1. Participating in Core Groups and Child Protection Conferences Patrick Ayre Department of Applied Social Studies University of Bedfordshire Park Square, Luton email: pga@patrickayre.co.uk web: http://patrickayre.co.uk

2. Objectives To gain awareness of the procedures when referring a child or young person to Children’s Services To understand your role and responsibilities when attending core groups and child protection reviews To gain knowledge on how to compile a professional report for child protection conferences To gain understanding of the interagency frameworks and child protection assessment processes, including the use of assessment frameworks

3. Typical natural history of a case Abuse or cause for concern identified Consultation/discussion within agency Referral  Initial Assessment

4. Typical natural history of a case Multi-agency strategy discussion to plan co-ordinated action Investigation (s47 or Core Assessment) Child protection conference to plan further action

5. Initial child protection conference “Where the agencies most involved judge that a child may continue to, or be likely to, suffer significant harm local authority children’s social care should convene a child protection conference”. “The aim of the conference is to enable those professionals most involved with the child and family, and the family themselves, to assess all relevant information and plan how best to safeguard and promote the welfare of the child”. Working Together 2010

6. Initial child protection conference Brings together and analyses information obtained about the child’s developmental needs and the parents’ capacity to respond to these needs to ensure the child’s safety; Considers evidence presented to the conference, taking into account present situation, family history and present and past functioning; Decides whether the child is continuing to, or is likely to, suffer significant harm; Decides future action required to safeguard and promote welfare, including need for child protection plan, planned developmental outcomes for the child and how best to intervene to achieve these.

7. Review child protection conference Review whether the child is continuing to suffer, or is likely to suffer, significant harm; Review health and developmental progress against planned outcomes in the child protection plan; Ensure that the child continues to be safeguarded from harm; and Consider whether the child protection plan should continue or should be changed.

8. Discontinuing a plan No likelihood of significant harm; Child has moved away; Child has reached 18 or has died.

9. Core group Led by named keyworker; Include the child if appropriate, family members, and professionals or foster carers working with the family. Arrange for the provision of appropriate services whilst awaiting assessment(s); Develop the child protection plan as a detailed working tool, and implement it;

10. Core group Monitor progress against objectives specified in the plan; Provide a forum for negotiating and working parents, wider family members, and children; Meet for first time within 10 working days of the initial child protection conference; Then meet often enough to facilitate working together, monitor actions and outcomes, and make any alterations required.

11. Core group Each member is jointly responsible Key worker has the lead role. Use information about the family’s history and functioning to inform decision making Keep the focus on the child Ensure child is seen alone where appropriate Attend to welfare, wishes and feelings, Understand the daily life experience of the child and its meaning to them

12. A child centred approach The purpose of assessment is to understand what it is like to be that child (and what it will be like in the future if nothing changes)

13. Checkpoint: Core group research What do social workers say about other professionals? What do other professionals say?

14. Core group: What do social workers say about other professionals? Have lower tolerance of risk Unwilling to share responsibility and chores even when social worker new or under pressure Anxious or less than enthusiastic about getting involved Try to do the business outside meeting, away from parents; afraid of parents Sometimes focused on parents instead of child (mirroring)

15. What do other professionals say? Greater knowledge disregarded and decisions overturned without consultation Trust difficult because of turnover Not always possible to be open with parents Resented demands when peripheral

16. Mental health or drugs issues Working on the same case but not working jointly Mutual incomprehension and misunderstanding False expectations and assumptions Abdicating responsibility Need for ‘interpreters’

17. Multi-agency meetings Collusion vs conflict Inclusion vs exclusion Facilitation vs determination

18. Multi-agency meetings Closed or open groups? Polarisation Exaggeration of hierarchy (Reder et al., 1993)

19. Multi-agency meetings: groupthink Shared rationalisations to support the first adequate alternative suggested by an influential group member; A lack of disagreement; An illusion of infallibility; Negative stereotypes of outsiders; Direct pressure on dissenters.

20. Multi-agency meetings: groupthink May appear late in conference; Outcome determined by information and perspective of social worker; Group ineffective in challenging risky decision making; Escalation of commitment and self- justification Hard to interrupt once symptoms present Kelly and Milner (1996)

21. Conference problems Attendance at conferences Protection plans omit objectives and outcomes Removal from the register

22. Response to overload Acclimatisation at individual, team, agency and geographical levels Lack of a strategic multi-agency response

23. Checkpoint: Acclimatisation Is acclimatisation present in any aspect of your work? What could you/do you do about it?

