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To think Health Visitor home visits should be compulsory by law? Distressing content.

(187 Posts)
PeaceBeWithYou Thu 03-Oct-13 19:47:17

If you miss one, cancel one, are not in etc, another one should be scheduled within 3 month period and if it is again missed without adequate explanation, then police should be granted access with a HV to check on the children's welfare. Health and well being home visits should be scheduled up to the age of 10 perhaps?

Rather extreme but could this have prevented Hamzah Khan's terrible life and needless, horrifying death?

Agencies were involved with the mother but she was 'obstructive' apparently. That poor boy must have been starved from birth to be so stunted in his growth. No medical reasons have been given and also no medical professionals were aware of it so it seems. No mention that Hamzah was ever seen by a HV. The mother did not seek medical attention either sad.

Those other 5 DC in the house were also subjected to living in absolute filth and from some of the houses I've sen it is probably the tip of the iceberg.

We are too bloody worried about upsetting parents and not enough focus is on helpless DC IMO. The gloves should be off. If you have DC which are part of society, then society should take a firmer hand into ensuring their well being as it seems all too apparent that some parents can't be trusted.

One life saved or changed would be well worth it IMO.

passedgo Mon 07-Oct-13 17:06:27

In most of the serious case reviews there were plenty of people involved, even the neighbour, but if the people in power don't take it seriously enough to enforce entry to the property the preventive measures won't help.

I think you're right that in the early days there would have been an opportunity to help this woman but DV is so tricky and can be hidden by the perpetrator through threats etc.

One thing that would help is a strict no booze or drugs rule. If you're found to be dependent on drugs or drink, you can't look after children under a certain age.

ringaringarosy Mon 07-Oct-13 16:03:56

i think possibly there needs to be some kind of campaign about looking out for one another,a bit like at christmas when were told to look after old people in case theyre lonely or cold,we should be looking out for each other,who knows,if hamzahs mum had help early on when she was in an abusive relationship and an alcoholic,this might not of happened,of course there are always going to be people who are just fucked up and want to do evil things,but some of these cases must stem from other things.

passedgo Mon 07-Oct-13 14:51:26

There was plenty of contact from HVs in Daniel Pelka's case but when you have this kind of thing, even the best HV won't help.

"On the 29th January 2008 a multi-agency domestic abuse Joint Screening meeting6 was convened which considered the previous incidents and Ms Luczak’s recent suicide attempt, resulting in the decision that an Initial Assessment be conducted by CLYP. There was no record of this decision in CLYP records or of an Initial Assessment being undertaken at this time."

ringaringarosy Mon 07-Oct-13 13:52:25

this would not work because it will only penalise the people who really look after their kids by making life difficult for them,the people who are really doing something bad will find a way to hide it.

The only time i have seen a hv or doctor is when i had my first baby,i have 4 now and another on the way,i see my mw but havnt seen doctors or hv as i dont feel the need to.

passedgo Mon 07-Oct-13 13:36:46

Miaow I've been there but I always respect (hard though it is) the fact that they are doing their job, they don't want to waste time, and if you've got nothing to hide then they can't blame you. The more information you give them the better, it gives them a clearer picture. Hostility just makes them more suspicious.

There is a huge difference though between cases and they should differentiate with the kind of case it is. Amanda Hutton should have had serious intervention given her vulnerability in a violent relationship. And there are cases like yours where assessment is more complicated.

It doesn't help that they are very inflexible, so insist on x and x not happening instead of finding a way of helping you avoid it happening (like your childminding issue).

I remember one woman, single parent, new to the country, who desperately needed counselling, was offered it but couldn't go because she didn't have childcare.

MiaowTheCat Mon 07-Oct-13 12:33:01

Right - first things first can we stop bandying around "known to social services" as some kind of instantly-proven-to-be-a-shit-parent band of automatic guilt and stereotyping. My family have the label - because of a fucking malicious allegation ruled out within 24 hours but a label we have no right to redress and can never get rid of - as do lots and lots of families and it hangs over your head constantly. So quit with the offensive presumptions on that one OK?

