3.12 Protocol for undertaking dynamic joint assessments by Children’s Services Social Care Workers, Health Practitioners and Midwives

SCOPE

This protocol details best practice for Social Care Workers, Health Practitioners and Midwives when undertaking joint assessments including pre-birth assessments. It should be read in conjunction with Working Together 2018 and the Norfolk Safeguarding Childrens Partnership (NSCP) Local Protocol for Assessment and where relevant the NSCP Pre-birth protocol. The aim of the protocol is to promote partnership working and embed the ethos of joint assessment, the sharing of professional analysis and shared understanding of the child and family’s strengths and risks. These principles should inform joint decision making around the need for further joint assessment and planning of interventions to support the child and family.

Joint Working during Covid 19

During Covid 19 this protocol should be adhered to. All reasonable measures should be taken to prioritise joint assessments. Visits to undertake joint assessments should be face to face where possible or via virtual technology based on a risk assessment and in accordance with local organisational policies and procedures. Where appropriate video calling should be considered to support effective joint working during the Covid 19 pandemic.

1. The purpose of the assessment is:

  • To gather important information about a child and family
  • To analyse their needs and/or the nature and level of any risk and harm being suffered by the child
  • To decide whether the child requires a plan to support them which may include a Family Support Plan (FSP), Child in Need Plan (Section 17) or consideration of a strategy meeting which may lead to a Child Protection Plan (Section 47)
  • To provide support to address identified needs to improve the outcomes for children and to make them safe

2. The rationale for joint visits and assessments

Every joint assessment should draw together relevant information gathered from the child and their family as well as wider family/community networks, contextual information and from relevant professionals using the Common Assessment Framework (Department of Health 2000) or the Diamond Assessment Framework (Risk in Child Protection Assessment Challenges and Frameworks for Practice, Martin C Calder 2015) and the Signs of Safety Framework. The aim is to use all the information available to identify worries, harm and any complicating factors as well as developing a picture of the strengths and safety for the child.

The expertise of the health practitioner is key to assessing the child’s health and development.

The benefits of joint visits and assessments include:

  • Ensuring assessments are rooted in child development
  • Continuity of service for the child and family irrespective of the outcome of the assessment
  • The ability to share thinking and jointly analyse what is happening for the child
  • Improving co-working and information exchange within the locality
  • Informing joint decision making and forward planning.

In order to support joint visits and assessments, each locality will arrange a minimum of monthly meetings between Team Leaders, a leader from the Healthy Child Programme (HCP), Midwifery Services and Children’s Services Social Care Teams to discuss joint visiting and joint assessment arrangements. Heads of Service for Social Care will meet with HCP Head of Locality a minimum of bi-monthly.

3. Planning the joint assessment

Where emergency action is necessary, such as a joint investigation with police, it may be inappropriate to involve the health visitor or midwife in the assessment until immediate safeguarding work has been undertaken. In all other cases, following the receipt of the referral from CADS the social worker will:

  • Make contact with the family to advise them that a joint assessment will be arranged with the health practitioner (or midwife in the case of pre-birth assessments)
  • Contact the Health Practitioner/Midwife to provide an overview of the concerns relating to the referral. Information should be exchanged between the practitioners and a time arranged to undertake a joint visit to the family within 5 workings days of the referral
  • The social worker should contact the family to confirm the time of the face to face visit/virtual contact
  • The social care worker will review LiquidLogic to ascertain any background information including starting or reviewing an integrated chronology as required
  • The health practitioner will review the health record for background information and for SystmOne, or other health records. The records should be appropriately flagged e.g. for SystmOne tick the vulnerable child/at risk box triggering the local vulnerable child status and add a high priority alert. The midwife will review hospital records. Consideration will be given to the completion of a chronology to be combined with the social care worker’s chronology if required
  • The social care worker will contact with other professionals for the relevant family members’ information prior to the home visit including the GP, schools/Early Years settings as appropriate
  • Where possible the health practitioner/midwife known to the family should undertake the joint assessment
  • The social care worker and health practitioner will make contact prior to the home visit to plan the assessment. The planning should include a review of the referral, exchanging of background information/chronology, discussion around which practitioner will lead the assessment with an agreement how the visit will be facilitated. The lead practitioner for the purpose of the visit will be determined by whether the family is known to either practitioner. In the event of neither practitioner knowing the family, the social care worker will be the lead practitioner.

