OPENING SECTION - KEY POLICY FRAMEWORKS
1. The introduction to this Guidance mentions that it has been updated in the particular context of the national Getting it right for every child approach and also the Recovery Agenda. These key national policy frameworks followed the original publication of this Guidance in 2003. They have a focus on overall recovery of the family and are relevant to all child and adult services working with children, individuals and families.
2. Services are encouraged to ensure that the key principles and features of these frameworks are included in any local protocols that they may develop or update in light of this guidance. These key features and principles are described in this Opening Section. For practitioners' ease of reference, the overall key messages from this Opening Section are also summarised below.
SUMMARY MESSAGES FROM OPENING SECTION - KEY POLICY FRAMEWORKS RELEVANT TO THIS GUIDANCE - GIRFEC AND THE RECOVERY AGENDAS
Getting it right for every child - Key Principles
All child and adult focused services should ensure that the roles of the Named Person, Lead Professional and the Co-ordinated Support Plan (CSP) Co-ordinator - and also the local channels to engage with these - are clearly described in locally agreed substance use protocols.
All services should be clear that they have a shared understanding of the indicators of a child's well-being.
All child and adult services should focus on a 'whole family' approach when assessing need and aiming to achieve overall recovery. This should ensure measures are in place to support ongoing recovery.
There needs to be effective, and ongoing co-ordination and communication between services working with vulnerable children and adults.
Possible barriers to recovery should also be considered where partners are developing local protocols.
All services need to effectively engage with men to improve outcomes and wider recovery for the family.
Effective adult recovery is often linked to effective follow-up and peer support to ensure that these individuals can parent effectively and minimise any additional pressures that they may be facing.
Services should ensure that they take account of local providers of these services when developing local protocols for addressing problem alcohol and/or drug use.
Also, quick access to appropriate treatments that support a person's recovery can improve the well-being of, and minimise risks to, any dependent children.
When generally considering the wider possible impacts on children, adult services need to be aware that recovery timescales set for adults may differ from timescales to improve the immediate circumstances, and longer-term outcomes for, children.
Adult services should therefore always keep in regular contact with child services to agree any contingency or supportive measures that might need to be put in place. This is particularly the case where any planned withdrawal of services may be planned.
In these circumstances it is vitally important to keep the child visible in the professional community.
GETTING IT RIGHT FOR EVERY CHILD (SCOTTISH EXECUTIVE, 2005)
3. The Getting it right for every child programme is the Scottish Government's main basis for delivering national objectives for children and young people.
4. There are links between Getting it right for every child and the wider Rights of the Child etc. which can be viewed at United Nations Convention on the Rights of the Child 1989 (UNCRC) and also the Children's Charter (2004).
5. Getting it right for every child specifically aims to promote co-ordinated action by services where appropriate to improve the life chances for all children and young people in Scotland in a timely and proportionate way. To achieve this it encourages:
- a shared understanding by all services of a child's well-being in eight areas.
- That is, that all services understand that children and young people must be: Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included.
6. This shared understanding by services of a child's well-being is a critical one for the purpose of this Guidance: An example - for practitioners' general interest/information - of how the Angus CAPSM/GIRFEC Learning Partnership sought to achieve this can be viewed at
7. Overall GIRFEC has ten core components which can be viewed at www.scotland.gov.uk/Publications/2010/07/19145422/. Critical components of early intervention and prevention as part of Getting it right for every child are that it promotes the designation of a Named Person in universal services for each child. It also promotes the role of a Lead Professional to co-ordinate and monitor the effectiveness of any multi-agency activity. Such activity would result from an assessment having identified that there are potential risks to a child's well-being if help is not immediately given. The key roles played by the Named Person and Lead Professional in individual child cases are described in some more detail below.
8. It is expected that key principles and features of Getting it right for every child will soon be given a statutory basis. Services are therefore encouraged to ensure that these are included in any local protocols that they may develop or update in light of this guidance.
