Working Together with Parents Network WTPN UK wide

Working Together with Parents Network (WTPN) • UK wide – based at Bristol University, Norah Fry Centre for Disability Studies – Lead: Beth Tarleton (academic researcher – specialises in parents with LD) • 900+ members from social care adults/children; health; legal; independent advocacy sectors – all professionals working with parents with LD • WTPN starting point: child’s welfare is paramount • Aim: Fair processes – respecting families’ rights under UNCRC, UNCRPD, Human Rights Act 1998, Equality Act 2010, Children Act 1989, Care Act 2014 • In 2016, the WTPN updated the Dept of Health 2007 Good Practice Guidance on working with parents with a learning disability • http: //www. bristol. ac. uk/sps/wtpn/policyessentials/ WTPN June/July 2018

Parents with a learning disability or a learning difficulty? • Meaning / preference / labels / practical consequences • IQ based diagnosis of learning disability [70] triggers eligibility for some services and support • A focus on ‘learning difficulties’, includes parents with a diagnosed learning disability and those with a milder impairment who struggle with the same issues of literacy, numeracy, abstract concepts, time, organisation and planning etc. but who lack a formal diagnosis and so are often not eligible for services and support. WTPN June/July 2018

MAY 2018 Parents with learning difficulties: Research and interventions Beth Tarleton and Nadine Tilbury 3

MAY 2018 Family situations • Families with multiple issues – complex cases • Parents often abused in own childhood/vulnerable to • • • exploitation Lack of support/education re parenting / social networks to support/ poor parenting role models Embarrassed by/harassed because of learning difficulty Social isolation and poverty more important than Learning difficulties No relationship between IQ and parenting ability over 60 Concerns about children usually ‘neglect by omission’ 4

MAY 2018 Outcomes for children ‘There is no consensus in the findings from studies reviewed about whether having a parent with intellectual disabilities [term used] inevitably results in poor child outcomes. Some studies suggest that these children will be disadvantaged by their parents’ low intellectual capacity; others suggest that once other factors are taken into account, such as heightened risk in pregnancy and poor birth outcomes, poverty and troubled parental childhoods, and social isolation and stigma, child development approaches population norms. ’ (Collins and Llewellyn 2012 page 80) ‘ 5

MAY 2018 Outcomes for children • A Different Childhood: Voices of 5 Adult Children of Parents with Intellectual Disabilities (PDF Download Available). Available from: https: //www. researchgate. net/publication/315834634_A_Diffe rent_Childhood_Voices_of_5_Adult_Children_of_Parents_with_ Intellectual_Disabilities • www. supportingfamiliesid. com • Researcher – Ph. D – child of parents with ‘intellectual disabilities’ 6

MAY 2018 • • Majority of the families were at risk of losing custody of their children and that extended family or support services protected the family unit and provided valuable support to the children. Some of the children had additional responsibilities growing up and all attributed this as instilling a sense of maturity and responsibility. All of the adult children achieved typical adult outcomes which included the completion of high school or the equivalent, successful employment and significant social relationships. The adult children interviewed typically did not define their relationship with their parents in terms of disability or limitations and all maintained a strong relationship with their mothers with ID. 7

MAY 2018 Support for parenting • Importance of social support and social networks, • Benefits provided by parent support groups • International call for ‘parental supports’ (Lightfoot and • • • La. Liberte, 2011; Tarleton et al 2006 and others) In the Uk: Parenting with support/Supported parenting in Scotland – in accordance with Good Practice Guidance. Advocacy vital for parents if there are concerns regarding the welfare of the children. Tailored parental education has been shown to be beneficial. 8

MAY 2018 Scotland is leading the way Supported Parenting services projects piloted in 2017 included: • Peer Support. • Parenting support and capacity building at home. • Mellow Futures Toddlers (adapted parenting programme for parents with learning difficulties focusing on the toddler years). • Knowledge exchange between partners in the Fife Care Pathway for mothers and fathers during pregnancy and shortly after. • Relationship counselling. 9

MAY 2018 Links for Scottish resources • scld. org. uk/wp-content/uploads/2017/08/PARENTING-GUIDEFOR-WEB. pdf • www. scld. org. uk/wp-content/uploads/2016/02/Guide-to. Supported-Parenting-141014. pdf • www. scld. org. uk/wpcontent/uploads/2015/06/Supported_Parenting_web. pdf 10

MAY 2018 Research and interventions in England • • Valuing Parents support service: Better outcomes for children of parents supported by service. Mellow Futures: over the course of the parenting programme the level of concern for the welfare of the majority of children was reduced. https: //www. mellowparenting. org/ Reports at: http: //www. bristol. ac. uk/sps/people/beth-jtarleton/publications. html Shared lives increasingly. 11

