Good Practice Guidance for working with Children and Families affected by Substance Misuse

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Good Practice Guidance for working with Children and Families affected by Substance Misuse

Part 3: Working Together to Tackle Problems

1. This section gives advice to agencies on meeting the needs indicated by assessment; when to involve other services to help children and their families; and how agencies should work together to plan and provide the support needed. It describes what should happen when parents' substance misuse prevents them from caring for their child(ren) safely.

2. It is not sufficient to protect children from the serious risks associated with parental substance misuse. It is important to provide for the wider needs of the child and family for therapy and support. This should include help for parents to develop their parenting skills, and intervention aimed at reducing or stopping substance misuse. This will require re-orientation and better co-ordination of adult substance misuse services and childcare services, geared towards early intervention. All staff should recognise that their efforts to assist their client are part of a complex set of interactions which will impact on individual workers from single agencies and the family as a whole. Not all problems can be solved, and no single worker cannot solve them alone.

'The Changing Children's Services Fund is providing resources for Barnardo's Hopscotch Project in Perth and Kinross for more therapeutic work with children affected by alcohol and drug problems and their families. Funding is also going to Shetland Islands Council to employ a worker to support children and young people affected by drug or alcohol use within their families.'

Plan for Action on Alcohol Problems

3. For Scotland's Children states that, wherever possible, children's needs should be met from within universal services unless a multi-disciplinary inclusive assessment of needs indicates otherwise.

The Health Promotion Nursery is a pilot project funded by the North Hamilton Blantyre Social Inclusion Partnership. The project consists of a multi-disciplinary team from the partnership agencies: Health Promotion, Education and Social Work Resources. It is based within the Whitehill Parent and Child Centre and St Paul's Primary School and it focuses on the health and well-being of children, parents and professionals on the campus. The project is based upon the Pacific Institute Training: Steps to Excellence and consists of a rolling programme of training for staff, parents and children.
The training has a strong community capacity-building theme. It concentrates on the promotion of health through building confidence and self-esteem, raising awareness and healthy lifestyles. This project is complemented by the Integrated Family Support Strategy and the multi-disciplinary team at Whitehill Family Centre who offer a range of family support groups at the nursery and school. This project supports children whose parents misuse drugs along with children with other problems.

4. When a person in any agency is worried about a child's welfare they should seek advice from one or more of the following:

Sources of advice

  • a designated senior staff member in their agency with responsibility for child protection, if there is one (schools, local authorities, police and health services and some voluntary agencies will have access to advice from designated senior staff)
  • the family's allocated social worker
  • the local duty social work service
  • the local Reporter to the Children's Panel
  • the local police female and child unit, or equivalent.

If the staff member thinks that a child may be in immediate danger, for example of physical injury or abuse, or the child has been left alone or abandoned, they should contact the local duty social work service or the police urgently. Out of office hours they should contact the emergency social work service or the police.

5. In most cases workers should tell the parent that they intend to seek advice from other agencies responsible for protecting children, unless to do so may increase the potential risk to the child, or endanger the staff member. Problem alcohol/drug using parents often fear that by disclosing their substance use to children's support agencies and seeking help they risk their children's removal from their care. Compulsory removal of children from their families is rare, even when agencies are worried about children's welfare. Local authorities have a duty to promote children's upbringing by their families wherever this is consistent with the child's welfare. Alcohol and drugs agencies should encourage the parent(s) wherever possible to seek help in their own right, with the agency's help and support if necessary. They should stress that social work's first priority is to help children in need and to keep families together where possible.

6. The social work service may offer childcare and respite, practical and material help, help with housing problems and other advice and information. It may allocate a social worker to provide direct assistance and counselling for the children and their parents. The social work service may arrange for another agency to provide support and help or support parents to get more help for their children from health, education or other services. The local authority, through the social work service or another department, may ask another agency for assistance under the Act 23 in discharging their duty to promote the child's welfare.

7. When referring on to another agency the staff member should give as much information as possible about what they are worried may happen to the child(ren) and why (See Part 4 - Sharing information and confidentiality). These agencies should provide information and advice about how to refer the family for help, whether child protection inquiries or a referral to the Reporter may be necessary, and what will happen next.

