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A Bright Future Choked by Neglect…? Inter-agency Working and Serious Case Review: A Case Study @SWSCmedia

Will you close the case or will you refer this for a serious case review?

Join us and share your views today (Sunday, 19 August 2012) at 6:00 PM BST (UK) / 1:00 PM EDT / 10:00 AM PDT @SWSCmedia.

You are a newly qualified social worker working in a central London local authority in a child protection team. Although newly qualified, you feel confident and do not consider yourself as newly qualified. In a conversation with one of your colleagues complementing you about your abilities, you explain that you have worked as a social work assistant for many years and in a way, have ‘seen it all too often’.

As a social work assistant, you followed both the Baby Peter and Victoria Climbie cases with interest wanting to understand the dynamics of what went wrong so that you won’t repeat it in your practice. You feel that at the heart of the problem was the lack of inter-agency working between professionals and believe that given your experience and knowledge of the sector combined with good communication skills you will not encounter any problems with inter-agency working.

It’s Monday morning and you are on duty desk when you receive a police referral stating that neighbours had called the police due to disturbance at a family home. The police found a ‘well presented’ intoxicated women and her teenage son Jack (aged 13). You do a check on the system and note that the family is not known to services. You log the referral on the computer system (FrameworkI) and discuss the case with your manager. The manager asks you to complete an initial assessment.

You undertake a home visit and mother apologises to you stating that she is sorry about the disturbance and explains and that she just had a little bit too much to drink. She goes on to say that this is completely out of character for her. She owns her own business which is rather successful. She is not married to Jack’s father and they are no longer in a relationship.

She invites you to look around her home and asks if you would like to see Jack. You confirm that you would and she introduces you to Jack and leaves you alone while she goes to the kitchen to make tea so that you can speak with Jack.

Jack is a bright and articulate 13 year old, he states that it was out of character for his mother to drink and that she never really drinks and suggests that perhaps this is the reason for her becoming intoxicated so quickly. He also states that he believes the neighbours called the police as he was playing his music too loudly and apologises.

You ask mother whether she provides consent for inter-agency checks mother explains that she would feel very embarrassed if her GP or the School were to find out that she had a visit from a social worker. Mother provides a recent report card and Jack is doing well achieving straight A’s. She also shows you a prize Jack won for an essay he wrote at school. You ask whether there is any professional she provides consent for you to contact and she states she can’t think of any.

You discuss the case with your manager and it is agreed that the case is closed and it seems that this was a ‘one off incident’ and although inter-agency checks were not carried out you saw written feedback from the school and all this seems appropriate and fine.

One month later and you receive a second referral for the family stating that police were called to A&E as mother presented intoxicated with a broken arm and Jack looked ‘dishevelled’.

You visit the family the next day and mother explains that her arm was very painful this resulted in her taking painkillers and when it felt that they were not working she decided to have a glass of wine with it and when this was still not working she decided to go to A&E.

You ask her if she drove to A&E and she explains that she took a cab with Jack as her arm is broken and she cannot drive. You speak with Jack and he states that his mother has had a very difficult time and he told her not to have wine with the painkillers but she was in so much pain she could not help herself.

You discuss the case with your manager and it is agreed that the case with stay open for you to undertake a core assessment as there are concerns around mother’s drinking. You see mother the next day and she explains that she still feels uncomfortable with the inter-agency checks and gives you permission to contact A&E to share information and undertake checks. However, she does not want you to contact Jack’s school or GP as she will find this too embarrassing.

She also informs you that Jack will start boarding school in a month’s time and provides you with written information to confirm this. She also provides you with a letter from the doctor reminding her to bring Jack in for an appointment for his asthma. You feel confident that although you have not contacted the agencies you have written information from them and all seems fine.

You undertake 3 more home visits and mother provides further information regarding Jack starting boarding school. The visit before the case is closed mother provides you with an email from the head of Jack’s boarding school stating that he is doing excellently at school and is adjusting very well to his new environment. During this period mother has been very forthcoming and remained engaged positively with you throughout the process. Furthermore, to allay your concerns regarding her drinking, she started and successfully completed a detox programme. Given all the positive improvement and that Jack is now at boarding school coming home once a month you and your manager decide to close the case. Mother thanks you for your involvement.

On a Monday morning, 6 months later, you are on duty desk and your receive a telephone call from A&E informing you that Jack died on Sunday night, and that doctors suspect that mother neglected his health and did not pay due attention to the severity of his asthma. Jack was at home when he had an asthma attack and did not have his inhaler. His mother had called the ambulance, but, he passed away on his way to the hospital. You are shocked and shaken by the news and speak to your manager who informs you to prepare for a “First Response” meeting where the case is re-examined by the relevant professionals involved.

In the “First Response”, Jack’s doctor, who you meet for the first time, presents letters showing that he was concerned about whether the mother was taking Jack’s asthma serious enough. You had never seen these letters before.

Each professional presents his/her case documentation and reasoning stating how they had done all that was possible for Jack. At this stage, the participants expect an explanation from you regarding your handling of the case and raise questions such as: why was the case closed when Jack’s asthma was a life-threatening risk and when there were concerns for mother’s drinking and possible neglect?

Aware of the new information and reflecting back on your practice:

Do you think the case was closed inappropriately?

Do you think there was neglect on the part of the mother? and If yes, should this go to serious case review?

Were you negligent or too optimistic in your practice?

Was there something that any of the professional could have done that could have prevented Jack’s death?

Was Jack’s death an unfortunate outcome due to him forgetting his inhaler at the boarding school? and therefore, should the case be closed?

Join us and share your views regarding these and other relevant questions today (Sunday, 19 August 2012) at 6:00 PM BST (UK) / 1:00 PM EDT / 10:00 AM PDT @SWSCmedia.


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