• • Enfield Integrated Learning Disabilities centre W Sussex Special Parenting Service – health and social care Cornwall Special Parenting Service – health and social care. Guidance on VIG. https: //www. cornwall. gov. uk/education-and-learning/schools-and-colleges/specialeducational-needs-file/information-advice-and-support/council-services/childrenspsychology-service/educational-psychology/video-interaction-guidance-service/ Plymouth Highbury Advocacy www. plymouthhighburytrust. org. uk/ Suffolk Accord – multi-agency, joint coordination adult/children’s services http: //suffolkscb. org. uk/assets/Working-with-Children/Policies-Guidance-and. Protocols/ACCORD/2016 -02 -03 -The-ACCORD-Protocol-Principles-and-Guidancev 5. pdf Coventry Grapevine – parent mentors, mothers learning together • • Adapted Triple P course available Website – www. wtpn. co. uk Easy Reads, Protocols, Research • • WTPN June/July 2018

MAY 2018 Cost savings from interventions? Bauer (2015) Preliminary cost-benefit analyses of support for parents with learning difficulties indicate that the expected return on investment, per £ 1 spent, resulted in a short-term return of £ 1. 80 to £ 3 to the government and that there was the possibility of longterm savings. http: //eprints. lse. ac. uk/64778/ 13

MAY 2018 Rip/Ripfa strategic briefing • https: //www. ripfa. org. uk/resources/publications/strategicbriefings/supporting-parents-who-have-learning-disabilitiesstrategic-briefing-2018/ Most research on mothers, recent research on Fathers: • http: //www. bristol. ac. uk/medialibrary/sites/sps/documents/wtpn/FWLD%20 SSCR%20 Findings% 204%20 page%20 summary%20 FINAL. pdf https: //www. youtube. com/watch? v=p. Ne 133 YO 5 S 0 14

MAY 2018 New ways of thinking about professional practice with parents with learning difficulties where there are concerns about child neglect. Beth Tarleton, Wendy Merchant, Danielle Turney, Nadine Tilbury Getting Things Changed project Norah Fry Centre for Disability Studies, University of Bristol 15

MAY 2018 Working with parents with learning difficulties - a focus on ‘successful’ practices • NHS research ethical approval • UOB research sponsorship and local research governance • 3 Research Advisory Groups - Professionals, Parents with LD, and Adult children of parents with LD • Working Together with Parents Network asked members to identify sites of “successful practice” in England. 3 sites chosen. http: //www. bristol. ac. uk/sps/wtpn/ • Focus on ‘learning difficulties’, including parents with a diagnosed learning disability and those with a milder impairment. 16

MAY 2018 Method Semi-structured interviews: • 8 parents with learning difficulties and the professionals involved with their support: • 37 professionals from Health, Education, Social Care, Voluntary Services Plus: • 1 Commissioner • 8 Managers Thematic analysis and discussion of themes from different perspectives of research team 17

MAY 2018 Details of mothers 9 mothers (less than half living with partners) • 2 mothers with one child only - baby and age 7 • 7 have one or two older children • 5 families older children have been removed • 1 family spends alot of time with grand parents • 1 child lives with family during the week • 1 child, who is disabled, has regular respite • 1 family has ongoing contact with previous foster carers 18

MAY 2018 Concerns about the welfare of the child • Grubbiness of child reported by nursery • Child needed to have 7 teeth out • Child under-weight • Older child very badly scalded • Concerns regarding father/partner/Uncle • Inappropriate friends • Family was homeless • Poor housing 2 Mothers felt the concerns were linked directly to their learning difficulties. One mother spoke of abuse in her childhood 19

MAY 2018 Adults involved with family 6 had support from family Professionals: ● Children’s social worker ● Special parenting service ● Usually an advocate (1 mum didn’t believe they helped, another family supported) ● Others varied: Health visitor, family aide, LD social worker, LD support worker if diagnosed LD, nursery, school ● In one area, tutors on college course. 20

MAY 2018 Differing relationships with Child’s social worker From feeling they didn’t understand them and wanted to remove their child to understanding they are there to help 'I will work with you because the judge said, and this is my last chance, but don't think that I don't – I can't trust you. I can work with you because I have to, and it's for the baby, to make sure that my baby stays with me. But I do not trust you. ' ‘I’ve had a couple of social workers that didn’t understand. ’ 21

MAY 2018 ‘They were friendly. She did help in some parts. She showed us all the things we needed to do to be able to move into our own house in the future, everything. ’ ‘I think it's just the safety of the child. Like making sure that they're looked after properly. They've got what they need, and not coming into any sufficient harm. ’ ‘It was just to see if they thought that I could cope by myself, if there was any sort of additional help they would need to give me, if I needed support, that sort of thing. ’ 22

