Joint Assessment - Adults and Children's and Families Services

Staff working in Social Care Services should be aware of their wider responsibilities in relation to those in need. This may extend beyond the reason for current Social Care Services involvement. It is not expected that staff working in either section of Social Care Services will be fully conversant with all legislation relevant to the other section but key statutory duties include:

• Section 17 of the Children Act 1989 - to safeguard and promote the welfare of children in need by providing an appropriate range and level of services;
• Section 47 of the Children Act 1989 - to enquire into any family situation where there is reason to believe that a child may be at risk of Significant Harm;
• Section 47 of the National Health Service and Community Care Act 1990 - to assess the needs of any person who may require community care services;
• Carers (Recognition and Services) Act 1995 - to assess the needs of a carer.

N.B. In principle, where there is a conflict of interest between the expressed needs of the adult and the child/young person, then the welfare and interest of the child/young person must remain paramount.

Professional staff should have knowledge of Social Care Services procedures appropriate to their position. So, members of staff who are assessing the needs of children and families should be conversant with East Riding Safeguarding Children Partnership Procedures and Guidance and the Child Care procedures. Staff who assess the needs of adults should be conversant with assessment procedures according to existing eligibility criteria.

N.B. There are statutory areas where procedures need to come together to effect a smooth transition from Children and Families and Adult Services e.g. where a child is a young disabled person between 16 and 18, they may already be the subject of a joint assessment under the procedures relating to young people with disabilities (see Part 7 of the Manual in relation to Children with Disabilities).

Social Care Services can only fulfil its total responsibilities if relevant information is exchanged about the respective needs of children/young people and adults with Parental Responsibility within the same household. Recognition needs to be given to the combined effects of individual problems or needs within family situations. The existence of two or more identified problems may justify access to a level of services to which the family would not be eligible if each problem were assessed in isolation.

Clear and appropriate communication is fundamental in joint working situations. Initial referrals may not always indicate either the degree of risk to children/young people in a household or the needs of the adult(s) with parental responsibility. The process of information gathering or Single Assessment is therefore crucial in helping to clarify subsequent actions and responsibilities.

Where, in the course of any assessment or any ongoing intervention and support, a member of staff on the Adults side of Social Care Services feels that a referral to the Children and Families' section is warranted, they should gain, where possible, the permission of the adult concerned (or their carer) to do so. Where it is felt that the child/young person is at significant risk and that such permission might jeopardise the welfare of the child(ren)/young person or interfere with any subsequent legal action, then such agreement must be waived.

The parental role within a family has 2 parts to it:

• 'Parental activity'. These are the things parents do as parents, (e.g. feed, dress and cloth children/young people, take them to school, take them on holiday, domestic tasks etc). Disability/ill health may restrict these parental activities;
• 'Parenting'. This is the concern and involvement that parents have in their children/young person’s welfare and development. It includes:
  • The emotional ties and relationships of parents with their children;
    The exercise of appropriate decision-making within the family and in the family's wider social situation;
  • Giving guidance and support to their children.

It is important to distinguish between these two parts of the parental role, for while parental activity may have been reduced, this should not be allowed to diminish the parent's role as parent. Practical support may compensate for the loss of parental activity and facilitate the maintenance of parenting.

There may be various circumstances in which the responsibilities of staff working on the Adults side of Social Care Services overlap with those of staff working with Children and Families. The initiative to cross-refer may come from either section. The appended diagram to this procedure summarises the main interface areas and suggests likely levels of involvement in assessment.

A child may be in need of services if:

• His/her health or development cannot be achieved or maintained without supportive services;
• His/her health or development is likely to be impaired without provision of such services;
• He/she is disabled.

(Refer to separate procedures on ‘Children in Need’)

A person may be in need of community care services if he/she:

• Is disabled;
• Has a mental health problem;
• Has a substantial, long-term health problem;
• Has a drug and/or alcohol problem.

