Video exercises

Clip four

Click here for Lee's Contact Sheet (Microsoft Word format)

Click here for Lee's Initial Assessment Record (Microsoft Word format)

Discussion

This exercises highlights a number of issues relating to recording, which are often hidden.

The first is that even a five-minute interview produces a great deal of information. This information is then passed through the filter of our professional knowledge and experience; judgements are then made about what is significant to record. Through this process the several thousand words spoken in the interview, our observations of Lee, Ms Whitchurch, Shane and the flat are reduced to several hundred words.

The second issue is that, despite the information available from the clip, there is not enough to make a judgement on some observations. In practice we actually need quite a substantial amount of information, often to verify our initial ideas and assumptions and to help us identify the most appropriate form of intervention. For example the Health Visitor would be able to advise us on Lee's development and whether this was delayed in any way. Information from the nursery would assist in making a judgement about Lee's emotional and behavioural development and Ms Whitchurch's basic care of the children. It may also help us to understand whether the parents who attended the nursery made Ms Whitchurch feel unwelcome, which would be significant in planning future day care for Lee.

The clip also illustrates that in practice we rely on all of our senses to help us to process information. For example smell would have helped us to assess the cleanliness of the home and the children's nappies. Touch would have been used to help to make a judgement on whether it was appropriate for the children to be dressed in nappies and tee-shirts. Although the children were dressed like this Ms Whitchurch was wearing a cardigan and the practitioner did not remove their coat, but we do not know the temperature.

We also completed an entry on a contact sheet on the visit. Contact sheets provide a brief record of all contacts on a case and help to give an overall picture of activity on the case, identify when more detailed records have been made on specific contacts and where these are located in the file.

However, when considering our version it is important to remember that it is based on both our observations and our opinions and judgements on what we saw and heard. You may not always agree with what we have recorded.

The initial assessment

Reason for initial assessment

We have not recorded the referrer's name or even that it was a 'neighbour' that made the referral. This is because the referrer has asked and has the right to remain anonymous. Under the Data Protection Act, 1998 Ms Whitchurch has the right to see the concerns raised, but not who raised them. However Ms Whitchurch may appeal against a decision by the Local Authority to restrict her access to this information, in which case the court would make the decision.

In recording the reasons for the initial assessment we have often used the precise words of the referrer. When the assessment is shared with Ms Whitchurch, using the words of the referrer may help her to appreciate why the local authority felt that it had to investigate. We did however, record that the referrer had suggested that Ms Whitchurch had learning difficulties rather than that she was 'not all there' and 'a bit slow'. We felt that these phrases were offensive and that the referrer's meaning was quite clear.

Child's needs

Health

In the case study Lee's age is given as three and a half. In reality the child who acted the part of Lee was only two. Therefore we would expect a child of Lee's age to be dry during the day. The fact that he was still in nappies is suggestive of developmental delay. However, we would need information from other professionals to confirm our impression. It is important to record this as it may support you in seeking permission from Ms Whitchurch to contact or refer to other agencies.

Education

Lee's speech and play as seen in the video are not at the level of a three and a half-year-old. One would have expected Lee to be using simple sentences in his speech. Although Lee did play with the pans and spoons, he did not actively engage with his brother nor did he show any evidence of imaginative or constructive play, which one would have expected to see from a three and a half-year-old.

Emotional and behavioural development: Self care skills

Although one would not wish to draw any conclusions regarding Lee's attachment to his mother on the basis of such a short clip, it is significant that Lee did not demand any attention from his mother during the visit. It is important to record his behaviour on this visit as this can be compared with behaviour on subsequent visits.

The fact that Lee played alongside, rather than with, his brother is also significant. We would have expected a three and a half-year-old to be trying to involve his brother.

Identity and social presentation

There was not a lot of information available in relation to Lee's identity and social presentation. We have recorded the contact that Lee has with significant adults and his initial response to the arrival of a visitor.

Family and social relationships

We have recorded our observations of Lee's interactions with his brother and mother.