I'm sick of the witchunting of parents and the "oooh but Baby P" if anyone dares object. I'm sick of a fucking ridiculous world where a conversation that goes "oh yeah we're having a bit of a crap time because of DD2's allergies but the health visitor's on the case and working with the dietician and GP to get it resolved" gets into a "because of your declaration we have to inform your health visitor you've told us this" - when the bloody "declaration" was relaying a conversation I'd had WITH the health visitor in the first place. (HV's comment when I told her they were going to be telling her this was an eye rolled "oh for god's sake" - I like my HV!) I'm sick of a world where I feel like I have to hold off getting anxiety treatment for months because more of my medical notes involve an account of the condition of the kids and my relationship with them than my own health. And woe betide you if you leave the kids with their father to pop down to the GPs - that one you could see the alarm bells and paperwork scrolling behind the GP's eyes (I think I did tell her - it's ok - the kids were seen at the children's centre this morning and by the HV this week so you can put the safeguarding form down - I just didn't fancy loading two kids into the car when their father's at home to watch them).

It just gets me, someone educated, well informed and rational very cross to be constantly viewed and treated as such - and I end up bloody parenting to cover my arse in advance. There's such suspicion and finger pointing already that I DO catch myself thinking daft things like when DD1 managed to pull one of those buggy books too tight and bop herself on the face with the bungee effect of it - that I won't go to baby group because then they'll document the bruises for future evidence - easier to just skip this week than face the interrogation. It's already fucking ridiculous and I'm sick of being treated like a criminal because I dared have a child.

The only distressing content is just how happily people would view everyone even MORE as suspects to be scrutinised 24-7... I hope you feel the same when your own kids are bringing up their kids too bloody scared to breathe for fear of being caught out by the system or having to go to A+E and risk triggering alarm bells or whatever.

horsetowater Mon 07-Oct-13 11:56:22

From the Yorkshire Post

"But by October 2009 after repeated failed appointments, Hutton’s GP surgery removed mother and child from the patients list - as is normal practice."

I have been banging on about this for years. Non-compliance is an indicator that there is a problem, not an excuse to get patients off your books. This woman was drinking a bottle of vodka every day.

horsetowater Mon 07-Oct-13 11:34:13

Friday the main reason they keep children with dysfunctional parents is because it saves money. There is also a libertarian aspect involved, giving people too many chances in the hope that the addiction is temporary. I agree with you that it's just not good enough.

In Hamzahs case, they sent a PCSO to visit, it was her second day. She kept going back and tring to make contact but this should have escalated much sooner. The neighbours had complained about nappies being thrown into the garden, he said he heard noises and believed there was another child in there. A PCSO should never have taken this on.

There was lots if history as well, she had her first baby young to a violent man, after she left him the oldest son took over. Eight children later, one every year, with pnd, she was dependent on those around her. Sadly the people and services she needed were not there.

filee777 Sun 06-Oct-13 14:36:37

I think drugs and alcohol are factors, but certainly not the be all and end all, parents can be bad regardless and good parents can be good regardless.

filee777 Sun 06-Oct-13 14:31:37

I just thought your comment was far too general.

friday16 Sun 06-Oct-13 13:31:15

I know plenty of pot-heads who are great parents, or folk who can't get through an evening without a drink but always put their kids first.

That's not what we're talking about. We're talking about methadone-maintained heroin addicts and a woman who was drinking two bottles of vodka a day.

filee777 Sun 06-Oct-13 11:19:08

I agree with the lack of judgment thing but I disagree with the 'alcoholics and druggies' thing, I know plenty of pot-heads who are great parents, or folk who can't get through an evening without a drink but always put their kids first.

friday16 Sun 06-Oct-13 10:27:56

When reports are made, and case conferences convened, social workers with protection in mind need to take and follow through sceptical, focussed action. Social workers must not accept conditions (filth, squalor, drug and alcohol use) that they would not tolerate for their own children. Children should be listened to, and should be at the focus of child protection. If a child being removed to a place of safety will cause harm and upset to alcoholics and drug users, that tough shit: it is not the role of small children to act as animated teddy bears for the comfort of inadequate parents. "Cultural sensitivity" (Climbie, Ishak, Pelska, probably Khan) must not trump child protection. Drug users and alcoholics are not fit parents, and should not be treated as such. When a child is being abused, they are the victim, not the abuser, no matter how touching their backstory.

