The Processes Managing Risk With Vulnerable People Social Work Essay
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This assignment will explore assessment processes and the management of risk in the protection of a vulnerable person. I will provide a brief case study and discuss how assessments and risk management has been applied to this individual case. This assignment will look at different theories and legislation that impact on risk management in social work and the field of child protection.
The case study that I have chosen to discuss is a case that I have held for two years. X is a four year old child who currently lives with his mother Ms X. X's name has been on Wrexham's Child Protection Register for three years under the category 'risk of emotional harm' due to concerns regarding Ms X's criminal behaviours and drug misuse and the impact that this has on the care that she can provide. Ms X has two older children and there were concerns that she was unable to meet the needs of these children due to the same issues. Ms X's eldest child spent ten years of his life in the care of the Local Authority, which sadly included over twenty different foster placements. He is now serving a custodial sentence and holds a lot of resentment towards his mother for the way that he was parented and his inappropriate life experiences. Ms X's second child was placed for adoption at an early age following the undertaking of assessments by different professionals, who felt that X was unable to appropriately care for the child. It has been assessed that Ms X's care of X is of a higher standard than the care of her older children, however there are still aspects of this that are considered to be a risk to X's emotional well being. Ms X has been unable to care for X for significant periods of his life as a result of serving three custodial sentences, the last being for a period of five months. During these periods X has been cared for appropriately by a family member, although has been extremely distressed and unsettled. This last incident of Ms X being arrested and imprisoned raised further concerns for X's sense of stability and emotional well being. As a result a meeting was arranged with the Local Authority's Solicitor and Head of Service to determine whether the risk to X was to the extent that Care Proceedings would need to be considered.
Looking at a person's history can allow different opinions and judgements to be formed, this history is also included as part of current risk assessments. In the field of child protection social work 'risk' is usually viewed as being negative and something that needs to be minimised or prevented.
The concept of 'risk' is very difficult to define; this is a result of it being ambiguous and contestable. The definition of it will rely on the situational context, field of application and the perspectives undertaken. Risk became a dominant preoccupation within Western society towards the end of the20th century, to the point where we are now said to live in a 'risk society' (Beck,1992), with an emphasis on uncertainty, individualisation and culpability.
When defining 'risk' it is often done in mathematical and probabilistic terms as a result of it relating to the expected losses which can be caused by a risky event and the probability of this event happening. It is mapped to the probability of an event which is seen as undesirable. When the loss is harsher in relation to the likelihood of the event then the risk will be worse. This negative conception of risk as risk avoidance or risk aversion can be contrasted with the more positive account based on risk taking in venture capitalism and finance as a measure of the variance of possible outcomes.
The systematic management of actuarial risk is risk management while the methodology for evaluating for evaluating is risk assessment. Across different professions techniques and methods used for managing and assessing risk can vary considerably. The resulting effect is that some professions, such as social work, are defined according to their ability and propensity to deal with risk. Kemshall (2002) argued that social work is predominantly concerned with handling and assessing risk instead of focusing on social need and justice.
It is argued in "Social Work in a Risk Society" that, as a response to risk, the reconfigurations between state, politics, science and people are particularly felt in world of social work (Webb, 2006). The reasoning for this is due to the vulnerable, dangerous and challenging populations under conditions of great uncertainty and crisis which social work invariably deals with. Due to this the opportunity for situations that present a risk are greater. The resulting effect is that social work role attempts to develop more extensive risk management and actuarial systems for trying to control this risk. (www.socwork.net).
The current risk to X's emotional well being has been documented through an individual child protection plan and support services identified. This plan is reviewed on a monthly basis through multi agency core group meetings. These meetings ensure that all agencies and the family have updated information regarding X's circumstances and are aware when issues arise that may be seen to increase the risk to X's emotional well being. The regular meetings also ensure that professionals and family members are included in decision making, such as presenting the recent concerns to a legal planning meeting.
It is important that the information was gained from agencies involved in the process and that their views were respected. I was aware that different professionals had their own view about what was going on and how this impacted upon X. I did not take these views as a fact but assessed the information that was received.
