View Bradford SCB Procedures View Bradford SCB Procedures

1.9.6 Joint Guidance for Working with Families in which the Problematic Use of Drugs or Alcohol is an Issue

RELATED CHAPTER

Safeguarding Children from Child Sexual Exploitation Procedure

AMENDMENT

In December 2014, this chapter was significantly amended throughout and should be re-read in full.

This chapter is currently under review.


Contents

  1. Introduction
  2. Purpose of the Guidance
  3. Governance Arrangements
  4. Information Sharing
  5. Referrals to the Children’s Social Care
  6. Effective Joint Working Arrangements
  7. Differences of Opinion
  8. Training and Supervision
  9. Local Service Information
  10. Monitoring Requirements

    Appendix 1: Checklist Risk Assessment and Parental Drug or Alcohol Use


1. Introduction

The Luton Early Intervention Strategy aims to support families with multiple problems, including those where alcohol and or drug use is a factor.

This guidance refers to the use of drugs and/or alcohol. Whilst there may be different treatment methodologies for adults with these problems, they are considered together because the consequences for the child are quite similar. Problematic drug and/or alcohol use refers to illicit drugs, alcohol, prescription drugs and solvents, the consumption of which is either dependent use, or use associated with having harmful effect on the individual or the community.

Many drug and/or alcohol using adults also suffer from mental health problems, which is described as Dual Diagnosis and there may be several agencies, from both Adult and Children’s social care, who are working with the family.

National Serious Case Reviews and Domestic Homicide Reviews have identified domestic abuse, parental mental ill health and drug and alcohol use as significant factors in families where children have died or been seriously harmed. Where all three issues are present, they have been described as the ‘toxic trio’.

A quarter of the alcohol and drug clients in treatment in Luton have child care responsibilities. For some parents their childcare responsibilities encourage them to enter treatment, stabilise their lives and seek support. Other parents can feel very anxious about the impact of their alcohol and drug use and decide not to inform a treatment agency that they are caring for children. Having a parent in treatment is a protective factor for children and a positive incentive for some parents to complete treatment successfully.

Adult Drug and Alcohol Treatment Services and Children’s Social Care must work together in order to identify, assess, refer, support and treat adults with the aim of protecting children and improving their outcomes.

The term ‘problematic use of drugs and alcohol’ is used throughout this document in preference to more familiar expressions such as ‘drug use’ or ‘drug misuse’. ‘Drug use’ or ‘misuse’ can be applied to a wide spectrum of behaviours from occasional recreational use of cannabis through to the heavy use of Class A drugs. It is felt that reference to ‘problematic use’ gives a more accurate description of the target behaviours.


2. Purpose of the Guidance

The purpose of this guidance is to:

  • Ensure children are safeguarded;
  • Ensure drug and alcohol services and children’s services work effectively together;
  • Ensure drug or alcohol using parents in treatment services are referred promptly to appropriate service provision;
  • Ensure referral pathways into children and family services are accessible to the children of drug or alcohol using parents;
  • Ensure referral pathways into drug and alcohol treatment services are available for drug or alcohol using parents;
  • Ensure effective joint working arrangements, including the sharing of information & the collation of data is maintained;
  • Ensure all staff are aware of their safeguarding responsibilities and attend the appropriate training.

This safeguarding guidance applies to unborn babies, children, and young people up to 18 years of age whose care is deemed to be at risk due to alcohol and/or drug using parent/s or carer/s. Risk assessments should take account of any other adults that the child/children may have contact with who may increase the risk because of chaotic drug and or alcohol use. Adolescent children can be at risk of sexual exploitation if there is chaotic drug and or alcohol use in their home.


3. Governance Arrangements

The Luton Drug and Alcohol Partnership is a member of the Luton Safeguarding Children’s Board and the Children’s Trust Board. LDAP reports to the Community Safety Executive, the Children’s Trust and the Health & Wellbeing Board. All jointly hold responsibility for this guidance.

Performance data and assurance reports concerning the operation of the drug and alcohol agencies within this guidance are reported quarterly to the LSCB Executive group and the Health and Well Being Board.

This guidance for safeguarding the welfare of children of drug and /or alcohol using parents allows for:

  • Prompt access to treatment for all drug and or alcohol parents with an identified treatment need;
  • All service providers to take account of the needs of the families in completing assessments and care planning using a risk and resilience framework approved by the LSCB.


4. Information Sharing

This guidance is for practitioners who have to make decisions about sharing personal information on a case-by-case basis, whether they are:

  • Working in the public, private or voluntary sector;
  • Providing services to children, young people, adults and/or families; and
  • Working as an employee, a contractor or a volunteer.

