can make the decisions, and in which situations, and how they should go about this.

The Adoption and Children Act 2002, introduced a completely new court order, Special Guardianship, which provides another option for legal permanence for children who cannot grow up with their birth families. Under the Act Special Guardianship is an order made by the court that places a child or a young person to live with someone permanently, and gives legal status for non parents who wish to care for that child or young person in a long term secure placement. A residence order is an order from the court to say who the child should live with. Adoption places a child or young person in a permanent home but upon adoption the birth parents lose parental responsibility, and links with the birth parents are lost in most cases, (Lowe & Murch, 2002). Long term fostering offers a similar approach, but it does not always allow the child or young person to feel a sense of security and belonging (Rushton,2003). Also, the long term foster parent would not obtain parental responsibility and therefore not have a legal right to have a say in the decisions involving the child/young person.

The role of a family court in child protection cases is to make rulings about the rights to custody of the children involved, (Shepard, 2004). A family court can be convened where the state, on the advice of care agencies, seek custody of a child or children. The family court hears evidence and recommendations from social service workers, doctors, mental health workers and other professionals. This evidence is intended to highlight the potential risk that the children are exposed to, (Bentovim & Miller, 2001). If the family court finds that the potential risk to children is too high then it may rule that custody should be removed from the parents and given, either temporarily or permanently, to the State (Schepard, 2004). Such children are referred to as ‘looked after’ children. The case of Michael and Perdita has reached the point where it has been recommended that Care proceedings in a family court take place and a decision over placement be made. The physical smacking and shouting reported by staff at the family centre may become evidential of the view of care services that it is necessary to recommend that custody of Perdita be removed from Josie.

With effect from 6th April 2011 The Family Procedure Rule 2010 came into force for all family proceedings, including adoption proceedings. Regarded as the most significant development in the procedure of the family courts for 20 years, (HMCS, 2010), ‘Family Procedure Rules 201,‘ replaces all existing procedural rules for family proceedings, creating a comprehensive and accessible source for all who come into contact with the family justice system. Covering all family proceedings in the High Court, the County Court and the Family Proceedings Court, the Rules were developed by Her Majesty’s Courts Service (HMCS) and the Family Procedure Rules Committee as a result of requirements set out in the Courts Act 2003. The Rules specify the need to secure that “the family justice system is accessible, fair and efficient and the rules are simple and simply expressed.”(HMCS, 2010)

In seeking solutions about how to intervene most effectively, using practice theories and approaches, there is a need for a holistic approach seeking to utilise any strengths in Josie’s case, before identifying where assistance may be required, (Gibbs, 2003). As a profession we are committed to the pursuit of social justice for the poor, disadvantaged, disenfranchised and oppressed people, (Finn & Jocobson 2003), however, prior awareness of the possibility of conflicting opinions, as to how to achieve this commitment, will enable the social worker to react thoughtfully and mediate effectively, (Dalrymple & Burke, 1995).

My recommendation would be for the Child Protection Conference to take place as required under the legislation. A main purpose of the conference is then to convene, in one place and at one time, all the relevant people interested in the care of Michael and Perdita, to include care professionals, medical practitioners, and if possible, subject to all necessary agreements and consents, Michael’s grandfather and Perdita’s father. Care professionals would then have the opportunity to decide whether legal proceedings ought to be brought on behalf of the children. This conference is a legal requirement and events have transpired to the point that this now cannot be avoided or delayed, however I would advocate that the outcome should, for now, include Perdita staying under the supervision of Josie, with the continued support of the foster mother Mary, whilst a more robust plan of support was investigated and recommendations made for additional support and education to aid improvements in her parenting capacity. I would further advocate for Michael to be placed with his grandfather under a special guardianship arrangement. Michael’s paternal attachment to date has been to his grandparents, as an older child Michael might struggle to deal with the status of being adopted and where there is evidence of a good relationship with members of the family, special guardian ship has the advantage of being less disruptive than either fostering or adoption, (Lowe & Murch,2003).

