Alternatives to residential assessment services

Alternatives to residential assessment services

Harriet newslttr

Local authorities need more alternatives to residential assessment services argues WillisPalmer Head of Operations, Harriet Jannetta

Local authorities are currently under massive financial pressure because of austerity measures. A recent survey by the National Children’s Bureau, in association with the British Association of Social Workers found that 70% of 1,646 social workers said the threshold for qualifying as a child in need had risen over the past three years as financial considerations played a larger role in practice. Six out of 10 social workers also felt that finances available to children’s services influenced decision making “very much” or “to a great extent”.

The reality is that managers in local authorities are constantly trying to find innovative and creative ways to deliver services at a reduced cost. In child protection, social workers and managers are regularly faced with the dilemma of how to balance risk, whilst keeping families together. This is against a backdrop of reduced resources, high vacancy and turnover rates in social workers, increased demand for services (The Guardian reported children’s social services in England have experienced increases of 3% in referrals, 5% in children in need, 29% in children subject to a child protection plan and 9% in looked-after children), an increase in care proceedings and in the length of time that proceedings are running.

Sir James Munby’s ruling in RE B-S has had huge and wide-ranging implications in relation to the evidence presented in care proceedings. Whilst the law has not changed the need to have considered all options and provide clear analysis and reasoning for and against adoption has become more explicit. Orders contemplating non-consensual adoption are a very extreme decision, a last resort, only to be made where nothing else will do, where no other course is possible in the child's interests, - when all else fails, to be made only in exceptional circumstances and where motivated by overriding requirements pertaining to the child's welfare, in short, where nothing else would do. In summary, the hurdles that need to be jumped have become higher but the means to achieve this has become fewer and fewer.

To top all of it last October the Legal Services Commission brought in significant changes to legal aid which have meant that local authorities are responsible for paying the full cost of residential assessments. Given that this cost can range from anything between £40,000-£65,000 for a standard three-month period, the change has serious implications for children’s services.

Nationally there has been an increase in the use of residential assessments (in my experience these are mainly ordered through the court) consequently local authorities are having to consider alternative ways to deliver parent child assessments that provide effective risk management and value for money.

Many local authorities have responded to this challenge by developing their own in-house community based assessments using mother and baby foster placements where there is a need for 24-hour support to manage the risks. The potential problems associated with this approach are the perceived lack of independence from the local authority felt by parents and their solicitors, and the fact that traditionally these placements have been for mother and baby; therefore including fathers/partners could present a very difficult dynamic for foster families to manage.  Furthermore, many local authorities, particularly in the London Boroughs, have difficulties recruiting new foster carers. Added to this the high turnover in social work staff and the struggles local authorities have in retaining experienced staff, having the dedicated resources to provide holistic high-quality parent child assessments that are accepted by the court within a dedicated timescale is not an easy ask.

Over the years centres like the Marlborough Family service and the Portman Clinic in London have pioneered and developed the multi-disciplinary assessment model. The dilemma here, however, is that the assessment takes place within the clinic, there are often long waiting lists so have the potential to add in delay to care proceedings and they are very expensive. The model, however, is well respected and there is significant evidence to show that it is successful in providing clarity about family’s potential to change and ability to sustain this into the longer term. The fact is that because this model is so successful many of us try to replicate it in various formats so that the courts have all the information needed to enable the Judge to make an informed decision.

In July 2014 The Childhood Wellbeing Research Centre (CWRC) was commissioned by the Department for Education (DFE) to undertake a small-scale research study to explore the role, costs and contribution that residential parenting assessments make to timely and effective decision-making in public law.   They concluded that a key strength of residential parenting assessments identified during the research was that it can provide relative safety without separating children from parents when the risks are high and/ or there are significant gaps in knowledge about parental functioning, or relationship dynamics.  The intensive nature of residential parenting assessments also has the potential to provide evidence of whether parents have the capability to provide ‘good enough’ parenting, on a consistent basis, within a relatively short timeframe, thus supporting the timely conclusion of proceedings.  However, in four out of 10 of the in-depth cases the expert panel and/or the research team concluded that a residential parenting assessment was inappropriate either because there was sufficient evidence available to reach a decision without it, or because a community based assessment would have been more appropriate.   In this context, it is important that children’s social care and the courts critically consider the circumstances of specific cases to inform decisions about their use.  They should not be used as a means of delegating or postponing difficult decisions, but rather as a tool to obtain evidence that cannot be reliably obtained in a community setting.

The conclusion therefore must be that what is needed is an independent community based multi-disciplinary assessment that enables families to remain living in their own home and provides the safety and intensity of a residential assessment.

Local authorities ideally need to develop commissioning arrangements with independent providers who have the expertise within their workforce to provide assessments of a parent’s intellectual functioning, attachment history, personality, their ability to recognise a child’s needs, acknowledge concerns and work in co-operation with professionals. Alongside this they can work with the child/children to assess their intellectual and developmental level, attachment patterns, behaviour, mental health, and explore their views of family functioning. Through drawing on a diversity of skills they would be able to provide holistic family assessments to look at the relationship between parent and child, to inform placement choice, contact arrangements and advise professionals about mental health and therapeutic needs. Through working with Independent providers, it would be possible to develop a holistic evidenced based assessment that incorporates the whole family’s full range of needs both present and future. The assessment would need to consider capacity to change and would make recommendations about longer term risk management. It would take place in the family home where children and their carers can be seen in their familiar surroundings. The assessment would be social worker led but would incorporate clinical psychologist; psychotherapist, child and adolescent psychotherapist, child play therapist, Mental Health Practitioner Adult/Child and social worker {PAMS trained if required}.

The benefits to this are that it has the potential to up-skill local authority social workers who through the commissioning arrangements can become part of the team and therefore learn from others’ expertise.  The cost would be significantly less than a residential, the family would be able to stay in their own home and community, the assessment would be bespoke to the family’s needs and would by its nature include treatment/intervention as well as assessment.

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