Category: Free Essays

Children Of Parents Who Misuse Alcohol Or SubstancesIntroduction

It is estimated that there are between 200,000 and 300,000 children in England and Wales where one or both parents have serious drug problems. Research and local knowledge have shown that substance and alcohol misuse in parents or pregnant women can have a significant impact on parenting and increase risk, especially for babies and younger children (Hidden harm 2003). This does not mean that parents who experience substance / alcohol misuse are poor parents. However the impact of substance misuse problems can, on some occasions lead to children and families needing additional support; or in a small number of cases support and multi agency disciplinary action to prevent significant harm.

The most effective assessment and support comes through good information sharing, joint assessment of need, joint planning, professional trust within the interagency network and joint action in partnership with families.

These guidelines apply whenever there are professional concerns about the wellbeing or safety of children whose parents or carers have substance/ alcohol misuse problems, specifically where these difficulties are impacting, or are likely to impact, on their ability to meet the needs of their children. These guidelines also apply to professionals working with pregnant women who have substance/ alcohol misuse problems, where their partners are known to have substance/alcohol problems or where someone with substance misuse problems is living in a household where children are present.

Aims

2.1. To increase the professional’s understanding of the impact of an adult’s substance misuse problems on children’s lives.

2.2. To enable universal and specialist services to improve their identification of children in need where adult substance/alcohol misuse is a problem

2.3. To enhance the provision of co-ordinated services to families in which there are dependant children of parents, carers or pregnant women with substance/ alcohol misuse problems.

Principles

3.1. All those who come into contact with children, their parents and families in their everyday work have a duty to safeguard and promote the welfare of children.

3.2. Parents, carers and pregnant women with substance/ alcohol misuse problems have the right to be supported in fulfilling their parental roles and responsibilities.

3.3. A multi agency approach to assessment and service provision is in the best interest of children and their parents/ carers.

3.4. Risk is reduced when information is shared effectively across agencies.

3.5. Risk to children is reduced through effective multi agency and multi disciplinary working.

3.6. While many parents, carers and pregnant women with substance/ alcohol abuse problems safeguard their children’s well being, children’s life chances may be limited or threatened as a result of these factors, and professionals need to consider this possibility.

Identifying The Need Of Children, Their Parents Or Carers, Or Pregnant Women With Substance/ Alcohol Misuse Problems

4.1. The birth of any new child changes relationships and often brings new pressures to parents. Agencies need to be sensitive and responsive to the changing needs of parents with substance/ alcohol misuse problems.

4.2. Parents, carers or pregnant women with substance / alcohol misuse problems may have difficulties which impact on their ability to meet the needs of their children, unborn child or new baby.

4.3. The adverse effects of alcohol/substance misuse on children are typically multiple and cumulative and will vary according to the child’s stage of development. They may include fetal alcohol syndrome, failure to thrive, blood-borne virus infections; incomplete immunisation and otherwise inadequate health care; a wide range of emotional, cognitive, behavioural and other psychological problems; early substance misuse and offending behaviour; and poor education attainment. These can range greatly in severity or may often be subtle and difficult to detect.

4.4. There is growing evidence to suggest that children often take on a caring role in families where there is parental drug or alcohol use. In some cases, it is particularly hard for children to cope with one or more parents with drug or alcohol dependency and they need help and support.

4.5. The risk of harm to the child may be reduced by effective treatment and support for the affected parent(s) and by other factors such as the presence of at least one other consistent, caring adult; a stable home with adequate financial resources; maintenance of family routines and activities; and regular attendance at a supportive school.

Guidelines For Referral And Assessment For Pregnant Women With Substance/ Alcohol Misuse Problems

5.1 All agencies are responsible for identifying pregnant women with substance/ alcohol misuse problems who may be in need of additional services and support.

5.2. When a professional identifies a pregnant women experiencing substance/ alcohol misuse problems an assessment must be undertaken to determine what services she requires. This must include gathering relevant information from her GP, PDAC, the Midwifery service, in addition to any other agencies involved, to ensure that the full background is obtained about any existing or previous diagnosis, or treatment for mental illness.

5.3. Consideration must be given to the impact and harm continued substance misuse has on an unborn child. Where this assessment identifies that a pregnant woman has substance / alcohol misuse problems a referral must be made to Powys Children’s services for a pre-birth assessment.

5.4. Where the need for a referral is unclear, this must be discussed with a line manager or the Safeguarding Children’s Team. If a referral is not made this must be clearly documented. Staff should ensure that all decisions and the agreed course of action are signed and dated. Section 10 gives guidelines in relation to assessment of risk.

5.5. A pre-birth assessment should be undertaken on all pre birth referrals and a multi agency meeting held to share information. If a pre-birth multi agency meeting is not needed this must be endorsed by a manager and the reason for the decision clearly recorded on the agency’s records.

Guidance For Referral To Pdac

6.1. In the case of pregnant women where there is evidence of problematic use of illicit, proprietary or prescribed drugs or alcohol, agencies becoming aware of the evidence should initially discuss the benefits of a referral to PDAC with the individual. If there is agreement referral should then be made to the appropriate area office of PDAC. This referral may be made initially by phone, but should be followed up immediately with a written referral. In the event that the woman is already a client of PDAC it would be appropriate to confirm that the pregnancy is known to them.

In the event of a woman refusing to agree to a referral being made it is the responsibility of the agency to consider whether a referral can be made without consent on Child Protection grounds. This would need to be subject of discussions between all the appropriate agencies – Children’s Services, Police, Health etc. PDAC will always be willing to discuss the appropriateness of referral prior to formal contact being made.

Guidance For Referral To Powys Children’s Services

A referral for an initial assessment to Children’s services must always be made if a parent carer or pregnant woman is considered to have significant substance/ alcohol problems. A referral should be discussed with a line manager.

NB If a child is in immediate danger then a referral to the police/social services should be made.

Partnership Working

Assessment and identification of parents, carers and children’s needs for services is not a static process. The assessment should also inform future work and build in an evaluation of the progress and effectiveness of any intervention.

Where more than one agency continues to be involved in a joint assessment or provision of services for parents or carers with substance misuse problems, and their children, regular review dates must be set to jointly review the situation and to ensure that interagency work continues to be co-ordinated. Each agency should document their own actions and responsibilities clearly and also the roles and responsibilities of other agencies.

References

All Wales Child Protection Procedures

Children Act 1989

Children Act 2004

DOH (2000). Framework for the Assessment of Children in Need and their Families.

Hidden Harm (ACMD) 2003

Appendix A
Guidelines For Professionals For Assessing Risk When Working With Drug Using Parents

The following assessment guidelines were developed by the Standing Conference on Drug Abuse (SCODA) [May 1997] to assist professionals in identifying children who may be in need or at risk as a result of parental substance/ alcohol misuse. They should be used as guidelines in the holistic assessment of the family.

Parental Drug Use

1. Is there a drug free parent, supportive partner or relative?

2. Is the drug use by the parent Experimental? Recreational? Chaotic? Dependent?

3. Does the user move between categories at different times? Does the drug use also involve alcohol?

4. Are levels of childcare different when a parent is using drugs and when not using?

5. Is there any evidence of coexistence of mental health problems alongside the drug use? If there is, do the drugs cause these problems, or have these problems led to the drug use?

Accommodation And The Home Environment

6. Is the accommodation adequate for children?

7. Are the parents ensuring that the rent and bills are paid?

8. Does the family remain in one area or move frequently, if the latter, why?

9. Are other drug users sharing the accommodation? If they are, are relationships with them harmonious, or is there conflict?

10. Is the family living in a drug using community?

11. If parents are using drugs, do children witness the taking of the drugs, or other substances?

12. Could other aspects of the drug use constitute a risk to children (e.g. conflict with or between dealers, exposure to criminal activities related to drug use)?

13. Is there adequate food, clothing and warmth for the children?

14. Are the children attending school regularly?

15. Are children engaged in age-appropriate activities?

16. Are the child’s emotional needs being adequately met?

17. Are there any indications that any of the children are taking on a parenting role within the family (e.g. caring for other children, excessive household responsibilities etc)?

Procurement Of Drugs

18. Are the children left alone while their parents are procuring drugs?

19. Because of their parent’s drug use are the children being taken to places where they could be “at risk”?

20. How much are the drugs costing?

21. How is the money obtained?

22. Is this causing financial problems?

23. Are the premises being used to sell drugs?

24. Are parents allowing their premises to be used by other drug users?

Provision Of Basic Needs
Health Risks

25. If drugs and/or injecting equipment are kept on the premises, are they kept securely?

26. Are the children aware of where the drugs are kept?

27. If parents are intravenous drug users:

Do they share injecting equipment?

Do they use a needle exchange scheme?

How do they dispose of syringes?

Are parents aware of the health risks of injecting or using drugs?

28. If parents are on a substitute prescribing programme, such as methadone:

Are parents aware of the dangers of children accessing this medication?

Do they take adequate precautions to ensure this does not happen?

29. Are parents aware of, and in touch with, local specialist agencies who can advise on such issues such as needle exchanges, substitute prescribing programmes, detox and rehabilitation facilities? If they are in touch with agencies, how regular is the contact?

Family Social Network And Support Systems

30. Do parents and children associate primarily with:

Other drug users?

Non-users?

Both?

31. Are relatives aware of the drug use? Are they supportive?

32. Will parents accept help from the relatives and other agencies?

Parents’ Perception Of The Situation

33. The degree of social isolation should be considered particularly for those parents living in remote areas where resources may not be available and they may experience social stigmatisation.

Do the parents see their drug use as harmful to themselves or to their children?

Do the parents place their own needs before the needs of their children?

Are the parents aware of the legislative and procedural context applying to their circumstances, (e.g. child protection procedures, statutory powers?

Children with Learning Disabilities.

Introduction:
A learning disability is a neurological disorder that affects the brain’s ability to process and respond to information. The term ‘learning disability’ describes the unexplained difficulty of person in acquiring basic academic skills of learning, although the person may be of average or above average intelligence. A person with learning disabilities may not have any major sensory problems like blindness or hearing impairment and yet struggle to keep up with people of their age in functions of learning and regular daily activities. However LD is not a single disorder but a group of disorders and as several social and legislative implications. In this essay we discuss the social implications of having learning disability and the policy frameworks that are in place to counter any anti-discriminatory practice against individuals with this condition.

Learning Disability – Issues, Causes and Approaches
When a person suffers from learning disabilities, there may be a distinct difference between the levels of achievement and the expectations of achievement and several difficulties in dealing with daily activities are manifested in different ways in different people. Difficulties in learning and achievement may be manifested through various phases of development and individuals also show difficulties in social and emotional skills and general behaviour. Learning disabilities in a person can affect a person’s basic skills of listening, comprehension, writing, reading, speaking, reasoning or calculating (Brown, 2003; Geary 2005). Since learning disability is not a disease but possibly a genetically inherited or environmentally caused group of disorders and there are no cures for the conditions though it can controlled using identification, accommodation and modification. Identification is the recognition of the condition in the individuals so that adequate support from parents, teachers, doctors and others in contact can be provided. Seeking help from school or a learning specialist may also be recommended for complicated cases. Depending on the type of learning disability, severity and the person’s age, different kinds of assistance can be provided. They also have right to assistance in the classroom and at school and workplace with special employment and educational benefits (Thompson, 1998).

From a legislative perspective, under the Individuals with Disabilities Education Act (IDEA) of 1997 and Americans with Disabilities Act (ADA) of 1990, people of all ages with learning disabilities are entitled to assistance and should be protected from all discrimination. This is also stated in the DDA or Disability Discrimination Act 2005 (UK) which forbids any discrimination based on disability. Thus the process of anti-discriminatory practice with regard to disability in universally accepted and has been a concern worldwide for social scientists, doctors and social workers alike (also see Thompson, 2001).

The causes of learning disabilities may be various and range from hereditary causes that are genetic. This is seen when learning difficulties run in the family and are found in many family members and sometimes people with learning difficulties may have parents or other relatives in the family with similar difficulties. The use of drugs and alcohol during pregnancy and complications such as low birth weight, lack of oxygen and premature or prolonged labour can cause brain damage and learning difficulties. Incidents after birth such as head injuries, nutritional deprivation, or exposure to toxic substances just after birth can cause or contribute to learning disabilities (Brown, 2003; Smith 2005). Instruction and support are planned for such individuals and this involves help from specialists as well as family members and carers.

The Department of Health in the UK suggests that there are around 160,000 adults with severe and profound learning disabilities most of whom are living initially in their family homes and later on in appropriate residential accommodation. Research also suggests that between 0.45% and 0.6% of children will have a moderate to severe learning disability. This suggests that there are between 55,000 and 75,000 children with a moderate to severe learning disability, the majority of whom live at home with one or two parents within England (DoH, 2002). The research studies indicate that LD is not caused by economic disadvantage but harmful exposures to tobacco, alcohol or toxic substances at the early stages of development can be prevalent in low income communities and trigger learning difficulties in developing children.

LD can be tackled or controlled and does not necessarily stop a person from achieving goals set. If the condition is properly identified, help and support are also available for special educational or professional needs. However learning difficulties do not affect all individuals in similar way and different people might be affected differently with the condition ranging from mild to severe (Gates et al, 1997). People may even have more than one type of learning difficulty and one third of people with LD also show some sort of attention deficit hyperactivity disorder (AD/HD), and such associated conditions makes it difficult for these people to concentrate on any subject matter or to stay focused and manage attention in specific tasks leading to inability to learn, remember or pay attention.

Learning disabilities in Children is a special area of study as children with learning difficulties should be identified early at school to provide them with special provisions and aids. Thus early identification helps in recognising needs of such children to help them academically, socially and psychologically (Brown, 2003). If children display signs of learning disabilities or attention deficits and inability to learn or concentrate, it is advisable to contact school authorities who can provide for special needs of such children (Cambridge et al, 2005). Thus the way a child develops learning skills, language skills, motor coordination and social skills and behaviour should all be observed carefully as any symptoms of an LD should be detected early to avoid problems in the child’s life and adequate support should be provided (Gates et al, 1997). Yet not all children who are slow learners develop learning disabilities and may develop certain skills gradually. If children do show learning disabilities symptoms, early intervention with specialised teachings strategies can help overcome difficulties for the children .Thus parents, and relatives or physicians of such children should help the children to understand that if they are struggling with their problems, help is not far away. Children with LD are subject to special legislative and social protection that emphasizes the necessity for provisions of special educational help and assistance at schools and social situations.

Studies on LD – Theories and Policies
From a more theoretical perspective Geary (2005) has discussed the role of cognitive theory in explaining learning disability in children. Basic research in mathematical disabilities is still in its nascent phase but the problem can be identified and the concepts used for remediation. Geary emphasizes the need for close links between theoretical and empirical research to understand the development of children’s numerical, arithmetical, and mathematical competencies and general research on learning disabilities in mathematics. Thus empirical research can help in transforming experimental procedures to judge such problems into assessment measures and understand the roots of the problems through cognitive theory using the appraisals of cognitive strengths and weaknesses of children with different forms of learning disability and developing remedial approaches based on the patterns of these strengths and weaknesses for individual children.

In another study Eisenmajer et al (2005) specify the characteristics of learning disabilities separating specific reading disabilities (SRD) and specific language impairments (SLI) and argue that many children who were tested for either SRD or SLI tend to demonstrate impairments both in reading and oral language development. The authors point out that there is a need to compare profiles of children with both oral language and reading impairments to groups of children showing SRD and SLI. To this effect, in a study conducted by Eisenmajer et al, reading, oral language, phonological processing, spelling, short-term auditory memory, and maths abilities of 151 children from 7-12 years were assessed in a Learning Disabilities Clinic. Within the groups, children who demonstrated either a specific reading disability or a specific language impairment and children who showed evidence of both reading and oral language impairments were compared and identified.

The results showed differences between the groups on maths, phonological processing, short-term auditory memory, and spelling measures, with the children who had both language and reading deficits performing at a lower level in these areas than the children with specific either reading or language deficits. The study concluded that children with both the disabilities are more likely to show difficulties in a wide range of learning activities than children who show either language impairment or a reading disability. Thus careful screening has been recommended in clinical and research settings that can accurately identify the nature of deficits in children with reading and oral language difficulties. A third category of children with mixed patterns of readings and language difficulties are identified.

One of the major areas of study is accessibility to health services and special educational services for disabled children. Wharton et al (2005) identified and studied mixed concerns about the accessibility of the general National Health Service (NHS) services for children with disabilities after recording conversations of members of a parent-run support organization. Representatives from a parent run support organisation prepared a questionnaire, aimed at examining the main issues related to general health services for children with disabilities and the questionnaires were administered as part of a semi-structured interview with 25 parents of children with disabilities (mainly showing learning disabilities). The 8 themes on which the questionnaire was based were ‘preparation’, ‘flexibility’, ‘parking’, ‘physical space’, ‘waiting areas and consultation rooms’, ‘health professionals’ understanding and knowledge of disabilities, particularly around communication’, ‘on the wards’ and ‘overseeing care’ and such areas of services provided by the NHS. The themes were then presented with the parents’ comments and suggestions and a general improvement of services for children with disabilities provided by the NHS has been recommended.

