Multidisciplinary Working to promote the protection and welfare of children

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1 Multidisciplinary Working to promote the protection and welfare of children Facilitators Ciara Toughy Family Support Worker, Salthilll- Knocknacarra Family Support Service Siobhan Sammon Social Worker- Galway City Social Work Department

2 Key Principles for Best Practice in Child Protection & Family Support The welfare of the child is of paramount importance. Children have a right to be heard, listened to and to be taken seriously. Taking account of their age and understanding, they should be consulted and involved in all matters and decisions which may affect their lives. Family Support requires a clear focus on the wishes, feelings, safety and well being of children. Early intervention and support should be available to promote the welfare of children and families, particularly where they are vulnerable or at risk of not receiving adequate care or protection. Family support interventions are needs led and strive for the minimum intervention required. Working in partnership is an integral part of family support. Partnership includes children, families, professionals and communities. Effective prevention, detection and treatment of child abuse or neglect requires a co-ordinated multi-disciplinary approach to child care work and effective inter-agency management of individual cases. All agencies and disciplines concerned with the protection and welfare of children must work co-operatively in the best interests of children and their families. Children should only be separated from parents/carers when all alternative means of protecting them have been exhausted. Re-union should always be considered.

3 CASE STUDY Amanda aged 34 has a long standing drug addiction to heroin and uses valium on a regular basis. She lived in Dublin for several years but moved to Galway in She has 4 children, Claire aged 11, Aisling aged 8, Tom aged 5 and Saoirse aged 2 months. She has no contact with any of the children s fathers. The family were originally referred to the Social Work Department in Dublin in late 2003, due to Amanda's drug use, domestic violence in her relationship at this time and periods of homelessness. Successive Child Protection Case Conferences were held between 2004 and 2006 to address these concerns, and the case was eventually closed to Child Protection in early At this time, Amanda was engaging well with the HSE Methadone Program, had secured accommodation and was no longer in a relationship with the children s father. The family moved to Galway in late 2007, and Amanda engaged with the local Methadone Programme and HSE Drug Service. Sporadic concerns reported to the Social Work Department between 2008 and 2009, but the family appeared to be managing well during this time. Prior to Saoirse's birth in March 2009, the HSE drug service re-referred the family to the Social Work Department as Amanda was using large quantities of valium and was testing positive for opiates (heroin) on a regular basis. Saoirse was detoxed at birth from methadone and heroin. A referral was also completed to the Family Support Service at this time.

4 Current concerns Amanda is going to be detoxed from the methadone program as she has continued to use heroin, street methadone and valium. Amanda completely minimises drug use and its impact I only used a little bit, it makes me feel normal. Amanda has presented a drowsy on several occasion to different professionals. All services involved with the family find it difficult to visit the family at home, very difficult to contact Amanda via phone. The Family Support Service have been working with the family since mid 09, Amanda has not been engaging with the service since May 2010 and has stopped taking the children to the service. Claire, Aisling and Tom have missed a significant amount of days at school, are always late, often without lunches or lunches late. The school never attends Case Conference. Amanda s extended family are supportive but are not aware of the extent of Amanda s drug use and are suspicious of the motives of Social Work Department, and Family Support, and are unhappy with the level of information the Drug Service are able to give them.

5 Concerns for Claire, Aisling, Tom and Saoirse Claire takes on an adult role, worries about mum and siblings but also dismissive of mum when she tries to assert authority Aisling is quite and withdrawn, and is very close to her mother Saorise is not meeting her development milestones Tom is constantly looking for mum's attentions, hits Saoirse and is having difficulty mixing with his peers in school. There is a very loving and warm relationship between Amanda and her children

6 Child Protection System The following services are involved in the children s Child Protection Plan: Social Work Department Family Support Service HSE Drug service and Methadone Clinic School PHN Gardai GP Galway City Council

7 Over to You? Considering the principles of best practice in Child Protection and Family Supportwhat inter agency work can be undertaken at this time to support the family in the children s best interest?

8 What happened next? A crisis point was reached and consideration had to be given to the children coming into care? A family Welfare Conference was convened- Permission was given to share the extent of the problem with extended family The addiction councillor, family support worker and social worker attended. Trust was built up between the services and the family the family came up with a plan

9 An Emergency Child Protection Case Conference was convened: A Supervision Order was applied for and granted The family were to avail of all the services of the services recommended The school attended the conference The maternal grandmother also attended, and moved in with the family to support and supervise the children while Amanda was off the methadone programme The drug service agreed to keep meeting with Amanda and take her back on the programme after a period Voluntary Respite was agreed to support Amanda and the maternal grandmother

10 What worked well from a Social Work Perspective: Communication between the family and services increased, which let to a better understanding of each services roles and balancing act of roles, responsibilities and boundaries Supervision Order more frequent case conferences held (4 monthly) Monthly reviews were held with the Drug Service, Social Work Department and Amanda Maternal grandparents involved in Care planning and Case Conferences

11 What worked well family support worker perspective Referral was made by Social Work Department in 2009 to provide parenting support to Amanda and provide groups/activities for the children. (Families engage in a voluntary capacity with the Family Support Service.) Home visits were offered on a weekly basis to discuss/encourage routines and parenting skills with Amanda. Clare and Ashling were offered a number of term-time and afterschool programmes with the project. Attendance up to Christmas was sporadic. Amanda was evasive with staff re: home visits and targeted pieces of work. Amanda disengaged for a period of time. This was made known to the social worker involved. Family Support was involved in the Family Welfare Conference and subsequent child protection conference meetings, and reports were submitted detailing our involvement and progress/concerns. Following this period Amanda agreed to avail of support and a Family Support Plan was identified.

12 What worked well family support worker perspective Concerns were made known by Family Support staff to the social worker involved, relating to Amanda s poor physical presentation and her admission of her use of street methadone and valium. Assessments were carried out with the family and the school to assess the children s emotional and developmental needs, so that a current Family Support Plan could be put in place. Clare attended the project two evenings a week to avail of homework support. This support was adjusted when the family s living arrangements were stabilised after the Christmas period. Clare was witness to a great deal of Amanda s drug use and was familiar with her need to get well. Clare was also seen to be taking inappropriate responsibility for her younger siblings by shielding them from the effects of Amanda s use/recovery. Individual work was offered to Clare to identify and cope with feelings and emotions through identified games and free play.

13 What worked well family support worker perspective Regular contact was maintained with the Social Work Department, especially during times of crisis and nonengagement. Family meetings were arranged to discuss issues with Amanda and support her where needed. In-home parenting support was made available to both Amanda and her extended family, in an effort to address the chaotic nature that had developed in the household. Amanda was aware that services were working together in the best interests of the children and her potential recovery. This aimed to avoid miscommunication between services and Amanda and ensure that interventions were appropriate.

14 Barriers to good Multidisciplinary Working to promote child protection Time Relationship difficulties/personality clashes Conflict between services- client/children gets lost Lack of understanding of services roles, responsibilities/boundaries

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