Care Proceedings Research Articles

Linking children's social care data to information about their care proceedings to understand the use of care proceedings and their effects on parents, children and local authorities.

AbstractCare proceedings are the most powerful child protection intervention; local authorities make applications for over 20,000 children each year in England and Wales. The Department for Education holds two administrative databases of children who receive services, for children looked after and children in need. These databases do not record the use of care proceedings. Data linkage is a powerful tool for revealing patterns not visible from a single data set; the Outcomes for children before and after care proceedings reform study linked these administrative records with a research database of care proceedings to examine children's care and service journeys associated with care proceedings. The researchers also devised a simplified method for use by local authorities with their own records and tested this with North Yorkshire County Council. Analysis of the linked data reveals how care proceedings are used and the impact of care proceedings on care demand. It provides the basis for analysis of cohorts of children subject to proceedings and feedback to social workers, children's guardians, and the judges and lawyers on their decisions and children's outcomes.

How to capture the experience of mothers with alcohol problems involved in English family court proceedings – lessons from the field

Purpose It proved difficult to recruit sufficient mothers to a prospective cohort study designed to explore the factors and characteristics of mothers whose children are the subject of the public care system as a result of their drinking, retaining or losing care of their children. In conducting interviews instead with social workers in six local authorities, the repurposed study aimed to explore their views of the barriers and facilitators to involving this “hard to reach” population of mothers in research at the beginning of care proceedings. Design/methodology/approach For this study, 36 semi-structured telephone interviews were conducted with child and family social workers and social work managers located in six English local authorities. Transcripts were analysed using Nvivo and coded thematically. Findings Workforce issues and social work workload, court timescales and the additional burden that participating in research at a time of enormous stress for mothers were described as barriers to recruitment. Social workers suggested that the criteria for including participants could be widened to include mothers in pre-proceedings and that recruitment could take place via substance use services with whom mothers do not have an antagonistic relationship. Research limitations/implications The perspective of social work practitioners and not mothers themselves on barriers to engagement in research is a limitation of the study. Innovative and flexible research design is needed to include the participation of mothers whose alcohol use has led to court proceedings in research. Originality/value Few studies have investigated the barriers and facilitators to engaging mothers in research at the point that care proceedings have been issued. The re-purposed study highlighted the particular stresses on mothers and social workers and made recommendations for alternative strategies for recruiting these mothers and representing their experience in research.

Considering the Cost of Family Preservation Courts: A Look at Child Welfare, Child in Need of Care Proceedings, and the Need for Family Preservation Courts Throughout Louisiana

Considering the Cost of Family Preservation Courts: A Look at Child Welfare, Child in Need of Care Proceedings, and the Need for Family Preservation Courts Throughout Louisiana

Born into Care: characterising newborn babies and infants in care proceedings in England and Wales

Background/rationaleNations with advanced child protection systems place considerable emphasis on the developmental salience of infancy. However, this emphasis is not matched by any differentiated analysis of the timing of family court intervention in the lives of infants or the final legal order outcomes of these cases. This presentation shares findings from the first ever population profiling study of infants subject to care proceedings within the family justice system in England and Wales.
 AimTo estimate the proportion of all infant care proceedings cases issued within 7 days and 4 weeks of birth and describe case and infant characteristics; to calculate incidence rates over time and by local authority and family court region; to describe and compare legal order outcomes according to age.
 Methods/approachData was extracted from case management records produced by the Children and Family Court Advisory and Support Service (Cafcass) England and Wales. Records were first restructured to link infants to legal order outcome data and birth mother records. Incidence rates were calculated using ONS mid-year population estimates and annual live births. Within the SAIL Databank, Welsh infant records were linked to birth registration and community child health data to produce a fuller picture of infant characteristics in Wales.
 ResultsThe cohort we created comprised all infants recorded as subjects within care proceedings in England (2007/08-2016/17) and Wales (2011/12-2018/19). The study captured the high proportion of infant cases that are issued at/close to birth, but also marked regional and local authority variation in incidence rates.
 ConclusionHigh rates of adoption, particularly for babies born to mothers without a previous family court history, have prompted calls for new preventative solutions. The President of the Family (Court) Division in England has initiated a review of legal proceedings at birth.