Considering governmental support for such individuals, a report by Foundation of People with Learning Disabilities, argues ‘because of the lack of employment opportunities, most people with learning disabilities in the UK are still considered “economically inactive”….they rely on benefits, such as Income Support (IS) and Disability Living Allowance (DLA), as well as other non-disability specific benefits like educational or special needs support’. (FPLD, 2005).

There has been a call for policy changes and need for the Government to consider a radical reform, including abandoning ‘incapacity’ as an organising principle and benefit seeking criterion and replacing it with compensation for ‘disadvantage in the labour market’ (FPLD, 2005). This approach can help remove inherent contradiction between move or looking to work and receiving protection offered by the special benefit status as many fear that any form of job can actually threaten benefit status. This sort of approach is also important from an anti-discriminatory perspective and the recently passed Disability Discrimination Act, 2005 strengthens existing regulations and adds new protection for the disabled.

The 2005 Act widens the definition of disability, extends protection offered to a larger group of people with mental health difficulties, places new duties on all public bodies, including schools, requiring them to promote positive attitudes towards disabled people and encourage their participation in public life; strengthens tenants’ rights to make reasonable, disability related alterations to their homes; improves disabled people’s access to trains and buses, including an end-date for modifications of 2020; and extends provision to private clubs of 25 or more members, including political parties (DDA, 2005). This Act is thus a step forward in anti-discriminatory practice and aims at inclusion of disabled individuals within mainstream society.

The Department of Health Learning Disability Task Force has emphasised on ‘Rights, independence, choice and inclusion’ for disabled individuals (DoH, 2005). Thus inclusion or active social participation is at the core of governmental and social policies to help children with learning disabilities lead a healthy independent life with considerable respect and attention from friends, family and society at large.

Conclusion:

In this essay we discussed the aetiology and signs of learning disability suggesting why an early diagnosis is important in providing equal rights and opportunities to a disabled individual. The social policies, frameworks and governmental initiatives as well as social work perspectives to counter any discrimination against such individuals have been discussed considering reports, legislative documents and research studies. We have highlighted the need for more inclusive policies, support in schools and identification and accommodation of children with learning disabilities to counter any discriminatory measures against such individuals.

Bibliography

Dalrymple J. and Burke B (1995)

Anti Oppressive Practice – Social Care and the Law

Buckingham Open University Press

N. Thompson (2001)

Anti-Discriminatory practice

3rd Ed. London,

Palgrave

N. Thompson (1998)

Promoting Equality

London Macmillan Press Limited.

Learning disability : a handbook for integrated care / edited by Michael Brown.
Salisbury : APS, 2003.

Dimensions of learning disability / edited by Bob Gates and Colin Beacock.
Publisher/year
London : Baillie?re Tindall, 1997.

Cambridge, Paul; Forrester-Jones, Rachel; Carpenter, John; Tate, Alison; Knapp, Martin; Beecham, Jennifer; Hallam, Angela
The State of Care Management in Learning Disability and Mental Health Services 12 Years into Community Care
British Journal of Social Work, Volume 35, Number 7, 1 October 2005, pp. 1039-1062(24)
Oxford University Press

Eisenmajer, Natasha; Ross, Nola; Pratt, Chris
Specificity and characteristics of learning disabilities
Journal of Child Psychology and Psychiatry and Allied Disciplines, Volume 46, Number 10, October 2005, pp. 1108-1115(8)
Blackwell Publishing

Geary, David C.
Role of Cognitive Theory in the Study of Learning Disability in Mathematics
Journal of Learning Disabilities, Volume 38, Number 4, July/August 2005, pp. 305-305(1)
Pro-Ed

Smith, L. A.; Williams, J. M.
Developmental differences in understanding the causes, controllability and chronicity of disabilities
Child: Care, Health and Development, Volume 31, Number 4, July 2005, pp. 479-488(10)
Blackwell Publishing

Wharton, Sarah; Hames, Annette; Milner, Helen
The accessibility of general NHS services for children with disabilities
Child: Care, Health and Development, Volume 31, Number 3, May 2005, pp. 275-282(8)
Blackwell Publishing

Also see
www.dh.gov.uk – Learning Disabilities publications, 2002.
Leaning Disabilities Taskforce, 2005.

FPLD, 2005 –
Foundation of people with learning disabilities
www.learningdisabilities.org.uk

DDA – Disability Discrimination Act, 2005 from
www.disability.gov.uk/

With an apparent increase in the number of children born to parents experiencing mental illness many issues have been raised concerning parenting capacity and the welfare and development of these children. This has many implications for social work practice in both Children’s Teams and Community Mental Health Teams and also for future policy development and service provision. Within this dissertation it is my intention to explore that the mentally ill are indeed capable of parenting their children safely and effectively and attempt to disprove the suggestion that mentally ill parents are unsafe and incapable.

Adults with mental health problems are one of the most excluded groups in society, however many are also parents and may need support to care for their children safely (Garley et al 1997). This means that service provision must encompass the needs of both parents and their children and assessments must take into account the needs of both these vulnerable groups. The human cost for parents with mental ill health is in attempting to parent their children in the face of stigma and adversities. Social Workers do not only need to support these parents but they also need to challenge the stigmas and adversities perpetuated by society. Society has perceptions of people with mental illness and this is largely negative, with the greatest misunderstandings being the perceptions of the more severe mental health conditions. Severe mental health conditions such as schizophrenia although not as prevalent as the depressive disorders are thought to affect one in two hundred adults each year (Mental Health and Social Exclusion Report 2004) and these conditions have a wider impact on the lives of the family, friends and community.

It is widely recognised that one in four people of working age experience mental ill health at some point in their life, (Office for National Statistics 2008) but these problems can present in a variety of ways, depending upon the individual and their circumstances. What perhaps is most important to consider is how the person presents in relation to what is ‘normal’ for them. Any great changes in mood or behaviour can be important indicators of deterioration in mental health, but it is clear that it would be dangerous to view this in isolation. It is therefore important to recognise that we all may experience various degrees of mental difficulty at some point in our lifetime.

People with good mental health can; develop emotionally, creatively, intellectually and spiritually. They are able to initiate, develop and sustain mutually satisfying personal relationships; they can face problems, resolve and learn from them. They can be confident and assertive, are aware of others and have an ability to empathise; they can use and enjoy fun as well as laugh at themselves and the world. Good mental health is not something we have, but something that we do to take care of ourselves and value who we are as people (www.pmhcwn.org). However people experiencing mental illness do not always possess these attributes therefore need support to achieve wellness.

To make the distinction between people who have children and then develop a mental illness or those who have a diagnosed condition before they have children the focus will be on the experiences of those people with mental illness who become parents and so have already been living with their condition or diagnosis.

The aim of my dissertation will be to explore these issues by critically examining current research, practice, service provision and policy. This will be in the form of a literature based review where I want to question whether people with mental health issues can indeed parent their children safely. Firstly the Methodology used to assimilate the research will be examined with an explanation of the methods selected. Chapter One will define mental health, then focus on the historical context, policy and legislation and on the theories and approaches to ways of working considering the challenges that the social workforce face in supporting service users with mental health needs. Chapter Two will explore the experience of those parents with mental health problems; consider the capacity of people with mental health problems and the experiences of children of the mentally ill. This will be considered, from both a child’s and a parent’s perspective. Chapter Three will focus on the main themes to emerge from my research which are stigma, risk, resilience and attachment. The Results and Findings will be explored which will discuss the findings and present an overview of common themes which have emerged. The Conclusion will then draw together all the information gathered.

Methodology

When approaching this dissertation the decision was made to conduct a literature review of the research currently available. This was because mental health is an area of interest and combined with a placement in a children’s team, where it became obvious that many parents experience mental health issues it was an opportunity to combine the two areas. Previously the author has worked in a statutory provision which was a service supporting children and young people experiencing mental health issues and also had a placement in a community mental health team. All of these experiences have made the author inquisitive to the difficulties that parent’s encounter when attempting to take care of their children and the views of services of their abilities to do so.

The search strategy used to locate appropriate material was to consider the various terms used when thinking about parental mental illness. Therefore a decision was made to search for the following terms; ‘parental mental illness’, ‘children living with the mental illness of parents’ and ‘capacity of parents with mental illness’. When further considering what needed to be learnt, the terms; ‘risk of children with mentally ill parents’ and ‘resilience of children with mentally ill parents’ were then explored as were ‘attachment of mentally ill parents’ and ‘stigma and mental health’. The concentration was on English speaking countries and so research was drawn together from Great Britain, Ireland, The United States of America and Australia. This was felt to be the most pertinent approach, as to broaden the search to further countries could create too much information and a difficulty in assimilating the research. Various databases were searched which included; Science Direct, Jstor and SwetsWise. The British Journal of Psychology, The British Journal of Social Work and Social Care Institute for Excellence proved to be invaluable as did the various mental health websites such as MIND. Government reports and Department of Health documentation added a further breadth to the research which was drawn together. This search produced a significant number of journal articles in the area which were appropriate for the purpose, and coupled with mental health websites and books on parenting capacity a rich variety of material was gathered. The information further obtained from legislation and policy documentation was also invaluable.

If there had been the time to explore this area in further detail it would have been suitable to have conducted a focus group amongst service users within the mental ill health community. From the research available it is clear that this research method was considered to be the most rewarding as service users felt the least threatened by the process (Garley et al 1997). It also garnered the most honesty from the participants and clarity of their experiences. They had felt safe in the knowledge that their recounting of their experiences would not be judged and their parenting abilities would be afforded due respect.

Another option could possibly have been to send out questionnaires to ascertain the level of support service user’s felt they were receiving from community mental health teams and children’s services. However this method may not have produced such a wealth of results as it would not have been a face to face intervention. When viewing research, non face to face approaches have sometimes not been as well responded to by prospective participants.

Chapter One

This chapter will focus on how mental illness is defined; look at the historical context of mental illness service provision, the legislation and policy documentation and approaches and theories to ways of working.

Defining Mental Illness

Mental illness can affect one in four adults of working age at some point in their life, according to the World Health Foundation (2001). This demonstrates how prevalent mental illness is within our communities and how anyone can be affected by it at some point in their lifetime. However mental illness is defined by society in a variety of ways; there is the legal definition, clinical definitions and popular public misconceptions. This section’s aim is to identify the three definitions of mental illness when considering the legal, clinical and public meanings.

Mental disorder is defined in a legal context as “arrested or incomplete development of mind, psychopathic disorder or any other disorder or disability of the mind” (www.yourrights.org.uk). There are various definitions of mental health and amongst these the Mental Health Act 1983 offers three different definitions for mental disorder: severe mental impairment, which is defined as “a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned” (Mental Health Act 1983, Part 1). Mental impairment, which is defined as “a state of arrested or incomplete development of mind (not amounting to a severe mental impairment) which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned” ( MHA 1983, Part 1). Then psychopathic disorder which is defined as “a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned” ( MHA 1983, Part 1). However the 2007 Mental Health Act amendments changes the way the 1983 act defines mental disorder, so that a single definition applies throughout and abolishes references to categories of disorder( MHA 2007)

The clinical definition comes from ICD-10, which is the International Classification of Diseases which was approved by the forty-third World Health Assembly in May 1990 and came into use in World Health Organisation member countries as from 1994. It is the international model for diagnostic categorisation of all general epidemiological conditions and health management. Within the ICD-10 there is classification of mental illness and mental disorders and this is used by clinicians to diagnose and therefore treat those people with mental illness. The foremost definition used is that ” any of various psychiatric conditions, usually characterised by impairment of an individual’s normal cognitive, emotional, or behavioural functioning, and caused by physiological or psychosocial factors” (ICD-10 Chapter V).

When considering the public perceptions of mental illness, what is clear are the many negative perceptions of mental illnesses and disorders. The stigma that goes along with being labelled as having a mental illness can have far reaching consequences and needs to be challenged as a social injustice for this group (Cleaver et al 1999). Stigma is largely a social construct, in that society reacts negatively as a result of being fed sensationalist stories by the media. The Mental Health Knowledge Centre at the Institute of Psychiatry within the Maudsley Clinic London aims to promote change in public perception by addressing attitudes towards mental health conditions. The aim is that this will be achieved through ongoing public engagement activities and providing information for friends, families and carers of those with mental illness. Also initiatives such as World Mental Health Day endeavour to change public perceptions by bringing the conditions into the public arena.

People experiencing mental disorders are often excluded from some societal norms due to a lack of knowledge or fear on behalf of the community as the Mental Health and Social Exclusion Report of 2004 puts this “Mental health problems can be both a cause and a consequence of social exclusion” (Mental Health and Social Exclusion Report 2004 p11). What is known is that mental health problems can affect anyone at any point in their life. However the debates around the differing definitions of mental health are important to discuss in relation to exploring the issues for people with mental health problems who are also parents. Stereotypical views of people with mental illness are that they are violent, unstable, and irrational and therefore their abilities to parent are questionable. These perceptions have been perpetuated by an ignorant society and need to be challenged.

The Office for National Statistics has collected data to illustrate the prevalence of common mental health problems in the general population (see fig 1).

Figure 1: Office for National Statistics (2000) Psychiatric Morbidity Survey.

According to the Office for National Statistics the average age of early onset psychosis is twenty-two, but up to half of mental health problems start in childhood. For men, the age at which common mental health problems peak is forty-five to forty-nine years and for women fifty-fifty-four years. When looking at the statistics in terms of gender prevalence, women experience higher rates of problems than men and their experiences tend to last longer with greater occurrences of relapse. However what is known is that young men aged twenty-five to thirty-four are the highest risk group for suicide (Office for National Statistics 2000).

Mental health illness is referred to in a variety of ways in the literature and research; therefore for the purposes of this paper, mental illness, mental ill health and mental health problems will be used interchangeably with the main emphasis being placed on the conditions of schizophrenia and psychosis rather than the depressive conditions.

Schizophrenia is a diagnosis given to some people who are experiencing severely disrupted beliefs and experiences. During an episode, a person’s experience and interpretation of the outside world is disrupted. They may experience hallucinations, lose touch with reality or see or hear things that are not there and act in unusual ways. An episode of schizophrenia can last for several weeks and can be very frightening (www.rethink.org). An episode of psychosis can be experienced in much the same way.

However to appreciate contemporary understanding of mental illness, the historical context needs to be explained and how parents have been viewed by society.

Historical Context

Historically those individuals who experience mental illness may be treated for their condition by their local General Practitioner in the local community, however those individuals who require more intensive interventions may fall under the support of The Mental Health Act 1983. Following years of the institutionalisation of individuals with mental health disorders came the Mental Health Act 1983, which made provision for these people to be supported in the community. This important legislation made provision for the safety and well being of those people experiencing mental distress. For the first time, mental illness was recognised as a condition that could be managed in the community and newly formed community mental health teams would be the people to assist. The Mental Health Act 1983 made provision for individuals needing treatment to be detained under section, which meant that they could be legally detained to ensure that appropriate treatment was administered either in the form of therapeutic intervention and or medication. This act was further amended in 2007, where one of the main amendments was to make provision for Community Treatment Order (CTO). This declared that a patient could be re-called for treatment in hospital if they had been discharged into the community and were not complying with the restrictions of their order.

Policies imposed by local authorities must work within the guidelines of both The Mental Health Acts 1983 and 2007 and The Children Act 1989 in conjunction with the Care Programme Approach 2008. These government laws state how the care and treatment of people with mental health and the care and protection of children should be managed. A comprehensive care plan should address all the issues around the person and allow for their ability to parent by assessing their parenting capacity.

Every Child Matters (2002) was one such provision developed to support children,” the main duties being to cooperate and improve well-being, and to safeguard and promote the welfare of all children in England” (www.everychildmatters.gov.uk ). Every Child Matters was developed following Lord Laming’s report of 2002 which was implemented following Victoria Climbie’s death in 2000. He highlighted within his report that a lack of integrative working across the different services and agencies had contributed to Victoria’s death. Every Child Matters legislates for improving information sharing between agencies to ensure the safety of children known to local authorities and this would be done by reducing the technical difficulties with the different interfaces used by the diverse services (ECM 2002). A huge challenge to overcome with much work still needed in this area as health, education and social services remain largely fragmented (ECM 2002). To attempt to overcome this, a common assessment framework was devised across services to ensure the information followed each child and reducing the necessity for duplication of information. These tools were then used to ensure that if a parent came to the attention of mental health services then the worker would be able to instantly determine if their children were also known to children’s services.

Legislation and Policy Documentation

The National Service Framework for Mental Health, from the Department of Health (1999) document states that local authorities have a duty to provide effective services for people with mental illnesses. Its aim is for individuals, who may or may not be parents, with a severe mental illness to be able to access and receive the range of mental health services that they need and consequently crises will be anticipated and averted. Therefore even if a parent is considered to pose a threat to their child they should be maintained with parenting support in advance. The recommendation being that there will be the integration of health and social care services with a strong emphasis on Interprofessional collaboration and this joined up working will promote the active participation of service users.

