Keeping severely harmed children with their extended family is not necessarily the best course of action for the child say Susie Essex, John Gumbleton and Colin Luger.

The Children Act 1989 takes the view that children are usually best placed with their immediate family and encourages the development of co-operative relations with parents or carers, even in cases where children have been seriously harmed.

Where it is not possible for children to remain with their immediate carers, the mobilisation of extended family support is encouraged. However, in both moral and legal terms there is an overriding duty to treat the child's welfare as paramount. This duty is at its most stark in cases where young children have been badly injured.

Our experience of working with families where very young children have suffered extreme physical injury - probably one or two per cent of all child protection investigations - has raised serious issues about the best approach to take. Children Act guidelines indicate alternative placement within extended families wherever possible, ideally by voluntary agreement.

But such placements often happen hurriedly after the discovery of sever injuries to a child. This leaves little time for a meaningful assessment of the suitability of the proposed new carers. Basic checks can be completed swiftly, but there may be areas of concern that only come to light when a more in depth assessment is made. There may then be resistance to moving the child a second time, before a final decision is taken regarding its rehabilitation.

One of the assumptions underlying placement in the extended family is that it will be safer than leaving the child with its present carers. But this may not be the case. And once a voluntary agreement has been reached, care proceedings are no usually considered.

Most of the situations we encounter have involved injured children being placed with grandparents. Conflicts of interest can arise between grandparents wanting to protect their grandchildren, but also their son or daughter. This can be exacerbated when there are stringent contact arrangements that they are expected to "police".

It can also be difficult for the extended family to fully accept that one of their relatives could have seriously injured their own child, especially if they are denying responsibility. It can be many months before professionals have fully assessed the cause of injuries, and decided whether rehabilitation should be considered. Meanwhile, the new family carers may become very attached to the child and find it hard to work towards rehabilitation, especially if they have concerns about their future safety.

For rehabilitation to succeed, the co-operation of the extended family is crucial. Without it, any smooth transition to the child's original carer - or to a foster or adoptive placement - will be very difficult, causing added emotional disruption to the child.

In these circumstances, the concept of a truly voluntary agreement between the local authority and family members is often a fallacy. The proposed new carers may come under extreme pressure form other family members to accept the child. And the agreement often consists of little more than a list of demands by the professionals, with little real input from the family.

Extended family members can find themselves torn between child care agencies and the original carers, fulfilling many of the roles of a foster placement without the assessment, preparation, training and support that many foster carers receive. This is obviously not fair to them and may lead to unrealistic expectations from professionals.

During relatively short placements in extended families the injured child often does well. This makes it more difficult to secure a long term placement outside the family should rehabilitation to the child's carers not be considered safe, and where long term placement in the extended family is not in the child's best interests.

We believe that in those few cases where very young children receive serious injuries - and it is not clear who is responsible - the following procedures would create greater safety for the child, and more clarity for families and professionals:

• Care proceedings should be initiated immediately and the court asked to make an Interim Care Order that clearly defines conditions and agreements;
• In cases of severe injury the child should be placed with foster parents. To minimise emotional damage, we would suggest a high-level of supervised contact with the original carers, at lest until the child is settled in the foster home;
• If a young child or baby is placed in the extended family, an Interim Care Order helps make clear on what basis; the seriousness of the concerns; and the local authority's powers. Court orders can be used therapeutically, not just as a punitive measure. In such situations, work will need to be undertaken with the extended family around such issues as divided loyalties; and
• With babies and young children it is crucial to begin a comprehensive child protection assessment as soon as possible.

While we generally agree with placing children in their own families wherever possible, this is not always appropriate. There can be disadvantages to children in applying this general principle in situations of severe abuse where responsibility for the injuries is unclear or denied. In these rare, but very serious, cases we believe the alternative ways we have suggested often meet children's best interests more closely.

Susie Essex, John Gumbleton and Colin Luger work for the NSPCC Avon Child and Family Centre, but are writing in a personal capacity.