Children and Young People (Scotland) Act 2014: National Guidance on Part 12: Services in relation to Children at Risk of Becoming Looked After, etc

Part Two: Supporting Children And Their Families

Getting it Right for Every Child

38. The Getting it Right for Every Child ( GIRFEC) approach is underpinned by early intervention and supporting families at times of difficulty. This applies to children from birth to eighteen years old and to young people beyond their 18 ^th birthday if still at school. The GIRFEC approach should reduce the escalation of problems that may lead to a child needing to become looked after. As part of GIRFEC, all children and their families have access to universal support services.

39. The Getting it Right for Every Child National Practice Model includes a 'My World' triangle which supports everybody involved with a child (aged from 0-18) to consider: How I grow and develop; what I need from people who care for me; and my wider world. In adopting a holistic understanding of the child's world, there is an opportunity to address a child's wellbeing needs at all stages of childhood. The national wellbeing indicators are Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included (commonly known as the acronym SHANARRI) as set out in section 96(2) of the 2014 Act.

40. The development and strengthening of support to families at the earliest stages is an important feature of GIRFEC. Between 2002 -2010, there had been a significant increase in very young children becoming looked after. In 2015, 40% of children who started to be looked after were under the age of five. ^[9] Research conducted by the Scottish Children's Reporter Administration ( SCRA) found an increasing trend in the use of Child Protection Orders, (including pre-birth) and the majority of children were consequently looked after away from their birth parents (70%). ^[10] Almost half of all child protection orders (n=734 in 2013/14) were for children under the age of two years old. Given that approximately two-thirds of children were already known to social services, the authors' of the SCRA report question whether the risks could have been identified earlier and interventions could have taken place to prevent the emergency intervention of a Child Protection Order.

41. In planning for the provision of relevant services in relation to family group decision-making services and support services in relation to parenting, local authorities, in collaboration with their Community Planning Partners, may wish to consider the current and projected demography of children at risk of becoming looked after, in order to develop and design services appropriately.

Family Group Decision-Making Services

42. The ethos underpinning family group decision-making services is a strengths-based, solution-focused model (rather than a deficit-based problem-focused one). Since the 1970s, social work theorists have increasingly recognised that families have the ability to identify their own solutions to the challenges they face. This can increase self-esteem and self-efficacy within families. Fundamentally in working with families, there is a shifting of power dynamics, and increased recognition of the strengths and resilience within family networks to overcome adversity.

43. There are a variety of family group decision-making service models. Family decision making services ( FDMS) is a term more commonly used in the USA. This encapsulates and widens the most commonly known Family Group Conference model ( FGC). There are a wide range of tools developed for practitioners to involve families in decision making where there are child protection concerns or youth offending behaviour. For example, an Australian Signs of Safety model has demonstrated improved engagement with the family where there are child protection concerns, as well as higher levels of job satisfaction from front line social workers. ^[11]

44. Recognising and developing supportive relationships within families to meet the needs of the child are fundamental to family decision making services. The FGC model has four distinct parts: preparation with the family and the wider network; information giving stage at the start of the Family group conference; private family time to develop a plan; sharing the plan with the co-ordinator and professionals for agreement. Increasingly there is recognition that a further step may be required for the family group to reconvene to discuss progress on implementing the plan at a later stage.

45. In 2015, a set of National Standards were developed for FGC in Scotland. ^[12] Building on an evidence-base, the key standards are:
a) The FGC coordinator is independent;
b) Children and young people are paramount in the FGC process;
c) The FGC should be family-led and include 'private family time' to make decisions and plans;
d) Everyone participating in the FGC will be prepared and supported through the process;
e) Families have the right to have their safe plans agreed and resourced;
f) The FGC should be sensitive to the family's culture, taking account of ethnicity, language and religion.

46. There is strong international evidence that families engage positively in the family group decision-making processes concerned with child welfare when given the opportunity. ^[13] In a research review, Ward and colleagues (2014) found family decision making models, as well as Motivational Interviewing and Family Partnerships Models can 'offer potential methods of engaging parents who are ambivalent about change, mistrustful of social workers, or not fully ready for change'. ^[14]

47. The quality of the independent coordinator in mediating with family members is considered critical to the success of the FGC process. Furthermore, there is a specific role for the child's advocate, supporting the child's participation in the process (as appropriate to age). Whilst acknowledging that more research is required to demonstrate the improved outcomes of children involved in FGC, the authors conclude that the evidence of participation is compelling:

'Studies of the experience of children and families using the FGC model suggest that FGC is a family-centred and strengths-based approach that promotes partnership between family and State, and can consequently act as an empowering process.' ^[15]

It should be noted that FGC is one of a number of successful evidence based early engagement services that include family group decision making.