MAY 2018 One family disliked one social worker -and really like the next due to different approach - ‘not suited and booted’ but ‘relaxed’ and supportive rather than ‘critical’ One family had 9 children’s social workers 23

MAY 2018 Changing relationships with the child’s social worker One mother’s story: ‘I'm going to put my hands up and say that my hygiene wasn't that brilliant, and I wasn't looking after my- ourselves. The place was totally in a mess, . . But as I say, it was both our faults why our son was taken. But this time we proved to them. We asked for help and we got help. ’ ‘With my daughter I thought, No, this time I'm going to show them how much I've changed. ’ 24

MAY 2018 Other mothers said: 'You know, and then sort of really edging me on, and saying, You are, you're doing really well. You're really listening to us, and. . . you know, since the first time we met you, we've come in, and you're really starting to listen and progress as a mum…. . So then that sort of put my mind to rest, and, maybe they're not here just to take her away. They are here to support me as well. ’ ‘But I did thank the last social worker that I saw, because I said, 'You have been supportive…. And now my prospects of social services are different: they're not always there to take your kids away. They’re there just to check the child, and just make sure you're doing what you should be doing. ’ 25

MAY 2018 Positive relationship with at least 1 professional • Workers from the special parenting service as well as health visitors and family support workers and children’s social workers • Parents felt ‘respected’ and ‘supported’ • Helped parents to understand learn • Parents felt they could contact professional if they needed advice even if not currently working with them 26

MAY 2018 ‘She is very understanding. I can talk to (special parenting worker), like I'm talking to you. She puts me on the right road. ’ ‘She helped me learn about how to be a proper parent, like how to do things properly with a baby. ’ ‘I got to see what I was good at. ’ 27

MAY 2018 Practical approach ‘Showing me stuff on, like, a doll. And, like, worksheets’. Easy information Showing how to do things Use of video Discuss feeding Teaching how to cook Help with budgeting Help to get on the housing list ‘Helps me play with him. ’ 28

MAY 2018 Professionals’ understandings about parents with learning difficulties Recognised on-going impairment ‘Mainly that parent has difficulty processing information, and may have difficulties with their own literacy, numeracy, and speech and language, that sort of thing really. ’ 29

MAY 2018 Recognised parents’ on-going support needs ‘A higher need for support and information in a way that suits them. ’ ‘Somebody who would actually need some extra help, either from family members, or from professionals, in order for them to be able to care for their child, to meet the child's educational needs, and emotional and physical need. ’ 30

MAY 2018 Recognised stigma parents face ‘Society's probably been quite cruel, even from when they started as children, because children in schools get picked on when they've got learning difficulties, and I think it can continue, you know, through life. ’ 31

MAY 2018 Recognised the multiple issues faced by parents ‘If you've got a parent whose mind is completely preoccupied with not having enough money, fear, maybe mental health issues, then it's very hard to sort of prioritise, and be thinking about your child's needs. So I would say that a percentage of the parents that we see with learning difficulties and neglect, it's actually because of those broader, social, mental health issues, that prevent all parents, actually, from being able to prioritise. ’. 32

MAY 2018 Understandings about neglect by parents Not deliberate neglect ‘Not maliciously neglectful’ ‘Parents with additional needs, OK, there might be neglect there, OK, there might be identified areas of neglect. However, potentially, probably, not intentional’ ‘Not automatically make the link’ between ld and neglect but would ask the question: . . . I would wonder whether those parents had been appropriately supported in a way that they could access and understand, to parent their children effectively. ’ 33

MAY 2018 Assessment of ability when children have previously been removed Person-specific ‘I don’t always think that people should have second chances. But obviously a lot of that will be dependent on the situation. And how many chances do you give someone? ’ Change should be recognised ‘something needs to have changed for children’s services to be convinced. ’ 34

MAY 2018 Safety of child ‘I believe that everybody has the right to appropriate support to parent their children effectively. And if they have had access to that and things haven't worked out, that doesn't mean that they shouldn't have the opportunity to try again with different, more. . . differently shaped support, or whatever, as long as the child is safe in the meantime. I think people can change. People can change. And also that sometimes where people talk about having a second chance, it's because the first chance wasn't appropriately supported in the first place, and that was why things went wrong. ’ 35

MAY 2018 Reaching decisions regarding removal ‘So if the scales tip, if you like, if you're sort of thinking, actually this child isn't safe, you know, this plan isn't working, it's a really, really hard process. It's a really hard process as an individual, but it is in a team. And it's no surprise that at those points there can be quite a lot of splitting, and sometimes conflict in the team, because different people are reaching that decision at different points of time. And I don't think there's a way round that; that's probably actually how it has to be. ’ 36