Understanding recurrent care proceedings: Competing risks of how mothers and fathers enter subsequent care proceedings in England

BackgroundDespite progress in understanding mothers' (re)appearances within family justice, fathers have not yet received due attention in research on recurrent care proceedings.
 Aims
 
 Compare parents' gendered risks of entering subsequent care proceedings;
 Map family relations underpinning recurrent care proceedings;
 Investigate the role of family members' life course characteristics (e.g. age, number of children) in shaping the risk of returning to court.
 
 MethodsAnalysis drew on 2007/08-2017/18 administrative records from the Child and Family Court Advisory and Support Services (Cafcass) in England. From a sample of recurrent parents (N = 24,460), a latent class analysis established profiles of who they returned with. A competing risks analysis of all parents (N = 165,550) modelled the risk of returning into each profile given index characteristics.
 ResultsOverall rate of return for mothers was 1.7 times that of fathers: 22% after 5 years, compared to 13% for fathers, and 29% and 17% after 10 years, respectively.
 Five distinct profiles of recurrent parents were established: 'recurrent family', 'recurrent couple', 're-partnered couple', 'complex recurrence', and 'lone parent'. The vast majority of fathers who entered subsequent proceedings did so as either a part of a recurrent family (41%) or recurrent couple (36%). However, these two profiles represented a much smaller proportion (25% and 19%, respectively) of all recurrent mothers, while the remainder returned with either a new partner or as a lone parent (49%), both with a new child. Complex recurrence represented a small proportion for both mothers and fathers (7% and 11%, respectively). The risk of each of these profiles is characterised by the distinct life course positions of the parent.
 ConclusionThe results underscore the value of a relational approach and understanding a parent's position within the life course in social work research towards building a fuller picture of recurrence.

Dilemmas and Contradictions in Hearing Children in Care Proceedings

The article is based on interviews with 22 children’s spokespersons in the Norwegian arrangement for indirect participation in care proceedings, and presents analyses of the spokespersons’ experiences of contradictions and dilemmas in their practices. Contradictions and dilemmas may be seen in light of the epistemological positions analysed from spokespersons’ accounts: their interpretation of their mandate and the status they ascribe to the child’s contribution to the dialogue. The article’s contribution is the presentation of analytical results that call for a discussion about the inherent contradictions in the mandate of an indirect participation arrangement, and contradictions between psychological and judicial aspects of the spokespersons’ practices.

Characteristics of Pre-Proceedings and Care Proceedings Cases in an English Local Authority, 2013–2017: An Exploratory Data Analysis

AbstractSince reforms in 2014, care proceedings—where a local authority seeks to intervene legally to protect a child—have become shorter, with greater emphasis on ‘front-loading’ preventative and analytical work before, rather than during, proceedings. National findings on case outcomes are emerging, but in-depth local analyses are still rare. This exploratory data analysis of 937 children in 522 families in one London local authority sought to identify trends in the length, outcome and nature of pre-proceedings and proceedings cases, including outcomes six, twelve and twenty-four months after the end of these processes. Consistent with national-level findings on care proceedings, from 2013 to 2017 both the pre-proceedings and care proceedings processes became shorter, and more likely to end with the child at home. The data do not suggest that this increased ‘decisiveness’ leads to rushed decisions. Only 1.4 per cent of the children stepped-down from pre-proceedings, and 6.6 per cent of the children who remained at home after care proceedings came into care within two years of that decision. This research offers a model for similar analyses by practitioner researchers within their own local authorities.