The Mental Health and Social Exclusion Report of 2004 activated by the Office of the Deputy Prime Minister detailed in action sixteen “better support for parents and their children” (Mental Health and Exclusion Report 2004 p105). This challenge was taken up by the Action Sixteen Group who would review its implementation. This body comprised of ;the Social Care Institute for Excellence, Barnardos, the Department of Health, National Children and Adolescent Mental Health Services Support Service, Family Action and the Mental Health Commission. This membership of the Action Sixteen Group brought together professionals who were dedicated to improving outcomes for parents affected by mental illness and their children. The key messages to emerge from their discussions were that the mental health services should ‘think family’ (www.scie.org.uk). This would be achieved by improved awareness, sharing of information across services and the development of resources for positive practice.

Action Sixteen worked together to review the existing provisions for parents with mental health needs, including the needs of mentally unwell parents who were also belonging to an ethnic minority group and or were also disabled parents. It determined that parents need to be enabled to lead fulfilling lives in the way that they chose. That sigma and discrimination must be challenged and the rights of parents must be promoted, social exclusion must be confronted through implementing evidence-based practice and getting the basics in order must be a priority (Fowler et al 2009). This means enabling mentally ill parents to have access to decent housing, advice on finance and benefits, training and employment. (Fowler et al 2009). All of this needs to be approached from an informed viewpoint and the most appropriate theories and ways of working considered.

Ways of Working

The challenges for the social work profession to assist mental health service users are immense, diverse and complex. When approaching work with any vulnerable service user group it is important for social workers to maintain their social work values and recommend a holistic approach to their interventions with families (GSCC codes of Practice 2002). This would mean balancing practical and emotional support, offering appropriate counselling and working in a therapeutic way to best support parents with mental health needs (Darlington et al 2005). As previously discussed parents with mental health issues may experience social exclusion or isolation and it is a challenge for social workers to support these individuals to maintain a more integrative life. They also need to be aware of the power relationship between those who provide and those who access mental health services and the disempowering consequences of being labelled a mental health service user (Williams and Keating 2000). Research studies have shown that it is a considerable challenge for people with mental illnesses to sustain and maintain social contacts and relationships (Huxley and Thornicroft 2003). Further research into this area as to how parents with mental illnesses can be encouraged to lead a more integrative life is needed.

The requirements for the social work workforce within the mental health sector are clear guidelines for working in an integrated team, with strong leadership and comprehensible policies to enable improved multi agency working. This is further challenged by maintaining and preserving the separate skill bases of each profession within a community mental health team. Community psychiatric nurses (CPN) have trained to specifically achieve a qualification, as indeed have their social work colleagues and the’ blurring’ of roles may create disquiet amongst individuals. With the new Approved Mental Health Professional (AMHP) role being made available to professionals from other disciplines this may create further challenges within multi-disciplinary working.

Only those professionals trained to become a health professional have the ability to administer medication and a large part of their role in working with the mentally ill is to ensure medication compliance. However medication is best supported if it works in conjunction with therapies (www.rethink.org) and the most recognised therapy to assist with mentally unwell individuals is Cognitive Behavioural Therapy (CBT). Cognitive Behavioural Therapy was developed by Aaron Beck (1921- ) in the 1960’s as a psychological approach to assist people in changing how they thought and felt (Beck 1975). This approach is widely recognised today as the foremost ‘talking therapy’ when working with the mentally ill.

Any professional will need to approach working with a mentally ill service user from an informed position. The experiences of the vast majority of people with mental health problems are that they are labelled. Labelling theory was first applied to the term “mentally ill” in 1966 when Thomas Scheff’s book- Being Mentally Ill was published. Scheff’s claim was that mental illness perceptions needed to be challenged as mental illness was a social construction. He purports that no one is deviant and no action is deviant unless society deemed it to be so and that symptoms of mental illness are regarded as violations of societal norms (Scheff 1966), so to challenge society’s view of their perception of mental illness is one way to assist those with mental illness and the stigma they experience as a result of labelling.

When considering a parent with mental illness and the approaches to working with these individuals a holistic approach would appear to be the most pertinent to consider appropriate. This means taking into account the persons physical and spiritual health as well as their mental health needs (Hunt 2009). The Care Programme Approach is now recognised as the best way to do this. The Care Programme Approach 2008 or CPA as it is referred to within services is a way of developing a plan of work individualised to each person’s needs. The Care Programme Approach has four main elements as defined in “Building Bridges: A guide to arrangements for inter-agency working for the care and protection of severely mentally ill people” (DoH 1995 p1). It works by assessing a person’s needs and then developing a plan in response to those needs; the plan is then implemented and reviewed regularly to ensure that it is continuing to meet the individual’s needs (www.dh.gov.uk).

The latest development in policy implementation is New Horizons; a government program of action which has been launched to improve the mental well-being of people in England and drive up the quality of mental health care. New Horizons is a comprehensive initiative that will be delivered by local government, the voluntary sector and professionals with an aim of creating a society that values mental health. This will be achieved by ensuring the foundations of good mental health begin in childhood and continue through the lifespan, emphasising the importance of prevention as well as treatment and recovery (New Horizons 2009). All professionals will be encouraged to identify children whose parents may be experiencing difficulties and signpost them to appropriate services.

The next chapter will consider how policy and legislation works in supporting parents with mental ill health by considering their experiences, how their capacity is measured and how their children view both their parent’s illness and treatment.

Chapter Two

This chapter will focus on the experiences of parents with mental health problems, their ability to parent, their parenting capacity and the experiences of children of the mentally ill. The numbers of parents who experience mental health issues is not clear but it is estimated that in excess of thirty per cent of the population may be affected.

Experience of Parents with Mental Health Problems

When considering the research available, what is clear is that the focus has been mainly on the female experience as women were found to be the main caregivers, Nicholson et al (1998). In a study, using focus groups with mothers, to explore the problems they faced as a result of their mental illnesses Nicholson et al concluded that the experiences these mothers recounted detailed ” their concerns, their struggles and their successes” (Nicholson et al 1998 p 638). They discussed the anxiety of stigma and the worry of having their children removed by social services as well as the everyday struggles of looking after children (Nicholson et al 1998).

In a study, to explore the experiences of new mothers Mowbray et al (1995) found that motherhood was a role of great significance for many women with mental health problems. The mothers in their study articulated just how important the experience of being a mother was to them, the joy that it brought for them and the growth in personal development it produced (Mowbray et al 1995). What is known is that parenting is viewed by society as being highly valued and although this is a common thread to all societies and cultures, most perceptions are that parents with mental illness are viewed negatively, (Mowbray et al 1995). Furthermore as parents with mental health problems are de-valued by society and their parenting capacities and abilities are questioned they fear that their children will be removed from their care therefore they avoid contact with social services even if they are aware they need support. This all adds to the stress that parents experience in coping with their mental illness and the demands of parenting. Nicholson et al (1998) found that parents felt unable to ask for the support they may need due to the fear that social services would remove their children from their care. This was a great fear for the mothers in this study but further studies have also corroborated this, for example Cleaver et al (1998) reviewed data from research and discovered that forty- two per cent of children who were initially referred to child protection services following an assessment of their parent(s) mental health became subject to care proceedings. This indicates an equal fear on behalf of the professionals involved with parents with mental ill health, the need to protect balanced against the needs of the parent to maintain normal family life. Parents have therefore identified that they will be viewed as flawed by society and perhaps incapable of fulfilling one of society’s most treasured roles and have their parenting abilities and capacity questioned (Ackerson 2003).

Parenting Capacity

Parents with mental illness may have difficulty in caring for their children because they feel a need to focus on their own needs or are unable to recognise their children’s needs and this can impact on their parenting capacity. Other influences can also impact such as relationship breakdown, poverty, unemployment and social exclusion.

There is a real difficulty in attempting to establish just how many parents have a diagnosis of schizophrenia or psychosis although it is estimated that as many as nine million adults may have a mental health need (www.family-action.org.uk ) Many of these illnesses go undetected with some parents refusing to acknowledge that they have a problem for fear of the consequences for their children (Beardslee et al 1983). For many parents the greatest fear being the removal of their children by social services. This is largely due to much of the current service provision being aimed at protecting children considered to be at risk from harm rather than supporting mentally ill parents to overcome the disabilities that hinder their parenting role. This could be better supported by intervention before a risk to the child becomes apparent (Kearney et al 2003). This is in direct conflict with the Children Act 1989, which recommends that wherever possible parents should be supported to care for their own children at home. This all creates a culture of fear for parents, as they cannot be honest about what they are experiencing as this may result in the removal of their children. However what is known is that there is a significant number of parents whose children are known to social services have a mental health problem (Crossing Bridges 1998).

Having a mental illness can impact on the parents’ ability to care for their children in a variety of ways such as; being unable to provide food, clothing, shelter and warmth or indeed be able to keep their children safe from harm (White et al 1995). However if a parent makes what is perceived to be an unwise or eccentric decision this does not necessarily mean that they are lacking in capacity (Mental Capacity Act 2005).

All parents are expected to provide; a safe physical and a secure emotional environment for their children, they are expected to demonstrate appropriate behaviour and provide opportunitie

According to Butler and Roberts (2004), there is a vast contrast in the shape and size of families in Britain today, with a significant increase in the number of people living alone; in same sex relationships; the number of divorces; single parent families; and Black and Ethnic Minority families (Boylan and Allan, 2008). This paper will seek to explain the impact that social work practice can have on marginalized families and moreover, Black and Minority Ethnic (BME) children and families.

Families who are in receipt of social work services may feel stigmatized by the visits of a social worker, far less than that of a health visitor and parents whose children have disabilities for example, may be offended by their inclusion on a register looked after by social services; and may also feel they are in receipt of ‘charity’ if such services are provided on a voluntary basis (Butler and Roberts, 2004). Aldgate and Statham (2001:73) found that parents value recognition of the circumstances surrounding their difficulties and the importance of respect for their different approaches to parenting and furthermore, that “parents respond well to being treated with dignity.” Butler and Roberts (2004:137) maintain that these values are “…what is needed to do the job, assuming that the job is one of helping families resolve their difficulties.” Banks (2006) emphasizes that every social worker needs to understand that personal and professional values can impact significantly upon children and families, with a need for an ongoing ability to scrutinise their own values (Banks, 2001).

It is unlikely that anyone would argue that parenting is not an occupation which is highly skilled and demanding; but considering the best practice to support families who are faced with difficulties is based around ‘partnership approaches’, which have the potential of developing particular relationships best suited to helping families solve their difficulties (Butler and Roberts, 2004). The strength of this method of social work lies at the heart of addressing the power imbalance between social worker and service user (Butler and Roberts, 2004) and as Coit (1978, in Butler and Roberts, 2004: 132) states: “partnership at a local level tends to mask structural inequalities and class antagonisms.” However, as Butler and Roberts point out, to achieve this requires a willingness of the social worker to think differently about their role with families, as they did in the past.

Social work practice before the introduction of the Children Act (1989) perceived families as needy and inadequate; it also adopted the concept of ‘dangerously dysfunctional’ families, which researchers in the 1980s became uncertain of the efficacy of that approach (Adams, Dominelli and Payne, 2009). The Children Act (1989) was by far a highly significant development in English law but contains “no magic cure for family problems,” as stated by (Allen, 2008: 1).

However, the 1989 Act’s legal framework, according to Adams, et al. (2009) set out clear expectations and principles that underpinned social work practice with children and families that included; the need for children to remain within their family network if possible, in the emergence of difficulties, families are to be supported in doing this; if intervention is to occur, evidence must be produced to support such action is preferable to no formal court order being made.

Allen (2008) explains that the object of the 1989 Act is to provide people who care for children the necessary legal tools to further the best interests of those children in their care. The harrowing death of Victoria Climbe and Lord Laming’s (2003) subsequent inquiry prompted the government to introduce the Children Act 2004 and the Every Child Matters (ECM) Green paper, which central features were early intervention and joined up working (Kirton, 2009). However, some writers have argued the effectiveness of (ECM) and described it as a lifeless vision of childhood based on a work ethic of academic achievement and social conformity (Williams, 2004 cited in Kirton, 2009).

Despite social work’s best intentions to meet the needs of children and families (Butler and Roberts, 2004), the Department of Health reported that it was continuing to fail comprehensively with BME families. In a study carried out by the Social Services Inspectorate of eight local authorities’ services to BME children and their families found that:

most councils did not have strategies in place to deliver appropriate services to ethnic minorities and that families were often offered services that were not appropriate or sensitive to their needs (Department of Health 2000: 1)

There are many generations of BME families in Britain who historically have lived with racism and the failure of social work to address the tendency to pathologize them based on “crude racial stereotypes” (Butler and Roberts, 2004: 71). According to the Bernardo’s website (2010), BME families are at a greater risk of experiencing poverty, higher rates of ill health, poor housing and racism. Dominelli (1997: 6) affirms that “racism is fundamental to the process of social exclusion and subordination among ethnic minorities… and flowing from this, their exploitation and oppression.” Dominelli (1997: 22) is clear in her close examination of racism and found that “no aspect of social work is free from it” stemming from White cultural domination in everyday routines. Butler and Roberts (2004) add that BME service users are treated the same as White service users and that a major failure of social work practitioners and planners is their adoption of a ‘colour blind’ approach. Furthermore, it may be the case that some people need to be treated differently in order to take account of experiences of racism and the value of cultural differences and strengths (Butler and Roberts, 2004).

Richards and Ince’s (2000) survey of 157 local authorities found some examples of good practice which offer a positive development to build on. Richards and Ince found that some local authorities’ anti-racist practice and culturally sensitive services were kept consistently up to date with further training and team meetings to stay on top of any issues, however, Butler and Roberts (2004) argue that this is rare and see social work as part of the problem and as the first step in making it part of the solution.

This paper set about to explain how social work practice might impact on children and families, with a closer focus on Black and Minority Ethnic families. It found evidence of a continued failure within social work to address the needs of BME families who are ethnically and culturally diverse through social work’s colour blind approach. Despite some rare examples of good practice, it could be that indeed social work itself is part of the problem faced by BME families.

How Effective is the Child Protection System in the United Kingdom with Specific Reference to Black African Children in Tackling Child Abuse?Introduction

Literature highlights some of the challenges for social workers assessing and making decisions about African children and families whose cultures differ from the majority of the white population in United Kingdom. The critical evaluation of knowledge and research in child protection and prevention of child abuse in black African children is important to the forming of social work policy, services and appropriate intervention. This is because there is need to provide appropriate intervention services which are culturally sensitive but at the same time preventing child abuse. It is important that black African children perspectives form part of policies and legislation. Several authors have critically analysed the evidence on service provision for black families in general. A pathologising approach to black families may lead to unnecessary coercive intervention and on the other hand a cultural relativist approach may lead to a non-intervention when services are required (Dominelli 1997, Chand 2000).

The purpose of the review is to explore if the child protection system is effective in preventing child abuse in black African children and their families. By child protection, the review will be referring to all the agencies and services involved in protecting and preventing child abuse. By relating to theory and research, there is hope to uncover gaps, themes and debates and also, raise questions which can be useful for future research. The literature review starts by setting the parameters that is, defining the terms that will be used, such as, child protection and child abuse. The literature review goes to set the historical and theoretical context because it is important to know how long literature and research has existed on the topic and what has been happening including research on culture differences, poverty, power issues and child protection. The review goes on to address the theoretical perspectives on the topic to analyse the theories that form the knowledge base in research. The review goes on to look at the major findings in research and literature by exploring the key themes such as factors that impact African children that can result them in being involved in the child protection system for example, child rearing practices, poverty and limited knowledge in cultural practices by social work professionals. Finally the review will look at the anti-discriminatory practice and user-involvement to show how professionals can work sensitively and provide culture appropriate services.

The literature search

Child protection system aims to prevent situations that can result in a child or young person aged sixteen and under experience abuse that puts them in danger of not developing appropriately or losing their life (Save the Children UK, 2008). The abuse can fall under the category of child abuse which could be in form of neglect, emotional, physicals and sexual, (Woolfson et al 2009). The search involved these terms. After establishing the specific area to be reviewed; the focus was on black African children and the child protection system. The area of child protection and black African children is a controversial area that has been neglected in literature and research and there is need to analyse themes and identify gaps in literature. The sources selected were journals, books, government records and articles. Electronic search engines were used because they provided a readily available wide range of literature and research articles which have been accepted for publishing. These sources were used as evidence and source of information because they had been accepted for publishing hence they would not provide with false information.

Review of the literature
Historical Context

In setting the historical context, the most important development in child protection is the formulation of the Children Act 1989 which was influenced by the public inquiries of the 1970s and 1980s child deaths, for example, the Maria Cowell. The Act stressed that the Local Authority’s duty is to safeguard and promote the welfare of children. However, research into how the Children Act was being put into action found that the child protection system was still focusing on single incidents of child abuse rather than planning to meet the wider requirements of children in need (DoH, 1995a). The studies also noted that many children and families received little or no support, the assessment of risk was low (Stevenson, 1998) and ignored the influences of poverty, unemployment and poor housing. This meant that a new way in thinking was needed about working with families. The result was publication of the Framework for Assessment of Children in Need and their Families (DoH et al, 2000) and Working Together to Safeguard Children (DoH et al, 1999).

