The case conference is a multi-disciplinary tool which people dealing with child abuse or violation of child rights may use to explore the problem of a particular child or of a group of children affected by the same problem from different perspectives and disciplines. It groups professionals or frontline officers from different backgrounds and sectors that, through their expertise and experience, would help in understanding the child s problem contribute in finding appropriate solutions and develop care plans. The focus of the multidisciplinary case conference is on the protection and welfare of the child. A family perspective is also favoured as the Convention on the Rights of the Child (CRC), in its preamble recognizes the family as the fundamental group of society and the natural environment for the growth of all its members and particularly children. So the Multidisciplinary Case Conference (MDCC) will review the safety and welfare of all children as well as the other members of the family. Special interventions may target parents so as to empower them to care for their children. The major functions and tasks of the MDCC The major functions of the MDCC and the main tasks to be performed by its members are as follows: 1. To examine the cause for concern, analyse available information and decide from a child rights and welfare perspective whether there is a child abuse or neglect case or if the child is at risk of being abused. The nature of the abuse or problem is then defined. 2. To share information collected through observation or intervention carried out by any member of the MDCC or institution. 3. To assess the level of risk the child may potentially face or facing now. 4. To make recommendations for the welfare planning of the child. 5. To assess the degree of risk and make recommendations for the welfare planning of other children in the family (if any). 6. To assess the overall situation of the whole family. 7. To agree on an inter-agency care plan to protect the child and empower the other members of the family (if necessary). 8. To identify the key social worker/fspo or any other officer who will lead the intervention and clearly define the roles of the other helping professionals in the implementation and follow up of the care plan for the child. 9. To decide how the child and parents will be informed of the outcome and decisions of the conference and who will be responsible of doing so. 10. To consider the need, if any, for statutory action to protect the child or to ensure the child s welfare. 11. To consider the need for subsequent MDCC with reference to : 1
(a) The need for further information (b) The need to review any follow up action; and (c) Any important decision of the MDCC that cannot be implemented because of circumstantial changes and which may jeopardize the well-being of the child; 12. To consider the need and timing to issue progress report to related parties involved in the follow up of the case. The Value of the MDCC The MDCC is a valuable tool in child protection or child welfare intervention. The positive aspects of the MDCC are: 1. It provides an opportunity for better association and association among professionals from different disciplines working for children. Thus facilitating the creation of comprehensive response protocols that are child friendly. 2. It helps the different institutions or departments or NGO s to understand the concepts and perspectives of the other professionals involved. Thus, they are able to locate themselves in the chain of protection. They understand their roles and responsibilities in facilitating well co-ordinated outcomes for child victim/witness/offender. 3. It prevents overlapping or duplication or interventions which often cause re-victimization of the child. 4. It contributes to the capacity building of each member of the MDCC. Through their discussions and interactions, it helps the different duty bearers to foster relationships among themselves. There is cross polination and fertilization of perspective and ideas. 5. It provides a platform and an opportunity to discuss any legal and ethical dilemmas that the professionals involved may face during their joint handling of the child and in any decision making proceedings. Factors contributing to successful MDCCs The MDCC is meeting of competent persons who through their expertise, experience and ability to foster interpersonal relationship will try to contribute in finding appropriate solution to a child s problem and in elaborating a care plan for him. The success of MDCCs would depend, inter-alia on the following: 2
(a) The personal commitment of each member (b) The development of a shared vision and the setting of common goals (c) Clarity of roles and communication among all members (d) The support and backing of each member of their respective institutions (e) The leadership skills of the chairperson (f) The collaboration and cooperation of various professional bodies like the society of psychologists, the medical council or the Bar Council Administration and Chairing of Child Protection Case Conferences Case Conferences should be chaired by a senior member of the organising agency with appropriate training and skills in the chairing of inter-agency conferences. The Chair should not have first line management responsibility for decision-making about the case. The organising agency has the responsibility for the administration and chairing of the case conference; Notice will be sent out as far in advance as possible The conferences will be held at a time and venue that is convenient to the majority of attendees The conference must have a dedicated person to take notes and produce a minute of the meetings All participants will receive a copy of the minutes Responsibility to convene MDCC 1. The officer-in-charge / supervisor / co-ordinator of the concerned units providing casework service like OCO, CDU, the MEHR as well as the medical social services units of Social Welfare Department and Hospital Authority will assume the chairmanship and the related responsibilities. 2. The Chairperson should be experienced in child rights and/or family service or paediatric service and have good knowledge on child protection and family work. 3. If two or more service units share the case, the unit that has the main responsibility for the family should chair the MDCC or arrange a Chairperson as appropriate. The unit to take up the chairmanship may or may not be the one that first discovered the child abuse incident. In case of uncertainties or difficulties, the units should discuss among themselves to decide who to chair the MDCC. 3