48. The values and ethos of family group decision making is often demonstrated in social work practice. In Scotland, the 1995 Act clearly embedded working in partnership with parents to address the needs of their children as does the Social Care (Self-Directed Support) (Scotland) Act 2013 which enshrines in statute principles of collaboration, participation & dignity, involvement and informed choice. The evidence reflects that social workers are influenced by participating in FGC processes; they use a strengths-based approach in all of their work.

49. There are opportunities in family group decision making processes to consider the applicability and provision of self-directed support options for children in need as set out in section 8 of the 2013 Act. The recognition of a family's strengths and abilities to identify, and be part of solutions, underpins the ethos of self-directed support. This works well with the asset-based approach of developing collaborative family plans to support and safeguard children and young people. The consideration of the range of options for self-directed support for eligible children can provide families with choice and autonomy in creatively considering how to best meet the needs of their children. Subject to age and maturity, children and young people will be an integral part of this decision making. For example, a number of local authorities are using a self-directed support approach and using money differently to support young people at risk of being looked after away from home to develop appropriate support plans.

Support Services in Relation to Parenting

50. In 2012, the National Parenting Strategy set out the values and ethos to support parents across Scotland. All parents and carers can require information, advice and support in caring for their children throughout their childhood and into adulthood. There is a broad definition of people who can be in a primary caregiver role:

'The very term 'parenting' now applies to a much broader range of primary caregivers. Grandparents, step-parents, kinship carers, foster and adoptive parents, 'corporate parents' of children looked after by the state, extended families, networks and communities - each has an important role to play in the care and upbringing of children and young people.' ^[16]

Fundamentally, the strategy is based on an ecological understanding where the local, regional and national context impacts on parenting. This approach recognises the responsibility of a wide range of public agencies to support parenting to achieve the common goal of improving the life chances of all Scotland's children.

51. Section 68(4) of the 2014 Act defines a 'qualifying person' in relation to an eligible child, and in so doing also recognises the broad range of persons who are in a caregiving role for a child who may be at risk of becoming looked after.

52. Support for parenting can be required at any stage of childhood. Based on research and extensive consultation, the National Parenting strategy highlights the need to:
a) Ensure all parents have easy access to clear, concise information on everything from pregnancy to the teenage years and beyond;
b) Offer informed, coordinated support to enable parents to develop their parenting skills, whatever their need, wherever they live, whether they live together or apart;
c) Take steps to improve the availability of - and access to - early learning, childcare and out-of-school care, taking into account parents in rural areas and those who work irregular hours;
d) Provide targeted support to families facing additional pressures that impact on day-to-day parenting;
e) Acknowledge and address the wider issues that can affect parents' abilities to provide a nurturing environment and care for their child. ^[17]

53. Some families can face adversities that impact on their day-to-day ability to care for their children. There are a wide range of reasons why children and young people may be 'at risk' of becoming looked after away from home. Research indicates that parental drug and alcohol problems, mental health issues, domestic abuse and parental learning disabilities can impact on a parent's ability to care for their children, however, as Ward and colleagues highlight:

'Experiencing any one of these problems does not preclude loving and effective parenting. The research suggests it is where multiple problems interlock and interact that there is a substantially increased risk that children will be exposed to maltreatment and suffer significant harm.' ^[18]

Therefore, it is important to recognise that the impact of these issues cannot be understood without considering the range of risks and the protective factors using the Getting it Right for Every Child National Practice Model. Furthermore, given this holistic understanding of family life, it is important that a range of support services work together from across statutory and third sector organisations to meet the needs of the child and family.

54. It should be recognised that families can face adversities where a child may be at risk of becoming looked after at any stage of childhood. In 2015, 29% of looked after children became looked after when aged between twelve and fifteen years old. ^[19] Therefore, it is critical that support for parenting is provided for this demographic. Using the GIRFEC approach, it may be recognised that direct support is required for children and parents separately, as well as working with the family, to effectively meet their needs. For example, there may be mental health concerns for young people, as well as parents.