Where there is an adult with parental responsibility who appears to meet the eligibility criteria for a full Community Care Assessment (Bands 1-3) and there are grounds for believing that the child(ren) are at risk of Significant Harm, then it is imperative that immediate direct communication takes place between the respective assessment teams to agree on appropriate interventions.

There may be value in joint visits, although it is not the responsibility of Adults staff to determine the degree of risk that child(ren) may be subject to. Where the assessing social worker from the Safeguarding Team decides that the children are at risk, then that worker will act within agreed Child Protection procedures according to the degree of perceived risk.

Each assessing/investigating officer has a contribution to make to decision making either through direct attendance at conference/planning meetings or through a written contribution focusing on the needs of the adult or child(ren) that are being or have been assessed. Individual Care Plans and child protection plans must be fully co-ordinated with each other.

Where an Adult with parental responsibility appears to have a low dependency (Bands 4 - 6) and the child(ren) are also in need, then information should be exchanged between both sections regarding assessed needs and services provided. An exchange of information may help determine, when taken together, that the circumstances of the household are of greater concern so as to justify more fuller assessment e.g. the child may turn out to also be a young carer in need of support.

In these circumstances, Children and Families staff will take the lead role in terms of assessment and response to the perceived risk to the child(ren).

Where any officer (Adult Services) involved with a family has reason to suppose that there is a child at risk of Significant Harm, s/he will immediately contact the Safeguarding Team and provide such information as s/he believes to be relevant to assist investigation e.g. background papers, and attend a Child Protection Conference if requested.

Where, during a child protection investigation, the adult with Parental Responsibility presents as needing an assessment for practical support services, the Social Worker/Safeguarding Team should pass on details to the District Care Management Team. Concurrent assessment should be considered if this appears reasonable to the family and workers involved.

If, during the course of a full Community Care Assessment (Bands 1-3), the children in the household are considered to be "In Need" (under the Children Act 1989), the Assessment Officer will refer this to the relevant Safeguarding Team and supply such information as is relevant.

Normally a child care assessment should only proceed with the consent of a person with Parental Responsibility or a Court Order.

Where a Social Worker involved with a child in need believes that an adult with Parental Responsibility required a Community Care assessment, he/she should refer this to the District Adults Team and supply such information as is relevant.

Young carer is a term that is increasingly being used. Within the context of assessment and service response it is important to recognise that:

• Caring for a family member may be something which the child or young person wants to do as an expression of their relationship with the cared for person.
• What is considered an acceptable level of a child or young person's involvement in caring tasks will vary. However, there is a point when the level of involvement will be detrimental to the child's welfare and development.

The existence of disability or ill health in one or both parents does not necessarily imply either:

• That parents can no longer parent effectively, or
• That children/young people will necessarily take on burdensome or inappropriate caring roles.

However, it may mean that such a situation exists or may develop in the future. Therefore, where a young carer situation is identified it should trigger additional questions within the assessment process. These questions are:

• In what ways is parental activity being affected by a parent's ill health or disability?
• Is parenting ability to parent being diminished by their ill health or disability?
• Are the nature or extent of the caring tasks being undertaken by children or young persons in the family adversely affecting their normal educational, social or emotional development, or are they likely to in the future?

If the assessment is not already a joint Children and Adults assessment, decide whether one is required.

Be guided by two questions when planning a service response:

• What support does the disabled parent/parent in ill health require to enable them to continue to fulfil their parental role?
• What support does the young carer require so as to overcome or prevent their caring role having a disruptive effect upon their normal emotional, social or educational development?

Service responses may include:

• Practical provisions, e.g. aids, adaptations, sitters, home care support etc, from appropriate providers.
• Counselling - for parents and/or the children.
• Peer group support, e.g. a disability group, a young carers support group.

Where joint assessments identify a service which is required to meet the needs of both child/young person and the individual with Parental Responsibility, the matter should be referred to the respective Team Managers for a decision on the funding of the service in question.