  • The social work service is responsible for assessing the nature, extent and urgency of any risk to the child and for deciding what to do.
  • The police are responsible for criminal investigation of allegations of abuse and neglect, and have emergency powers to act to protect a child in immediate danger. For example, the police have powers of entry into a household in which children are at risk because they have been left alone. The social work service and the police may work together in some cases.
  • The Reporter will arrange for inquiries into the child's circumstances by the social work service if need be.
  • Local authority social work services may ask other agencies to attend a case conference, may register a child on the local child protection register and prepare an inter-agency child protection plan.

Case example

A couple are former heroin injectors, now on a methadone programme. They have two children, one aged 5 years and the other aged 1 year. Both children were born whilst their mother was using drugs. The older child sustained a badly bruised arm a few months ago. The local authority carried out child protection inquiries but the results were inconclusive. The child was not placed on the child protection register but a 'day carer' was allocated to offer the family help at home. The couple get intermittent support from maternal grandparents. The grandfather drinks heavily and has been violent to his own wife in the past. A health visitor is involved with the family, but doesn't have any information about the parents' drug use. The woman finds it difficult to talk to her GP and doesn't want to confide in her social worker. A drugs counsellor visits the couple but has had no training or advice on childcare. The male partner doesn't want professionals involved with the family. All of the agencies are worried about how well the family is coping, how the children are developing and whether there are other problems the family isn't telling them about.

Key issues

  • key professionals involved with the family lack sufficient information and are working in isolation in a situation which makes them anxious, where little improvement is evident
  • the day carer is the only person in close contact with the children and able to identify their needs; she will need careful support and supervision from the social work service to work with the parents to improve their parenting
  • the GP should ensure that the health visitor has accurate and up-to-date information about the parents' drug use and prescribing arrangements
  • the local authority social work service should carry out an assessment, co-ordinating input from other agencies, which identifies the problems and needs of the parents and children separately; this assessment should include careful exploration with the father of his concerns about professional involvement
  • an inter-agency care plan should be drawn up by the local authority social work service with the parents, and the health visitor, the drugs agency and the GP
  • the care plan should set out the family's needs and what the day carer will do to help, describing the circumstances in which she will be required to involve a social worker, if one is not allocated to the family, and who will be responsible for deciding what to do next
  • the care plan should identify a contact person in the social work service for all the agencies if they think a case conference is necessary
  • staff visiting the family may need support from their agency to manage worries about potential hostility from either of the two families
  • the social work service should talk with parents and grandparents about the latter's support for the family, any problems that may occur and how this can be improved.

8. When any agency or professional decides that a child needs help they should refer the family to the local authority social work service, or, if they think the child may be in need of compulsory measures of supervision, the Reporter. The local authority has a statutory duty to provide services to promote the welfare of children in need and to protect children who may be at risk of significant harm (see Appendix 1). These duties relate to the whole local authority, but are normally carried out by the social work service, which should provide help to promote the child's welfare and reduce the level of any risk to the child.

9. The Child Protection Audit and Review 24 outlines the procedures to be undertaken where neglect or abuse is suspected.

10. Alcohol and drugs agencies' responsibilities to support their adult clients as parents and maintain a focus on child welfare do not end after referral to the social work service or other child protection agencies. Parents will need support from familiar professionals with whom they have established relationships. It is crucial that specialist alcohol- and drugs-related professionals and children's support agencies work together closely to help families make best use of the help available.

11. The key to making effective decisions in determining the degree of risk to the child is good inter-agency communication and collaboration in assessment, planning and intervention. In the minority of cases in which things have gone badly wrong and children have suffered severe abuse and neglect, inquiry reports highlight problems and failures in inter-agency communication. Social work services for children and alcohol and drugs-related agencies supporting adults have a complex task to combine support for parenting, help to stabilise and reduce substance misuse and assess the effects of both on levels of risk to any child(ren) in the family. Any intervention by one agency will influence or contribute to these aims. This demands open and honest communication between professionals in different agencies and sharing of information about progress and regression. A parent's encouraging signs of progress in recovery from the perspective of an alcohol and drugs agency, may be too late or too slow for a child whose early experience is one of deprivation, trauma and unpredictable parenting, and who has a strong attachment to substitute carers. The child's welfare will be the paramount consideration in any decisions made by a local authority, court or children's hearing.

