Assessing Luka

This is my essay entry for the MA Social Work Module “Applied Professional Practice in Children and Family”. I received 80% mark for this, which I am very happy considering I feel rather uncomfortable being a bureaucrat in local authority (social service) position. When I started writing this essay, I kept on telling myself, “You are talking Bull S**t!” Whenever I quoted a piece of legislation or standard operating procedure for social worker, Karl Pilkington’s Bull Shit Man kept on popping up in my head 

Anyway, here it is… my essay:

Assessing Luka

(Protecting Childhood, Preventing Homicides)

 “My name is Luka, I live on the second floor, I live upstairs from you, Yes I think you’ve seen me before

If you hear something late at night, Some kind of trouble. some kind of fight, Just don’t ask me what it was

I think it’s because I’m clumsy, I try not to talk too loud, Maybe it’s because I’m crazy, I try not to act too proud

They only hit until you cry, After that you don’t ask why, You just don’t argue anymore

 Yes I think I’m okay, I walked into the door again,Well, if you ask that’s what I’ll say, And it’s not your business anyway,I guess I’d like to be alone, With nothing broken, nothing thrown

 Just don’t ask me how I am…..”

Without this 1987 song by Suzanne Vega playing in my head, I could not write or even think about child protection. When children died in the hands of their parents or main carers, the media and society tend to point fingers at ‘social services’. However, reading serious case reviews from the point of view of a student social worker reveals layers after layers of this social construct called children, family, and the jargon ‘child protection’. Still what social workers do on daily basis – filling forms, asking questions, writing reports, attending meetings – seems so far away and disconnected from the bigger picture, from the raison d’etre of social work and the rights of the child.

Using legal documents from UN conventions, national statutory law, to local safeguarding board guidelines as frameworks, this essay will discuss assessment and child protection with a critical analysis about risk and safeguarding children. What is childhood and why the protection of children is paramount (UN General Assembly, 1989). Children and families social workers are trying to prevent Luka from joining Jasmine Beckford, Kimberley Carlile, Tyra Henry, Victoria Climbié, Peter Connely, Daniel Pelka, Keanu Williams, and Hamza Khan. Luka represents children in danger of abuse and serious harm, children (who should be) under child protection plan. Luka also represents children in our society who are categorised as ‘children in need’. Together with other professionals (Department of Education, 2013), social workers have the responsibility to not only prevent Luka from ending up in serious case review, but to also support Luka to  “stay safe, be healthy, enjoy and achieve, have economic well-being, and able to make positive contribution” (DfES, 2004;  The Treasury, 2003). This paper is trying to reflect and make sense of the daily form filling job – that we called ‘initial assessment’ or ‘core assessment’ or what now changed to ‘children and families assessment’ or CAFA – and connect it to saving Luka.

Legal framework

When Luka’s neighbour reported that there were “some kind of trouble some kind of fight,” a local authority children social worker would go into Luka’s flat together possibly with a child protection police officer and conduct a Section 47 investigation under Children Act 1989. This is the everyday child protection job social workers. Many would do this almost automatically, following the well memorised standard operating procedure – just like a Boeing 747 pilot runs the pre-flight checklist before taking off.

Taking a step back from the daily routine, Luka’s right to live safely as a child was protected by United Nation Convention for the Right of Child (UNCRC). In the Universal Declaration of Human Rights, “the United Nations has proclaimed that childhood is entitled to special care and assistance” (UNCRC, Preamble). A child is “every human being below the age of eighteen years” (UNCRC, Article 1). The convention was ratified by UK Government in 1991. About the same time as the UNCRC, the UK’s House of Common passed the Children Bill, and in November 1989, what we now know as the Children Act 1989 was born.

The implication of the international and national law is the duty to protect children from harm, including harm posed by their main caregiver (UNCRC  Article 19). This duty falls onto local authorities. However both UNCRC and Children Act 1989 also recognised that family is “the natural environment” (UNCRC, Preamble) and that children are best cared for within their own families (Children Act 1989).

The two duties – protecting children from harm and protecting family unit as the best environment for a child to grow – is one of the many dilemmas in the world of social work. Further in this essay more conflicting positions of social workers will be discussed.

Dilemmas and conflicting positions where a social worker should and would stand are questions that might be unanswerable. As Dickens (2011) stated, “social work is forever being in the middle”, in between. It is a profession that “in almost constant movement and change” (Turney, 2009, p.2). Social work’s dilemmas are one of Derrida’s undecidable (Collins & Mayblin, 2011).

