Multi-Agency Practice for Children - Essay Example

Multi-Agency Practice for Children Introduction Throughout the 1990s there had been an increasing emphasis on the need for joined-up government and inter-departmental co-operation, but the literature on the promotion of joint working in the area of social welfare used terms such as ‘collaboration’, ‘co-ordination’, ‘inter-agency’ or ‘multi-agency working’ both interchangeably as well as in quite distinct ways. The terms refer to the attempt to achieve government goals by agencies, groups and sectors working together rather than separately. They are generally regarded as highly positive forms of working in that they bring organizations together with beneficial outcomes for service users. Wigfall and Moss (2001) define multiagency work as a "range of different services which have some overlapping or shared interests and objectives, brought together to work collaboratively towards some common purposes" (Wigfall & Moss, 2001, p.71). Despite the fact that the concept of multi-agency working assumed an increased importance throughout the 1990s, there was very little information about how to translate this into practice, and even less about how the expectation of inter-professional co-operation was impacting on education. Although the sense was roughly working together, Clark (1993) in his Typology of Multidisciplinary Education comments it to be equivalent to bringing various professions together to understand a particular problem or experience. In this way professionals from various disciplines may afford different perspectives on "issues at hand", and the conglomerate perspectives can be implemented in a single go (Clark, 1993, p.220). Since the deliverables were unclear, implementation was affected to a great degree. There was no available guidance. In theory, the 1989 Children Act provided the solution. In practice central government devolved responsibility for its implementation. This, however, did not provide sufficient guidance to local authorities, and hence they were undermined. There was overall agreement that coordination between agencies is a mandatory and a necessary practice, but it was recognised by all who worked, how difficult was it to be achieved despite legal requirement. The accepted wisdom over partnership working usually emphasizes structural and process factors without referencing the partnerships between those working in and across agencies on which the development will depend. The system and legal framework was designed on the assumption that agencies would understand and respond to their roles spontaneously, despite many agencies were underequipped to do so. However, the fact that new legislation in the form of the Children Act 2004 together with the Every Child Matters agenda has now been deemed necessary. Many schools now have assumed a greater role in safeguarding their students, but in some cases, it is still not clear how it will happen. How the agencies would promote the child's welfare. Some directives are available. Multiagency working is now a legal requirement. They must cooperate if asked as long as the requirement within their defined roles. The Children Act 2004 section 10 clearly states that agencies must make provisions to promote cooperation between one another with a common goal of child welfare (Stahmer et al., 2008, 99-108). Multi-agency working has been acknowledged to be good practice since this framework has the provision of coordination of work of those involved, thus allowing sharing of resources leading ultimately to better outcome for children as their holistic needs are addressed. This can be economically beneficial since joint finding of projects may make these feasible, which otherwise would not have been possible. Obviously this is a framework that can be implemented in the school or early-year settings. Education services or specialist services such as disability support and education welfare may be involved. Social workers and family aides from the Social Services and parents and carers may be involved as different collaborating agencies. From the health sector, midwife, health visitor, school nurse, general practitioners, mental health workers, and psychologists and psychotherapist may be involved. Police and nongovernmental voluntary social workers may also serve as agencies. It would naturally be the question what are the functions of these groups. David (1994) in his discourse Working Together for Young Children: Multi-professional in Action categorized these functions. In the case of school children or early years, their job is to provide education and care. The Educational services are designed to provide expert support for specific issues, such as, dyslexia, dyspraxia, physical disability, autistic spectrum disorder, children with hearing or visual impairment, and/or attendance problems. Social services provide support services to children in need. These support services also have child protection incorporated within the service as indicated by law. Whenever some harm is suspected, the social services organise assessments, has been empowered to seek court orders, and would look after children in care. The parents and carers must take part in decision making about care. Parental responsibility is an important concept, and parents especially mothers should never lose parental responsibility. Perhaps, one of the major work roles are sub- served by the health department. Midwives are involved in universal health monitoring of mothers and newborns. The health visitors conduct the universal health and health development monitoring of all children who are under 5 years of age. The school nurses perform universal health monitoring of school age children. In collaboration with these health professionals, the general practitioner provides medical help in indicated cases. The mental health workers especially at the community level support parents where it is