Where practical support in the home is required to meet the needs of both adult and child(ren), a decision will need to be taken as to whose needs are primary and therefore which budget services should be purchased from. It may be possible that some identified tasks are clearly for the benefit of the child(ren) ie. they would not be required were the child(ren) not present in the household. Others may be required irrespective of the child(ren)'s presence and would therefore more likely fall to Adult Services to secure.

The value of clear and direct communication in all joint assessment and working circumstances cannot be overstated. Being aware of existing processes like the Child Protection Conferences, Care Plan formulation, the Core Group and the Child Protection Plan, and contributing to them as necessary will enhance decision making regarding future tasks and responsibilities e.g. keyworker role.

During the formulation of the respective Child Care and Adult plans, the responsibilities of each service in respect of reviews will need to be established. This should include the frequency of review, those to be consulted about/invited to reviews, and any expectations in respect of written reports. In some circumstances e.g. where both the child and adult have high dependency needs the timing of reviews will need to be co-ordinated between the two services and consideration given to the appropriateness of a joint review taking place.

Where two keyworkers are appointed to focus on the separate needs of the adult and child, it is essential that regular liaison takes place e.g. over any significant changes/deterioration in family circumstances.

1. On referral:
   Collate information and determine whether it indicates assessment by both sections of Social Care Services. Copy of referral to respective sections within one working day, with urgent referrals passed on immediately.
   
   
2. On initial adults assessment:
   
   1. There appears to be child(ren) at risk of Significant Harm - refer verbally to Child Care Management Team immediately and pass on relevant papers same working day;
   2. There appears to be child(ren) in need - refer to Child Care Management Team in writing within one working day.
      
      
3. Subsequent actions - agree with Safeguarding Team:
   1. Roles and contributions towards assessment of needs within household. NB. Refers any areas of difficulty to District Adults Manager for resolution; or
   2. Contributions to decision-making forums (case conference, Care Plan meetings).
      
      
4. Care Plan Formulation:
   1. Agree tasks and responsibilities with Child Care Team;
   2. Keyworker/monitoring responsibilities;
   3. Negotiate resources with Adults providers;
      N.B. Any disputes about purchaser responsible should be resolved by District Adults Manager in conjunction with Child Care Team Manager.
      
      
5. On initial children/families assessment or during course of ongoing intervention/support:
   1. Appears to be adult with high dependency needs - refer verbally to District Adults Care Management Team immediately and pass on relevant papers same working day;
   2. Appears to be an adult with low dependency needs - refer to District Adults Care Management in writing within one working day.
      
      
6. Subsequent actions - agree with District Adults Care Management Team.
   1. Roles and contributions towards assessment of needs within household;
      N.B. refer any areas of difficulty to District Adults manager for resolution.
   2. Contributions to decision making forums (case conference, Care Plan Meetings).
      
      
7. Care Plan formulation:
   1. Agree tasks and responsibilities with District Adults Care Management;
   2. Keyworker/monitoring responsibilities;
   3. Negotiate resources with Adults providers.

N.B. Any disputes about budget responsibility should be resolved by District Child Care Manager in conjunction with District Adults Manager.

8. In the event of a change in circumstances:
   
   If known first within children’s section, the adults section Care Co-ordinator, (where allocated), or key worker will be informed.
   
   If known first within the adults section, the Social Worker will be informed.
   
   Any changes of services within either section will be in accordance with existing procedures. If additional services are required from the other section, the relevant District Manager will be notified.
   
   
9. District Managers (adults/children’s)/Hospital Team Managers must consult with each other to consider whether any additional resource provision or joint assessment is required.
   
   
10. Reviews:
    During the formulation of the respective adult and children’s Care Plans, the responsibility of each section in respect to reviews will need to be established and will include:
    • Frequency;
    • Those to be consulted prior to review;
    • Those to be invited;
    • Any expectations in respect of written reports.

In some circumstances, e.g. where both the adult and child(ren) have high dependency needs, the timing of reviews will need to be co-ordinated and consideration given to the appropriateness of a joint review taking place.

Click here to view Flowchart: Adults/Children and Families Joint Assessment Interface.