The role of adult social care for parents with learning disabilities when their children are no longer in their care

In order to locate the role of ASC at the time of the removal of the children from their parents the research team firstly sought to understand the role of ASC, if any, during the stages leading up to and during childcare proceedings when a parent has learning disability.

Messages from practice

• There was a very low awareness in adult social care (ASC) and children’s social care (CSC) of the Good practice guidance on working with parents with a learning disability written for the then Department of Health and Department for Education and Skills in 2007 and there is an urgent need for guidance to be developed in line with contemporary social work practice, developed in collaboration with practitioners in ASC and CSC.
• There was a similar lack of awareness across ASC and CSC social workers of legislation, integral to the practice of the other department, notably the Care Act 2014 and Children Act 1989 and other relevant legislation.
• All eight case study sites were asked to provide any protocol or practice guidance relating to working with parents with learning disabilities. Only two dedicated protocols were provided, one being LA 8 where there was an integrated learning disabilities team (ILDT).
• Working relationships between ASC and CSC were heavily dependent on individuals and their own networks. The divide between the two was evident to a greater or lesser extent in all eight where comments that were repeated by those in both services included that staff ‘spoke different languages’ and were driven ‘by different legislation’.
• It was recognised by those working in ASC that they worked with an element of positive risk-taking. CSC, on the other hand, had to hold the risk of keeping children safe. So where ASC was involved at this point their staff often feeling they were the ‘secondary’ partner. This also meant that referrals for support from CSC would not necessarily be prioritised because ‘at least someone from social care was involved’. In turn this contributed to those in CSC referring to ASC’s ‘unrealistic’ thresholds which meant it seemed pointless to refer many parents with whom they worked.
• There were positive examples of how ASC had engaged with parents throughout this phase including where removal of children occurred, but they were few and far between. Most were in LA 8 where there was an Integrated Learning Disability Team (ILDT). In these cases ASC had usually been involved with the parent prior to CSC’s involvement, but there were other instances where the tenacity of a CSC social worker led to ASC’s engagement.
• ASC was rarely involved in assessing parenting capacity but the ILDT in LA8 had developed a screening tool to help social workers consider if a psychological assessment of a learning disability would be appropriate and they also trained social workers to be aware of and identify learning disabilities, as well as offering a consultation and referral service.
• LA 8 – with the ILDT – was also the only LA that was in line with the Good Practice Guidance in providing ‘multiple specialist assessments’ to identify how best to address the impact of the parent’s learning disability on their parenting capacity, although this expertise was not generally requested by CSC and so was usually confined to those with whom they were already working.
• Where parents were already known to ASC it was more likely, although by no means inevitable, that ASC and CSC would work together to ensure that there were reasonable adjustments made in terms of contact centres, advocacy, timing and expectations.
• If ASC had not been involved prior to the removal of the children the pathways to involve them at that stage were not in place. It was at this point CSC usually withdrew contact as their focus on the child had come to an end and moved to the child’s new care arrangements.
• In some LAs there was a Pause Practice or a similar LA services to support parents who have experienced the removal of children from their care. While some, but not all, will work with parents with a learning disability, those working in ASC were often unaware that such a service existed.
• In some instances where ASC had been alerted and were willing to engage with parents, they had found it difficult to maintain contact because parents saw them as part of the same system that had removed their children. ·
• Despite offers to support parents with LD with whom they had not previously worked the ILDT rarely received direct requests from CSC for post-removal support.
• Judges, CAFCASS and lawyers thought ASC should be required to be involved after removal of children from parents with learning disability, if only to help with housing and benefit applications and/or monitor the progress of any recommendations that were made for psychological support to help them process the trauma and grief, as these were not always acted upon.
• ASC also encountered some problems in determining the best route to take when they were involved in post removal work when:
  • Thresholds for mental health services were high.
  • Improving Access for Psychological Therapy (IAPT) or Talking Therapies services did not always make reasonable adjustments for people with learning disabilities, and several ASC representatives said that referrals had been refused.
  • On the rare occasions when ASC had arranged for psychologists in learning disability teams to become involved, the interventions to address the associated trauma were intensive and the psychologists’ workloads made it difficult to conduct such intensive work. Those in ASC reported sometimes encountering service users with unresolved trauma as a consequence of having a child removed many years previously.
• The implications for practice focus on policies and structures to improve communication and practice across ASC and CSC.

