Social Work Provision for Deaf and Hearing Impaired Children and Young People Ros Hunt Alys Young, Rosemary Oram, Carole Smith Social Research with Deaf People group (SORD) University of Manchester

This presentation Why integrated children's services are of interestWhy integrated children's services are of interest The research methodsThe research methods The findingsThe findings The importance of these findingsThe importance of these findings

A policy change Integrated children's services would have different impacts in different areas:Integrated children's services would have different impacts in different areas: –Cradle to grave (disaggregation) –A minority service –New opportunities Patchy and non-existent engagement with early interventionPatchy and non-existent engagement with early intervention What are the social care needs of deaf children - The wrong question?What are the social care needs of deaf children - The wrong question?

So..... Funding from NDCSFunding from NDCS Specialist Research UnitSpecialist Research Unit Specialist Voluntary OrganisationSpecialist Voluntary Organisation

Why are d/Deaf children different? 1. Establishing communication between parents/carers and children of enough quality and quantity to enable optimal language acquisition, development of emotional relationships, learning as a child within a family.

Why are d/Deaf children different? 2. Effective reciprocal communication in social, educational and community contexts to assist psychological development, socialisation, identity formation, confidence and social competence.

What did we do? Phase 1Phase 1 –Five Local Authorities –17 interviews Phase 2Phase 2 –Questionnaire –Respondents represented 52 LAs Largest and most comprehensive study ever undertaken in this area of practiceLargest and most comprehensive study ever undertaken in this area of practice

Service arrangements (n=52) 4 had no formally designated service arrangements at all in respect of deaf children and their families.4 had no formally designated service arrangements at all in respect of deaf children and their families. 6 had specialist deaf children and families teams (5 led by Education, but in 2 there were no SW qualified staff)6 had specialist deaf children and families teams (5 led by Education, but in 2 there were no SW qualified staff) 22 CDTs had designated responsibility but in only 12 was there any deaf child related expertise (and that included v basic expertise)22 CDTs had designated responsibility but in only 12 was there any deaf child related expertise (and that included v basic expertise)

Service arrangements 6 officially provided through specialist d/Deaf Adult services (but with training and systems issues)6 officially provided through specialist d/Deaf Adult services (but with training and systems issues) 6 contracted out to voluntary organisations (but with limits)6 contracted out to voluntary organisations (but with limits) 8 ‘other’ (e.g. shared between Authorities but at least 2 with no qualified social workers)8 ‘other’ (e.g. shared between Authorities but at least 2 with no qualified social workers)

Why should variation in service arrangements matter?

It matters because.... Without specialist teams/specialist service arrangements/specialist knowledge within wider teams, referrals are far less likely to trigger even a basic assessment: Medical model understanding of what counts as ‘complex’ [only one thing affected – the ears…!]Medical model understanding of what counts as ‘complex’ [only one thing affected – the ears…!] Teams unable respond to all but the substantive and criticalTeams unable respond to all but the substantive and critical But no understanding of substantive and critical based on the complexity of deafnessBut no understanding of substantive and critical based on the complexity of deafness

It matters because.... Without specialist teams/ service arrangements:Without specialist teams/ service arrangements: –Workers forced into ‘ways and means’ to provide any kind of service –Systems (e.g. computers) don’t allow appropriate involvement/transfer of knowledge –No clear referral or provision pathways (we introduced people to each other) –Extremely poor joint working –Hardly any preventative services –Only in a ‘crisis’ did families get a service or other professionals work with social workers

Qualified social workers? Over a quarter (28.3%, n=13) of the Local Authorities did not employ any qualified workers who were specialist working d/Deaf adults and/or deaf children. In no case can this result accounted for by the Authorities concerned having contracted out arrangements whereby a specialist voluntary organisation for example, provides services.Over a quarter (28.3%, n=13) of the Local Authorities did not employ any qualified workers who were specialist working d/Deaf adults and/or deaf children. In no case can this result accounted for by the Authorities concerned having contracted out arrangements whereby a specialist voluntary organisation for example, provides services. In 46% (n=23) of the Local Authorities there were no qualified social workers who worked with deaf children and their families either as officially part of or as the whole of their job remit.In 46% (n=23) of the Local Authorities there were no qualified social workers who worked with deaf children and their families either as officially part of or as the whole of their job remit. The median staff complement of qualified social workers working with deaf children and their families was 0.25The median staff complement of qualified social workers working with deaf children and their families was 0.25