When a social worker entered Luka’s flat and conduct her Section 47 enquiries as dictated by Children Act 1989, her duty in keeping Luka safe from harm is part of her duty to protect human rights, child’s rights, as well as following guidance and procedure set by her national government and her employer the local authority. National framework that governs the assessment of children in need and their family today was set by The Department of Health (2000), it is then replaced or amended by Working Together 2013 (DoE, 2013), although this new document is basically using the same triangle of child’s developmental needs, parents’ capacity, and impact of wider environment – the basis of Common Assessment Framework (CAF), as shown in the picture below.

The latest national guidance (DoE, 2013) covers “the legislative requirements and expectations on individual services to safeguard and promote the welfare of children and a framework for Local Safeguarding Children Boards (LSCBs) to monitor the effectiveness of local services”. It explained the meaning of “safeguarding and promoting the welfare of children” as “protecting children from maltreatment, preventing impairment of children’s health or development, ensuring that children grow up in circumstances consistent with the provision of safe and effective care, and taking action to enable all children to have the best outcomes” (DoE, 2013, p.7).

NSPCC report (Harker et.al, 2013) described children’s safety in numbers: “There were 56 child homicides across the UK in 2011/12. In 2011, 40 children under 15 died as a result of assault or undetermined intent across the UK.” The numbers get higher on the abuse and neglect section.  Within the same period, over 600,000 children in England were referred to local authority social services by individuals who had concerns about their welfare (DoE, 2013, p.7). Ofsted (2010) recorded that “between 1 April 2009 and 31 March 2010, there were 194 serious case reviews, among them 90 died. The other 104 were involved in serious incidents, following a history of concern by agencies involved, including being the subject of a child protection plan. The most common characteristics of the incidents were physical abuse or long-term neglect.”

Guidance and standard operating procedures are put in place to safeguard children and to ensure their basic rights are met. Current legislations are also influenced by death of children. The standard operating procedures that social workers today have to follow are results of learning from serious case reviews, mostly pointed at human errors within the system. In the UK, safeguarding discourse was born after failures to save the lives of children. Local Safeguarding Children Boards (LSCBs) were established by the Children Act 2004, not long after the death of Victoria Climbié. LSCBs’ function is “to identify emerging problems through learning from practice and to oversee efforts to improve services in response” (Munro, 2011).

Among the findings from serious case reviews, there are common threads that led in each case. The Treasury (2003, p.5) listed them as: failure to intervene early enough, poor co-ordination, failure to share information, lacking professional with a strong sense of accountability, not enough frontline staff, poor management and lack of effective training.

In other words, LSCBs and the procedures to safeguard children are institutional defence mechanism as Menzies-Lyth (1959) said, “Culture, structure and mode of functioning are part of the organisational defence mechanism against anxiety.” These culture, structure, and standard operating procedures are also organisational defence against human errors, against the unpredictability of human with their miscommunications, misinterpretation of information, even feelings and other human traits. Social workers’ safeguarding guidance and procedures are like pilot’s flight manuals – to protect service user (or passengers) from human errors.

Assessing Luka

Let’s come back to the time when a social worker walks into Luka’s flat. She would not have documents such as the Working Together 2013, she would not have the Children Act 1989 or 2004, nor would she have any print out of UN’s Universal Declaration of Human Rights and UNCRC. What she would carry in her bag would be pens and assessment pro forma with sets of questionnaires to ask Luka’s parents, as well as to ask Luka without his parents. This pro forma is one of the many assessment tools used by social workers to protect children. For that brief moment, the questionnaires could be the only handy tool to protect Luka, and to defend the social worker’s own psyche against anxiety (Menzies-Lyth, 1959), it is the defence mechanism against the unknown.

Surely the social worker knows about creative narrative-based approach that involves conversation (Roscoe et al, 2011). However, for the brief moment of walking into the unknown of Luka’s flat, the ready-made question and checklist was a handy tool to help making a decision of whether Luka is safe to stay with his parents or should be taken to emergency paediatrician right away.

Just like Menzies-Lyth’s culture, structure and mode of functioning, the assessment pro forma with its standard questionnaires is an organisational – in this case the Children’s Services – defence mechanism against the unpredictability and flaws of human. The assessment pro forma, the forms and questionnaires, protect Children’s Services from human ‘weakness’ and feelings, from the social worker’s possible tendency of wanting to see the best in people, in Luka’s parents. The pro forma and standard questionnaire is similar with that of a flight manual and checklist for airline pilots before, during, and after they took their Airbus A380 with five hundred passengers into the sky.

