I have been placed in a statutory placement with a local authority working within a frontline child protection team. This team manages the child protection and child in need cases on a long-term basis that have been passed on from the children’s assessment team. It is the responsibility of a social worker within a child protection team to recognise and address any potential risk of significant harm to a child, as outlined in the Children’s Act 1989. The local authority has a duty to safeguard, support and promote the wellbeing of any child in need within their area (Davies, 2012).
The team will carry out assessments to determine the needs of the child; using a strengths-based and holistic approach; considering the needs of the whole family within its social context (Davies, 2012). The objective is to facilitate and support children and their families to solve their own problems. Following these assessments, it is the role of the social worker, with support from a team manager to determine the level of risk to the child and outline the next steps. In some cases, this will be a referral to another service to offer support in the areas of need. In other cases, it is necessary for the case to be placed on a plan. Each case will vary and with direction from the Children’s Act 1989, the level of risk involved will determine whether the case be placed on a child in need plan, as per section 17 of the Act, or whether section 47 safeguarding enquiries should be made, with a view to progress to a child protection plan.
Irrespective of the progression of the case, the role of the social worker remains focused on directly providing, or facilitating access to, a variety of services to support children and their families. The aims of these services range from improving parental capacity, increasing competence and confidence, introducing positive changes to children’s day-to-day experiences and supporting children with their recovery from the impact caused by abuse or neglect (Davey et al, 2009).
According to the local statistics, as of 2014, the areas covered by my team had an overall population of 109,487. It covers 81.08 square kilometres making the borough one of the most densely populated in the East Midlands in addition to having one of the highest ethnic minority populations in the East Midlands (Nottinghamshire Insight, 2017). This has significant impacts on the service user group within the team and it is therefore paramount to consider potential conflicting traditions, values and ethics when working with children and families from other cultures. (PCF 3).
This analysis will focus on two cases I worked on during my time within this team. Alongside the work detailed below, I had the opportunity to build and develop my professional skills in a range of new and challenging areas. (PCF 7)
I have anonymised the service users in guidance with confidentiality and data protection policies (General Data Protection Legislation, 2018).
Case 1 :-
During my time on placement I was allocated to manage a case that was already at the child in need stage. According to the Department of Education, 1.1 million children were in need of help and protection at some point between 2014 to 2015 and 2016 to 2017 (Department of Education, 2018). A child or young person is identified as being ‘in need’ of services following a Child and Family Assessment. Nottinghamshire Safeguarding Children’s Board have outlined that the need for an assessment mainly falls upon whether or not the child meets the threshold for tier 4 of the Pathway to Provision which outlines the guidance for practitioners to follow when identifying a child, young person and/or family’s level of need, and referral pathways to the most appropriate service to provide support (Nottinghamshire Safeguarding Children’s Board, 2019).
The child in need process is underpinned by section 17 of the Children Act 1989.This states that a local authority’s initial role is to support the children and their families, facilitating them to remain a family unit and therefore reducing the need for compulsory action. This allows the local authority an element of control to decide how best to achieve the aims of the child in need plan (Legislation.gov.uk, 2018). This plan should be formulated by the social worker, parents/carers and other professionals working with the child or young person and the child or young person themselves. The plan should be outcomes focussed and should be based around the needs of the child. Wilson 2018 states that when working with children we should focus on talking with children, as opposed to about children, and this will emphasise their contribution to the process. This mirrors the views of Carl Rogers (1961) who argues that the individual is the expert of their own life and experiences.
This case consisted of two siblings who share the same mother and father. Child A is a 12-year-old female and child B is a 10-year-old male. Child A and B live with their mother but spend time with their father one night per week and every other weekend. Mother and father have a good relationship and are civil for the children, however, father does not have a good understanding of mother’s mental health which can cause tension between them. That being said, this has not impacted on the relationship either child has with both parents.
The mother recently received a diagnosis of emotionally unstable personality disorder. Emotionally unstable personality disorder is characterised by pervasive instability of interpersonal relationships, self-image and mood and impulsive behaviour (Knott et al, 2016). Families where a parent with dependent children has a mental illness are prevalent, with one epidemiology study finding that 21-23% of children live in such families (Maybery et al, 2009). It could be argued that a parent with a personality disorder is unable to provide their child with the stability and consistent emotional warmth that they require. That being said, the presence of a parent with a mental health diagnosis does not necessarily lead to adverse outcomes in families (Reupert et al, 2015). As discussed in The Family Options intervention which stemmed from the understanding that the disabilities conveyed by mental illnesses to individuals are context-related, and differ with the requirements and demands of a particular role – in this case, parenting (Nicholson and Henry, 2003). It was argued that the majority of parents aspire to have positive family experiences and productive relationships with their children, whose ages, stages, and, consequently, needs change over time. This proves more difficult to manage for parents with a mental illness. Therefore, the family options intervention model aims to encourage recovery and build resilience, focussing on the parents existing skills to improve wellbeing; making the stress of parental responsibility more manageable (Reupert et al, 2015).
