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Resistant Families

Working with Resistant and Non-Compliant Families

Introduction
This guidance has been developed in response to the recommendations arising from both local and national Serious Case Reviews. The current SCB interagency procedures guide workers to address resistance from families on a multi agency basis and recommends that a strategy meeting should be convened to consider the impact on the children and determine any further action required to safeguard children.

Additionally multi agency case supervision can be undertaken in order to explore ways forward.

Purpose
The purpose of this guidance is to:

  • Assist staff working with hostile/threatening and non-compliant parents/carers and those who use disguised compliance.
  • Help workers identify where these actions may be impacting on childcare/child protection issues.

Therefore this guidance is to assist with those situations where families are unable or unwilling to engage in partnership with workers to effectively promote and safeguard the welfare of children.

Context

  1. The nature of child protection work is such that parents and carers may at times feel angry and react in a hostile or threatening way towards workers who are involved with them and their families. The agencies policies and procedures for the safety of their staff should be made known to all staff.
  2. Employers should have in place practical day-to-day processes to support staff who may be undertaking home visits. Practical procedures should include the provision of mobile phones and logging with colleagues where you are going and your anticipated return time.
  3. Recognition must be given by managers to the impact on social workers and other staff of parental aggression and any fear that is aroused in them and the consequences for decision making and practice. Adequate professional supervision and support must be given in these situations.
  4. The Department of Health has recommended methods for training social care students and practitioners in order to assist them in dealing with situations in which they may feel threatened or fearful. Properly prepared and disciplined discussion is important, together with an analysis and an understanding in the different ways in which practitioners may be affected. They further recommended that training should be ongoing.

Principles

  • Workers in Stoke-on-Trent serve a diverse population with differing needs. Practice needs to be inclusive to reflect these differences. All agencies should have in place procedures and guidance for working with parents/carers and the approach needs to be positive and anti-discriminatory with effective communication. If communication is not clear people may behave in a way that seems to be non-compliant where in fact the issue may be one of developing effective communication.
  • Confidentiality must not compromise the welfare and protection of children. “Working Together to Safeguard Children” (2013) states that agencies should have arrangements in place to work effectively with other organisations to safeguard and promote the welfare of children, including arrangements for sharing information.

Where non-compliance is an issue, sharing information across agencies can assist in forming a plan to address this.

Definitions
For the purpose of this guidance the following broad definitions are being used:

Resistant and Non-compliant
behaviour which produces damaging effects, physically or emotionally, in other people and involves proactively sabotaging efforts to bring about change or alternatively passively disengaging.

Non Effective compliance
; involves service users not admitting to their lack of commitment to change but working subversively to undermine the process due to concealment, superficiality, dishonesty or incapability.

Recognition of Hostility and Non-Compliance
Factors associated or contributing to hostility and non-compliance include:

  • Isolation
  • Stress and violent experiences in childhood
  • Disinhibiting effects of alcohol and certain drugs
  • Mental illness
  • Some psychotic states
  • Sensory impairment and;
  • Medical or social history indicating a low tolerance or frustration and the potential for violence

Situations associated with resistance and non-compliance includes:

  • Child protection enquiries
  • Removal of child into care
  • Domestic abuse
  • Previous threats of violence
  • Presence of weapons
  • Potentially dangerous animals (snakes/dogs)
  • Research showed that “high levels of parental mental illness, alcohol and drug misuse and domestic abuse feature significantly in families where children become involved in the child protection system” and these factors need to inform any assessment and ongoing work.

Recognition of Non-Effective Compliance
Factors, which may indicate and evidence non-effective compliance:

  • No significant change at reviews despite significant input
  • Parents/carers agreeing with professionals regarding required changes but put little effort into making changes work
  • Change does occur but as a result of external agencies/resources not the parental/carers efforts
  • Change in one area of functioning is not matched by change in other areas
  • Parents/carers will engage with certain aspects of a plan only
  • Parents/carers align themselves with certain professionals

Effect on Professional Practice and Decision Making
People naturally tend to evade frightening confrontations. When workers are involved with families who are known for hostile, resistant or exhibiting bizarre behaviour, or where the worker feels uncomfortable, suspicions of child abuse may not always be as thoroughly investigated into or followed through as they might otherwise have been. For example:

  • Only one ring at the door bell /deliberate light tapping at the door
  • Only waiting 5 minutes for the family to arrive for an appointment
  • Not challenging when appointments are missed or the family arrive late
  • Not challenging lack of change with the family
  • Accepting unlikely explanations
  • Lack of agency challenge when staff are involved in above
  • Managerial / professional collusion with staff in respect of poor family engagement

To confront parents/carers may, in the mind of the worker produce a hostile response or lead them to believe any positive professional relationship will be lost. This may result in professionals colluding with the family and failing to protect the child.

