Assessing risk in child protection - but what risk?

When one thinks of assessing risk in child protection, one might automatically think about risk to a child. Is the child safe? If not, what needs to be done? Should the child be left with parents or removed? If there are immediate risks, can they be mitigated. These are all important risk questions.

However, there are two other facets of risk that are often not spoken about but can play very crucial roles in assessing risk in a family - risk to the social worker and risk to the agency. Both of these risks are by products of the outrage that occurs when a child is seriously harmed or killed while child protection is involved. There have been a myriad of high profile cases in Canada, Australia, New Zealand, the UK, Ireland, the United States and elsewhere. Here in Canada, we are awaiting the release of the Hughes Inquiry into the death of Phoenix Sinclair. It is expected to be released early in 2014. Based on prior inquiries that Justice Hughes has done in other provinces, one can expect a thorough report that will make for grim reading. It is these types of reports that are needed but also create a fear response - who wants to have the next high profile case in the media after all.

Phoenix Sinclair

For the social worker, this means that each case decision is also influenced by the risk to the social worker. What is likely to happen if this decision turns out to be riskier and problems occur? When this pressure exists within the decision making process, then there develops a tendency at self protection. This leads to more conservative decision making where getting more intrusive with a family seems like the best path.

So too for the agency or the team managers who do not want to be the next team under public scrutiny. 

Thus, the decisions around what a child needs are influenced by matters that have really nothing to do with the risks to the child.

Some attempts have been made to influence this decision making process by introducing programs such as Signs of Safety. This looks to a family's strengths that can be utilized and enhanced. The goal is to reduce the number of children living away from home. It does require that the agency take more risks that enhancement can occur. The early research tends to be promising. But it does require that the agency be able to tolerate the higher risks. Even more important, is for the politicians to be able to accept the risks.

When things go wrong, politicians have zero tolerance for errors even though errors under any program are inevitable. Child protection decision making is done in a reality of partial information that is almost constantly changing. It is politically difficult to defend the imperfections of decision making when the public is outraged.

There are also factors that child protection cannot solve particularly poverty, crime in neighbourhoods, family breakdowns and unemployment - even those increase risks. Politicians can create social policies that do reduce those risks - but cannot eliminate them.

Thus, while we want social workers to be the best they can at the work they do, no matter how well budgets are managed and case loads are kept low, there will still be errors and fatalities - albeit fewer. This is a very hard argument to sell as a politician but it is reality.

Readers might also find this comparative work between the UK and Belgium of interest

Also of interest will be this blog from Chris Mills in the UK.

Social Worker Sanctions

CommunityCare in the UK has reported that two social workers have been sanctioned as a result of their work in a case known as Child F.

Barry Smith was suspended from the social care register for two months and Marilyn Tweedale received a three-year admonishment, following two conduct hearings held last week.

The serious case review found that there were practice errors. The East Riding Safeguarding Children's Board notes that the "Agencies did not coordinate and manage the risk that Adam Hewitt was known to pose to children and information passed to the police  from Children's Social Care should have led to the police reopening the case against Hewitt following earlier allegations." The social workers were sanctioned were noted to have failed to properly assess the risk associated with the case.

As we have seen in many cases, there was a lack of coordination of information between agencies that hampered effective decision making. The Serious Case Review states: “No agency thought to take stock and initiate a process that would have brought all the information about Male 1 into a single arena from which a plan should have merged, to assess and manage the risk he presented to children. “

The SCR also notes a flawed initial assessment that meant that Mr. Hewitt was able to continue access to the child. This raises one of the fundamental issues in case management. What we initially see in a case tends to lead to the unfolding of a case plan. If the social worker becomes attached to that case plan, then the case direction does not get the ongoing re-assessment that is often needed. We never know everything in a case and often lack quite substantive information. This means that we should be open to reconsidering case plans on an ongoing basis.

Very telling about the environment in which the case occurs, are these comments from the SCR: the social worker involved felt overwhelmed by complex cases and had little opportunity for reflection and planning. This goes some way towards explaining how on one hand the social worker understood the risk factors as evidenced in the case closure letter sent to Ms A, but also failed to consider successfully the risk factors in a comprehensive recorded account. The social worker clearly required direction and support which managers failed to make available. It is also noteworthy that the social worker felt “too junior” to challenge the direction offered by managers.  Lord Laming in his 2009 recommendations identifies the need for “respectful challenge” for childcare professionals.”

If a social worker is not in a position to challenge issues within a case, not able to ensure that case consultations are occurring, and have time to consider what is going on in a case, then poor case management occurs. In addition, cases are often very complex and it is unwise to expect that one case worker is going to be able to determine the best course of action. Supervision is crucial.

In what might be a self serving view, the SCR notes comments from the mother. “The mother of Child F states that the message from the assessing Social Worker did not convey the clarity that was necessary regarding the level of risk posed by Male 1.  Her view is that she was told he possibly posed a risk but other men were also named as possible perpetrators in the earlier allegations.  The mother considers that had she been given clear information that he was believed to be the perpetrator of the injuries, she would have terminated the relationship.” However, these comments do raise an important issue that social workers need to attend to – being very clear with clients. When there are risk factors that a client must attend to, the social worker should not be couching language in ways that can lead to an ambiguous understanding.

Social workers also need to be ready to state that risk exists and to take the steps needed to protect a child. That may anger people which makes them harder to work with. Such is the nature of our work.