Transcript Child abuse on the front page: Learning

Putting it onto paper:
Recording and report writing
Patrick Ayre
Department of Applied Social Studies
University of Bedfordshire
Park Square, Luton
email: [email protected]
web: http://patrickayre.co.uk
Learning from enquiries
Those who cannot learn from
history are doomed to repeat it
(George Santayana)
Learning from enquiries
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The importance of recording is not always
understood
We don’t always think enough about Why?
and Who?
Information not accessible
Incomplete or out of date
Facts and judgments not distinguished
Little assessment and analysis
Oppressive language
Managers not always fully engaged
Comments from ‘Recording with Care’
A Director Says:
‘My staff are good at what they do, not what
they write down’
A Social Worker Says:
'I didn't become a social worker because I
wanted to be a typist or a computer
programmer. I want to work with people, not
waste my time in front of a machine’
On the other hand
A Team Manager Says:
‘I couldn't believe the information wasn't there! I kept
thumbing through the file, trying to find it. I know
we've talked about lots of things in supervision. I just
thought it was being written down - but I don't have
time to check!‘
Lord Laming says:
‘The case file is the single most important tool
available to social workers and their managers when
making decisions as to how best to safeguard the
welfare of children under their care.’
Framing your writing
You will want to consider the usual
questions:
How, Who, What, When, Where and
Why.
In the planning phase, start with
 Why (are you writing this)?
 Who (for whom is it intended)?
For whom are we recording?
Service users
 Social workers
 Managers
 Legal advisers
 Other agencies
 Insurers
 Councillors
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Why record?
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History
Support partnerships
Provide continuity
Facilitate reflection, analysis and planning
Support professional development
Evidence for resources
Management monitoring
Evidence for enquiries and investigations
Evidence of acceptable standards
Formal reports
May seem like a chore BUT:
 Can get everything down (less risk of forgetting
something or missing it out)
 You can check the information and make sure it is
accurate.
 You can spend time thinking about how you
express things
 The other parties will read in advance, so may
spend less time presenting orally:
– Should only be asked about disputed parts of the
report
– The other side may not need to ask questions or may
even fold!
Selling you opinion
What would you look for
yourself?
Selling you opinion
What would you look for
yourself?
 Presentation
 Content
Presentation
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Make it pretty and easy to read
– Neat
– Double spaced
– One side only
– Numbered paragraphs and pages
Language
Good grammar
 Good sentence construction
 Simple sentences
 No unnecessary, unexplained jargon
 Appropriate tone (formal so no slang, no
contractions, no use of first names for
adults)
 Sensitively phased (but not watered
down)
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Content problems
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Incomplete
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Biased
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Conclusions and recommendations
poorly argued and justified (or absent
altogether)
The chain of reasoning
Facts
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Analysis/summary
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Conclusions and recommendations
What do they want to know?
Who you are
 Why you are reporting
 The facts of the matter
 The conclusions to be drawn from the
facts
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The facts
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‘It is the task of practitioners to share,
sift, search for and weigh the
significance of their information’
(Morrison 2009)
The facts
Family composition (attach a genogram)
 Background history (family and
individual)
 Recent events
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The facts
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Tell the story chronologically without too
much editorialising
 Facts sufficient support your argument and
also to refute counter arguments
 First hand evidence is best but give source of
any information
 Make sure that you have put information as
fully and accurately as possible (Checklist:
Who, what, when, where, how)
Seeking strong evidence
Information may be:
 Ambiguous
 Missing
 Assumption-led
But can become ‘firm-ground’ if further
enquiries are made or it is explored
further
Bias and Balance
Include information favourable to the
other side as well as that favourable to
yours
 It is your job to make judgements but:
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– avoid empty evaluative words like
inappropriate, worrying, inadequate
– Give evidence for descriptive words like
cold, dirty and untidy
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Beware the danger of facts
Bias and Balance
Born in 1942, he was sentenced to 5
years imprisonment at the age of 25. After
5 unsuccessful fights, he gave up his
attempt to make a career in boxing in
1981 and has since had no other regular
employment
Lies, damned lies and killer bread
Research on bread indicates that
 More than 98 percent of convicted felons are bread users.
