National Risk Framework to Support the Assessment of Children and Young People

2.3 Stage 2 - Risk Analysis

What Do We Mean by Analysis?

Analysis involves the process of breaking down what is known about the complexity of a child and family's circumstances into smaller parts, so as to acquire a better overall understanding of what is, or may be, going on. Analysis critically draws on the information gathered, and the quality and character of the information collected can shape how analysis is applied and the early conclusions reached.

Analysis is where information that the professional has gathered is then:

• Sorted
• Weighted in terms of its significance, and
• Ultimately made sense of

While separated out here as a distinct stage, analysis is obviously a dynamic, interactive process that is present in all aspects of risk considerations; from information gathering to the implementation of day-to-day risk management through the Child's Plan and case review. It also draws upon reasoned induction from the information obtained and from practitioner intuition about what may be going on for a child and their family.

Through good use of analysis practitioners may reach a more informed and insightful position whereby they can competently and confidently convey what it all means for the individual child, the adult carer/s, and the various relationships between each, as well as the services involved. Analysis should, thus, provide practitioners with a clearer picture of circumstances and inform future interventions that address need and manage/reduce risk for children and families.

Making sense of the information gathered through analysis is, thus, the key task of the assessment process after acquiring the information. The principal output of any analysis is the development of a risk management plan - the Child's Plan - that sets out specific tasks aimed at successfully addressing the risk factors that have been identified while also building upon any known resilience's and/or protective factors.

Using Analysis to Understand the Child's World

Analysis of information requires that practitioners appropriately share information, actively discuss its character, meaning and significance and work closely together to reach better understandings of what is going on for the children and families involved.

Risk is a fundamental element of child welfare and protection practice: it is uncertain, often changing in nature and focuses on the three dimensions of what is known about the child, the parent/carer and the wider environment. Informed analysis will not only help determine the nature of current circumstances but also the potential likelihood of an event or series of events occurring/recurring.

Making sense of complex family and social situations is not an easy task. Analysis demands a thorough investigative approach on the part of practitioners, and it requires that they forensically and systematically examine circumstances and events to help understand:

• Why they may have arisen - the reasons, triggers, history?
• What they mean for the individuals and others involved - their significance and impact?
• How, if possible, they may be addressed - how best to manage, minimise and resolve?

Practitioners, therefore, need to reflect critically on all information gathered - its source, credibility, integrity, validity, whether it corroborates, challenges or contradicts the current assessment and analysis. They also need to be aware of any potential for bias and the difficulties of working solely on the basis of information that is contested.

Ultimately, analysis is about making sense of a child and family's circumstances (what is the information telling me?) and the decisions/outcomes reached are influenced and determined by the exercise of professional judgement in relation to this, be it individual and/or collective. It is neither appropriate nor possible to provide simple answers for practitioners about how to do analysis as this is determined by individual case circumstances and the available practitioner skills, ability and knowledge as well as the service responses to these.

It is possible, though, to provide a core range of tools within the Framework that help build more analytical approaches to practice and which greatly assist practitioner ability to better undertake the task of analysis. These can also support practitioners to achieve better overall understandings of family history, context and dynamics and assist in obtaining improved outcomes for children, young people and their families. In following the guidance below, practitioners may be supported to establish common cultures of practice around risk, using common tools and a common language. These tools, and the Framework supporting them, assist practitioners to gather and organise the available information around the child and their family, establish more rigorous evidence about their circumstances and make better informed decisions about the range of interventions and actions to be taken.

How to Use the Risk Indicator Recording Sheets to Aid Analysis

Having gathered information using the Risk Indicator Recording Sheets - Generic, Matrix Related and Resistance Related - practitioners are guided to the Analysis section and asked to consider "what is the information telling me?".

Practitioners should…

1 Consider the information gathered and identify the key risk factors for each child, parent/carer and the child's wider world. The Recording Sheets will highlight the specific areas of concern/risk (your evidence) but you should give an overview of what you consider to be the key issues within the three domains of the My World Triangle (Generic Risk Indicators) and those gathered relative to the Matrix and Resistance Related Indicators. This is a very visual exercise and immediately practitioners should be able to see if risks vary from child to child within a sibling group.

