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Contents

1. For Thinking
2. For Planning
3. Police - Multi Agency Risk Management
4. Risk Assessment and Management
5. Working the Case
6. Meeting the Service User
7. Formulate Your Plan
8. Personal Experience

1. For Thinking

• Consider the situation you are handling, the risks to the workers, community, other professionals, family, and desired outcomes for now and in the future.
• Identify other professionals involved in this family/with this individual, for you will never be working alone.
• Consider the duty of care to yourself, other professionals and all Children, Young People and Families staff as well as other service users, family members and the community.
• Consider the type of worker to be used - do not use one who is inexperienced, local to the risk or will be placed in any danger in or outside of working hours.
• If the risks are significant, consider moving the case to a team outside your area, and conceal the full identity and location of the worker/s. The Directorate has experience of workers successfully working anonymously with a dedicated mobile phone line for a specific case.
• Be prepared to think outside normal practice situations. This is not a normal situation and alternative ways of thinking and working need to be sought e.g. this person would not use the normal duty system.

2. For Planning

• Approach this from a safe neutral position or use someone else who is away from the front line and is not involved emotionally or personally.
• Use an experienced worker who is confident and can think and plan safely and has experience of handling risky and difficult situations. If the worker or manager feels uneasy then respect their wishes and seek another. Not everyone will be confident to undertake this level of work.
• Ideally the worker will see this as a challenge and an opportunity to use their skills to the most effect.
• Use two workers if the risk is significant and they feel more comfortable.
• Never work alone. Use your manager to share and explore your thinking, ask your manager to double check every step with you and share risks with those in higher authority i.e. Service Manager and Operations Manager.
• Gather all known information, support and advice from agencies on the individual concerned and the risk.
• Continually write and check out plans and cover every eventuality and all options of plans going right or wrong.
• When you devise your plan for the case make it very clear and ensure each agency knows its own responsibility and is signing up to an agreed Multi Agency Plan.
• The arrangements for managing risk to staff and safe-working practices should be agreed by the Operations Manager at a meeting attended by the appropriate managers and practitioners.
• If, in the course of working the case, the risks to staff increase or major changes to the risk management arrangements are proposed, the meeting should be re-convened to consider them and plan accordingly.
• You will need to continually make assessments of risk throughout, to suit every situation you will find yourself in.
• Share your plan at all levels and seek advice from the Public Protection Officer before putting it into operation.

3. Police - Multi Agency Risk Management

• The Police have a dedicated Public Protection Officer in each locality. This person convenes monthly Multi-Agency Risk Management Meetings (MARMM).
• Consultation with this person is crucial as he/she becomes your informal ‘risk manager’ and should be consulted every step of the way.
• If the service user is particularly dangerous then s/he will be the subject of a MAPPP (Multi Agency Public Protection Plan) at Level 3. These meetings are held more frequently according to the risks posed to the public.
• Do not hold risks personally or individually within the agency, share with other agencies in a multi agency forum i.e. MARMM.
• If the service user is dangerous, then the police may already be involved. If not, ask them to become involved straight away.

4. Risk Assessment and Management

• Identify the risk to be managed, begin to understand the risk to be faced and how it might be managed to achieve the desired outcome.
• Identify all the areas with which the service user may need help and support.
• Identify key family and friends who may be a source of protection.
• Examine the impact this may have on you – confidence will be the key.
• Look at expected behaviour and the range of behaviours that might be exhibited in the future. Plan for each type of situation. Each may cause additional concern and may need a different approach.
• Seek advice from other involved or specialist professionals on how to manage this behaviour. Find out how this person has been dealt with in the past, what has worked and not worked and use this to your advantage.
• Obtain as much information from all agencies involved especially the police, criminal records, pre sentencing reports, psychiatric reports and from old departmental files. (Forewarned is Forearmed)
• Respect advice whether you agree with it or not. Do not think you know better than those experts who deal with this type of risk every day.
• Do not assume that you or other professionals are at less risk if the service user acts in an uncharacteristically friendly way.
• Find out if the service user has a good relationship with another professional, and use this person for advice, support and meetings.
• Share and check out all information and plans with the Police Public Protection Officer.

