Chapter 10 – Implementing the principles on working with children and their families |
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UPDATE:
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Contents
Support, advice and advocacy to children and families
Children in ‘Families at risk’ having very poor outcomes
Effectiveness of parenting and family interventions
Introduction |
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| 10.1 | The general principles set out in Chapter 5 draw on findings from research. They underpin work with children and their families to safeguard and promote the welfare of children (See also paragraph 2.18 in Statutory guidance on making arrangements to safeguard and promote the welfare of children under section 11 of the Children Act 2004 (2007) London: HM Government.) This chapter sets out in more detail specific aspects of working with children and their families. |
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| 10.2 | A family group conference (FGC) is a decision making and planning process whereby the wider family group makes plans and decisions for children and young people who have been identified either by the family or by service providers as being in need of a plan that will safeguard and promote their welfare. FGCs do not replace or remove the need for child protection conferences, which should always be held when the relevant criteria are met. FGCs may be valuable, for example: |
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| 10.3 | It is essential that all parties are provided with clear and accurate information, which will make effective planning possible. The family is the primary planning group in the process. Family members need to be able to understand what the issues are from the perspective of the professionals. The family and involved professionals should be clear about: |
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| 10.4 | Where there are plans to use FGCs in situations where there are concerns about possible harm to a child, they should be developed and implemented under the auspices of the Local Safeguarding Children Board (LSCB). This work should involve all relevant organisations and individuals, and ensure that their use is applicable to other relevant LSCB policies and procedures. Inter-agency training is necessary to build the relevant skills required to work with children and families in this way, and to promote confidence in, and develop a shared understanding of, the process. |
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| 10.5 | Children and families may be supported through their involvement in safeguarding processes by advice and advocacy services, and they should always be informed of services that exist locally and nationally. Independent advocates provide independent and confidential information, advice, representation and support, and can play a vital role in ensuring children have appropriate information and support to communicate their views in formal settings, such as child protection conferences and court proceedings. |
| 10.6 | Where children and families are involved as witnesses in criminal proceedings, the police, witness support services and other services, such as those provided by Victim Support and Youth Offending Team work with young victims of crime, can do a great deal to explain the process, make it feel less daunting, and ensure that children are prepared for and supported in the court process. The practice guidance Provision of Therapy for Child Witnesses prior to a Criminal Trial (2001) makes it clear that the best interests of a child are paramount when deciding whether, and in what form, therapeutic help is given to child witnesses. Information about the Criminal Injuries Compensation Scheme should also be provided in relevant cases. |
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| 10.7 | The local authority has a responsibility to make sure children and adults have all the information they require to help them understand the processes that are followed when there are concerns about a child’s welfare. Information should be clear and accessible and available in the family’s preferred language. |
| 10.8 | Family members or friends should not be used as interpreters, since the majority of domestic and child abuse is perpetrated by family members or adults known to the child. Children should not be used as interpreters. |
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| 10.9 | Children from all cultures are subject to abuse and neglect. All children have a right to grow up safe from harm. In order to make sensitive and informed professional judgements about a child’s needs, and parents’ capacity to respond to their child’s needs, it is important that professionals are sensitive to differing family patterns and lifestyles and to child-rearing patterns that vary across different racial, ethnic and cultural groups. At the same time they must be clear that child abuse cannot be condoned for religious or cultural reasons. |
| 10.10 | Professionals should also be aware of the broader social factors that serve to discriminate against black and minority ethnic people. Working in a multi-racial and multicultural society requires professionals and organisations to be committed to equality in meeting the needs of all children and families and to understand the effects of racial harassment, racial discrimination and institutional racism, as well as cultural misunderstanding or misinterpretation. |
| 10.11 | The assessment process should maintain a focus on the needs of the individual child. It should always include consideration of the way religious beliefs and cultural traditions in different racial, ethnic and cultural groups influence their values, attitudes and behaviour and the way in which family and community life is structured and organised. Cultural and religious factors should not be regarded as acceptable explanations for child abuse or neglect and are not acceptable grounds for inaction when there are concerns that a child is or may be suffering or likely to suffer harm. Professionals should be aware of, and work with, the strengths and support systems available within families, ethnic groups and communities, which can be built on to help safeguard children and promote their welfare. |