MAY 2018 Working with parents - positive practice Focus on welfare of the child/ren ‘It could be successful practice that you've identified that a parent can't do it, and that child is in a place where it is now having all of its needs met. ’ ‘We absolutely sit on the fence whether the good outcome is the child being removed or the child staying… Whatever is right for the child. … You know, they can both be really good outcomes” (Specialist parenting service) 37

MAY 2018 Understanding the parent and their situation ‘I think it's having a clear understanding of their difficulties, and knowing what works and doesn't work for them … communication is key in my job, so it's finding out what best – what tools are best to use, what format's best to use, what approach is best to use. So I think it's a caseby-case approach, on just, you know, having a … profile of a parent, and actually what works and doesn't work for them. ’ ‘ 38

MAY 2018 Clarity about concerns ‘Just, you know, working openly and honestly, you know, keeping the person, you know, aware of, you know, what your sort of thinking is, and, you know, what things you're sort of worried about, you know, regularly discussing that. ’ (Children’s social worker) ‘We did it around the Signs of Safety: what we were worried about, what's working well, and what needs to happen. So that Mother was clear, you know, what, as professionals, what we're worried about, what was working well, and what needs to happen. Because actually the concerns that we had, they weren't Mothers and Mother’s partner’s concerns. ’ ) 39

MAY 2018 Relationship with the parent ‘Clinical skills are obviously important, but without a relationship with families, then all is lost, in my opinion. So a great deal of effort needs to go into building relationships, building trust, in order to get the best outcome for families. ’ 40

MAY 2018 Parents are central to the team ‘I think it is that: it has to be working as part of the team, but with the parent with learning disability as part of the team. Not the client, and not the person with LD, it's just all being a team and working together…. ’ 41

MAY 2018 ‘So it's actually understanding that they're still the expert on their child, they are the parent. You know, and it's a team approach. So it's ensuring that they know who we are, what our roles are, you know, in a professional manner, but also caring manner in there. Yeah, I'd expect us to be very much talking to parents, ensuring that they're happy to have that information, to have that consultation at that time, for us to be involved, but also really well-informed on anything that, you know, sort of we're trialling, doing, recommending, you know, and that they're part- you know, they're very much the lead on, and part of that team around their child. . . it's the only approach that works; parents really need to be part of the decision-making. ’ 42

MAY 2018 Tailoring support to family’s needs ‘But with Mother we actually, you know, took a doll and took it into the sleep environment, and put it down in the cot, and showed her how to make the cot up, and what things to think about and so on, and were much more hands-on and practical with that. And also repeating it, so that she could understand it […]. . . we used a DVD about how to attach baby at the breast, what that looks like, we showed her with a doll, we gave her the opportunity to hold a doll, we lent her a DVD and went through it with her about how to hand express if she couldn't attach baby to the breast, and what that would be like, and showed her how to do that with a little breast, and all those kinds of things working up to the birth’ ‘ 43

MAY 2018 Meetings • • Flexible timings Short Easy read versions of reports Involve advocate Accessible room Transport Reminders Easy read note confirming what was said. 44

MAY 2018 Practical ways of working together • Use of cognitive assessment to explain parents needs to team • ‘Team around the child’ approach • Specialist workers providing training and role modelling how to work with parents to rest of the team 45

MAY 2018 Resources used • Assessments - PAMS especially ‘I need help’ questionnaire, Cognitive, SALT • Easy communication - pictures, plain talk, no jargon, no abstract concepts • Change resources – My Baby 0 -1 • The Social Baby video • Breast feeding video • Use of doll. • Signs of Safety & I Thrive • Video interaction Guidance 46

MAY 2018 Professionals working together ‘So it's been around parenting skills …. crucially the way that we've worked; we've never worked just singly with Mum, giving this advice, it's been about working with the team who've been able to then go and apply that at home. And show very practically what needs to be done’. ‘So we do talk a lot between professionals, about, sort of, what's not working. Quite clearly, very quickly, you know, if something isn't working, it's picked up and discussed as a group. And part of that is sort of case-by-case sharing, so you're learning on the job with reallife cases, about, sort of, what works here. And then, you know, as I say, you would take that to case reviews, and also to CPD. ’ 47

MAY 2018 The 6 Ts Working with parents takes: ↓ Time Trust Tenacity Truthfulness Transparency Tailored response Professionals worked in accordance with the Good Practice Guidance on Working with Parents with a Learning Disability ( Do. H & Df. ES 2007, WTPN 2016) 48

