Assessing, planning and managing
Assessing needs and risks
51. Assessment of need and risk is an essential element in the care of young people with sexually harmful behaviour. Comprehensive assessments can:
- contribute to young people being treated fairly;
- ensure the nature and meaning of their sexual harmful behaviour is understood;
- identify their needs;
- quantify risk; and
- identify risk management strategies.
52. A range of assessment tools is available for assessing risk in young people with sexually harmful behaviour. Many assessment tools take static (pre-existing or unalterable) risk factors into account but not dynamic (changeable) risk factors. Some risk assessment tools do not help staff identify factors which reduce risk or indicate whether a young person is likely to respond positively to education or treatment.
Examples of tools being used by the schools included the following:
- AIM ( Assessment, Intervention and Moving on) is an assessment model which looks at offence specific factors, developmental factors, and family/carer and environment/ community dynamics. The model has ten steps to help practitioners gather and analyse information relevant to the concerns about the young person, as well as their strengths and weaknesses;
- ERASOR6 is designed to assess the risk of re-offending with 12-18 year olds who have previously committed a sexual assault. It looks at sexual interests, attitudes and behaviour, historical sexual assaults, psychosocial functioning, family/environmental functioning and treatment; and
- ASSET (Youth Justice Board 2000) and YLS/ CMI assesses the risk of offending in general.
53. Practitioners may also make a range of other assessments of young people, including an integrated assessment, Looked After Children ( LAC) Assessment and Action Records, reports to children's hearings, and child protection assessments. In addition, following the review of the management arrangements of Colyn Evans, the Scottish Executive decided to develop measures to improve identification, risk assessment, planning for and management of young people who sexually offend.
Care Planning and Management
54. The objectives and management of reviews of looked after children are set out in regulations and guidance, and provide a framework for care planning. National care standards state what young people can expect from service providers. The commissioning authority is responsible for the linked processes of assessment, planning and reviewing. The authority retains this responsibility throughout the period the young person is looked after, including before and after any residential placement(s). Nonetheless residential schools are charged with the care and welfare of the young people on a day to day basis.
55. We found that initial assessments of the young people completed following their admission generally included an assessment of the risk of harm to others and of re-offending. However, in a third of files we were unable to find whether or not this had been completed. ERASOR (Worling and Curwen 2001) was the most frequently used model. The majority of young people were assessed at the beginning of their placement as having been at high risk of re-offending with a minority assessed as medium or low risk. There were no differences in the risk levels presented between the groups of young people in the four schools. Older boys were more likely to be admitted to a secure unit, often as a result of a court appearance. These boys were more likely to have been placed on the sex offender register and therefore plans were in place for their release into the community. Approaches to assessment, particularly the tools used, varied between residential schools and between residential schools and community-based projects. They were underpinned by different theoretical models, completed to different levels and the evidence for outcomes was not always clearly stated. Assessment reports compiled by schools were not always shared with the commissioning authority.
56. Looked after children reviews were held at the prescribed intervals and were chaired by a representative of the commissioning local authority. Some reviews were conducted without a full case chronology supplied by the commissioning authority. The reviews covered a number of different areas of the young people's progress, including their education, safety, development of social skills and improvements in behaviour, for example that a young person had stopped bullying other young people. Between reviews, schools provided responsible social workers with regular reports on the progress of the young people. In addition schools completed internal reviews of progress which were normally attended by the responsible social worker. We found examples of commissioning authorities which had not clarified what they could expect of the young person's placement, and on occasions they failed to hold the school to task and to an agreed timetable.
57. The young peoples' care plans were updated at their reviews. The ways in which care plans were implemented varied. Some schools relied heavily on in-house provision whilst others commissioned external services. For example three of the schools employed psychologists to work with the young people.
58. We considered that the outcomes of many reviews were unsatisfactory because some progress reports from the school were absent, in particular reports from specialist programmes. Care plan objectives were not always implemented and the reasons for this were not apparent. Sometimes assessment findings and care practice were not brought together, for example not all staff working with the young person were aware of a plan to support appropriate behaviour.
59. We learned from schools and local authority staff, and noted from files, examples where incidents of sexually harmful behaviour were described in vague terms. There appeared sometimes to be reluctance on the part of staff to go into detail about the young people's behaviour. Staff told us that they found it difficult to strike a balance between recognising what the young people had done and not wanting to label them.
60. Residential schools can provide the most effective programme's when they have precise and comprehensive information about the nature, extent and background of each young person's sexually harmful behaviour.
61. Local authorities and service providers work more effectively together when they use the same criteria and terminology. This ensures key information is understood. All those working with young people with sexually harmful behaviour must recognise the importance of providing detailed descriptions of that behaviour. Providers and purchasers of services would benefit from agreeing a classification of information for the basis of ongoing work with young people.
62. Commissioning authorities benefited from being precise about their expectations of each placement. This was most likely to be achieved when 'out of authority' placements were made by a multi-disciplinary screening group which continued to have a role in reviewing the progress of the young person. Where screening groups had a continuing involvement they were informed both by LAC review outcomes from previous placements and reports produced by schools on their performance.
63. We found several models of assessment in use with the young people. Risk management plans varied both in content and quality and all agencies working with young people with sexually harmful behaviour need to give attention to the role and purpose of assessment.
64. We found good examples of assessing, managing and planning when schools:
- were provided with a comprehensive multi-agency chronology of key events in the young person's life by the commissioning local authority at the start of their placement;
- prepared a single care plan for each young person which included objectives for education, health and care and stated the links between specialist interventions and day to day care and education;
- regularly audited case files to make sure that work with young people was completed to task and timetable; and
- used one of the structured risk assessment tools.
Commissioning local authorities should provide the school with a comprehensive assessment of the young person. This should include a risk assessment and a chronology of the young person's life events. They should be precise about what they want for them and clear about what will be offered both in terms of specialist interventions or programmes and the young person's day to day care.
Schools should scrutinise the comprehensive risk assessments and chronologies received from the commissioning authority, to make sure they are complete and up to date. This should form the basis of the schools ongoing assessment of the young person's progress. That progress should be shared with the responsible social worker at key points. Specialist providers should routinely share their assessments with the responsible social worker and school staff.
The Scottish Government should produce guidance on how best to assess children and young people who may present a high risk of harming others.