Parents as partners

"Even though we're drug users, we want to be treated with respect."

Karen - recovering drug user

"Just because I drink does not make me a bad mum. I love my kids."

Liz - a mother with alcohol problems
(Castlemilk 1998)

12. It is good practice to work in partnership with parents and, where possible, parents should be included in any multi-agency meetings, in assessments and in developing care plans.

Achieving partnerships with parents and children in the planning and delivery of services to children requires that:

  • parents have sufficient information, both verbally and in writing, to make informed choices
  • parents are made aware of the help available
  • parents are aware of the consequences of any decisions they may take
  • parents are actively involved where appropriate in assessments, decision-making meetings, care reviews and conferences
  • parents are given help to express their views and wishes and to prepare written reports and statements for meetings where necessary
  • professionals and other workers listen to and take account of parents and carers' views
  • there should be clear and accessible means for families to challenge decisions taken by professionals, and to make a complaint if necessary
  • administrative arrangements take account of the needs of parents and children; for example, the timing, location, environment and conduct of meetings should take account of their needs. 25

13. Professionals should be open and honest with parents about the problems and risks they perceive. Working with parents as partners does not mean their wishes determine decisions, but that their views are sought and taken into account. Parents may need independent support to help them talk to professionals and participate in assessments and meetings. This may mean bringing along a friend or family member, an independent representative or advocate from a support agency or even a solicitor. Agencies should consider whether they should arrange independent advocacy for the parent or the child, for example through family support or children's rights organisations. 26

Inter-agency plans for family support

14. National guidance on promoting children's welfare recommends that local authorities' support to children in need should be based on written agreement with the family about their needs and the services to be provided. 27 When different agencies are working with individual members of a family, such agreements should take the form of an inter-agency plan describing the respective roles and responsibilities of professionals in providing support to and monitoring the family's progress. If agencies have concerns about a child's safety or welfare, the plan should say what these are and how professionals will help the family to reduce the risks to the child. The plan should be reviewed at regular intervals with the family and all contributing agencies. The objective should be to provide sufficient help at an early stage to reduce the need for compulsory supervision or legal intervention, whilst promoting and safeguarding the child's welfare.

"I need someone (worker) who knows the score. Knows when I'm at it and challenges me."

Sue - drinking mum

15. Local authority social workers will usually be best placed to prepare and co-ordinate the implementation of an inter-agency plan for family support. Other workers, such as family centre or residential staff, a drugs/alcohol agency keyworker, health visitor or criminal justice supervising officer may also carry out this role. The plan should identify the most appropriate person to carry out this role, in consultation with the family. If other agencies do not carry out their tasks as agreed in the inter-agency plan, the co-ordinating professional should ensure that the plan is reviewed with the network of agencies involved.

Difficulties in maintaining contact and seeing children

16. It can be very difficult either to establish or maintain regular contact with people who have substance misuse problems. Planned appointments or visits may not be kept and parents may not respond to letters or calls. In some cases parents may go to great lengths to avoid contact and they may be evasive and/or aggressive. In some circumstances parents may have stronger incentives to keep in touch with treatment and support agencies. When keeping appointments with, or visiting their patients or clients, these agencies should keep children in mind and alert child welfare agencies if families' problems intensify or conditions deteriorate to a level likely to present risk to children. The inter-agency plan should include a definite timescale within which children must be seen by a staff member from one of the agencies involved.

17. Agencies responsible for child welfare should include both planned and unplanned home visits in their contact with families, observe the child and his/her interaction with the parents, and gather information about daily routines and sleeping arrangements. A number of inquiry reports have highlighted situations in which professionals failed to identify children suffering neglect and poor parenting resulting in significant harm, when parents had refused entry to the family home and professionals did not persist in gaining access to the child. Workers should persist in their efforts to contact the family or see the child until they are satisfied that the child is not at risk of significant harm.

18. Even though professionals gain access to a household, the child(ren) in the family may not be seen. Staff should record every unsuccessful attempt to see the child(ren) and follow up to make sure that the child has been seen by someone, either by checking with other professional colleagues or agencies, or by repeating the visit quickly. Agencies should ensure that staff have access to advice from specialist colleagues or child protection agencies if they are persistently unable to see a child. They should include in local policies and guidance the expectations on their staff in such circumstances. It is essential that every child in the family is seen and assessed: one child's situation may be very different from the others.