Psychiatric assessment of adults in care proceedings

SUMMARYPsychiatric assessments of adults involved in care proceedings can play a critical role in assisting the family court to resolve proceedings justly. To properly carry out this role, the psychiatric expert should have an up-to-date understanding of the wider context within which they are working. This article outlines the legal framework of care proceedings in England and Wales and summarises the key aspects of the process. The duties of the expert and how the expert is engaged are explained. Finally, guidance is presented on how the expert should approach questions that are commonly raised in these proceedings.LEARNING OBJECTIVESAfter reading this article you will be able to: •appreciate the legal framework relevant to care proceedings in England and Wales•recognise the circumstances in which expert psychiatric evidence relating to adults in care proceedings is commissioned•understand the common questions posed to expert psychiatrists undertaking assessments of adults in care proceedings and develop an assessment framework.

Experiences of social work intervention among mothers with perinatal mental health needs.

Perinatal mental health difficulties are prevalent among women, and the vulnerability of young infants makes this a time when families experiencing multiple adversities may be particularly likely to attract state intervention. However, very little is known about how mothers experience social work intervention during the perinatal period. This study explored experiences of social work intervention among women with perinatal mental health difficulties. Qualitative semi-structured interviews were carried out with 18 women with 6- to 9-month-old babies, who had been treated in England for a perinatal mental health difficulty and also had social services intervention. Interviews were analysed using thematic analysis. Findings suggested that mothers had a predominantly negative view of children's social services, especially when social workers had significant child protection concerns. The fear of being judged an unfit mother and having their babies taken away overshadowed their encounters. Mothers felt that social workers would not accept they could be good mothers in spite of their difficulties and set them up to fail. Some felt that social workers focused exclusively on the risks to the baby and did not acknowledge the mother's own needs or understand perinatal mental health. In some cases, social work intervention was described as intensifying pressure on mothers' mental health, leading to escalating difficulties and increased likelihood of care proceedings. At the same time, our study also included examples of mothers forming positive relationships with social workers, and of 'turning points' where initially negative interactions stabilised and child protection concerns lessened. Women's accounts highlighted the importance of feeling 'known' by social workers who understood and respected them. The findings also suggested there may be value in improving collaboration between social workers and mental health professionals to create more space for representation of women's needs as well as those of their babies.

Linked lives: Gender, family relations and recurrent care proceedings in England

In the wake of a “national care crisis” in England, an increasing number of parents return to the family court as repeat respondents in care proceedings and lose successive children from their care. Despite considerable progress in understanding the trends and patterns of mothers' (re)appearances in care proceedings, knowledge of fathers and of parents' family relationships in recurrent care proceedings remains very limited. Whilst such relationships are fundamentally at stake in care proceedings, they remain largely unexplored. Analyzing population-level administrative data from the family courts in England (2007/08–2017/18, N = 25,457 recurrent parents), we have, for the first time, uncovered a five-fold typology of family relations between mothers, fathers and children as they navigated repeated sets of care proceedings. We show that each identified profile is characterized by parents' gender as well as distinctive life-course positions of the parents and children. Our findings show that a substantial number of fathers are ‘visible’ in care proceedings, and that the majority of those that return to court do so with the same partners and children, as part of either a recurrent family or recurrent couple. Mothers' recurrence is characterized by their re-partnering experiences and lone appearances before the court. The results underscore the value of applying a relational approach in social work research and practice, to build a fuller picture of recurrent care proceedings. This research provides new evidence to inform the development of holistic, gender-sensitive and father-inclusive services in the English family justice system.

Who should pay for the continuity of post-trial health care treatments?