4. The Chairperson should not directly handle the child abuse case. Guidelines for the Chair: o The Chair will take time prior to the Case Conference to become familiar with the issues; o The Chair will consider and rule on requests that a parent is excluded from the Case Conference or requests that the child should attend the Case Conference; o Where there is a decision to exclude a parent/s and the child (if attending) from the Case Conference, the Chair must ensure that this is recorded in the introduction to the minute and shared, in writing, with the parent/s or child as soon as practical after the conference; o In each and every case the Chair will meet with the professionals attending the case conference prior to its commencement and before the parents and child are invited in, to confirm if any professional needs to share information without the parents being present. If so, this should be done prior to the parents joining the Case Conference; o The Chair will meet with the parents (and child if attending) prior to the Case Conference and confirm their understanding of the purpose and process of the Case Conference and to ensure they have had an opportunity to read all relevant reports; o Written decisions made at the Conference will be distributed to the appropriate agencies and the parents and the child, by any means appropriate to his evolving capacities. o The Chair will ensure the accuracy of the Case Conference minutes and that they are distributed to the appropriate agencies and the parents within one week. Depending on the child s evolving capacities, he may also be informed of the minutes, by any means appropriate. o The Chair will usually chair any Case Conference that reviews the registration of the child; o The Chair will check whether there are any issues of disability or ethnicity, religious or cultural background that the Conference should take into consideration; 4
o The chair will have the authority to challenge any lack of progress in taking forward the child protection plan. THE CASE MANAGER To facilitate coordination of the services rendered by different professionals and reduce the child s stress and trauma of repeating the abusive experience, the case manager approach should be adopted so that the child only needs to interact with the case manager for most of the time whenever situation allows. Under most circumstance, the key social worker handling the case would normally take up the role of the case manager. However, other professionals involved should also cooperate with the case manager as appropriate in order to ensure coordinated intervention among different personnel. The role of case manager includes: (a) To prepare the child and his/her parents/guardians/carers for the steps/ tasks involved in the intervention process so as to reduce their anxiety and enlist their cooperation. (b) To collect relevant information from other professionals/personnel involved; (c) To share relevant information with other professionals/personnel involved on a need-to-know basis; (d) To take necessary actions, including the application for Court Orders, to safeguard the immediate well-being of the child; and (e) To ensure that actions taken by the responsible parties are well coordinated; (f) To render timely assistance and support to the child and his/her family members; (g) To have access throughout the course of investigation to the supervision and advice from a senior colleague/supervisor who has the proper training and experience in handling child abuse; (h) To consult other professionals in case of any difficulty encountered. Role of Other Participants in Child Protection Case Conference The Conference will require certain information from those attending. This information should be factual. The Conference may ask for judgement and professionals opinions. This too should be based on fact as well as experience and fact or opinion should be clearly identified as such. The Conference will require accurate and up to date information about the child subjects, parents/carers and other members of the household. From the organising agency: 5
Details about the reason for the need for the Conference A chronology of significant events, agency and professional contact with the child and family Information on the child s current and past state of health and development Information on the capacity of the parents and other family members to ensure the child s safety from harm, and to promote the child s health and development The expressed views, wishes and feelings of the child, parents and other family members An analysis of the implications of the information obtained for the child s future safety, health and development in terms of unmet need within the family Recommendations about how needs can be met in a manner that ensures the safety of the child and promotes their health and development From other agencies: An explanation about the service that has been provided and about how the family has responded to that service Concerns about the safety and development of the child from that agency s perspective Recommendations about how unmet need can be addressed It is recognised that for some professionals, especially those who do not attend Case Conferences on a regular basis, the prospect of doing so can be quite a daunting one. The key to contributing effectively is preparation and the following pointers should be of some help Make sure you understand the process of the Conference (the Chair will be happy to discuss this with you in advance of the Conference) If you have submitted a written report, it is good practice to let the parents and, where appropriate, the child, read it in advance of the meeting. In cases where the child cannot yet read, it is strongly recommended to inform him of the content of the report orally. Basic information about the family must be accurate (spelling and pronunciation of names, dates of birth, etc.) The way you give your information should be well thought out. At times difficult and sensitive information must be shared about parents and in their presence. This 6