MAY 2018 Role of specialists services Expert knowledge/advice/guidance/joint work Models: • Consultation model - parental learning disability specialists were called in to support or advise other practitioners such as health visitors / school nurses; • Hub model - in which specialists at the centre co-ordinated all other practitioners’ involvement with the family. Driven by health sector practitioners, even where most of the dayto-day support/work needed was from the social care sector. 49

MAY 2018 • • Specialist teams based in: Health and LD team Children’s services Integrated health and social care • Led by health professionals: clinical psychologist, SALT, OT. 50

MAY 2018 Impact of specialist services Confirmation of existing positive approaches • Usually based on a belief regarding maintaining children at home, if safe, and importance of relationship based practice Reframing and supporting understanding • Positive use of cognitive assessment to explain how to work with parents • Explaining parents situations, reactions and fear of engagement • Challenging negative assumptions about parents 51

MAY 2018 Policy considerations: • The Good Practice Guidance on working with parents with a learning disability • Strategic planning for future need • Budgets o Funding advocacy o Pooled budgets 52

MAY 2018 The Good Practice Guidance on working with parents with a learning disability DH/Df. ES 2007 updated by WTPN 2016 ‘I mean it's all in the Good Practice Guidelines which we have then translated into our local policy, which just sort of says how we operationalise all of that. ’ ‘In terms of guidance, what would be widely known amongst our social work teams is the Good Practice Guidance, . . . which is very much driven by our legal services, and saying, you know, you should be really familiar with this, and making sure that …’ 53

MAY 2018 ‘So I think for successful practice to happen, you need to have all of those markers that are in the Good Practice Guidelines: it needs to be collaborative, it needs to be positive, it needs to completely have the child's needs at the heart of the plan, of the practice, as well as the parent's needs, so there needs to be a good balance. ’ 54

MAY 2018 ‘I think successful practices are everything from the Guidance. So making sure that, you know, the information's accessible, that we have clear referrals and timely referrals, that we do have a joint protocol. . . , that the support is designed based on the individual's needs and strengths, and. . . that there's long-term [approach], advocacy – all of that. ’ ‘I also think it's successful when there's. . . all the agencies are working to the same agenda, going back to that challenge, that we all believe that, yes, this is do-able. This parent can do, and be safe, and be good enough to be able to do that. And I think that attitude is. . . you know, adds to the success of it. ’ 55

MAY 2018 5 main principles of the Good Practice Guidance: • Accessible information and communication • Clear and co-ordinated referral and assessment procedures and processes, eligibility criteria and care pathways • Support designed to meet the needs of parents and children based on assessments of their needs and strengths • Long-term support where necessary • Access to independent advocacy www. bristol. ac. uk/sps/wtpn/policyessentials/ 56

MAY 2018 Strategic planning for future need ‘What else do we need to change? I think the commissioning strategy, I might actually have a think about getting our commissioner involved now! Yeah, let's change that, shall we? ’ ‘If we don't know what the needs are, and the potential need is. . . If we get some facts and figures, we can plan more accordingly, to be able to meet that. . I don't think we probably collate the unmet need, things that we're not able to provide, in a formalised way, so that we can then put our case to our commissioners in order to say, 'Look, can we address this need that we're finding at the moment? ' So I need – yeah, perhaps I as manager need to change that. ’ 57

MAY 2018 Major investment made in PAMS expertise in one area, in terms of training, finance and systems. Yet no statistics about anticipated numbers of parents with learning disabilities. ‘We have xxx children currently on child protection plans; it's interesting that I can say lots of data, but I don't know how many of those children’s parents have got a learning difficulty. ’ ‘The learning disability team aren't liaising with us about what they must know could well be coming through, I guess. ’ ‘We rely on the service provider to identify need and to notify us as commissioners as and when they see that need shifting significantly. ’ 58

MAY 2018 Budgets ‘Can’t really say how much we spend on supporting parents with learning disabilities because it’s a sort of needs-led thing. ’ ‘and that's all out of my budget. It makes savings in other people's budgets. ’ 59

MAY 2018 Financing advocacy where there are concerns for the children ‘Care Act advocacy provision. . . separate to our learning disability, advocacy, commissioned provision, . And that's where sometimes parents with LD receive that support…. where it's around parenting it is a very, very resource-intensive piece of work, that has a longer duration than a lot of their other casework…. we've talked about that, but haven't made any decisions about putting parameters around that. We leave that to the provider to manage their resources, and prioritise their resources. . . [sometimes we end up using our] section 17 money, if we're feeling that actually that is an absolute necessity. ’ 60

MAY 2018 Pooled budgets - children’s / adults’ / health ‘We commision jointly from the pooled LD budget … whilst there will be some health outcomes, quite often the outcomes are around parenting function and independent living. [Midwives, Health visitors, maternity services, antenatal care? ] at the moment we don’t really have a joined up approach to commissioning in that context…. That’s something to develop I think. ’ S. 75 arrangement for pooled budgets LD services between LA/NHS plus contribution from Children’s Services to help focus on family 61