24. The Child Safeguarding System (nominal)

25. The Child Safeguarding System (actual?)

26. Reporting to the Conference Two main purposes: To help the conference to decide if there are grounds for making a CP plan To help to decide what the plan should be

27. Social worker’s report to conference Chronology of significant events; Child’s current and past developmental needs; Capacity of the parents to ensure the child is safe from harm, and to respond to developmental needs; Family history and current and past functioning; Wishes and feelings of the child, parents and other family members;

28. Social worker’s report to conference Analyses Assessment Framework information –Child’s strengths and difficulties; –Parenting strengths and difficulties; –Family and environmental factors; –Effect of parenting on the child’s health and development. Includes the local authority’s recommendations

29. Reports of other professionals Details of involvement with the child and family; Knowledge of child’s developmental needs; Capacity of parents to meet these needs; Impact of current and past functioning and family history on the parents’ capacities; Wherever possible written report in advance.

30. Reporting to the Conference May seem like a chore BUT: Can get everything down (less risk of forgetting something or missing it out) You can check the information and make sure it is accurate. You can spend time thinking about how you express things The conference and the other parties will read in advance, so may have less time speaking: –Should only be asked about disputed parts of the report –Those with a different view may not need to ask questions or may even fold!

31. Selling you opinion What would you look for yourself?

32. Selling you opinion Presentation Content

34. Presentation Make it pretty and easy to read –Neat –Double spaced –One side only –Numbered paragraphs and pages

35. Language Good grammar Good sentence construction Simple sentences No unnecessary, unexplained jargon Appropriate tone (formal so no slang, no contractions, no use of first names for adults) Sensitively phased (but not watered down)

36. Content problems Incomplete Biased Conclusions and recommendations poorly argued and justified (or absent altogether)

37. What do they want to know? Who you are Why you are reporting The facts of the case The conclusions to be drawn from the facts

38. Introduction Qualifications & current employment Experience and expertise How long involved with family and capacity Purpose of report Sources of information from which the report is compiled

39. The chain of reasoning Facts  Analysis/summary  Conclusions and recommendations

40. The facts ‘It is the task of practitioners to share, sift, search for and weigh the significance of their information’ (Morrison 2009)

41. The facts Family composition (attach a genogram) Background history (family and individual) Recent events

42. The facts Tell the story chronologically without too much editorialising Facts sufficient support your argument and also to refute counter arguments First hand evidence is best but give source of any information Make sure that you have put information as fully and accurately as possible (Checklist: Who, what, when, where, how)

43. Bias and Balance Include information favourable to ‘the other side’ as well as that favourable to yours It is your job to make judgements but: –avoid empty evaluative words like inappropriate, worrying, inadequate –Give evidence for descriptive words like cold, dirty and untidy Beware the danger of facts

44. Bias and Balance Born in 1942, he was sentenced to 5 years imprisonment at the age of 25. After 5 unsuccessful fights, he gave up his attempt to make a career in boxing in 1981 and has since had no other regular employment

45. Lies, damned lies and killer bread Research on bread indicates that More than 98 percent of convicted felons are bread users. Half of all children who grow up in bread-consuming households score below average on standardized tests. More than 90 percent of violent crimes are committed within 24 hours of eating bread. Primitive tribal societies that have no bread exhibit a low incidence of cancer, Alzheimer's, Parkinson's disease, and osteoporosis. In the 18th century, when much more bread was eaten, the average life expectancy was less than 50 years; infant mortality rates were unacceptably high; many women died in childbirth; and diseases such as typhoid, yellow fever, and influenza were common.

46. Incomplete or out of date

48. Can you trust a snapshot?

49. Collecting and interpreting information Importance of comprehensive family assessments, especially male figures Need for medical evidence to be considered within the overall context Understanding thresholds, especially the importance of neglect and emotional deprivation and the need to accumulate evidence

50. Capturing chronic abuse Judging the impact of long-term abuse is an essential component of any assessment but how well do we do it? Judgements subjective and prone to bias Intangible: Difficult to capture and compare High threshold for recognition Neglect is a pattern not an event

51. Capturing chronic abuse Judging the quality of care is an essential component of any assessment but how well do we do it? Judgements subjective and prone to bias Intangible: Difficult to capture and compare High threshold for recognition Neglect is a pattern not an event

52. Our image of assessment

53. The reality of assessment?

54. Capturing chronic abuse Judging the quality of care is an essential component of any assessment but how well do we do it? Judgements subjective and prone to bias Intangible: Difficult to capture and compare High threshold for recognition Neglect is a pattern not an event

55. The pattern of neglect: atypical

56. The pattern of neglect: typical

57. The pattern of neglect

60. What we would hope to find

61. What we found

62. Chronic abuse and the principle of cumulativeness  Incidents scattered through files  The problem of proportionality  Acclimatisation

63. Assessment Pitfalls When faced with an aggressive or frightening family, professionals are reluctant to discuss fears for their own safety and ask for help Attention is focused on the most visible or pressing problems and other warning signs are not appreciated Parents’ behaviour, whether co-operative or uncooperative, is often misinterpreted Not enough weight to information from family friends and neighbours Not enough attention is paid to what children say, how they look and how they behave In Cleaver, H, Wattam, C and Cawson, P Assessing Risk in Child Protection, NSPCC, 1998

