View Working Together View Working Together

Chapter 47: Framework for Managing Risks of Significant Harm to Children

Contents

  1. Introduction
  2. What is risk and what is risk management?
  3. Issues related to assessing risk
  4. The Luton Risk Management Framework
  5. Information Gathering

    References

    Appendix A - Significant Harm

    Appendix B - The Assessment Framework


1. Introduction

1.1 The LSCB Risk Management Framework provides a model for the assessment of harm to children (and unborn children), practitioners and managers through the inter-related activities of information gathering, analysis and judgement.
1.2 In particular the Framework will assist professionals and managers to make decisions as to whether the threshold for Significant Harm has been met or not met (see Appendix A).
1.3

The Framework expands on the requirement to undertake a risk assessment as part of a Section 47 Enquiry as outlined in Action to be Taken where a child is at risk of Significant Harm Procedure.

The scope and focus of the assessment will be that of a risk assessment which:

  • Identifies the cause for concern;
  • Evaluates the strengths of the family;
  • Evaluates the risks to the child/ren;
  • Considers the child's needs for protection;
  • Evaluates information from all sources and previous case records;
  • Considers the ability of parents and wider family and social networks to safeguard and promote the child's welfare;
  • Considers how these risks can be managed.

It is important to ensure that both immediate risk assessment and long-term risk assessment are considered.
1.4 The Framework is closely linked to the Assessment Framework (DOH 2000) by drawing together relevant information from the three domains; the child's developmental needs, the parenting capacity and the family and environmental factors.  Consequently, the aim of this approach is not just to minimise harm or danger to children, but also to maximise their welfare.
1.5

The Framework draws on the recommendations from an analysis of Serious Case Reviews,

"Information and evidence should be collected, and systematic observation assessed within the context of an ecological framework based on clearly understood developmental and psychosocial theories including the relationship and developmental histories and processes that have shaped parents, families and children.

The ecological developmental framework should also provide a conceptual structure and language for presenting a case formulation that should include (i) a clear case summary and synthesis of the knowledge brought together by the assessment, (ii) a description of the problem/concern, (iii) a hypothesis about the nature, origins and cause of the   need/problem/concern, and (iv) a plan of the proposed decisions and/or interventions. It needs to be emphasised that the Assessment Framework provides an ecological developmental structure which, if used well, should ensure that both practitioners and managers work together in a clear, coordinated and collaborative way." (DCSF 2008)

The Referral and Assessment Team will provide guidance to operational decision makers about the processes to follow and the considerations to be weighed. 

However, staff should also be aware of specific policies for certain situations (e.g. Joint Agency Protocol for Working with Vulnerable Parents where one or both parents have Mental Health Problems).  All decisions must be recorded and signed off at the appropriate management level.
1.6 Staff will be supported in making judgements within national and local policy and procedures and wherever their decisions are based on best practice and authoritative research evidence.
1.7 Risk decisions are often thought of solely in terms of child protection.  Other childcare decisions can also involve balancing significant and conflicting risks for a child and his or her family (e.g. whether or not to accommodate a child, whether a young person should move to independent living).  The Framework can be usefully applied to other decisions in childcare.


2. What is risk and what is risk management?

2.1 This Framework is based on a theory of risk assessment in which risk is defined as the relationship between the degree of harm and the probability of the believed harm occurring (or of protection being provided).  Brearly (1982) states that risk assessment must consider the dual components of evaluation and probability. Probability includes factors, which increase and decrease likelihood.
2.2 This Framework defines 'risk management' as identifying the potential for a poor outcome for a child (or their family) and taking steps to reduce the possibility of it occurring or minimising its effects.
2.3 Such decisions often involve risk, and as such are often finely balanced with valid arguments supporting different possibilities.  By definition there will never be an entirely risk-free option, only a choice between different ways forward, all of which carry risks.
2.4 Each option in a risk decision is likely to have potentially beneficial outcomes as well as potentially adverse ones.   A decision to take no action can be a valid risk decision and should be recorded as such.  It is important that decision makers weigh these in the balance of their decision and record all the dilemmas, considerations and conclusions carefully.