19. Where professionals responsible for children's welfare in health or social work services repeatedly fail to gain access to a child(ren), the local authority should consider whether there may be a need to apply for a Child Assessment Order, requiring parents to make the child available to professionals (see Appendix 1). If there is any concern that a child may be in immediate danger the social work service or the police should be contacted promptly.

20. All agencies in touch with families where there are worries about children's safety or welfare should try to help the parent(s) understand these concerns, and to motivate them to make changes necessary to promote and safeguard their children's welfare. They should discuss with the parent(s) the need for support from child protection agencies, such as the local social work service or the Reporter where this seems necessary. Referral to these agencies should generally be made with the parents' knowledge and consent, unless it is felt that this will have adverse consequences for the child(ren)'s safety. Where the parent does not accept help or agree to a referral being made, but worries about the child persist, the practitioner should contact the social work service without delay.

Case example

Two brothers, aged 13 years and 11 years, occasionally attend appointments at a community-based drug agency with their mother. Two years ago she underwent detoxification and a period of community-based rehabilitation, but relapsed after six months. Her drug use has escalated since separating from the boys' father. He also uses drugs. They have frequent arguments. There is some evidence of domestic abuse and she has threatened suicide once or twice recently. The boys have made their own meals, dressed themselves and got themselves to school since they were very young, and have been left alone several times in the evenings and overnight. When much younger they were looked after by the local authority for several months at their parents' request. At these times their parents said they were trying to sort out their problems but progress has always been short-lived. School staff are now worried about both boys. The oldest is behaving aggressively and disruptively and his younger brother, whilst working hard, is quiet and very eager to please. They have few close friends and no interests outside their home. The older boy is now truanting regularly. He follows his mother when she goes out to buy street drugs to make sure that nothing happens to her. The boys do not confide in anyone and the parents don't have any help with looking after them.

Key issues

  • different agencies have discharged their separate responsibilities conscientiously but overlooked evidence accumulating over many years that these children needed help; their parents have not been able to provide consistent and secure parenting and care because their need for drugs and their personal difficulties have taken precedence over their children's needs; there is little information about the boys'experiences at home; problems are now more entrenched and much more difficult to tackle
  • school staff are now very worried and should seek advice from the local authority education welfare or social work service about help and support for the boys; the needs of both boys should be fully assessed alongside their parents' problems
  • the local authority social work service should enable the boys to express their views and wishes about what should happen
  • the local authority social work service should agree a care plan with both parents, involving school staff and the drug agency; the plan should set out the boys' needs and how these will be met, what support from agencies will be provided to individual family members, who will monitor progress and what will happen if the boys' circumstances do not improve
  • the local authority should explore whether there may be effective support from extended family or other sources, and identify a consistent carer for the boys in the event of further short-term accommodation becoming necessary
  • school guidance staff can ensure that teachers provide appropriate support for the boys in class and assist better integration in school
  • sources of out of school support through services for young carers should be explored
  • the drugs agency may offer the boys information and support in responding to crises brought about by their parents' drug use and conflict
  • if parents continue to make little progress in resolving their drugs-related problems, the local authority should seek advice from the Reporter who may consider referral to a children's hearing.

How can I tell if a child needs protection from harm?

21. When the effects of his/her parents' substance misuse is causing, or is likely to cause a child 'to suffer significant harm', 28 or 'to suffer unnecessarily and be impaired seriously in his health or development', 29 the local authority social work service should consider, whether:

  • the child may require to be looked after, but parental co-operation can be achieved in terms of Section 25 of the Children (Scotland) Act 1995 - see Appendix 1
  • the child requires the protection of a structured compulsory supervision requirement but may remain at home
  • it is not in the child's interests to remain at home.

22. The decision to authorise the local authority to arrange for the child(ren) to be looked after away from home, with their extended family, or in foster or residential care is a matter for a children's hearing or a court.