In the short term, Perdita remains a potential safeguarding issue. The staff have concerns over her being smacked and if this was viewed as a regular occurrence then most professionals would agree that Perdita was at least subject to inadequate parenting, whereas others would go further, and describe this as physical maltreatment, (Harwarth,2002). However, it must be born in mind that Josie may believe that she is attempting to be a good mother and merely modelling her own behaviour on her own experiences (Bandura 1977). The reason for Josie taking an excessive disciplinary approach to Perdita may be linked to her own experience of childrearing. If Josie was herself physically or emotionally maltreated, she may have developed ambivalent or disorganised attachment behaviours which apply to her own parenting relationship with Perdita, (Ainsworth 1989, Dominelli, 2002). The evidence base for proving that child maltreatment is passed form one generation to another is not conclusive (Macdonald, 2001), however it would need to be considered that Josie’s experiences of being raised in care could have an impact her own parenting skills which could be improved with education and support.

The following legislation provides for the recommended solutions for this case study. The Children Act 1989 states that, where possible, the welfare of the children must be attempted inside the family environment. Thus the Children Act allows for social work professionals and other carers to monitor the current home situation before formulating their final recommendations. The Child Protection Act 1999 makes provision for Child Protection Conferences and such a conference regarding both Perdita and Michael would be an important short term measure to assess the risk to the children and to co-ordinate a Child Protection Plan for them. Legislation under the Child Protection Act 1999 would allow social workers to place either child on the Child Protection Register which would then require the design of a Child Protection Plan, to control future proceedings towards ensuring the safety of the children. These plans would clearly define what duties each care agency has for the protection of the children, and ensure that there is coherent and productive communication between these individual agencies, (Harwarth,2002). After the initial conference a further meeting can be convened after three months and then further six monthly conferences if felt necessary. I do not feel that Josie’s actions have reached the threshold for removing Perdita, at this time, and instead advocate further education and support should be indentified and provided to help improve her parenting capacity, of Perdita, in the short term, with the potential longer term aim of being placed in suitable supported accommodation to receive Michael also. However, I must also accept that if such short term support measures prove unsuccessful, and improved parental capacity is not observed, then it may be necessary to bring a public law case (family court) against Josie as set out in the Children Act 1989. If the court thinks it necessary to remove custody of Michael and Perdita from Josie, then the Adoption of Children Act 2002 would be utilised to make provisions for the long term care of the children under the status of ‘looked after’ children.

After the child protection conference there would be clear summaries, which identify from the information gathered, the child’s developmental needs, parenting capacity and family and environmental factors. In each of these domains, both strengths and difficulties would then be identified, (Booth & Keegan, 1996). Children’s needs do not exist in a vacuum, (Hugman, 1991), therefore the inter-relationships between the child, family and environment must be understood.

Michael and Perdita are not yet ‘looked after’ children, since Jodie is their biological mother and as such, the provisions for ‘looked after’ children are not part of my recommendations, at this time, however, this could become a possibility. If this happened, then Perdita’s father, by virtue of having parental responsibility, would need to be consulted and his viewpoint sought before any final placement decision was made, hence my recommendation he be present, if agreement is possible, at the child protection conference. Fundamental to the recommended plan, from the beginning, is the commitment of all the parties involved, and the signatures to the plan of those who have lead responsibility, for ensuring it is carried forward. There should also be a clear recorded statement, on the plan, about when and how it will be reviewed, as reviewing the child’s progress, and the effectiveness of services, and other interventions is a continuous part, (Booth & Kegan, 1996).

Some of the information for these recommendations would have been gathered at the initial and core assessments and could have been complimented through the use of questionnaires and scales, (Department of Health, Cox and Bentovim, 2000). The Home Inventory (Caldwell and Bradley, 1984) and the Assessment of Family Competence, Strengths and Difficulties (Bentovim & Bingley Miller, 2000), also provide important information about the child’s world and family functioning respectively.