64. Information handling Picking out the important from a mass of data Interpretation Decoyed by another problem False certainty; undue faith in a ‘known fact’ Discarding information which does not fit First impressions/assumptions Too trusting/insufficiently critical Distinguishing fact/opinion Department of Health (1991) Child abuse: A study of inquiry reports, 1980- 1989, HMSO

65. Fact or opinion? 1. There are inadequate play and stimulation opportunities available. 2. The bruise and swelling are consistent with hitting his head on the door. 3. This is the first incident of abuse to the child. 4. The flat is unsuitable for bringing up a young child. 5. Mrs Green is good at keeping her flat tidy. 6. Experienced professionals are better at dealing with child protection issues. 7. Children who were abused usually become abusers. 8. The child said his dad hit him. 9. I saw Peter playing with his toys when I last visited. 10. Mrs Green does not display appropriate parenting skills when relating to her son

66. The chain of reasoning Facts  Analysis/summary  Conclusions and recommendations

67. Analysis Studies (and SCRs) highlight problems in the quality and level of analysis Assessments too static and descriptive, resulting in an accumulation of facts that are not analysed in a way that offers an explanation of the situation (Brandon 2008)

68. But what is analysis? You have gathered lots of information but now what? All you need to do is ask yourself my favourite question: “So what?” You have collected all this data, but what does this mean, for the young person, for the family and for the authority?

69. Analytic thinking ‘a conscious and controlled process using formal reasoning and explicit data and rules to deliberate and compute a conclusion’ (Munro, 2007) ‘Analysis should be seen as acting like a good secretary keeping a check on the products of intuition, checking them for known biases, developing explanatory theories and testing them rigorously’ (Thiele, 2006)

70. Intuition and Analysis Intuitive thinking – unconscious process that allows the integrations of a large amount of information to produce a judgement in an effortless way Gut feelings: ‘take advantage of the evolved capacity of the brain and are based on rules of thumb that enable us to act fast and with astonishing accuracy’ (Gigerenza, 2007)

71. Intuition versus Analysis It is the combination of intuitive and analytic modes that produces the kind of evidence-based practice by which social work knowledge establishes its relevance, expertise and authority Morrison 2009

72. Risk assessment  The dangers involved (that is the feared outcomes);  The hazards and strengths of the situation (that is the factors making it more or less likely that the dangers will realised);  The probability of a dangerous outcome in this case (bearing in mind the strengths and hazards);  The further information required to enable this to be judged accurately; and  The methods by which the likelihood of the feared outcomes could be diminished or removed.

73. The chain of reasoning Facts  Analysis/summary  Conclusions and recommendations

74. Summarise the main issues and the conclusions to be drawn from them. (The facts do not necessarily speak for themselves; it is your job to speak for them.) Define objectives as well as actions Draw conclusions from the facts and recommendations from the conclusions Explain how you arrived at your conclusions (Have you demonstrated the factual/theoretical basis for each?) Consider and discuss alternative possibilities

75. Conclusions and recommendations In particular: Whether you think a plan should be made (referring to the official criteria) Relevant recommendations (mainly relating to your own service)

76. Conclusions and recommendations In drawing conclusions be aware of the extent and limitations of your own expertise. Conclusions may be supported by research Your recommendation should usually be specific (not either/or) Remember: conclusions may be attacked in only two ways –founded on incorrect information –based on incorrect principles of social work

77. What is good use of research? Relevance, and applicability (including fit, where conducted, age, culture); Reliability and validity; Credibility of source; Be careful with new or controversial theories; Be aware of and address counter arguments; Don’t go outside your expertise.

78. Conclusions and recommendations Problems: Unsupported assertions or judgements Inability or unwillingness to analyse and draw conclusions Failure to answer the key question: ‘So what?’

79. Reaching a decision ‘Often a decision is made first and the thinking done later’ (Thiele, 2006) As humans, we resort to simplifications, short cuts and quick fixes! We reframe, interpret selectively and reinterpret. We deny, discount and minimise We exaggerate information especially if vivid, unusual, recent or emotionally laden and We avoid, forget and lose information

80. Good Assessments Are clear about the purpose, legal status and potential outcomes Are based on a clear theoretical framework Are clear about context and value base Are collaborative and promote accessibility for service users Are based on multiple sources of information Value the expertise and understanding service users bring to their situation Are clear about missing information

81. Good Assessments Identify themes and patterns about needs, risks, protective factors and strengths Generate and test different ways of understanding the situation Give meaning to themes, using knowledge based on experience/research Lead to an evidence-based conclusion Use supervision to assist reflection, hypotheses and objectivity Are able to record and explain outcomes Are reviewed, updated & amended in light of new information

