Children living with parental substance misuse: A cross‐sectional profile of children and families referred to children's social care

Parental substance misuse is a significant public health and children's rights issue. In the United Kingdom, social workers frequently work with children and families affected by substance misuse. However, relatively little is known about this population, particularly at point of referral to children's social care. This paper reports on the largest known study of parental substance misuse as a feature of children's social care work in England. The paper provides a cross‐sectional profile of 299 children living with parental substance misuse and referred to children's social care in one local authority in England. Data were collected from social work case files at the point of referral to social care about the child, family, the wider environment, and parental substance misuse. The findings show that children affected by parental substance misuse frequently had other support needs relating to their well‐being and mental health. Children were also likely to be experiencing other parental and environmental risk factors. The significant historical—and in some cases intergenerational—social care involvement for some families indicates potential issues with the capacity of services to meet needs. Recommendations for practice are discussed with a particular focus on the need for early, comprehensive support for children and families.     

Towards Accountability in Social Work: One Year's Intake to an Area Office

Summary Monitoring one year's referrals to an area office of a socialservices department, we found that of the 2,436 referrals representing2,057 cases, about half were already known to the area office.Demographically the clientele fell largely into three groups—theelderly, young families and children. The main problem groupingsconsisted of those with physical disabilities or suffering fromfrailty in old age, those with financial and environmental problems,and families with disturbed relationships and child care problems.Most of the clients had short-term help and at the end of sixmonths only 11% of the referrals were still open. Distinctive profiles emerged when comparing the routes by whichclients with different types of problems reached the area officeand the help they got once they had passed its threshold: (a) The elderly and disabled, mainly referred by the healthservices, received predominantly practical help. (b) Those with financial and material problems, largely self-referred,received information, advice and referral to other agencies. (c) The disturbed families, referred by many different sources,received detailed exploration, assessment and casework. Those clients who were passed on for more extended help to thelong-term teams—some 10% of the intake—were mainlythe very vulnerable elderly and disabled persons, and childrenwho had been taken into care or who were in need of surveillanceand protection for other reasons. The study raises questions about the methods of service deliveryin response to the demands made on the area office and discussespossible changes in approach towards more community-orientedpreventive work.     

Adapting the Friends of the Children programme for child welfare system‐involved families

Research has shown the importance of long‐term, caring adults for children in foster care. This paper reviews the Friends of the Children (FOTC) long‐term mentoring programme and how it was adapted to serve children and families with child welfare system involvement. This study's two research questions are (1) How do Friends (FOTC's paid professional mentors) currently work with, and in turn, have an impact on, child welfare‐involved families? and (2) How can Friends better support child welfare system‐involved caregivers and families to promote family stability, permanence, and child well‐being? Data were collected from 21 caregivers (foster and biological), 24 FOTC Friends, five child welfare workers, and five teachers. Qualitative analyses of focus group, interview, and open‐ended survey data revealed a wide variety of ways Friends currently support children and families. In addition, several recommendations were made for strengthening programming. These findings provide valuable insights into providing long‐term mentoring to child welfare system‐involved children and families.     

A racial comparison of Family Group Decision Making in the USA1

This study examined Family Group Decision Making (FGDM) among a nationally representative sample of African‐American and White children investigated for maltreatment in the US. While FGDM was developed for work with ethnic minority families, there is no research on how this is being carried out in the US, where African‐American children are overrepresented in child welfare services. The study views racial differences in child, caregiver and maltreatment characteristics related to FGDM; composition of FGDM meetings; service referrals and receipt; and service satisfaction. Data are from the National Survey of Child and Adolescent Well‐being (NSCAW), a study of 5501 children ages 0–14. Current analyses include African‐American and White children (n= 4129). Stratified, bivariate and multivariate regression analyses were used. Results showed that while race was not related FGDM receipt, different characteristics lead to FGDM among African‐American and White families. Surprisingly, caregivers report feeling no more involved in decision‐making in association with FGDM. FGDM is provided at low rates overall (10%) and less frequently among White caseworkers. Child access to mental health services increases in relation to FGDM. Implications are discussed.     