 Half of all children who grow up in bread-consuming
households score below average on standardized tests.
 More than 90 percent of violent crimes are committed within
24 hours of eating bread.
 Primitive tribal societies that have no bread exhibit a low
incidence of cancer, Alzheimer's, Parkinson's disease, and
osteoporosis.
 In the 18th century, when much more bread was eaten, the
average life expectancy was less than 50 years; infant
mortality rates were unacceptably high; many women died in
childbirth; and diseases such as typhoid, yellow fever, and
influenza were common.
Incomplete or out of date
Can you trust a snapshot?
Information handling
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Picking out the important from a mass of
data
Interpretation
Decoyed by another problem
False certainty; undue faith in a ‘known fact’
Discarding information which does not fit
First impressions/assumptions
Too trusting/insufficiently critical
Distinguishing fact/opinion
Department of Health (1991) Child abuse: A study of inquiry reports, 19801989, HMSO
Fact or opinion?
There are inadequate play and stimulation
opportunities available.
2. The bruise and swelling are consistent with hitting his
head on the door.
3. This is the first incident of abuse to the child.
4. The flat is unsuitable for bringing up a young child.
5. Mrs Green is good at keeping her flat tidy.
6. Experienced professionals are better at dealing with
child protection issues.
7. Children who were abused usually become abusers.
8. The child said his dad hit him.
9. I saw Peter playing with his toys when I last visited.
10. Mrs Green does not display appropriate parenting skills
when relating to her son
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Assessments
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Assessment work is complex and
emotionally demanding
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Collation and analysis of large bodies of
information from multiple sources
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Continuous series of mini-decisions
about what to collect, how to collect
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Each mini-decision has an impact on
the assessment
Assessment Pitfalls
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When faced with an aggressive or frightening
family, professionals are reluctant to discuss
fears for their own safety and ask for help
Attention is focused on the most visible or
pressing problems and other warning signs are
not appreciated
Parents’ behaviour, whether co-operative or
uncooperative, is often misinterpreted
Not enough weight to information from family
friends and neighbours
Not enough attention is paid to what children
say, how they look and how they behave
In Cleaver, H, Wattam, C and Cawson, P Assessing Risk in Child Protection,
NSPCC, 1998
Child centred assessment
The purpose of assessment is to understand
what it is like to be that child or young person
(and what it will be like in the future if nothing
changes)
Assessment pitfalls
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Rule of optimism
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Start again syndrome
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Natural love
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Cultural relativism
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Too much
not enough
Analysis
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Studies (and SCRs) highlight problems
in the quality and level of analysis
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Assessments too static and descriptive,
resulting in an accumulation of facts that
are not analysed in a way that offers an
explanation of the situation (Brandon
2008)
But what is analysis?
You have gathered lots of information but now what?
All you need to do is ask yourself my favourite question:
“So what?”
You have collected all this data, but what does this
mean, for the young person, for the family and for the
authority?
Analytic thinking
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‘a conscious and controlled process using
formal reasoning and explicit data and rules
to deliberate and compute a conclusion’
(Munro, 2007)
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‘Analysis should be seen as acting like a
good secretary keeping a check on the
products of intuition, checking them for known
biases, developing explanatory theories and
testing them rigorously’ (Thiele, 2006)
Intuition and Analysis
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Intuitive thinking – unconscious process that
allows the integrations of a large amount of
information to produce a judgement in an
effortless way
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Gut feelings: ‘take advantage of the evolved
capacity of the brain and are based on rules
of thumb that enable us to act fast and with
astonishing accuracy’ (Gigerenza, 2007)
Intuition versus Analysis
It is the combination of intuitive and
analytic modes that produces the kind of
evidence-based practice by which social
work knowledge establishes its relevance,
expertise and authority
Morrison 2009
Decision making, intuition and
bias
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‘Often a decision is made first and the
thinking done later’ (Thiele, 2006)
As humans, we resort to simplifications, short
cuts and quick fixes!