MAY 2018 ‘So for children, or for parents with learning disabilities, following the assessment, if there was a need for ongoing support, it would be a discussion with children's about why is that support needed. So if it's support around the parents' needs, under the Care Act, then that would clearly come from me and my purchasing budgets. If the need is around support for the child, and isn't around the parenting of the adult, then children's would pay for it. Or from time to time, I know in the past we have got into – because it's quite hard to disentangle that sometimes – we have got into some joint funding arrangements. But it's on a case-by-case. We don't have a pooled budget that automatically funds it. ’ 62

MAY 2018 ‘It's a parent budget or a child budget. You know, we all – I mean I know there's been an argument for quite a long time that the learning disability parenting team should be funded by children, because it's about parenting. That's the view of the adult services. And the view of children's services is, it is about parenting, but it's about working with the adults, therefore it's you. ’ ‘Clearly, with budgets shrinking over the years, it's kind of – you know, children's services have tried to push onto adults, and adults have tried to push onto children's. . but I have to say. . . certainly my experience, both here and in other places I've worked, is that … actually, to kind of not do that, and to try and work together, in the long-run saves money. ’ 63

MAY 2018 Links Successful practices report: http: //www. bristol. ac. uk/medialibrary/sites/sps/documents/wtpn/GTC%20 SUMMARY%20 REPORT %2016. 5. 2018%20 designed. pdf Good practice Guidance: http: //www. bristol. ac. uk/medialibrary/sites/sps/documents/wtpn/2016%20 WTPN%20 UPDATE%20 OF%20 THE%20 GPG%20 -%20 finalised%20 with%20 cover. pdf 64

Parents with learning difficulties – the policy and law in 2018 WTPN June/July 2018

“If I was a ‘normal’ parent, people would assume I was a good parent, until I proved I wasn’t. But if you have a learning disability, people assume you are a bad parent, until you can prove you’re not. ” Scottish parent [video – SCLD] WTPN June/July 2018

Re EV (A Child)(No 2)(Scotland) • “So far as the father is concerned, it was not for him to show that he possessed the necessary parenting skills. The onus lay on the local authority to demonstrate that he did not, and that any resulting risk to the welfare of the child could not be addressed by the provision of support. ” [57] [2017] UKSC 15 WTPN June/July 2018

• Key legal issues and case law • The Good Practice Guidance on working with parents with a learning disability 2016 • Experts • Assessments • Areas for scrutiny and challenge • Successful practices / resources WTPN June/July 2018

Key legal issues • Recognition of the right to parent • Working towards re-unification, where possible • Full participation, at all stages • Fair processes, throughout WTPN June/July 2018

The legal context • United Nations Conventions on o The Rights of Children o The Rights of Persons with Disabilities • Human Rights Act 1998 – private and family life, fair trial, discrimination • Equality Act 2010 – reasonable adjustments, public sector equality duty • Children Act 1989 – welfare of the child, child in need, child protection • Care Act 2014 – parenting, independent advocacy • Children and Families Act 2014 – experts, timescales WTPN June/July 2018

S. 149 Equality Act 2010 Public Sector Equality Duty Public authorities required to have due regard to the need to eliminate / advance / foster EHRC Technical Guidance describes “due regard” as meaning that “in making decisions and in other day-to-day activities a body subject to the duty must consciously consider the need to do the things set out in the general equality duty: eliminate discrimination, advance equality of opportunity and foster good relations. ” WTPN June/July 2018

Duty to reduce the need for care or supervision orders Schedule 2 (7) Children Act 1989 • Duty to take reasonable steps designed to reduce the need to bring care proceedings for care or supervision orders WTPN June/July 2018

Good Practice Guidance on working with parents with a learning disability (2007/2016) • Key document. 5 main principles: v. Accessible information and communication v. Clear and co-ordinated referral and assessment procedures and processes, eligibility criteria and care pathways v. Support designed to meet the needs of parents and children based on assessments of their needs and strengths v. Long-term support where necessary v. Access to independent advocacy WTPN June/July 2018

Joint Committee on Human Rights Seventh Report “We consider that if the recommendations for good practice in each of these areas were implemented effectively, this could significantly reduce the risk that parents and children would be separated, in breach of the Convention. ” A Life Like Any Other (2008) WTPN June/July 2018

London Borough of Hackney v Williams & Anor [2017] • The existence of ‘good practice’ guidance about such issues of course does not have the force of law but can provide a useful benchmark against which to measure if the local authority have acted proportionally. WTPN June/July 2018