THE RESPONSIBILITIES OF THE NAMED PERSON AND THE LEAD PROFESSIONAL
9. The Named Person is a role designated within Universal Services of health or education (that is, those services that are generally and routinely accessed by the wider population - for example, General Practitioners, Schools). The Named Person that is appointed depends on the age of the child.
10. This would ordinarily be the midwife then Public Health Nurse/Health Visitor until the child reaches school age - at around five. In primary school, the role is likely to be undertaken by the Primary Head Teacher - and in secondary - by a member of the school management team responsible for pupil and pastoral support. In practice, this is often delegated to guidance staff.
11. The role of the Named Person is to ensure there is a first point of contact for children, their families and for involved agencies where there are any well-being concerns about a child. Their role is to take initial action if a child needs extra help and is critical in supporting early intervention and prevention.
12. Sometimes, the Named Person will assess - usually with the child and family - that the child needs help in order for his or her well-being to be improved. That help should be recorded in a single-agency assessment and child's plan. These should pay attention to the Child's overall needs and should reference those areas of well-being to be improved.
13. Where the needs of a child and/or family are more complex a multi-agency response may need to be considered - which can often be the case where problem alcohol and/or drug use is a factor.
14. As part of any multi-agency assessment, that may take place, the Named Person may also identify the need for a Lead Professional to be nominated. In these circumstances, the Named Person - having identified that a Lead Professional is needed to help co-ordinate this multi-agency activity - should initiate the agreed help. To do so, they should follow locally agreed arrangements with more targeted services to ensure that help is given. Their assessment will be the basis on which targeted support to a child and family will be built.
15. The Named Person has a responsibility to continue to have a key role here with the child - even where colleagues and practitioners in other agencies may be working directly with the family and are leading the delivery of the Child's Plan.
16. The Lead Professional is the person within the network of practitioners supporting a child and family who will make sure that the different services act as a team. It may be that they are nominated because they have the best relationship with the individual child and family. Their role is to co-ordinate the delivery of any agreed multi-agency Child's Plan.
17. The (multi-agency) Child's Plan is any agreed multi-agency action plan agreed by involved services. It describes the range of supports needed by a family and also identifies those services that will deliver these. Both the family and the services involved should be clear about the purpose of the Child's Plan and what is expected of each family member and service.
18. What is important regarding the responsibilities of the Named Person and Lead Professional is that any help that is given to a child - whether from a single service or from a group of services working together - is recorded in a Child's Plan. This should take account of all information known about a child's circumstances and should pay attention to how the child's well-being is to be improved by the help that is given.
19. Further information on the roles and responsibilities of the Named Person and the Lead Professional can be found at the GIRFEC web pages. Also, where children have additional support needs that require a Co-ordinated Support Plan (CSP), the Code of Practice on Additional Support for Learning makes clear the relationship between the roles of the Lead Professional here and the CSP Co-ordinator.
RECOVERY AGENDA - 'WHOLE FAMILY' FOCUSED RECOVERY
"You need more support when you come off the drugs".
Helen - ex heroin addict and single parent
20. All child and adult services should also take account of the Recovery Agenda when developing local protocols to address problem alcohol and/or drug use.
21. The Recovery process was described in the 2008 national Drugs Strategy (The Road to Recovery) as:
"a process through which an individual is enabled to move-on from their problem drug use towards a drug-free life and become an active and contributing member of society" (Scottish Government, 2008, p vi).
22. The recovery focused workforce includes anyone who has a role in improving outcomes for individuals, families or communities with problem drug and/or alcohol use. Scotland's drug and alcohol workforce is drawn from a wide range of sectors, including health, education, social work and the third sector. Our aim is for this workforce to be united around a shared vision, focused on the needs of individuals.
23. A recovery focused professional typically provides:
"timely, sensitive, person-centred, evidence-based support that is appropriate and empathetic which empowers individuals to set their own recovery objectives, manage their own care, and sustain recovery." (Scottish Government/COSLA, 2010, p3).