We reframe, interpret selectively and
reinterpret.
We deny, discount and minimise
We exaggerate information especially if vivid,
unusual, recent or emotionally laden and
We avoid, forget and lose information
Good assessments are...
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Clear about the purpose, legal status and
potential outcomes
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Based on a clear theoretical framework
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Clear about context and value base
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Collaborative and promote accessibility for
service users
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Based on multiple sources of information
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Value the expertise and understanding
service users bring to their situation
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Clear about missing information
Good assessments…
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Identify themes and patterns
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Generate and test different ways of understanding
the situation
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Give meaning to themes, using knowledge based on
experience/research
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Lead to an evidence-based conclusion
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Use supervision to assist reflection, hypotheses and
objectivity
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Are able to record and explain outcomes
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Are reviewed, updated & amended in light of new
information
Learning from Past Experience
Major themes from SCR reviews of the 90s:
Collecting and interpreting information
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Importance of comprehensive family
assessments, especially male figures
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Failure to give sufficient weight to relevant
case history
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Understanding thresholds, especially the
importance of neglect and emotional
deprivation and the need to accumulate
evidence
Learning from Past Experience
Major themes from SCR reviews of the 90s:
Collecting and interpreting information
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Importance of comprehensive family
assessments, especially male figures
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Failure to give sufficient weight to
relevant case history
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Understanding thresholds, especially the
importance of neglect and emotional
deprivation and the need to accumulate
evidence
Learning from Past Experience
Major themes from SCR reviews of the 90s:
Collecting and interpreting information
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Importance of comprehensive family
assessments, especially male figures
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Failure to give sufficient weight to relevant
case history
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Understanding thresholds, especially
the importance of neglect and
emotional deprivation and the need to
accumulate evidence
Assessment and analysis
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Suspected injuries and unconfirmed bruises over
limbs - not explained.
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Previous history of abuse by older sibling - off Child
Protection Register
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Single mother and new boyfriend
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Concern by school staff about negligence in hygiene,
clothing and school attendance
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Growth at the third centile - no medical reason
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Uncle visiting - ex-convict
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Mother was abused as a child
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Financial problems - on social security
Assessment and analysis
“He is a young boy who is confused about
his current situation. Until the child care
planning meeting confirms the long-term
future plans for him he will effectively
remain in limbo. This is affecting his ability
to feel secure. He is noticeably anxious at
school on Mondays prior to contact at
home and he therefore learns very little
on that day. By Wednesday of each week
he calms down again”
Conclusions and recommendations
Problems:
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Unsupported assertions or judgements
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Inability or unwillingness to analyse and
draw conclusions
Conclusions and recommendations
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Summarise the main issues and the
conclusions to be drawn from them. (The
facts do not necessarily speak for
themselves; it is your job to speak for them.)
 Define objectives as well as actions
 Draw conclusions from the facts and
recommendations from the conclusions
 Explain how you arrived at your conclusions
(Have you demonstrated the
factual/theoretical basis for each?)
Conclusions and recommendations
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In drawing conclusions be aware of the
extent and limitations of your own expertise.
 Conclusions may be supported by research
(Don’t go outside expertise; be careful with
new or controversial theories; be aware of
counter arguments)
 Your recommendation should usually be
specific (not either/or)
 Remember: conclusions may be attacked in
only two ways
– founded on incorrect information
– based on incorrect principles of social work
Inaccessible information
‘it may be that a contributory factor in the
failure of various professionals involved in
Victoria’s case to read the file was that
the information was not presented in a
sufficiently convenient and accessible
way...This is one of the reasons why I
regard the inclusion in any case file of a
clear, comprehensive and up-to-date
chronology as absolutely essential’
Inaccessible information
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Files very long
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Records very badly structured
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Patterns missed and ‘chronic abuse’
overlooked
Capturing chronic abuse
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Judging the quality of care is an essential
component of any assessment but how well
do we do it?