55. It may be useful to consider that support services in relation to parenting for children and young people who are 'at risk of becoming looked after' should be informed by the evidence-base. Professor Harriet Ward and colleagues (2014) provide key research findings concerning factors which promote or inhibit parental capacity to change in families where there are significant child protection concerns. The review highlights the use of effective intensive interventions aimed at improving parenting skills or addressing other specific problems, for instance, drug or alcohol misuse, which can complement social work support to a family. There is recognition that parenting does not 'exist in isolation' and it is important to understand and address issues in the wider context:

'Interventions designed to increase parenting skills can be effective and can have a positive knock on impact, reducing other parental problems by increasing self-efficacy and self-esteem. However, in cases where parents are facing complex, multi-layered problems, an integrated package of support may be required, tailored to meet the needs of each member of the family.' ^[20]

56. In recognition of the range of support that may be required for children and parents; local authorities should adopt a multi-agency approach to deliver services. There is a critical role for specialist health professionals in supporting the health needs of parents (for example, where there are mental health problems, substance misuse or learning disabilities). There should also be consideration of the impact of poverty on the stress and strains of daily life, with practical support provided to maximise income (for example, ensuring eligibility for financial support and access to hardship funds), ensure basic needs of the family are met (e.g. functioning utilities), and that there is a safe home environment.

57. There is a growing body of evidence-based interventions that may be useful to support practitioners and service deliverers in providing relevant services. ^[21] Work with children and families should be informed by a robust evidence base wherever possible. It is acknowledged that innovations will not always have an evidence base but can be developed on sound and reflective practice models. As highlighted in the Christie Commission, families and communities should be involved in the development of services. There is some evidence to suggest that models with high levels of family engagement and involvement in decision making can lead to improved outcomes for children.

58. As previously highlighted, research conducted by the SCRA found an increasing trend in the use of Child Protection Orders ( CPOs), (including pre-birth) and that the majority of children were consequently looked after away from their birth parents (70%). In the audit of CPOs between 1 ^st October and 31 ^st December 2013, just over a quarter (27%) were for pre-birth children with the most common established ground being 'lack of parental care' (77%). ^[22] This indicates that where there are child protection concerns requiring a CPO for pre-birth children, there is a risk of the child becoming looked after away from their birth parent/s.

59. There is strong evidence that pregnancy for mothers and fathers can be a critical 'turning point', where parents who previously have been problematic users of drug and/or alcohol, involved in criminal behaviour or engaged in other risky activities, seek to change their behaviours for the wellbeing of their child. ^[23] Relevant services should be provided to pregnant women who the local authority considers are going to give birth to a child who will be at risk of becoming looked after (section 68(5) of the 2014 Act) and the father of the child or a "qualifying person" in relation to an eligible pregnant woman (in terms of section 68(6) of the 2014 Act).

60. The provision of relevant services, through support for parenting and/or family group decision-making services, for eligible pregnant women is particularly salient. The role of health services as part of a multi-agency approach is critical in supporting families who are experiencing adversity. Guidance developed for health care services, A Pathway to Care for Vulnerable Families (0-3), sets out an aim 'to ensure vulnerable children (from conception to age 3) and families in all parts of Scotland receive support that is equitable, proportionate, effective and timely'. ^[24] Supporting parenting using a strengths-based approach is advised 'when parents are partners in the endeavour rather than being coerced'. ^[25]

61. One example of an evidence-based intensive family support programme for very young children is Family Nurse Partnership which was developed in the United States of America. The Family Nurse Partnership ( FNP) programme was implemented in NHS Lothian in 2010 and has since been expanded to Tayside, Greater Glasgow and Clyde, Fife, Ayrshire and Arran, Highland and Lanarkshire. ^[26] The FNP programme is a licensed preventative home-visiting programme which aims to improve outcomes for young first time mothers and their children through a structured programme of home visits delivered by specially trained Family Nurses from pregnancy until the child is two years-old. Although the evaluation was limited in scope, the FNP in NHS Lothian demonstrated the value of developing therapeutic relationships with clients. However, one identified barrier for involvement with FNP was the engagement with parents who had problematic drug and/or alcohol use.

