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Growing Support
1 What supports do familes need?
Characteristics of fieldwork sites
The sample
1. Young children have a range of needs that must be met if they are to reach their potential. These include:
- nourishment;
- physical care;
- secure attachment to a consistent carer or carers;
- stimulation and human interaction;
- stable and consistent routines;
- opportunities to explore the world around them and have increasing independence; and
- protection from danger.
2. The Children (Scotland) Act 1995 identifies children in need, within a wider definition including children who are disabled or affected by disability, as including children in need of care and attention because:
- they are unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development unless a local authority provides services for the child; or
- their health or development is likely to be significantly impaired, or further impaired if such services are not provided.
3. The Act places a duty on local authorities to safeguard and promote the welfare of children in need in their area and, where possible, to promote their upbringing by their families. To achieve this local authorities must provide a range and level of services that meet children's needs. 1 Other agencies, including health services, are required to collaborate with them. 2
4. This report describes the findings and conclusions of an inter-disciplinary review of social work and health services in Scotland to support vulnerable families with young children aged 0-3 years. It also takes account of other important services such as early education and childcare, housing, health services for adults and Children's Hearings.
5. The inspection team visited five areas - Glasgow, Moray, South Ayrshire, Edinburgh and West Lothian. The areas were chosen because they represented different population sizes and social demography and provided services in different ways. We reviewed social work case records and talked with families who used services. We interviewed professionals in local authority and health services and the voluntary sector and met with Children's Reporters in each of the five areas. Appendix A provides an account of the inspection process as experienced by the two lay members in the inspection team. Appendix B provides a summary of the people who were interviewed.
6. This review set out to answer the following questions:
- What support do local authorities and health services provide for families with very young children?
- How well do these services meet the needs of these families and how far do they improve outcomes for children in need?
- How well do services work together?
7. We looked at social work and health services for families with young children and some services provided by local authority education departments. Some of these services provided advice, guidance or assistance to all families with young children, including those who may be vulnerable. Others were designed to promote children's welfare in adverse circumstances and included services for children whose health or development would otherwise be compromised. We did not look at specialist services for children with disabilities or children affected by disability, although some information about the experience of families with disabled children emerged from our review of case records and in our discussions with parents. This review was informed by an overview of relevant research and practice literature that is included in Appendix C. Appendix D lists the members of the steering group for the review.
Characteristics of fieldwork sites
8. The local authority areas we visited were diverse. Glasgow presents particular and chronic economic and social problems in concentrations unmatched in the other four authorities. There are pockets of significant disadvantage and deprivation in each of the authorities although in Moray this is more widely dispersed.
9. There were fewer social work practitioners per head of child population in Glasgow than in the other areas visited with the exception of Moray. Of the five, Edinburgh has the highest ratio of practitioners per child population. South Ayrshire's expenditure on children's services as a proportion of all Social Work Department spending is approximately half that of the other local authorities. The authority has a significantly lower rate of registration on the Child Protection Register than any other Scottish local authority.
10. The local authorities all reported a number of factors that placed services under pressure and all stated that demand now outstripped existing capacity. Each local authority had plans for expanding support to families with children under 3 but there was little evidence at this early stage that this had yet made significant impact at a local level because:
- vulnerable families are transient and highly mobile - current systems of health screening and health care, allocation of support and duty services are geared towards stability of tenure in housing;
- access to all services in some rural areas, suburban villages and peripheral urban areas can be very poor;
- of increasing need linked to high levels of drug misuse, particularly on peripheral public housing estates in urban and suburban areas; and
- increasing numbers of young single parents from ethnic minority communities present distinctively different needs in urban areas.
11. Additionally, Glasgow reported that the local authority has disproportionately fewer resources to meet high concentrations of need since local government reorganisation.
12. The demand on social work services from the Children's Hearing system has been rising rapidly in recent years. Referrals of children to Reporters on grounds of lack of parental care rose by 71 per cent from 1998/99 to 1999/2000. 3
The sample
13. The review examined the case records of 147 families with children aged 3 years or under in touch with social work services. The majority of these families were experiencing profound and acute stresses. More than four out of five of these families had a social worker allocated to help them. Of the remainder, most were supported by staff in family centres or similar services. A small number had been in touch with the local authority's duty service.
14. Over a third of the families, 58 (39 per cent) had been the subject of child protection enquiries and 55 (37 per cent) of the index children were, or had been named, on the Child Protection Register. A fifth, 31 (21 per cent) had been referred by the Reporter. Fourteen (9 per cent) had been looked after in local authority accommodation. Twenty-three (16 per cent) cases involved young mothers who had been accommodated by the local authority just before or during a pregnancy and were now parents of young children. At the time of the review the index child was looked after by the local authority in over a third of the sample cases. Three-quarters of these looked after children lived at home.
15. More than half the families in the sample (54 per cent) were headed by a lone parent. The proportion of lone parents in the sample was high in each of the five local authorities. The percentage of families in Scotland headed by a lone parent at the time of the 1991 Census was 15 per cent. Almost one in five of the families were affected by mental illness, usually that of a parent or partner. A similar proportion included a history of drug dependency or alcohol misuse. In over a quarter of the families there was a history of domestic abuse. The incidence of family difficulties we found in this sample are similar to the characteristics and experience of families in which social services have conducted child protection enquiries. 4
16. In 31 cases drug misuse was a significant factor in the families' need for support. These families presented a wide range of other problems usually linked to parental drug misuse. Some families were homeless or highly mobile, with a succession of tenancies. Several parents, usually although not exclusively fathers, had been imprisoned for offending. Relatives were a strong source of support in many families with children looked after regularly and sometimes permanently by grandparents or parents' siblings. Four babies had been born withdrawing from drugs.
17. Almost all (94 per cent) of the families whose cases we reviewed appeared to be of White British ethnic origin. But in almost a third of these cases (30 per cent) the ethnic origin of the family was not recorded. Eight families were recorded as being of non-white British origin, the majority of these families were of Asian origin. One family included a child of mixed race who lived with her White British mother. This child's father was described as Asian. There was no other information about him in the child's case record. In most cases (138) it seemed likely that the family's first language was English. In three of the seven cases involving Black families the family's first language was not recorded.
18. The family's religious persuasion was recorded in only six cases (4 per cent). Two of these were White British families, one Catholic and one non-practising Protestant. The remainder were Muslim Pakistani families. It appeared that ethnicity, culture and religion were perceived as relevant only if a family was Black.
19. In one case involving deaf parents it seemed that the parents' first language was likely to be a sign language as staff needed interpreters to assist communication. This was not recorded.
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