A Common Assessment framework was also developed to promote more effective earlier identification of children’s additional needs and improve inter-agency working. A review into previous deaths of children indicates failures to listen to children, sharing of information, follow procedures and recognising indicators of abuse. The main response to the deaths of children due to local authorities’ failures has been to seek bureaucratic solutions such as introducing new guidelines, laws and procedures (Ferguson, 2005). However, the Laming 2003 enquiry into the tragic death of Victoria Climbie in 2000 is particularly significant because it pointed out the inter-agency approach established after Maria Cowell’s death in 1973 was not followed and it considered implications for the whole of the child protection system (Batty, 2003). Laming (2003) highlights the misjudgements made on the Climbie’s case based on cultural assumptions that led to a tragedy. However, Garret (2006) argues that the Laming report (2003) appears to detach a child’s race from core assessments and this was echoed in the Every Child Matters which appears to mention very little about the needs of children from other races. After the Victoria Climbie enquiry there has been recent death of children known to social services such as, baby P (2007) and Khyra Ishaq (2008). This begs the question, where is the child protection system going wrong? There are debates on how to provide social work interventions and family support that are culturally sensitive and competent to African children and their families who are at risk of significant harm (Stobart, 2006; Holland 2004, Robinson 2007; Mama 2004). This was highlighted in the Laming Progress Report (2009) which set out challenges faced in safeguarding children such as: “… there is still need to improve knowledge and skills to understand children and their family circumstances. Also the laming report noted that despite the progress in inter-agency working there are still problems of day to day reality of working across organisational boundaries and culture… ”, Laming Progress Report (2009). When reviewing literature it is important to note that there is a sparse of research on black African children and the child protection system in the Britain hence it is difficult to set out the historical and theoretical context. Where research and literature exists, the data is still not plausible because it is mixed with other research data from minority ethnic populations and their experience differs widely.

Theoretical and research perspectives that shape knowledge

Different theories and perspectives inform knowledge base in literatures surrounding African children and the child protection system. When researching this area there is need to look at experiences of African people and their involvement with child protection hence researchers can use the black perspective which is based on the notion of common experiences that black people share. The black perspective criticises repressive research and theories that are likely to oppress black people, (Robinson 2007). African families will always refer to their culture as frame of reference to their parenting capacities (Bernard and Gupta, 2008) and understanding and acknowledgement of the black frame of reference will enable social workers to come up with accurate and comprehensive assessments of African black children involved with the child protection system, (Robinson 2007). Other literature is based on the ecological perspective and highlights the importance to analyse the impacts of social exclusion, poverty and immigration on black African children and their families, (Gibbs and Huang 2003). However, Robinson 1998 argues that there is a danger of over-generalising and stereotyping because individual members from the same culture can behave differently from the pattern that is typical of that culture. However, other researchers argue that postmodern theories have gained popularity in social work, (Pease and Fook 1999; Leonard 1997). Researchers have argued against postmodern theories who want a better understanding of identity, combining personal with structural elements of living (Dominelli 2002; Graham 2002), drawing on the idea of what holds people together, (Badiou 2001). The lack of appropriate preventative support services which are culture sensitive often result in social work operating against the interests of black children involved in child protection, (Barn 1993, Graham 2002). Social work has operated within a problem oriented framework which is characterised by deficit and dysfunctional theories of black families (Robinson 2008).

Major finding in literature and research

Research agrees that black African children and their families are disproportionately represented in child protection (Graham, 2006; Barn et al 1997; Bernard and Gupta 2008). When looking at experiences of black African children and their families and how best to offer them appropriate intervention it is important to acknowledge background in terms of religion, culture, language and beliefs (Bernard and Gupta 2008; Gibbs and Huang 2003; Robinson 2007). Research shows that black African families may experience oppression and discrimination within the child protection system (Chand, 2008). A lot of literature appears to draw attention to the parenting in African families and how their culture is neglected in a lot researches and there is little empirical evidence especially about African parenting in Britain (Bernard, 2002; Graham 2006). Parenting by African families is entwined into an already debate of what constitutes child abuse (Francis, 1993; Chand 2000). Barn, 2002 argues that child abuse is a socially constructed phenomenon and most of literature surrounding child abuse is based on western society’s views and middle-class. This can lead to discrimination and stereotypes towards African families’ rearing practices and lead to unwanted intervention and social care involvement. There is well documented literature focused on how culture influence parenting of African families involved with child protection system, (Brophy et al 2003, Bernard, 2002; Graham 2006). However, the empirical research is limited but the little data that exists poses the notion that cultural practices appear to play some part in African children being involved in the child protection system, (Mama, 2004). Literature suggests that African families practice harsh punishment for children, however, Barn et al 2006; Thoburn et al 2005; Nobes and Smith 1997, challenge such stereotypes and in their study, they found no significant differences between ethnic groups with regard to physical punishment. However, these studies cannot be generalised to African families easily because the majority of the participants where white parents.

There is gap in research on the parenting by black African families and a recurrent theme in literature is the need to acknowledge cultural and social contexts of parenting and experience of African black families to make sense of child abuse and provide appropriate intervention for children and families involved in the child protection system, (Holland 2004, Robinson 2007, Stobart 2006). A focus on ethnicity or identity, preclude issues of power and oppression operating in the everyday experiences of children’s lives to be appreciated, (Graham, 2007). Research found that most black African families live in poverty and social exclusion and how this impacts on parenting, (Bernard and Gupta 2008; Gibbs and Huang 2003; Robinson 2007; Platt, 2007). A study of more than 7,000 children looked after by 13 Local Authorities found that children who were not of the white origin where more likely to be put into care due to poverty (Sinclair et al, 2007). Sinclair et al’s study is very important because it is a comprehensive qualitative study which focuses on the needs of children in care systems involving their perspectives and investigates the outcomes for children. The study also suggests how the care system should function and managed which is important to social work professionals and policy makers. However, data produced cannot be easily generalised to the entire population of African children because their experiences varies.

There has been research critically examining the treatment of asylum seeking children and the child protection system and there is argument between the Children Act 1989 and immigration legislation and policy and Jones (2001) argues that ‘social work profession singularly failed to provide critical scrutiny on the status and relationship of immigration and child care law and the erosion of children’s rights’. Other researchers agree with Jones, that vulnerability of asylum seeking children has emotional and legal aspects, (Woodcock, 2003; Chase, 2009). Kohli 2006, argues that legislation obstruct the provision of preventative services to vulnerable children and their families. Research has highlighted the fragility of African children who claim asylum such as having suffering trauma due to their circumstances that led them to claim asylum such as war and torture, (Hodes, 2000, 2002; Ehntholt and Yule, 2006; Dyregrov and Yule, 2006). Research shows that there is a gap in research on asylum seeking children and social work to inform practice, (Kohli and Mather 2003; Okitikpi andAymer 2003). Rustin 2005, states that there is a complicated interaction between social workers’ knowledge in asylum seeking children and the existing stereotypes regarding these groups of service-users, (Bernard and Gupta 2008; Robinson 2007; Barn 1993; Owen and Statham 2009).

Bernard and Gupta (2008) go on to cite other factors that affect African children such as asylum seeking, AIDS, loss and separation and this is important because when providing intervention to African children there is need to comprehend their background to offer appropriate services which do not discriminate them any further. Young (1990) states that black children often experience multiple-oppression for example, they suffer from stereotypes from society and also they are invisible to the child protection system. Graham (1999) goes on to argue that intervention with African families is at the centre of wider debates and conflict; and evidence from research continues to show over-representation of African children and their families in child protection. The debates seem to focus on power imbalances and how to involve African families to gain control over their lives, (Graham, 1999; Young, 1990). Other researchers highlight the issues of language in child protection and the provision of appropriate intervention services, (Chand 2000, Ahmed et al, 1982). The use of children as translators in sensitive child protection issues is unethical and inappropriate, and also the use of an interpreter can distort the assessment process, (Chand, 2000). Bernard and Gupta (2008) go further to look at other factors that affect black African children that other literature seems to neglect such as how gender norms place women in an inferior position within African cultures and this can limit mothers to protect their children in the environment of domestic violence, however Owen and Statham (2009) argues that the is limited evidence to maintain or challenge this notion. Nevertheless, in Masson et al (2008) study, domestic violence was evidenced as a cause of concern in the court files of half the children of Black African mothers implicated in their study of care proceedings.

Research and evidence from Climbie enquiry propose that social work professionals involved with black and minority ethnic families might not act in child abuse cases because of fear of being regarded as a racist (Scorer, 2005; Bernard and Gupta, 2006). Nevertheless, literature and research fail to provide a large amount of evidence to support this notion for example, Gordon and Gibbons (1998) in their study found no differences between ethnicity in terms of children being placed on the child protection register and factors such as parents’ mental health problems, criminal activities or the child not fitting in a reconstituted family were the reasons for involvement than ethnicity (Williams and Soydan, 2005). However, Selwyn et al 2008 found that social work professionals were more uncertain and occasionally puzzled regarding how best to promote the needs of ethnic children and they felt further self-doubting in their assessment. Recurring themes in literature is the significance of social work professionals to build up on culturally sensitive work with black and ethnic families (Gray et al., 2008; Sue, 2006; Laird, 2008; Stirling et al., 2009; Hodge, 2001).

Anti-discriminatory perspectives and the incorporation of knowledge from service users

Thompson, (2008) states that anti-discriminatory practice has been used in Britain to account for good practice in social work to counter structural disadvantages however, Graham 1999, argues that anti-discriminatory practice fails to provide a knowledge base for social work that is ‘engaged in the collective development of the black community’. Professionals can indirectly oppress African children and their families through practice for example, by imposing their personal values or power, (Dominelli 2007). Research and literature talks about the child protection providing cultural sensitive services and training social work professionals have the knowledge and skills in working with different cultures. However this can actually create further oppression and social divisions. The majority of the workers will have dominant Eurocentric views which encourage further social divisions for example, excepting the view that African families live in poverty and not fight and challenge this view by providing services that help families to counter these structural inequalities in society. Dominelli (2007) argues that there is need to address the systems that reaffirm racist dynamics rather than challenging them. Dominelli (1992) argues that black children and families are over-represented in the controlling aspects of social work and under-represented in the welfare aspects of social work.

Problems with communication and working in partnership have been highlighted in literature. Chase’s (2009) study found that young people described complex relationships with social workers and other social care professionals and were also more mistrustful of the interplay between social care and immigration services. There is limited research that incorporates service user involvement (Buchanan 2007; Bernard 2002) taking in their lived experiences however, an important study by Chase 2009 found that young people often described complex relationships with social workers and other social care professionals and were also more mistrustful of the interplay between social care and immigration services. Recent policy has tried to enforce advocacy as a way of promoting social justice and incorporate disadvantaged groups’ views on the services that are appropriate for them. In Bowes and Sims (2006) empirical study, they found that black and minority ethnic communities gave support to advocacy services, however, they were still marginalised by the services they were already using. There appears to be a need of qualitative research and literature that includes an extensive study of black African children’s perspectives and experiences, (Graham 2007) which forms a value base to inform practice in social work.

Relevance to policy and practice

Using the ecological approach the Framework For Assessment of Children in Need and their Families (DoH, 2000), places a requirement on social work professionals to take account of cultural background and socio-economic positions of families paying attention to power imbalances in relationships, (Dalrymple and Burke, 1995). Dalrymple and Burke (1995) argue that an understanding is needed of the association between personal experience and structural realism of inequality. Therefore service users perspectives should form part of policies and legislation respecting and literature highlights that children’s rights may still lack from policy and legislation, therefore, these notions challenge professionals to take children’s views seriously and appreciate their contribution to research, (Aubrey and Dahl 2006). Lots of research appears to focus on empowerment through cultural knowledge inviting new thinking about the challenges faced by black communities, (Aubrey and Dahl 2006). The complex social circumstances experienced by many African families pose challenges for social work professionals working to safeguard and promote children’s welfare.

In order to safeguard and promote welfare of African children acknowledgement of sources of discrimination and oppression, a commitment to human rights and social justice must be met.

Several authors have critically analysed the evidence on service provision for black families in general. A pathologising approach to black families may lead to unnecessary coercive intervention and on the other hand a cultural relativist approach may lead to a non-intervention when services are required (Dominelli 1997, Chand 2000). Either way appropriate intervention is not provided for black and ethnic minority children. The quality of services in black communities is a focus for debate and raises important issues about the lack of policy initiatives based upon needs and aspirations of local communities (Graham, 2002). By drawing on strengths perspective professionals can illuminate how parents draw on cultures as a resource to parents in circumstance of adversity whilst not excusing behaviour that is harmful to children.

Conclusions

There is gaps in research on child protection and black African families and a recurrent theme in literature is the need to acknowledge cultural and social contexts of parenting and experience of African black families to make sense of child abuse and provide appropriate intervention for children and families involved in the child protection system, (Holland 2004, Robinson 2007, Stobart 2006). Research shows that there is a gap in research on asylum seeking children and social work to inform practice, (Kohli and Mather 2003; Okitikpi andAymer 2003). There is need for research centred on black African children and there is also need to involve them in forming of policies, challenging the notion that only ethnicity causes the experiences faced by African children. This is because by having cultural sensitive intervention, there can be reinforcement of stereotypical services and discrimination ignoring other things such as gender, age and class.

Care has been taken to ensure the provisioning of adequate information to the mother of the child to be placed under observation. I have informed the mother of my reasons for conducting the exercise. I have reassured her on the protection of confidentiality of all my observations and have informed her that I will use a pseudonym for referring to her daughter in all my written work. I have accordingly asked her to chose a pseudonym for her daughter and have accepted her suggestion for calling the child Kirsty.

Kirsty’s mother, Jane, has been informed that the child will not be influenced or pressurised in any way. She will be free to answer or not to answer questions and even to withdraw from the exercise at any time she so desires. I have obtained her consent to the conducting of the observation exercise in writing. The signed consent statement is available in Appendix 1. Whilst Kirsty’s father was not at home at the time of the study, Jane informed me that he was aware of the exercise and had agreed to the same.

1.3. Observation Process

The exercise was conducted at the garden of Kirsty’s house. Kirsty lives with her parents in a small cottage near the beach. The house has a small fenced garden. It was quiet and sunny when the observation was conducted in the presence of Jane, and her neighbour, Priya, a young woman in her mid-twenties. Whilst it is recommended that the observation was conducted in the presence of the child’s mother, care should be taken to ensure that she does not actively participate in the observation process.

I carried the Sheridan Scale for 5 year olds for the exercise and noted my observations in the appropriate boxes during the observation process. The observation began at 11 am and continued for a couple of hours, wherein I observed Kirsty’s behaviour in the course of some small games that she played, first with her dolls and then with her set of building blocks.

1.4 Views of Family

Jane informed me about Kirsty’s mild asthma, which had first surfaced when she was three and continued to trouble her even today. She was under medical treatment and her GP had advised her that most children outgrew childhood asthma by the time they were 15 or 16 years old. Jane informed me happily about the child’s excessive attachment to her father, who had a travelling job and was out of the home for more than two weeks each month.

Whilst both parents loved their daughter, the father absolutely doted on her and showered her with gifts when he was home. The child had of late begun to act wilfully and was apt to become very upset and show signs of aggressive behaviour if her wishes were not met immediately. Her school teacher had also spoken to Jane about Kirsty’s wilful behaviour athatupset once in a while.

1.5. Summarisation of use of Sheridan Scale and Assessment Framework Triangle

Asthma, even if it is mild, is known to adversely affect the development of children. Jane’s information on the whole reinforced my findings from the application of the Sheridan scale for 5 year olds. I had carefully applied the Sheridan test for various parameters, including posture and large movements, vision and fine movements, hearing and speech, and, to some extent, social behaviour and play. Whilst the child responded positively to the various facets of the test, and was particularly proficient in dancing with me to tapping of feet, skipping, sketching and painting, she appeared to have trouble in skipping and in participating in more strenuous forms of physical activity. Her mother also became apprehensive if the child engaged in dancing and running.

I also found her to be more wilful and apt to become upset if she did not find what she was looking for, or if her smaller wishes, like asking for a glass of water were not immediately fulfilled. She appeared to miss her father, who had to constantly go on business trips.

The Common Assessment Framework triangle helped me in understanding the developmental needs of the child from three perspectives a) the developmental needs of the child b) family and environment factors and c) parenting capacity. Use of the CAF triangle helped me in realising that whilst the parents were taking good care of her various physical, health and educational needs, their overprotective nature was resulting in slowing down of her self care skills as well as her emotional and behavioural development.

2. Psychological Theories and Life Span Development

Cognitive development is a process whereby a child’s conception of the world alters with respect to age and experience. Cognitive psychology, primarily known as the developmental stage theory, seeks to explain the quantitative and qualitative intellectual abilities that occur during a child’s developmental years. The work of Piaget is important in understanding human development. Piaget suggests that the idea of cognitive development is intrinsic to the human organism and language is contingent on cognitive development.

Piaget proposed that reality is essentially a dynamic structure of continuous change, one that involves transformations and states. Whilst transformations refer to the various changes that a person/thing undergoes, states refer to periods in between transformations. A child’s cognitive development is primarily dependent on his/her ability to adapt to various situations. Therefore, if human intelligence is to be adaptive, it must be able to “represent both the transformational and static aspects of reality”. He suggested that whilst operative intelligence directs dynamic or transformational aspects of reality, figurative intelligence represents static periods in between.

