[Verified Answer]: The Risk Factor: Where Do We Go From Here

The Risk Factor: Where Do We Go From Here? It is often far from easy for social workers & health care professionals in the child protection field to know – never mind prove – that the course of action they are taking is ultimately in the best long-term interests of children at risk. This is particularly so where staff are trying to ensure that children at risk remain with their birth parents. Professionals Key concerns Lauren Gayle, a Children & Families social worker regularly faces this dilemma and is currently working with Angela Jones and her three year old daughter, Julie. Angela’s community mental health nurse and a health visitor referred them to her team because of Julie’s failure to thrive. Angela was six months pregnant with her second child but has only seen a midwife once having missed three appointments. Despite the help of the mental health nurse both before and after Julie’s birth, Angela still seemed unable to parent properly and neighbours reported seeing her in a drunken state. Angela promised the health visitor she would change and has asked her to promise not to say anything to the social worker or midwife. Angela has a diagnosis of psychosis and is a regular user of cocaine and cannabis. She also has some learning difficulties. A Family Centre support worker carried out an initial assessment and then met Angela twice a week to try and help her improve her daughter’s safety and general stimulation. Angela has had two older children removed in to care who have since been adopted. It also materialised that Angela’s parents were alcohol abusers, that she had started to use alcohol regularly from about the age of eight, and that she engaged in prostitution in her early teens. “In person she was very engaging and lucid and obviously loves her daughter” Lauren says. She began regular reviews of how the family was coping, especially the risks posed to Julie. She obtained a paediatrician’s assessment to make sure there was no organic reason why Julie’s weight was so low. A Children’s Nurse carried out some play work during the appointment and observed a reluctance from Angela to join in with play. Lauren met regularly with the health visitor, mental health nurse and the family’s GP; they brought in considerable extra resources, including intensive child minding and debt counselling and introduced Julie to a playgroup. “I hoped that this high level of support and education would really make a difference to her parenting skills and, of course, it helped us to manage the considerable risks to Julie’s health and safety”. Some members of the team, however, felt that the resources could be put to better use elsewhere. During this period, which lasted 18 months, Lauren Gayle and her colleagues gradually gave Angela back some responsibilities, such as managing money and other specific tasks. “But it became clear that she was either unable or unwilling to put into practice what she knew had to be done. Obviously, we couldn’t carry on like this, so we planned a child protection conference. A difference of opinion arose between the professionals: The GP, health visitor and midwife stated that Julie and the baby should be protected from further harm and placed in foster care. The social worker and mental health nurse felt that Angela should be given more time to demonstrate change and that the children should remain in her care, with support and regular home visits. There has been criticism of the length of time the team worked with Angela with little signs of change –that care proceedings should have been initiated much earlier in Julie’s best interests. Social workers struggled with this dilemma and felt that Angela should be given more time in light of concerns for her mental health and learning disabilities. In the end the Court issued a care order and Angela’s daughter Julie, and the baby, were placed in foster care. Introduction • Outline the main issues in the case and the professionals involved. Main Body • Analysis of four ethical dilemmas in the case. AC1.1 • Analysis of at least two examples good and poor practice in case management. AC2.1 • Analysis of the reasons for the different ethical arguments of the GP and Social Worker AC3.1 Conclusion • Was the case handled appropriately within the legal framework of the Children Act 1989 and the NMC/HCPC Code of Practice? Recommendations • Write at least 2 recommendations to improve the way H&SC professionals work together with children and families?