Dealing with Persistent Non-Engagement with Services by Uncooperative Families

There are frequent occurrences where children, and/ or their families, are referred to an agency without their full appreciation of the need for a service or indeed with open objections to that referral. Professional judgment, based on evidence gathered via assessment, shows that the plan needs to be actioned in the interests of the child. As such, there is a need for all agencies involved in safeguarding  children to be alert to the different types of non-engagement and react to it in a consistent and effective manner.

Persistent non-engagement with a service should trigger a review and impact assessment in respect of any children within a family.

The overall aim of this policy is to facilitate multi-agency decision-making and planning in such cases to ensure joint ownership of decisions.

Where a referral to a service is accepted by an agency as valid, necessary to ensure the child is kept safe and is able to thrive, and where the referral is based on assessed need, it should be considered that the engagement of the parents is required. By refusing to work with the agency in completing the assessment, the parents or carers would be potentially causing neglect to the child: "avoidable impairment" of health, education or other need.

When need has been assessed, every effort must be made to ensure that the parents are fully included in decision-making processes. If the assessment is completed using the Early Help Assessment (EHA) then they should have a copy and have completed the permission to share the information.

If the assessment is in a format other than an EHA then they should be shown a copy of the assessment and asked for their views on the recommended course of action. Good practice suggests that this should be done in person wherever possible but, bearing in mind the scope of this policy, it is possible that assessments may need to be posted, either by hand delivery or recorded delivery, by the author of that assessment.

The plan which stems from the assessment would include appointments being offered considering family circumstances, transport, other children in the family, and be at a suitable venue.

A useful definition of the type of behaviour being addressed by this policy is "unrelenting, steadfast opposition to a course of action proposed".

The detail of the definition will vary from family to family taking into account their circumstances.

Issues to be considered when determining the action required are;

Impact on assessment - if there are outstanding areas of assessment to be completed, can this be done via liaison with other professional colleagues who would be able to share the information with other agencies as part of their responsibilities under Working Together.

Impact on the child/family - if the recommendations are not carried out, will the child suffer Significant Harm and what will be the effect be on the family functioning? For example, will stress levels increase to a level where breakdown is likely?

Impact on availability of resources - is this a one-off chance to access a resource for the child or their family?

Therefore, where the point is reached that there is either:

• Firm evidence of harm being suffered, or imminently likely to be suffered;
• Imminent threat of resources being withdrawn from a family even though the assessed need remains;
• Evidence that the family is failing to engage with more than one agency this protocol should be invoked.

'Disguised compliance' involves a parent or carer giving the appearance of co-operating with agencies to avoid raising suspicions, to allay professional concerns and ultimately to diffuse professional intervention.

The term is attributed to Peter Reder, Sylvia Duncan and Moira Gray who outlined this type of behaviour in their book Beyond blame: child abuse tragedies revisited ( (1993) London: Routledge).

"Sometimes, during cycles of intermittent closure, a professional worker would decide to adopt a more controlling stance. However, this was defused by apparent co-operation from the family. We have called this disguised compliance because its effect was to neutralise the professional's authority and return the relationship to closure and the previous status quo." (pp 106-7).

Examples of disguised compliance would be a sudden increase in school attendance, attending a run of appointments, engaging with professionals such as health workers for a limited period of time, or cleaning the house before a visit from a professional.

All agencies should collate failed appointments if they suspect a family is operating in this mode - this assists in evidencing this issue by giving an overview of co-operation levels and reason for failed appointments.

Single agency approach

Within supervision, the worker and their line manager will discuss the case. Issues to be considered are likely to include;

• Other agency involvement,
• The use of EHA as an assessment tool to inform decision-making,
• Consultation with the EHA Coordinator.

Progression to become multi agency concern

If the single agency approach is not successful, a multi-agency meeting under the EHA procedures is appropriate to explore whether there are other ways of engaging the family, for example, where it is believed that one agency has a more constructive working relationship with the family - this may be the health visitor or midwife who may be viewed by some families as more acceptable than Children's Social Care

What action is taken?

EHA - the EHA will be the key assessment tool for all agencies in determining the impact of non-engagement on the assessment, on the child and on their family. The EHA can be collectively updated by all agencies involved to give a holistic view of the child's situation together with an effective chronology which is critical to informed decision-making.

EHA processes are the best way of bringing all agencies together to determine the needs of the family. A 'Team Around the Child' or other multi agency meeting should be attempted in all cases except those where a management decision within the lead agency is made to exclude parents due to risk of immediate physical violence.

Professionals Meetings - in all cases where a Team Around the Child Meeting is convened but the family fails to arrive, professionals present should continue to meet and plan their engagement with the family.

There should be a dual purpose to this:

1. To explore, share and affirm the information held on single agency assessments as a means of updating EHA;
2. To formulate and set a timescale for an engagement plan with the family concerned. This will vary according to each circumstance but must be reviewed within a maximum of 6 weeks.

Where Children's Social Care is not already involved and non-engagement continues, a worker from Children's Social care should be invited to attend the first multi-agency review, which should take place within 6 weeks. Children's Social Care workers should provide information and advice to the review about any strategies not yet known or tried and on the referral process to Children's Social Care where deemed appropriate. Children's Social Care should continue to attend reviews of the plan where appropriate.

Where Children's Social Care become involved and non-engagement continues, the multi-agency review will need to consider making a referral to Children's Social Care with a view to a Strategy Discussion/Meeting, Section 47 Enquiry and for a Child Protection Conference.

It may, in some circumstances, be valid for the multi-agency meeting to decide to take no further action. This course of action should be confirmed and approved by line managers in each agency and only in the absence of safeguarding concerns.

Each agency should have a system to highlight where a referral is a repeat referral. Within Children's Social Care this covers a 12-month rolling period, so a repeat occurrence is any referral made within 12 months of the last one and for the same presenting reason.

Where a repeat referral is received, a manager in the agency should make a decision, based on a review of the up-to-date chronology of the case, whether this repeat referral warrants an escalation of response through the multi-agency processes - see Resolving Professional Differences/Escalation Policy.

Each agency should have guidance in place for when a professional is unable to gain access to a home.

Following a 'no access' visit the responsibility for any assessment of the situation rests with the professional who has been unable to gain access. The assessment should include:

• Liaison with other relevant agencies;
• The needs of the child and the parents'/carers' capacity to meet those needs;
• The environmental context of the child's situation;
• Consideration whether immediate intervention is required to secure the child's welfare.

Where there are clear safeguarding concerns a referral should be made to Children's Social Care - see Making Referrals to Children's Social Care Procedure.

If there are clear indicators that a child is home alone and/or at risk of Significant Harm, the Police should be called and the need for the child's immediate protection through Police Protection or an application for an Emergency Protection Order should be considered.