Kent County Council v A Mother [2011] • “All social workers and family support workers, working with children and families need to be trained to recognise and deal with parents with learning disabilities. The [Good Practice] Guidance issued by central government needs to be followed. ” WTPN June/July 2018

Medway Council v A and Others [2015] • “It is clear that the purpose of the 2007 Do. H Good Practice Guidance, namely to ensure that appropriate steps are taken to ensure services and training are in place to meet the needs of parents with disabilities, has yet to be met in Medway; and there appears to have been little if any awareness of the Do. H Good Practice Guidance's recommendations shown by Medway's practice in this case. ” WTPN June/July 2018

Applying the GPG principles If GPG had been complied with, judges would not have had to criticise lack of / absence of: • • • Specialist foster carers Specialist assessments Effective communication Independent advocate Joint working between children and adult services WTPN June/July 2018

GPG principles absent • Targeted and suitable expert assessments are required. Re C [2014] • The courts must be careful to ensure that the supposed inability of parents to change might itself be an artefact of professionals’ ineffectiveness in engaging with parents in appropriate terms. Re G and A [2006] • I have to question whether [the social worker] was able to communicate orally with SH. Derbyshire County Council and SH [2015] • The Local Authority’s duties under Article 8 include the duty to ensure that the processes by which decisions about children are made are fair and that the parents are sufficiently involved in that process. A Father v SBC & Others [2014] • At the heart of the problems in this case has been the division of the LA’s work between adult social services and children’s services … they did not work together or form a consistent view of the case. ” Re S [2013] WTPN June/July 2018

Re Y [2017] Bridging the gap • http: //www. familylawweek. co. uk/site. aspx? i=ed 180330 Public Law Clients with Learning Disabilities – Bridging the Gap. Gillian Geddes, barrister, Hind Court [publication of judgment awaited] • Disconnect between realities on the ground (child meeting milestones, doing acceptably well) and social workers’ view (mother could not meet child’s future needs) • Ability to learn - the psychologist, who had assessed the mother for 90 minutes some considerable time before the court hearing, gave evidence that she believed mother could not learn - yet support workers confirmed mother had learned how to cook, follow charts and lists, carry out basic risk assessment of potential partners • Prediction - all the child workers predicted mother could not keep child safe from future harm – but this was speculative. Difficult to know, at this stage, what impact the (as yet unidentified) support would have on the welfare of the child. WTPN June/July 2018

Re Y - Bridging the gap (cont) • Not child care experts – the Judge was wrong to dismiss views of support workers on the basis that they were not child care experts • Targeted assistance - obligation of the court to assess extent to which inadequacies in the standard of parenting can be overcome by targeted assistance. • Better environment - avoid asking whether permanent separation from the mother provides a better environment for the child to be brought up in; instead, focus on whether parenting under such a support package would be harmful to the child’s health and development. • Intense environment - negative assessment followed 12 week residential, again in contrast to support workers’ views. The intense environment of the residential assessment unit was recognised by the court. WTPN June/July 2018

Re T (A Child) [2018] • Court of Appeal noted from earlier cases that: • It is not open to the LA to decline to accept the court’s assessment and evaluation of risk, and it cannot refuse to provide lawful and reasonable services that would be necessary to support the court’s decision if by doing so it would unlawfully breach the rights of the family concerned. WTPN June/July 2018

A Local Authority v G [2017] (cont) • To describe the Guidance as a ‘counsel of perfection’ is to give a charter to ignore it which should be robustly challenged; [para 215] HHJ Dancey WTPN June/July 2018

President’s Guidance 10 April 2018 President of the Family Division’s Guidance – Family Proceedings: Parents with a Learning Disability • ‘My primary purpose in issuing this Guidance is to bring to the attention of practitioners and judges, and to commend for careful consideration and application by everyone, the very important “Good practice guidance on working with parents with a learning disability” issued by the Working Together with Parents Network and the Norah Fry Centre in September 2016: ’ WTPN June/July 2018

Children and Families Act 2014 • Expert reports can only be commissioned if the court deems it “necessary to resolve proceedings justly”. • Reliance placed on social worker’s reports and assessments – – What is their expertise in working with parents with learning difficulties? – How have they applied the GPG principles? – Is their assessment specifically tailored for a parent with learning disabilities? WTPN June/July 2018

HB v PB [2013] Fabricated illness case, but clear parallels with parents with a learning disability cases. • The social worker had no – awareness of the relevant guidelines – training in relation to these cases – experience of such cases • The court found the LA had ‘failed to attach any, or any appropriate significance to the important national published guidance relevant in cases of this kind’ and had failed ‘to ensure that the allocated social worker was aware of the relevant Guidance’. • The court said it could not ‘allow the Local Authority’s hard pressed financial resources to allow me to release it … from its clear statutory responsibility …’ WTPN June/July 2018