deemed necessary. The psychologists and psychotherapists assess and support children and parents where it is necessary. If a child is harmed or his safety is affected in any way, the police is responsible by law to gather evidence if any crime is suspected and would refer evidence to Crown Prosecution service. The voluntary sector may play a very important role in that they carry out independent assessments. They can provide direct support or funding to children and families. Wherever, there is a lack in statutory services, they can complement these. However, voluntary sector provides services in a localised fashion, and their endeavours can be seen as less stigmatising (David, 1994, 47-79). Thus it appears that all agencies should monitor the children whenever necessary. In the multi-agency approach, they have the opportunity to share information as required. Knowledge about work roles of other agencies may enable any agency to refer to other agencies and/or services as and when required. Jointly, they can take part in decision making processes, assessments, and planning meetings. They are entitled to be advocates for the child and parents, and they should be prepared to challenge where deficiency of services are encountered. As has been analysed by White et al. (1990), the principles of The Children Act leads to the paramouncy of the child so they are eligible for parental responsibility, prevention, protection, partnership, participation, planning, and permanency (White, Carr & Lowe, 1990, 13). Multi-agency working can go a long way to embody these principles. There is an expressed need for the agencies to cooperate, especially among Social Services, Education, Housing, and Health. This means the respective authorities must comply with requests for services if those are compatible with their duties. This is a perceived acute necessity of multi-agency working, especially in children with special education needs (The Children Act 1989, Section 27, 5). HM Government (2006) demonstrates proactive approach in that they insist on multi-agency practice to safeguard children. In their publication, Working Together to Safeguard Children, they have provided a guideline as to what are the responsibilities of each agency in ensuring multi-agency practice (HM Government. 2006). This document is in line with the broad agenda of supporting children and families as indicated in Every Child Matters (The Stationary Office, 2003). This sets out the duties and responsibilities of all agencies in safeguarding children, and as per the 2006, fourth version, all agencies must follow it. This concept has evolved over a period of time. Not going into the details of the history of its evolution, it can be stated that the concept of safeguarding children has evolved from narrow protection based minimal state intervention to a broader approach involving promotion of welfare of the children. In these occasions, law provides the scope of state interventions, and these apply to the areas of parental learning disabilities, social exclusion, mental illness in parents, substance abuse by parents, and situations of children in domestic violence. There is evidence that many children are abused, and in such cases appropriate support services must be available for them. Thus it can be extrapolated to the fact that The Children Act 2004 provides legal support to the agenda enumerated in Every Child Matters. If the welfare of the children is the prime goal, as required by current law, agencies must be proactive in making arrangements so that there are cooperation and collaboration among different agencies dedicated to improvement of the wellbeing of the children. As indicated in Every Child Matters, these services can be extended to schools with co-location of services in schools with involvement of more multidisciplinary teams with lead professionals. With more and more interagency services, the needs assessment can be done more accurately and speedily. This indicates that this would be a better process of service delivery through single assessment, shared information, and common referrals, where Children's Trusts may be able to integrate the services under one plan. In child protection, partnership is an important concept that may happen in four levels. Level 1 involves provision of information, so a clear and accurate impression about the issue is created; level 2 is predominantly passive involvement, such as receiving information and observing meetings; level 3 involves participation, where active involvement leading to contribution to discussions and decision making happens; level 4 indicates full partnership aimed at protection and welfare of the child. This level is the desired goal where shared values lead to a shared task or goal, where all parties involved contribute to resources and skills through development of trust between partners where free negotiation of plans may happen to lead to a joint decision making (Department of Health, 1995). This would also indicate that there would be mutual confidence that each partner will deliver. To deal with these better, there must be a sense of equality between partners with open choice to enter partnership. The team must agree on a formalised arrangement for agreed working. Open sharing of information is an important attribute to the whole process. As expected, there would be necessity to deal with power issues between agencies, and hence there must be a mechanism of monitoring, reviewing, and ending the partnership as required. Stainton Rogers (1989) suggests ways of conflict resolution in between agencies. Few steps such as clearly agreed and defined functions, tasks with agreed boundaries, well organised and established communications, well-developed local relationships can help overcome ignorance and prejudice about each other. This can be achieved through definition of common goals, usage of common language, demonstrating respect to different