Chapter 43 – Lorna O’Reilly and Jamie Grennan (D3SOP3)
Domain 3 Standard of Proficiency 3
Be able to determine the appropriate tests/assessments required and undertake/ arrange these tests.
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KEY TERMS Five Pillars of Social Work Services Role of Social Care Workers in the five Pillars Case study |
Social care is … a profession or calling where you go to work every day and strive to make a positive difference in the lives of those you are supporting, always being non-judgemental, empathic, understanding and trying to do so with a smile on your face, even on the most difficult of days. It is empowering service users to bring about positive change in their own lives and equipping them with the skills to manage any possible future crisis they may experience without the need for service provision. |
This proficiency is focused on appropriate tests and assessments used in social care practice and what work is involved in undertaking or arranging the use of these practice tools. To help you understand this proficiency we, as social care workers in Tusla, have provided examples of the assessments used in the protection of children. The chapter begins with an overview of the structure of Tusla.
Five Pillars of Social Work Services
Social care workers in Tusla require a level of professional decision-making to be able to assess situations and plan interventions. To begin, let us give you a breakdown of the current Tusla structure and where social care falls into this. As of 2015, Tusla Social Work Services have been divided into five pillars. These pillars are:
1 Duty social work team: Often referred to as the ‘front door’, this is the team that deals with all child protection concerns reported in the area. This team is further broken down into two sub-teams: the screeningteam, who screen every child protection concern reported and decide on the most appropriate action; and the initial assessment team. If the screening team feel that the level of concern meets the threshold for further assessment, the initial assessment team will then carry out an overall assessment on the family, looking at the risk of harm to the children and identifying areas for possible support.
2 Child protection social work team: If the initial assessment found that the children are at ongoing risk of harm attributable to parenting, they will refer the family to the child protection team, often referred to as the ‘long-term team’. The social workers on this team work with the family around reducing harm, linking them to appropriate supports and measuring the family’s engagement and progress with these supports.
3 Children in care (CIC) social work team: If a child has been deemed to be at ongoing risk of significant harm and all possible supports have been exhausted, in some situations Tusla then has to look at bringing that child into state care. When this happens, the child will be allocated a social worker from this team. The social worker will devise and work within the child’s care plan, attending to any of their presenting needs.
The child’s care plan covers areas such as:
- Why the child needs a care placement.
- Legal status of the placement.
- The child’s needs – health and education, emotional and behavioural, family and relationships, self-care and self-identity and the child’s hobbies and interests.
- The child’s own views and the parent’s views.
The CIC social worker will also support contact between the child and their family, attend court when needed and assess whether reunification with the parents would be possible in the future.
4 Fostering social work team: The social workers on this team, often referred to as link workers, are the main support for foster carers of children in care. This team recruit, assess, train and support Tusla foster carers at all stages of the fostering process. The team also identify the most suitable foster placement for the child by looking at their presenting needs and care history. Appropriate matching of foster carer to the child’s needs is very important to the success of the placement.
5 Prevention, partnership and family support (PPFS) team: This team consists of social care workers and family support practitioners, and this is where we work. Social care workers work directly with children, young people and parents to provide support around issues such as mental health, substance abuse, challenging behaviour, placement breakdown and family relationships. Family support practitioners work with parents on issues such as household management, budgeting, appropriate parenting and supporting these parents with their own health needs and welfare entitlements. The PPFS team also has a child and family support network (CFSN) co-ordinator, who co-ordinates Meitheal for our area and links with all appropriate services. Meitheal is a Tusla-led early intervention practice model designed to ensure that the strengths and needs of children and their families are effectively identified, understood and responded to in a timely manner so that the children and families get the help and support they need. It is an early intervention, multi-agency response, tailored to the needs of the individual child or young person (Tusla 2018). Many of our team members are also trained as lead practitioners and independent chairs for Meitheal. Unique to our area, our team is line managed by the senior child and family support network (CFSN) coordinator, who oversees and allocates all referrals into our team and supervises and supports the staff in all aspects of their work. The senior CFSN co-ordinator is also responsible for overseeing Meitheal and the Child and Family Support Networks in the area and supporting and encouraging all services to proactively work together in order to ensure the best services possible for children and families in the area. Meitheal is proactively advocated through the Networks.
