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

Part 6: Building Strong Inter-Agency Partnerships

1. Effective collaboration, good joint working and a sharp focus on the family as a whole, are essential if children of substance misusers are to receive appropriate help. This section describes the roles and responsibilities of the key agencies involved in support for families affected by substance misuse, and highlights the importance of integrated strategic planning and good collaboration between agencies at all strategic and operational levels.

2. Existing barriers to inter-agency working include:

• uncertainty about roles and responsibilities of other agencies and professionals
• different perceptions of issues such as confidentiality, and unwillingness to share information
• poor or no access to information technology, and agencies' incompatible IT systems
• professional or agency protectionism
• perceived inconsistency between legislation and professional guidance applying to different agencies
• pre- and post-qualifying training restricted to one professional perspective
• lack of understanding of the legal process
• different funding streams.

3. Agencies and services need to overcome these barriers to achieve better outcomes for children and their families.

4. We place great emphasis on the need for agencies to work in partnership, across organisational and professional boundaries. The roles and responsibilities of agencies in touch with parents and children to promote children's welfare and protection are set out in national guidance on inter-agency co-operation in child protection, and on implementation of the Children (Scotland) Act 1995. ³⁵ Agencies working with parents and families affected by substance misuse should be familiar with this guidance.

5. Local authorities have statutory duties:

• to safeguard and promote the welfare of children in their area;
• to promote the upbringing of children by their families;
• to make enquiries into children's cases where they may be in need of compulsory measures of supervision;
• to act to protect children when they may be at risk of significant harm; and
• to assess adults who have drug and/ or alcohol problems (National Health and Community Care Act, 1990).

6. These duties are carried out by the social work service. Local authorities also provide a wide range of services for children and families as well as services for adults. Other departments and services within the local authority have significant roles to play in supporting children and their families for example through education, housing, leisure and other activities. Social work criminal justice services and community care mental health and addiction services will have particular responsibilities for assessing the risk to and safeguarding the welfare of children of parents with whom they will come into contact. Criminal justice staff should contribute to assessment and management of support to families in which parents have repeated episodes of imprisonment, including arrangements for children's contact with parents in prison.

7. If a local authority or anyone else receives information which suggests that a child may be in need of compulsory measures of supervision, the social work service will make enquiries and give the Children's Reporter any information which they have been able to discover about the child. Anyone with concerns about a child's safety may refer to the Reporter. The Reporter will make an initial investigation prior to arranging a children's hearing, if necessary. The Reporter may ask for information from other agencies or arrange for the local authority social work services to undertake an assessment or prepare a social background report. Where it appears to the Reporter that a child may be in need of compulsory measures of supervision and it appears that one or more of the grounds set out at Section 52 (2) of the Children Scotland Act 1995 exists, s/he shall arrange a children's hearing to consider the case.

8. Teachers, school and child care staff including nursery staff, school nurses, the education welfare service, school liaison services and after school services are well placed to observe physical and psychological changes in a child which might indicate neglect or abuse, and they must pass on information to social work services about any concerns. New Community Schools have an important part to play. Teachers have a key role in delivering drug education programmes for pupils, which help children to develop skills, knowledge and understanding to make positive lifestyle choices.

9. A wide range of health professionals manage the care and treatment of people with substance misuse. GPs provide families with care, including ante- and post-natal care. GPs and pharmacists involved in the prescribing, dispensing and monitoring of for example methadone have an important role to play in assessing the capacity of parents to look after children. Community nurses such as midwives and health visitors should monitor the health and development of children when providing families with ante- and post-natal care.

10. Community alcohol or drug agencies in the statutory and voluntary sectors provide a variety of services to problem substance misusing parents, aimed at alleviating family stress or enabling them to enhance their quality of life in the community. These may be a source of advice and expertise for statutory agencies on working with substance misusers. Statutory agencies should, where appropriate, provide advice and support to voluntary organisations in promoting effective child protection practice in their agencies.

11. The police have a general duty to protect the public and to investigate on behalf of the Procurator Fiscal, where they believe that a criminal offence may have been committed. The Procurator Fiscal, as the Lord Advocate's local representative, has a duty to investigate the circumstances of any crime or suspected crime brought to his or her attention. S/he acts in the public interest and decides whether to bring criminal proceedings. The Scottish Prison Service (SPS) has a responsibility as part of its drug strategy to work in partnership with agencies in the community and to encourage prisoners to address their drug-related problems as a first step towards rehabilitation. SPS is developing and extending throughcare services for prisoners and ex-prisoners with addiction problems.

12. These agencies are only part of a large network of organisations and services, including voluntary and private child care agencies, which must collaborate to support children of substance misusing parents effectively, and make sure that they achieve their full potential without fear of neglect, injury or other adverse circumstances.

"We need to have stigma-free services."

Ex-drug user running family support group

Planning services for parents with substance misuse and their children

13. Inter-agency Drug and/or Alcohol Action Teams are responsible for co-ordinating policy and preparing local strategic plans for services to people with, or affected by, substance misuse. Child Protection Committees are responsible for developing policy, inter-agency procedures and training for agencies working together to protect children at local level. They monitor and review local child protection procedures regularly and work to promote better understanding amongst agencies of their different roles and functions in child protection.

