Protecting children: Have we been asking the wrong questions?

Each year there are over half a million referrals to children’s social care in England. This requires a huge amount of specialist work by social workers and their colleagues to assess the situation of children, ensure they are protected and that families’ needs are understood.

A new research programme, led by NCB and the Universities of Kent and Cambridge, presents an exciting new opportunity to develop the evidence base for this work. The Living Assessments programme will harness service data, the experience of children and families and the perspectives of professionals. It will develop new insights into working with families to understand the needs and risks they face.

Our initial work on this project suggests there are many unanswered questions about the focus and direction of children social care.

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Financial pressures on services, and heightened public awareness of extreme cases of abuse, have had an impact on how social workers are expected to respond to families. Whilst assessing a child’s risk of significant harm has always been a part of social work, in such a climate it has inevitably come to dominate the job. The received wisdom is that social workers should be particularly vigilant for three risk factors in family life: parental mental illness, parental substance misuse and domestic violence. Alarm bells ring loudest when these issues occur in combination in what has come to be known as ‘the toxic trio’.

Such a focus on these three factors as sources of risk to children can make building relationships with parents harder. The parents we work with, who have first-hand experience of children’s social care, have described feeling unfairly questioned, judged, and stigmatised by the focus on the toxic trio in risk assessments, especially when relatively little support is available to help parents address these and other difficulties in their lives.

Of course, it is vital that services follow the evidence to keep children safe. It is well established that individually parental mental illness, substance misuse and domestic violence are associated with poorer outcomes for children. But what does the evidence say about how these combine as ‘the toxic trio’ and how central it is to protecting children?

A recently published systematic review has investigated the available research evidence.

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The researchers found that the concept of the toxic trio, and the focus on it by children’s social care, is backed up by very little evidence. There is only anecdotal evidence, as yet, that they multiply risk to children. There has also been little inquiry into whether these factors increase the risk of harm more than others.

Studies into the toxic trio are inconsistent in how they define the three factors – sometimes including learning disability within the scope of mental illness for example. Whether or not families are supported to address the three factors, and what effect this has for risk to children, has not been investigated.

Data from assessments of families’ needs, which could provide important insights, also has its flaws. Despite deprivation presenting obvious challenges to parents, and being known to be a key factor in the likelihood of social care intervention, it is not routinely recorded through social care assessment data.

We need to look for ways to improve approaches in children’s social care in an evidence-informed manner. The Living Assessments programme will see new analysis of linked social care, health and education data to ask what factors predict social care intervention and the kinds of involvement that predict positive outcomes for children and families. For now, the extent and nature of the gaps in the evidence base force the question: have social workers been encouraged to focus on too a narrow set of issues?

In asking this question, we should also take the opportunity to review the vision that lays behind policies and priorities in social care. We hope that the Government’s eagerly anticipated Care Review will enable this by exploring why, as well as their experience of care, how children come into contact with the social care system

We must all work together to build a more supportive, holistic and well-evidenced approach to working with struggling families.

By Keith Clements, Senior Researcher, and Ava Berry, Research and Policy Analyst, at NCB.