must not be watered down due to the professionals anxiety, but should be presented in a way that is as manageable as possible to the parent The parents have the right to challenge information, so it is important to ensure it is accurate Other participants need to be left with a clear idea of your involvement All opinions should be substantiated with an explanation of how they were arrived at. You should not make unsubstantiated value judgements If you have positive comments to make about the child/family, make sure these are made If you disagree with any points made by other professionals you should voice your disagreement and the reasons for it It is a good idea to give some thought to what contribution you could make to a Child Protection Plan, should the child s name be placed on the Child Protection Register. This should include the amount of time as well as professional expertise you could contribute. Confidentiality Case conferences will contain the facility to exclude parents for a brief period between the main information sharing and the decisions and recommendations section. This is strictly to allow for relevant third party information to be chaired, i.e. police information relating to other parties, and for legal opinion to be sought where appropriate. The Chair will remind conference members that any information tabled during this section that could/should be shared with parents will be repeated once parents re-enter the conference. Preparation of Parents It is a requirement of parental participation that the report writing social worker ensures that attending parents/carers have had an opportunity to read the report prepared for the meeting before attending and have been able to clarify any queries or misunderstandings. This should preferably be in the presence of the report writer. In exceptional circumstances it may be considered appropriate for parents/carers not to have read the report prior to the meeting. This decision will only be taken in consultation with the Chair. Parent/carers, and supporters where appropriate, will be invited and where necessary assisted to attend a pre-meeting briefing with the Chair 30 minutes before the meeting. This is to assist their participation and will: 7
outline the purpose and function of the meeting including focus on the child(ren) outline who will be attending and why explain the meeting s agenda giving a clear outline of how and when parents/carers will be expected to contribute establish that parents are aware of the contents of reports establish parents literacy and linguistic ability and any other special needs, and agree a strategy for dealing with these Preparation and participation of the child in the Conference. Article 3, CRC: In all actions concerning children, whether undertaken by public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interests of the child shall be a primary consideration. Article 12, CRC: States parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child. According to the Convention of the Rights of the Child (CRC), when addressing issues concerning a child, several important principles should be taken into consideration. Thus, in the case conference procedures, a special attention needs be given to the child before, during and after the conference. One of the main objectives of the Convention is to ensure full participation of the child in all matters concerning, be it directly or not, his life and his environment. Therefore, as its article 12 stipulates, every effort should be made to assist children and young people to have the opportunity of ensuring that their views are made known to conference. In doing so, it will enable the final decision to be effectively in the best interests of the child, as the Convention stipulates in its article 3. Participation of the child in the conference can be achieved in many different ways: 8
via someone attending the conference, whom the child trusts, who can represent their views and feelings - there is an expectation that whoever represents the child s view would arrange to see the child to advise them of the outcome child can give letter or send taped information to conference with someone they trust or directly to the chair some young people may feel that they wish to attend the conference and in these circumstances the social worker must discuss this with the person who is to chair the meeting. The chair and Case Manager will decide how this can best be managed as it may not be appropriate for the young person to attend the whole of the meeting. A direct contact with the child is highly recommended so as to allow him to express himself and explain his motivations to attend the meeting. alternatively a child or young person can request to meet with the chairperson either before or after the conference. Whenever children and young people contribute to conference, the chair will write to the young person to thank them for their contribution and to advise them of the outcome of the conference. Reports The case manager must prepare a written report for a Child Protection Case Conference covering the following areas:- Subject(s) and family details Incident leading to the Conference Subsequent Investigation Relevant Background/Family Information Current Situation Family Views Child(ren)s Views Assessment of Risk 9
Recommendations This report must be received by the Conference Chair at least one day in advance of the Conference, and must have been shared with parents/child prior to their attendance at Conference. A written report outlining the medical examination and findings must be available for Conference and should be received by the Conference Chair at least one day in advance of the Conference. Written reports by other key professionals should also be forwarded at least one day before the conference and wherever possible should be shared in advance with the family. A written report assists in presenting somewhat complex information and this represents professional good practice. The conference chair will check whether parents have had the opportunity to read all reports prior to commencement of the Conference, it is therefore important that every effort is made to go through the report in advance to avoid delay to the conference start time. Case Conference Tasks A Conference must undertake the following tasks: a) maintain the child/ren as the primary focus so as to promote their protection and welfare. b) examine current circumstances and concerns, and evaluate the findings of the child protection investigation leading to Conference. c) establish and evaluate all relevant information relating to the child and family circumstances, including any previous abusive incidents. d) determine whether concerns are sufficiently substantiated to warrant a Child Protection Plan. The only decision a Case Conference can make is whether or not a child needs a Child Protection Plan. In certain circumstances a Conference may recommend that this decision is deferred pending further investigation and that the Conference be reconvened at a later stage. When a decision is made that a child needs a Child Protection Plan. Conference must identify the reasons why a Child Protection Plan is needed. 10