Messages from parents

• Of the nine parents seen, eight described experiencing immense loss after their children were no longer in their care. In the case of the ninth parent the child was looked after by the other parent and they had regular contact.
• Only three of the nine referred to any support around the time when their children had been removed. In one case it came from a social worker in ASC with whom this parent had been in contact before the court proceedings. In the other two cases it had come from the same advocacy service that had been involved throughout the court proceedings.
• Two other parents had been assessed some time prior to court proceedings for support from ASC but had not met the threshold for a service.
• One of the barriers to accessing specialist care and support was the parents’ lack of formal diagnosis of LD. Three parents had not had a LD diagnosis when they went through care proceedings and had children removed from their care. One parent had had two children removed and although the social worker from CSC had suggested that she might have a learning disability a referral to ASC had been refused. It was subsequently accepted only when she had a third child and her parenting capacity was being assessed.
• In one case a parent had met the threshold for ASC in the LA where she had been living but when she moved to another, following the removal of her child, she did not meet the threshold.
• Building trust, maintaining long-term support and helping parents to understand why their children were no longer in their care were key elements valued by the few parents who had experienced these wherever this came from but they had also been shattered when a professional left an agency or was promoted.

One solution to funding support

• A joint working protocol between children’s and adult services and other partner agencies supported by a senior liaison practitioner.
• The cost involved in implementing the protocol including the employment of the practitioner was estimated at £86,000.
• This cost would have to be compared with the improved outcomes for parents and their children. The magnitude of these cost-consequences remains uncertain and difficult to gauge based on this study alone.

The aim of the project was to examine the role of adult social care (ASC) when children are removed from parents with learning disabilities following child care proceedings. A review of research found few references to the role of ASC. However, interviews with a purposefully wide range of individuals from different professions with an interest in this subject (n=83) helped to refine further the aspects that should be explored. These scoping interviews were followed by discussions in 24 English local authorities (LAs) with 73 professionals. This enabled us to identify LAs for eight in-depth case studies in which we interviewed 178 professionals from ASC and CSC, as well as representatives from Family Justice Boards, private and public law, advocacy services and intermediaries, and parents whose children had been removed.

The work was conducted in collaboration with the parents’ group in the Elfrida Society, Research in Practice and the Working Together with Parents Network although responsibility for the findings and implications for practice lie with the researchers.

Over the past 10-15 years there have been calls and policy/practice shifts to bring health and adult social care closer together, but at the same time the divide between ASC and CSC has widened since they were made the responsibility of two different Government departments in 2007 and split into two separate directorates at LA level. It transformed the way local authority social care services are planned, commissioned, financed and delivered. The concerns that CSC would become distanced from issues that affect parents, such as parental disability or mental ill-health, while social workers dealing with adults would not be involved in decisions relating to children and child protection, have been confirmed by this study. Concerns about communication between the two existed before the split2 but these have escalated over the years and there have been few studies that have attempted to explore the consequences of the split. The divide is not helped by training routes into social work which mean those intending to work in one sector (adult, children’s or mental health) will probably know very little about the others. It is important that this gap is bridged. In relation to this project there were many examples where social workers in CSC did not understand ASC and similarly those in ASC did not understand CSC. This is not acceptable in relation to parents with learning disabilities or, indeed, any parent in need of support from ASC. Structures to bring the two agencies together to provide improved support to parents with LD – at and before removal – include:

• Assuming a holistic approach with family at the heart.
• A joint protocol across ASC and CSC supported by a senior service liaison practitioner and a named person in both ASC and CSC to take the lead on parents with learning disabilities.
• Joint training – including on early identification / on screening tools.
• Pathways to support developed by ASC and CSC for parents at point of removal.
• ASC on Family Justice Boards.