14. The Children (Scotland) Act 1995 requires local authorities to produce local Children's Services Plans, which should take into account health and education provision for children in need and their families. In drawing up their Children's Services Plans, local authorities must consult widely with other agencies. National guidance sets out how local authorities should prepare these plans. The Scottish Executive issued guidance in October 2001, following a review of planning requirements for children's services, in consultation with relevant statutory and voluntary sector interests. This took into account the work of the multi-disciplinary task force, the Action Team, whose exploration of ways of promoting more integrated services for children is set out in For Scotland's Children. It states: 'The leaders of the children's services planning process should liaise closely with the local DAT to ensure that drug services are sensitive to ... the children of adult drug users' and that local authorities and NHS Boards should now see children's services plans as joint productions, while still involving the voluntary sector, the children's reporter and other interested parties.' Drug and/or Alcohol Action Teams, Child Protection Committees and children's services planning groups should take these new developments into account when designing local services for children and young people affected by parental substance misuse, and their parents.

Putting local policies and protocols in place

15. Drug and/or Alcohol Action Teams, agencies involved in preparing Children's Services Plans and local Child Protection Committees should work together to ensure that all relevant local interests agree a framework of common policies and protocols based on this guidance for work with families in which parents have substance misuse problems. In many areas these will consolidate much of the good practice already in place.

16. Statutory agencies which contract drug and alcohol services from the independent sector should ensure that any contract includes agreed child protection procedures.

17. Some areas already have groups in place to implement local policies.

18. Whilst all relevant interests must contribute to the task, Drug and/or Alcohol Action Teams working closely with Child Protection Committees should take responsibility for ensuring the development of local policies and protocols and should set target dates for implementation and review of these (this comes within Corporate Action Plans under the 'children and young people' pillar of the national strategy). Local alcohol strategies should take account of the needs of children of problem drinkers. When looking at prevention and children's strategies (see p. 41 of Plan for Action on Alcohol Problems) consideration should be given to this area. They should be incorporated within local child protection policies and procedures.

Links between substance-related and children's services

19. Local services should regularly review how well inter-agency co-operation is working and use this information to inform the Drug and/ or Alcohol Action Team and the Child Protection Committee of local inter-agency training needs. The following checklist may help agencies assess progress in achieving effective inter-agency co-operation.

Strengthening collaboration through training

20. Training is an important lever in developing good practice and improvements in collaborative working between agencies, with greater emphasis on the connections between substance misuse and poor outcomes for children. Training should underpin the implementation of protocols for joint working at all levels to make this guidance operational.

21. Joint training should enable the appropriate transfer across professional groups of knowledge and skills in working with drug users and with children. The Scottish Training Initiative on Drugs and Alcohol (STRADA) funded by the Scottish Executive has joint training as one of its aims, and will address work with substance misusers and their children. Multi-agency training initiatives should seek to:

• clarify the different roles of agencies involved with problem substance misusing parents and with children, and improve communication between them
• challenge stereotypes and prejudice which might hinder honest communication with parents who misuse substances
• develop a better understanding of how substance misuse affects parenting, child care and development, and improve risk assessments for children
• explore concepts of harm reduction, and methods of care and treatment for substance misuse
• ensure that the differences between drug and alcohol problems are taken into account
• recommend frameworks of good practice in assessment and inter-agency collaboration and joint working.

22. As part of their comprehensive training strategy, STRADA offer a training module on children and families affected by problem drug and alcohol misuse. They also provide leadership training for Drug and/or Alcohol Action Team members.

23. All maternity staff should receive basic alcohol and drugs awareness training to enable them to identify substance misuse in pregnancy. This should be identified as a priority as continuing professional development. The Scottish Executive and HEBS are committed to developing an assessment proforma to guide health professionals in their discussions with pregnant women about folic acid, diet, smoking, drugs and alcohol.

What is being done already

Policy/Guidance on Children and Substance Misuse

For Scotland's Children
Child Protection Audit and Review
Tackling Drugs in Scotland
Plan for Action on Alcohol Problems
Integrated Care for Drug Users
Single Shared Assessment
National Framework for Maternity Services
Supporting Families and Carers of Drug Users

Mainstream Initiatives
SureStart
New Social Inclusion Partnerships
New Community Schools
Healthy Living Centres

Funding Streams
Changing Children's Services Fund
Lloyds TSB Foundation
Drugs Rehabilitation Funding
Social Inclusion Partnerships
SureStart

Local Delivery
Drug and/or Alcohol Action Teams and Child Protection Committees
Drug and/or Alcohol Action Teams Corporate Action Plans and Children's Services Plans

Training
STRADA - Children and Young People
Children and Families Affected by Problem Drug and Alcohol Misuse
Leadership - for Drug and/or Alcohol Action Teams Management

Monitoring
Drug and/or Alcohol Action Teams Corporate Action Plans
Child Protection Committees Annual Reports
Social Work Services Inspectorate Annual Report Process
Multi-disciplinary inspection of child protection services
Lloyds TSB/EIU - evaluation of some services

Research
Centre for Drug Misuse, Glasgow University
Robertson Trust

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