23. Significant harm or serious impairment may result from the presence of maltreatment or the absence of adequate care. There is likely to be evidence of a negative and enduring impact on the child's current circumstances and development, coupled with the likelihood that this will continue, and result in greater harm. An assessment of whether or not harm to a child is 'significant' is a matter initially for professional judgement and subsequently for determination in individual cases by the courts and children's Hearings. A single incident may seem insignificant but when considered cumulatively with others may indicate the likelihood of damage to the child's development in the longer term. The risk of harm may be to the child's physical, social or emotional development or welfare. The local authority, children's hearings and the courts have a duty to consider the welfare of the child throughout his childhood when planning how best to meet the child's immediate and future needs.

When enough is enough

When a parent consistently places procurement and use of alcohol or drugs over their child's welfare and fails to meet a child's physical or emotional needs, the outlook for the child's health and development is poor. Problem alcohol or drug using parents themselves acknowledge this and it is the duty of professionals to act in the child's best interests when parents cannot.

24. If support provided to the family does not improve the child's circumstances, other action, such as child protection enquiries, compulsory measures of supervision or removal of a child from his/her parents' care may be needed. The threshold for this kind of action is reached when there is evidence or suspicion of a lack of parental care or supervision, or abuse or neglect which may cause a child to suffer significant harm. There need not be evidence of deliberate abuse or neglect to prompt action. Agencies should consider first and foremost the current and potential effect of continuing adversity on the child, regardless of the parent's intention. The local authority or other child protection agencies must intervene, even against a parent's wishes, if it seems likely that a child may suffer significant harm if things are left as they are. Other agencies, such as schools or substance-related services for adults, may become aware of the child's situation first. In these circumstances they must refer the family to the local authority social work service or the Reporter.

25. In some families the risks to children appear too great to allow them to stay. The local authority, normally through the social work service, has a duty to act to protect the child and will seek authorisation from a court or children's hearing to remove the child from an unsafe situation. Where removal from a parent's care is necessary, the local authority should make every effort to restore the child to his/her family, whenever this is consistent with the child's welfare. Sometimes this will not be possible.

26. If an assessment of risk using the framework for assessment of substance misuse and parenting has not been undertaken before a child's removal, it should be completed as soon as possible thereafter. A specialist agency or the social work service may undertake this. The results should be considered jointly in the light of other information held by each agency, the outcome of social work assessments of the child(ren) and their needs, the quality of the parent(s)' care of the child(ren), and likely prognoses. This may require the involvement of other professionals, such as child psychologists, teachers and doctors, or other family members or carers.

"Taking the kids into care should be the last resort."

Helen - parent reunited with her two sons

"Everyone thought that when my kids were taken into care I would stop drinking. The opposite happened. I just binged all day - I had no one to look after."

Jill - drinking mother of two children
(Castlemilk 1998)

Care planning

27. When a child is looked after away from home, the local authority must prepare a written care plan describing the purpose of the placement, likely duration, and the services and support to be provided. This should set out:

  • the problems that led to the local authority looking after the child(ren);
  • what support the social work service, other local authority services such as education, and other agencies will provide to the parent(s) to tackle these problems; and
  • the needs of the child (both in the placement and as a result of his/her experiences) and how he/she would benefit.

Parents, and their representatives, should be given a copy of their child's care plan.

Both the parent(s) and the network of agencies supporting the family should be aware of the range of possible outcomes when the local authority looks after a child away from home:

  • short-term placement in foster, or residential care, and a speedy return home if problems can be resolved quickly
  • if problems persist, the child remains looked after during a longer period of planned assessment and support for the family to bring about positive progress
  • if the level of potential risk to a child in his/her parents' care remains high, the local authority may seek permission from a children's hearing, or a court for the child to be looked after by other carers in the longer term, or permanently; this may mean care by extended family, residential care, foster care or adoption.

The child's social worker should explain these possible outcomes to the parent(s) and the circumstances in which the local authority may decide long-term substitute care or adoption may be necessary. Alcohol- and drugs-related agencies may provide support for parents in these circumstances, but should be mindful of their responsibility to work with other agencies to secure the child's welfare. In some circumstances it may be helpful to arrange independent advocacy and support for the parents.