| 10.12 | Professionals should guard against myths and stereotypes – both positive and negative – of black and minority ethnic families. Anxiety about being accused of racist practice should not prevent the necessary action being taken to safeguard and promote a child’s welfare. Careful assessment – based on evidence – of a child’s needs, and a family’s strengths and difficulties, understood in the context of the wider social environment, will help to avoid any distorting effect of these influences on professional judgements. |
| 10.13 | All children, whatever their religious or cultural background, must receive the same care and safeguards with regard to abuse and neglect. |
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| 10.14 | ‘Families at risk’ is a shorthand term for families whose members experience, or are at risk of, multiple and complex problems – such as worklessness, poor mental health or substance misuse, offending behaviour by adults or children – which frequently lead to very poor outcomes for children, young people and adults within the families. The safety and welfare of children living within these families are more likely to be a cause for concern than those from the population as a whole. |
| 10.15 | The term ‘families at risk’ was first was adopted following the Families at Risk Review undertaken by the Cabinet Office’s Social Exclusion Task force with the Department for Children’s Schools and Families. |
| 10.16 | The review found that families at risk, because of the multiple difficulties they face, have a significant likelihood of facing a crisis situation without preventative support. Problems experienced by family members, could include combinations of the following factors: |
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| 10.17 | Early action to prevent and address problems for children and young people is critical to stop children living in these circumstances having poor outcomes in life. This means a co-ordinated approach across services to identify and intervene early with families with children who are at the greatest risk of having poor outcomes. An agreed list of warning signs which could prompt concerns being raised about a child’s welfare (such as a permanent exclusion from school, repeated truancy or involvement in anti-social behaviour, knife crime, violence, and/or gangs) should identify that whole family intervention may be necessary to safeguard and promote a child’s welfare. Targeted parenting and family support is provided through services such as Family Intervention Projects (FIPs) and parenting programmes and services as set out in the local authority’s Parenting Strategy. |
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| 10.18 | ‘Think Family’ is an approach promoted by Government based on co-ordinating the support provided by adult and children’s services to a single family in order to secure better outcomes for the children through the use of targeted, specialised and whole-family approaches to addressing family needs. It is about making sure the different parts of the systems around families work together in a way which intervenes early in family dysfunction. In addition, that they tailor the support provided to individual family members, taking into account the needs of the family as a whole and how addressing family needs can contribute to safeguarding and promoting each child’s welfare. |
| 10.19 | Services of all types come into contact with families at risk of poor outcomes: universal, targeted and specialist; statutory, voluntary and independent; and children, adult and family. The Social Exclusion Taskforce research showed that whilst families at risk of very poor outcomes are often in contact with a wide range of services, evidence suggests that the support provided is only effectively coordinated and persistent when a crisis occurs. This was despite the fact that universal services such as schools, GPs and health visitors had often identified them as highly vulnerable to poor outcomes very early in their involvement. |
| 10.20 | Effective interventions for children in families at risk of very poor outcomes depends upon the ability of services and the practitioners already working with family members, to ‘assess’ and then ‘decide’ on the most appropriate types of interventions to support and achieve better outcomes for each child whilst at the same time, whenever possible, helping the child’s parents and other adult family members if they are experiencing problems which are having an impact on the families ability to function effectively. However, focusing on the full range of needs within a family should not detract from the over-riding duty to safeguard and promote the welfare of the children within the family. |
| 10.21 | ‘Think Family’ practice depends on children’s services developing arrangements with local adult services so that the impact of any problems that mothers, fathers and other key carers are experiencing are seen in the context of the welfare of the children for whom they are responsible. Adult services also have a crucial role to play in minimising the risk of parental problems such as domestic violence, learning disability, substance misuse or worklessness affecting children’s outcomes. |