The children were referred to children’s social care following the mother taking an overdose and self-harming. Mother was admitted to hospital for medical treatment but was not detained under section 5 of the Mental Health Act 1983. When mother was discharged from hospital, she admitted to feeling vulnerable and unable to meet her children’s needs. This meant that both children stayed with their father for approximately six weeks. This was not ideal for the children due to there being three other children in that household; two of whom have complex behavioural needs.
Child A has been experiencing low moods and has been self-harming, resulting in superficial injuries. A study conducted by the University of Manchester and Keele University, and was funded by the National Institute for Health Research (NIHR) found that since 2011 there has been a 68% increase in rates of self-harm among girls aged 13 to 16 (NHS, 2017).
Child A receives pastoral support from her school to address her emotional wellbeing. When I discussed the reasons for self-harm and low moods, Child A spoke about her use of social media and how this contributed to her low moods and self-esteem. A study conducted by Glasgow University questioned 467 teenagers about their social media use. Alongside this, they analysed their sleep quality, self-esteem, anxiety and depression levels against their “emotional investment”. The results of this analysis showed a connection between social media use and poorer sleep quality, lower self-esteem and higher anxiety and depression (BBC news, 2015). I found when working with Child A, it was beneficial that I was a young female as Child A stated she found it easier to speak to me and found our topics of conversation relatable. I was able to speak with Child A about the channels of social media that she uses from my personal experience with these same platforms. I took the opportunity to reflect on my experiences as a young girl in secondary school and the pressures faces and was able to empathise with Child A whilst maintaining a professional relationship. (PCF 1, 2, 3, 5, 6 and 7)
Around a year ago, Child B was diagnosed with attention deficit hyperactivity disorder (ADHD) which has been defined by the NHS as is a behavioural disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness (NHS, 2018). A few months later he also received a diagnosis for autism; defined by the National Autistic Society as a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them (National Autistic Society, 2018). The National Autistic Society also report that autistic children may be at higher risk of being abused than others, this can be more difficult to detect due to the limited speech, communication difficulties and the struggle some autistic children face with identifying their emotions (National Autistic Society, 2018). Upon receiving the diagnoses, mother admits that she found this difficult to manage and struggled to process this information emotionally. When we explored this further, we discussed how this could have been the trigger for mother’s decline in emotional wellbeing; leading to the suicide and self-harm that bought the case about. (PCF 3, 6 and 7)
Child B is still in mainstream school who feel that based on his presenting needs and behaviours, Child B would benefit from one to one support. Child B was recently excluded from school following a residential trip where he had run away and tried to start a fire, and then again when he took a decorating tool into school. School had discussed with me the correlation between mother’s emotional wellbeing and Child B’s behaviour. They believed that if mother was low in mood, this caused Child B’s behaviours to become more challenging. When this was explored with the family, we were able to build on strategies for mother to adopt to try and prevent the impact of her emotional wellbeing on her parenting as it is not something that had been previous bought to her attention. (PCF 6 and 7)
Whilst managing this case, I had the opportunity to chair two of the child in need review meetings on this case. (PCF 1, 5, 7 and 9) The first child in need review meeting that I chaired was also my first direct observation. At the time, I felt this placed a lot of pressure on me as a student social worker as I had the anxieties of chairing my first meeting alongside the pressures of my first direct observation. Upon reflection, I can see that having this meeting observed was actually positive as I had to put together a plan in preparation for my direct observation which I then utilised as the agenda for the child in need review. This therefore relieved some of the pressures during the meeting and I was able to focus more on the content and worry less about the structure. (PCF 5, 6 and 7)
It is outlined in the Nottinghamshire Safeguarding Children’s Board that a review of the child in need plan should be held every 6-8 weeks, with all professionals and family members involved at the planning meeting, and any other professionals who may have become involved since. My role as the chair of the child in need review is to ensure that invites are sent, a location is arranged and booked, with consideration made to the family’s accessibility, and to prepare for the review. I took copies of the last child in need plan with me for attendees to follow and to promote participation. It is also my responsibility to ensure attendees receive a copy of the updated plan within 5 working days. (PCF 1, 3, 4, 5, 8 and 9). Reviews are held to ensure that the plan is meeting the needs of the child. During the review, attendees should share information, discuss progression and update the plan if necessary. If the child is still on the child in need plan after 6 months then the team manager should chair the review meeting, it then becomes their responsibility to review the effectiveness of the plan, and should seek to understand the reasons for any lack of progress (NSCB, 2019).