EXAMPLE OF ANALYSIS OF RISK INDICATOR SHEET RETURNS (using the example already noted)

Risk Indicators for:
Child 1: Child currently aged 3 months. Clear history of being born prematurely, experiencing early maternal separation via placement in Special Care Unit (SCU) as a result of experiencing NAS which required dual medication (Oramorph and Phenobarbital) and close clinical supervision for an extended period of 4 weeks. Mother discharged post birth prior to baby. Erratic and irregular commitment by both parents to contact visits with newborn at SCU.
Child 2: Complete similarly for Child 2 capturing key details highlighted from completion of the Risk Indicator Sheets.
Child 3: Complete similarly for Child 3 capturing key details highlighted from completion of the Risk Indicator Sheets.
Child 4: Complete similarly for Child 4 capturing key details highlighted from completion of the Risk Indicator Sheets.
Parent/Carer: Complete in terms of what's known and discovered about the parents/carers capturing key details highlighted from completion of the Risk Indicator Sheets.
Family and Wider World: Complete in terms of what's known and discovered about the child's wider world, again capturing key details highlighted from completion of the Risk Indicator Sheets.

2 Having identified and recorded the key areas of risk/concern for each child via the Recording Sheets, practitioners then need to form a view as to the overall level of concern taking account of the interaction between the child, parent/carer and the child's wider world. When answering the question - "what is the information telling me about the level of concern" - they need to consider issues of frequency, duration, severity, single event/cumulative concern etc.

What is the information telling me about the level of concern/risk? (Consider frequency, duration, severity, single or accumulative in nature -significance of factors in reaching a conclusion about the level of risk).

By reviewing the information acquired on the Risk Indicator Sheets, and the analysis undertaken within the individual sections for each child, the parents/carers and the child's/family's wider world, practitioners should be better placed to make sense of the range of needs and risks presented - for both child and adult. Practitioners will also be better placed to assess the dynamic relationship of each parent/carer to each child and to identify any similarities or variance in this and the needs/risks identified. The children, their need and risk profiles and presentation are, thus, examined individually and, where part of a sibling group, also considered collectively. The practitioner is then better placed to provide a well informed view as to the overall presentation of the concern/s for each child, the range of tasks that may be required to address needs/risks and the kind of timeframes that may be required to be worked to in order to progress any possible change. As the Risk Indicator Sheets actively lead practitioners through a number of known potential risk factors there may be less likelihood of failing to consider a key element or of missing traits and patterns that prevail.

3 As each area of risk is explored and analysed - using the My World Triangle and the Vulnerability Matrix and exploring Parental Resistance - practitioners will begin to form a professional view as to the level of risk/concern that may be present for each individual child. The 12 Risk Questions/Prompts and the model outlined below for considering parental resistance can also be used by practitioners as a further aid to ensure that all aspects - risk, resilience and resistance have been actively considered.

Risk Questions/Prompts

Areas for Consideration		Practitioner Prompts
1.	Are you able to describe the current incident of concern - record these accurately?	What are the parent's attitudes and responses to your concerns? Is their explanation consistent with the injury/incident? What status does the child have within the family?
2.	Have you assessed all areas of potential risk?	Note and record each risk factor separately (eg. child, parent, family, surrounding environment, type and nature of abuse, intervention issues)
3.	Can you describe the potential behaviours of concern?	Rather than focus on the individual, assess each worrying behaviour individually - as each is likely to involve different risk factors
4.	Can you describe the nature of the risk factors?	How long have they been operating? How severe are they? Are the injuries/incidents one off or cumulative over a period of time
5.	Grade the identified risk factors, and be alert for especially serious risk factors (High, Medium or Low - this is a professional judgement)	For example, previous corroborated or uncorroborated concerns, unwillingness or inability to protect. If a young baby is with an alcoholic mother and basic care (safety) is not being provided then the severity of the risk is clearly high. If the child is older and has a number of protective factors around them (eg. a good school, grandmother who can spend lots of time with them) then the severity of the risk posed by the alcoholic mother may not be high
6.	How serious are the consequences of the abuse occurring for the child, for the child's family and for the agencies involved?	We need to distinguish between the likelihood of the behaviour occurring from its seriousness if it does. For example, someone may indicate they are allowed to smack their child, thus, the likelihood is that the child will be smacked again in the future and we need to assess the impact of the action of the child
7.	Detail ALL previous incidents of abuse and neglect	Detail any previous incident of abuse or neglect (type and frequency) in this family and/or any record of the current caretakers having abused or neglected other children Is there a pattern of abuse (such as physical abuse being repeated) or is it changing (such as the concerns spanning a range of abuses)? Do they accept any of the previous concerns? Do they have any insight into their previous behaviour? If so why the lapse? Do they accept or reject themselves as a continuing risk?
8.	What are the strengths in the situation being analysed?	A broad view should be taken of possible strengths including extended family and community supports but they should be related to the abuse or neglect under consideration. Here too the emphasis is on the situation being assessed but consideration should also be given to factors from the caretaker's past where there is evidence that these are strengthening current coping capacity. For example, a parent who has "coped" for a number of years prior to the current concerns can show the capacity under other circumstances to provide appropriate care for the children
9.	Do any risk reducing factors exist?	An admission by a parent of the problem and a willingness to co-operate with a treatment and intervention programme can reduce risk. The use of interventions known to bring benefits (eg. appropriate, regular medication for a mental illness would also reduce risk)
10.	What are the prospects for change in the situation and for growth?	A risk assessment should attempt to forecast how a situation will develop in the future. Clearly, the capacity for improvement or deterioration in the current conditions is central to any such assessment. A key indicator of the likelihood of change is the parent's attitude to the abuse or concerns - an acknowledgement of the difficulties and a preparedness to work towards change would normally be seen as lessening the risk and the denial of the problem as increasing it Other areas may include parenting skills and the capacity to learn - so can ways of teaching and imparting parenting skills, matched to the parent(s) methods of learning, be improved? Do they have the capacity to generalise learning to adapt it to new situations? Have they made some changes previously but could not sustain?
11.	What is the risk associated with each intervention?	Removing a child allegedly in danger from its family exposes them to other dangers which can be equally damaging We need to consider whether the benefits of intervention outweigh the problems of separation if we are considering removal from the home - the inability to place siblings together in substitute care, the location from the placement may be some distance and can, thus, disrupt the child's peer networks, schooling and social life
12.	What is the family's motivation and capacity for change?	As noted, a genuine shared understanding and acknowledgement of concern on the part of the parent/carer alongside a willingness and ability to work with services would normally be viewed as supportive to reducing risk potentials, while an absence of each would likely increase risks However, care needs to be taken not to discriminate against parents solely on the basis of their taking a different view of the abuse or alleged abuse from practitioners. Key questions to ask include: Does the parent have insight into your concerns? Do they want to change? Do we have the resources to help? How long will it take? Can they maintain the changes? Does the child need to live somewhere else?