Social work has been contaminated by the idea that they should not be judgemental of "other" lifestyles. That has to change.

filee777 Sun 06-Oct-13 10:19:11

Then what, in your opinion, needs to change Friday.

friday16 Sun 06-Oct-13 10:17:57

You don't think there is room for both?

No. Specialist, trained social workers have routinely failed when trying to balance supporting the mother with protecting the child, and they are only involved when there are already concerns. It would be impossible to be appropriately sceptical when there are no prior concerns (ie, when the chance that abuse is happening is perhaps a hundred times smaller) and 99 times out of 100 they would be right to support the mother rather than regard it as abuse. And, as JakeBullet points out, even if they did start reporting suspicions, the amount of extra work created would detract from real protection work.

ender Sun 06-Oct-13 10:15:11

Ninjanurse - you said you're a staff nurse working with a health visiting team. You mentioned that you do new birth visits.
Am surprised at this, I thought the first visit was done by a HV who made an assessment then delegated to skill mix team if appropriate.
Is this happening because the PCT can't recruit qualified health visitors? Or perhaps it's to cut costs, HVs earn more than staff nurses.

filee777 Sun 06-Oct-13 09:22:27

Interesting Friday.

You don't think there is room for both?

Although, of the three hv's, one has been completely useless.

Well has anyone got any thoughts on what should change? Because surely something must.

friday16 Sun 06-Oct-13 09:17:54

they have been reported to SS multiple times. The HV comforts the mum every time this has happened

The protection of Peter Connelly failed because the social worker assigned to the case, MW, saw her role as supporting Tracy Connelly. Each time there was a threatened escalation of protection, MW worked with Tracy Connelly - whom she saw, at that point, with some justification as a vulnerable victim - in order to stabilise the situation. In the case of Keanu Williams, the SCR explicitly points out that because of her extensive experience in the care system, Rebecca Shuttleworth was plausible and convincing as a victim and knew how to work the social workers to keep them onside. Having now (thanks filee) read the SCR into the death of Declan Hainey, at paragraph 18 it states "(mother) presented as an articulate and intelligent woman who was able regularly to provide very plausible reasons for failure to attend for planned appointments".

Health Visitors are not primarily intended to do child protection. Child protection requires what is referred to as "respectful disbelief" or "professional scepticism": there are already protection concerns, and the social worker should be starting from the position that if the child is being abused, then the carers are lying. It's the failure of that scepticism, when the social worker starts to believe the carer and see them as the victim, that is the heart of several recent failures of protection.

Should Heath Visitors arrive in houses and start from the position that if the child is in any way remarkable (underweight, overweight, marks, not sleeping, making poor eye contact, too noisy, not noisy enough) or the house is in any way remarkable (too tidy, too untidy, too warm, too cold) that the mother is lying and the child is at risk? If "yes", then what you've just done is destroyed the potential value of health visitors to the 99.9999% of parents who are not abusers. If "no", then your desire to have them as frontline investigators of potential abuse just failed.

TidyDancer Sun 06-Oct-13 07:30:18

so,etching should be 'something'

TidyDancer Sun 06-Oct-13 07:29:51

In the one case I personally know of that needs so,etching done about it, the HV has been fucking useless, but then so has every other agency/organisation. The two children in the family live in squalor (not quite as bad as the Hamzah case, but could easily get there) and they have been reported to SS multiple times. The HV comforts the mum every time this has happened, not offering any real support to improve things and the mum is now able to avoid seeing her in the home. SS have told the mum that because they have seen worse, no further action will be taken. Police were refused entry at the front door on one occasion and never pursued it.

The DCs are neglected and not abused in the family I refer to, but I have no faith in any agency if that situation can be allowed to continue. I fail to see how increased visits from an HV would help.

JakeBullet Sat 05-Oct-13 23:28:36

As an exHV I have to say that I don't think this would work....although I can utterly understand OP's thinking about it.

