The Smart Family Case Study Social Work Essay
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Published: Mon, 5 Dec 2016
“We know far more about how to prevent the primary occurrence of maltreatment than how to respond effectively once maltreatment has occurred” (Munro, 2010, p. 22)
Preventing harm is beneficial, therefore, to social work with the Smart family, children Zac, Karly and Tierney; their Mum, Sam; Paul, father of the girls; and Mike, father of Zac. Focus on harm prevention, however, can create defensive practice, considering only safeguarding welfare and not its promotion (Tunstill et al., 2010). Critical exploration of both safeguarding and promoting of these childrens’ welfare, therefore, forms the basis of this essay, considering the application of ‘child in need’ and ‘significant harm’ to the complexity of lives depicted. Critical evaluation of skills and methods required in assessing rights and needs of these children, will then be explored, followed by steps which could be taken to safeguard and promote their welfare. Relevant research informing my thinking provides an evidence base for substantiating arguments made. Conclusions drawn, however, are done so in recognition that actual practice would benefit from engagement with this family in assessing, planning and intervening.
The Children Act (1989) [CA] places a duty on the local authority to promote the welfare of children, provide services to those in need and safeguard childrens’ welfare by investigating, and taking action, in situations concerning significant harm, which I consider to be relevant as a social worker in a case involving concerns regarding the welfare of three children. Furthermore, as a number of professionals are involved in working with the Smart family, the importance of multi-agency co-operation in safeguarding and promoting their welfare, emphasised in Working Together (DCSF, 2010) beneficial to engagement with this family, as is the policies’ detail regarding the implementation of Children Act principles. Significant factors impacting the work undertaken with this family, however, are also determined, in my view, by local authority policy and bureaucratic process, interpreting how legislation and national policies are implemented with individual families. Differential rates of court order applications, for example have been found in demographically similar local authorities (Dickens et al., 2007), suggesting work with this family to be impacted not just through law and policy creation but also their implementation at a local level (Marinetto, 2011).
Analysing concepts of child in need and significant harm relation to this case, however, also require consideration of critically applying a researched evidence base to information gathered about the family. Nutritional deficiencies, for example, resulting from sporadic meal provision, a concern Sam’s health visitor raised, can be detrimental to all areas of child health and development (Kursmark and Weitzman, 2009), suggesting the Smart children may not achieve a reasonable standard of health and development (s.17, CA). The persistent failure to provide adequate food constitutes neglect (DCSF, 2010) suggesting the presence of significant harm, relating to health and developmental impairments (s.31, CA). Significant harm, however, must be attributable to the care given by parents not being what it is reasonable for them to give (ibid.). Regarding food provision therefore, I would argue, contexts of poverty require consideration, affecting 27% of children currently living in the UK (Adams et al., 2012). Sam and Paul’s financial situation, therefore, might dictate how possible it is for them provide regular meals, causing the children to need services which promote their welfare (s.17, CA). Without this context, however, the children may be suffering significant harm, through their parents unreasonably denying them regular meals (s.31, CA).
Food insecurity has also been associated with externalising behaviours (Belsky, et al., 2010), highlighted in Zac’s aggression at school. Furthermore, regular meals have been linked with educational achievement (Roustit et al., 2010), suggesting Zac’s current cognitive difficulties, reading 4 years below his actual age, may be attributable to a lack of food. Whilst Zac’s educational development suggests his being a child in need, relevance of significant harm is less clear, in that without assessing causes of cognitive delay, the contribution of food provision to such difficulties cannot be ascertained and, as such, the extent to which parental care is insufficient. Zac’s current delay may also be associated with poor attendance at primary school, which is linked with poor attainment (Sheppard, 2009) and behavioural difficulties (Carroll, 2011). Furtermore, Karly’s attendance at primary school is also poor, which if not addressed may lead to similar developmental impairments, relating to concepts of child in need.
Inconsistent food provision may also be impacting Tierney’s development, who at 18 months is not walking and appears to have delayed speech, developmental concerns consistent with concepts of child in need. Whilst specialist assessments may indicate medical contributions, nutritional deficiency impacts physiological and cognitive development, required in language development (Rosales et al., 2009) and learning to walk (Hanson et al., 2011). Parental neglect has also been linked to language delay (Vernon-Feagans et al., 2012) and lack of routine and poor living conditions, both identified as problematic for the Smart family, are prevalent in cases of neglect (Long et al., 2012). As such, Tierney’s home environment may be contributing to her language delay. At 18 months, however, speech development is varied and what appears to be delay, may not be indicative of problematic language development (Graham, 2011), suggesting, in my view, that the extent of current concerns, in isolation are insufficient to constitute ‘significant’ harm.