Considering Parental Resistance and Risk

A crucial task for the worker is to assess the parent's commitment to engaging and implementing change. Horwath and Morrison (1999) developed a model to provide a framework for assessing parent's responses to change.

GENUINE COMMITMENT Parent recognises the need to change and makes real efforts to bring about these changes	TOKENISM Parent will agree with the professionals regarding the required changes but will put little effort into making change work While some changes may occur they will not have required any effort from the parent. Change occurs despite, not because of, parental actions
COMPLIANCE/APPROVAL SEEKING Parents will do what is expected of them because they have been told to "do it" Change may occur but has not been internalised because the parents are doing it without having gone through the process of thinking and responding emotionally to the need for change	DISSENT/AVOIDANCE Dissent can range from proactively sabotaging efforts to bring about change to passively disengaging from the process The most difficult parents are those who do not admit their lack of commitment to change but work subversively to undermine the process (ie. perpetrators of sexual abuse or fictitious illness)

How to Use the Resilience/Vulnerability Matrix to Aid Analysis

The Resilience/Vulnerability Matrix sits within the National Practice Model and practitioners will be familiar with this analysis tool and its use to sort information gathered using the key headings of vulnerability, resilience, adversity and protective factors.

Resilience-Vulnerability Matrix (Daniel, Wassell and Gilligan, 2010)

The aim is to organise the information collated from the Record Sheets into a matrix that provides some indication of risk and resilience to help identify what action may be necessary to better meet the child's needs and manage/reduce risk. The Matrix Risk Indicators link directly to the four quadrants of the Matrix - Resilience, Vulnerability, Factors of Protection and Adversity - adding Resistance as a key consideration also. To do this, practitioners should take the following steps:

Step 1 Complete the Matrix Related Risk Indicator Sheets as fully as possible.

Step 2 Practitioners should explore each area of the Matrix in detail using the the individual Recording Sheets. The record sheets will clearly identify which risk indicators are relevant to the child, parent/carer and child's wider world.

Step 3 Practitioners should weigh up the information and identify those factors of resilience and protection which may reduce potential risk. Information gathered within each of the four areas can be integrated in to local assessment framework processes and report structures.

Step 4 Having collected the information, practitioners should start to make sense of what each section means. It is important to pull each of the three areas together to provide an over-arching pathway that not only informs the plan, but also indicates whether this is a single or a multi-agency response. It should also help determine whether the threshold for initiating child protection processes is met.

Understanding What the Information is Telling Me

The following is an integrative framework designed to indicate the balance of risks and strengths. Calder (2010) has organised the currently available evidence base for each of the possible quadrants as follows.