I understand that different professionals and organisations can have different means of assessing risk. This can be challenging when making decisions and plans. In this particular case, when Ms X received a custodial sentence there were professionals that felt that the risk to X's emotional well being was 'immediate'. Other professionals did not see the risk as being immediate as there was an appropriate family member to care for X when Ms X was arrested. The category of risk to the child appears to be a factor in the assessments that are made. Despite efforts to refocus children's services away from a preoccupation with risk of significant harm towards supporting families to meet the needs of their children, the risk of immediate harm continues to take priority. In many of the case examples, the needs of children had been overlooked or resources were not available until risk of immediate harm was apparent. Indeed, the focus was on specific types of harm, children who were deemed at risk of physical or sexual abuse (i.e. immediate harm) caused more concern than those who were potentially at risk of neglect or emotional abuse. This was an issue that both service users and practitioners linked to near misses, as well as to more serious adverse incidents. (Bostock, L et al, 2005).
Since the 1970's child protection work has become less optimistic and more reactive when in 1973 the death of Maria Colwell created a public outcry and preoccupation with retribution and blame (Parton, 1996). The abuse of children became something that social workers should be able to predict and prevent. Assessing risk is one of the main roles in the field of child protection which usually means trying to minimise and prevent potential and identified risks.
Assessment has always been integral to social work practice. Since the 1990's there has been a steady increase in interest in the field of child care social work assessment. Its importance in social work practice is widely acknowledged. Assessments are undertaken by social workers to gain access to resources such as family support workers and funding and are also used to assess risk. Assessments are used by managers and Courts to inform the decision making process, consequently social work assessments can have a lasting and profound impact upon children and their families.
Assessments can also include linking with other organisation liaising and negotiating using interpersonal and communication skills. For Thompson (2000) interventions can either challenge inequality or reinforce them it is therefore important to recognise inequalities and power imbalances and this can lead to empowerment through promoting equality.
For Coulshed and Orme (2006) there is no understanding that the information gained from social work intervention and assessments might be interpreted in many different ways, depending on which theoretical approach is used.
For O'Sullivan (2002) there is mounting pressure to base decisions on research evidence but he believes there are serious failings in this approach. Therefore O'Sullivan (2002) believes that research studies need to have a supportive rather than significant role in relation to decision making. Evidence based practice and relevant theories should inform social work practice when assessing risk. For this particular case I researched attachment theories and the impact that separation could have on X as a result of his mother's imprisonment. Bowlby's attachment theory which Beckett (2005) uses to look at how early life experiences on children's affect long term psychological development. Research suggests that insecure attachments in childhood can also have a negative impact on behaviour in childhood and throughout adult life. Bowlby (in Crawford and Walker, 2005) believed that the prolonged separation of the child from their mother, especially in the first 5 years of their life could cause mental health issues in later life. These include oppositional-deviant disorder(ODD), conduct disorder(CO) or post-traumatic stress disorder(PTSD) all of which have been linked to early traumatic experiences, including abuse or neglect. (http://psychology.about.com)
However as Crawford and Walker argue there have been criticisms of early thinking of attachment theory as children can make attachments to other people not just their mother. These may include extended family members. Crawford and Walker (2004) believe that as social workers we must consider how life experiences may have influence on the individuals' growth and development. Throughout my involvement with X in assessing risk and devising plans I have ensured that his individual life experiences were considered. I was aware that X has previously been separated from his mother for a significant period, which could lead to the conclusion that X's attachment to his mother was already insecure.
When completing risk assessments the long and short term affects of the identified risk need to be explored, this ensures that the social worker can gain a 'bigger picture' of how the identified risk could have an impact on the person's life. I have explored different information and research regarding the effects of parental incarceration and ensured that the family and other professionals involved in the case had access to this information.