Workers may also misinterpret the behaviour of parents/carers. What may appear to be defensive/uncooperative behaviour may be designed to mask hidden issues in the family such as domestic abuse, mental ill health and drug or alcohol misuse and child protection issues.

If workers have a poor understanding of the symptoms of mental ill health, child protection, drug/alcohol misuse/domestic abuse and the consequent impact on the family they may operate at a lower level of expectation and the impact on the child is not recognised.

Clients Using Non Effective Compliance
Workers may believe they have engaged in a positive way with parents/carers in addressing risk and working towards change. However, this may not be the case. As a consequence the following may happen:

  • Cases can drift
  • Risks are not reduced
  • Risks may actually be increased and
  • Workers may fail to recognise significant issues of concern, misinterpret vital information and lose interagency communication

The child, therefore, remains in a high risk, unprotected environment.

Interagency Communication
The Stoke-on-Trent SCB Information Sharing Protocol promotes multi agency communication and is the agreed basis on which information across agencies will be shared. (See Procedures Section A07).
The Victoria Climbie Enquiry states “The Government should issue guidance on the Data Protection Act 1998, the Human Rights Act 1998 and common law rules on confidentiality. The Government should issue guidance as and when these impact on the sharing of information between professional groups in circumstances where there are concerns about the welfare of children and families”. (January 2003) - Recommendation 13
The Government have acted on this recommendation and has produced guidance “What to do if you're Worried a Child is being Abused” contains a lengthy guide on information sharing.

Training
Whether working with complex families with issues of hostility and compliance or with families where there are issues of domestic abuse/mental ill health, child protection and alcohol or drug misuse, it is essential that workers are able to assess the motivation to change of their clients. Their ability to do so may be impaired when working with this service user group.

To compliment training in assessment and analysis there is a need to develop a more experimental approach looking at the feelings that can be engendered in workers and the possible effects on practice and decision-making.

Please refer to this website for details of safeguarding training opportunities: Professionals / Training

Supervision
Managers have a vital role in providing the environment and mechanisms to allow workers to explore the impact of working in such situations and the effect on their practice.

Managers are responsible and accountable for providing workers with support and supervision, in accordance with the agencies policies to enable them to voice their fears and concerns and ensure that the response should include appropriate action being taken.
If any worker feels uncomfortable or unhappy about working with a family, they must immediately consult with a supervisor, so that the problem can be shared. Asking for support is not a weakness in practice. The worker should record their feelings so that other professionals are alerted to the issues and a multi agency meeting convened if necessary.

Risk Assessments
Employers have responsibilities under the Health and Safety at Work Act 1974, the management of Health and Safety at Work Regulations and the Workplace Regulations 1992 for the safety of staff.

Risk assessments should, wherever possible, include other agencies involved with the children and their families. The outcome of the risk assessment undertaken by a single agency should be shared with any other agency known to be involved with the child or family.

The outcome of the assessments should ensure that in addressing staff safety, the needs of the children are not compromised and that action is taken to ensure children’s needs are actively considered and are paramount.

Joint Visits and Consultation with other Agency Staff
Where there is the presence of a contributing factor, multi agency joint visiting should be the “norm” wherever possible. Visiting with a colleague from the same team and acknowledging that workers in some agencies are more competent in working with service users with particular needs or behaviours.

Chronologies
The recording systems are important in assisting workers in identifying patters of non-effective compliance and drift. The use of chronologies are a useful tool and should be standard practice. They will aid the analysis of information, allow for the recognition of developing patterns and promote effective case management.

Management Action
The welfare of the child is paramount and workers across agencies must work together to ensure that the welfare of the child is maintained with clear lines of communication, accountability and joint working. This is particularly important when a child is not subject to a Child Protection Plan.

Where there is evidence of non-compliance and concerns for the child/ren remain, managers must take immediate action to put in place strategies for acting on the concerns and safeguarding children.

Managers must ensure that children are seen and timescales for reviewing progress of plans are set and monitored regularly.

  • Defaulted visits and appointments should be rigorously followed up and any more than three defaulted visits should alert staff and managers to convene a multi agency meeting.
  • Where the child is not subject to a Child Protection Plan a multi agency meeting should be convened within 7 working days to consider the concerns, the impact on the child and identify a plan to address the concerns.
  • Where a child is subject to a Child Protection Plan, the Core Group should be convened immediately within 3 working days to review the Child Protection Plan and develop appropriate plans to safeguard children, including consideration for removal of the children.

These actions should be recorded and their presence made known to workers and partner agencies who are involved with the family and who may subsequently be required to visit.

Managers must ensure that their agency procedures and the SCB multi agency Child Protection Procedures are followed.

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