I have taken regular calls about children who have not been seen by anyone for long periods of time and in most cases there is good reason for this. Parents who go abroad regularly, those who shun nurseries etc and travellers etc.

Finding these children takes time ...on one occasion it took me nearly 18 months to track down a child who the nursery expressed concerns for as he had simply disappeared from their nursery and they had concerns about his development. It turned out that the parents had gone abroad for a year and returned to a completely different address over a year later.

I have also seen families who have good reason for requesting no further HV involvement. Those who have children with disabilities are often inundated with appointments and the last thing they need is to add a HV to that.

The key issue is that most children are seen regularly by SOMEONE ...usually that is in nursery etc and then later on school. It doesn't have to be a HV but perhaps there needs to be a system for flagging up those children not being seen by anybody.

In the case of AH, she would have had regular post natal visits from a midwife and a new birth visit from a HV. Evidently life was more normal then as none of these visits flagged up concerns. AH was an experienced mother and rightly left to make her own decisions regarding baby clinics etc. most women who have had a third, forth or fifth baby will not bother with baby clinic and in the absence of any safeguarding concerns there is no reason for interference.

I gather that systems for checking on children who have not been seen by anyone are being looked at in the light of this case. I doubt that it will result in enforced HV contact though.

filee777 Sat 05-Oct-13 23:13:32

I don't think you can possibly say (regardless of the retrial) that it was not wholly unaccountable that the little
Boy was missing for so long and nobody noticed. That's the point I am trying to make, children should not just 'go missing' and I do believe that a lot more needs to be done to make social workers and other HCP's have more powers as they are the people who see it, not just hear about it from a script.

Thanks for the link I read it through and it's interesting to me that after hearing she was absolutely responsible for leaving that little boy to die, that it might not be the case. It shows up yet another flaw in our social system.

I have to sleep now, but I will think on it and come back. Thanks again.

friday16 Sat 05-Oct-13 23:05:41

Definitely would have helped in the other two cases though.

How do you know that?

There hasn't been an SCR into the Khan case published.

The other example you quoted, the death of Declan Hainey, I simply can't see what point you're making.

The mother had been under constant supervision by social services, and had been subject to repeated case conferences. The child was seen at home (Significant Case Review, paragraph 24) and concerns were raised to a senior social worker, but nothing was done. Again I ask: why do you think the problem is people being detected as being at risk, rather than what is done? How in this case would someone else reporting concerns have helped?

After the child's death, by the way, it's a complete car crash of a judicial process.

The mother was prosecuted and convicted, but all the convictions have been overturned by an appeal court and the original trial was, we now know, a total shambles. There's no evidence that the child was mistreated, at least to the extent of serious harm, as the appeal court rejected all the evidence (given, we now know, by an "expert" who had no medical qualifications, and neglected to mention that the other witness who supported her was her PhD student).

At worst, you have a child who died of unexplained causes and whose death wasn't reported by a mother who was very vulnerable. So you think that a child who may not even have being abused could have been "saved" had there been more contact? On what possible evidence?

Read about the whole disaster here.

filee777 Sat 05-Oct-13 22:38:07

Sorry I must have my case reviews crossed.

Definitely would have helped in the other two cases though.

I think there are two issues here, one with children disappearing and another with totally inadequate judgement calls being made by relevant authorities.

friday16 Sat 05-Oct-13 22:28:34

I think it would have made a difference to Williams

How? He was seen at home, repeatedly (SCR p. 39). Those visits raised concerns. Within a few months, there had been a S.47 enquiry and a core assessment. (page 40).

Keanu Williams was killed in spite of an a S.47 enquiry, a core assessment and a recommendation tha an IPCC be convened? What do you think a health visitor could do better? The failures started once social services were considering protection measures, not in realising that protection was needed.

"...the focus of the meeting was not on the history of Rebecca Shuttleworth and Keanu but on the immediate concerns about Father 1‘s reported ‘threats. Rebecca Shuttleworth was seen by the professionals as plausible and as a ‘victim’ in relation to Father 1."

He didn't die because people didn't know he was at risk. He died because people didn't do anything about it.

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