I approached this study with the assumption (politically and professionally derived) that state intervention is ‘necessary’ in some families’ lives and that professionals can identify the point at which a child is, or is not, in ‘need’ of support or intervention. In my practice and for the purpose of this research the notion of ‘in need’ is defined by the Children Act 1989 section 17 as:
a) He is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by a local authority under this Part;
b) His health or development is likely to be significantly impaired, or further impaired, without the provision of for him of such services; or
c) He is disabled
(Children Act 1989, s17(10))
My overall personal ‘theoretical bias’ is toward constructionism and therefore I regard notions and terminology surrounding ‘children in need’ as socially constructed. As Burr (2003) suggests, there are numerous constructions of the world, each of which will result in different action. Lock and Strong (2010) in their explanation of social constructionism write:
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‘Social Constructionism’. This is the claim that we are not just individually encapsulated information processors, but are inherently social beings who go through a remarkable process of becoming enculturated adults and experience the world in all its glories and disappointments: simply put, we are humans who are constructed through our inherent immersion in a shared experiential world with other people. (Lock and Strong, 2010. p5)
From a constructionist stance I therefore approached the study from a perception that policy, procedures, team dynamics and individual attitudes would all impact on the process of assessment by shaping how front line social workers constructed notions of ‘child in need’. The initial stages of the literature review had also begun to identify that variable factors such as team dynamics and personal perceptions could impact on assessment outcomes and decisions ultimately shaping the assessment process as a whole (Holland 2000; Horwath, 2005 and 2007). However, I did not choose to undertake the study from a purely constructionist perspective as I felt this would, potentially, have taken my research into a theoretical paradigm which explored the social construction of the fetus, childhood, and motherhood rather than the process of assessment. Instead I chose to approach the study from the perspective of street level bureaucracy.
3.3.1 Street level bureaucracy
In his writing on American society in the 1970s, Lipsky (1980) described public service workers who, as part of their role, meet directly with the public in the process of delivering services as ‘street-level bureaucrats’. Occupying a critical position in the delivery of front line services Lipsky stated:
Although they are normally regarded as low-level employees, the actions of most public service workers actually constitutes the services “delivered” by government. Moreover, when taken together the individual decisions of these workers become, or add up to, agency policy. (Lipsky, 1980 p3).
Thinking about the research aim and questions as a whole, the point at which a legal, policy or procedural document was actually implemented by a social worker seemed central to the notion of what a pre-birth assessment was. Social workers’ decisions becoming, or adding up to the agency policy, had resonance with my practice experience of managing pre-birth assessments without ever feeling there was ‘sufficient’ guidance to assist in the task.
As I began to undertake the literature review, the notion of street level bureaucracy also seemed relevant in relation to issues such as professional culture and social work decision- making. Given that the literature review had identified that pre-birth assessment, particularly within the context of the Assessment Framework (DH 2000), represented a gap in the body of
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knowledge and research into assessment practice I began to wonder about the professional knowledge base upon which social workers were approaching their practice.
In relation to public employees and street level bureaucracy Hjörne et al. (2010) comment:
They meet the citizens face-to-face as a routine part of their job, and they participate in institutional decision making and what services to provide and how to respond to the issue. Because of these face-to-face routines, street-level workers are the only actors who have access to both institutional rules and procedures and to the clients’ experiences, needs and demands. (Hjörne et al. 2010 p303).
Having access to information about the unborn child and the family and then implementing plans within the context of national and agency policy and procedure, I thought it interesting that social workers were engaged in this process without, apparently, any significant research base with which to underpin their actions. For example, in thinking about my practice experience, I was aware of the assessment time frames of seven working days for an initial assessment and 35 working days for a more in depth core assessment as imposed by the Assessment Framework (DH 2000). I was also aware of the implementation of the Integrated Children’s System as a means of ensuring accountability and managerial processes focused on performance indicators. This led me to question how the imposition of time frames that sought to ensure timely assessment of children in need could be applied pre-birth. In particular how did they ‘fit’ with the nine-month duration of a pregnancy that may not end on the actual given expected date of delivery?
Westell et al (2009) reviewed the debate surrounding regulatory practice introduced by government and the potential for regulation to reduce the ability of street level bureaucrats to act autonomously. Wastell et al (2009) identified that, on the one hand, more rules and guidelines may generate more need for interpretation but, on the other hand they may control employees to such an extent that they lose the benefits of professional autonomy. Whilst the purpose of my study was not to consider the degree of autonomy experienced by social workers undertaking pre-birth assessment, the impact of autonomy was a factor that could not be ignored by virtue of the significance I felt it had. As Lipsky (1980) points out, discretion is a main characteristic of street level bureaucrats’ jobs because they often work in situations that are too complicated to reduce to simple explanations and/or solutions. As the review of the literature had identified, pre-birth assessment, as in other social work assessment work, is complex activity and so social workers are required to use discretion as they function at the interface between the procedural world and practice realities. This, in turn, places them in the position of having to make potentially life-changing decisions about a mother and her baby by interpreting information from a range of sources and applying this information within a procedurally-led framework of assessment. To paraphrase Lipsky (1980) I was interested to
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explore the actions of social workers in delivering pre-birth assessments to service users and how these added up, in effect, to agency policy.