In understanding cognitive development, Piaget essentially focuses on accommodation and assimilation. Whilst the former focuses on absorbing one’s environment by altering pre – existing schemas in order to fit the new information, the latter concentrates on assimilating new information by fitting it into pre existing cognitive schemas.

Whilst placing Kirsty’s development within the context of Piaget’s stages of development – in it recognises that children adopt particular types of behaviour and actions during each stage I feel that she was adequately well developed, both operatively and figuratively. Moreover, she was able to assimilate and accommodate to the environment with equal ease. Her enthusiasm to play

Introduction

Community care essentially aims to provide individuals in need with social, medical and health support in their own homes, as far as possible, rather than in residential establishments or in long-stay institutions. The enactment of the NHS and Community Care Act in 1990 marked a watershed in the evolution of community care practice in the UK (Means, et al, 2002, p 71). Implemented after years of discussion on the social and financial viability of maintaining people in institutions and homes, the NHS and Community Care Act, initiated by Margaret Thatcher, showcased her desire to radically change the practice and delivery of social and health care in the UK (Means, et al, 2002, p 71).

The years following the passing of the Act have witnessed significant developments in the practice and delivery of social work in the country. This short essay attempts to investigate the basic reasons for the enactment of the NHS and the Community Care Act, its basic ideology and thrust, and its impact on the social work sector of the country. The essay also studies the developments in social care that have occurred in the years following the act, with particular focus on direct payments for people with learning disabilities, social care provisions for carers and the contemporary emphasis on personalisation.

NHS and Community Care Act 1990

Whilst the initiation of the policy of community care in the UK is by and large attributed to Margaret Thatcher’s conservative government, the concept of community care, even at that time, was not exactly new (Borzaga & Defourny, 2001, p 43). The need for community care existed from the beginning of the 1950s. It aimed to provide a better and more cost effective way to help individuals with mental health concerns and physical disabilities by removing them from impersonal, old, and often harsh institutional environments, and taking care of them in their home environments (Borzaga & Defourny, 2001, p 43). Although various governments, since the 1950s, supported the need to introduce community care and tried to bring in appropriate changes, lack of concrete action on the issue resulted in constant increase of the number of people in residential establishments and large institutions during the 1960s, 70s and 80s (Borzaga & Defourny, 2001, p 43).

With numerous negative stories coming out in the media on the difficult conditions in such establishments, Sir Roy Griffiths was invited by Margaret Thatcher to investigate the issue of community care for the residents of such establishments and make appropriate recommendations (Harris, 2002, p 11). The Griffiths, (1988), Report named “Community Care: Agenda for Action”, followed by the publication of a White Paper “Caring for People: Community Care in the Next Decade and Beyond” in 1989 led to the enactment of the NHS and Community Care Act 1990 (Cass, 2007, p 241).

Apart from being a strong attempt to improve the lives of people in long term institutions and residential establishments, the law was also an outcome of the conservative government’s desire to bring market reforms into the public sector and stimulate the private sector to enter the social services, as well as its conviction that competitive markets would be better able to provide more economic services than a bureaucratised public sector (Harris, 2009, p 3). With social services being among the highest revenue spending departments at the local authority level and domiciliary and residential services for older people consuming the bulk of social service funds, community care for older people presented an obvious area for introduction and implementation of market principles (Harris, 2009, p 3).

The act split the role of local and health authorities by altering their internal structures, so that local authority departments were required to ascertain the needs of individuals and thereafter purchase required services from providers (Lewis, et al, 1994, p 28). Health organisations, in order to become providers of such services, became NHS trusts that competed with each other. The act also required local social service and health authorities to jointly agree to community care plans for the local implementation of individual care plans for long term and vulnerable psychiatric patients (Lewis, et al, 1994, p 28).

The act has however come in for varying degrees of criticism from service users, observers and experts, with some observers claiming the altered care conditions to be unresponsive, inefficient and offering little choice or equity (Malin, et al, 2002, p 17). Other experts, who were not so pessimistic, stated that whilst the system was based upon an excellent idea, it was little better in practice than the previous systems of bureaucratic resource allocation and received little commitment from social services; the lead community care agency (Malin, et al, 2002, p 17). The commitment of local authorities was diluted by the service legacies of the past and vested professional interest, even as social services and health services workers were unable to work well together (Malin, et al, 2002, p 17). Little collaboration took place between social and health services and the impact of the reforms was undermined by chronic government underfunding. The voluntary sector became the main beneficiary of this thrust for the development of a mixed economy of care (Malin, et al, 2002, p 17).

Developments after the Enactment of the NHS and Community Care Act

The assumption of government by the labour party in 1997 resulted in the progressive adoption of numerous forward looking policies in various areas of social care. The publication of a white paper in 1998 reinforced the government’s commitment to promotion of community based care and people’s independence (Means, et al, 2002, p 79). The paper focused on assisting people to achieve and maintain independence through prevention and rehabilitation strategies, with specific grants being introduced to facilitate their implementation. The Health Act of 1999 removed obstacles to the joint working of health and social services departments through provisions for pooling of budgets and merging of services (Means, et al, 2002, p 79). The formulation of the NHS plan aimed to improve partnership between health and social care, the development of intermediate care and the construction of capacity for care through “cash for change” grants for development of capacity across social and health care systems (Means, et al, 2002, p 79).

Direct Payments for Individuals with Learning Disabilities

The Community Care (Direct Payments) Act 1996, which came into operation in April 1997, marked a radical change in the provision of community care for people with disabilities, including those with learning difficulties (Tucker, et al, 2008, p 210). It was illegal, prior to the implementation of the act, for local authorities to support people with disabilities by making cash payments in lieu of providing community care services. Policymakers however realised that many local authorities were successfully supporting independent living schemes, centres for independent living and personal assistance schemes (Tucker, et al, 2008, p 210). Such schemes handled community care payments for disabled people and provided them with help to organise assistance or support. The Community Care (Direct Payments) Act built on this situation, allowing direct payments to be made to replace care services, which otherwise would be given by social service departments (Tucker, et al, 2008, p 210).

Direct payments provide flexibility in the way services are provided to eligible people. The giving of money, in lieu of social care services, helps people to achieve greater control and choice over their lives and enables them to decide on the time and mode of delivery of services (Tucker, et al, 2008, p 210). Direct payments can not only be used for services to satisfy the needs of children or their families but also enables carers to purchase the services they need to sustain them in their roles. Research conducted in 1997 in the utilisation of direct payments by people with learning difficulties revealed that whilst utilisation of direct payments by people with learning disabilities was increasing, such utilisation was low among women and individuals from minority or black ethnic groups (Tucker, et al, 2008, p 210). Research also revealed the presence of wide differences in the interpretation of the capacity of persons for consenting to direct payments by local authorities. Whilst some local authorities felt that direct payments could be sanctioned to all persons with learning difficulties who were able, with assistance, to successfully control and use direct payments, other authorities did not heed the fact that such people could indeed be assisted to communicate decisions and consequently assumed their inability to consent to direct payments. Such interpretations, it was felt, could debar many people in need from obtaining the facility for direct payments (Tucker, et al, 2008, p 211).

Assistance for Carers

Recent years have seen a number of social care initiatives for easing the condition of carers. Carers are people who provide assistance and support, without payment, to family members or friends, who are unable to manage without such assistance, on account of illness, frailty or disability (Government Equalities Office, 2010, p 1). Carers can include adults who care for other adults, parents who care for disabled or ill children, or young people who care for other family members. The government’s social care policies for carers include supporting people with caring responsibilities for (a) identifying themselves at early stages, (b) recognising the worth of their contribution, and (c) involving them from the beginning in designing and planning individual care (Government Equalities Office, 2010, p 1).

Such policies aim to enable carers to (a) satisfy their educational needs and employment potential, and (b) provide personalised support, both for carers and the people they support, to enjoy family and community life and remain physically and mentally well. Whilst the NHS and community care Act 1990 looked at carers as valued resources because of their ability to provide support, it did not refer to their rights; relying instead on rhetoric to deliver the message of their value to society (Government Equalities Office, 2010, p 2). Succeeding years have however witnessed greater focus on the needs of carers and to progressive introduction of suitable laws and appropriate policies. The passing of the Carers (Recognition and Services) Act 1995 drew attention to the needs of carers. This was followed by the passing of the Carers and Disabled Children Act 2000 and the Carers (Equal Opportunities) Act 2004 (Government Equalities Office, 2010, p 2). These acts entitle carers for (a) assessment of their needs, (b) services in their own right and support in accessing education training, employment and leisure opportunities. The proposed equality bill introduces four new opportunities for carers. It (a) requires public authorities to give due consideration to socio-economic disadvantages, whilst exercising strategic planning functions, (b) takes account of associative discrimination with regard to disabled people, (c) provides for prevention of indirect discrimination, and (d) calls upon public bodies to ensure that their policies are designed to eliminate harassment and discrimination and further equality of opportunity (Government Equalities Office, 2010, p 2).

Personalisation

The concept of personalisation in social care, whilst discussed for some years, was formally inducted into social care practice in the UK with the publication of Putting People First in 2007.

The concordat outlined the concept of a personalised adult social care system, where individuals will have extensive control and choice over the services received by them. The government committed that social services would progressively be tailored to meet the preferences of citizens, with person centred planning along with self directed support becoming mainstream activities, assisted by personal budgets for maximising control and choice (Aldred, 2008, p 31). Whilst personal budgets and direct payments form an important aspect of personalisation, the idea concerns fitting services to the needs of people, focusing on outcomes, and recognising the worth of the opinions of service users assessing their own needs, planning their service, and producing their outcomes (Aldred, 2008, p 31).

Conclusions and the Way Forward

This essay investigates the reasons behind the enactment of the NHS and the Community Care Act and studies the developments in social care that have occurred in the years following the act, especially in areas of direct payments for people with learning disabilities, social care for carers and personalisation. It is obvious from the results of the study that social care in the UK has experienced significant change and metamorphosis since the enactment of the 1990 act.

Whilst significant progress has been made a consensus s growing that the British social care system is facing a crisis because of drivers like increasing demographic pressures, alterations in family and social structures, rising public expectations, increasing desire for greater choice and control, and eligibility for services (Glasby, et al, 2010, p 11). The need to move people out of local accommodation because of rising rents exemplifies the challenges faced by the social care system.

With the financial system becoming more challenging, the social care system will have to find ways of improving efficiencies without diluting the quality of care (Glasby, et al, 2010, p 11). The next round of social reforms, whilst attempting to achieve better delivery efficiencies will have to renew its commitment to satisfying social expectations and basic human rights, reducing costs, preventing future needs, helping people to regain independence, freeing individuals to contribute, and supporting carers to care and contribute to society (Glasby, et al, 2010, p 11).

Are the objectives of the “Every Child Matters policy” set by the government being met in actual use and practice?
Contents (Jump to)

Abstract

Chapter 1 – Introduction

Chapter 2 – Method

Chapter 3 – Results

3.1 Every Child Matters Green Paper

3.2 Children’s Act 2004

3.3 Children’s Trusts

3.4 Every Child Matters: Change for Children

Chapter 4 – Discussion

Chapter 5 – Conclusion

Tables – Diagrams

Bibliography

Abstract

In September of 2003 the policy initiative “Every Child Matters” was presented to Parliament, sparked by the death in 2000 of eight-year-old Victoria Climbie, who was a victim of child abuse, and murder by her aunt Marie-Therese Kouao, and bus driver Carl Manning (BBC New, 2005). The striking as well as earth shaking factor in this tragic instance is the very strong possibility exists that Victoria’s suffering, and death could very well have been prevented. While it is impossible to predict what might have happened, the official inquiry into this case as headed by Lord Laming, investigated every facet, including the child protection system (BBC News, 2003). The preceding uncovered that there were at least twelve incidences whereby the system failed Victoria Climbie in terms of her welfare. Most noteworthy, in terms of the system becoming alerted to the potential of child abuse and or problems, were the child’s two visits for injuries to the hospital, the second, which entailed a two-week stay (BBC News, 2003).

The horrific summary just provided does not do justice to the details contained within this case that outraged the public as well as authorities. The Laming Report uncovered that information sharing between agencies failed to take the necessary and required steps to intercede (The Victoria Climbie Inquiry, 2003). The Inquiry resulted in the recommendation of a structure that would eliminate the potential for ambiguity in the decision making process for children and families (The Victoria Climbie Inquiry, 2003). This examination of child care policies shall analyze if the resulting Every Child Matters policies are meeting the purpose for which they were developed and devised.

Chapter 1 – Introduction

The death of Victoria Climbie resulted in an Inquiry conducted by Lord Laming to investigate the childcare system and make recommendations based upon the findings. In keeping with the aforementioned, the Inquiry Report recommended the following changes as well as inputs to the system (The Victoria Climbie Inquiry, 2003):

Elimination of what the Inquiry termed as “buck passing”, through guidance procedures,
Implementation of a coherent set of practices, policies, protocols and strategies for service delivery,
Placement of the preceding into statues that define a clear process for monitoring as well as decision making of performance and follow up,
Reduction of what the Inquiry called the ‘gap’ between the intention of the agencies, and the achievement as demonstrated by actual performance, eliminating the unpredictable facets of service delivery though the improvement of efficiency as well as effectiveness,
Addressing the preventive aspects with families and increasing the support invention process that has deteriorated through proper funding and staffing,
Understanding that the protection as well as support of children calls for a broader scope than just the statutory agencies. The process needs to include close association with community-based groups to broaden the scope of involvement, information, alerts and resources.
A change in the manner that the agencies approach, see and work, as represented by the utilisation of their resources. The preceding calls for all agencies to carry out their part of the process, with a clear delineation to staffing of their primary responsibilities to children and families. The recommendations in these areas consisted of the following:
Services must be child as well as family oriented,
Be responsive to needs and opportunities,
Services must have adequate resources,
Be capable to delivering measurable national outcomes with regard to children,
Be clear in terms of accountability throughout the agencies and organisation,
Be transparent in its work processes and open to detailed scrutiny,
Services, procedures, guidelines, protocols and policies must be clear as well as straightforward in terms of being understood,
Services need to be placed on a statutory foundation, given the powers to ensure delivery of the outcomes desired.

To achieve the aforementioned ends, the Inquiry set forth structure changes that recommended major changes within the structures that deliver services to children and families (The Victoria Climbie Inquiry, 2003). It also identified that a key weakness in the system were the circumstances under which case reviews were conducted, adding that the that structure needs to be replaced by one that is more comprehensive as well as active (The Victoria Climbie Inquiry, 2003). Another critical aspect in the problems uncovered by the Inquiry was the referral and response levels of the agencies. The Inquiry made specific reference to sections 17 and 47 of the Children Act 1989 whereby (The Victoria Climbie Inquiry, 2003):

Section 17

The segment of the Children Act 1989 places the responsibility as well as duty on the local authority for the safeguarding and promotion of welfare for children that are in need in their area.

Section 47

The section of the Children Act 1989 calls for the local authority to make inquiries in instances where it is believed and or thought necessary whereby a child is suspected of being exposed to harm.

The problem with the preceding, especially Section 47, is that the Inquiry found that considerable confusion existed as to what inquiries should be made, with permission from the child’s carer required before other invention measures could be introduced if the preceding was refused (The Victoria Climbie Inquiry, 2003). Under Section 17, the social services could respond only when exceptional circumstances dictated, after permission as outline above had been obtained (The Victoria Climbie Inquiry, 2003). Furthermore, it was found that once the Section 17 designation assigned a label to a case, it was downgraded in terms of status and frequently poor follow up ensued (The Victoria Climbie Inquiry, 2003).

The aforementioned aspects were brought forth in order to have a basis for understanding the reasons and dynamics of the recommendations of the Victoria Climbie Inquiry (2003), the resulting policies, and performance since enactment. This examination shall investigate how the objectives of the Every Child Matters policy is being met through the use of council and agency support. This document is structured to present the methodology utilised, followed by the results of the research process, which is then discussed to determine the significance of the findings, and the implications. A conclusion has been utilised to summarise the examination, drawing upon the information and research uncovered to formulate what the preceding uncovered.

Chapter 2 – Methods

The methodology utilised in this examination entails a combination of evidence based research techniques and quantitative research. The term research in this examination represents a systematic inquiry “characterized by sets of principles, guidelines for procedures and which is subject to evaluation in terms of criteria such as validity, reliability and representativeness” (Hitchcock and Hughes, 1995, p. 5). In the context of this paper, social research represents “the collection and analysis of information on the social world, in order to understand and explain that world better” (Hitchcock and Hughes, 1995, p. 5). Key to the preceding process is the collection of evidence to support the research process, which requires much fuller information to fulfill its directive (Evans, 2006). The foregoing calls for a strong design in the research process to generate the evidence base (Potter, 2007). The foregoing was accomplished by reviewing the legislation as well as historical development of the Every Child Matters initiative, starting with the reasons that prompted its development.

Quantitative research represented conducting the gathering of information systematically, looking for relationships in the examination in the context of the study. Newman and Benz (1998, p. 2) tell us that “Most quantitative research approaches, regardless of their theoretical differences, tend to emphasize that there is a common reality on which people can agree.” With that underpinning, this examination strived to look for a clear delineation of facts that would closely approximate the preceding statement. To this end, surveys and studies were used as a basis for correlating facts, combined with the key purposes behind varied legislation. This look into the programmes that have led up to and are part of the “Every Child Matters” initiative shall utilise evidence based practice to uncover the facts, assess what has been gathered, and critically appraise the process and strategies in their present state.