skills, and ensuring knowledge about local arrangement, so together the agencies can accomplish a better future. These are necessary since it has been observed that since there are different core functions of different agencies, these may actually clash and compete with one another (Stainton Rogers, 1989, 82-94). Moreover, different agencies may have different values, beliefs, cultures, and practices. Furthermore, authorities may fail to clearly demarcate boundaries that would lead to fuzziness in lines of authority, hence decision making. Conflicting social policies and legislation may contribute to this problem about why different agencies are involved. These are few important barriers to smooth functioning of multiagency practice. However, there are certain other factors that may aggravate these barriers. These are poor communication, lack of free sharing of information, and conflicting professional and agency cultures. These barriers cam be obviated with the use of hybrid professionals who have experience of different agencies. Joint training of the agencies may also prove to be helpful (Joughin & Law, 2005). In this context, certain moral and ethical issues may arise. All agency members have right to act against these issues and draw notice of the authority in these cases. These are Individuals having / using power or status Structural issues in another agency e.g. staff shortages, delays Another agency not delivering promises Another agency doing something you believe is wrong or against child’s interests Unreasonable demands from another agency Another agency using different legislation to justify their actions, or inaction Safeguarding is a term that has increasingly replaced child protection when referring to the prevention of and response tp child abuse and neglect. A basic definition of safeguarding has been provided in a joint inspectorate review of services for children, young people, and their families. In that, safeguarding means keeping children safe from harm, such as, illness, abuse, or injury. HM Government (2006) Working Together to Safeguard Children states that it not only involves protecting children from maltreatment, it also prevents impairment of children's health so as to ensure that they are growing in an environment of safe and effective care, where professionals ensure that the children get optimum chances to enter adulthood successfully. Parental care should be adequate to prevent significant harm to children, although what is significant is not known (HM Government, 2006). It is considered to be severity of ill treatment, degree and extent of harm, duration, and frequency. There are statistical data available that indicate the severity of the problem, however, from the flow chart below, it is apparent that without a multi-agency involvement, it is not possible to address these issues concerning such a widely prevalent problem. Adapted from Powell, C., (2007). Safeguarding Children and Young People. P 7-107. Following initial child protection conferences, one can easily conceive the idea of a multiagency team participating in such process to address such issues. Adapted from Powell, C., (2007). Safeguarding Children and Young People. P 7-107. It is to be considered also that schools have important roles in safeguarding children. The schools may prevent, protect, and support in these situations. The nominated teacher has an important role to play. They are responsible for coordination of child protection work in the school, in order to ensure that the school appropriately acts at all levels. He must ensure that all staff knows the procedures. In any event, these nominated teachers liaise with other relevant agencies, and for this purpose, he ensures attendance in multiagency meetings. There must be school child protection policies which would provide details of how schools will meet the main aims of the service, namely, prevent, protect, and support (MacDonald & Roberts, 1995, 23-47). Schools would also set out procedures for the staff to follow in fulfilling the goals, and would also set out its roles as a member of the multiagency team. To this end, monitoring is an important function. Monitoring ensures clarification of the nature and extent of concerns. It provides a clear record of the development of concerns. It helps to identify patterns of behaviour. The other benefits of monitoring are it reduces adult anxiety, enables subsequent referrals to social services, and ensures consistency of services. The abuse to the children may be manifested through inappropriate injuries, body language and behaviour, drawings and writings, indications of neglect, and would clearly indicate the nature and quality of contact with parents (Baginsky, (ed.) 2008, 31-45). Assessment is an important parameter, and assessment in the given scenario occurs best through a multi-agency approach. The assessment must be made through assessment of needs of each child separately. It should also have formal and clear assessment of parenting capacity and ability of the parents to change. The strengths in the family would be assessed, which would consider the environmental impact on the family. Shared information and joint planning in the multi-agency team may direct ways to move from helplessness to clear objectives. If there is a change necessary, then that change must be based on clear assessment of the each child's needs where there is a necessity to set a clear, specific, tangible targets for change. There is a need for a review process through sharing of information. The needs of the children include the needs for protection, and this would happen through a child-centred process dictated by assessment. Thus the process would be rooted in child development and ecologically sound. This would involve working with the families that ensures equality of opportunity. In this assessment framework provided by DOH (2000), there is provision for building on the