Children’s social work teams failed to respond appropriately to over a fifth of referrals from adult services that raised substantial concerns over the impact of parental mental health issues, a review has found.
A joint Ofsted/Care Quality Commission (CQC) analysis of 105 case records from nine local authorities found that children’s teams had wrongly made an initial decision to “take no further action” in more than one in five cases where the level of concern raised by adult mental health services merited a response.
In half of those cases, adult social workers were forced to make “repeated referrals” before children’s social care teams decided to take action, inspectors found.
In some cases children’s services had “not given enough weight” to concerns raised by adults practitioners, while in others the concerns had not been communicated clearly enough by adult teams.
Communication was often poor between adult mental health services and children’s social services departments, the review found.
“In a few areas there were good examples of referrals being robustly followed up by adult services. However, adult services did not consistently challenge decisions they were unhappy with,” the Ofsted/CQC report said.
“While staff were generally aware that there were escalation processes in place, these processes were not used in the cases examined even when adult services remained unhappy with the decisions made.”
The extensive review found that the quality of joint working between adult and children’s services “varied considerably”. The quality of joint working was stronger between children’s social care and adult drug and alcohol teams, than between children’s social care and adult mental health services.
Other issues raised by the report include:
- Assessments were not consistently seen as a shared activity between children’s social workers and adult mental health practitioners.
- The majority of assessments of children where parents or carers had mental health difficulties did not provide a comprehensive analysis of the impact of their mental ill health on the child.
- Parents cutting themselves or taking overdoses featured in a lot of cases, but the impact this had on children “was not always recognised and assessed” by professionals.
- Risks posed to children by parents or carers’ mental ill health were not “identified early enough”, in some cases due to adult practitioners failing to recognise the impact.
- In many cases child protection conferences and reviews, core groups and child in need reviews were well attended by mental health practitioners. But in some areas adult services staff said that workload problems sometimes affected their availability to attend relevant meetings.
- Shortfalls in data collection, and in some cases staff not completing forms, meant it was difficult to determine from most mental health records if there were children in the household or if the adult with the mental health difficulties was a parent or carer in contact with children.
On the basis of the findings, the CQC and Ofsted has recommended that the government should require mental health services to collect data on children whose parents or carers have mental health difficulties. Local areas are already required to report on the number of users of drug and alcohol services who are parents.
Sally Rowe, deputy social care director for Ofsted, said:
“If children living with parents with mental health problems are to receive the right support and protection then the same level of scrutiny should be applied as those whose parents have issues with substance abuse. That is why we believe it should be a mandatory requirement for this data to be collected to ensure local agencies are focused on the needs of these children.”
Philip King, director for regulatory development at the CQC, said:
“The point of our joint work is not to question the parenting ability of people with mental health problems, many lead perfectly ordinary family lives. However, information from some notable serious case reviews highlight the fact that some parents and their children need additional support due to the effects that mental illness can have on families.”
“In these circumstances identification and early help is key, and this is what we have identified as the issue,” King added.
Andy McNicoll is Community Care’s community editor