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| 10.22 | Supporting mothers and fathers and key carers can be a sustainable way of securing better outcomes for children. Research suggests that using evidence-based parenting and family support programmes, for example, through the Parenting Early Intervention Programme, can have lasting effects in improving behaviour even in cases where they are initially reluctant to accept help. Providing help with parenting impacts upon a range of outcomes for children and young people. A meta-analysis of over 40 studies conducted in 2003 showed Family Based Interventions had substantial desirable effects (Farrington and Welsch (2007). Saving children from a life of crime; Farrington and Welsh (2003). Meta analysis in ANZJC.) A review by the National Institute for Clinical Excellence (NICE) highlighted the value of parenting programmes in improving the behaviour of children with conduct disorder (NICE (2006). Parent – Training/education programmes in the management of children with conduct disorders. In NICE Technology appraisal guidance 102.) Eleven out of fifteen studies showed statistical long terms effects (between one and ten years). Conduct disorder is one of the main reasons for referrals to Children and Adolescent Mental Health Services (CAMHS) and the estimated cost of a one-year cohort of children with conduct disorders in the UK is £5.2 billion (Friedli and Parsonage (2007). Mental Health Promotion: Building an Economic Case. Northern Ireland Association for Mental Health.) |
| 10.23 | Parenting interventions tend to work best when both parents are included in the intervention (or separate partner-support is provided). The ability of workers to engage parents effectively and consistently and to achieve ‘buy in’ to what is often a demanding and rigorous change management programme, is crucial to the success of any intervention. There is considerable skill, tenacity, determination and tolerance required by parenting practitioners and key workers who will need to identify the appropriate drivers for change in their clients. They need to understand the underlying reasons for the behaviours displayed by families and agencies, be solution focused in their approach and be able to draw on the necessary support themselves to enable them to set and sustain realistic goals. |
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| 10.24 | When working with families it is important to ‘Think Fathers’ as well, including where the father is himself a young person. A child’s father can have a significant, positive impact on the child’s outcomes but only where he is causing no harm to the child – for example, research shows that children with highly involved fathers do better at school and are more empathic in the way that they behave. More and more fathers want to be involved within their family and in their children’s upbringing even if they are no longer living with the children and their mother. However, many fathers find this difficult and feel they are not recognised or encouraged to get involved, by schools or health services. For example, children’s services as a whole can still be very mother-focused and fathers can, often inadvertently, be made to feel unwelcome or uncomfortable when they try to use them. Managers and commissioners should therefore make sure that their services take account of the needs of fathers and actively look for ways to engage them. The Dad Test (2009) (see the Think Fathers website) sets out practical steps organisations can take to remove these barriers to fathers’ participation. |
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| 10.25 | Joint work with FIPs funded through the local authority ‘Think Family’ Grant may also be appropriate where the needs of a family are complex and require a high level of face to face contact and family-focused interventions. All local authorities receive funding to set up at least one FIP. The health contribution is key to this and is currently funded centrally to pay for a part-time health professional to work with the FIP team in every local authority. With their systematic contact with families FIPs can help identify earlier, children about whom there are concerns that they are, or may be, suffering or be likely to suffer harm. In these situations, a member of the FIP team should make a referral to children’s social care. Family involvement with FIPs does not replace or remove the need for the processes set out in Chapter 5 to be followed. Where a FIP team is involved with a family they should continue to be involved, as appropriate, in any assessments, section 47 enquiries and subsequent work led by children’s social care. |
| 10.26 | Chief Executives will need to nominate an officer responsible for reporting to the Director of Children’s Services (DCS) on the adequacy of safeguarding arrangements between FIPs and children’s social care. In addition, the FIP also should have a designated person for safeguarding with clear lines of accountability through their manager to the Head of Quality and Safeguarding in their relevant service and through them to the DCS/Chief Executive for ensuring the implementation of effective practice with regard to safeguarding and promoting the welfare of children. |
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| 10.27 | The Family Nurse Partnership is an evidence based, intensive preventive programme for vulnerable, young first time mothers that is being tested across England. The programme is voluntary and family nurses visit from early pregnancy until the child is two years old. The family nurses build close relationships with clients and use the programme methods and materials to improve antenatal health, child health and development and parents’ economic self-sufficiency. |
| 10.28 | The family nurse works with vulnerable young people and their babies. They play a key role in the prevention and early identification of babies and young people who may have been, or are likely to be, abused or neglected. They will refer a child to children’s social care as a ‘child in need’, when appropriate, and will act on concerns that a child may suffering or likely to suffer significant harm. Family nurses receive weekly supervision and together with the supervisor work closely with named professionals with safeguarding responsibilities. |
| 10.29 | Family nurses have close contact with and in depth knowledge of children and families which means they have an important role at all stages of the safeguarding and child protection process. This includes completing common assessments, taking on the lead professional role where appropriate, information sharing, contributing to assessments, and involvement in implementing a child protection plan. Family nurses will make available relevant information to child protection conferences about a child and family, whether or not they are able to attend. |