strength of the families through an inter-agency approach. This as expected would be a continual process that would take place in parallel with other actions and services. As in any care service, this should be grounded in evidence-based knowledge (Department of Health, 2000). From Anning, A. (2006) Developing multi-professional teamwork for integrated children's services: research, policy and practice. Framework for Need Assessment of Children and their Families The main reasons why children come into care are abuse or neglect, family problems, disability, and socially unacceptable behaviour. With these problems, these children may live in with residential care, foster care, family network carers, parents, placement for adoption, secure units, or even lodgings. Social workers are key responsible agencies for implementation of two key multi-agency plans, such as, care plan and the personal education plan. They are also responsible for visiting children in care at least once every 28 days. The multiagency care plan involves a number of agencies depending on the needs assessment. The relevance of overall care plan must be reviewed regularly through multiagency meetings first every 28 days, then every 3 months, and then every 6 months. The multiagency team comprises of The carer The social worker School or early years setting staff A relevant health professional The child themselves The parents The meeting is chaired by an independent reviewing officer. The child must get support for personal educational plans. There are certain barriers to this process that may hinder the outcome. These are lack of effective advocacy, lack of stability, long periods out of school, low expectations, failure to share information, bad pre-care experiences, unmet emotional needs and low self-esteem, negative attitudes and assumptions (Fitzgerald & Kay, 2008, 12-17). Department of Education suggests some principles to improve these problems. These may be prioritising education, having high expectations, ensuring and promoting inclusion. As expected, these would achieve continuity and stability. Moreover, involvement of a multi-agency team would ensure early intervention through prioritization of action through listening to the children. Conclusion There is long tradition of working with parents in early childhood settings. Government legislation and guidance strongly encourage working in partnership with parents. Children's services and community care plans call for consultation with parents about the way in which services for children are developed, organised and delivered. There is growing evidence of the long-term benefits of preventive work with parents and young children within mainstream open access services. Parents and professionals can help children separately or they can work together to the greater benefit of the child. However, the explicitly multidisciplinary nature of government initiatives in recent years and their focus on co-ordination and integration of early years’ services provides an ideal environment for implementation of such. Some have argued that a multidisciplinary approach can be achieved through the provision of inter-professional training opportunities as part of continuing professional development programmes in order to overcome barriers to effective inter-professional collaboration. But this response can be criticised for not challenging the vested interests or viewpoints of existing professional groups, which should be dealt in a different manner. Reference List Anning, A. (2006) Developing multi-professional teamwork for integrated children's services: research, policy and practice. Maidenhead, Open University Press. 83-94. Baginsky, M. (ed.) (2008) Safeguarding Children and Schools. London, Jessica Kingsley Publishers. 31-45. Clark P. (1993) A typology of multidisciplinary education in gerontology and geriatrics: are we really doing what we say we are? Journal of Interprofessional Care. 7, 3, pp 217-227 David, T. (1994) ed. Working Together for Young Children: Multi-Professionalism in Action. London, Routledge. Department of Health. (1995) The Challenge of Partnership in Child Protection: Practice Guide. London, HMSO Department of Health, Home Office, Department for Education and Employment. (2000) Framework for the Assessment of Children in Need and their Families. London, The Stationery Office. Fitzgerald, D & Kay, J. (2008).Working Together in Children’s Services. London, Routledge.12-17 HM Government. (2006) Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children. Norwich, The Stationery Office. (http://www.everychildmatters.gov.uk/socialcare/safeguarding/workingtogether Joughin, C & Law, C. (2005) Evidence to Inform the National Service Framework for Children, Young People and Maternity Services. London, DfES & DH MacDonald, G & Roberts, H. (1995) What works in the Early Years?: Effective interventions for children and families in health, social welfare, education and child protection. Essex, Barnardo’s. 23-47. Powell, C., (2007). Safeguarding Children and Young People. Open University Press. England, P 7-107. Stahmer, AC., Sutton, DT., Fox, L., and Leslie, LK., (2008). State Part C Agency Practices and the Child Abuse Prevention and Treatment Act (CAPTA). Topics in Early Childhood Special Education; 28: 99 - 108. Stainton Rogers, W. (1989) Effective co-operation in child protection work In Morgan, S & Righton, P eds. Child Care: Concerns and Conflicts. London, Hodder & Stoughton. pp 82-94 The Children Act (1989). Office of the Public Sector Information. 1-34 The Children Act (2004) (http://www.opsi.gov.uk/acts/acts2004/20040031.htm) The Stationary Office (2003). Every Child Matters. White, R, Carr, P & Lowe, N., (1990). A Guide to The Children Act 1989. London, Butterworths, 13-17. Wigfall, V & Moss, P. (2001). More than the sum of its parts? A study of a multi-agency child care network. London, National Children's Bureau. 71-73. Read More