Manchester Safeguarding Children Board (MSCB) outlined the flow chart of reporting serious concerns (2009, p.8 and 2010, pp.65-69) not only for social workers, but for all professionals involved in working with children and families. It is part of the standard operating procedure, put in place for all workers involved. The guideline with its flow chart is no different than the manual book and manufacturer directive for pilots, co-pilots, mechanics, and all involved in operation of an airline. The standard operating procedures and manuals are there as a tool to minimise risk as well as an organisational defence against human error.

As the social worker starting to get to know Luka and his family, the handy tool of forms and pro forma might gradually becomes unnecessary. As Milner and O’Byrne described, the next stage in assessment process after preparing and collecting data are “applying professional knowledge or analysis, making judgement, and deciding on future action – or inaction” (2009, p.4). Assessment is not just gathering information, it is also interpreting the information in order to understand Luka, his family, and their circumstances, and further it is to decide what services and resources are necessary to effect changes (Middleton, 1997, p.5).

Although the first encounter with Luka and his parents on that Section 47 inquiry (Children Act 1989) would be very brief, the process of assessing Luka has only just begun. If Luka is not at risk of serious harm that night, the social worker will still have to come back within a period of time to do a further assessment and decide further whether Luka needs the help of early intervention, should he be put into category of child in need as described in Section 17 Children Act 1989, or should he be put under child protection plan. Even after the second decision, the process of assessment is still on going, “it is a dynamic process that can never be complete, true or comprehensive,” declared Middleton (1997, p.6).

The dilemma that Luka’s social worker will face later is deciding what service Luka will need – should it be ‘service-led’ or ‘needs-led’, or what Middleton called purchasing model with restricted resources (1997, p.12). Luka’s social worker will have to reflect within herself, realising the power she is going to exercise over Luka’s and his family. She needs to be aware that “assessment is not a benign process as it seems to happen to the socially disadvantage and that at its worst, assessment is the exercise of power by one section of society over another” (Middleton, 1997, p.1). Using creative-narrative model (Roscoe et al, 2011), the social worker can change assessment from judging to getting to know people and their situation with the intent of changing it for the better (Middleton, 1997).

Milner and O’Byrne (2002, p.263) reminded us of social constructionism in assessment, “If we diagnosed, the naming makes it ‘real’. Language assigns meanings and thereby constructs what is being talked about, constructs our identities.” Taking the position of social constructionism, being uncertain is not a sin. Uncertainty is acceptable as we are not the only experts; the service users in some ways are the best experts to help us (Milner & O’Byrne, 2002, p.266).

Bearing in mind barriers to seeing the child as part of the assessment are easy to overlook. Horwath (2011) mentioned a few barriers such as reducing the framework to ‘the Triangle’; separating risk of harm from need. Most common barrier is target-oriented style by both practitioners and managers that overemphasise on timescales and form completion. Another barrier that social workers have to be aware of is what Martin Luther King stated, “People fail to get along because they fear each other; they fear each other because they don’t know each other; they don’t know each other because they have not communicated with each other” (1958).

Though this essay is about social work and hence like the rest of this course is seeing things from the place and space, from the point of view of social worker, just imagine for a second what would be the feelings and emotions and thoughts of Luka and his family. This was probably not the first visit by a ‘professional’. They must feel like Audre Lorde when speaking to others, “I’m reminded how difficult and time consuming it is to have to reinvent pencil every time you want to send a message.” (1979b, p.78)

Is Luka ‘at risk’?

Before deciding whether or not Luka is ‘at risk’ of serious harm, we need to critically discuss about this concept, this social construct called ‘risk’. What is risk? Thornton (2013) reminded us that “risk is not the same as danger” and that it is involved uncertainty. In general term, Oxford English Dictionary defines risk as “exposure to the possibility of loss, injury, or other adverse or unwelcome circumstance; a chance or situation involving such a possibility”. The shortest and most straightforward definition of risk is “effect of uncertainty on objectives” (ISO 31000 [2009], guide 73:2002)

Our objective is for Luka to grow up being healthy, staying safe, enjoying and achieving, making positive contributions, and achieving economic well-being (DfES, 2004 and The Treasury, 2003). However the uncertainties that are affecting these objectives are how his developmental needs will be met with current parents’ capacity and his wider family and environment situation (DoH, 2004 and DoE, 2013). Hence the course of action – or inaction – that the social work will take under conditions of uncertainty will expose Luka to possible loss in order to have the chance of benefit (Milner & O’Byrne, 2002, p.271).