5. Working the Case

• Find the safest place for you to work with the service user. If the service user is already linked into another agency e.g. probation and is familiar with this then use that office. (Another risk assessment is needed)
• Do a thorough risk assessment of any place you are going to use. Consider your own safety and that of other service users. 
• If using a local authority office then inform Human Resources, the Police, office managers etc. Another risk assessment is needed. The Police will install a Panic Alarm if necessary. However time is needed to put these systems in place.
• If workers and locations are going to remain anonymous then you will need a dedicated telephone number for the service user contact. (Mobile).
• Remember to inform all agencies and professionals of your anonymity, it is very easy for them to make a slip if they do not know.
• Information by now should show whether the worker should be male or female, and whether one or two workers are needed.
• Again be guided and supported from those people who manage risk daily, i.e. Police, probation, prison staff.
• Always let your manager or someone else know what and where you are going, (usual risk management)

6. Meeting the Service User

• Inform the service user of your plans for meeting, expectations of behaviour, what s/he should do when s/he gets angry, and the consequences if s/he does not conform.
• Use a written agreement if necessary.
• Organise an exit route for the service user that will not endanger others if s/he is angry.
• Remember the basics about personal safety when sitting in a room with the service user etc. Remember to inform others of your movements.
• Prepare for the first and every meeting by going through your risk assessment and plan with your co-worker, or other professional support and office staff.
• Inform the police of your movements, have police presence if necessary or on stand-by.

7. Formulate Your Plan

• Make your plan, write it down and share it with the service user in a safe environment. 
• Make it plain and simple, with clear consequences for unacceptable behaviour.
• Build in realistic goals and rewards for good behaviour. This will probably be over some time and the plan will show trust on both sides therefore the risk posed will become less. 
• Never change any arrangements or timings unless agreed by the service user.
• Never show fear or intimidation and challenge behaviour only in a safe environment.
• Try to challenge thinking and behaviour over more than one session and allow the service user time to absorb he has to conform, by allowing him to withdraw from the meeting. Resume again another day.
• Lay down your rules and expectations and show respect.
• Be Bold and Clear and in Control. 
• Be up-front and honest and lay the whole situation on the line.
• Written agreements drawn up with the service user, in the service user’s language, will facilitate the plan and make expectations on both sides clear.
• Stick to your agreements. 
• Inform the service user of the risk he poses, how the risk is being managed and the tight plan of protection in place.
• Explain whether there is police involvement and/or other agencies supporting. This shows the service user that a tight package of control and support is in place and it takes some of the pressure off you.
• Use only named workers, which should be kept to a minimum.
• If possible identify good family or friends that can be used as supporters and protective agents and share all risks and information with them (especially if the concerns are about child protection).
• Share some of the responsibilities with family and friends if possible.
• Be prepared to listen to the service user and family and if possible compromise.
• Evaluate at all times, never work alone, use the multi agency forum and check out each step with them before putting a new plan into operation.
• Allow extra time, estimate the case to take three – four times longer where there is so much risk, liaison, report writing and inter agency consultation.
• Build up a relationship with the service user based on openness, honesty, trust and respect.
• Use supervision daily if necessary if not weekly updates should be shared with your manager.
• Enjoy the challenge, and build in your own reward system, for you will have earned it!!

8. Personal Experience

The service user I worked with had a personality disorder. He had a criminal record for being violent, unpredictable, with mental health problems. He did not like social workers; he was prone to self-harm and had convictions for threats to kill. He was aggressive and intimidating towards professionals, and had threatened two social workers already. He had a past history of attacking a social worker. The case involved his first unborn son and care proceedings were instigated.  The father had behaved threateningly towards social workers just before going to prison for a six-month sentence for actual bodily harm.

The father was detained in prison when the case was allocated to me; therefore time was on our side.

The task and plan was to see if this man could safely become a parent and partner within the community. Assessments needed to show if he was able to meet his child’s needs, to continue a relationship, to work with professionals and change his past unpredictable behaviours. The prognosis was poor and failure was expected very quickly.

A meeting was chaired by the Operations Manager and attended by the Service Manager and Team Manager. Arrangements for managing the risks were decided: previous engagements with local social workers had been difficult and the case was transferred out of the local area. The new workers and their locality were anonymous and contact was by a mobile phone number only.

 The plan was formulated over a couple of weeks, shared and managed in a multi agency forum at Level Three of the MAPPA process. It was discussed with Probation and the Police and each step gone through before being put in place.

The plan was also put before the court. All the legal advisers, including the service user’s lawyer, worked together, each reinforcing messages of risk management and safety.

