3.12 Protocol for undertaking joint visits and assessments by Social Workers, Health Visitors and Midwives, for children under 5
This protocol details best practice for social workers, health visitors and midwives when a statutory assessment under the Children Act 1989 is required for a child under 5 (including pre-birth assessments). It should be read in conjunction with Working Together 2018 and the 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 assessment and planning of interventions to support the child and family.
A statutory assessment is required by law under the Children Act 1989 when children are considered to be ‘in need’ or suffering/at risk of suffering ‘significant harm’. It is the responsibility of Local Authority social workers to undertake assessments of the needs of individual children to determine what services to provide and action to take.
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 is a Child in Need (Section 17) and /or is suffering or likely to suffer Significant Harm (Section 47)
- To provide support to address identified needs to improve the outcomes for children and to make them safe. This may include ‘stepping down’ to planning within a Family Support Plan Framework.
Every statutory 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 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 factors for the child.
For children under 5 the expertise of the health professional 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 and Team Managers in Health Visiting, Midwifery Services and Social Care Assessment Teams to discuss joint visiting and assessment arrangements. Heads of Social Work will meet with Healthy Child Programme (HCP) Locality Managers a minimum of bi-monthly. Meetings will be rotated across different agency bases.
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 visit will be arranged with the health visitor (or midwife in the case of pre-birth assessments)
- Contact the Health Visiting/Midwifery Team 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
- The social worker should contact the family to confirm the time of the visit
- The social worker will review LiquidLogic to ascertain any background information including starting or reviewing an integrated chronology as required
- The health visitor will review SystmOne for background information and 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 worker’s chronology if required
- The social worker will contact the GP for the relevant family members’ information prior to the home visit and also relevant schools/Early Years settings
- Where possible the health visitor/midwife known to the family should undertake the visit. If this is not possible the visit should be undertaken with the duty health visitor
- The social worker and health professional will make contact prior to the home visit to plan the visit. The planning should include a review of the referral, exchanging of background information/chronology, discussion around which practitioner will lead the visit 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 worker will be the lead practitioner.
- 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 and consent obtained
- The practitioners will explore the issues facing the family using the domains of 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 worker seeing any older children on their own, these will be arranged with the family.
- Following the joint visit the social 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 assessment visit
- 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/SystmOne record/hospital records
- 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 visit and any follow up visits and multi-agency information to their Team Leader/Supervisor. They will keep each other informed about any actions resulting from their respective supervision.
- Assessments 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 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 whether a strategy meeting is required to consider initiating a Child Protection Conference, or whether a Child in Need Meeting or Step-down meeting 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 and Escalation Policy should be followed
- Both practitioners will record the assessment and plan in accordance with their organisation’s record keeping policy. The social worker is responsible for the production of the assessment but its content, analysis and actions should be informed by the assessment and analysis from the health visitor/midwife and any other professionals involved. Consideration can and should be given to jointly producing a report to share with the family
- The social worker is responsible for planning any type of multi-agency Signs of Safety meeting to agree plans and services to be put in place. Where there is no further role for the social worker, the social worker is responsible for informing the family and sharing the assessment with them and any other professionals involved. This should be jointly undertaken with the health visitor/midwife where appropriate
- The social worker will be the lead for any resulting Child in Need or Child Protection Plan
- 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.
- Risk in Child Protection Assessment Challenges and Frameworks for Practice, Martin C Calder 2015