Harnessing support from extended family

28. Relatives and extended family can be a crucial source of support and help for the child and his or her substance misusing parent(s). However, this may not always be straightforward. Family relationships may become strained by the parent's substance misuse and by relatives' anxiety and anger about their health, or the welfare and care of children (Zuckerman 1994). Agencies should explore with parents and, where appropriate, children whether other supportive family members might be able to help, and how the agency might help make this happen. This might mean helping a parent to talk to their own parents or siblings about their problems and how extended family might help.

29. If a child cannot be cared for adequately or safely by his or her parent(s), the local authority should first consider whether someone suitable in the extended family may look after him or her. This may be on a voluntary basis by agreement with the child's parent(s) or with the authority of a court or a children's Hearing.

30. Care for children by extended family arrangements will need sensitive and effective support from local authorities. This should include:

  • financial and material support when needed
  • help to negotiate agreements and decisions with the child's parent(s) and other agencies
  • support, where appropriate, to become permanent carers for the child if s/he cannot be brought up by his/her birth parents
  • advice about their family member's substance use and when and how to talk to children about this
  • respite care when needed
  • help with accommodation issues.

The Effective Interventions Unit (EIU) has recently published a report into 'Supporting Families and Carers of Drug Users'. 30 The report investigates the impact that drug use can have upon others. The report also investigates methods of supporting families and carers and the range of agencies that can deliver such support, including a study of the role and function of family support groups. It concludes with a set of key principles and issues to address for Drug Action Teams, agencies and service providers, family support groups and a list of key resources available.
Copies can be obtained by contacting the EIU on: 0131-244 5117.

The document is also available on the web at: www.isdscotland.org/eiu/eiu/htm

31. Unlike foster carers, extended family carers are not local authority employees, although many of the tasks and issues they face will be similar. They will need at least the same quality and degree of support as foster carers, but agencies should also acknowledge the complex emotional and legal relationships between extended family carers and the children they look after. Catering for the interests and needs of the child(ren), the problem alcohol or drug using parent(s) and extended family members involved, requires skill, sensitivity and tact. The situation can create conflict between family members, and the child may need protection from this and from the stresses of the assessment process. The welfare of the child is always the paramount consideration, but local authorities should also assess and provide for the needs of extended family carers to enable them to help as best they can.

Case example

A 20-year-old woman presented to hospital maternity services 12-16 weeks' pregnant. She was injecting heroin and using diazepam, financed by prostitution. Her GP had been prescribing methadone but her behaviour in the surgery led to her removal from the practice list. Her partner, the baby's father, deals and uses heroin. They live in bed-and-breakfast accommodation. The specialist maternity service for pregnant women with substance misuse carried out other routine investigations and assessed her and the baby's father. She was prescribed methadone and her partner referred to a local community-based drugs project who provided an appointment within two days. A hospital social worker referred the couple to the area team for allocation. At 18 weeks the woman was admitted to hospital to manage detoxification from benzodiazepines. She was admitted again at 29 weeks having relapsed. The maternity service hosted a pre-birth case conference at 32 weeks' gestation, which recommended that the baby be placed on the Child Protection Register when born. Thereafter the mother used only prescribed methadone until her baby was born. She gave birth to a healthy but low birth-weight baby boy who developed withdrawal symptoms. He remained in the neonatal unit for treatment, and nursing staff carefully assessed how his mother was managing his care. She seemed to do well in the first few days but left the hospital with her partner and did not return for several days. When she returned she appeared drunk and when worried nursing staff refused to let her take her son home she assaulted a nurse and was arrested. The local authority sought a Child Protection Order and placed the baby with emergency foster carers. The local authority is now carrying out an inter-agency assessment and supervising the mother's contact with the baby in a family centre to see whether he can go home. Concurrently the social worker is assessing whether the maternal grandmother may look after the baby in the medium-term. Drug treatment services are working with the mother to stabilise her emerging chaotic substance misuse.

Key issues

  • maternity services should be readily accessible and responsive
  • assessment of pregnant drug users must include social circumstances and risk as well as medical and health care needs and ante-natal and maternity services should work closely with other disciplines and professionals both within their service and in other agencies
  • pregnant women should have access to methadone substitution therapy if indicated: there are obstetric benefits due to its long action
  • fathers' or partners' substance misuse should be assessed and rapid access to treatment should be arranged
  • babies should remain with mothers whenever possible, with admission to special care nursery only considered when medically indicated
  • multi-disciplinary planning meetings during pregnancy and after delivery enable good communication and informed decision-making; these should consider whether a child protection case conference is necessary
  • social work services should ensure regular contact between parents and children in care and consider placement with extended family wherever possible.