Lack of routine and boundaries, might also be related to Zac being found by the police, unsupervised in the city centre, at 10pm, suggesting neglectful parenting, through a lack of adequate supervision (DCSF, 2010), or parental control (s. 31, CA). Sleep deprivation has been linked to poor attention and impulsivity (Beebe, 2011), noted as concerns for Zac, as such current routines, or lack thereof, limiting the security of sufficient sleep, may be impacting his ability to maintain a reasonable standard of development (s.17, CA). Establishing the presence of routine, or degree of supervision, is not possible on the basis of a singular event and as such the relevance of significance harm in relation to these factors is difficult to ascertain with additional information, making it a key consideration within assessment.
Lack of family routine and predictability could also be contributing to Zac’s behaviour at school (Deater- Deckard et al., 2009), and further exacerbated if concerns regarding domestic violence between Paul and Sam are found to be accurate (Moylan et al., 2010). Living in contexts of violence increases risk to children of physical and emotional abuse (Montgomery, 2009) and can affect secure attachment development (Levendosky et al., 2011), which I consider noteworthy as Tierney is at a key age for this, requiring sensitive and responsive care givers (Beijersbergen, et al., 2012) and Zac’s early attachment relationships are likely to have been disrupted by frequent foster care placements (Leve et al., 2012). In light of this, should domestic violence be evident, significant harm may be relevant and irrespective of its presence, current conflicts and instability in the family home, are likely to be impacting the childrens’ emotional development, suggesting their being children in need (Cummings and Schatz, 2012).
Significant harm often results from the long-standing impact of an accumulation of factors, rather than requiring a singular traumatic event (DCSF, 2010). Assessment, therefore, requires skilled critical reflection upon the inter-relatedness and cumulative effect of factors, both detrimental and protective (Rose and Barnes, 2008). In isolation, for example, there may be no evidence that Sam is currently misusing any substances. Associations exist, however, between substance misuse and domestic violence (Gilbert et al., 2012) and with chaotic lifestyles (Straussner, 2011), both possible concerns for Sam. Considering their cumulative effect, therefore, the likelihood of substance use still being problematic could increase, subsequently heightening, in light of its impact on child welfare, risk of significant harm (Traube, 2012). Ecological approaches, therefore, which consider the relationships between various parts of a system, can create a context for managing the complex interconnectedness of relationships, helping to avoid minimisation occuring when problems are viewed in isolation (MacKenzie et al., 2011).
The complex interplay of factors affecting the Smart children, I would suggest, requires a thorough knowledge of the family’s case file, including events which previously escalated risk of harm or promoted the childrens’ welfare, providing insight into current circumstances. Chronologies and genograms can provide visual aids in analysing such events and relationships and their impact upon one-another. Genograms can also beneficially be constructed in collaboration with families, highlighting unknown relationships and exploring conflictual ones.
Good preparation can also support the ability to form trusting relationships quickly, in communicating care for, and competence working with, families, which I would suggest, is key in creating relationally-interactive assessments, founded on principles of empathy, respect and transparency (Healy and Darlington, 2009). Creating contexts where collaborative exploration of assessment can occur, in my view should also be valued, accumulating everyone’s views, children, parents and professionals, on problems and strengths within the family and involving them in shaping the purpose and direction of assessment (Gallagher et al., 2011). Collaboration, however, is a two-way process and should also involve being clear about concerns and regularly discussing how the childrens’ welfare is currently being safeguarded and promoted (O’Leary et al., 2012).
Families may be understandably reluctant to engage in such relationships, however, perceiving assessment to involve ‘experts’ defining parenting competency and judging them as adequate or not (Buckley et al., 2010). Exploring the presence of domestic violence with Sam, for example, may differ if she views my role as collaborating with her to implement plans which make things better for her family, than if she views my role as assessing risk to the children and her inadequacy in protecting them from harm. Effective communication, a warm, empathetic approach and persistence may therefore be required, in challenging this perception and undertaking assessment in a way which seeks genuine collaboration, rather than tokenism (Platt, 2012).