5 Pillars of Tusla Social Work Services
Role of Social Care Workers in the Five Pillars
There are a number of social care workers in each of these five pillars. Each team requires a different style of work.
Duty Social Work Team and Child Protection Team
Social care workers on the duty team screen concerns reported to Tusla under the supervision of the duty social work team leader. They assess the needs using the RED process (review, evaluate and direct). This is the process through which cases are currently referred from social work services to the PPFS team. Social care workers also support the social workers on their team when needed for completing a home visit or responding to an emergency. Social care workers on the child protection team also assess the need in specific cases and can also make onward appropriate referrals to RED or directly to the community supports. On this team, the social care worker will also monitor families’ progress with the supports identified for them, such as reviewing progress with the allocated worker on the PPFS team.
Children in Care (CIC) Social Work Team and Fostering Team
Social care workers on the CIC team provide direct work and support to children in care by way of completing life story work and supporting them in understanding their change in living situation. Social care staff on this team would also facilitate and supervise contact between the child and their family when required. Social care workers complete safeguarding visits of children in care awaiting allocation to a social worker. In doing this, the worker assesses how the child is doing in their placement and may identify areas of support needed for the child. The aftercare service is also a part of this team; it supports young people from age 16 in preparing to transition from Tusla care arrangements. All aftercare workers are also trained social care professionals with experience of practice in the field. Aftercare workers support young people in many ways, including sourcing allowance, housing, employment and education. The role of the social care worker on the fostering team is to address issues that may arise in the foster placement and support the child or young person so that the placement does not break down.
Prevention, Partnership and Family Support (PPFS) Team
When working on the PPFS team, there is a requirement to be able to assess and plan an intervention for a child and family. The models we mostly use in our assessments include Signs of Safety (Turnell & Edwards 2017), Meitheal and My World Triangle. We are always mindful of theories in psychology and sociology such as attachment theory, systems theory and scaffolding. Our interventions are based on various models of practice. These include Karen Treisman’s trauma-informed practice (Treisman 2017), which takes the trauma experienced by a child into account in assessing and planning an intervention for them. The adverse childhood experiences scale (ACES) is useful when assessing trauma present (CDC 2020). The Circle of Courage and Purposeful Use of Daily Life Events are also models of practice that we follow.
All our assessments and interventions are based on strengths and needs analysis, such as that used in the Meitheal process. When a member of our team receives a referral form, it will have identified needs present for the family. Our staff will begin their work by meeting with the child and parent to get an understanding of their exact situation and measuring where they are at currently. With this information, the practitioner will then plan the most appropriate intervention for this family. As each child and family is different, one approach does not fit all, and each intervention needs to be tailored to suit the person it is being delivered to. We find that including the child and parent in planning a support that works best for them yields the best results. Their participation and engagement is the key to the support being successful.
Our team continues to measure progress while completing the intervention, ensuring that it is best meeting the service users’ needs at all times. There will be times where a certain approach may not be working so we would then consult with the child and family and identify what we can do to adjust the plan. We also continuously measure the progress of our interventions in supervision with our line manager. Sometimes, we identify that a child requires another support that our service cannot offer. We would then advocate on behalf of the child or family or empower the parent to ensure that they get this support. We work collaboratively with other services involved with the family to ensure that the best service is provided. This is done by way of a strategy meeting or a Meitheal where appropriate.
Social care workers on the PPFS teams work across all the levels of the Hardiker model (Hardiker et al. 1991) and across the Tusla pillars.
Hardiker model (DCYA 2012: 16)
Level 2 of the model corresponds with cases we work with that are not currently open to a social work team and are deemed low-level cases. These are typically families stepped down from social work or engaging with Meitheal. Level 3 of the model corresponds with cases where the families are open to social work. In this case, we would be working on actions set out in a child protection or family support plan devised by the social worker or following on from a child protection case conference. Level 4 of the model corresponds with cases where the child often has to be removed from the family home if it is found to be in their best interests to be placed into care. Staff from the PPFS team will do a case transfer to the social care workers on the CIC team to ensure that the child continues to get support.
In our practice, we have found that when we begin our assessment and work with a family, focusing on relationship building gives a good basis from which to deliver a meaningful programme to the child and family, which in turn will help bring about positive change. A positive relationship will also allow the family to be more open with you, which will enable you to get a more accurate assessment of the family and the progress they are making by measuring how this support has positively changed any aspects of family life.