High Concern

Low Concern

Current injury/harm is severe Pattern of harm is continuing/escalating Parent indicating repeat behaviour likely Access to Vulnerable Persons Diagnosis of untreatable mental health and substance misuse A history of interpersonal conflict and violence - power and control issues, poor negotiation and lack of autonomy Recent separation or recurrent reconciliations Uncontrolled contact between perpetrator and child The parent unwilling or unable to protect the children High levels of trauma in parents, childhood not recognised as a problem Previous child protection concerns with no significant changes effected or sustained Parents not accepting their behaviour is a concern and are unwilling to work with practitioners Children too young to be able to take any action to protect themselves and require rapid parental change Child presenting as fearful of parents or other household member Children engaging in self-harm, substance misuse, dangerous sexual behavior or other 'at risk' behaviours Parent is young - under 21 years Evidence of social isolation and lack of social supports Resident in violent, unsupportive neighborhood Parent experiencing high levels of stress Physical and social environment chaotic, hazardous and unsafe Family remaining unpredictable and potential for change limited Parents demonstrating good protective attitudes and behaviours Family with clear, positive boundaries in place Family demonstrating good communications Family demonstrating ability to positively process emotional issues Family positive about receiving help Young person living in supportive environment Network of support and supervision available to young person Young person with positive plans and goals Young person with positive relationship with school/work Young person with experienced consistent positive care Young person with at least one emotional confidant Young person with good problem solving and negotiation skills Family being adaptive and developed new coping strategies when stressed Parent/carer demonstrating empathy and responds appropriately to cues of others Family taking responsibility for their own behaviour Able to manage frustration and unfavourable events - displaying good self-regulation when confronted with stress or difficulty Resolving conflicts and make decisions that support stability and recovery (assertive, tolerant, forgiving, cooperative; able to negotiate and compromise) Thinking and communicating effectively (rational cognitive processing; adequate verbal skills; able to focus on the tasks requiring attention)

No history of significant trauma or abuse Recognition of the problem Perpetrator demonstrating remorse/ empathy Perpetrator accepting responsibility for their behavior Children able to protect themselves if the need arises Healthy peer relationships No documented school problems No history of behavioural/emotional problems Parental mental health and/or substance problem responsive to treatment Parent with empathy for the child Parental competence and capacity in key areas of parenting Risk reactive to circumstances (eg. loss) and parents/carers display capacity to make improvement and change Family with access to social support/networks and access to child care facilities Difficulties, illness or disabilities on the part of the adult carers temporary Stressors within normal range of day-to-day circumstances and carers display capacity to cope Parents and young person appearing not to care what happens Young person with poor communication skills Young person with no support/is rejected by parents/carers Young person excluded from school Family/young person appear isolated Absence of supportive/structured living environment Parents/carers unwilling/unable to supervise Family enmeshed in unhealthy social networks Family with high levels of stress History of unresolved significant abuse in family Family unable to understand the consequences of their behaviour Family refusing to engage or only engage conditionally with services Lack of available resources to meet identified needs resources (familial and professional) Family seem vulnerable in the face of perceived external threat Family displaying low self-esteem Family/child with negative expectations and goals Family isolated and lacking in supports

The information gathered will indicate the overall calculation of risk that then has to be managed. An indicator of what each quadrant means is presented below and will aid practitioners in quantifying the level of risk and future potential change on the part of the parent/carer.

Low strength/ high concern Parents are likely to be at the pre-contemplative stage and unlikely to move from this position. Families assessed to be in this category are the most worrying. The children are likely to need to be looked after, probably long term. The length of time in care will be dependent on the parent's ability to change, however their own upbringing may have left them too damaged to change.

High concern/ high strength Parents may be more willing to change at this level. There will be parents at different stages of change. There could be worries about children living in these families and alternative placement may be an option however this depends on the parent's ability to change. There is more scope for working with families in this group and less need to separate.

Low concern/ low strengths Families in this group are highly unlikely to need care. These are the referrals that are likely to be referred on a number of occasions before they are willing to change. Community resources are the best outcome. This group of children/young people should not come in to care as generally there are no issues to put the child at risk at home.

Low concern/ high strengths Network of support and supervision is available to child/young person. Families in this group are generally of little worry and would probably benefit from standard support systems, school, GP etc. Generally these families should not be referred to social services as their needs are similar to the standard population. They may need advice and guidance from standard services.

Step 5 When completed the Recording Sheets provide an evidence base as to how decisions have been reached. In addition the recording sheets can form part of the evidence presented to a Sheriff for a CPO (Child Protection Order) or inform multi-agency discussions through the Core Group.

NOTE - For further information on the Resilience/Vulnerability Matrix and its application refer to the National Guidance.