10.3 Joint Services Protocol re: Families and Children Affected by Parental Substance Misuse

Working Together to Safeguard Children A guide to inter-agency working to safeguard and promote the welfare of children states. "It is the responsibility of LSCB's to take full account of the particular challenges and complexities of work in this area by ensuring that there are appropriate:

• LSCB policies and procedures in place;
• Interagency protocols in place for the coordination of assessment and support, particularly across adult drug and alcohol services and Children's Services;
• Close collaboration with local Drug Action and alcohol services, as well as a number of other agencies including heath, maternity services, adult and children's social care, courts, prisons, and Probation Providers";
• Substance misuse is a factor in a significant number of children in need and child protection cases. A third of all adults in drug treatment have childcare responsibilities, for some this encourages them to seek treatment, and being in treatment will be a significantly protective factor for the children. Data shows that parents that enter treatment are retained and successfully complete their treatment at a similar level or better than other people in treatment. However some of the children affected may be at risk of neglect, they may be taking on inappropriate caring roles and in some cases they may be experiencing serious harm.

• Misuse of drug and/or alcohol by parents/carers does not on its own automatically indicate that children are at risk of abuse or neglect, although it is essential that all workers recognise that this is a high risk group;
• Conversely it is important to be mindful that misuse of drugs and/or alcohol by other significant people in a child/young person's life, who are not primary carers, such as a sibling, a parent's new partner, other family member, and frequent visitors to the home, may place the child in an environment of drug/alcohol misuse that may mean they are at risk of harm * Agencies who work with parents/carers should be aware that parental drug/alcohol misuse, and an environment of, drug/alcohol misuse could affect that the quality of parenting provided to the children in the household;
• In these environments, where drug or alcohol misuse is a feature, children often do not receive the level of care needed in order to meet the Government's Every Child Matters Outcomes: stay safe, be healthy, enjoy and achieve, make a positive contribution, achieve economic well-being either in the short or the longer term;
• If there is a concern that a child may be a "child in need" due to living in an environment where drugs/alcohol is being misused, all agencies, subject to professional codes of confidentiality, have a duty to share information with Children’s Social Work Services. Their confidentiality codes must reflect this duty;
• When there are concerns about the parents' ability to provide adequate care, in such circumstances the needs of the child must be seen as paramount;
• The Children Act 1989 states that it is the duty of every local authority: to safeguard and protect the welfare of children within their area who are in need; and so far as is consistent with that duty, to promote the upbringing of such children by their families by providing a range and level of services appropriate to those children's needs.

• Children Acts 1989 and 2004;
• Every Child Matters DfES 2005;
• Hidden Harm (ACMD) 2003;
• Framework for Assessment of Children In Need and Their Families (DHSC 2000);
• Working Together to Safeguard Children 2015;
• Supporting information for developing local joint protocols between drug and alcohol partnerships and children and family services PHE Dec 2013;
• Silent voices - Supporting children and young people affected by parental alcohol misuse (Sep 2012);
• Munro review of child protection: final report - a child centred system 2011;
• What about the children?  Joint working between adult and children’s services when parents or carers have mental ill health and/or drug and alcohol problems (Ofsted 2013);
• Children's Needs-Parenting Capacity: Child Abuse-Parental Mental Illness, Learning Disability, Substance Misuse and Domestic Violence.

The Making Referrals to Children's Social Care Procedure outlines the referral process and thresholds for accessing a Social Work Assessment in Solihull.

Three sets of circumstances have been identified as warranting a referral to Children's Social Work Services.

• Where targeted support services have been offered but there is refusal or reluctance by the parent / carer to engage or engage consistently with the support being offered and therefore the identified cause of concern/need is not being addressed, i.e. no improved outcome for the child;
• Where targeted support services have been in place but the parent or carer appear unable to make the required changes in order to improve outcomes for the child;
• Where a child has been identified as having suffered or likely to suffer Significant Harm.

• Working Together to Safeguard Children refers to the report by the Advisory Council on the Misuse of Drugs, Hidden Harm, which estimated that there are between 200,000 and 300,000 children of problem drug users in England and Wales - i.e. 2-3 percent of all children under the age of 16;

• Working Together to Safeguarding Children (2010) (now archived) also refers to Strategy Unit figures (2004) that in England an estimated 1.3 million children are affected by parental alcohol misuse;
• Parental substance misuse can and does cause harm to children and young people at every age, from conception to adulthood, including physical and emotional abuse and neglect;
• Hidden Harm also states that a thorough assessment is required to determine the extent of need and level of risk of harm in every case.
• Individual pieces of information may not be significant in isolation, but when various pieces of information are collated and analysed from a child-focused perspective, there may be an indication that a child may be in need.

• Assessment is an ongoing process. The first stage of assessment starts when any professional becomes aware that there is a child in a drug/alcohol misusing environment;
• There are a number of assessment tools currently in use by agencies within Solihull, which differ between adult and children's services. It is essential that agencies that provide services primarily to adults assess needs in a way that includes and focuses on the needs of the child;
• Consultation about pregnant substance users should take place with Children's Social Work Services as early as possible in the pregnancy to assess the impact of substance misuse upon the unborn child and, if appropriate, enter in to relevant treatment;
• When confronted with a child in a drug/alcohol-misusing environment, professionals need to ask themselves, "What is it like for this child to live in this environment?" They need to also consider the impact of this experience on the child's welfare and well-being, both now and in the longer term;
• Areas to consider should include pregnancy, basic care, child's physical and emotional development, pattern of parental drug/alcohol use, procurement and financing of their use, health risks, professional and family support, violence, home environment, parental mental health, parents perception of their situation, any other substance users within the household or those with access to the child, historical concerns such as previous children removed;
• This framework attempts to provide a basis for professionals to begin to assess the impact that parental, or other significant persons substance misuse may have on the care of children in the family. It reinforces that substance misuse should be seen in the context of family life and functioning, not purely as an indicator or predictor of child abuse or neglect;
• Should professionals consider that the child is at risk of Significant Harm or at risk of needing to be accommodated now or in the foreseeable future, then they have a duty to refer the matter to Children's Social Work Services, in accordance with these procedures; 
• If emergency action may be necessary to safeguard the child(ren), then an immediate Strategy Meeting will be held;
• If it is not an emergency, then Children's Social Work Services will discuss the referral with the referrer and other relevant professionals (always with the police if there is a possible criminal offence), and decide what further action needs to happen;
• It is important to note that professionals do not have to be absolutely certain that the threshold for referral for Children's Social Work Services has been met before seeking advice about concerns, which have come to their attention;

• Each agency should have a copy of the LSCB's procedures and consider how they will compile their own procedures in order to implement this protocol;
• Each agency should ensure that all relevant staff receive training in the implementation of this protocol and the LSCB will provide Multi-Agency training in respect of the impact for children and young people living with a parent who has substance misuse issues or are exposed to substance misuse of another person in their home;
• Agencies need to ensure that staff members have the knowledge and skills needed to undertake the level of assessments that are expected of them relevant to their roles and responsibilities.