62. There should be specific consideration given to the support needs of parents with learning disabilities. International research has identified that children are more likely to be removed from parents with learning disabilities. In 2015, the Scottish Consortium on Learning Disabilities refreshed the Scottish Good Practice Guidelines for supporting parents with a learning disability. ^[27] The guidance was developed to:
a) Help services to improve their support for parents with a learning disability and their children;
b) Increase the chances of the children of parents with a learning disability continuing to live with them in a positive and supportive environment that meets the children's needs;
c) Increase the chances of avoiding family breakdown which has enormous social and financial consequences.

The guidance also provides information for practitioners engaging with parents with learning disabilities where child protection proceedings are necessary.

63. Where parents have learning difficulties, it is likely that long-term support is required to be tailored throughout the different stages of childhood. The key elements of successful parenting skills support are:
a) Clear communication and ensuring parents have understood what they are told;
b) Use of role play, modelling, and videoing parent and professional undertaking a task together, for discussion, comparison and reflection;
c) Step by step pictures showing how to undertake a task;
d) Repeating topics regularly and offering opportunities for frequent practice; and
e) Providing/developing personalised 'props': for example, finding a container which will hold the right amount of milk for the child so that the parent does not have to measure out the milk.' ^[28]

64. There are also children who may be living with another family member or family friend in an informal kinship care or guardian arrangement who may be at risk of becoming looked after. As defined under section 72(2) of the 2014 Act, a qualifying person in relation to a kinship care order, along with kinship carers and other care givers are entitled to support services in relation to their parenting role. Research indicates that some children who are cared for by their wider family in their early years can present some more challenging behaviour as they become adolescents explained through early adverse experiences. ^[29] The provision of kinship care assistance for eligible children and kinship carers and guardians is set out in non-statutory guidance for Part 13: Support for Kinship Care of the 2014 Act.

65. A further group to consider are disabled children who are at risk of becoming looked after due to the local authority and/or health board providing a care placement to meet the needs of the child. In the majority of circumstances, this is a voluntary agreement with parents and will often be short-term (for example, provided as a 'short break service'). This provision of support can be hugely beneficial for children and parents and/or primary carers. However, it could be considered that in some circumstances, the provision of a support service for parenting a disabled child may result in a child no longer requiring a placement away from home. Where appropriate, this form of parenting support may be welcomed. For this group of children, there should be specific reference to self-directed support under the Social Care (Self-Directed Support) (Scotland) Act 2013.

Views of the Child and other persons

66. Under the 1995 Act, local authorities have a duty to ascertain the wishes and feelings of children when making decisions that affect their lives. This is in line with Article 12 of the UNCRC which states that the views of the child should be taken into account (subject to age and maturity) in decisions.

67. Under article 3(4) of the 2016 Order, a local authority must, in considering the likely effect on an eligible child's wellbeing, so far as reasonably practicable, ascertain and have regard to the views of the child and such other persons as the local authority considers appropriate. This could be done via the Family Group Decision-Making Services, highlighted above, which can provide a valuable setting to ensure this duty is met. An English study exploring children's experiences in FGCs from twenty families involved found:

Their responses suggested overall that they had valued the experience of being consulted, of being listened to and, on the whole, they had welcomed the provision of opportunities for families to work together on issues free from the attentions of social services. ^[30]

However, the authors caution that there were negative views from a minority of children and young people; thus, 'our study suggests that although FGCs can usefully include children and have a clear role in children's welfare practice, they are not the panacea for all ills or necessarily the route to empowering practice for all children or all families'. ^[31]

68. Local authorities should be aware of local or national advocacy organisations that can support children and families to fully participate in decisions that affect their lives. The decision of the state to look after a child is a serious intervention and timely access to advocacy to ensure the child's views are sought and heard is encouraged. This is subject to the age and maturity of children and may be difficult to ascertain with very young children. For children with complex disabilities and for those whom English is not their first language, extra effort should be taken to ensure their views are taken into account.

Publication of information about the provision of relevant services

69. Under article 4 of the 2016 Order, local authorities must publish, in such a manner as they consider appropriate, information about the provision of relevant services; the ways in which a person can contact the local authority about that provision; and other matters the local authorities deem appropriate.

70. The information should be provided in a timely and accessible manner. A local authority should keep published information under review and, where appropriate, publish revised information. Information should be available in a range of languages and formats on request. It is recommended that local authorities should include information about their complaints procedures within their publications.