Chapter 3 – Results
3.1 Every Child Matters Green Paper

The ”Every Child Matters” Green Paper (literacytrust.org.uk , 2003), contains four main proposal areas that were devised in response to the recommendations as made under Lord Laming’s Inquiry Report concerning the death of Victoria Climbie. These four key areas are (literacytrust.org.uk, 2003):

support of parents and carers,
early intervention, along with effective protection,
accountability and integration,
reform of the workforce

To aid in achieving the preceding, the Green Paper recommended a ‘Parenting Fund’ of ?25 million to be added for a three-year period to underwrite the changes (literacytrust.org.uk, 2003). The critical aspect as identified under the Victoria Climbie Inquiry (2003) was early intervention, which the Green Paper advised represented improving the information sharing between agencies and authorities, the utilisation of a singular and unique identification number so that all information would fall under the same file, and the development of a common data network that is coordinated among all authorities and agencies to ensure that all information resides in one file database (literacytrust.org.uk, 2003). Governmental changes as identified under the Green Paper called for the creation of a Director of Children’s Services to deliver education to local authorities and children’s social services as well as the position of the Minister for Children, Young People and Families in the Department of Education and Skills that would have the responsibility for coordination of policies across all agencies and authorities (literacytrust.org.uk, 2003).

3.2 Children Act 2004

The Children Act 2004 put into place the legislative foundation to enable the policy changes as put forth under the Every Child Matters Green Paper (literacytrust.org.uk, 2004). The objective was the maximisation of opportunities, along with minimising risk for children and young people via the leadership of the Director of Children’s Services within the local authorities (Brachnell Forest Borough Council, 2007). The Children Act 2004 advises that the total number of children in the program has remained fairly consistent over the past ten years, with only minor upward and downward fluctuations (Department for Education and Skills, 2004).

The Children Act 2004 was enacted on 15 November 2004 and established (Department for Education and Skills, 2004):

A Children’s Commissioner whose responsibility is to champion the interests and views regarding children as well as young people.
Makes it the duty of Local Authorities to co-operate with other Local Authorities as well as agencies and bodies to improve the well being of children through information sharing and other forms of cooperation.
Made it the duty of Local Authorities to implement local Safeguarding Children Boards that include key partners to participate.
The provision for databases that contain information that enables better sharing capabilities between all authorities, agencies and other bodies.
The development of an integrated inspection framework, along with Joint Area reviews to provide an assessment on progress

The important facets of the preceding changes and modifications to the Children Act 1989 is that it set forth the following (Department for Education and Skills, 2004):

Duty to Cooperate

The Children Act 2004 under section 10 sets forth the duty for local authorities and agencies to cooperate with the guidance under the Act, thus representing the authority as well as framework for children’s trusts.

Guidance on the Children and Young People’s Plan

Under section 17, it contains the key facet regarding the implementation of children’s trusts via a strategic plan for local authorities and allied services, partners and agencies.

Guidance with respect to the roles as well as responsibilities of the Director of Children’s Services with regard to the Lead Member of Children’s Services.
Guidance on Working Together with the objective to Safeguard Children.
Guidance under section 11, on the Duty to Safeguard and Promote the Welfare of Children

The preceding aspects were actualised under the Children Act 2004 through a national framework for change that specifies areas, working inwards to achieve targeted timetables as shown below:

3.3 Children’s Trusts

Children’s Trusts represents the framework whereby all services for children and young people are brought together in an area, supported by the Children Act 2004 (everychildmatters.gov.uk, 2007a). The central foundation of the Children’s Trusts is that they represent the active core of support for those who work daily with children, young people as well as families, with the objective being the delivery of improved outcomes via more integrated as well as responsive services (everychildmatters.gov.uk, 2007a). The integrated strategy utilises the following methodology for effective results and working processes (everychildmatters.gov.uk, 2007a):

the use of a joint needs assessment,
sharing decisions on priorities,
the identification of the resources available, and
the devising of a set of joint plans to deploy the preceding.

The critical aspect of the foregoing is the joint commissioning that pools resources to deploy the best outcome by directing action to those resources and the people best qualified to complete the services (everychildmatters.gov.uk, 2007a). In March of 2007 a national evaluation of the Children’s Trust Pathfinders was conducted that took in all 35 units and included a number of evaluative reports conducted on various segments of the program (everychildmatters.gov.uk, 2007b). The evaluation resulted in a number of recommendations that identified shortcomings and limitations in the delivery of services (national children’s bureau, 2006):

The evaluation stated that a clarification is needed regarding exactly what the term participation means as there were different interpretations uncovered in the analysis.
The approach procedures concerning participation were determined to be less than effective in terms of being systematic.
To move participation beyond listening to active engagement that involves users.
The development of support systems to enables the end users, children – young people – families, to fully participate as well as engaging them in a strategic manner.
To see that participation utilises a broad range of differing and diverse methodologies to solicit as well as gain the views of children, young people and families.
Recognition that the community as well as voluntary sectors have important roles and have users that have difficulty interacting with official bodies.
Take the time, along with the commitment to construct as well as improve the infrastructure needed for effective participation by end users.

The study of user participation that entailed case studies in eight children’s trusts, along with three additional sites involved 107 professionals from management as well as differing levels in education, health, social care as well as local authorities (national children’s bureau, 2006). The perception of professionals was positive in terms of the increased engagement with users, children, young people and families, commenting that it helped to raise their self esteem as a result of being part of the process (national children’s bureau, 2006). User perceptions among those surveyed indicated a lack of participation, and or limited experience, also commenting that there was a lack of information regarding this aspect (national children’s bureau, 2006). The users cited that they would be interested in participatory engagement, as long as it was meaningful, as opposed to being tokenistic, and if such participation actually resulted in change (national children’s bureau, 2006). In addition to the preceding, the surveyed users indicated that feedback in terms of important issues as to where they were, and the actions being taken, and or the outcomes would be useful in transparency (national children’s bureau, 2006). The survey participants also indicated that they felt more involvement would improve relationships.

Those surveyed added that they felt that listening was not a culture trait in the country, thus participation was not, in their opinion, a positive process unless they could see results based upon a broad feedback from issues they participated in, as well as those of other users (national children’s bureau, 2006). The users surveyed also added that they felt that participation was not really representative, voicing the opinion that the same people were asked about their views and opinions repeatedly, as opposed to the process seeking out more individuals to participate (national children’s bureau, 2006). The methodology, in terms of gathering opinions was also questioned, in that the field of reach could be widened through the utilisation of questionnaires as well as discussion groups (national children’s bureau, 2006). It was suggested that such measures should be advertised broadly, and utilise a wide variety of measures in order to make the process participatory as opposed to being selection based (national children’s bureau, 2006).

The manner in which the overall process operates, is designed and performs was also raised. Users, community and volunteer groups indicated that this represented a key area as the process is supposed to represent one of inclusion, thus, their inputs in these areas should be consulted (national children’s bureau, 2006). One specific example was the drafting of questionnaires. Users felt that they should be included in the process to design the questions that would appear on questionnaires as well as assist in the discussion panel formulations to make the process truly participatory (national children’s bureau, 2006). The preceding represent limitations that users felt did not involve them in the overall process that was designed to aid and benefit them.

The foregoing factors represent clear indications that users want to as well as should be a more active part of the process. Their views indicated that they desired to be included in the developmental phases as opposed to being interview subjects, and felt that they should have a deeper, and more meaning participation level as members of the public, especially as members of the public for whom the services are targeted. Strategic involvement represents an important issue in that it engages users and provides inputs that the overall process can utilise in modifying and improving service delivery as well as the notification process on the part of the public as to potential abuse issues. The foregoing view is brought forth by Petr (2004, p. 79) who points to the importance of the inclusion of parents and users in the process as a means to heighten participation. The foregoing approach is also espoused by Northridge et al (2005), who state research partnerships should be an inclusive process that involves participants and community agencies in the process. Boyden and Ennew (1997) also advocate the importance of users in the participation process in terms of taking part and being involved, as well as the benefits of gaining insights from their inputs.

The study concluded that users want greater participation in the process, and that a variety of methods and approaches need to be utilised to obtain the views, ideas, input and concerns (national children’s bureau, 2006). It also recommended that a broad variety of methods should be utilised and exploited in order to obtain the views of users as well as their recommendations and suggestions, providing more transparency in the processing and outcome of the aforementioned to make the system more effective and user, community based (national children’s bureau, 2006).

3.4 Every Child Matters: Change for Children

“Every Child Matters: Change for Children” (HM Government, 2004) represented the national framework to improve outcomes for children as well as young people (Brachnell Forest Borough Council, 2007). The policy indicates that it is committed to seeing that five key outcomes are achieved that are important to a child’s well being, these represent “… being healthy; staying safe; enjoying and achieving; making a positive contribution, and achieving economic well being … (HM Government, 2004). The initiative sets forth key objectives and targets with regard to the underpinning of the entire framework of children’s services. The foregoing are represented by the following (HM Government, 2004). :

The improvement as well as the integration of all services, covering a child’s early years, in the schooling environment, along with health services.
To provide more specialised help to prevent problems, promote opportunities, and most importantly to act early as well as effectively in the event that problems arise.
To reconfigure services so that they revolve around the child and family under children’s centres, extended schools, and through professionals engaged in multi disciplinary teams.
To develop and have engaging as well as dedicated leadership throughout all levels of the system.
The development of an atmosphere of shared responsibility throughout the system and across system lines that focuses upon the safeguarding of children, as well as protection from harm.
To heighten the listen atmosphere, centring on children, young people and families in the assessment processes, along with planning facets, and especially in face-to-face encounters.

The preceding bear strong similarity to the recommendations and findings as set forth under the study conduced by the National Children’s Bureau (2006), which pointed out that these lofty objectives have not fully been met. The five outcomes as represented by “… being healthy; staying safe; enjoying and achieving; making a positive contribution, and achieving economic well being …” (HM Government, 2004), upon deeper examination entail the following:

Be Healthy
physical health
emotional and mental health
sexual health
lifestyles that are healthy
the election not to partake of illegal drugs
and that carers as well as families actively promote healthy choices
Stay Safe
safety from maltreatment, violence, neglect and exploitation sexually
safety from accidental injury as well as death
safety from bullying and discrimination
safety from criminal activities, crime and anti social behaviour
that security and stability are seen to
Enjoy and achieve
that children and young people are ready for school
that children and young people attend school
that they achieve social as well as personal development and have recreational activities they enjoy
Make a positive contribution
that children, young people and families are engaged in decision making as well as support their communities
that children, and young people engage in behaviour that I law abiding, both in an out of school
that they develop self-confidence
that they develop behaviour that is enterprising
Achieve economic well-being
that young people engage in higher education, training and or employment
that young people are prepared and ready to be employed
that children and young people live in homes that are decent in sustainable communities
that they have access to transport
and that they live in households free of low income

All of the preceding have been set as objectives to foster the development of children and young people through adulthood as well as address the tragic situation as brought forth by the Victoria Climbe situation. In order to attain the foregoing, local children’s services under the Children Act 2004 are held accountable for the deliverance of improved outcomes via inspection (HM Government, 2004). The preceding is to be accomplished by (everychildmatters.gov.uk, 2007c):

Robust and active inter-agency accountability and governance
The “local authority director of children’s services” establishment of cooperative arrangements with like service units and local authorities (everychildmatters.gov.uk, 2007c).
The partners in this arrangement include entities from the “public, private, voluntary and community” sectors (everychildmatters.gov.uk, 2007c).
Area child protection committees are replaced by local safeguarding children boards

Under the foregoing “Every Child Matters: Change for Children” (HM Government, 2004), the integrated strategy represents the following elements (everychildmatters.gov.uk, 2007c):

The joint assessment of the local needs that involve users.
The utilisation of a singular plan that is shared between all children’s service units.
The pooling of budgets.
The use of joint area reviews for the inspection of children’s services on the local level.
Integrated frontline service delivery to improve user outcomes at the strategic level.

In terms of integrated processes, “Every Child Matters: Change for Children” (HM Government, 2004) calls for (everychildmatters.gov.uk, 2007d):

The use of “new common initial assessment” frameworks to “reduce duplication and improve referrals” (everychildmatters.gov.uk, 2007d).
Improved information sharing.
The re-engineering of “local processes and procedures … to support integration around the needs of children.

The integrated frontline delivery represents the manner via which the foregoing is accomplished within the overall framework (everychildmatters.gov.uk, 2007e):

“Integrated, accessible and personalised services “ represent the manner via which the preceding will be approached, building the processes “around the needs of children and young people” as opposed to service, and or professional boundaries (everychildmatters.gov.uk, 2007e).
The shift of focus to prevention as well as safeguarding.
Services to be co-located in locations such as children’s centres as well as extended schools.
The reform of workforces to result in staffs that are well trained, with the credo that children are the focal point, understanding that their needs are uppermost.
The “development of multi-disciplinary teams” along with professionals.

The strategy representing the improvement of outcomes is founded upon “changing the behaviour of those working with the users via more integrated as well as responsive service delivery (everychildmatters.gov.uk, 2007e). The foregoing calls for the use of specialist support that is embedded throughout the system, and which can be accessed by all service units (everychildmatters.gov.uk, 2007e). The key to the process is in workforce reform in terms of attitudes, trained staff, the internal development of common skill sets and knowledge base, utilising the element of trust as well as information sharing (everychildmatters.gov.uk, 2007e).

Chapter 4 – Discussion

In equating the results achieved under the programmes established for Every Child Matters the Department for Children, Schools and Families published a report equating evidence in support of the plan (2007). The Report assessed the achievements as well as shortcomings and limitations of progress thus far as achieved:

Table 1 – Results Findings – Every Child Matter Be Healthy

(Department for Children, Schools and Families, 2007)

Be Healthy

Proceeding Well

More Work Required

Most children are happy, however

room for improvement

Infant mortality rates are

relatively high

Suicide rates are low

High rates of low birth weights

Breast feeding rates increased

Increase in obesity rates

Rates regarding physical activity

Have improved

School lunch rate usage is down

Rates for teenage pregnancy are

high, but falling

Sexual activity disease rates

are increasing

Smoking rates have decreased

Alcohol consumption has increased

Trends concerning drug use

are down among the 11

through 15 age group

Cannabis usage remains high overall

Table 2 – Results Findings – Every Child Matter/Stay Safe

(Department for Children, Schools and Families, 2007)

Stay Safe

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This is paper details the effects of social, economic and environmental conditions on the development of children. This paper analyzes a hypothetical family at 13 Cherry Blossom Street. The paper focuses on Jane Robertson, and her family of four children. The Children are, Susan, Jermaine, Mark and Cary. Susan is 8 years old; Mark is 14 years, Jermaine 3 years, while Cary is 18 months.

The four children undergo a lot of social problems, Mark is rude and depicts some anti-social behavior, while is less concerned about her health, emotional and ashamed of her family. Jermaine is malnourished, depicting some unwarranted behaviors while Cary never goes out of the house.

This paper outlines how the overall health and development of these children is affected, and it highlights the measures that health practitioners should take for purposes of rectifying their problems, and working in partnership with the family to find an acceptable solution.

It will describe the development milestones for these children, and compare different theoretical approaches to child development. This study gives a description of the impact facing children who are neglected and abused, and explain the principles of partnership between families and social workers in regard rectifying social problems affecting these children. It has an assessment, and a plan in which the family ought to take in rectifying the problems affecting their children, and a conclusion.

Child development is a process that children undergo from the periods of their infancy, to adolescence (Kenner, 2004). The process involves changes in their biological make up, emotional and psychological characteristics, to the time they are independent and autonomous. Genetic make-up of the child may influence his/her emotional and psychological situation (Altmann, 2006). Basing on this analysis, genetics and pre-natal development make part of the study of child development.

Developmental changes occur because of a process controlled by the genetic make-up of the child, and as a result of human interactions and the ability of learning from the environment. Child development involves the ability of a child to learn from the environment; therefore children will struggle to find culture and identity during this process of development.

In relation to age, the following are stages of child development. Children under the ages 0 to 4 weeks are newborn babies, while those between 4 weeks to 1 year are toddlers. Social workers refer to children under the age of 1 to 3 years as preschoolers, while those under the age of 6 to 13 years as age schooled children.

The adolescents are children between the ages of 13 to 20 years. In the case study above, Mark is an adolescent, while Cary and Jermaine are preschoolers. Susan is an aged school child, and it is important to study their developmental stage because of how it affects their social, emotional and educative development.

Mark is a 14 year old child, and there are certain developmental milestones associated with children of his age. One of the development milestones for adolescents is rapid growth in weight and height. During this period, male children normally gain an average of 3 to 4 inches in height, and a gain in weight usually results from the growth of their development muscles.

From the case study, we do not know the weight and height of Mark, but we are told that is weight does not reflect those of his age. In other word, he is underweight. This is probably because he doesn’t eat properly. Another development milestone for this age is a growth in their brain capacity.

