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  CASE STUDIES


 
Introduction Beginnings Making sense of the information Deciding what to do Reviewing the plan
 
     
     

Stage 4 - Reviewing the plan

Case information

  • 24 hour, 7 days per week family support has been put into home (in spite of worries over costs, intrusiveness and stress on workers)
  • 10 year old girl has chosen to stay at a school friend's home and this appears to be working well
  • Housing department has allocated family new accommodation that offers an opportunity for a fresh start
  • There is more detailed information about the children's needs e.g. 3 year old boy hits and threatens the girls, one of the girls refuses to sleep on her own or have her hair washed
  • There is evidence of mother's commitment to her children despite all the pressures, and she is beginning to question the role of the men in relation to the family
  • The mother is well aware that she could lose her children if things do not work out
  • The men are very unhappy about the social work intervention

Key questions

  • What information do we have that will help us know whether the plan is working?
  • What has been achieved so far in relation to the objectives agreed in the care plan?
  • How far are the individual needs of the children being met?
  • How far are mother's needs being met?

Research focused questions

  • Are the children safe?
  • Are new needs being uncovered?
  • If so, what are they?
  • Where are the men?
  • What contact are they having with the family?
  • Does the plan need to be changed?
  • Do the priorities need to be adjusted?
  • What is the resource position - is the plan sustainable?
  • What is the contingency plan?

Relevant knowledge

Reviewing the Plan

The ten year old girl in the case is being looked after by the parents of a school friend. The other children are at home. Jackson & Thomas's On the Move Again? What works in creating stability for looked after children summarises a lot of the research in this area. On P.98 they list what they regard as the implications for practice:

  • Staying at home offers the best chance of stability (but, of course, this has to be balanced against the assessed risk of harm to the child);
  • Placement with relatives is preferable to placement with strangers (interestingly, in this case the girl has negotiated the nearest thing to a kin placement);
  • For school age children equal attention should be given to school as to the care placement;
  • For children with more difficulties we should look for carers with previous experience;
    Long-term placements with carers with children close in age are to be avoided (one research finding which goes back more than thirty years);
  • The child's existing social networks should be maintained wherever possible;
  • Siblings should stay together unless there are strong reasons to the contrary;
  • Preparation for placement in other families is vital as is the involvement of birth parents as far as possible;
  • There needs to be work on building up support for the carers, the child and the parents from the start;
  • Where a child is known to have special needs, extra support should be provided at the beginning rather than wait for things to go wrong.

Reference was made to Robbie Gilligan's work on resilience in Stage 1. Another recent source on the same topic is Tony Newman's Promoting Resilience: A review of strategies for child care, 2002.

Attachment, trauma and resilience: Therapeutic caring for children is foster care, is a highly accessible and moving text about one family's attempt to help children recover from their early experiences.

The main focus of the work was within the family home - initially via intensive family support and then later at the local family centre when they were able to pick up the work. The references to parenting programmes in the Making Sense of the Information section and the material on methods of intervention are again relevant here. The care plan will have specified the objectives to be achieved, the timescales within which change is to be measured and the services to be delivered based on the assessment of needs. A review provides the opportunity to assess whether the desired outcomes have been achieved, whether the services have been effective, whether there are new needs that should be addressed and whether the necessary collaboration between practitioner and the family has been sustained. In a complex case, and this is a complex case, the care plan will need to be renewed making any modifications that have proved necessary in the light of experience. The point was made at the beginning. This is a cyclical process not a straightforward journey from one point to another. A key component in this case as it turned out was the direct, skilled and determined contribution of the social worker. While he was responsible for co-ordinating the activity of other people, he played an active role in working with the mother, managing the risks posed by the men and promoting contact with the girl placed with her school friend.

Earlier a simple distinction was made between knowledge for understanding and knowledge for intervention. It is important to remember that research also has something to say about the how of intervention, the way in which a service is offered and delivered. For example, Social Work Decisions in Child Care: Recent Research Findings and their Implications, the first DHSS research summary to be published in 1985, made the following statement on p. 20 based on a number of studies about which social worker characteristics clients value:

'What was appreciated most was honesty, naturalness and reliability along with an ability to listen. Clients appreciated being kept informed, having their feelings understood, having the stress of parenthood accepted and getting practical help as well as moral support. The social workers whose assistance was valued had a capacity to help parents retain their role as responsible, authority figures in relation to their children. These social workers ere actively involved in the processes, negotiations and family dynamics of admission and discharge. When these qualities were present, social work help was highly valued.'

While the above is a distillation of the core characteristics of effective social work practice with children and families derived from some nine studies, it is equally pertinent to this particular case. The social worker identified the mother's commitment to her children at an early stage, assessed both risks and protective factors, engaged energetically with a range of complex issues, identified relevant resources and used the skills of others alongside his own. The mother clearly appreciated what he did. This did not mean that everything went smoothly, that appropriate resources were always available or that everyone agreed all of the time. But there is evidence that this social worker made a ifference in meeting the needs of these children and this family.


Other references

As for previous stages plus:

Hughes L. & Pengelly P. (1997) Staff Supervision in a Turbulent Environment: Managing Process and Task in Front-line Services

Munro E. (1999) 'Common Errors of Reasoning in Child Protection Work', Child Abuse & Neglect Vol.23, No 8

Munro E.(1998) Improving Social Workers’ Knowledge Base in Child Protection Work, British Journal of Social Work, 28, 89-105


Some general questions about support structures:

There are repeated messages in the Child Abuse Inquiries about the importance of Supervision. You might like to consider the availability of support in cases that you are currently worrying about.

For Practitioners:

What supervision are you receiving currently?
What is your view of its frequency and quality?
How well aware is your supervisor of your current pressures?

For Supervisors:

What supervision are you giving currently?
What is your view of its frequency and quality?
How well do you think you know your staff's current pressures?
What is your view of the frequency and quality of the supervision you are receiving?
How well aware is your manager know of current pressures?

Evidence-based or knowledge-based practice can be just fashionable words.

What library (books, journals, website and other) resources do you have in order to access some of the material quoted in the case study?
How accessible are these resources?
What opportunities are there within your agency to support you in your attempts to make your practice more effective?
If you were to look at a current child care file now, would there be evidence of your attempts to apply your knowledge?

     
       
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