Getting our priorities right: good practice guidance

Introduction

Purpose of the guidance

1. The purpose of this guidance is to provide an updated good practice framework for all child and adult service practitioners working with children and families affected by problematic parental alcohol and/or drug use.

2. Adults can recover from problematic alcohol or drug use while being effective parents and carers for children. However, where parental alcohol and/or drug use becomes a problem this can have significant and damaging consequences for any dependent children. This can result in risks to their wellbeing and impair an adult's capacity to parent well. Where children are affected as a result, they are entitled to effective help, support and protection, within their own families wherever possible. Parents too will often need strong support from services to tackle and overcome their problems and help them to promote their child's full potential.

3. This guidance helps all child and adult-focused services to provide this support. It is focused primarily on prevention and early intervention measures by services where a child is considered to be in need of some form of help or support. However, where significant need for a child is identified at any stage by services, child protection procedures apply: the National Child Protection Guidance for Scotland describes in detail the relevant procedures and when they should be applied, and for that reason, that guidance should be used in conjunction with this guidance, where appropriate.

4. Getting Our Priorities Right is designed for everyone who has an interest in the wellbeing of children and families. It has been drafted in consultation with people who work with problematic alcohol or drug using adults as well as with children and young people. The guidance should be useful for social workers, medical and health staff in hospitals and also in the community, public health nurses and health visitors, education, housing and third sector staff, Children's Reporters, police, Procurators Fiscal and prison staff. Parents, families and their representatives will also find this guidance useful where it describes what they should expect from services.

5. The guidance is also directed at those leaders and senior managers responsible for ensuring effective local service delivery. This is because a shared vision at strategic and operational partnership levels is at the heart of delivering effective service support and improving outcomes for vulnerable children and families.

6. This updated guidance reflects and - is framed in the context of - the national GIRFEC approach and the Recovery Agenda. These significant programmes followed the original publication of this guidance in 2003. Together, these provide operational frameworks for child and adult-focused services working with all children, individuals and families.

7. The guidance places a strong focus on early intervention: that is, services working together at the earliest stages to help children and families and not waiting for a crisis or a tragedy to occur. This is because early identification and timely intervention - particularly when problems first arise - can prevent escalation. Compulsory measures of supervision and early intervention are not mutually exclusive and consideration should be given as to whether compulsory measures of supervision might be required to ensure compliance with identified interventions. With the right interventions at the right time, parents and children can receive support to better manage any problematic alcohol and/or drug use and any other difficulties that they may have.

8. A number of local practice examples and tools were shared by those involved in the update of this guidance. Some are presented here as useful references, but rather than include all within this guidance, WithScotland has collated and made them accessible. Services may choose to contribute to this resource and share examples of local practice on an ongoing basis.

Getting It Right for Every Child ( GIRFEC)

9. GIRFEC is the Scottish Government's overarching approach to promoting appropriate, proportionate and timely action by services to improve the wellbeing of all children and young people in Scotland. It encourages early intervention supported by a shared understanding by all services of a child's wellbeing as defined by eight indicators: Safe; Healthy; Achieving; Nurtured; Active; Respected; Responsible; and Included. The Children and Young People Bill will put this definition and other key elements of the GIRFEC approach on a statutory basis. This shared understanding by services of a child's wellbeing is a critical one for the purpose of this guidance.

10. Overall, GIRFEC has a number of core components and key elements of these are set out below.

• The Named Person is a role designated within the universal services of health or education, in most cases the health visitor for pre-school children and for primary school aged children their Head Teacher. If they are in secondary school this is likely to be a member of staff responsible for pupil support. The Named Person is first point of contact for children, their families and relevant agencies where there are any wellbeing concerns about a child that they themselves cannot help with. Their role is to take initial action as necessary and is critical in supporting early intervention and prevention of deterioration to wellbeing. The Children and Young People Bill will ensure that every child from birth to the age of 18 has a Named Person.
• Where the needs of a child are more complex, a multi-agency response will often need to be considered. A Lead Professional will be identified from amongst the practitioners involved and their role will be to take forward the co-ordination of the activity supporting that child. Unlike a Named Person, which flows directly and automatically from the function of the universal services of health and education, the Lead Professional should be the practitioner best placed to co-ordinate multi-agency activity supporting the child and their family.
• In addition to service co-ordination as described above, it is important that planning around the child is also co-ordinated. The Child's Plan is the single or multi-agency action plan agreed by involved services. It describes the range of support activities needed by a family and identifies who has responsibility for delivering these. The Children and Young People Bill will place a duty on service providers to produce, maintain and, where appropriate, transfer responsibility for the Child's Plan for those children who need one.

11. Further information about the Children and Young People Bill can be found on the Children's Legislation webpage. More information on the roles and responsibilities of the Named Person and the Lead Professional can be found at the GIRFEC web pages. Also, where children have additional support needs in education, they may require a Co-ordinated Support Plan ( CSP): the Code of Practice on Additional Support for Learning makes clear the relationship between the roles of the Lead Professional as described here and the individual responsible for co-ordinating the educational support, the CSP Co-ordinator.

Recovery Agenda

"You need more support when you come off the drugs"

Helen - person in recovery and single parent

12. All child and adult services should take account of the Recovery Agenda when addressing problematic alcohol and/or drug use. The recovery process was described in the 2008 National Drugs Strategy ( The Road to Recovery) as:

"a process through which an individual is enabled to move-on from their problem drug use towards a drug-free life and become an active and contributing member of society." ^[2]

13. The recovery focused workforce includes anyone who has a role in improving outcomes for individuals, families or communities with problematic drug and/or alcohol use. Scotland's drug and alcohol workforce is drawn from a wide range of sectors, including health, education, social work and the third sector. This workforce should be united around a shared vision, focused on the needs of individuals. A recovery focused professional typically provides:

"timely, sensitive, person-centred, evidence-based support that is appropriate and empathetic which empowers individuals to set their own recovery objectives, manage their own care, and sustain recovery." ^[3]

14. The nature of recovery - including its start and end points - will vary considerably from person to person and needs to be based on an individual's own needs and goals. Sustained recovery is a journey which takes place over several years, during which a person's strengths and overall ability to recover can grow. The following points are relevant to services focused on children, individuals and families where problematic alcohol and/or drug use is a factor.

• Recovery outcomes can be improved for all concerned when wider family circumstances are considered.
• It is vitally important services note that recovery timescales set for adults can often differ considerably from those that might otherwise be set to improve the wellbeing of - or to protect - any dependent children they may have.
• Children's and adult services must keep in regular contact to agree any contingency or wider supportive measures that might be needed.
• Stigma is one of the biggest issues that can prevent individuals from recovering from problematic alcohol and/or drug use. It can mean that families are reluctant to approach services for support or to reveal the extent of their substance use - for fear of judgement or repercussions.