Managing Work and Care: A Difficult Challenge for Immigrant Families

This paper explores the strategies used by immigrant families to reconcile work and care for young children in Finland, France, Italy and Portugal. Drawing upon interviews with couples or lone parents who have children below age ten, it shows that immigrant families rely on a diversity of work/care strategies. These strategies include extensive delegation of care (mostly to formal or non‐familial informal care), negotiation of care within the nuclear family (both partners sharing the care responsibilities as well as older child care), mother‐centredness (mothers cutting back on working hours), child negligence (leaving children alone) and the superimposition of care upon work (taking children to work). Almost all immigrant families, but especially first‐generation ones, suffer from the absence of close kin networks to support childcare, strong pressure to work and from work (long or atypical hours) and various integration problems such as social isolation, lack of information on services, and problems with housing. However, our findings show that migration patterns, among other factors, have a significant impact on work/care strategies. Highly qualified “professional migration” is more associated with extensive paid delegation (often private and high‐cost), “marriage migration” with mother‐centredness, and “unskilled worker migration” with low‐cost solutions supplemented by workplace care, older child care and negligence. First‐generation unskilled worker migrant families are more exposed to occupational and residential segregation, atypical working hours, low earnings and difficulties in managing work and care for young children. Findings point to the still weak regulatory function of the different welfare states in the protection of these families.     

Local Authority Intake Teams

Summary Amongst the many developments in social services organisationin the decade since Seebohm, specialist Intake Teams responsiblefor all initial referrals and short term work received by anArea Team, remain a popular form of local organization. Thispaper describes a small national survey of English local authoritiesto collect information on both intake teams and their long termcounterparts, and briefly outlines some of the major findings.The survey produced a broad picture of both the present structureof local authority fieldwork departments, and the personal characteristicsof social workers and their team leaders. The paper goes onto examine the relationship between intake and long term teams,particularly in terms of referral rates, relative caseloadsand the case transfer process; and concludes with an outlineof teams satisfaction with the intake system, and some indicationsof desired future developments.     

The significance of a secure base: a psychosocial model of long-term foster care

ABSTRACT Long‐term foster care has been a much neglected area of social work practice and research. Yet there are obvious challenges that need to be understood when building a family for life in foster care. Is it possible for foster families, where there are no biological or legal ties between carers and children, to provide care, concern and family membership not only through childhood but also into adult life? The study on which this paper is based set out to explore that question by investigating the experiences of 40 adults, aged 18–30, who grew up in foster families. Qualitative interviews were conducted, transcribed and analysed. Theoretical frameworks from attachment and resilience were brought together with concepts such as ‘belonging’ and ‘family membership’ to make sense of the narratives provided. An integrated and dynamic psychosocial model of long‐term foster care was developed, which emphasizes the significance of a secure base and has some important implications for practice.     

Everybody needs good neighbours: an evaluation of an intensive project for families facing eviction

This paper presents details of a largely qualitative evaluation of an intensive multi‐method Project, with a residential component, which aims to help families facing eviction to overcome their housing‐related difficulties. The families served by the Project had a host of other problems related to parenting, with child care and protection issues, addictions and mental health difficulties figuring prominently. Just over half the referrals came from the local authority housing services, with nearly all the remainder coming from the social work department. The majority of families made good progress, but in some cases it proved harder to have an impact on parenting than on tenancy‐related matters. Nevertheless, the Project was deemed to have helped some families stay together or be reunited, resulting in substantial financial savings for social work services. Crucial ingredients were good management, stable staff, shared ‘ownership’ by other agencies, a repertoire of challenging methods, and a holistic approach.     

Child Well‐Being Scales (CWBS) in the assessment of families and children in home‐care intervention: an empirical study

This paper reports research carried out in Italy designed to investigate the usability of Child Well‐Being Scale (CWBS) for the outcome evaluation of home‐care interventions for vulnerable families and children in need. Using a pre‐ and post‐test design, the study traces the changes in 18 vulnerable families and 23 children in need included in a programme of home‐care intervention over a period of 11 months. All the families and children were assessed twice: at intake and at the end of the intervention (after 6 months). Furthermore, 10 families and 11 children had a longer intervention and were assessed three times. Moreover, two focus groups involving 13 home‐care workers and 11 face‐to‐face interviews were used to collect practitioners' points of views on CWBS. The results generally support the idea that families' and children's situation improved over time, as shown by an improvement in almost all of the considered dimensions after 6 months and after 11 months. Specifically, the families improved more on household adequacy in the long term while children on the child performance dimension improved in the short term. Practitioners reported that CWBS was an aid to multi‐professional decision‐making, as the systematic evaluation of the subscales was a practical base upon which to activate shared decision‐making during the casework.     