The need for a Child Protection Plan (CPP) should be considered separately in respect of every child in the family or household. Conference will also recommend a range of other actions forming the basis of the Child Protection Plan, for example: nominate a Social Worker as Key-Worker for the child who is subject to a Child Protection Plan. determine what steps are necessary to ensure the protection of all children in the household. This may include a recommendation that Care Proceedings be initiated by Social Care. recommend how a multi-agency assessment of the family should be undertaken, highlighting the specific areas to be covered. recommend how a multi-agency plan to protect the child(ren) should be developed, implemented and co-ordinated. nominate membership of a core group who will be responsible for undertaking the assessment and implementing the Child Protection Plan. consider the need for any criminal proceedings against the perpetrator(s) of the abuse. consider whether an application should be made to the Criminal Injuries Compensation Board for compensation for the child. agree to review the Child Protection Plan within three months of the Conference and at least six-monthly thereafter. It is expected that any undertakings made at Case Conferences will be honoured and that any significant deviation from the agreed Child Protection Plan will not be implemented without the Conference being reconvened to consider the proposed change of CPP. When a Conference decides that a Child Protection Plan is not required the family will be offered continuing support from agencies as necessary. The Multi-disciplinary Case Conference Minutes of Proceedings The Chair is not responsible for taking the minute, but will check it for accuracy and sign it. However there is a responsibility for all attendees to check the minute. A copy of the minute should be circulated to all those invited to attend. The minute will: Record who attended and any apologies or absences 11
Summarise established or new information and key points from the discussion at the Conference Identify one main category of abuse and highlight any others that are relevant Record decisions of the Case Conference and responsibility for action on registration, recommendations for the inter-agency Child Protection Plan and the date and time of the next conference with any reservations or dissenting views on these matters also being recorded Parents will receive a copy of the minute, but this will not include a note of any discussion that took place during any closed session held prior to them joining the meeting. The Child Protection Plan When a Case Conference decides a Child Protection Plan is needed it will specify the category of abuse appropriate (see the signs and symptoms at appendix 1). A child will only need a Child Protection Plan if the conference is satisfied that the risk of significant harm, as defined within the above categories, is such as to warrant a multiagency plan. One of the following requirements must be satisfied for a Child Protection Plan to be required: There must have been one or more identifiable incidents which can be defined as child abuse and which can be seen to have adversely effected the child, and, an assessment of risk considered by the conference has concluded that further such abuse is likely to occur, or Significant harm within the definition of child abuse is considered likely on the basis of professional judgement of the assessed risk based on the findings of the investigation in this specific case. Consideration should be given individually to any other children residing in the same household and a risk assessment in respect of each of these considered by conference to determine whether any of them should also have a Child Protection Plan. Siblings, or other children in the household, will not automatically be subjects of a Child Protection Plan. The Child Protection Plan should set out what work needs to be done, why, when and by whom. The plan should: describe the identified needs of the child, and what therapeutic services are required; 12
include specific, achievable, child-focused objectives intended to safeguard the child and promote his or her welfare; include realistic strategies and specific actions to achieve the objectives; clearly identify roles and responsibilities of professionals and family members, including the nature and frequency of contact by professionals with children and family members; lay down points as to when progress will be reviewed, and the means by which progress will be judged; and set out clearly the roles and responsibilities of those professionals with routine contact with the child, e.g. health visitors, GP's and teachers, as well as any specialist or targeted support to the child and family. The Child Protection Plan should take into consideration the wishes and feelings of the child, and the views of the parents, insofar as this is consistent with the child's welfare. The Key Worker should make every effort to ensure that the children and parents have a clear understanding of the objectives of the CPP, that they accept it and are willing to work to it. Child Protection Review Conference Every Child Protection Plan will be reviewed by a review conference within the first three months of when the Child Protection Plan was implemented and thereafter not less than six monthly. All conference participants will be invited to participate in the review, plus parents/carers of the child. Children and young people may also be invited to participate, dependent on their age and understanding. To determine the appropriateness of the child attending the key worker must consult the conference chair. A written report will be submitted for consideration by the conference covering the following: a) significant developments since the initial case conference/last review b) whether the recommendations of the last conference/review have been implemented, if not why not? c) the current level of risk to the child(ren) with a Child Protection Plan d) level of risk to other children in the household e) appropriateness of existing Child Protection Plan/suggested changes to the plan f) effectiveness of inter-agency collaboration 13
g) whether the Child Protection Plan should continue or end h) whether any children without a Child Protection Plan should become the subjects of child protection procedures Any amendments to the Child Protection Plan must be formally notified in writing to the agencies concerned.. 14