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Judgements subjective and prone to bias
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Intangible: Difficult to capture and compare
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High threshold for recognition
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Cumulativeness and acclimatisation
The pattern of neglect: atypical
The pattern of neglect: typical
Intervention
Intervention
The pattern of neglect
'Good enough' level
Intervention
Intervention
The pattern of neglect
Intervention ceases
'Good enough' level
Intervention
Intervention
A pattern of decline
Cumulativeness
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Threshold for
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Failure of cumulativeness
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Threshold for
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What’s the problem?
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Chronic abuse and the principle of
cumulativeness
 Incidents scattered through files
 The problem of proportionality
 Acclimatisation
Inclusive recording
How would I feel if this was written
about me?
 What would a lawyer make of this?
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Managers not fully engaged
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No comprehensive recording policy
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No reading and signing of files
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No recording of decisions and
advice/instructions on files
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Inadequate auditing
Micromanaging assessment and reporting
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Format: Endless predetermined tick boxes
and text boxes
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Content: Repetitive and disaggregated
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Concept: Routinised and mechanistic
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Purpose: Well, what is the purpose?
?Understanding what it is like to be that child,
and what it will be like if nothing changes
Micromanaging assessment and reporting
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Format: Endless predetermined tick boxes
and text boxes
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Content: Repetitive and disaggregated
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Concept: Routinised and mechanistic
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Purpose: Well, what is the purpose?
Understanding what it is like to be that child,
and what it will be like if nothing changes 
Getting the assessment done 
Recording guidelines
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Be clear about the purpose of the record
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Describes what has happened, what you
have done and why
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Complete and contemporaneous
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Distinguish facts from opinion
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Remember to be accurate, relevant and
concise while still providing a complete
record.
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Use clear and unambiguous language.
Recording guidelines
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Demonstrate assessment and judgment
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Use language that is respectful.
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Give due consideration to diversity issues
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Sign and date each piece of written
information, including messages.
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Be aware of confidentiality.
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Indicate who or where the information has
come from.
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Involve service users at all stages
Managing the task
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Recognise importance, not just for the
agency but for the service user or carer.
See recording as an integral and important
part of your practice.
Plan your recording. Allocate time to record
and minimise interruptions and diversions.
Record information as you go along. Don’t let
it build up!
When planning a significant contact with a
family or individual include recording as part
of your time allocation.
Legal underpinnings
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Data Protection Act 1998: Guidance to Social
Services, Department of Health, March 2000
Children and families should be:
– informed of their right to access their records
– encouraged to contribute to records and check
their accuracy
– informed about information held about them and
when that information is to be shared with others
– reassured of confidentiality and that their records
are kept in a safe, secure place
Confidentiality
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All personal information is confidential
 Need to know
 One purpose
 Disclosure without consent
– to protect children, individuals or the public
– to prevent, detect or prosecute a serious crime
– to meet legal requirements, such as a subpoena.
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Inform service users of disclosures
 Security of data
Framework for Assessment of Children
in Need and their Families
‘a systematic way of analysing,
understanding and recording what is
happening to children and young people
within their families and the wider context
of the community in which they live’
( DH 2000)
Framework for Assessment
Framework for Assessment
Framework for Assessment
Stresses the need for interagency cooperation
Builds on responsibilities under section 47
of the CA 1989
Based on the following:
Legislative basis
 Protocols/procedures
 Lead responsibility
 Involvement of child and family
 Information sharing
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Principles
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Child-centred
Informed by child development theories
Ecological in approach
Equality of opportunity
Involvement of child and family
Builds on strengths as well as identifying
difficulties
Interagency approach
A continuous process (not single event)
Grounded in evidence-based knowledge