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Within: Safeguarding Children and Young People

Related to: Alcohol, Substance Misuse, Carers, Domestic Abuse, Mental Health and Illness Complex Families People with Multiple Needs

Definition

The Munro review of child protection identified the relationship between parental problems, such as poor mental health, domestic violence and substance misuse, and abuse and neglect1,

Toxic/Complex Trio Profile

The Council has begun a piece of work to develop a better understanding of the support and safeguarding being provided to B&NES families with children where at least one parent/carer is experiencing one or more of the Toxic/Complex Trio issues, mental health, domestic abuse and substance misuse; with particular focus on those that are experiencing all three. The aim is that this information will identify strengths and weaknesses within the system to help develop more effective, coordinated and targeted support and interventions. This is in line with Ofsted requirements and the Local Safeguarding Children’s Board’s (LSCB) commitment to keep children in B&NES safe.

Fair Processing Notice

As part of the Toxic/Complex Trio Profile a Fair Processing Notice has been produced.

A Fair Processing Notice is a notice that explains how your personal data might be used. Processing personal data must above all else be fair, as well as satisfying the relevant conditions for processing.  “Processing” broadly means; collecting, using, sharing, storing, retaining and disposing of personal data.  “Personal Data” is information that relates to an individual who can be identified either: (i) from the information; or (ii) from the information combined with any other information which is already in the possession of, or likely to come into the possession of, the person or organisation holding information.

Click here to see the Fair Processing Notice 

Click here to see a summary version of the Fair Proccessing Notice 

Privacy Impact Assessment

As part of the Toxic/Complex Trio Profile a Privacy Impact Assessment has been produced.

A Privacy Impact Assessment is a process which helps an organisation to identify and reduce the privacy risks of a project. 

Click here to see the Privacy Impact Assessment

Toxic/Complex Trio Profile Questionnaire - The first stage of the Toxic/Complex Trio Profile has now been completed. This involved a questionnaire designed to find out the following:

  • What services record in terms of their client’s children.
  • Whether services record Toxic/Complex Trio needs of their clients.
  • How services decide whether clients have Toxic/Complex Trio needs.
  • If services conduct risk/needs assessments for their clients.
  • Whether risk/needs assessments include an assessment of risk to a client's children.
  • The interventions services put in place to safeguard their clients and their children.
  • The other agencies services refer clients and their children to for additional support. 

Fifty eight respondents from thirty eight different services responded to the questionnaire. Only four services sent the questionnaire did not respond. 

Results

Important to note - Educational establishments are counted as one service.

Some of the key results from this questionnaire:

Information collected about a client’s children - For 58% of services, all respondents said that their service collected all of the pieces of information about a client's children listed.

Monitoring Toxic/Complex Trio needs:

  • For 87% of services, all respondents said that their service monitored mental health needs, and for 95% of services at least one respondent said they did.
  • For 87% of services, all respondents said that their service monitored substance misuse needs, and for 95% of services at least one respondent said they did.
  • For 74% of services, all respondents said that their service monitored domestic abuse incidents, and for 84% of services at least one respondent said they did.

Conducting risk/needs assessments of clients:

  • For 68% of services at least one respondent said that their service conducted risk/needs assessments for all of their clients and for 63% of services, all respondents said that their service conducted risk/needs assessments for all of their clients.
  • For 79% of services all respondents said their service conducted risk/needs assessments for some or all of their clients.

Inclusion of children in risk/needs assessments

  • For 65% of services all respondents said that their service included risk to a client’s children in their risk/needs assessments, and for 73% of services at least one respondent said they did. 

Click here for more results from the 2016-17 Toxic/Complex Trio Profile Questionnaire  

Prevalence

Click here to see a briefing paper on Toxic/Complex Trio and Parental Needs

Specific estimates2 in 2011 based on a range of sources identified the extent to which these factors relate to various parts of the safeguarding journey.

Table 1 - Parental Needs and % Prevalence in the Safeguarding Journey (2011)

Parental NeedReferral Initial AssessmentChild Protection ConferenceCare Proceedings
Mental Illness10.416.82542
LD0.82.6N/A22
Drug/Alcohol5.811.42523
DV4.816.75551
  • Prevalence estimates are based on reported incidents carried out within individual studies and so as a result will be heavily influenced by reporting practices. 

Assessment of Service Data 3

An assessment was conducted of the following service-level data in order to try to gather a snapshot of overlapping family need as understood in practice. Analysis was conducted at the household level to account for different recording standards between agencies.

Data was assessed from the following sources:

  • Social Services – Single Assessments May 13- Dec 14

  • Developing Health Independence (substance misuse) Cases – Snapshot Feb 2015 for cases where client presented with dependent child & substance misuse need and/or mental health

  • Southside Family Project (Specialist family support, IDVA and Domestic abuse support) Cases – 14/15 cases presenting with one or more of the following needs: Mental Health, Substance Misuse, Domestic Abuse.

Table 1 – Total cases known to each agency with associated factors.

Criteria

DHI

CYP Single Assessment

SSFP

Substance Misuse

105

136

37

Domestic Abuse

Not recorded

173

259

Mental Health

16

168

82

Within the single assessment cohort, households with more than one of the associated factors represented 17% of all assessments, however they accounted for 70% of cases where concerns were substantiated with an ongoing risk resulting in a CP conference, higher than the 55% expected from national research (above). This suggests that these factors are acting as significant drivers to local social care activity as would be expected from national data.

Table 2 – Families with >1 factors known across multiple agencies.

Rows

DHI

CYP Single Assessment

SSFP

Gap

DHI

16

*

*

>10*

CYP Single Assessment

139

28

 

SSFP

83

55

69

* data <5 suppressed

Follow-up analysis examined the relationship between the different agencies. Gaps (households appearing on one list but not another) were identified. An in-depth assessment was conducted of a random sample of families from within lists provided by Southside Family Project in April 2015 to examine the risk of cases being missed from services.

This assessment discovered the following (NB: Figures are to be considered indicative and do not possess statistical reliability):

  • 10% were known to the [[Complex Familes|Connecting Families]] team.

  • 100% had contact with Social Care or Children’s Centres.

  • 90% had direct contact with council services in the previous 12 months.

  • 10% had accessed support from the Welfare Support team.

  • 50% families had [[Early Help|CAFs]] completed at some point.

With regards specific risk factors, there was notable discrepancy with regards assessment between agencies, for example in this sample, domestic abuse was identified as a factor in 80% of SSFP cases, but only 30% of cases known to the Council, but there was inconsistency across all criteria assessed.

 Socio-economic factors

Using the above data, analysis was also conducted on the distribution of these families across the socio-economic spectrum calculated through the Indices of Multiple Deprivation. This analysis suggests a strong concentration of risk within the most deprived quintile (20%) of the local authority. Comparable rates were created using the 2011 census population for households with children. 

Fig 1 - Rate of family households experiencing mental-ill health, domestic abuse and/or substance misuse 4

This demonstrates that quintile 5 (our most deprived communities) are nearly 6 times more likely to experience households with these recorded needs than the least deprived communities.