82. Spotting the bad ones: Organisational Clues Mythology exists about the family – ‘this family is/always/behaves like Negative stereotypes about other agencies exist so their information is discounted Sudden changes about view of risk not explained Sudden changes of plan not rationally explained

83. Worker clues Gut feelings says something is wrong Worker does not ask difficult questions Analysis does not account for facts/history Proposed plan does not address issues raised in assessment Practitioner is working much harder than the parents to explain significant concerns The child’s story is missing

84. Inter-Agency Clues Agencies have conflicting views of the family/risk Agencies have strong views but offer ambiguous/limited evidence Some agencies unwilling to share information Pressure to agree suppresses permission to question / inter-agency acclimatisation

85. Family Clues Parental intentions not supported by actions Parental optimism involves denial of difficulties Children's accounts conflict with parents’ Parents’ ‘talk’ about their child is contradictory/lacks coherence Co-operation is only on the parents’ terms

86. Assessment frameworks Common Assessment Framework (CAF) Framework for the Assessment of Children in Need and their Families –Initial Assessment –Core Assessment

87. What is CAF “The CAF is a shared assessment and planning framework for use across all children’s services and all local areas in England. It aims to help the early identification of children and young people’s additional needs and promote co- ordinated service provision to meet them”

88. What does CAF consist of? A pre-assessment checklist A multi-agency assessment process A standard form for assessment, planning and review

89. When to do one? Any time you are worried about a child’s progress towards the five ECM priority outcomes

90. What does it consist of? A pre-assessment checklist A multi-agency assessment process A standard form for assessment, planning and review Consent form

91. Framework for the Assessment… “This Framework must be used by Children’s Services in any assessment of a Child in Need and his/her family, to which all partner agencies will contribute as appropriate”. It “provides a systematic basis for collecting and analysing information to support professional judgements about how to help children and families in the best interests of the child”.

92. Framework for the Assessment…

93. Initial Assessment… “a brief assessment of each child referred to social services with a request for services to be provided” Maximum of 7 working days Uses Framework to determine: –whether the child is in need, –the nature of any services required –Whether core assessment should be undertaken.

94. Core Assessment… “an in-depth assessment which addresses the central or most important aspects of the needs of a child and the capacity of his or her parents or caregivers to respond appropriately to these needs within the wider family and community context”. Led by social services, but Will invariably involve other agencies

95. Bonus material: Specific problems Hesitancy in challenging Hostile and ‘difficult to engage’ families ‘Start again syndrome’. Very young children physically assaulted known to universal services or adult services rather than children’s social care Well over half: domestic violence, or mental ill health, or parental substance misuse ‘Hard to help’ young people

96. “Hard to Help”: The complexity of the challenge Young people may be Victims, Perpetrators Parents Any combination of the above but have the same right to be safeguarded as any other child.

97. The background “The reviews showed that state care did not always support these young people fully and that they experienced ‘agency neglect’” Brandon and others (2008).

98. The young people (Brandon and others) History of rejection, loss and, usually, severe maltreatment Long term intensive involvement from multiple agencies Parents: history of abuse and current mental health and substance issues Difficult to contain in school Typically self-harming and misusing substances, often self-neglect

99. The young people (Brandon and others) Numerous placement breakdowns Running away, going missing Risk of dangerous sexual activity including exploitation Sometimes placed in specialist settings, only to be withdrawn because of running away

100. The young people (My experience) Long involvement, but not always intense Sometimes few placements, but all wrecked by the young person Common factor that local services just did not know what to do with them. ‘By the time of the incident, for many of the young people, little or help was being offered because agencies appeared to have run out of helping strategies’ (Brandon and others, 2008).

101. The response Reluctance to identify mental illness and suicidal intent (CAMHS) Failure to respond in a sustained way to extreme distress manifested in risky behaviour (sex, drugs, suicide attempts) Instead of ‘pulling together’, multi-agency response shows fragmentation, ignoring, responsibility shifting, freezing/inertia and generally avoidant behaviour Reasons for running not addressed adequately

102. The response Running away leads to discharge [More generally, does rejection of services lead to total abandonment?] Age used as a reason for not imposing services No proper assessment of competence; allowed/forced to choose [Dealing with incidents but failing to recognise patterns]

103. The obstacles Hard to get a purchase on the system Wrong children, wrong adults (Ayre, 2000) Lack of off-the-shelf resources The limited resources are poorly coordinated and integrated Government targets not child centred or child driven Different agency agendas and mutual misunderstanding; falling down the gap

104. The solutions? Biehal (2005) recommends adolescent support teams in the community [but is that enough?] The complexity of the challenge requires flexible collaborative, individualised responses built around the young person Specialist assessment and treatment?