BackgroundThe bioethical debate in the world on who should pay for the continuity of post-trials treatment of patients that have medical indication remains obscure and introduces uncertainties to the patients involved in the trials. The continuity of post-trial treatment was only incorporated in the 2000s by the Helsinki Declaration. The Universal Declaration on Bioethics and Human Rights, published in 2006, points out that post-trial continuity may present a broader scope than just the availability of the investigated medicine. In the latest version of this Declaration, in 2013, it was stated that “prior to the start of the clinical trial, funders, researchers and governments of the countries participating in the research should provide post-trial access for all participants who still require an intervention that was identified as beneficial. This information should also be disclosed to participants during the informed consent process”. However, a systematic review on the registration of phase III and IV clinical trials, from the clinical trials website, demonstrated that the understanding of the various guidelines and resolutions is conflicting, generating edges in the post-trial setting. For the health authorities of countries where clinical trials take place, the uncertainties about the continuity of the treatments generate gaps in care and legal proceedings against health systems, which are forced to pay for the treatments, even if they are not included in the list of medicines available to the population.MethodsFifty-one representatives from the health, judicial, legislative, patient and academic organizations of eight countries of Latin American and South Korea took part in a meeting in Chile, in 2017, to discuss the responsibility of the treatment continuation after clinical trials. From a hypothetical case of development of a new drug and its studies of efficacy and safety, the participants, divided in groups, proposed recommendations for the problem and pointed out the pros and cons of adopting each recommendation. The groups were, afterwards, confronted by a simulated jury and, finally, issued a final recommendation for the problem. Then, an analysis was made on the content of the recommendations and the pros and cons in adopting conservative or liberal positions, besides the possible impacts of a restrictive regulation regarding the conduction of clinical trials, pointed out by the groups, before and after the simulated jury.ResultsThe theme was widely discussed and about 12 recommendations were proposed by the participants. The main ones took into account aspects related to patients’ rights, economic factors and the development of new technologies, above the position of industry and research institutes, as well as the legislation in force in each country.ConclusionThe countries of Latin America and South Korea, currently, do not have laws that address patients’ rights, moreover, there is no definition on who should be responsible for post-trial treatments. It is suggested that the World Health Organization issue a resolution recommending that all associated countries determine that the pharmaceutical and medical device industries, or those that sponsored it, should continue to provide treatment to all patients who participated in clinical trials and have medical indication to the continuity.

Care in crisis—Is there a solution? Reflections on the Care Crisis Review 2018

AbstractIn 2017, the number of applications for care orders in England and Wales was the highest ever recorded at 14,207. This is a significant factor, contributing to the rise in the number of children who are looked after, which is at the highest level since 1985.The authors reflect on the recently published Care Crisis Review 2018, a sector‐led review, which examines the reasons for the rise in care proceedings and the number of children in care. The review sought to identify changes to policy and practice within local authorities and the family justice system, in an attempt to divert cases away from the family courts and to reduce the number of children in care, where it is safe to do so.Whilst the legislative framework is largely effective and the system generally works well, there is insufficient funding and resources to meet the needs of children and their families when they seek help, regardless of whether this is at an early stage or when they are in crisis and most in need of care and protection.

Courts, care proceedings and outcomes uncertainty: The challenges of achieving and assessing “good outcomes” for children after child protection proceedings

AbstractThe professed aim of any social welfare or legal intervention in family life is often to bring about “better outcomes for the children.” But there is considerable ambiguity about “outcomes,” and the term is far too often used in far too simplistic a way. This paper draws on empirical research into the outcomes of care proceedings for a randomly selected sample of 616 children in England and Wales, about half starting proceedings in 2009–2010 and the others in 2014–2015. The paper considers the challenges of achieving and assessing “good outcomes” for the children. Outcomes are complex and fluid for all children, whatever the court order. One has to assess the progress of the children in the light of their individual needs and in the context of “normal” child development, and in terms of the legal provisions and policy expectations. A core paradox is that some of the most uncertain outcomes are for children who remain with or return to their parents; yet law and policy require that first consideration is given to this option. Greater transparency about the uncertainty of outcomes is a necessary step towards better understanding the risks and potential benefits of care proceedings.

