Review and re-assessment
A care plan has been in place for some months. It is now time to review needs and the services currently provided to meet them. You will need to make a report with a recommendation for the future.
- You may consult any family member at this stage.
- You may consult four professionals at this point.
- You may consult four data sources now.
Consult one family member:
I don’t know what is going wrong but, just when my MS is stable, both children have started to play up. Celeste worries me because she has so much anger in her. She lashes out at Sophie, me and children at school. She has been suspended once because she hit another pupil who had to go to hospital as a result. Sophie has got a boyfriend who is much older than she is. Sophie tells me that she is going to school but the school attendance officer tells me that she is missing lessons. She does not always come home when I tell her to, she stays out too late, and I do not like the influence he has over her.
We are old enough to have boyfriends if we wish. We can take care of ourselves. No-one seems to understand what it is like for us. We wish that people would just leave us alone.
We see Evelyn only occasionally now. When we do, she talks a lot about Sophie and Celeste. She is very worried about both of them and seems at a loss to know what to do. Celeste visits us every week. She is not as happy as she used to be. She gets irritable quickly. We see Sophie much less since she started seeing her boyfriend. We think she is too young to have a serious relationship.
Consult four professionals:
Evelyn’s MS has remained stable but it is not possible to predict how long this will last. Psychologically speaking she seems to have adjusted to the knowledge of her prognosis and she has begun to express concerns about both her children.
Sophie is now missing from school several days each week. This may be because she continues to look after Evelyn. However, I have seen her in town with an older man on several occasions. On one occasion, she introduced him as her boyfriend. Celeste is also getting into trouble at school routinely, most recently for an unprovoked attack on a younger pupil that required hospital treatment and for which Celeste was suspended.
Sophie no longer comes to youth club. I have seen her out with an older man. Other young people tell me that they are having a relationship. Celeste comes to youth club occasionally and each time she picks fights with other young people. She can be very aggressive and angry, out of control.
Sophie’s work continues to suffer because of non-attendance. Recently she has begun talking about a boyfriend and seems to enjoy the attention he gives her. She has been seen out with him when she should be in school. Evelyn seems unable to stop this from happening. Celeste is becoming much more aggressive in school. She presents as very angry. Recently she attacked a younger pupil for no apparent reason. Celeste was suspended. Evelyn tries hard with the children but they are not responding to her at the moment.
Evelyn’s MS has remained stable and the care package has done much to relieve pressures on her and the children. She seems more accepting of her personal situation but she has begun to express anxiety about both Sophie and Celeste. This is a relatively new development but I suspect that it may be more longstanding, having been hidden by Evelyn’s preoccupation with her own ill-health.
I have provided some minor aids and adaptations to enable Evelyn to continue with practical and care tasks at home. These will enable her to manage personal and practical tasks as long as her MS remains stable.
As a result of assessments it will be possible to make some structural alterations to Evelyn’s home but the work is not likely to happen for several months.
Consult four data sources:
No information contained on the register but the child protection co-coordinator has received a request that a case conference be held.
Records that Evelyn has previously expressed concern about her parents; notes that the Education Welfare Service has visited the home and that both schools involved have asked whether social workers are involved because of concerns about the children. Recently both the EWO and the schools have telephoned with concerns about Sophie and Celeste.
Guidance is available, which details when exclusion might be appropriate, the procedure to be followed, and the groups most likely to be subject to this sanction. Other strategies should have been tried and failed.
Child poverty and social exclusion are related to teenage pregnancy. Government guidance on approaches to teenage pregnancy is available. www.dfes.gov.uk/teenagepregnancy
A research report on girls and exclusion argues that the relative invisibility of girls means that help is not always forthcoming before and after school exclusion. Girls may be unwilling to take up support and services are sometimes too compartmentalised since they are based around such specific needs as pregnancy. www.jrf.org.uk
These advise you of the duty to investigate when a young person is at risk of signigicant harm and of the protective powers available in an emergency. Working together with other agencies is stressed through sharing information and case conferencing.
Think of any Acts of Parliament that you judge relevant at this stage of the case.
Think about which guidance documents would be relevant at this stage of the case.
At this stage of the case, with the information you have, the following 15 Acts are relevant. How many did you identify correctly?
- NHS and Community Care Act 1990 - section 47 discretionary duty to assess where there appears to be a need for community care services. Section 46(3) lists the services you can provide after an assessment.
- Disabled Persons Act 1986 - section 4 absolute duty to assess a disabled person. Section 8 requires you to assess the willingness and ability of any carer to care.
- Children Act 1989 - in addition to powers and duties towards children in need, section 47 provides a duty to investigate situations where children might be at risk of significant harm. Child assessment and emergency protection and police protection orders are available. The threshold for care proceedings is in section 31.
- Children Act 2004 - strengthens co-operation and information sharing between agencies responsible for the welfare of young people.
- National Assistance Act 1948 - section 29 definition of disability relevant to the decision about use of the 1986 Act. It also lists the range of services that can be provided, amplified in circular LAC(93)10. Section 21 enables the provision of residential care.
- Chronically Sick and Disabled persons Act 1970 - section 2 lists the services available for disabled people.
- NHS Act 1977 – section 21 and schedule 8 list the non-residential services available to respond to illness and mental disorder.
- Education Act 1996 - outlines the legal obligations on parents to secure their child’s education (section 7).
- School Standards and Framework Act 1998 - provides the framework for discipline in school, including exclusion as a last resort.
- Human Rights Act 1998 - contains the duty to positively promote people’s rights.
- Data Protection Act 1998 - governs what information can be shared between agencies in what circumstances.
- Carers (Recognition and Services) Act 1995 - assessment duty towards carers of any age providing regular and substantial amounts of care.
- Carers and Disabled Children Act 2000 - assessment duty towards carers over 16 whether or not the cared-for person is undergoing assessment.
- Carers (Equal Opportunities) Act 2004 - carers over 16 must be informed of their right to an assessment.
- Disability Discrimination Act 2005 - a duty to counteract discrimination and promote equal opportunities.
The following 14 pieces of guidance are relevant at this stage of the case.
- Care Management and Assessment: Practitioners Guide, 1991
- Community Care in the Next Decade and Beyond: Policy Guidance, 1990
- Community Care Assessment Directions 2004
- Direct Payments Guidance: Community Care, Services for Carers and Children's Services (Direct Payments) Guidance 2003
- Fairer Charging Policies for Home Care and Other Non-residential Social Services, 2003
- Carers and Disabled Children Act 2000 and Carers (Equal Opportunities) Act 2004: Combined Policy Guidance, 2005
- Fair Access to Care Services 2002
- Working Together to Safeguard Children, 2006
- Framework for Assessment of Children in Need and Their Families, 2000
- Children Act 1989 Regulations and Guidance, 1991
- Common Assessment Framework for Children and Young People: Practitioners' Guide, 2006
- Information Sharing: Practitioners' Guide, 2006
- Information Sharing: Further Guidance on Legal Issues, 2006
- Lead Professional: Practitioners' Guide, 2006
Make your decision:
The correct decision is to reassess the current care plan and to investigate the need for protective measures. With Evelyn's disability currently stable, the community care services that she is receiving may be sufficient, although plans to meet her future needs should be reviewed every six months. However, there is sufficient evidence to suggest that Sophie may be at risk of significant harm, which must be assessed in partnership with Evelyn and in an inter-agency context. Services under the Children Act 1989 also need to address Celeste, and the risks present, make it appropriate to intervene in this family's life as the welfare of young people is paramount. Immediate protection will sometimes be the proportionate intervention but such action would have to be the only means of enabling people's welfare to be safeguarded and promoted.