3. Issues related to assessing risk

3.1 The overall purpose of assessment and management (i.e. intervention) is to manage the risk effectively and, if possible, to prevent a future occurrence of harm to a child.  The major difficulties for practitioners and managers are presented in the assessment of risk rather than its management.  Once a potentially dangerous and risky situation has developed, the task of addressing it and formulating strategies is relatively straightforward compared with the initial recognition of risk factors prior to the assessment.
3.2 Any traditional models of risk, work on the premise that the best predictor of future behaviour is past behaviour.  However, it is important to note that in real-world professional work situations, workers are forced to carry out assessments with incomplete information and time restrictions in which to consider courses of action and restricted resources and alternatives.


4. The Luton Risk Management Framework

4.1 The Framework provides a means of gathering and sorting information in order to reach judgements at various points in the protective process about the risk of significant harm to, or safety for, a child.  See Appendix B (Appendix B should be printed on A3 paper)
4.2 The Framework supports decision making during a Section 47 enquiry, a core assessment or casework with children where there are ongoing concerns that their welfare is being compromised.
4.3 Recording at each stage is essential and should be incorporated into existing recording formats.
4.4 The first consideration of risk assessment is the type and degree of harm. Significant harm for the purpose of child protection intervention is defined in Section 31 of the Children Act 1989.  See Appendix A.
4.5

There are three, overlapping stages to in the risk assessment process:

  1. Gathering information
  2. Analysis of information
  3. Judgement of risk

Click here to view the Risk Management Flowchart
4.6

To best way to understand the Framework is to consider the process in reverse.
 

Judgement of risk
4.7

To reach a judgement on the level of risk and whether the local authority should intervene and how to safeguard and promote a child's welfare in the immediate or long term, the assessment of risk process needs to determine:

  • What are the harm consequences for the child or young person? Describe actual and believed harm: provide indicators, observations and opinions to demonstrate consequences for the child or young person.  Are the harm consequences extreme, serious or concerning? 

    and

  • What are the factors that increase and decrease the probability of harm?  Is the probability of harm highly likely, likely or unlikely?
4.8 The conclusion of the judgement will need to consider what the likely impact(s) is/are of the proposed intervention on the child, their family and other significant others.  
4.9

When rating a risk level to a child's situation, professional judgment must always be applied. The following grid is a guide only. Some cases of extreme harm consequence should be rated as high or very high risk, regardless of probability. For example, a death threat towards a child by parent or unexplained broken bones to infant:

Risk Level Harm Consequence Harm Probability
Very High

Extreme
Serious

 Highly Likely
Highly Likely
High Extreme
Serious
 Likely
Likely
Medium Extreme
Concerning
Concerning		 Unlikely
Highly Likely
Likely
Low Serious
Concerning
 Unlikely
Unlikely

 
 

Analysis of information
4.10 The answers to the above questions will be informed by analysing three inter-related areas (severity, vulnerability & likelihood) and balancing these against the identified safety or protective factors that are likely to minimise any identified negative issues. 
4.11

Consideration of information relating to these four dimensions is essential to achieve the goal of the risk assessment process: a judgement regarding overall risk founded on clear statements about the degree of believed harm and the probability of the believed harm occurring.  The analysis stage should cover the following areas:

  • The severity of the known or believed harm.   Severity refers to the type and degree of harm which has, is or is likely to be suffered and its impact on the child (the Assessment Framework triangle can be used to think about the impact the abuse has on the child's developmental needs and what the parental capacity is to help the child to be protected, to be a believing advocate and support the child in recovery and the healing process) . It takes into account the pattern of past harm (as relevant) to the estimation of severity of any believed future harm;
  • The child's vulnerability to harm.   Vulnerability refers to factors relating to the age and aspects of the child or young person's development or functioning, as well as the opportunity for further exposure to harm or for protection and the parental capacity for change.
  • The likelihood of known or believed harm being repeated, continuing or cumulating. Likelihood refers to those factors which increase the probability of harm, such as patterns of abuse or neglect towards the child or other children in the family, attachment and quality of relationships, attitudes of the parents to harm, and complicating factors (Reid at al (1995) identified three important organising principles consistently associated with occurrences or recurrences of child abuse or neglect for children. These authors regard risk as residing in characteristics of the caregiver and state: 1. The first and most important dimension of caregivers' characteristics that should be considered is their prior pattern with respect to the treatment of children. The number of maltreatment events they have initiated, their severity and recency are the most basic of guides to future behaviour. In the absence of effective intervention these behaviour patterns would be expected to continue into the future. 2. If an individual believes that they are correct in their opinions about children, they will attempt to continue their behaviour so long as they are not prevented from doing so. 3. The third dimension concerns the presence of 'complicating factors', most significantly, substance abuse, mental illness, violent behaviour, and social isolation. The relevance of complicating factors is the extent to which they, singularly or in combination, diminish the capacity to provide sufficient care and protection to the child or young person).
  • The degree of safety for the child.  Safety refers to the capacity of a parent, other family members or significant adults to protect and care, the child's own capacity to gain protection (depending on their age and development) and the isolation of the family from support.  Strengths are positive attributes in relationships, skills and personality. Within the Framework these attributes are considered as they act to support, enhance or develop capacity, motivation or competence to protect and care.  Turnell and Edwards (1999) state that:
    • Both the potential for harm and for safety must be considered to achieve a balanced risk assessment and risk management
    • Strengths that increase the potential for safety are evident in even the worst case scenarios and these are fundamental building blocks for change
    • A constructive approach to building safety can be taken which may be different to efforts to minimise harm
    • A strengths perspective can be actively (and safely) incorporated into what may otherwise become a 'problem saturated' approach to risk assessment and risk management.


5. Information Gathering

5.1 At any phase of the protective or risk assessment process, a practitioner should gather, analyse and judge information under five information categories.  Three of these categories are linked to the Assessment Framework (see Appendix B).  The key points listed below under each of the five categories are likely to be the most significant in terms of gathering information; however other factors listed in the three domains of the Assessment Framework need to be explored.  This will ensure all the child's needs are considered and addressed whether these relate to child protection concerns or not.
5.2 The five essential information categories are:

The Child or Young Person

  • age
  • development
  • functioning

The Parents

  • attitudes to harm and to the child
  • relationship with the child
  • functioning
  • parenting capacity
  • parenting history

The Opportunity for Harm

  • access of alleged perpetrator
  • exposure to harm

The Source of the Harm

  • incident or harm causing behaviour
  • severity
  • history and pattern (one off incident, or series or pattern of abuse or neglect)
  • type of abuse or neglect (or combination)

The Networks

  • informal and formal alternative carers and significant others
5.3 Practitioners and managers will also need to consider whether there are any secondary factors that should be taken into account at the information gathering stage. For example, any organisational, resource or inter-agency working factors which are likely to contribute to increasing risk?  These secondary factors will need to be addressed, as they become known to ensure their impact is eliminated or minimised.
5.4 As with all assessments, all sources of information will need to be identified including  records from other agencies,  parents, other family members and significant adults, and the child.  Where there is conflicting evidence the reasons for this, needs to be identified and recorded prior to reaching conclusions as to the reliability of the information.
5.5 All information must be verified and recorded as such, distinguishing between fact, observation, hearsay or a parent's account of an event and opinion.


References

Adock, M. (1999) in The Child Protection Handbook, ed Wilson K & James A, London

Brearly, P. (1982) Risk and Social Work, Routledge, London

Department for Children, Schools & Families (2008) Analysing Child Deaths and Serious Injury through Abuse - What can we Learn? A Biennial Analysis of Serious Case Reviews 2003-05

Department of Health (2000) Assessment Framework of Children in Need and their Families

Department of Human Services, State Government of Victoria, Australia (1999) Victorian Risk Framework: A Guided Professional Judgement Approach to Risk Assessment in Child Protection

London Child Protection Procedures (LSCB, 2007)

Reid, G., Sigurdson, E., Christiansen-Wood, J., Wright, A. (1995) Basic Issues Concerning the Assessment of Risk in Child Welfare Work, University of Manitoba, Canada

Turnell, A. & Edwards, S. (1999) Aspiring to Partnership: The Signs of Safety Approach to Child Protection. Child Abuse Review, 6: 179 - 190

With grateful thanks for use of original document by Merton LSCB.


Appendix A - Significant Harm

Click here to view Appendix A


Appendix B - The Assessment Framework

Click here to view this flowchart

End