“..that warm feeling that [alcohol] gave me was what I interpreted love would feel like..” Lived experience of excessive alcohol use and care proceedings by mothers in the family justice system in the UK

BackgroundWhen mothers who have been identified as using alcohol excessively appear in child care proceedings seeking to retain care of, or be reunited with, their children, family courts primarily focus on whether those mothers can make lasting changes to their use of alcohol, very often requiring them to achieve abstinence. The aim of this study was to advance the evidence base around how such mothers make sense of their alcohol use, and their position as mothers, in the systems and processes around care proceedings. MethodsQualitative, face-to-face interviews were carried out at various children and families' services locations across the UK. These yielded in-depth accounts, to which Interpretative Phenomenological Analysis (IPA) was applied. ResultsSix mothers were recruited from collaborations with 31 local authorities. Themes relating to alcohol use included relationships in childhood, repeated traumatic events, and the use of alcohol to self-manage these. In response to extreme fear arising from violence in their relationships with older men, alcohol provided the means to function. Escalation of alcohol use in participants' lives was accompanied by greater isolation, alongside shameful feelings about being a “drunk”, which were barriers to help-seeking. Themes relating to motherhood in the context of care proceedings included wanting to change behaviour for themselves and their children, being excluded from their children's lives, and experiencing a continual requirement to prove their parenting and their abstinence from alcohol. Language used by social services, the courts and alcohol treatment services, placed mothers in conflicting positions of being in recovery, but having to present as recovered. ConclusionDespite excessive alcohol misuse in mothers being closely enmeshed with other issues, awareness and understanding of factors such as complex trauma, and how to support mothers with these factors, is limited, and should be considered in terms of improving research and best practice.

Infants in care proceedings

Toni Badnall-Neill explains how commissioning can support better outcomes for very young children taken into care

Duration of care proceedings off target

The time it takes care proceedings to be completed is rising and Cafcass chief Anthony Douglas says it is likely to continue

Frontline funds: social workers to get budgets to support families

Councils are to trial giving social workers money to spend on practical help for families, such as a new fridge, short break or childcare. Experts say the funding will be targeted at children most at risk of care proceedings

Parent training interventions for parents with intellectual disability.

Research suggests that the number of intellectually disabled people with children is increasing. Intellectual disabilities do not inevitably cause parenting difficulties, but it may impact on an individual's capacity to parent a child effectively. Children of parents with intellectual disabilities may be at increased risk of neglectful care, which could lead to health, developmental and behavioural problems, or increased risk of intellectual disability. Compared with other parents, those with intellectual disabilities are more likely to be involved in care proceedings. To assess the effectiveness of parent training interventions for parents with intellectual disabilities designed to support parenting, parent-child relations, safe parenting or family environments, or to develop parenting skills. In July 2017, we searched CENTRAL, Ovid MEDLINE, Embase, CINAHL and six other databases as well as two trials registers. We also searched reference lists of included studies and contacted experts in the field to identify additional ongoing and unpublished studies. Randomised controlled trials (RCTs) and quasi-RCTs comparing parent training interventions for parents with intellectual disabilities with treatment as usual or a control group. We used standardised Cochrane methods. As of July 2017, we identified four trials with 192 participants that met the review inclusion criteria. Participating parents were mostly mothers (seven fathers were included in two studies), and children's ages ranged from one month to six years and five months.One study was conducted in Australia, one in Canada, one in the Netherlands, and one in the USA. Each studied a different intervention and considered different outcomes. Three interventions were delivered at home, and one in a community venue (e.g. a church). Interventions varied in duration from seven weeks to 12 months. They included a range of practical childcare skills, home safety and developing parents' ability to respond sensitively to their children. Parents in the comparison groups included in the review received treatment as usual and most of these received the index intervention after the study was complete.One study was funded by the Ontario Mental Health Foundation and the Ontario Ministry of Community and Social Services Research Grants Program; one by the Alabama Development Disabilities Council; one by the Best Practice Parenting Education Initiative of the Commonwealth Department of Family and Community Services and the New South Wales Aging and Disability Department; and one by ZonMw, The Netherlands Organisation for Health Research and Development.It was not possible for us to conduct a meta-analysis. The GRADE quality assessment varied from very low to moderate across the studies.Primary outcomesNo study reported on the 'attainment of specific parenting skill targets'.'Safe home practices' and 'understanding of child health': one study (30 parents, very low-quality evidence) reported some improvements in parents' knowledge of life-threatening emergencies, ability to recognise dangers, and identify precautions, in favour of the intervention group. It also found limited, very low-quality evidence that parent training improved parents' ability to understand child health, implement precautions, use medicines safely, recognise child illness and symptoms, and seek medical advice (i.e. visit the doctor). Another study (22 mothers, very low-quality evidence) reported improved attainment of skills related to childcare and safety, in favour of the intervention group.Secondary outcomes'Parent-child interaction': one study (40 mothers, very low-quality evidence) reported improved maternal-child interaction following parent training at 12 months follow-up. Another study (83 mothers, 2 fathers, moderate-quality evidence) reported that inclusion in the intervention group led to a steeper decline in parenting stress related to the child compared to the control group.'Parents' retention of child': one study (22 participants; very low-quality evidence) reported that before joining the programme nine of 11 (82%) families with a previous child had had the child removed from their care by child protection authorities due to maternal maltreatment, compared with only four of 22 (19%) families after participating in the programme (only one of these four mothers had also had a previous child removed).No study reported data on: 'return to independent care of child' or 'lifting of child-related court order'. There is some very low-quality evidence that some parents, mainly mothers, with intellectual disabilities are able to provide adequate parenting if they are given appropriate training and support to learn the parenting skills they need. However, there are few studies exploring how interventions might work, for whom and in what circumstances. In particular, there have been few studies that include fathers with intellectual disabilities, or that explore the views of parents themselves.There is a need for larger RCTs of parenting interventions, with longer follow-up, before conclusions can be drawn about the effectiveness of parent training for this group of parents.

