IRO Challenge – How ‘Patrick’ was helped to return home

October 24th, 2015

This scenario shows how IROs’ use of professional ‘challenge’ enabled professionals to re-consider the significance of the child’s relationship with family. While recognising that it may occasionally be better for a child to stay separated from their family or to have limited contact, this scenario reminds us of the importance of robust assessment and family support to inform a view about a child’s safe return home wherever possible.

Contextual factors

The UN Convention of the Rights of the Child describes the family as ‘the fundamental group of society’. It recognises parents’ role in protecting and promoting the rights of their child and requires the state to help parents fulfil their responsibilities. Where it is necessary for children to be cared for outside of their families, they have a right to alternative care provided by the local authority – care that is subject to regular review, chaired by their IRO, to ensure the care placement continues to be responsive to the child’s views as well as their changing circumstances and needs.

We know from research that the long-term consequences of looked-after children not getting the right care are poorer outcomes for them and increased pressures on already over-stretched local authorities.

The most common outcome for children leaving care is to return home to a parent or relative but we know from research that there are weaknesses in social care practice around assessment, decision-making, planning and support for children and families when children go into, and return home from, care. Children’s reunification home can be fraught with difficulties and risks need to be better assessed and managed. Around half of children who come into care because of abuse or neglect suffer further abuse if they return home (NSPCC, 2012). Moving in and out of care can result in long term and irreversible damage to children.

Local authorities spent £2.5 billion in 2012-13 supporting children in foster and residential care, a real terms increase of 3% since 2010-11 (National Audit Office (NAO), 2014). The Head of the NAO, Amyas Morse has stated that:

Most children are taken into care because of abuse and neglect. But too many of them are not getting the right placements the first time. If their complex and challenging learning and development needs are not correctly assessed and tackled, the result is likely to be significant long-term detriment to the children themselves as well as cost to society.

Case Study: “Patrick”

Patrick, aged ten, had been in foster care for four years due to his parents being unable to manage his life threatening illness. Patrick had never settled completely with his carer, he presented as a sad child despite his carer’s warmth and commitment to him. Fortunately Patrick had developed a good rapport with his IRO. He met with his IRO before his review and was able to share some of his worries and concerns.

At the review meeting, Patrick’s social worker advised the IRO of an intention to reduce Patrick’s fortnightly contact with his mother to six times a year. The social worker had developed a view that Patrick’s sadness was intertwined with a need to attach to his foster carer and reduce the links with his birth mother. The social worker felt that by reducing Patrick’s contact with his mother, he might better identify with his carer’s and settle.

The IRO took a different view to the social worker. Having spoken with Patrick and the important people around him, the IRO felt that there should be a re-assessment of Patrick’s situation as she could no longer be sure that his care plan was meeting his needs. The IRO challenged the social worker’s feeling that Patrick’s contact was the cause of his sadness. The IRO acknowledged that Patrick was now older and his health more manageable and therefore considered that the social worker should complete an up-to-date assessment of his needs. Assessment would inform a judgement about whether Patrick’s overall care plan was sufficiently meeting his needs and whether a change of care plan was needed.

Re-assessment of Patrick’s needs was completed by the social worker and was very positive. A robust support package was put in place and Patrick returned to the full time care of his mother. Patrick is now presenting as much happier and reports that he is very happy.

Messages from Research

Reference chapter seven from the NSPCC’s book, ‘Promoting the wellbeing of children in care’, which was launched this month.

Holmes (2014) ‘Supporting Children and Families Returning home from Care Counting the Costs’ which shows that the total estimated cost for all failed reunification is £300 million a year but improved support for children’s reunification would cost an estimated £56 million.

Improving outcomes and making a difference

• Make sure a social work assessment of the families’ needs is undertaken as soon as reunification is an option to ensure best outcomes
• Demand better assessment, support and monitoring of children to make sure that reunification is actively considered as part of permanency planning.
• Use practice based knowledge and relevant research to question whether and what type of support the parent(s)/family may need to help change family dynamics.
• Compel and challenge the ‘corporate parent’ to fulfil the full range of its obligations to make sure children and young people experience the right care at the right time.