This results to changes in their emotional, physical and psychological capabilities. For example, Mark is always concerned about his mother’s alcoholic condition. This reflects an emotive element in the sense that he is worried that the mother might abuse alcohol, and results to illness or possibly death.

He is also unable to control his temper in regard to his father, since he fights against him on most occasions. He shows love to his brother, but he is never kind to Susan because of her mental superiority, compared to hers. Mark sleeps less because of the problems affecting him, and this is not a development milestone among teenagers, since they require longer time of sleep to cope with changes in their body mechanism.

Susan on the other hand portrays characteristics of development milestones that affect 8 year old children. At this stage, children develop friendships outside their family arena. This is portrayed in Susan when she leaves for school. She is picked by a neighbor friend and her two daughters. This is because a child of her age develops friendship with their teachers, other parents or children of the same age as themselves.

Another development milestone affecting children at the age of Susan is that they view themselves in relation to their appearance, items under their possession, and the activities they are most proficient in (Altmann,2006) . For instance, Susan is so much concerned about her dressing, and she takes good care of herself in regard to the food she eats. She also covers her inability to read the school board, protecting her dignity.

At this stage, children develop an attitude of self-consciousness, and they take note of every little detail surrounding their environment. For instance, Susan fears taking her friends to her house fearing that they may find her mother drunk. Cary and Jermaine on the other hand are preschoolers.

At the age of 18 months, most children learn how to walk without getting help. However, Cary is unable to portray this characteristic. Another main development milestone at this age is the ability of a child to play with items such as pens, dolls, blocks and any other thing he/ he lays a hand on. However, Cary is unable to do this; instead she is seen always sitting on his chair, with sleepy eyes. She has a runny nose, and a dirty nappy, a general characteristic of children falling in this age group (Kock, 2006).

Jermaine on the other hand is a 3 year old preschooler. At this age, children are able to hop, stand, use items such as scissors, and they gain an ability to draw sketches. At this age, children have an interest in gaining new experiences, and they liaise with their peers (Kenner et al, 2004). According to the case study, the only characteristic Jermaine shows of the children under his age, is the ability his ability to speak a few words.

There are various theoretical approaches to child development studies. One of the theories that explain the development of a child is the ecological systems theory. This theory denotes that, the ecological development of a human being greatly influences his growth and development (Kock, 2006).

This theory observes the development of a child in relation to his social, economic and political environment, and denotes that they are part and parcel of the child’s development, and they shape the characteristic of the child. Another theory that explains the process of child development is the behavioral theory (Knefelkamp et al, 1978).

John Watson is the main proponent of this theory, and it denotes that a child develops his trait by learning from the environment. John Watson is of the opinion that a child will make an extra effort on whatever he does to gain recognition.

A better example is reflected when a school going child works hard in class for purposes of getting approval from the teacher concerned. Another theoretical framework explaining the development of a child is the cognitive development theory. This theory believes that a child contributes to his or her own development by use of his intellect.

It denotes that in circumstance when a child faces conflict, he/she will arrange his intellect and devise ways and means of coping with the situation. This is mostly applied in mathematical situations, where a child learns numbers, and will develop mechanisms of ensuring that he or she remembers every detail correctly.

In our case study, there are numerous consequences of abusing and neglecting these four children. The consequences of this action fall under the following categories, behavioral, psychological, cognitive and physical consequences.

Abusing these children will lower their self-esteem, leading to insecurity and lack of attachment to their primary providers. They may develop physical illnesses, such as brain damage or even speech difficulties. These children will develop depression and other psychological incapability’s.

This is because of stress and the stigma they face. They will become underachievers in school and develop anti-social behaviors such as prostitution, drug abuse, engaging in crime like activities, etc (Masling et al, 1996).

PART B: PARTNERSHIP PRINCIPLES

The main idea of partnering with parents is to protect the interests and the welfare of the children. Parents look for social workers who have an interest in them, and when they work in partnership with them, contributing some specific skills and knowledge, it will assist in ensuring that their children are safe. One of the principles in partnering with a family organization is adopting a strength based approach.

Parents know the character traits of their children, and while working with them, social workers should avoid judging them (Salkind, 2002). They should initiate measures of building upon the various strengths of the parents in question, sharing their experience in relation to child development and knowledge.

Another principle is respect and accountability (Sundberg, 2008). Social workers should respect the views of the parents they work with, and avail social services to them without prejudice and discrimination. They should respect their cultural, religious and gender views as this will ensure effective cooperation between them and the parents in question. This would develop trust, and therefore a better working relationship.

Social workers must possess skills that will effectively enable them interact with parents for the purposes of finding a solution for proper development of their children. They should observe proper ethics procedures, in relation to parenting, and parent-practioner relationship, depicting decency and honesty while dealing with these people.

This will develop trust, and a good working relationship, enabling a practitioner to diagnose the problem affecting the specific family set up (Masling et al, 1996). Another principle is to develop a listening ear to the views of the parents in question. This will enable them to reveal their desires, creating a sense of openness, therefore finding a solution for the problems affecting their children.

It is the duty of the social worker to initiate and maintain the partnership, because partnership is a process (Gurian, 1999). This principle acknowledges that partnering with parents requires attention and patient, since some parents are reluctant to cooperate with third parties in relation to parenting their children.

In this case study, the importance of inter-agency communication is important because these three children require different help, that one agency cannot provide. For instance Mark involves himself in criminal and anti-social behavior. There is the need of the police to stop these behaviors, and a psychologist to counsel Mark.

Communication between the psychologist and the police will help them gather information for the purposes of helping Mark overcome his social problems (LeComer, 2006). Cooperating with each other, will enable these social organizations to gather information relevant for their cases and use for purposes of protecting the needs of this children and enhancing their welfare.

PART C: AN ASSESSMENT AND A BASIC PLAN OF ACTION:

This is an assessment framework for the family of Jane, and it includes appropriate services these children and their mother needs. In assessing the child’s welfare and needs, this paper takes a three tier approach, and it looks at their environmental and family set up, the parenting capacity of Jane, and the development needs of the four children.

Assessing the Development Needs of the Four Children in the Case Study:
Health Needs

Jermaine is a three year old child with health problems. She is malnourished, with hollow eyes, a sign of starvation. She also wets the bed, a bad development for children under the age of 3 years. In assessing her health condition, it is poor, and she needs medical attention.

Mark is a 14 year old child, and he has sores and cold, meaning he is on immunization. Mark rarely sleeps and worry’s a lot about the alcoholic condition of his mother. Children under his age increase in height and weight, while Mark is under weight for his age.

Mark needs medical attention to treat the cold and the sores he has, and a psychological help for enable him overcome worries, emanating from his mother’s alcoholic problems.

Susan does not have a serious health problem, while Cary cannot walk, and has a running nose. This is a serious problem at her age, since children of her age learn to walk, and therefore she needs medical attention to care for the running nose, and diagnose why she is unable to walk.

Emotional Development

Mark is concerned on the welfare of the mother, and has affection for his brother Jermaine. This child needs a psychological help to overcome the problems the worries he has concerning the mother.

Susan on the other hand is ashamed of her mother’s alcoholic behavior, and she can’t invite friends over, because she fears they may encounter her. She covers up for her inability to read the schools board. Susan needs a counselor to highlight this problem, so that she can obtain help.

Jermaine is clingy to Jane, while Cary is unable to portray any emotional development because of his age. Jermaine needs an extra social care, that’s full of love and warmth, as opposed to shouting’s that come from Jane.

Educational Development

Mark performs poorly in class, and is unable to attend all his session; therefore a doubt arises whether he will finish his GCSE exams. Mark needs proper tutorship and counseling in regard to his educational problems. The school needs to report his situation to concerned authorities, and measures put in place to ensure that the child develops a proper attitude towards schooling and education.

Susan performs well in class, and she is bright, and the only problem she has, is her inability to read the schools board. The needs to put an extra effort on learning how to read the board, as this will enhance her self-esteem.

Jermaine attends a nursery, and because of his nutritional status, teachers concentrate on giving him food. Jermaine needs attention in regard to his nutritional status, and this will enhance his academic person. Cary is still young to attend school, and therefore she doesn’t need any educational attention.

Family and Social Relationships.

Susan is popular in school, and she has friends on the neighborhood. This is a sign of a healthy development milestone to Susan, and since children of her age experience the desire to make friends and associations. Her relationship with the brother is not stable, because they argue a lot.

This is because she wants to take the role of a parent towards the brother. Jane needs to get concerned on the conflict between Susan and Mark. She has to create boundaries for their interaction based on respect and understanding. Mark on the other hand is greatly attracted to his brother Jermaine, taking the role of a nurse when his mother is away.

Mark has problems in his relation with the father. He fights with the father, and this is a social problem. There is a need to create a mechanism of advising Mark on the importance of respecting his father, despite his weaknesses. Mark forms an association with Thomas, who speaks to him concerning his situation.

Jermaine on the other hand is clingy to his mother, while Cary, is anti-social and unable to play. These children need a diagnosis from a psychologist on better ways to help them in their family relations.

Self-Care Skills

Susan cares for herself, and is concerned with her diet, and Mark is also clean and well dressed, with an interest of learning how to use the washing machine. This is a characteristic of the development milestone they face.

Jermaine on the other hand needs proper care and maintenance, since the nursery washes his clothes, and they give him new ones. This is a responsibility of his mother, and it portrays neglect and abuse. This situation also affects Cary, since she has a continually running nose, and wears dirty napkins. Children at this age cannot care for themselves.

Assessing the Development Needs of the Children in terms of Parental Capacity.

The children lack emotional support from their mother. Jane is always drank and shouts at the children. Jermaine suffers the most in regard to this situation. Mark always fights with the father, and Susan is ashamed of the mother due to her alcoholic conditions.

They lack basic care, such as clothing, and this is evidenced when Jermaine discreetly receives clothes from the nursery he attends. Cary is always dirty, with a continuous running nose, symbolizing neglect and lack of basic care.

Mark on numerous occasions fights with his father, and it is a sign that there is no social and physical security in terms of parenthood within Jane’s family. The mother has racist tendencies, and on most occasions, he abuses Mark because he is black. This shows lack of parental love and care towards Mark, from the mother.

Assessing the Development Needs of the Children in Terms of Family and Environmental Factors.

Mark faces social problem because of the set up his upbringing. He comes from a poor neighborhood, and he believes that his father is a petty drug dealer. There is an easy access of alcohol from the neighborhood of the family.

For example, the mother of Mark is alcoholic, while her father of Jermaine, Susan and Cary died of alcoholic related diseases. Marks father lives in the neighborhood, and he is a petty drug dealer. These environmental conditions play a role in the development of Marks anti-social behaviors.

Jane is unemployed, and she lives in a social institutions house. This status plays a role in bringing up her children. For instance Mark has a cold, and sores, and because of her unemployment status, Jane lacks money to take the child to the hospital.

Plan of Action:

The first stage is to convene a meeting of social workers responsible for providing care to vulnerable and abused children. This meeting is for purposes of looking at the information at hand, and makes recommendations and coordinated efforts for helping these children.

The next process is to establish a core group that will follow up the case, and initiate measures and mechanisms of helping the children out of their current state.

Finally, the social workers should identify the areas of needs, and irrespective of their skill, they should make a coordinated effort at helping Mark, Jermaine, Cary and Susan develop favorable developmental milestones.

Critically evaluate, the evidence and application of the knowledge and practice skills required in helping children during the enquiry, investigation and assessment phases of childcare and protection work.

The objective of this article is to explore the evidence and knowledge, values and skills that social workers use in child protection investigation and assessment. In the course of this commentary and self-evaluation, we will highlight the responsibilities of professionals in social work and:

a) articulate the professional role and tasks of social workers and demonstrate an appreciation of the role and tasks of other significant professionals in childcare and protection investigation and assessment

b) articulate what social workers understand by interdisciplinary work and their part in this

c) articulate the values which inform the practice of social work during inquiry, investigation and assessment, paying particular attention to practice when conflicts arise

e) demonstrate an example of anti-discriminatory practice during inquiry, investigation and assessment in relation to at least one of the following: race, gender, disability, poverty, sexuality and religion

f) demonstrate effective practice in assessing, planning and evaluating interventions (Moore, 1985)

g) convey a knowledge and understanding of models of investigation, assessment and risk analysis in practice

h) make effective links between the commentary on the practice of social work and the theoretical bases in relevant literature

For our purposes, we would investigate all these aspects of social work blending theory and practice, assessment and investigation and analyze the roles and responsibilities of social workers and their approach towards interdisciplinary collaborative practice. We would also critically evaluate the following case study to show the application and efficacy of knowledge and skills of social workers in childcare and protection work.

Case Study:

14-year-old boy from Ireland, arrived in Scotland after being abducted by a man from Dublin. Past history of the boy is given as follows- he had been sexually abused by a neighbour for many years. The case of abuse went to court, the accused man was found not guilty due to lack of evidence. The boy ended up in children’s home and then on the streets in Dublin. He was persuaded by an older man to come to Scotland for better life. The man passed the boy off as his son (as he had no passport) and brought the boy to the UK. Once in the UK the boy was sexually abused by the man, ran off and went to police station. The social worker became involved as responsible and testified in police interview that the boy had learning difficulties.

Application of Knowledge and Skills in Social work for Childcare and Protection:

Social workers have the objective of improving people’s lives and help people to function in the best possible way within their social environment, helping them to deal with their relationships and solve their personal and family problems. Social workers also deal with issues of domestic and sexual abuse and often provide requisite care in a health related setting. Short-term intervention, community based care and ambulatory services are provided by the social workers and governed by care organizations (Howe, 2005). Child, family and school social workers provide social services and assistance to improve the social and psychological functioning of children and their families and try to maximize academic achievements of the children and improve family relationships. Social workers help to find foster homes and care services for neglected, abused and abandoned children and address problems of misbehavior, truancy, delinquency and sexual deviation in children and adolescents. Child, family, and school social workers typically work in schools, care settings, individual and family services agencies, or State and local governmental agencies providing social support (Munro, 2002). These social workers that work for children are also known as child welfare social workers, child protective services social workers. Social workers who work with entire families are family services social workers, occupational social workers, or if they work for betterment of aged people they are gerontology social workers.

Child protection services are aimed at preventing and protecting children from being harmed through neglect or abuse at home, at school, in the community or in society at large. The Social work department of the UK government contributes to a multi-agency collaborative approach to care and protection of children who are vulnerable and easily exploited and abused. The collaborative efforts of the Police, Health, Education and Housing departments ensure a coordinated response towards the care and protection of children. This is coordinated and supervised by the Child Protection Committee, which follows the legislation noted in the Children’s Scotland Act, 1995 (Francis, 2000).

The Department of social work has a specific responsibility for the promotion of child protection and welfare. For protection of children from abuse and neglect, the Social Work Services have the following responsibilities:

Supporting families to maintain children within their own home and community where appropriate.
Investigating allegations of child abuse.
Where necessary, providing appropriate care placements for children.
Referring those children who are believed to require compulsory measures of care to adequately protect them to the Reporter to the Children’s Hearing system.
Organizing and chairing multi-agency child protection meetings.
Coordinating multi-agency child protection plans for those children on the child protection register.

One of the most important phases in child protection and care is assessment. In the assessment stage, the needs of children and their families and views of the carers are taken into consideration by the social workers, health professionals, and psychologists who perform the assessment and determine the individual and varied needs and assess how they can be met (Walker, 2003). The social workers, health professionals, housing officers, teachers, the police as well as carers and the children or young people themselves, contribute to a multi-agency assessment of needs. The legislative framework followed for childcare in social work is the Children Scotland Act, 1995 (Francis, 2000), some features of which are discussed later in the context of the case study.

Considering the case study of the 14-year-old boy discussed above we evaluate the knowledge and skills of social workers in the investigative, inquiry and assessment phases of child protection work.

According to the Children’s Scotland Act, 1995, the following legislative framework was provided if a person is not a natural parent or do not have parental responsibilities.

Care or control of child by person without parental responsibilities or parental rights.

5.—(1)Subject to subsection (2) below, it shall be the responsibility of a person who has attained the age of sixteen years and who has care or control of a child under that age, but in relation to him either has no parental responsibilities or parental rights or does not have the parental responsibility mentioned in section 1(1)(a) of this Act, to do what is reasonable in all the circumstances to safeguard the child’s health, development and welfare; and in fulfilling his responsibility under this section the person may in particular, even though he does not have the parental right mentioned in section 2(1)(d) of this Act, give consent to any surgical, medical or dental treatment or procedure where—

(a)the child is not able to give such consent on his own behalf; and

(b)it is not within the knowledge of the person that a parent of the child would refuse to give the consent in question.

(2)Nothing in this section shall apply to a person in so far as he has care or control of a child in a school (“school” having the meaning given by section 135(1) of the [1980 c.44.] Education (Scotland) Act 1980).

Views of children.

6.—(1)A person shall, in reaching any major decision which involves—

(a)his fulfilling a parental responsibility or the responsibility mentioned in section 5(1) of this Act; or

(b)his exercising a parental right or giving consent by virtue of that section,

have regard so far as practicable to the views (if he wishes to express them) of the child concerned, taking account of the child’s age and maturity, and to those of any other person who has parental responsibilities or parental rights in relation to the child (and wishes to express those views); and without prejudice to the generality of this subsection a child twelve years of age or more shall be presumed to be of sufficient age and maturity to form a view. (2)A transaction entered into in good faith by a third party and a person acting as legal representative of a child shall not be challengeable on the ground only that the child, or a person with parental responsibilities or parental rights in relation to the child, was not consulted or that due regard was not given to his views before the transaction was entered into.

