The children in the cases

At the extreme end of the spectrum there were two cases where children had died and another where a child was in hospital with severe injuries that are usually associated with shaking or some other serious trauma (retinal haemorrhage and subdural haematoma). In one of these cases the father had been arrested for murder and while he was denying responsibility the child had been in his care and the social worker could see no other explanation. In the other two cases there was uncertainty: in one because the injuries could have been caused by congenital problems arising from a difficult birth and in the other there was also uncertainty if the injury was non-accidental.

These are extremely serious cases, stressful to deal with, and the uncertainty as to what happened was very difficult to manage. The workers in these cases were often very cautious about coming to conclusions because of lack of information, disputed information or a refusal by doctors to commit themselves.

A worker involved in the case of the young child with retinal and brain injuries, was asked how she responded to the news that he had two injuries commonly associated with non-accidental trauma:

Well on its own um it would make me feel I need more information really and what are the medical team implying about the significance of that ...um... so it was a question of trying to make sense of the information we were being provided which was fairly scant really...um...

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because it was a child who had attended a routine ophthalmology appointment in X one week and the retinal haemorrhages had been picked up on that appointment and further review organised with a more specialised medical person at Z Children’s Hospital for the following week...so there was a confusion, there was more than one hospital involved and a team of medical professionals involved (TM1)

This worker talks about trying to make sense of the information and assess it carefully in context despite its suggestive nature. Buckley (2003) in her study of Irish social workers noted this “sense making” response to complex information was common and ran counter to the assumptions of orderliness and predictability that lie behind the official procedures.

In the case where the worker was reasonably sure the father was the culprit complications revolved around another issue: how to act to protect the siblings? This was a feature of several cases. Were siblings at risk in situations where a child had been hurt in sometimes uncertain circumstances? What was the best way of protecting them? In one of the above cases family members were asked to look after a child, in another the authority moved quickly to take the case to court to ensure a quick decision was made.

In another case that a member of the team was already involved in there was a dreadful domestic abuse incident where a man tried to set fire to his partner and the house in front of their children.

What had happened were over a 6 hour period, and the 2 children were at home, the father was under the influence of a cocktail of drugs, alcohol, seriously assaulted the mother in front of the children, brought a can of petrol into the house, poured a can of petrol all over mum and the stairs, had a lighter, were threatening to burn her and the house down, threw some clothes into the garden and actually set them alight. (SW5)

As she rather chillingly put it:

They (the children) could have died that night

The difficulty of knowing the significance of an apparent injury or possible abuse and assessing the levels of risk was a feature of a number of other cases. In a case I observed a child returned to his mother from a period with his father with a bruise which was reported by the Health Visitor. The team took this very seriously but as further information came to light about the custody dispute between the parents, the mother’s state of mind and the extent and visibility of the bruise so the nature of the situation had to be reassessed. In another there were reports concerning a family one of the team was working with of the mother’s behaviour:

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And there’s been reports...we had an anonymous referral before I was involved about mum hitting A, the oldest one. There’s this incident not long ago where the Children’s Centre staff reported that she’d grabbed him by the arm and dragged him and sworn at him, so you sort of think there’s a risk there perhaps from mum (SW4)

What significance is to be given to such incidents which might be observed, say, in a shop or other public space on a daily basis?

Sometimes it was not clear what, if anything had happened and, if it had, what its significance was. In one case a 2 year old child had spent a night with an uncle who it transpired was associating closely with a known paedophile. Had the child been sexually abused? Was it necessary to know when that meant putting the child through a distressing and invasive medical? In another the worker was alerted by a neighbouring authority that a man having regular overnight contact with his children was a known sex offender. Was he putting his children at risk? Could his ex-partner protect them from him?

There were cases where decisions made in the past had to be revisited. In one case the child had been removed because of neglect and parental mental health issues but had returned home and the case closed as conditions seemed to have improved. But some years later the child had talked at school about the conditions at home and his mother’s erratic behaviour and it became clear on visiting that this was not a safe place for him. The authority were now in the difficult position of applying for a Care Order, having once had a Care Order discharged on the same boy.

In another a pre-birth assessment had concluded that the baby would be safe at home but it rapidly became clear after the birth that this was not the case and the family had to be reassessed.

In another case involving previous decisions – where a child had been severely injured in the past (either by the mother or father, it was not known for certain) – the mother was pregnant again and an assessment was needed to determine whether or not she would be able to care for the new child.