3.6.3 Parents with Additional Needs |
SCOPE OF THIS CHAPTER
Parents and carers of children referred to Children's Social Care may have a range of additional needs including those arising from acute or chronic physical illness, mental illness, physical or learning disability, or sensory impairment.
None of these issues in themselves necessarily prevent a parent from offering good enough care. However there are a number of factors which need to be taken into account when assessing, planning and reviewing the delivery of social work services.
It is particularly important to involve parents to the maximum possible extent in the interests of building a working partnership, as many will necessarily be involved with Children's Social Care and other support services over a number of years. It is essential that intervention aims to minimise the social effects of long-term illness and disability.
Contents
1. Assessment
Due to the significant impact of long-term parental conditions a Core Assessment should normally be carried out on all the children of the household in response to a request for services by or on behalf of a parent with additional needs. Within this the following factors need particular consideration:
What is the Impact of the Condition?
While it is essential to establish the factual basis of any additional parental need in terms of diagnosis, prognosis, treatment, responsible professionals etc. the most important aspect for a child care social work assessment is the impact of the disability or other condition on every-day parental tasks and responsibilities. The Core Assessment provides helpful guidance as to children's needs and parenting tasks at different developmental stages. Where a condition is variable it will be important to establish which can be managed all of the time, which only on good days etc.
Does the Parent take Responsibility for Managing Their Condition?
A parent with additional needs may be reliant on co-operation with support services, taking medication or other treatment. The situation is particularly complex with mental health conditions where the onset of an episode may be accompanied by a decline in co-operation. If a parent is worsening their condition through persistent failure to co-operate with services, through self-neglect or abuse of alcohol or drugs the outlook for their ability to care for a child successfully is bound to be compromised.
Are There Factors Within the Family or the Overall Network That Mitigate the Effects of the Parent's Condition?
Clearly the ideal situation is for there to be another adult within the household able to give direct practical and emotional support both to the parent and the children. Input from others within the social or family network is often essential to a family's continued functioning but can be difficult to ascertain. It is important not to assume that more assistance is being given than is actually the case and it is important to meet all of the adults who play a part in the care of the children wherever possible. It is also often the case that vulnerable parents can attract others who can have a negative impact on the family.
Are the Parent's Problems Worsened due to Avoidable Factors?
Examples of this would be unsatisfactory housing, lack of adaptations or failure to claim available benefits. This calls for a rounded and holistic assessment as well as joint working with colleagues in adults' services. It is essential that such problems are identified and tackled, even where there may be contributory parenting problems.
To What Extent Does the Child Provide Direct Care for the Parent?
Anyone providing care for a member of their family on account of illness or disability is entitled to a 'carer's assessment', which for a child is undertaken within the framework of the Initial or Core Assessment. While it may be unavoidable that the child undertakes some additional responsibilities it is important that these are neither inappropriate nor impede his or her normal life or development such as attendance at school or participation in normal social activities. For information and resources please see the Young Carers Website
What is the Children's Level of Resilience and Overall Well-being?
It is unavoidable that many children who live with parents who have additional needs will have to play a role either in the direct care of the parent or in general household chores and care of siblings. It is important to have an accurate idea of the nature and extent of this, but the impact of on children will vary according to their individual history, personality and relationship with parents. Even where children have to undertake a great many responsibilities this may be balanced by positives in their family lives and needs to be seen in the context of their overall health, educational progress and other indicators of their well-being.
Guidance in the Framework for Assessment Practice Guidance is useful here, as are the Family Pack of Questionnaires and Scales.
2. Planning and Intervention
Where an assessment indicates that a family in which there is parent with additional needs requires ongoing services these should be provided within the context of a Child/Young Person's Plan for each applicable child. This should support continuity of service and approach even where there are changes in staff. Please see the general guidance regarding ongoing work with children in need within this chapter.
Within this the following points should be considered:
Feedback from parents' groups is that loss of control and failure to respect their rights as parents can be associated with intervention. It is therefore essential that there is good communication and that parents are kept fully informed at all times.
Parents with additional needs may present as angry and demanding. This may be an aspect of their situation e.g. to a diagnosis of serious illness or may relate to previous unhappy experiences. Either way it is important to deal with this in a professional way.
Most parents will be receiving services of some level from adult health or social care services. These professionals will obviously see the adult as their client or patient and it is important for workers in children's social care to make an investment in building working relationships through regular telephone communication and joint visiting.
Services should be regularly reviewed within the CYP plan - it is important to involve the parent and significant members of the informal network as well as adult services in order to meet the family's needs in an holistic way.
Feedback from parents is that practical help is highly valued: it is important therefore that there is effective working together between adult and children's services to ensure that appropriate benefits are accessed and that where necessary there is a sharing of costs e.g. for domiciliary help between adults and children's budgets.
3. Child Protection and Legal Action
Child protection issues can occur in families where parents have additional needs, as they may in any other family. It is important in considering an appropriate response to ensure that any child protection situation has not been created or exacerbated through lack of appropriate services, as this may be argued in any court proceedings.
For guidance regarding parents who have mental heath problems and parents who have learning disabilities please see: London Child Protection Procedures Chapter 5.33.
Good practice guidance on working with parents with a learning disability (DH / DfES, 2007)
Please note that whatever the previous history it is important to ensure that each assessment takes full account of the current situation and any improvement in the parent's condition or social circumstances.
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