Looking to the future

32. In the early stages of a first care placement both agencies and parent(s) may be optimistic that speedy progress will be made towards the child's return home. Nevertheless, in the light of evidence that children affected by parental substance misuse are more likely to experience repeated separation and multiple care placements, the local authority should make early contingency plans to reduce the length of time that children may drift in substitute care under uncertain plans.

If assessment indicates that a child is at risk in the care of a parent misusing alcohol or drugs, the child's social worker should consider the following:

  • the needs of the child and how these might best be met. This should include an assessment of family ties and support for the child and while family members may be the most appropriate carers for the child, either alone or in partnership with others such as foster or respite carers
  • in consultation with specialist alcohol or drugs agencies supporting the parents, the local authority should determine a realistic timescale in which problem alcohol or drug using parents should stabilise and reduce alcohol intake or drug misuse, agreed wherever possible with parent(s)
  • if the parent(s) fails to make demonstrable progress within this period, the social work service should consider advising the Reporter or children's hearing
  • if a child is placed in substitute care more than twice in one year, because parents' substance misuse makes them unable to look after the child safely, the local authority should seek advice from the Reporter or, if the child is under supervision, a review hearing; care away from home may have to be considered
  • the local authority social work service should consider how permanency with family carers might be achieved, either through adoption, a Parental Responsibilities Order, or support for family carers' application for parental responsibilities or residence.

33. If extended family members are caring for a child on a long-term or permanent basis, the local authority should support them to obtain legal security for the child's placement, and appropriate legal responsibilities and rights under Part 1 of the Children (Scotland) Act 1995. Where there are good reasons not to do this, the local authority should secure the placement by other means, e.g. by applying for a Parental Responsibilities Order. If grandparents are older carers, or there are concerns about their health, the local authority should help them to make contingency plans for the future care of their grandchild(ren). As far as possible they should be enabled to make their own decisions about where the children in their family should live, unless this is not consistent with the children's welfare. Children and their carers should know what will happen, and be content with proposed arrangements, should the placement end suddenly.

Mending relationships

34. Optimum care for children is not only a matter of finding the right placement and ensuring safety and stability. Children, parents and other family members will need help to come to terms with trauma and parenting failure, and to repair relationships, whatever the eventual outcome. The local authority must make decisions, with the parent(s) and others, about family members' continuing contact with children placed away from home - with whom, at what frequency and where this should take place. This will depend on:

  • the child's age and stage of development
  • the stage of placement and the care plan for the child
  • the degree of stability in the parents' circumstances
  • parents' capacity to maintain reliable and supportive contact
  • the child's and parents' views and wishes, and those of any other relevant person
  • any order by a court or children's Hearing
  • the views of the child's carers.

35. Where the child is deemed to be at little risk in the parents' care and the local authority plans a speedy return home, contact should be frequent and regular, with minimal restriction. Parents may need help in managing periods when the child is in care, for example in forming positive relationships with foster carers, or help in adjusting to the child's return home and taking up the primary parenting role once more.

36. When parents' problems do not improve, contact may be difficult for both child and parent to keep up, and it may become a source of disappointment and perceived failure for both. The child's social worker should explore honestly and carefully with parents what they feel able to undertake, and help both parents and children to repair relationships and/or relinquish contact as gently as possible. The parent(s) may need help to present their views and wishes to the local authority, and may look to trusted workers in their alcohol or drugs related services for additional support.

37. When a parent is not able to resume care of their child they will need help and counselling to come to terms with this. The local authority responsible for the placement of the child should provide or arrange this through the social work service or another agency. The loss of their child, whether to foster or adoptive carers or extended family, may exacerbate or intensify a parent's problem substance misuse. Some parents may quickly have another child, exposing themselves and their new baby to the possibility of further trauma and harm. These parents will need careful assessment and intensive help if they are not to repeat their pattern. Alcohol- and drugs-related agencies, children's services and childcare agencies will have a part to play in their support.