Learning from History : Lesson 2 : A Comprehensive Assessment

Monday, October 1st, 2007 by David Lane &, chrisdurkin

In the August edition of the Webmag, we explained that a study of social work files covering the last three or four decades had suggested that there were lessons for today’s practitioners. For the purpose of this series, six topics have been chosen, and in each case, David Lane describes what he has found out from the files, and Chris Durkin comments from the viewpoint of current practice and teaching about social work. It should be emphasised that the Lessons will all focus on general issues, and will not disclose any confidential information.

David Lane :

Last month I suggested that the main way of avoiding bad practice was the steady application of good standard practice, simply doing what might reasonably be expected of professional workers. This month I am focusing on one aspect of practice.

Assessment is part of good standard practice in social work, but time and again in the files I have dealt with, there have been fairly complex cases which have carried on year after year without any social worker taking a more thorough look at the situation.

Lack of strategy

Frequently the records read as a series of one-off responses to problems with no long-term strategy informing the decision-making. This is found most often in cases where the primary problem was poverty and associated neglect, leading to poor standards of care, but without obvious evidence of abuse. In some cases, successive social workers provided generously for families’ physical needs without asking why a family continued to live in such conditions. (Did they actually like living like that? Did they feel trapped and defeated? Was it the extra demands of a disabled child which kept them anchored in poverty? Was it the result of the money going on drink?)

Have we had stereotypes of certain sorts of clients, which have led us to limit our views of what more intensive intervention could achieve? In some cases families were seen as “typical of the neighbourhood”, as numbers of poor families with low standards were allocated housing on the same estate. This description seemed to imply that no other questioning was needed.

Because their problems were seen to be low-level, no one felt it necessary to undertake an in-depth assessment of the families’ needs. So the files got fatter and further needs were met with practical help of various sorts, sometimes for decades, as successive children arrived, grew older and left home. Yet a review of the work undertaken over many years of low-level problems could have led to a fresh understanding of the family’s needs.

It seems to me that one of the motivations for being in social work is that the variety of human behaviour, motivation and emotions is so complex and fascinating. Why do people choose to live in squalor, for example? Why are abused children so loyal to abusive parents? Why do some partners stay together when they spend so much rowing? Every individual, partnership and family is different, and there is endless variety.

How, then, is it that some cases carry on for decades without anyone trying to understand the dynamics within the family better, or looking into the backgrounds of the parents and asking what made them tick, or even reading through the voluminous records to see what patterns may become apparent over a period of years? In some cases there appears to have been a lack of curiosity about clients, with no explicit reason for failing to enquire more closely, such as the threatening the conduct of some clients or a reasoned conclusion that nothing can be achieved by investing more time.

There were occasions when a new social worker usefully took a fresh and more decisive approach to a family. The papers contain some excellent and insightful analyses, full of backing information for readers to form their own understanding of the case. Sometimes, though, an apparently full report may omit any information about the period before the family was known to the department, as if their backgrounds were of no interest.

Understanding

In other cases, the facts are all there, but no attempt was made to make sense of the situation, to understand what the individuals involve wanted to achieve, how they had failed, what they feared, or even what they wanted social services to do for them. Without the thread of understanding knitting the facts together, it is hard to help families achieve their goals.

Unfortunately, some of the official guidance on assessments has tended to be mechanistic in this respect, encouraging social workers to be objective (which is not a bad thing in weighing up information) but implicitly discouraging them from trying to be empathetic and get alongside the client in understanding the problems faced. There was the odd case where a social worker doing this got the wrong end of the stick, but at least making it all explicit meant that the perception was challengeable.

I can imagine social workers who read this wishing to retort that in view of the pressure under which they work they do not have the time for such analyses. But when one reads family records which cover decades and frequent changes of social worker and supervisor, and when not one of them has asked fundamental questions, it becomes apparent that the services offered must have been fairly superficial, and that the practical services provided (with all the money and staff time entailed) may have been wasted for want of a more detailed inquiry at depth.

Chris Durkin:

One of the messages I try and get over when I teach is that assessment is the cornerstone of good social work practice, a statement that I don’t think anybody would disagree with. However, I feel sometimes that assessment can be a decision for inaction. If all else fails and we cannot think of anything better to do we press the button and seek yet another assessment.

Problems of assessment

In my view social workers are brilliant at gathering information; what they are sometimes not so good at doing is analysing that information and making decisions based on that information. As David points out, so often people just add to their files more and more information, rather than taking stock and reviewing the existing information.

The process of assessment feels like a comfort blanket that we are reluctant to let go. Yet the essence of being a professional is the ability to draw on a degree of expert knowledge in order to make decisions. One of the criticisms people have of the assessment models introduced in the last few years is that they are too prescriptive, part of a wider ethos of performance management. This culture of prescription can be seen as a wider societal attitude to risk in that the procedures become the driving force, with guidelines being introduced to reduce risk. The irony is that, far from improving people’s ability to make professional judgements, the process can actually reduce it. This reductionist approach means that staff feel that they are merely administrators who have to tick the relevant boxes.

The tick box mentality means that assessment becomes a static event rather than a process that develops and changes over time. As I have commented previously, the model advocated by the Government is the Common Assessment Framework (CAF), an ecological approach to child development which is a very useful model in that, although the child is seen as being central, account must also be taken of both the family and the community within which the child lives, in other words an holistic approach needs to be undertaken. What this and other models do not do, however, is provide us with models of intervention - there are no instant solutions.

Analysis and judgement vital

Although procedures and guidelines clearly have there place, it is the ability to analyse the data gathered and make judgements that distinguishes the good practitioners. Marion Brandon et al’s study shows that the CAF works well when an “informal, relaxed and friendly manner” is adopted “…with more concentration on relationships than acting bureaucratically and completing a form” (Brandon et al 2006: 64).

CAF is a model for early intervention that requires practitioners to make very difficult decisions, identifying early needs and thus preventing cases becoming ‘child protection’, because as the authors show (drawing on evidence from research), “…most children who die from abuse or are seriously injured are not child protection cases but children known to have additional needs…” (Brandon et al 2006: 64).

Brandon M, Howe A,Dagley, V.,Salter, C., Warren, C. and Black, J.(2006), Evaluating the Common Assessment Framework and Lead Professional Guidance and Implementation in 2005-6. DfES Research Report RR740, DfES. (accessed 21/9/2007)
http://www.dfes.gov.uk/research/data/uploadfiles/RR740.pdf

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