There have been a variety of long-term effects on children identified which are associated with the incarceration of parents, one example is the child's level of development. Even if a child-parent attachment has already developed, for example as in the case of infants in the first 9 to 12 months of there lives that have been in either their mothers or fathers care, the disruption caused by parental incarceration will likely have an adverse affect on the quality of their attachment to their parents. (Parke et al 2001). The quality of infant or toddler child-parent attachment can even be impacted by even less drastic changes such as divorce, or moving home (www.hhs.gov). Insecure attachments between parents and children, which is believed to be a consequence from adverse changes in one's life circumstances, have been linked to a variety of negative outcomes for the child; these include diminished cognitive abilities and poorer peer relationships (Parke et al 2001). In light of this information it is not surprising that when their parents are serving custodial sentences, it has been observed for young children between the ages of 2 and 6 years of age to suffer from a range of adverse outcomes which are consistent with research on the effects of insecure attachments (Johnson, 1995). One estimates states that 70% of young children whose mothers were in prison had emotional or psychological problems. Children are said to exhibit internalising problems, such as, depression, anxiety, withdrawal, guilt and shame (Bloom & Steinhart, 1993; Dressler et al, 1992, cited in Parke et al, 1992). It has been documented that young children are also at risk of externalizing worrying behaviors such as anger, aggression towards caregivers and siblings (Fishman, 1983 cited in Parke et al 2001).
Since the Children Act 1989 was implemented in October 1991 there has been a debate between the appropriate emphasis of social work practice in terms of risk and need. This has been closely linked to the centrality of the assessment with social work gaining momentum.
Within the act there is no definition for the term risk, child protection is instead constructed with the term "significant harm."
Under s.31(9) of the Children Act 1989:
'harm' means ill-treatment or the impairment of health or development;
'development' means physical, intellectual, emotional, social or behavioural
'health' means physical or mental health; and
'ill-treatment' includes sexual abuse and forms of ill-treatment which are not
physical. (Brammer 2007)
Within risk assessments in social work the term 'risk' has been associated with the negativity of harm and child death (Parton 2000). This mixed with the 'blame culture' that is present in today's society has an impact on the way in which risks are viewed in the field of child protection.
Due to the complexity, and the protracted nature of the work, most social work is of little interest to the media and the wider public. Social work stories only become of interest when major failures occur in the system. (Wroe, 1988). Social workers have been very publicly 'named and shamed' in the aftermath of the tragic Baby P case, one newspaper's headline stating 'Blood on their hands'. The Sun newspaper appeared to lay the blame almost exclusively on the heads of social workers, launching a petition calling for every social worker who had been involved in the case to be sacked and prevented from working with children again (Brody 2009). The Baby P case was shocking and serious mistakes were made, this has created a fear amongst social workers of making mistakes regarding the risk to a child. Social workers and other professionals are now more aware of the negative implications of risk. Following the death of Baby Peter the Children and Family Court Advisory and Support Service (CAFCASS, 2009 in Parton, 2010) produced figures which demonstrated a nearly 50 per cent increase in care applications in the second half of 2008-09 and the demand for care continue to remain at a unprecedented high level.
Assessment is a fundamental skill in social work interventions; it is more than collecting information and is a process rather than an event, which you return to again and again. Therefore it was important to be aware when new information was brought forward regarding the family it was included and the assessment was updated. It acts as a basis for intervention and can form clear objectives. It is important to recognise that there may be multiple problems and all need to be taken into account. Legislation and policy requirement needs to be taken account of, both locally and nationally. Strengths as well as weaknesses need to be assessed. I had to take these into account whilst continuous assessments were being carried out to gain a clear understanding of the bigger picture, as identified in National Framework Triangle (2000).
It is important that children have the right to have their voices heard and to be included in the decisions that affect their lives. It is crucial to engage with the children in the family in order to establish if they are in need or at risk of significant harm. Throughout the period that I have been allocated as the social worker to X I had considerable power to make decisions which would affect the family such as judging whether they were eligible for service, therefore there is a power imbalance. For Milner and O'Byrne (1998) power within social work practice can be used to empower others when working in an anti oppressive way, if power is used incorrectly it can exclude and marginalise service users. As a social worker I was seen as the expert, the service user according to Thompson (2000), by therefore occupies a more powerful position.