Despite the Working Together to Safeguard Children (2018) document indicating that all agencies should have arrangements in place for sharing information, during the meeting, it became apparent that other professionals were not always forthcoming with providing updates or participating. The Working Together document states that effective sharing of information between professionals and local authorities is essential for effective identification, assessment and service provision (Working Together to Safeguard Children, 2018). On more than one occasion during the child in need review, I had to challenge other professionals; one example of this is in respect of Child A who was working closely with a mental health specialist whose role it was to explore self-harm and Child A’s self-esteem. When this was discussed, the mental health nurse provided minimal information to the meeting, leaving questions from both myself and the mother unanswered. It fell upon myself to emphasise the importance of multi-agency working. (PCF 1, 2, 4, 5, 6, 7, 8 and 9).
Following my direct observation, my practice educator gained feedback from professionals and the family, it was noted that I had built a good, working relationship with mother which, according to other professionals and the family friend who attended, was not always easy due to her mental health. (PCF 1 and 3). Barker, 2003, described the term rapport as “the state of harmony, compatibility, and empathy that permits mutual understanding and a working relationship between the client and the social worker” (Barker, 2003, p.359). During practice, social workers aim to develop a productive working relationship with service users to use as a platform for work to be undertaken (Trevithick, 2003). I feel that this positive relationship was the foundation for the great progress the family made during the time I was working with them. My practice educator had mentioned to the other professionals that she felt the meeting may have been a little too lengthy, however, they reassured her that previous meetings had been much longer due to mother having a lot of input. It was therefore noted that I had managed this well. (PCF 1 and 9).
When reflecting on this observation during supervision with my practice educator, we discussed the influence of the systems theory when chairing a child in need review meeting to ensure that wider family and universal services are utilised. (PCF 5, 6 and 7). Maclean and Harrison state that the systems theory highlights a person’s support network but recognise that these networks can be placed under strain at times. This strain prevents the system from running smoothly. However, it has been argued that this can be managed when short, or long term if necessary, services are put in place to balance the system again (Maclean and Harrison, 2015). The Social Care Institute for Excellence, 2004 discusses the relevance of the systems theory to social work; explaining the recurring patterns of behaviour between families, groups and organisations; concentrating on the relationships the components of the ‘system’ rather than the components in isolation (Social Care Institute for Excellence, 2004).
During my time managing this case, my work with each child was different to meet their individual needs. (PCF 3). With Child A, I focussed on exploring her emotions and triggers for self-harm. Through completing an ecomap; a visual display of the formal and informal systems in Child A’s ecology, I was able to support Child A in recognising her support networks which she could utilise when she was feeling low.
Bronfenbrenner (1979) outlines the ecological model of the systems theory which places the service user at the centre of a five-levelled system (Beckett, 2010). By incorporating the systems approach via the ecomap with Child A, I was able to draw upon the microsystem; the close relationships she had with her mother and father, and then exploring her friendships. We then utilised these to explore whether or not Child A would feel comfortable approaching these people for support, and whether or not she thought they would provide support. On completion of this, Child A was able to see that she is not as isolated as she may have first thought. I discussed this with my practice educator during supervision and we discussed the benefits of utilising family and friends both to Child A; by highlighting her existing support networks that that she has already built a trusting relationship with, and the local authority; by utilising existing support networks, the local authority may not need to refer elsewhere; therefore, reducing costs and strain on services.
In respect of Child B, we worked together on his understanding of his diagnoses of ADHD and autism, we explored how these looked to Child B and in what ways did Child B feel ‘different’. We then used a comic strip to create a story that Child B could use to explain autism and ADHD to his school friends who may not fully understand why he sometimes behaves or thinks differently to them. (PCF 3 and 7).
I was able to see this case through to closure; the family had made positive progress in terms of understanding the individual needs of both children and both the children and mother were engaging well with universal services. Through intensive support from mental health services, Child A had recognised and developed some alternative coping strategies, leading to a reduction in self-harm. Child B received support from his play therapist to recognise his learning style and his school agreed to incorporate this into his lessons, this enabled Child B to feel more involved and focussed. Both mother and father worked with me to further develop their understanding of their children’s individual needs and they worked together to ensure that both households were consistent with their routines and boundaries; this was particularly important for Child B due to him having autism.
A range of legislation and policies were used to inform my practice throughout this case. The main legislation being the Children Act 1989; ensuring that thresholds for section 17 Child in need are met, along with section 10 which states that professionals should work in partnership with each other. Alongside this, the Working Together to Safeguard Children documents, published by the department of health in 2018 outlines the expectations of multi-agency working in order to keep children and young people safe. (PCF 4, 5 and 6).