Expert Reports • Re TG (Care Proceedings: Case Management: Expert evidence) [2013] EWCA Civ 5 – The judge will need to consider the nature of the particular expert evidence the admission of which is in issue. ‘The evidence of an expert in one discipline may be of marginal use; the evidence of an expert in another discipline may be crucial’. (Munby P. ) • Re B (A Child)[2013] UKSC 33 the court highlighted the need in care cases for the court to be presented with the best possible evidence upon which to make the decision. Decisions which require the ‘highest level of evidence’. WTPN June/July 2018

Assessments Re Z (A Child: Independent Social Work Assessment) [2014] EWHC 729 HHJ Bellamy sitting as a HC Judge held: ‘In any case in which a local authority applies to the court for a care order, the assessment of the parent is of critical importance. That assessment will be a key piece of the evidential jigsaw, which informs the local authority’s decision-making, in particular with the formulation of its care plan. If the assessment is deficient then it is likely to undermine the reliability of the decision-making process. It follows from there, that any assessment of a parent must be, and must be seen to be, fair, robust and thorough. ’ [130] WTPN June/July 2018

WTPN Assessment guidance www. wtpn. co. uk Parenting Assessments for Parents with Learning Difficulties • Sets out basic guidelines and key messages • Addresses erroneous assumptions e. g. IQ is a predictor of parenting ability / children will not receive adequate stimulation / parents will not be able to learn new skills • Provides authoritative research references in support • Suggests factors that the assessment should take into account so that appropriate supports and teaching methods are identified and provided • See also the British Psychological Society Good Practice Guidance for Clinical Psychologists when Assessing Parents with Learning Disabilities WTPN June/July 2018

Guiding principles include • Process is predominately child-focused rather than on parental behaviour alone • Process uses language and communication that the parent can understand • Content takes a contextual and functional approach • Use of psychometric testing should not be the main or only source of assessment • Importance of identifying parents’ strengths as well as needs • What supports are and have been available – were they suitably targeted to meet the needs of the family? • Good enough parenting – no greater expectation is to be required of a parent with learning difficulties WTPN June/July 2018

Invalid assessments • Invalid assessments – no advocate, – unable to participate fully, – assessor not PLD experienced, – not tailored or appropriate – assessment not specialist – PAMS / Learning Curves etc. WTPN June/July 2018

Appropriate legal assistance Pre-proceedings list for solicitors - Is the solicitor / barrister familiar with: • The President of the Family Division’s Guidance (April 2018) Family Proceedings: Parents with a learning disability https: //www. judiciary. gov. uk/publications/family-proceedings-parents-with-alearning-disability/ • The Good Practice Guidance on working with parents with a learning disability (2016) http: //www. bristol. ac. uk/sps/wtpn/resources/ • Care Proceedings and Learning Disabled Parents - A Handbook for Family Lawyers. Abigail Bond • Relevant case law since the 2016 GPG e. g. re Y, re G • Law Society Practice Note http: //www. lawsociety. org. uk/support-services/advice/practicenotes/meeting-the-needs-of-vulnerable-clients-july-2015/ • Advocate’s Gateway Toolkits http: //www. theadvocatesgateway. org/ • PAMs, Learning Curves, Shared Lives, other local or national projects, programmes, initiatives, support WTPN June/July 2018

Areas for scrutiny / challenge • Has the LA done what it can to avoid the threshold being reached? Or to avoid the need for removal? • Have the processes been fair? • Have the principles of the Good Practice Guidance been applied? E. g. – Has there been a reliance on numbers and diagnoses rather than the individual’s strengths and needs? – Has there been too much focus on process and not enough on outcomes? – Was the foster placement suitable? – Was the assessment tailored and appropriate? – Was the parent able to participate fully? – Are concerns speculative or evidence-based? – Have options to address risk been identified as well as the risks? WTPN June/July 2018

Speculation not facts / identifying risk but not options • Speculation / Identifying the risks, but not exploring options to address those risks – – – won’t be able to provide stimulation won’t be able to help the child with its homework the people providing support will be doing the parenting the child will become more attached to the supporter than the parent yes, they’ve made good progress and the child is reaching all its developmental milestones but • that’s with support … • who knows if they will maintain that progress … • the child’s needs will change and they won’t be able to manage … WTPN June/July 2018

WTPN contacts www. wtpn. co. uk Beth. Tarleton@bris. ac. uk – WTPN co-ordinator and researcher Nadine. Tilbury@bris. ac. uk – WTPN Policy Officer WTPN June/July 2018