For Morris (2000) the Framework for the Assessment of Children and their Families (DoH, 2002) is targeted at a professional audience which means that service users are not provided with guidance about what they can expect as best practice in assessment or what the minimum standards are. This means for Morris (2000) the development of a working partnership or effective participation is limited as only the social worker has the guidance needed and the information about the service that is offered.
For Milner and O'Byrne (1998) power within social work practice can be used to empower others when working in an anti oppressive way, if power is used incorrectly it can exclude and marginalise service users. As a social worker I was seen as the expert, the service user according to Thompson (2000), by therefore occupies a more powerful position.
Due to Ms X being female I looked at how gender affects the issue of drug misuse and offending. An awareness of gender difference should play a key role according to Barnes and Norma (1992), in understanding and responding to needs. But a women centred approach cannot ignore the experiences which divide and separate women as well as uniting them. For example black women in the UK will be affected by cultural differences, racism and in some cases language difficulties as well as by sexism. Barnes and Norma (1992) believe that there is considerable evidence to show that women are more likely to be identified as experiencing emotional problems. Mental disorders amongst women are often identified as behaviours which deviate from what is regarded as "normal" female behaviour.
New and emerging 'radical' values concerned with challenging oppression are very distinct from 'traditional values' as described in the Code of Practice which emphasise individualised relationship between the social worker and the service user.. We must decide whether to interpret values traditionally as a commitment to respect for people, equal opportunity and meeting needs or radically as a concern with social rights, equality and citizenship. Though there should be no presumptions that the emergence of new values or the development of traditional ones will lead to changes in professional practice. If there is no organisational backing or changed professional education, practice is likely to remain unchanged.
Risk assessment methods in the field of child protection continue to be criticised for being time consuming and being overly actuarial. Accountability in child protection social work tends to focus on the family, as opposed to external factors, such as poverty in terms of neglect (www.northerncja.org.uk). It must be highlighted that 'risk' can be defined differently dependant on the individual completing the risk assessment. Differing agencies and workers have different values, cultures, interpretations and language relating to risk. I am aware that the thresholds of risk vary not only across agencies but within agencies (Brown and White 2006). As highlighted by (Barry 2007) social workers with more experience may operate a higher risk threshold than their more recently trained colleagues. Throughout my involvement with X and his family sought advice from colleagues, managers and the Local Authority Solicitors when required and advised to do so.
Prior to the use of risk assessments the child protection system could have been seen to be ineffective. Risk assessments usually require the social work to contact all other agencies that the child is known to. According to (Parsloe 1999) In the pre risk assessment days inter agency communication was lacking compared to today's standards and because of this children were harmed or even killed, who otherwise could have been saved. The introduction of child protection case conferences has ensured that information between agencies is shared and acted on appropriately, which will undoubtedly improve the quality of assessing risk.
In the case of X child protection case conferences allowed recommendations to be made to all professionals involved which aimed to minimise the risk to X. The case conferences reviews also ensure that any recommendations and actions have been completed by professionals and the parents. As highlighted in (community care.co.uk) child protection case conferences have greatly improved communication between agencies, resulting in the risk posed to a child being reduced considerably.
In conclusion, it must be noted that assessing risk in the field of child protection has improved greatly since its introduction. Social workers now have various documents and theories designed to determine the different risks that affect vulnerable children. The importance of inter agency communication is now highlighted in policies and procedures that social workers must adhere to. Recent media attention directed at social workers has undoubtedly created a fear amongst not only social workers but other professionals in allowing and promoting risk taking. This has resulted in an increase in the referrals received by children's services and an increase in children's names being placed on the child protection register of the Local Authority that I am employed by. The different categories that risk is defined under has an impact of the action that is taken by social workers and other professionals. This essay has highlighted the issue that the risk of 'neglect' or 'emotional' harm is not seen to be as 'urgent' as a child that is at risk of 'sexual' or 'physical' harm. I am conscious that risks that are identified can vary depending on the individual that is assessing the risk. I am aware that as a social worker it is important that I recognise my own values and how this could impact an assessment that I complete.
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