Risk in the world of social is about judgement, about predicting the future. The most difficult job of Luka’s social worker is analysing the information that she gathered through the pro forma questionnaires, then evaluating and drawing conclusion (Turney, 2009, p.2) or making the right decision.

The next question is can we calculate risk? In aviation, one engine failure in a four engines Airbus 380 is a calculated risk that a pilot can take while continuing to fly towards their destination. When another engine failed, the risk factor is higher. The pilot in command will then need to assess other factors to reach a decision whether to continue to the final destination or to divert to the nearest airport. In the story of Luka, the risk his social worker has to calculate is whether or not Luka will be seriously harmed if no intervention were carried out. Among many data to consider is Luka’s bruises, where they are and how likely they are to be accidental or intentional. Just like the pilot in command, the social worker will then decide and coordinate the course of action – with the co-pilot or support worker, with the flight engineer or the health visitor – and later be accountable in discussion with her line manager.

Social workers calculate the uncertainty factors, the risk, using tools such as Common Assessment Framework for early stages (DoH, 2000), or the more complex child protection inquiry (Turney, 2009) such as the Safeguarding Children Referral Form (or SCRF), Initial and Core Assessment, or Section 47 Inquiries (MSCB, 2010). If the social worker decides to remove Luka from his parents, she will first of all try to find out if there is any connected person – wider family members or family friends – who might be able to look after Luka temporarily. She then do a quick assessment and might decide a temporary approval for connected person for 16 weeks (Care Planning, Placement and Case review (England) Regulations 2010, Regulation 24) while more in-depth assessments are being commissioned.

As detailed an assessment can be, social workers need to accept that “no system can fully eliminate risk. Understanding risk involves judgement and balance. To manage risks, social workers and other professionals should make decisions with the best interests of the child in mind, informed by the evidence available and underpinned by knowledge of child development.”  (DoE, 2013, p.22; UNCRC Article 3 and 4)

Calder (2003) suggested the perspective of risk management instead of risk control. The first has more room for partnership with service users whilst the second tends to have ‘covering backside’ mentality. Risk management perspective accepts risk as everyday phenomena that require balance between strength and weakness.

Reflecting power, the power to reflect

Assessment process, measuring risk and deciding on intervention are everyday routine for social workers. There is always a danger that social workers would turn their ‘auto pilot’ on. However, human have capability to reflect, and reflection is a power waiting to be exercised. Luka’s social worker might as well described herself to Luka as having a superpower – the power to reflect and the power to help Luka exercise his own power. In the language of children, Luka’s social worker could say to Luka, “My superpower is listening to you and helping you to gain your own superpower.” Although what she meant here is that she is exercising her power and helping Luka to exercise his; as Foucault theorised, “power is not possession, it is something that everyone can exercise” (Pirie, 2009, pp.196)

So let’s exercise our power to reflect, let’s do a reflection on power. First of all, social workers need to keep check with their ability to exercise power with – not their power over – their service users. The relationship between power and knowledge (Foucault, as cited by Stokes, 2004, p.187) means that social workers are in position to control knowledge, to control the knowledge flow to Luka and his parents. In other words, the social worker can exercise her power in choosing what to tell and what information to hold from Luka and his family. Many service users are not aware of their rights, or have knowledge for example of the difference between voluntary accommodated under Section 20 of Children Act 1989 and Interim Care Order (Section 38 of Children Act 1989).

Foucault (1981, p.52) stated, “In every society the production of discourse is at once controlled, selected, organised and redistributed by a certain number of procedures whose rule is to ward off its powers and dangers, to gain mastery over its chance events, to evade its ponderous, formidable materiality”. For Luka’s social worker, there is always a danger of exercising power over Luka and his parents with an objective – consciously or not – to cover her back, to control risk (Calder, 2003). Falling to this trap is so easy, as there is a piece of oppressor in all of us (Freire, 1993) and that it “comes in many different forms” (Lorde, 1979b, p.79).

Second point of reflection is that “the place and space we inhabit produce us” (Probyn, 2003, p. 294). Social worker’s own experiences, emotions, history of relationship with her own main caregiver, would unavoidably affect her point of view of Luka and his family. There might be certain details in her interaction with Luka and his parents that triggered emotions and reactions in herself due to her past experiences (internal working model, Howe et al, 1999, p21; Gleitman, 1991).