How does FDAC Succeed with Parents with Substance Misuse Problems? Exploring Relational Practices within the English Family Drug and Alcohol Court

Parental substance misuse is a significant risk factor for child maltreatment and is frequently involved in care proceedings. Outcomes are often poor and family reunification is prone to breakdown. In this article, the contribution of the English Family Drug and Alcohol Court (FDAC) is examined. Adapted from the US family drug treatment court model, FDAC offers a radically different approach to ordinary care proceedings by treating parents as well as adjudicating. The article draws on a mixed‐methods evaluation of FDAC which reports better recovery and reunification rates than ordinary court. It presents findings from interviews with 42 parents and 154 court observations of 89 cases, focusing on FDAC's relational practices. The article concludes that these relational practices offer hope to substance‐misusing parents and that the approach merits wider attention because of its therapeutic potential and distinctive approach to justice.‘The contribution of the English Family Drug and Alcohol Court (FDAC) is examined’Key Practitioner Messages FDAC is a helpful approach to care proceedings for substance‐misusing parents. Parents value clear, consistent and honest messages about their progress when delivered in the context of trusted relationships and intensive support. Parents need holistic help that takes into account damaging early‐life experiences. ‘Parents need holistic help that takes into account damaging early‐life experiences’

‘She was there if I needed to talk or to try and get my point across’: specialist advocacy for parents with intellectual disability in the Australian child protection system

ABSTRACTParents with intellectual disability are overrepresented in child protection matters due to a combination of socioeconomic disadvantage and assumptions of parenting incapacity by child welfare workers and courts. Inability to understand the investigation process or instruct a solicitor can deny these parents equal access to justice. Specialist support can ensure parents exercise their legal capacity to participate in proceedings and have their views heard. Semi-structured interviews were undertaken with parents with intellectual disability (n = 10) who accessed a specialist advocacy programme in New South Wales, Australia. Thematic analysis was used to identify the influence of advocacy on parents’ experiences. Parents felt powerlessness as they navigated a bewildering child protection and court system that had prejudged them unfit to parent. This compounded the grief and loss of child removal. The advocate played a critical role in creating a bridge between parents and professionals. This helped to build parents’ skills and confidence and improve the disability awareness of professionals. Specialist advocacy for all parents with intellectual disability in care proceedings is consistent with Australia’s obligations under the Convention on the Rights of Persons with Disabilities.