This includes front-line staff working in health, education, schools, social care, youth work, early years, family support, offending and criminal justice, police, advisory and support services and culture and leisure. It is also for managers and advisors who support these practitioners and for others with responsibility for information governance. See Information sharing: Guidance for practitioners and managers (DfE).

In general, information sharing about safeguarding is in the best interests of the child, but needs to support the delivery of effective drug and alcohol treatment for the service user. Preventative services should be accessed with the clients consent where possible at the earliest opportunity to reduce the risk of more serious concerns arising at a later stage.

However, In the following circumstances information can be shared without consent:

  • If there is a risk of significant harm to a child/children, there is a statutory responsibility to refer to children’s social care. Client consent is not required to do this; however, it is good practice to discuss the reasons for the referral with the service user and any decision not to do so should be recorded, along with the reason for not doing so;
  • If child protection services make enquiries about drug/alcohol using parents as part of a section 47 enquiry, or if the child is subject to a child protection plan, there is a statutory duty to share information with child protection services. Client consent is not required to do this, but it is good practice to inform service users about the reasons for sharing information, unless you believe that this would place a child at increased risk.

Details of the referral routes and pathways for children and family services and the local drug and alcohol partnerships and treatment providers is contained in the LSCB guidance document Working with Families in which the Problematic Use of Drugs or Alcohol is an Issue. This is available on the LSCB website and forms part of the LSCB level 2 training.

Where a parent drops out of drug or alcohol treatment, all relevant services will be notified and agencies may wish to increase their level of support to mitigate against a potential increase in risk to children and young people.


5. Referrals to the Children’s Social Care

Referrals will fall into several levels:

  • Additional needs identified where parents do not reach the threshold for a statutory referral but would benefit from additional support and a Early Help Assessment (EHA) is completed (level 1);
  • Statutory referral, either for a child in need or child protection concern (level 2/3);
  • Emergency referrals, where there is a risk of immediate harm to a child (level 3).

Click here to view the Flowchart for Drug & Alcohol Agencies to Assess Safeguarding Concerns.

Responsibilities of Drug & Alcohol agencies

Recording of Information: all parents who have a child living with them or who may live with them in the future should be asked standard questions responses to which may be shared across the partnership to ensure an appropriate data set is collected in relation to safeguarding.

The designated safeguarding lead within the drug and alcohol agency will usually review information gathered both in the assessment (checklist see appendix one) and throughout treatment and monitor the need for onward referral, either to universal children/family services, children’s social care, or to the Referral & Assessment Team.

The designated safeguarding lead will be the main contact for referrals into the Referral & Assessment Team and other children and family services and may represent the service in relation to safeguarding issues at external meetings/forums.

If the service user does not have children of their own but lives with someone else’s children or has contact with, but does not live with their own children, the data outlined above should still be collected in relation to the child(ren) in question and appropriate information/services offered.

Where there is current social work involvement, either as a child in need or child protection case, staff in the drug or alcohol service will liaise with the social worker to identify the support needs of the parent and proposed treatment plan.

If there are professionals meetings in place, the drug/alcohol workers should participate in these meetings, though would usually not be sufficiently knowledgeable about the family to provide the lead professional role.

The range of services available for service users/families who do not require a statutory referral are available on the LDAP website.

For each type of referral, a referral pathway must be specified, including reference to local thresholds for referral to the range of children’s social care services.

Safeguarding Adults at Risk

Whilst this guidance is concerned with safeguarding children the Safeguarding Adults Board has a similar guidance that is concerned with safeguarding adults at risk. Adults can be at risk because of:

  • Their own drug and or alcohol use;
  • The use of drug and alcohol by others who live in their homes particularly if they have physical or emotional difficulties;
  • Contact with drug dealers who occupy their accommodation or exploit them through the use of drugs and or alcohol for economic or sexual gains;
  • It is expected that Children’s Social Care and alcohol and drug workers will refer adults thought to be at risk to the Initial Referral Management Team for Adult Social Care on 01582 547659 or 01582 547660.


6. Effective Joint Working Arrangements

Services are expected to work together to deliver effective support to families affected by drug and alcohol use. This should support the development of treatment and care plans which reflect both family and drug and alcohol use issues and which can be shared with both professionals involved and the family themselves. Where possible, all professionals working with the family should be invited to review meetings, as well as more formal professional networks.

Drug and alcohol use services can provide specialist input for assessments when requested, including attendance at meetings, written information where appropriate and advice around drugs/alcohol, their effects and treatment services available.

Where the family is known to drug and alcohol services, the treatment worker or safeguarding lead would usually attend these meetings.

When Children’s Social Care does not know the family a representative of a Luton Drug & Alcohol provider can be invited.

In Luton the Adult Shared Care Drug Service is commissioned to work with Children’s Social Care to provide drug testing for service users where there are safeguarding concerns. This is usually only under taken as part of a wider package of treatment and with the consent of the service user.