Acknowledging the social worker’s unique place and space, we are reminded of the politics of positioning (Haraway, 1988) where “vision is always a question of the power to see and subjectivity is multi-dimensional”. Where the social worker stands, or her own standpoint, produce her situated knowledge (Hill-Collins, 1990). Realising where she stands – or using standpoint theory – can “open the way to stronger standards of both objectivity and reflexivity” (Harding, 1991 p.163). In Harding’s (1991, p.269) epistemological language, “experiential foundationalism provides a uniquely legitimative criterion for identifying preferable or less false beliefs”.

The third point of reflection is the danger of rewriting Luka. This is when the social worker colonises Luka’s story and narrative (Hooks, 1990). As Hooks pointed out, “often speech about ‘other’ annihilates and erases.” It’s so easy to put words into Luka’s mouth, filling the assessment form with the social worker’s own language and jargons in the section where she should be quoting ‘the child’s wishes and feelings’.

It is also impossible for the social worker to enter Luka’s flat as a ‘neutral’ assessor. As soon as she knocks on the door, she is making an impact on the life of Luka and his family. She is also there trying to make a difference. Her impact on Luka and his family is not insignificant. Psychology describes this as the Hawthorne effect (Landsberger, 1958). Whilst quantum mechanics explain this as the observer’s paradox (Wilner, 1987; Ozeki, 2013, pp.396-397) where the act of observing or gathering information unavoidably implicates and affects the observed (Kumar, 2009, pp.226,244,262; Bohr, 1949, p.210; Bohr, 1928, p.54). As postulated by physicist Heisenberg (1971, p.63) in quantum world, “It is the theory which decides what we can observe.” Luka’s life in his family was almost like the proverbial Schrodinger’s cat – he could be either loved and well taken care of or abused to his death or none of these (Ozeki, 2013, pp.396,413-415) until the social worker enters his world.

The next point of reflection is the intersectionality of oppression that Luka and his parents are experiencing (Crenshaw, 1991, p.1252). The social worker is implicated in at least two ways: her own intersectionality and experience because of who she is, and the intersectionality of the Luka and his parents. Understanding “how social and cultural categories intertwine” (Knudsen, 2005) is a useful tool for reflection on assessing Luka and his parents. Being aware and recognising the multiple oppression model (McDonald & Crenshaw, 1999) and the multiple identities that both social worker and service users have is another point to reflect.

Last but not least, the important power of “letting it be”. One of the most difficult powers to exercise is to occupy the dialectic without trying to solve everything.

Spivak (1999, p.425). Spivak gave us the consolation that we do not need to “guard the question”, instead we can be peacefully accept the “unanswerable question”. She also listed ways to practice deconstruction – among her thirteen points is “notice the strategy of exclusion of other by the text so that it may conserve its synthesis. Then undo the binary opposition between the text’s self – its constitution of subject, object, predication-and its excluded other; meaning becomes undecidable, dialectic economy” (2005, p.98). We can deconstruct the usual thesis-antithesis-synthesis model – or assessment-intervention-report writing habit – by deconstructing the binary between subject and object or between social worker and service user.

Deconstructing the binary of social worker versus service user could mean using creative narrative-based approach that involves conversation (Roscoe et al, 2011). Challenging binary by acknowledging difference as Lorde (1979a, pp.110) said, “Difference must be not merely tolerated, but seen as a fund of necessary polarities between which our creativity can spark like a dialectic.” She further said that “Only within that interdependency of different strengths, acknowledged and equal, can the power to seek new ways of being in the world generate.”

Minh-ha (2011, p.125) reminded us to always have “a constant questioning of our relationship to knowledge”, and “ongoing critical view of the system” that “is motivated, not be a mere desire to blame, to right the wrongs and to oppose for opposition’s sake, but by the necessity to keep power and knowledge (ours and theirs) constantly in check for our own survival”.

As the last but not least point of reflection is Derrida’s undecidability (Collins & Mayblin, 2011) and Crenshaw’s concept of intersectionality (Crenshaw, 1991). Both can be critiques to standardised tick-boxes style of assessment. Although social workers still have to base their reports and assessments on pro forma, being aware of all these points of reflections might at the end, safe Luka’s life without depriving him of healthy family life as UNCRC dictated. Still, sometimes social workers just have to accept the dialectic, the unanswerable questions and the undecidable, and do their best to safeguard Luka with the limited tools available.

 

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