Legislation and policy is in place to ensure that the voice of the child is heard in a meaningful way. Our core principle is to listen to the voice of the child in our practice and promote their views. We often do this creatively to ensure their voice is heard by adults in their lives, ensuring that the child understands that the decisions made by adults in their lives will include their opinions but not always their desired outcome. Child and youth participation is an important aspect of our work and this is how we ensure that young people’s voices are heard. We have facilitated several child and youth participation groups, all of which have also been awarded Investment in Children awards. In being creative with our work in this way, we ensure that we remain professional throughout and are mindful of boundaries at all times in our practice.
Case Study 1
This is a fictional case study but reflects a possible referral to our service. None of the names or incidents are based on a real-life referral.
The Gardaí sent a notification to duty social worker Mary noting their concerns about a family where a 16-year-old male (Peter) was under the influence of drugs. Peter lives with his mam (Laura), who is parenting alone and is struggling with her son’s behaviour. While under the influence, Peter would become quite aggressive in the home and had lashed out at his mam on several occasions. Laura stated that Peter is verbally abusive towards her on a regular basis. Laura also has an eight-year-old boy (Ryan) and notifying Gardaí are concerned about the effect that witnessing these violent incidents is having on Ryan.
On receiving the notification from the Gardaí, Mary began an intake record (IR) in relation to the incident. In linking with Laura, Mary established that Peter’s behaviours have increased over the past number of years. According to Laura, Peter had begun smoking cigarettes with his friends but then moved on to smoking cannabis. Laura added that if she tries to address this with Peter he can become abusive towards her. Laura stated that she is worried that Peter will begin to use harder drugs if he continues on this cycle. Laura advised that Peter’s school attendance began to drop when he entered secondary school; he did complete his Junior Certificate exams last year, but did not return to school.
When describing her eight-year-old son Ryan, Laura said that he is a quiet boy and that he is afraid of Peter. Laura said that when Peter begins to become aggressive towards her, she will usually contact her brother and sister-in-law to take Ryan for the night so that he is not in the home when Peter becomes heightened. Laura stated that on the night in question, Peter returned late from being out with friends and became abusive towards her. Laura did not have the opportunity to call her family for support at this time. In having family available to support her in this way, Laura is being proactive in putting safety in place for her son Ryan. In completing the IR, Mary reviewed closed files and established that there had been two previous referrals to the social work team five years ago regarding domestic violence from the children’s father
Shane towards Laura. Laura stated that Shane is no longer in the family’s life. Laura is also concerned about Ryan having witnessed this domestic violence, as he has begun to ask her questions about ‘the time when daddy used to hit you’. Mary informed Laura about the supports available to her from the PPFS team. Mary described the role of the social care worker who could support Peter and Ryan individually in relation to their needs. Mary also explained the role of a family support practitioner who could offer support to Laura in her parenting as well as accessing her own supports for her past experiences. Laura stated she would be happy to receive this support and gave consent for a referral to be sent to the RED (review, evaluate, direct) meeting for this support. Mary closed the case to duty at this time as Laura had family support to help her when Peter becomes aggressive and has consented to a referral for support for the family.
The referral for support for the family was sent to be discussed at the fortnightly RED meeting. This meeting is attended by duty social work team leaders and PPFS senior child and family support network co-ordinators (senior CFSNs) to agree on the most appropriate delivery of support to the family. In discussing this family, Laura was accepted to the PPFS team for family support and Peter was accepted to the PPFS team for social care worker support. In discussing Ryan and his needs, it was agreed that he would most benefit from play therapy at this time. The senior CFSN can access this through the local child and family support networks by referring the child to the local family resource centre, which receives funding to offer play therapy support for children in the community. Following the meeting, the senior CFSN rang Laura, discussed the option of play therapy for Ryan and received her consent to send the referral to the local family resource centre for this intervention. The senior CFSN also advised Laura that she has been accepted to the PPFS team for family support and Peter has been accepted for social care worker support. The senior CFSN advised that the workers will be in contact with the family upon allocation.