Drug screening of adults

Cambridge Community Services (CCS) Adult Drug Service (Telephone: 01582 708308) in Luton will provide Children’s Social Care with drug screening results (urinalysis and mouth swabs) for active service users involved in safeguarding procedures. The frequency for drug screening is once a month unless there are exceptional circumstances, which has to be authorised by the Service Manager/Team Lead. Results for drug screening will be reported back to the Social Worker either verbally or in writing as required. Social Workers are able to contact the service to confirm the drug screening results.

Where new service users are identified by Children’s Social Care in need of drug treatment, a referral should be made as soon as possible. The assessment process for opiate substitute prescribing as part of drug treatment requires all service users to be screened for confirmation of opiate dependency. SCDS can provide Children’s Social Care with advice on the most appropriate drug service/s for service users to access if there is no opiate dependency.

Should the family be subject to safeguarding procedures the frequency for drug screening is as above.

CCS does not provide drug screening for service users who are not prepared to engage in drug treatment. In these circumstances should Children’s Social Care consider drug screening to be appropriate this can be commissioned through the LBC Children’s Commissioning Unit.


7. Differences of Opinion

The Resolution of Professional Disagreements Relating to The Safeguarding of Children and the Escalation of Professional Concerns sets out arrangements for resolving professional differences of opinion. See Escalation Procedures.


8. Training and Supervision

All staff should follow the LSCB existing training arrangements.

All organisations working with drug and alcohol using parents must ensure that all staff (including volunteers and administrative staff) have a mandatory Induction, which includes familiarisation with their child protection responsibilities and the LSCB Interagency Safeguarding Procedures to be followed if they have a concern about a child.

The Drug and Alcohol National Occupational Standards provide competencies across the range of roles within the sector. Specific competencies relevant to children and family services are:

  • AA1.1 Recognise indications of drug and alcohol use;
  • AA1.2 Refer individuals with indications of drug and alcohol use to specialists.

Click here to visit the Federation of Drug & Alcohol Professionals website.

All Professionals who work or has contact with children, parents and other adults in contact with children should be able to recognise, and know how to act upon evidence that a child’s health or development is or maybe being impaired. For example, drug use services and criminal justice agencies should always consider the implications for children of parents or users behaviours and the impact these may have on their parenting capacity.

Line management supervision plays a key part in the management of individual cases. As such, staff with line management responsibilities should ensure they are up to date with the latest developments around safeguarding as well as drug and alcohol use, to ensure they have the ability to effectively address these issues in supervision.

All cases should be monitored, in children and family services for drug and alcohol use and in drug and alcohol use services for safeguarding issues. It is the

responsibility of the line manager to ensure this occurs in cases their supervisees are holding. It is suggested that local guidance clearly identify effective supervision as essential in the management of cases operationally.

LDAP and Children’s Social Care will arrange an annual workshop for social workers and drug and alcohol workers as an induction and refresher for this guidance to ensure a shared understanding of the safeguarding responsibilities where parents capacity to provide suitable care for their children is affected by their chaotic drug and or alcohol use.


9. Local Service Information

Details of the drug and alcohol services in Luton can be found on the website for Luton Drug & Alcohol Partnership.


10. Monitoring Requirements

Safeguarding the welfare of the children of drug and alcohol using parents is identified as a priority by LDAP and is explicitly addressed in the local needs assessment and annual treatment planning processes.

LDAP receives and reviews data and information from treatment services in respect of safeguarding (the minimum dataset includes the fields identified in the Supporting Information document). LDAP receives information regarding the number of drug using offenders in the criminal justice system that are parents or in regular contact with children and reviews the response to these families.

LDAP receives and reviews data and information from treatment services in respect of safeguarding (the minimum dataset includes the number of parents and pregnant drug users fast-tracked into treatment, the number of referrals to LBC Children’s Social Care, the number of case conferences and core groups attended).

LDAP receives and reviews data and information from LBC Children’s Social Care in respect to the number of referrals received where drug and/or alcohol use is highlighted and the number of referrals made to drug and/or alcohol treatment services.

As part of the LDAP contract and performance management arrangements, LDAP sets NDTMS data completeness expectations in relation to the identification of parents in treatment.


Appendix 1: Checklist Risk Assessment and Parental Drug or Alcohol Use

The following checklist outlines a number of key issues, which should be taken into account as part of an assessment of risk.

This checklist should be completed with the parents/carers where possible. Third party information (for example, from neighbours or relatives) may also be sought to validate this information, though issues of confidentiality should always be addressed.