Section 6 especially highlights the views of the children in parental rights and responsibilities, so our case study here in which the 14-year-old boy was deliberately brought to Scotland and was forced to live with a man who abused him repeatedly is definitely illegal. Section 6(2) specifically mentions that a person can claim parental responsibility only when there is complete consent by the child. This has again not been the case here.

The legislative care procedures for children at risk of harm is as follows:

Short-term refuges for children at risk of harm.

38.—(1)Where a child appears—

(a)to a local authority to be at risk of harm, they may at the child’s request—

(i)provide him with refuge in a residential establishment both controlled or managed by them and designated by them for the purposes of this paragraph; or

(ii)arrange for a person whose household is approved by virtue of section 5(3)(b) of the [1968 c.49.] Social Work (Scotland) Act 1968 (provision for securing that persons are not placed in any household unless the household has prescribed approval) and is designated by them for the purposes of this paragraph, to provide him with refuge in that household,

for a period which does not exceed the relevant period;

(b)to a person who carries on a residential establishment in respect of which the person is for the time being registered (as mentioned in section 61(2) of that Act), or to any person for the time being employed in the management of that establishment, to be at risk of harm, the person to whom the child so appears may at the child’s request provide him with refuge, for a period which does not exceed the relevant period, in the establishment but shall do so only if and to the extent that the local authority within whose area the establishment is situated have given their approval to the use of the establishment (or a part of the establishment) for the purposes of this paragraph.

Usually when a child, as understood by a young person below the age of 16 is in any risk of harm as in this case study, it is legally required to provide him with shelter and protection at a residential establishment managed by local governmental authorities and social care services. In cases of neglect, abuse or torture this protection is mandatory. Thus the knowledge and skills of social workers to protect any child under 16 is also related to her understanding of legal implications and framework. The initial stage is assessment of the child’s needs followed by inquiry and investigation through background checks and psychological tests in which problems of the child and his background and social environment are analyzed. In this case study, the 14 year old boy is assessed with the help of past history, police records, psychological and medical tests and it was revealed from these procedures that we was not only tortured and abused by the person who took him away from Dublin, but was also suffering from learning disabilities. Thus along with the conditions of neglect and abuse, the child can also be considered disabled and separate legislative procedures have to be considered in this case.

For Children with disabilities, the legal implications are as follows:

Children affected by disability.

23.—(1)Without prejudice to the generality of subsection (1) of section 22 of this Act, services provided by a local authority under that subsection shall be designed—

(a)to minimise the effect on any—

(i)disabled child who is within the authority’s area, of his disability; and

(ii)child who is within that area and is affected adversely by the disability of any other person in his family, of that other person’s disability; and

(b)to give those children the opportunity to lead lives which are as normal as possible.

(2)For the purposes of this Chapter of this Part a person is disabled if he is chronically sick or disabled or suffers from mental disorder (within the meaning of the [1984 c.36.] Mental Health (Scotland) Act 1984). (3)Where requested to do so by a child’s parent or guardian a local authority shall, for the purpose of facilitating the discharge of such duties as the authority may have under section 22(1) of this Act (whether or not by virtue of subsection (1) above) as respects the child, carry out an assessment of the child, or of any other person in the child’s family, to determine the needs of the child in so far as attributable to his disability or to that of the other person.

Assessment of ability of carers to provide care for disabled children.

24.—(1)Subject to subsection (2) below, in any case where—

(a)a local authority carry out under section 23(3) of this Act an assessment to determine the needs of a disabled child, and

(b)a person (in this section referred to as the “carer” ) provides or intends to provide a substantial amount of care on a regular basis for that child,

the carer may request the local authority, before they make a decision as to the discharge of any duty they may have under section 2(1) of the [1970 c.44.] Chronically Sick and Disabled Persons Act 1970 or under section 22(1) of this Act as respects the child, to carry out an assessment of the carer’s ability to continue to provide, or as the case may be to provide, care for that child; and if the carer makes such a request, the local authority shall carry out such an assessment and shall have regard to the results of it in making any such decision.

A child is considered to have a disability if he is chronically sick or suffers from some form of mental disorder that stops him from actively participating in normal daily activities. As we have already indicated the three stages of inquiry, investigation and assessment are important in child protection and childcare. In the inquiry and investigation phases, the police and the social workers obtain the history and background of the child. In the assessment phase, health workers, doctors, social workers, carers, and psychologists work together to assess the problem of the child, instances of abuse and the legal implications of the child’s conditions. Assessment of disability, if any, the child’s mental, physical and social problems and the general abilities and health of the child is important (Walker, 2003). Knowledge of legal implications and skills of social work practice and theories on mental health and disabilities are not only useful but also necessary in childcare and protection work. The ethical consideration and values are also considered here by the social worker as anti-discriminatory measures for disability, poverty, race or gender are also taken into consideration (Banks, 2001). A disabled person is entitled to his human rights to be treated equally and any discrimination would come under oppressive or discriminatory practice. It is the responsibility of the social workers to see to it that this is avoided. As we have already indicated a recognition of models and theories of practice, values and ethics of social services and an ability and appreciation of working in a collaborative effort with other professionals in varied fields are the most important characteristics in social work and child protection.

Conclusion:

In this case study, a 14-year-old boy abused and abducted was brought to UK where he sought the help of police, who according to legal requirements provided him with residential care. The boy was looked after by carers and social workers in the residential care arrangement where his condition was investigated further by the police and his mental and physical conditions were also assessed by social and health workers. In this article we discussed the importance of knowledge and practice skills of social workers relating the values, dilemmas and ethical considerations of childcare and highlighted the importance of legal implications using the relevant clauses in the Children’s Scotland Act, 1995.

Bibliography

Banks, Sarah. 2001. Ethics and values in social work /Sarah Banks. 2nd ed. Basingstoke :Palgrave.

Francis, Joe. 2000. Child protection and social work practice :exploring the impact of the Children (Scotland) Act 1995. University of Edinburgh, Department of Social Work.

Howe, David, 2005. Child abuse and neglect :attachment, development and intervention /David Howe. Basingstoke :Palgrave Macmillan.

Moore, Jean G. 1985. The ABC of child abuse work /Jean G. Moore. Aldershot :Gower.

Munro, Eileen. 2002. Effective child protection /Eileen Munro. London :SAGE.

Scourfield, Jonathan. 2002. Gender and child protection /Jonathan Scourfield ; consultant editor, Jo Campling. New York :Palgrave

Walker, Steven. 2003. Social work assessment and intervention /by Steven Walker and Chris Beckett. Lyme Regis :Russell House Publishing.

Scottish Local Government Information Unit. Children (Scotland) Act 1995:a guide. Scottish Local Government Information Unit,1995.

Also see

Children Scotland Act, 1995

http://www.opsi.gov.uk/acts/acts1995/

Child Protection – Social work services

http://www.inverclyde.gov.uk/Social_Work/

Professional child care in the field of social work, have come under intense scrutiny recently. Much of this scrutiny, concerns the way in which partnership and interagency work contributes to best practice in the assessment of children, young people and families. This paper seeks to explore the principles of collaborative work and highlight why it is necessary that inter-agency work is successful and efficient in the field of social work. In doing so, will provide examples and discuss current guidelines for partnership work and strategies of new assessment practices to ensure its effectiveness. The essay will also address common problems of interagency and partnership work and identify policies to guard against these potential issues.

The Department of Health (1998) in encouraging the use of partnership, stressed that “joined up services” should be the hallmark of good service delivery. The Audit Commission (1998) declares that for services to be efficient and effective, there must be “mandatory partnership working”. At a basic level, inter-agency and partnership are formal institutional terms attributed to the practice of and need for different agencies and sectors to “work together”. According to Whittington (2003), “partnership is a state of relationship at organizational, group, professional or inter-personal level, to be achieved, maintained and reviewed”, while “collaboration is an active process of partnership in action.” It is within the umbrella term of partnership, that terms such as ‘inter-agency’ and ‘multi-agency’ arise to pin down the policies and concretise the practice of ‘joined-up’ work between agencies.

The principles of collaborative working stipulate that there should be seamless interaction between agencies to facilitate best practice and ultimately improving care services. In a research of 30 multiagency organizations in health and education and over 140 staff, Atkinson et al (2002) found the following necessary principles for inter-agency work:

Common aims and objectives
Organizational commitment to the aims and objectives
Thorough understanding of the various roles and responsibilities of other involved professionals and agencies
Solid leadership
Ensuring task delegation and referrals are to the correct personnel
Access to resources

In addition, Whittington and Bell (2001) established that the ability to work together effectively require many skills which are essential for social workers, such as: the ability to challenge discrimination by other agencies and professions, the ability to conduct multi-disciplinary meetings, the ability to respect and manage issues of confidentiality, and being able to handle conflicts and manage systems and human resource that will need to adapt to change.

There are many policy directives which mandate partnership work within services relating to child care and assessment, and one of these is the 2003 government green paper, Every Child Matters policy document which stipulates the development of Children’s Trusts, to ensure that agencies work effectively together to safeguard and promote the welfare of children. Children’s Trusts emerged after the death of eight year-old Victoria Climbie who even after repeated visits to hospitals and visits by social workers, her abuse was not identified and she subsequently died. The Laming Report of 2003, an inquiry into Victoria’s death concluded that the young girl’s death could have been avoided if individual social workers, police officers, doctors and nurses who came into contact with the girl, had effectively responded to Victoria’s needs. He emphatically declared that Victoria’s death represented a “gross failure of the system”, wherein, not one of the agencies or individuals “had the presence of mind to follow what are relatively straightforward procedures on how to respond to a child about whom there is concern of deliberate harm”.

The Children’s Act of 2004 in Section 10, mandated the “duty to co-operate” on agencies involved in child care protection and assessment. On November 18, 2008, the Children’s Trust outlined in a release which identified the partners with a duty to co-operate as: district councils, the police, the probation board, the youth offending team, the Strategic Health Authority and Primary Care Trusts, Connexions partnerships, and the Learning and Skills Council. Moreover, in 2004, the government rolled out the National Service Framework for Children and Young People (NSF), a ten year strategy document which aims to improve the support and services that young people, children, parents and carers receive. It stipulates ten different standards which will largely depend on efficient partnership and inter-agency work to be successful.

To assist in the efficient assessment of children and young people across services, the Common Assessment Framework (CAF) ensures that frontline delivery of integrated services to children and young people are streamlined for maximum efficiency. It is a standardised assessment methodology across service sectors, which aims to ensure that any inadequacies in service delivery to children are picked up quickly. The CAF looks into the child’s social and health environment to assess the role of the parents or carers, as well as the child’s own strengths and weaknesses, in order to make a reasoned and informed judgment about the child’s present and future well-being. This CAF method of assessment provides much more room and space for preventative action.

The Working Together to Safeguard Children (2006) is another policy guideline for frontline managers and social workers to improve inter-agency work in order to safeguard the welfare of children. It asserts that all persons with responsibility for children must display full commitment and that there should be clear lines of accountability. The job of safeguarding children and young people, falls under the authority of the Local Authority (LA) whose main objective is to ensure that young people are protected from harm, They ensure this by vigourously pursuing exacting partnership standards “with other public organisations, the voluntary sector, children and young people, parents and carers, and the wider community” (Working Together to Safeguard Children: 2006). A tripartite system which incorporating the police, the Local Authority and other agencies help to improve the quality of service and ensure the seamless interaction between agencies in safeguarding children. Social Workers who are directly involved in the assessment of children and young people, must be knowledgeable to these inter-agency links and all up to date protocols of inter-agency work to ensure best practice.

Behan (2005) at the National Conference for Integrated Children’s Framework, stated that “services must improve outcomes for children, and organise themselves round the child rather than expect the child to move from one service to another. To be successful services have to work in partnership.” As was demonstrated in the Victoria Climbie case, and more recently the case of “Baby P”, who died after being tortured by his mothers and two others and whose suffering was missed by the many individuals and agencies who came into contact with him, inter-agency does not always work, despite many policy guidelines and duty of care responsibilities. This essay will now examine some of the challenges to effective collaborative working.

One of the most prominent challenges to effective and efficient inter-agency and partnership work to safeguard children from harm, is the existence of power struggles between various agencies. As stated earlier, Atkinson et al (2002) asserted that a commitment to the ideal and practice of partnership must be bought into by all agencies to avoid power struggles. There are many instances, whereby social workers sometimes outline that their child care reports are not heeded by health care professionals who come into contact with children deemed at risk. Leiba and Weinstein (2003) argues that while many social workers have to work closely with nurses and doctors in the UK to safeguard children, there were significant ideological and cultural differences with how they approached their work. Mathers and Gask (1995) suggests that GP’s become frustrated with the long assessment process that social workers require for best practice.

Leiba and Weinstein (2003) lament that such differences can cause power struggles between health professionals who may thin that “medical-know-how” should trump seemingly long-winded assessment models. They further state that power struggles can be exacerbated by the nature of professional education which normalise professionals into different, values, jargon and culture and the “fear of dilution and associated professional protectionism” ( Leiba and Weinstein: 2003). The language of health has been said to be very alienating and does not usually give space to social work theories and assessments (Peck and Norman: 1999). Leiba (2003) maintains that even though the Health Act of 1983 and the National Service Framework stipulates greater co-operation between health and social care services, in practice this has been very hard to achieve. He cites the example of requirements for a single assessment strategy across services, but highlights how each agency continues to compile its own data. because accommodate the Douek (2003) further argues that parents and carers can become very frustrated when the collaboration process is not a seamless one and a lack of co-operation from a parent or carer can be extremely detrimental to the child assessment process.

Conclusively, it can be stated that the cases of Victoria Climbie and more recently “Baby P”, demonstrate that in order to safeguard and protect children and young people from harm, it is absolutely essential that inter-agency and partnership guidelines are executed. The many policy directives such as the NSF, the CAF, and the 2006 Working to Safeguard Children document should be zealously advocated across agencies and total organizational commitment to the principles around partnership should be elucidated from top to bottom in institutional structures, in order to eliminate power struggles. Social workers, with responsibility for child assessment, should vehemently pursue best practice by following Whittington’s (2003) earlier advice, and report negligence and discriminatory practices which could lead to the harm of children. Such practices ultimately benefit the children and young people and their families, when total commitment to partnership is shown and inter-agency policies do work.

References

Atkinson, M., Wilkin, A., Stott, A., Doherty, P. and Kinder, K. (2002) Multi-Agency Working: A Detailed Study. LGA Research Report 26. Slough, Berkshire: National Foundation for Educational Research.

Behan, D. (2005) Inspecting Children’s Services in Partnership. Paper presented at the National Conference for Integrated Framework. Accessed on December 7, 2008 at: http://www.csci.org.uk/Docs/inspecting_in_partnership.doc.

Children’s Workforce Development Council. (2006) Common Assessment Framework. http://www.everychildmatters.gov.uk/resources-and-practice/IG00063/

Department of Health. (1999) The Challenge of Partnership in Child Protection: Practice Guide.

Department of Health. (Spetember 2004) National Service Framework for Children, Young People and Maternity Services. The Stationery Office. Accessed on December 7, 2008 at: www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/ ChildrenServices/ChildrenServicesInformation/fs/en

Department for Education and Skills (2006) Working Together to Safeguard Children. Accessed on December 7, 2008 at: http://www.everychildmatters.gov.uk/_files/AE53C8F9D7AEB1B23E403514A6C1B17D.pdf.

Douek, S. (2003) Collaboration or Confusion: The Carers’ Perspective. In, Jenny Weinstein, Colin Whittington, Tony Leiba, Collaboration in Social Work Practice. London: Jessica Kingsley.

Laming WH. (2003) The Victoria Climbie Report. London: Stationery Office. Accessed on December 7, 2008 at: www.victoria-climbie-inquiry.org.uk/finreport/finreport.htm.

Leiba, T. and Weinstein, J. (2003) Who are the Participants in the Collaborative Process and What Makes Collaboration Succeed or Fail? In, Jenny Weinstein, Colin Whittington, Tony Leiba, Collaboration in Social Work Practice. London: Jessica Kingsley.

Mathers, N.J. and Gask, L. (1995) Surviving the “Heartsink” Experience. Journal of Family Practice, Vol. 2 (17), pp. 6-183.

Peck, E. and Norman, L.J. (1999) Working Together in Adult Community Mental Health Services: Exploring Inter-professional Role Relations. Journal of Mental Health, Vol. 8 (3), pp. 231-242.

Whittington, C. (2003) Collaboration and Partnership in Context. In, Jenny Weinstein, Colin Whittington, Tony Leiba, Collaboration in Social Work Practice. London: Jessica Kingsley.

Whittington, C. and Bell, L. (2001) Learning for Interprofessional and Inter-agency Practice in the New Social Work Curriculum: Evidence from an Earlier Research Study. Journal of Interprofessional Care, Vol 15 (2), pp. 153-169.