Pauls’ inconsistency within the family home and the absence of information regarding Mike’s current involvement in Zac’s life, may lead me to give less significance to their engagement in the assessment process, placing expectations to provide good enough parenting, solely upon Sam (Brown et al., 2009). Irrespective of Paul and Mike’s legal parental responsibility, however, determined by their names being on birth certificates (s.2, CA), they play an important role in the lives of their children, affecting welfare and development through presence and absence (Coakley, 2013). As such I consider it important to assess the role that these fathers currently play in family life, the involvement they would like to have and risks and strengths associated with such involvement (Maxwell et al., 2012).
Observations, in my view, are also a key element of assessment, both of relational interactions and of living environment (Urwin and Sternberg, 2012). They have the potential, however, to be intrusive, unrepresentative of actual care and undermining of collaboration with parents. Clear understanding, therefore, by all involved, of their nature and purpose should be facilitated (Welbourne, 2012). Whilst multiple observations may create a more holistic picture of family life, reducing the impact of observer effects (Gambrill, 2012), in reality, quantity may be determined by time scales. This creates opportunity, however, in my view, for collaborative assessment, discussing with Paul and Sam how interactions may have occurred differently, had I not been there, indicating insight into, and valuing their expertise in, good enough parenting.
Children have a right to have their views heard and taken seriously (UNCRC, 1989) and as such, I would argue, should be actively involved in the whole assessment process, making adaptations, in light of their developmental capabilities, to enable engagement. Clear and simple language is required in explaining the purpose of assessment, as is gaining feedback confirming understanding and exploring their views on the best ways to undertake them (Petrie, 2011). Practical activities, in light of Zac’s educational difficulties, could better enable his engagement, such as photographing important things in his life, opening up discussions around strengths, worries, wishes and feelings (Pimlott-Wilson, 2012). Karly, being younger, could engage through play activities, using toys and imaginary play to express feelings about current situations, without having to talk directly about them (Landreth, 2012). Tierney, I would suggest, is harder to engage directly in assessment due to her communicative abilities. Behavioural communication, however, I would suggest can reveal a great deal and I would suggest that skilled awareness of this would be relevant to all three children (Handley and Doyle, 2012). Consideration should not only be given regarding how to incorporate their views in plans made, but how, when made, such plans are communicated sensitively, clearly and honestly to all three children, giving consideration to their developmental capabilities (Polkki et al., 2012).
Assessment is an on-going process and should not, in my view, be seen simply as a predecessor to intervention (Brandon et al., 2009). In light of this, it is possible to begin considering steps which can be taken to safeguard and promote the welfare of these children, whilst recognising the uncertainty which accompanies the continuous changes prevalent within family life and therefore the need for dynamic plans which can adapt to accommodate these (Welbourne, 2012).
Providing it is safe to do so, children should be supported to grow up within their own family (CA, 1989). Steps taken, therefore, to safeguard and promote the welfare of Zac, Karly and Tierney should seek to uphold this right. Consideration, however, must also be given to their health and development and whether remaining within the family is likely to, or resulting in, significant harm (s.31, ibid.). Even where legal steps are being considered, however, I would argue that the continuation of collaborative relationships with parents should still be sought, as greater engagement is likely to be seen if plans are constructed in partnership with parents (Gallagher et al., 2011).
It may be that the welfare of all three children can be safeguarded and promoted by Zac temporarily living away from the family home, allowing Sam to focus on the care of Karly and Tierney, as she has demonstrated capacity, in the past, to parent younger children given sufficient support. In light of this, however, it is important that such steps are not taken because Zac is seen to be a problem but because it would be more beneficial for him than maintaining the status quo. Greater paternal contact, may be one such benefit achieved, by exploring the possibility of Zac living with his Dad under a residence order (s.8, CA). With the information currently provided, however, the suitability of such a placement needs careful consideration, including Mike’s capacity to parent, giving particular regard to his previous substance misuse and its impact on his care of Zac. If this is not possible, it may be that Zac has strong positive relationships with Paul’s extended family, whom he could live with, as kinship care has been found to have positive impacts on identity formation, stability of placement and behavioural and mental health outcomes (O’Brien, 2012).