Impact on the child’s development

  • What is the child’s age and developmental stage?
  • What is the quality of the relationship between the child and parent/carer, and the child and peers?
  • Is the child showing signs of emotional distress through his or her behaviour? If so, does the parent/carer recognise this?
  • Does the child have support networks: friends, relatives, school?
  • Is the child up to date with health checks/immunisations/dental checks etc?
  • Is the child attending school regularly and on time? Is the child making satisfactory educational progress?
  • Does the parents/carers drug or alcohol use disrupt the child’s daily routines? If so what is the effect?
  • What is the effect on the child of parental mood/behavioural changes?
  • Is the child assuming responsibilities beyond his or her years? Has the child taken over the parenting role in the family?
  • Does the child experience violence involving his or her parents?
  • What models of behaviour is the child observing?
  • Does the child have a satisfactory concept of acceptable behaviour?
  • Does the child witness the taking of drugs or intoxicated behaviour? What effect does this have on the child?
  • What arrangements are made for safeguarding the child during drug use or periods of intoxication?
  • Is the child left alone or inadequately supervised while the parents/carers obtain drugs/go out drinking?
  • Is the child taken to places where his or her safety is placed at risk? What risks are involved?
  • What is the child’s understanding of drug and alcohol use?
  • Does the child need specific drug or alcohol education to reduce the risk of future use?

The pattern of parental drug or alcohol use

  • Is there a drug-free/sober parent/carer, supportive partner, or relative?

If the parent uses drugs, is their use:

  • Experimental? Recreational? Chaotic? Dependent?

If the parent/carers use of alcohol is problematic

  • Do they drink every day? If so how much?
  • Is there a pattern of binge drinking? What form does it take?
  • Does the user move between categories at different times? Does the drug use also involve alcohol or a combination of drugs?
  • Do the levels of care differ according to whether a parent/carer is using drugs/alcohol at the time or not?
  • Has there been an increase or decrease in stability in the pattern of drug or alcohol use over the previous six months?
  • Is there any scope for negotiating changes that might reduce risk, such as a change from injecting to oral use, a move from buying drugs to receiving medication by prescription or reduction in consumption?

Accommodation and home environment

  • Is accommodation adequate for children?
  • Are parent/carers ensuring that rent and bills are paid?
  • Does the family remain in one area or move frequently. If the latter, why is this?
  • Are others with problematic drug or alcohol use sharing the accommodation? If they are, are relationships with them harmonious, or is there conflict?
  • Is the family living in a drug or alcohol using community?
  • Could other aspects of drug use constitute a risk to children (for example conflict with or between dealers, exposure to criminal activities related to use, exposure to drug dealing)?
  • Are there adequate food, clothing and warmth for the children?

Procurement of drugs or alcohol

  • If the parents/carers use drugs, how do they acquire them?
  • How much are the drugs or alcohol costing?
  • Is this causing financial problems?
  • How is the money obtained? If through crime, or prostitution is this affecting the care and development of the child?
  • Are the premises being used to sell drugs?
  • Are the parents/carers allowing their premises to be used by others with problematical drug or alcohol use? How does this impact on the child?

Health risks

  • If drugs, alcohol and/or injecting equipment are kept on the premises, are they kept securely?
  • Are the children aware of where the drugs and alcohol are kept?

If the parents/carers are intravenous drug users:

  • Do they share injecting equipment?
  • Do they use a needle exchange scheme?
  • How do they dispose of syringes?
  • Are parents/carers aware of the health risks of injecting or using drugs?

If parents/carers are on a substitute prescribing program, such as methadone:

  • Are parents/carers aware of the dangers of children accessing this medication?
  • Do they take adequate precautions to ensure this does not happen?
  • Are parents/carers aware of, and in touch with, local specialist agencies that can advise on issues such as needle exchanges, substitute prescribing programs, detox and rehabilitation facilities? If they are in touch with agencies, how regular is the contact?
  • Is there any history of a mental health problem, including personality disorder, alongside the drug or alcohol use?
  • Is there evidence of other health problem associated with drug or alcohol use?

Family's social network and support systems

Do parents/carers and children associate primarily with:

  • Others with problematic drug or alcohol use?
  • Non-users?
  • Both?
  • Are relatives aware of the problematic drug or alcohol use? Are they supportive?
  • Will the parents/carers accept help from the relatives?
  • Will the parents/carers accept help from statutory/non-statutory agencies?
  • The degree of social isolation should be considered particularly for those parents living in remote areas where resources may not be available and they may experience social stigmatisation.

The parents/carers perception of the situation:

  • Do the parents/carers see their drug or alcohol use as harmful to themselves or to their children?
  • Do the parents/carers place their own needs before the needs of their children?
  • Are the parents/carers aware of the legislative and procedural context applying to their circumstances, (e.g. child protection procedures, statutory powers).

End