Service users, such as Josie, know little about the servicers available to them therefore social workers must act as the brokers to resources through referring them, (Payne, 2005). Just as the problems facing families are often interlinked, so the service providers for children and their families need to work closely together to be most effective, (Schneider & Lester, 2001). It is important that all those concerned with services to children and families, statutory and voluntary bodies, community groups and families, contribute to the development of these plans, (Payne,1996). Everyone benefits if services are properly co-ordinated and integrated, (Rushton,2003). The structure and organisation of services to safeguard children are dictated by core legislation, guidance and policy, (Dalrymple J. and Burke B (1995). Government key objectives for improvements in outcomes, for children in need, can only be achieved by close collaboration between professionals and agencies working with children and families, (Harwarth, 2002).

In particular Working together to Safeguard Children (DOH, 1999) and the Framework for the Assessment for Children in Need and Their Families, (DoH, 2000), provide comphrehensive guidance. The Framework for Assessment, (DoH,2000) provides guidance on the initial assessments and core assessments of a child in need including time frames that need to be met.

Section 11 of The Children Act 2004 establishes the duty of different service providers to co-operate.

“The support and protection of children cannot be achieved by a single agency… Every Service has to play its part. All staff must have placed upon them the clear expectation that their primary responsibility is to the child and his or her family.” Lord Laming in the Victoria Climbie Inquiry Report, Paragraphs 17.92 and 17.93.

Securing the wellbeing of children, by protecting them from all forms of harm, and

ensuring their developmental needs are responded to appropriately, are primary aims

of social work (Milner & O’Byrne, 1998). The effectiveness with which a child’s needs are assessed will be key to the effectiveness of subsequent actions and services and, ultimately, to the outcomes for the child and this can only happen within an interdisciplinary and multiagency context.

Many social workers practice in settings where they complete dual roles, protecting vulnerable individuals, and the community at large, in addition to playing other supportive roles, (Payne, 1996). In order to demonstrate adherence to working in an anti- discriminatory and anti-oppressive way it would be important to record the specific views and opinions and feelings of all concerned and attempt to build these, (sometimes contradictory) views into the recommended solutions where possible.

At times it would be important to advocate on the family’s behalf with other agencies, taking time to reassure Josie that her views will be sought and listened to in this process, whilst also listening to and integrating the potentially different needs of Michael, the grandfather and Perdita’s father, (Sinclair et al, 2007).

Only by working in partnership with the family could you begin to empower them to enable to seek the correct support and assistance. No matter where they are employed, social workers are influenced by the social work value of self determination for their client, (Thompson 2002). In defending this value you can begin to ensure that there has been an adherence to anti-discriminatory and anti-oppressive practice. Further to these general aims, policy guidelines and codes of practice provide the framework for such casework, and are there to enable professionals maintain the standards expected of them, (Payne, 2005). Using the Department of Health Framework for Assessment, as the initial assessment tool, would provide the opportunity to highlight and record the clients involvement in the solutions recommended. The aim of the practice guidance is to make transparent the evidence base for the assessment framework, thereby assisting professionals in their tasks of analysis, judgement and decision making and working together to promote anti-discriminatory and anti-oppressive practice.

If we are not attuned to recognising and challenging discrimination we run the risk of condoning it, or even exacerbating it, through our own actions, (Thompson, 1998). We need to be sensitive to discrimination and oppression to avoid the pitfall of becoming oblivious to their existence, (Tomlinson & Trew, 2002). Giddons (1977) argues that power is intrinsic to all social interaction, we therefore cannot escape the significance of power in our dealings with other people. Assessments and subsequent care plans are more effective if the child and family feel empowered and involved throughout the process (Department for Education and Skills, 2001), to demonstrate that for Josie and her family you had worked in an anti-discriminatory and anti-oppressive way it would be important to establish and document their individual contributions to the process, and ensure they felt involvement in the solutions and recommendations made. One of the hallmarks of good practice in traditional approaches to social work has been a sensitivity to feelings, (Dominelli, 2002), this aim should run through all aspects of the recommendations.

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