4. Undertaking the Joint Assessment

  • Following introductions to the family the lead practitioner will outline the reasons for undertaking the assessment, explain how the joint assessment process works and clarify how the outcome of the assessment will be shared with the family
  • Confidentiality and information sharing should be fully explained to the family
  • The practitioners will explore the issues facing the family using the domains of the Common Assessment Framework (Department of Health 2000) or the Diamond Assessment Framework (Risk in Child Protection Assessment Challenges and Frameworks for Practice, Martin C Calder 2015) and the Signs of Safety Framework. Harm, complicating factors, family networking, strengths, safety and past harm, risk of harm should all be explored in detail, and a genogram should be undertaken
  • The home visit should include an assessment of the home including where the child/children sleep at night. If access to areas of the home is declined, practitioners should seek advice from their Team Manager/Supervisor
  • Where there are immediate safety issues, the practitioners should remain in the home unless to do so would put them at risk and seek further advice and/or contact emergency services as appropriate
  • Where follow up actions or further visits are required, including the social care worker seeing any older children on their own, these will be arranged with the family.

5. Analysis and agreeing actions following the joint assessment

  • Following the joint assessment, the social care worker and health practitioner will have a debrief to discuss their initial analysis of the family’s situation. This will be based on the information known and the observation and discussions from the joint assessment
  • Actions and interim plans should be agreed, which may include seeing children on their own, visiting the family again for the purpose of further assessment, visiting absent parents or family members, and gathering information from other professionals/agencies
  • Both parties should be clear about who will do what and how further information will be shared that contributes to the assessment. The practitioner taking responsibility for any follow up actions should be recorded on the child’s LiquidLogic/health record
  • Where there are specific concerns relating to neglect, arrangements should be made to commence the Graded Care Profile (GCP) assessment jointly by the two practitioners with the family
  • Practitioners are responsible for reporting their analysis of the initial assessment and any ongoing assessments and multi-agency information to their Team Leader/Supervisor. They will keep each other informed about any actions resulting from their respective supervision.

6. Joint assessment outcomes and further action

  • Joint assessment may take a number of visits in order to fully assess the situation for a child and their family. Communication and collaboration is important throughout the joint assessment process
  • The focus must always be on the child’s lived experience and the level of risk and harm to the child. Discussions should include what further planning is required
  • In the event of a professional disagreement around the type of plan required for the child/children, the case should be discussed between the Team Leader/Supervisor and the NSCP Resolution of Professional Disagreements Protocol should be followed
  • Both practitioners will record the joint assessment and plan in accordance with their organisation’s record keeping policy. The social care worker is responsible for the production of the assessment but its content, analysis and actions should be informed by the joint assessment and combined analysis from the health practitioner/midwife and any other professionals involved. The report must always be discussed and shared with the family
  • The social care worker is responsible for planning any type of multi-agency Signs of Safety meeting to agree plans and services to be put in place. This should be jointly undertaken with the health practitioner/midwife where appropriate
  • With consent from the family, the family will be supported to identify a lead professional for any resulting Family Support Plan
  • Joint supervision should be considered at any point during the joint assessment to promote shared understanding in the best interests of families to ensure that children, young people and their families receive the right levels of support and interventions at the right time.

7. References

  • Common Assessment Framework (Department of Health 2000)
  • Risk in Child Protection Assessment Challenges and Frameworks for Practice, Martin C Calder 2015
  • Local Assessment
  • Pre birth
  • Resolving professional disagreement
  • Working together 2018
  • GCP
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