Accommodating Zac outside of the family home, however, does not mean his welfare will necessarily be holistically promoted. His emotional and behavioural development may be indicative of attachment difficulties (Fearon et al., 2010) and a mentoring scheme, which have been found to support positive emotional development in boys displaying aggressive behaviours (Younger and Warrington, 2009), may be of benefit to Zac. Educational concerns have also been highlighted for Zac and although a more stable, home environment may support his educational development (Turley et al., 2010), sufficient impairment may have already occurred to warrant specialised support. Whilst Zac’s school may be better positioned to facilitate this, I would suggest it to be a key part of plans for promoting his welfare.
Sam’s capacity to parent, even two children, may also be significantly impacted by domestic violence (Levendosky et al., 2011). If following assessment, it is found to be present, the risk of harm to children living in contexts of violence (Stanley, 2011), could create the need for care order applications (s.31, CA) or voluntary foster care (s.20, ibid.), in respect of Karly and Tierney. If Sam is willing to engage with support, however, she could be supported to live independently, with her two children. Significant risk of violence continues, however, when domestically violent relationships end, requiring additional steps to protect Sam and her children, from continued risk of violence (Stanley et al., 2012). Enabling safe and productive contact, between Paul and his children, would also need consideration, including the girls wishes and feelings regarding this (Featherstone and Fraser, 2012). If both Paul and Sam, however, admit to the violence, engage with support and commit to removing it from their relationship, it may be that they can remain living as one family unit, although careful consideration is required as to how such commitments can be monitored and what domestic violence support is available for the whole family (Stanley, 2011). Irrespective of the presence of violence, however, Paul’s inconsistent living arrangements, combined with regular arguments, create conflict and instability which could impact emotionally upon the girls (Davies et al., 2012) and therefore steps are required to safeguard and promote their emotional welfare, exploring options of permanency for Paul and therapeutic family work being undertaken, finding less confrontational resolutions to disagreements (Cummings and Schatz, 2012).
Lack of routine, in my view, is impacting multiple areas of the childrens’ welfare, including school attendance and meal provision. Colourful charts laying out daily routines, such as meals, school, play, bathing and bedtimes, created in collaboration with the family, could reinforce the childrens’ basic needs, act as a visual reminder for maintaining routine, make tasks seem more manageable and create reassurance for the girls around their needs being met (Rees, 2011). Such a tool can support measurable outcomes, with home visits occuring at key times, to monitor progress and provide support where it is needed. For such interventions to be effective, however, the continued development of collaborative, trusting and supportive relationships is required, whilst being clear about the necessity of the childrens’ needs being met (Darlington et al., 2010).
Tierney’s welfare, in particular, could be promoted through using a local childrens’ centre, supporting language development, mobility, attachment relationships and providing parenting support (Sheppard, 2012). Whilst attendance cannot be compulsory, Sam has engaged with support in the past and, I would suggest, collaborative planning will increase the chances of her engaging again (Gladstone et al., 2012). Social workers, however, have supported this family over many years and although engagement is not described, deterioration in the childrens’ development has continued. Presuming that my interventions, therefore, will necessarily have a greater impact is uncritical and as such I would argue the importance of clarity, openness and honesty regarding expectations upon Sam and Paul and that if they are unable to safeguard and promote their childrens’ welfare, with support, care order options will be pursued, which could result in the children being adopted.
Concluding this case study, I would suggest is a complex task, particularly as assessment and welfare planning are part of a continuous process and therefore natural conclusions do not necessarily occur. Both concepts of significant harm and child in need, I would argue, to some extent have been shown to be relevant to the Smart children and that interventions to promote health and development are required. Whilst a range of assessment skills and methods have been explored, implementing these in practice is more complex than conveying them within an argument and, I would suggest, is largely dependent upon the quality of working relationships with family members (Platt, 2012). Analysing this case study has demonstrated to me the uncertainty which pervades safeguarding and promoting welfare within social work (Ferguson, 2010), the need to make purposeful space for assessing strengths and protective factors (Roose et al., 2012) and the complexity of striving for holistic analysis of inter-related presenting factors , whilst recognising that uncertainty will remain in the ever-changing reality of lives (Saltiel, 2013). Despite this, however, social work requires a degree of decisiveness, in collaboration with family and discussion with managers, as safeguarding and promoting the welfare of these children necessitates competent and effective assessment, planning and intervention (Munro, 2010).
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