From large survey 50% of Authorities - no systematic arrangements for ensuring that deaf children and their families receive a joint assessment involving health, education and social care, nor a defined multi-disciplinary ‘pathway’ for planning and service provision.50% of Authorities - no systematic arrangements for ensuring that deaf children and their families receive a joint assessment involving health, education and social care, nor a defined multi-disciplinary ‘pathway’ for planning and service provision. Over 50% of Authorities - no formal referral arrangements between social work and education professionals “where deaf children and their families may require assessment and/or service provision”Over 50% of Authorities - no formal referral arrangements between social work and education professionals “where deaf children and their families may require assessment and/or service provision” Nearly 45% of Authorities - no formal referral arrangements between social work and health professionals “where deaf children and their families may require assessment and/or service provision”Nearly 45% of Authorities - no formal referral arrangements between social work and health professionals “where deaf children and their families may require assessment and/or service provision”

From large survey: Just over a third of Authorities were of the view that education colleagues were responsible for the needs of deaf children and their families (including social care needs) unless referral was appropriate at particular points in time (e.g. transition), or some exceptional circumstance occurred.Just over a third of Authorities were of the view that education colleagues were responsible for the needs of deaf children and their families (including social care needs) unless referral was appropriate at particular points in time (e.g. transition), or some exceptional circumstance occurred. Even if a deaf child was formally identified as a ‘child in need’, in only two thirds of the LAs would that child and family be offered even an initial assessment (drops to fewer than half where there is no specialist team arrangement)Even if a deaf child was formally identified as a ‘child in need’, in only two thirds of the LAs would that child and family be offered even an initial assessment (drops to fewer than half where there is no specialist team arrangement)

From: Young, Hunt, Smith (2008) “I see the role of the social worker… as supporting, empowering, informing, helping them make choices, being alert to any safety issues and that can be in its widest possible sense from say traditional safeguarding and child abuse issues right the way through to life stage work so if you know that a child is just moving from primary to secondary school, are they Ok with road safety, when they are moving up to teenage stage, are they ok about the community, do they know that they themselves can get to their GP, can they use interpreters, that sort of thing. So it’s empowering at different life stages for the child, informing, supporting the family when you’re thinking of the whole family.”“I see the role of the social worker… as supporting, empowering, informing, helping them make choices, being alert to any safety issues and that can be in its widest possible sense from say traditional safeguarding and child abuse issues right the way through to life stage work so if you know that a child is just moving from primary to secondary school, are they Ok with road safety, when they are moving up to teenage stage, are they ok about the community, do they know that they themselves can get to their GP, can they use interpreters, that sort of thing. So it’s empowering at different life stages for the child, informing, supporting the family when you’re thinking of the whole family.”

Our conclusion to the 2008/2009 reports: Despite evidence of pockets of exceptional good practice and comprehensive provision.Despite evidence of pockets of exceptional good practice and comprehensive provision. There is clear evidence on a widespread basis of:There is clear evidence on a widespread basis of:

Conclusions poor integrated children’s services arrangements in respect of deaf children and their families.poor integrated children’s services arrangements in respect of deaf children and their families. a lack of specific attention to deaf children and families’ social care rights and needs;a lack of specific attention to deaf children and families’ social care rights and needs; poor recognition of need and provision of assessment;poor recognition of need and provision of assessment; severely limited ability to work preventatively within a broad understanding of safeguarding;severely limited ability to work preventatively within a broad understanding of safeguarding;

Conclusions ambiguous pathways of service provision;ambiguous pathways of service provision; responsiveness only in situations of acute need, (the escalation of which may have been preventable);responsiveness only in situations of acute need, (the escalation of which may have been preventable); lack of focus on the psycho-social developmental, linguistic and cultural challenges and differences of the full diversity of deaf children.lack of focus on the psycho-social developmental, linguistic and cultural challenges and differences of the full diversity of deaf children.

In these circumstances, and with specific reference to social care, there is strong evidence to suggest that the statutory duty on Local Authorities to co-operate within Children’s Services to promote the well being of children is being significantly compromised in relation the well being of deaf children and their families.