Does differential response make a difference: examining domestic violence cases in child protection services

Large numbers of domestic violence (DV) cases on child protection caseloads have necessitated the development of practices that address both DV and child safety. The first step in this process is to gain an understanding of the differences between DV‐involved cases and other forms of maltreatment. The implementation of a differential response service model in Ontario offered an opportunity to compare risk assessment ratings, service outcomes and recurrence and to identify pathways of DV cases through child protection services (CPS). A sample (n = 785) of child protection investigations over a 4‐month period was examined. Of these investigations, 26% cases were DV referred; 87% of the DV victims were mothers; perpetrating partners were mostly absent from investigations; non‐white families were more often investigated for DV than white families; and DV cases were more likely to remain open for ongoing CPS. Only one‐third of DV‐exposed children were assessed as having been harmed and most community referrals were made for the victim parent. Mothers were the primary target of investigation, remaining in CPS for extended service provision although recurrence rates were lower than found in other investigations. Results are discussed to inform investigative procedures, assessment and service response to more adequately respond to children and families when DV is present.     

Returning children home from care: What can be learned from local authority data?

International Human Rights and child rights conventions as well as U.K. wide legislation and guidance require that children in care should be returned home to one or both parents wherever possible. Reunification with parents is the most common route out of care, but rates of re‐entry are often higher than for other exit routes. This study used 8 years of administrative data (on 2,208 care entrants), collected by one large English local authority, to examine how many children were returned home and to explore factors associated with stable reunification (not re‐entering care for at least 2 years). One‐third of children (36%) had been reunified, with adolescent entrants being the most likely age group to return home. Three quarters (75%) of reunified children had a stable reunification. In a fully adjusted regression model, age at entry, being on a care order prior to return home, staying longer in care, being of minority ethnicity, and having fewer placements in care were all significant in predicting chances of stable reunification. The results underline the importance of properly resourcing reunification services. The methods demonstrate the value to local authorities of analysing their own data longitudinally to understand the care pathways for children they look after.     

Parental substance misuse and child care social work: findings from the first stage of a study of 100 families

Parental misuse of drugs or alcohol is known to be a common issue for child care social workers, yet there has been surprisingly little British research on the topic. The study reported here attempts to address this gap. All files going for long‐term allocation in four London boroughs over on average 1 year were examined (290 files). Parental substance misuse (PSM) emerged as a major feature of social work caseloads. Of the 290 cases, 100 (34%) involved concerns about parental substance misuse. The families involving substance misuse were more vulnerable on a variety of measures: the children were younger, the parents had more individual problems and the families lived in more difficult social situations. PSM cases tended to be ‘heavy end’ at the point of allocation: they accounted for 62% of all children subject to care proceedings and 40% of those placed on the child protection register. There was a fairly even spread between alcohol and drug misuse, and a number of cases involved both. Substance misuse specialists were rarely involved in working with families, primarily because parents said that they did not think that they had a problem. Suggestions for ways in which policy and practice with PSM might be improved are made in light of these findings.     

A place of our own: a narrative review of the family housing services literature

The problem of family homelessness has been widely recognized by both policymakers and social service providers. What is not clear, however, is the overall effectiveness of housing intervention services provided to homeless families. This narrative review of the literature discusses 10 studies from 1991 to 2013 on both transitional and supportive housing in order to assess under what conditions and for whom these interventions are most effective. More specifically this review evaluates the research regarding which elements of intervention services are most helpful to families, the outcomes associated with these programmes, and the short‐ and long‐term effectiveness of housing interventions. Evidence suggests that while these programmes produce positive outcomes for families, a one‐size‐fits‐all model of housing may not be effective for all families. Limitations and directions for future research are also discussed.     