A social care worker (Siobhan) was shortly allocated to work with Peter. Siobhan organised an initial home visit with Laura and Peter to discuss the referral. Siobhan described her role, explained that the intervention can be delivered in an informal way and discussed how they could incorporate Peter’s interests into the intervention. Siobhan explored this with Peter, who said he enjoys playing hurling and would like to be a mechanic when he is older. Siobhan reassured Peter that the first few sessions together can be done by going hurling. Peter was happy with this and did agree to meet with social care worker again. Siobhan was aware that it was important for Peter to want to spend time with her and this was a great opportunity for relationship development. In meeting with Peter by way of activities such as hurling, Siobhan also assessed what support was needed for Peter at this time. She based her initial assessment in planning Peter’s intervention using the signs of safety ‘Three Houses’ tool by way of a worksheet.
Taking Peter’s age into account, the social care worker explored the questions from this by talking while hurling, etc. The Three Houses tool looks at the house of good things, the house of worries and the house of dreams and explores what these would look like for each child. This is in keeping with the signs of safety model, which is Tusla’s current working model for practice. The social care worker explored with Peter what was good for him – he identified his family and friends; what he was worried about – he identified as his future prospects; and his dreams for the future – which Peter said were to be a mechanic and to have a sports car! The social care worker was also acutely aware of the My World Triangle tool for looking at children’s development when planning an intervention with Peter.
The social care worker used this information and her newly formed positive relationship with Peter to work on steps to get Peter to his goals. In exploring his drug use, the social care worker gave Peter the space to speak about this and for Peter to identify that drugs are having a negative impact on his life and that he wants to quit. Peter agreed for the social care worker to make a referral to the Midlands Youth Drug and Alcohol Service (MYDAS). The social care worker supported Peter in engaging with a worker from MYDAS around harm reduction and eventually abstinence from drugs.
The social care worker discussed with Peter and Laura the Meitheal process. Both thought that this process would benefit their family and they agreed to engage in it. The social care worker completed the Meitheal request and the strengths and needs form and engaged as the lead practitioner throughout the process. The holistic approach to meet Peter’s needs was ensured throughout this process.
In discussing things that are good for Peter, the social care worker gave him space to discuss his relationship with his family members and encouraged him around how to make these more positive. The social care worker discussed with both Peter and Laura activities they can do to improve their relationship and encouraged them to complete these. In exploring Peter’s dreams of being a mechanic, the social care worker used their local network connections and linked Peter up with the local employment officer who gave support in applying for an apprenticeship. Peter began an apprenticeship and was very happy with his progress. At this time, Laura was also engaging well with a family support practitioner and Ryan benefited greatly from play therapy intervention. The social care worker supported Peter in settling into his apprenticeship and encouraging him in his drug abstinence. When the social care worker could clearly see that the family were doing consistently well and all goals for working with Peter had been completed, they completed closure work on the case. The social care worker ensured that the family were aware of where they could access support should they ever need it again.
In this case study, it is clear how the assessment tools used enabled the social care worker to deliver a beneficial intervention and bring about positive change in the life of Peter and his family.
TASK 1
Based on this case study discuss the key assessments and interventions that supported the family and young people.
Tips for Practice Educators
To support the students with this proficiency, provide them with literature and policies on tests, assessments and interventions used in placement.
Support the student with understanding of assessments/tests, set tasks that will help them develop their assessment skills.
Recommended reading for students on placement: Three Houses tool and Hardiker model (Hardiker et al. 1991).
References
CDC (Centers for Disease Control and Prevention) (2020) Adverse Childhood Experiences Prevention Strategy. Atlanta, GA: CDC.
DCYA (Department of Children and Youth Affairs) (2012) Working Together for Children: Toolkit for the Development of a Children’s Services Committee (2nd edn). Dublin: Government Publications.
Hardiker, P., Exton, K. and Barker, M. (1991) Policies and Practices in Preventive Child Care. Aldershot: Ashgate.
Treisman, K. (2017) A Therapeutic Treasure Box for Working with Children and Adolescents with Developmental Trauma. London: Jessica Kingsley.
Turnell, A. and Edward, S. (2017) Signs of Safety Workbook (2nd edn). Perth, Australia: Resolutions Consultancy.
Tusla – the Child and Family Agency (2018) Meitheal Toolkit: Dublin: Tusla.