The plan was broken down into three clear stages, each dependable on the first being achieved.  It was clear and achievable for the father, and with built-in goals and rewards along the way. The plan had clear consequences for any unacceptable behaviour: it would lead to the end of the assessment process and the subsequent loss of his son.

The whole plan was written down and explained to the father in prison.

A separate assessment of risk had been undertaken for this prison visit and each visit after that. The management of risk was shared among probation, prison staff and social workers. Prison officers were on hand to manage the father’s risky behaviour and to go through the plan with him. The probation officer had also arranged our identity to be kept anonymous while in the prison.

Another visit was set up to reinforce the conditions of the plan, again the visit was held in the safe environment of the prison, with extra prison staff and another risk assessment had been undertaken. The father was challenged on each of these visits. Two more contact visits took place, these with the mother and baby and in a more relaxed setting in the prison. The same workers conducted all these visits and a relationship began to be built up.

Two Level Three MAPPP meetings were held during this time and the plan was continually refined and updated. 

A named probation officer was made the key contact person for the father. This person had worked with the father for the past year and a relationship of trust had begun. A strategy was in place such that when angry and unable to cope the father would remove himself from the situation. The Probation Office was to be used for our meetings with the father.

A comprehensive multi agency plan of daily support and visits had been set up to take effect on the father’s release.

The plan was ‘tweaked’ at times. A compromise had been reached with the father to allow him one night with his partner on release before sending mother and baby away. This was for a period of 4 weeks to a confidential placement within the family, in order to test out the father’s ability to work with the plan, with social workers, other professionals and to begin to address his previous difficulties, start to change behaviour, etc.

All social work visits took place in the Probation Office with the named probation officer present. The father did remove himself on occasions when he could not cope.

Assessments of risk were ongoing and these were shared regularly with the Unit and Service Managers.

Progress was made and we moved into the next phase of the plan

Assessments of the extended family had been undertaken. All information and risks had been shared with them. Police officers had reinforced the risks and panic alarms were installed. Both mother and maternal grandparents were identified as key protective people.  Mother and baby returned and went to live with her parents. The first supervised contact took place in the grandparents’ home.

Clear instructions, expectations and consequences were explained to both parents and the father before contact. An assessment of risk was undertaken with Police officers prior to the contact and a Police car was stationed outside the home. Two social workers supervised contact along with the grandparents.

This heavy-handed approach was never used again and the police were kept on stand by only. The police were informed through MARMM of what was going on at all times, and the father knew this.

Although the future prognosis remains uncertain, the father has achieved everything that was asked of him. The biggest change is the father no longer uses alcohol to excess. His partner and her parents (and extended family) and friends, remain a major part of the protection plan. Everyone involved knows the full history and the risks posed by the father.

.The Local Authority has moved into the third stage of reuniting the family.

The risks have decreased due to the father’s behaviour. Trust has been built up between the service user and Social & Health Care (now Children, Young People and Families). MARMM are still involved and the father is no longer seen as a Level Three risk. The risks are still being held collectively and within the court jurisdiction.

A further meeting in Social & Health Care (now Children, Young People and Families) has been held by the Operations Manager to review the risk management arrangements and to work out how/when to transfer the case to a new social worker closer to the family’s home address.

Personality disorders are not treatable, and there is no cure. The only way forward was to provide a safe and manageable plan around the baby. Expert opinions were sought. The local authority worked closely with the Forensic Psychology Service and a managed plan was devised by the local authority.

It is too soon to say whether the father will be able to maintain his changed behaviour, as we have not finished. We have delayed the Final Hearing due to the progress, as time for monitoring was the key element.

The father is scared that he will not be able to achieve and hold on to what he wants most in the world and that is a family. (Rejection, poor childhood experiences, failed relationships, drug abuse; etc. has meant that he has little self worth or self esteem.)

The risk for the child is great. There is no guarantee that the father will not revert back to his previous aggressive and unpredictable behaviour. However we believe we have addressed the risk. Risk assessments have been made with the family, and contingency plans are in place for this eventuality.

Part of the ongoing work will be to prepare and support the father for the possibility of failure or separation from the family.  Although our priority is the safety of mother and baby, the father will remain part of his son’s life and will be part of a community. We will no doubt continue to contribute to the ongoing risk assessments through MARMM.

One of the issues for the local authority is the amount of time and resources that have been used in this case. The family alone have been visited weekly, two hours at a time, and over 80 hours of social work time have gone in so far.

End