Long Term Social Work in a Primary Health Care Setting

Summary This study was designed to explore which factors characteriselong term clients and to investigate the relationship betweenthe burden on medical and welfare resources in a general practicesetting. Two groups of clients were studied; 135 long term clientsreferred over a five year period, where contact was maintainfor a minimum of one year and 157 cases referred during a sixmonth period, in all of which the duration of social work interventionwas less than 12 months. Few differences were found betweenthe characteristics of the two groups, nor did any individualsocial worker emerge as being particularly predisposed to maintainlong term contact However, a significant change in the proportionof referrals which became long term was found over the fiveyear period under consideration, and policy regarding the handlingof cases was therefore felt to constitute a major influenceon the length of contact with any particular client Relationshipswith other members of the primary health care team were generallyfound to be good, especially in relation to the long term clients.Moreover, the OPs' workload with regard to these clients wasfound to be reduced following social work intervention. Theseclients' consultation rates dropped significantly after receivingsocial work help, and continued to drop when the case had beenclosed.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

Facilitating access to services for children and families: lessons from Sure Start Local Programmes

With the introduction of the highly publicized Sure Start Local Programme (SSLP) initiative in 1998, the UK government introduced a community‐based set of provisions targeted at families with children under 4 years who were living in some of the 20% most deprived and disadvantaged geographical areas in England. These programmes were designed to combat the adverse effects of poverty and disadvantage on the long‐term outcomes for children and families. One challenging dimension for programme development has been the facilitation of access to the services on offer in these programmes. Drawing on findings from the implementation module within the government‐commissioned National Evaluation of Sure Start, this paper examines the way in which SSLPs have sought to facilitate access to services for their local communities and to encourage community members to take up and continue using those services. This paper presents a detailed overview of programme activity in respect of access. It identifies a continuum of access and a model of three styles of parental service use. The paper highlights the implications of the SSLP implementation process for the development of subsequent related initiatives such as children’s centres and extended schools.     

Preferentially rejected children and their development in permanent family placements

Several studies of family placements have indicated poorer outcomes for children who are placed singly in new families. In an effort to understand why this may be so, this paper explores differential outcome among a group of children who were placed singly with adoptive or long‐term foster families during middle childhood. A small number of these children were ‘only children’ at the time of placement but most had siblings living elsewhere. Particular attention is paid to preferential rejection by birth parents in the children's backgrounds. Preferential rejection indicates that one child has been rejected while siblings are accepted. This was found to be associated with poorer progress in placement. The methodological and statistical detail of the analyses are to be found in another paper. We focus here on describing the patterns which emerged and the ways in which the findings may assist practitioners in making and supporting permanent placements.     

The Common Assessment Framework form 9 years on: a creative process

Legislation within England states that local authorities should provide services for all those families in need. However, research has identified that regardless of the introduction of strategies to identify need and enhance family support, ongoing barriers to services adhere. Taking a social constructionist approach, this study explored professionals' experiences of the use of the Common Assessment Framework form. Data were collected in four different local authorities in two phases. Forty‐one professionals from a variety of agencies took part in semi‐structured interviews. Data were analyzed thematically. Findings demonstrate that the professionals experienced difficulties in working through the Common Assessment Framework process, for example, in completing the form and engaging families. This situation led to the more experienced and knowledgeable professionals utilising creative ways to successfully navigate the ‘referral process’. Such creative working practices included the terminology used to complete the form and how the process was ‘sold’ to parents, so that they could be in a better position to engage parents and complete the Common Assessment Framework form. Because of this, more experienced professionals seem to be able to accelerate the referral process in order to access much needed support services for children and young people.     

Exploring drivers of demand for child protection services in an English local authority

This paper reports on an empirical study of child protection services in a local authority where rates of investigations and interventions rose to unprecedented levels during the course of a single year. The aim of the research was to explore explanations for this rise in demand among the providers of children's social care in the area. Using an interpretative qualitative design, a series of focus groups and interviews were carried out with practitioners and managers (n = 25) from statutory services and Early Help. The findings identified a combination of long‐term and short‐term drivers of demand. Long‐term factors emphasized the impact of rising levels of deprivation combined with cuts to community‐based services for children and young people. Short‐term factors ranged from a more proactive approach to child neglect to more effective multi‐agency partnerships and joint decision making. The interaction between these factors was found to be accentuating an underlying shift to “late intervention” across the sector. The findings are contextualized in relation to contemporary debates about the crisis of demand for children's social care and the complex relationship between prevention and protection.