HEALTH PROMOTION: SCHOOL AGED CHILDREN USING THE COMMON
ASSESSMENT FRAMEWORK
The family to be assessed are the Webster family. Concern was raised when it was discovered that daughter Fiona, aged 13 years, was six months pregnant. Fiona lives with her mother, Elizabeth aged 32 years, her father, Will aged 30 years and three siblings. Fiona’s elder sister is Lucy, aged 15 years who is mother to a six month old baby boy. Her younger siblings are Tracey, aged 11 years and Paul, aged 4 years. It is noted that Will Webster is currently serving a two year prison sentence for theft and Elizabeth Webster is unemployed. Fiona attends the Newbury Pupil Referral Unit after a history of lack of attendance at mainstream primary school. This document will outline the process and outcome of the Common Assessment Framework carried out to recognise the needs of Fiona and her family and outline a proposed resolution to the benefit of those involved.
“The ‘Every Child Matters’ Green Paper proposed the introduction of a Common Assessment Framework (CAF) as a central element of the strategy for helping children, young people and their families.” (Dept. for Education and Skills Consultation 25.08.04, Dfes 1.1).
It was considered that there are five priorities to be address in carrying out this form of assessment. These are health, safety, enjoyment and achievement, promoting a positive contribution and economic well-being.
The issue of health cover both physical and mental health. The quality of living conditions and diet are also a priority.
Safety considers the level of protection overall and any possible neglect to the child or within the family.
It is important for the child to be encouraged to reach his individual potential and to develop skills which are required during and after transition to adulthood.
Children and families can be encouraged also to make a positive contribution to the surrounding society and to be discouraged from partaking in any criminal or antisocial behaviour.
Financial concerns need to be addressed in terms of an individual’s potential not being restricted by financial restraints.
Each of these criteria was considered in the case of the Webster family and will be discussed when the involvement of different agencies is addressed at a later point.
There are a wide variety of agencies that work with young people and their families and previously different agencies used different assessment formats to determine the facts and strategies needed. Frequently, a particular family will require the intervention of two or more agencies and, unfortunately, if each agency is assessing the situation according to its own criteria then it is possible that there will exist a distinct lack of coordination and interaction between professionals. This can result in a biased and sometimes detrimental outcome to the situation of concern. This can also result in overlap of information whereby families are ‘processed’ several times without any collusion between agencies.
“each agency has its own approach to assessment, there is a lack of coordination and consistency between them, in some cases leading to important needs not being picked up early enough, or at all, and in other cases leading to agencies asking families for similar information time and time again.” (Dept. for Education and Skills Consultation 05.08.04, Dfes. 1.1)
“Integrated working is where everyone supporting children and you people work together effectively to put the child at the centre, meet their needs and improve their lives.” (www.cwdcouncil.org.uk/what-is-integrated-working)
The use of an integrated working approach allows practitioners to identify the needs of the individual at an earlier stage, provide the suitable support for that individual and will produce a better outcome. There is a more complex mixture of the expertise and skills of the various professionals in conjunction with the needs of the individual and family.
The Common Assessment Framework aims to provide a client centred approach to the needs of young people and families. In the case of the Webster family the initial focus began with the PRU school nurse realising through discussion with Fiona that she was indeed pregnant. The school nurse became concerned about various physical symptoms which Fiona exhibited which were outside Fiona’s normal behaviour. During her periods, Fiona was usually given extra ‘quiet time’ to deal with painful cramps. Instead of these symptoms, it was noted that Fiona became frequently sick and pale, and tired and tearful. After a careful discussion with Fiona it was established that she was, in fact, pregnant.
“the Child Act, 2004, requires local authorities to lead on integrated delivery through multi-agency children’s trusts to develop and children and young people’s plan, and to set up a shared database of children, containing information relevant to their welfare.” (www.everychildmatter.gov/social care, welfare/protection)
The Common Assessment Framework provides an eclectic approach to assessment and implementation of what is deemed to be most beneficial for the individual and/or family. It is a form of assessment common across various services. Schools play an important role within this framework
“The Children’s Plan (2007) sets out the expectation that all schools will provide access to the core offer of extended services by 2010, including swift and easy access (SEA) to targeted and specialist services such as speech and language therapy, sexual health advice and support , Child and Adolescent Mental Health Services and Special Education Needs and disability services.” (www.cwdcouncil.org.uk/the common assessment framework and schools, fact sheet)
Every school will decide which member of staff is best suited to be fully trained in CAF procedures. After selection, the staff member will be required to undergo a comprehensive training process of relevant procedures. Frequently, staff involved in pastoral care are deemed most suitable although learning mentors, school nurses, head of years and headteachers can also be trained.
Managers of staff who carry out a CAF also is required to undergo training.
“School governors now have a statutory responsibility to promote the well-being of pupils. Schools are inspected against the five Every Child Matters outcomes as part of the new Ofsted inspection framework” (www.csdcouncil.org.uk/the common assessment framework and schools, fact sheet)
“Work is under way to develop and implement a national system of IT support for CAF (eCAF) to provide authorised practitioners throughout England with access to a system which allows them to store and retrieve CAF information electronically, across agency and geographical borders where necessary.” (www.csdcouncil.org.uk/ the common assessment framework and schools, fact sheet).
ContactPoint is an important part of the Every Child Matters programme. Its purpose is to improve services to children with strong emphasis on early intervention and prevention. It can take a lot of time to access different agencies but with this service, if all services are involved on a national system, it will work for children who receive a variety of services or who move across local authority boundaries.