24. Recovery is also heavily referenced in the 2011 Quality Alcohol Treatment and Support (QATS) Report which outlines guidance on the effective delivery of this recovery focused, evidence-based and person-centred services for people affected by problem alcohol use.
25. The nature of recovery - including its start and end points - will vary considerably from person to person and needs to be based on an individual's own needs and goals. Sustained recovery is a journey which takes place over several years and during which a person's strengths and overall ability to recover can grow.
26. A growing number of recovery supports (e.g. peer support) are available and that are often delivered by third sector organisations. Adult services should take account of these when developing their local protocols to address problem alcohol and/or drug use.
RECOVERY AND CHILDREN AND FAMILIES
27. The following points are relevant to services focused on children, individuals and families where problem alcohol and/or drug use is a factor.
- Recovery outcomes can be improved for all concerned when wider family circumstances are considered.
- For example, the overall recovery of an adult may be linked with effective follow-up supports to ensure that they are able to parent their children effectively and to continue on their recovery journey. This should - in turn - minimise the wider pressures on the parent and the child and help to promote recovery for all of the family.
- Quick access to substance services for parents can also minimise risks to any dependent children and improve outcomes for them and their parent(s).
- The HEAT (A11) Waiting Times Target gives people faster access to appropriate treatment to support their recovery from a drug and/or alcohol problem. By March 2013, 90% of clients will wait no longer than three weeks from referral to appropriate drug and/or alcohol treatment that supports their recovery.
- Also, it is vitally important that services note that recovery timescales set for adults can often differ considerably from those that might otherwise be set to improve the well-being of - or to protect - any dependent children they may have.
- This includes in those circumstances where adult recovery timescales may need to be adjusted - or - when there is any planned withdrawal of an individual support service to the family.
- This may occur, for example, where an adult's substance use is considered to be reduced/improved as a result of effective treatments and support.
- It is vitally important that child and adult services keep in regular contact here to agree any contingency or wider supportive measures that might be needed.
- These should be put in place to ensure the ongoing recovery for both the parent and the child - particularly in the event of any alcohol and/or drug use relapse by the parent.
- Understanding and recognition of the needs of children and their own recovery journey. Recovery for children - an approach or intervention that recognises the impact and support needs of children or young people whose parent/carer is on their own recovery journey.
"I'll be there for my mum all the way. She's coming off the drugs to get me back....that makes me feel good 'cos I know my mum's going to go through a really, really hard time just to get me back"
(Shelley 12 years, Barnard & Barlow 2002).
BARRIERS TO RECOVERY INCLUDING GENDER CONSIDERATIONS
28. When developing local protocols, services should also account for any possible barriers to recovery. Some of these are described below:
- Stigma is one of the biggest issues that can prevent individuals from recovering from problem alcohol and/or drug use.
- It can mean that families are reluctant to approach services for support or to reveal the extent of their substance use - for fear of judgement or repercussions.
- Parenting can be compromised where there are frequent hospital admissions, prolonged periods of illness, chronic symptoms which affect day-to-day functioning, or social isolation and lack of supportive social network as a result of stigma. This in turn can affect family life.
- Women are less likely to enter treatment for a number of reasons. These include: inflexible service designs that do not reflect their child care responsibilities, increased stigma, fear of losing children, shame, and professionals' attitudes, preconceptions and lack of sensitivity to women's experiences (Plant 2008).
- Services to support children need to reflect these realities where interventions are designed for mothers.
- Research shows that disadvantaged, marginalised fathers tend to be unsupported and ignored by professionals, despite the father being a potential asset as well as a potential risk to the family (Lewis and Lamb 2007; Daniel and Taylor 2001)
- Lack of visibility of someone who has had a similar journey and has achieved recovery.
- There is a need for effective engagement with men by services at all stages from pre-conception, pregnancy through to childcare. This includes more effective information sharing between services working with men - for example, Criminal Justice Services as well as adult substance and children's services.
Email: Graeme Hunter