Parenting capacity

In our record we highlight Ms Whitchurch's strengths as well as concerns. This is not simply because we would be sharing the record with Ms Whitchurch. It is often by approaching issues through the parent's strengths that areas of weakness can be overcome.

Basic care

We have recorded the children's dress here. We observed that in contrast to the boys Ms Whitchurch was in tracksuit bottoms, top and cardigan and the social worker did not remove her coat. However, we could not assess the significance of this because we do not know the time of the day nor the temperature in the flat or season of the year.

Ensuring safety

Ms Whitchurch had, in our opinion, unrealistic expectations of Lee. In practice we would expect that this issue would have been explored more fully with Ms Whitchurch.

Emotional warmth

Ms Whitchurch did seem quite proud of Lee and the way he helped her. But we also noted that she showed little enjoyment, pleasure or warmth in her interactions with the children.

Stimulation

The fact that Ms Whitchurch had put pots and pans out for the children to play with is a strength, which could be overlooked because of the nature of some of the concerns about Lee.

Guidance and boundaries

There is not a lot of information available to us on how Ms Whitchurch provides Lee with guidance and boundaries. However, although we do not know when Lee stopped attending nursery, the incident of sending him to bed without anything to eat is significant. Again we would want to explore this issue with Ms Whitchurch.

Issues affecting parent/carers

We felt that it was important to record our impression of Ms Whitchurch's presentation even if, at this stage, we do not know why she is behaving in this way. The observation that the house is untidy, that the children were not dressed and that Ms Whitchurch did not remember the appointment suggests that she is having some difficulty in organising things on a day to day basis. Along with her tiredness and lack of affect this could be caused by depression. However, this is simply our initial hypothesis. It is important that when formulating hypothesis that one does not discount other possibilities. In this case for example that Ms Whitchurch may have learning difficulties or problems with drugs and alcohol. In this case, based on the information available, we thought that depression was the most likely cause. We have noted that we would be undertaking further assessment to test out this hypothesis.

Family history and functioning

For some areas we had no little or no information, for example on the local environment and the family's income. Where this is the case it is important to identify it in the record.

We know that Lee's father comes at weekends and 'takes the children off Ms Whitchurch's hands' but no more than this. Similarly we are aware that Ms Whitchurch's mother visits during the week, but we do not know whether this contact is supportive to Ms Whitchurch. It is easy to move to the next step and record that 'Ms Whitchurch is supported by her mother', but we do not yet know this. Close contact even with mothers is not always welcome or supportive! We have noted that Shane's father visits infrequently because he has problems, although we do not know the nature of them.

Social resources

We do not know what resources are available locally. Ms Whitchurch's comments about the nursery are important, as they will help in planning any future day care for Lee.

Housing

We have recorded our initial impression and that we had limited opportunity to explore this issue. In reality we would know a lot more about the property at the end of a visit, for example we would have asked to see the children's bedrooms.

Employment and income

We had no information about these issues, and have simply recorded this.

Sometimes even in reality, we may complete an initial assessment without being able to record something under all the domains in each dimension. It is not always necessary or appropriate to record in each dimension and it is a mistake to try and record something if we have no information or evidence. For example, consider a situation in which social services is informed by a hospital accident and emergency unit that a young child has a serious injury. The paediatrician says s/he does not believe the injury could have been caused accidentally and the mother has told nursing staff that the father did it. There may be no information available on the child's identity, social presentation, self-care skills or education. However, there is enough information available to complete the initial assessment and recommend section 47 enquiries.

Summary

We have used the summary to draw out key points from the information gathered. In practice this would have assisted in developing a plan of further actions.

Exercise two

For this exercise you will need some detailed record sheets.

The family is an open case to one of the other practitioners in the team who is currently on leave for three weeks. Given the nature of the referral the practitioner has been asked to make a home visit to Lorraine to discuss the anonymous referral.

Based on the clip write a detailed record of the visit for Shane's file as if you were the practitioner visiting the family.

Click here to go to the video

Now compare your version with ours >>