The rationale is that basic details will be held on every child in England, along with details of names and contact for parents, guardians, GPs, schools and any other service dealing with the young person.
“Explicit consent will be required to record contact details for sensitive services (defined as sexual health, mental health and substance abuse” (www.everychildmatters.gov.uk)
Security of information is paramount to ContactPoint – professionals require specific training of the service, undergo enhanced CRB disclosure and there are several case management systems in operation. “The Regulations, which came into force on 1 August 2007, provide the legal framework for ContactPoint under section 12 of the Children Act 2004.” (www.everychildmatters.gov.uk)
Once it was established that Fiona was definitely pregnant, it was important to establish the estimated delivery date and also assess Fiona’s general health and also that of the baby. Fiona agreed to a home visit by the school nurse in order to support her in telling her mother of her condition. Fiona was anxious because her sister had recently undergone a similar situation and she was afraid that her mother would take the news very badly. Fiona generally has a good relationship with her mother and immediate family although there has been a background of problems arising from Fiona’s association with pro-criminal peers. Fiona’s mother does find it difficult dealing with her children’s choice of friends and feels quite isolated with her husband in prison. Elizabeth does, however, support her children and grandchild to a good standard and does keep the home clean and tidy despite damp and cramped conditions. Elizabeth did not seem shocked by the pregnancy news and did state that she would agree to attend medical appointments with Fiona and give her support where possible.
The family’s physical needs are met by Elizabeth – all physical needs are met and she ensures that the children are protected from harm and danger, including self harm. There is no evidence of parental substance abuse and Elizabeth does try her hardest to provide a moderate quality of care with consideration to housing issues and also financial restraints.
An appointment was made for Fiona to attend the local general practice to see her doctor. She was accompanied by her mother who is being very supportive of her daughter. After a pregnancy test confirmed the pregnancy, the usual appropriate checks were carried out. Fiona was referred to a health visitor and also appointments were made for her to attend the anti-natal clinic at the local hospital as an emergency patient. It was important to establish an expected delivery date and to do the routine scans and blood and urine tests.
The GP, family doctor, took time to talk through the important emotional feelings of both Fiona and Elizabeth. Emotional warmth and stability was considered. Both were positive about the baby and there seemed to be a bond between mother and daughter demonstrated by physical contact, comfort and cuddling which demonstrated a secure attachment. Fiona has always refused to say who the father of her baby is.
The referral was made to the health visitor who would give Fiona and Elizabeth appropriate advice throughout and after the pregnancy and birth. Fiona will be encouraged to develop a more mature sense of self esteem and understanding of the responsibility needed as a young mother. It was established that Fiona needs opportunities to gain confidence in her potential parenting skills and that she realises that there will be a high level of support given to her. She will be in close contact with her health visitor to ensure that all aspect of mother and baby care and made clear, precise and Fiona knows that she does have a high level of support from a variety of agencies dealing with teenage pregnancy. Fiona will be put in contact with a variety of teenage pregnancy support groups as well.
It is essential that Fiona continues her education during the remainder of her pregnancy and also in the time after birth. It has been explained to Fiona that it is important for her to continue her studies even on a part time basis over this period. Her head teacher at the Pupil Referral Unit is keen to make this a working practicality. Mr Simmons has said that he will be a point of contact as to Fiona’s education and will support her in her learning programme and also and emotion and social problems which might materialise once the other pupils realise Fiona’s condition and circumstances.
A realistic timetable will be drawn up for Fiona which will allow her to try to fulfil her education potential over albeit a longer schedule.
This case study of the Webster family is, unfortunately, a rather common one. There is a history in this family of teenage pregnancy. Elizabeth fell pregnant with Lucy at an early age and subsequently Lucy was pregnant at 14 years of age. Now the younger sister Fiona is pregnant at 13 years old. It is a reoccurring life story and despite the fact that there is a good level of support within the family network of females it does reflect on the educational achievements of these lives. Despite the family ‘sticking by each other’ there are obvious financial and housing concerns as the family continues to grow. There is also a lack of male intervention in the family household while Will is in prison and both Fiona and Lucy refusing to identify the fathers of their babies.
It has come apparent that if a Common Assessment Framework had been effectively in place at an earlier date then this situation may not have occurred or would have been picked up at an earlier date. Although Fiona had a record of non-attendance at mainstream school and also has a police record of collusion with under-age alcohol drinkers, there was no apparent cause for concern at an earlier date with the PRU situation.
A lot has been learned from this family case. The Websters are very typical of some family life in England nowadays. In past years teenage pregnancy was looked upon as a stigma but this is no longer the case, perhaps partly due to intervention of various agencies who help both socially and financially. With that in mind it is important that this increasing amount of help agencies work together to form an integrated package for each individual who needs their help. Fiona and her family will now be referred to a social worker who will liaise with the other agencies to ensure that they all receive the information and support which they need. A national network will provide much-appreciated help to agencies.
It is essential when presenting an assessment or document for the purposes of educational reasons that all individuals must be protected from identification. To achieve this, all persons named, addresses given and contact numbers are fictitious – it is necessary to use pseudonyms, and they have been used here. In this assessment the facts of the case are true and the procedures undertaken are set procedures.
The family will undergo careful continual assessment by all agencies concerned with a view to achieving the outlined goals and outcomes.
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Common Assessment Framework Consultation 25.08.04 , Department for Education and Skills.
www.cwdcouncil.org.uk/what-is-integrated-working
www.cwdcouncil.org.uk/the common assessment framework and schools fact sheet.