2.1.9 Pre-Birth Assessments

SCOPE OF THIS CHAPTER

This protocol is designed to ensure a clear pathway between the respective services within Children's Social Care and to ensure that there is a consistency of approach between teams.

The following principles apply:-

Each new pregnancy, where there are, or may be, significant concerns regarding the unborn child, must be the subject of a new assessment, giving due regard to the history.
The assessment process should begin as early in the pregnancy as is possible.
The purpose of a pre-birth assessment is i) To consider whether additional support is needed to promote good enough parenting and plan accordingly ii) to determine the extent of risk to the forthcoming child iii) in conjunction with other relevant agencies, to formulate a plan in response to this risk.

The depth and type of assessment will vary. In some situations, it would be a duplication of previous work to undertake a detailed pre-birth risk assessment as the circumstances may already be well known and little may have changed; in other situations, there may be some significant differences from the past to justify a different approach to the expected child.
The case will be regarded as open if there is involvement from a unit within Children's Social Care with the expectant mother or with a previous child of the mother.

Where Concerns are Identified and the Case is not Currently Open within Children's Social Care
Where Concerns are Identified Regarding an Unborn Child and there is Ongoing Social Work Involvement from Children's Social Care from Part of the Service other than a Child and Family Team.
Where Concerns are Identified Regarding an Unborn Child and there is Ongoing Social Work Involvement from Children's Division from a Child and Family Team.

1. Where Concerns are Identified and the Case is not Currently Open within Children's Social Care

Where the case is not open, a referral will be made to the Children's Initial Contact Point (CICP) who will, if appropriate, pass it through to the Assessment Team which covers the address of the expectant mother to undertake a pre-birth assessment.

Whether an initial or core assessment is required will be determined by the extent and nature of the concerns raised and the history of the case.
Where the assessment and matrix of need indicates a lower level of concern, it may be sufficient for the assessment team to signpost or refer the parent(s) to appropriate community based services - such as Sure Start, Sure Start Plus, or Family Centre
Where on-going services are required, and a number of differing agencies are involved, but the concerns do not meet the threshold for convening a Child Protection Case Conference (CPCC), the Assessment Team should give active consideration to convening an inter-agency child in need support meeting.
Where the assessment and matrix of need indicates that there is a need for on-going social work involvement from a Child and Family Team, the appropriate point of transfer is upon completion of the assessment.
Where it soon becomes apparent that a long term involvement from a Child and Family team is required, the expectation is that the work will move on quickly from the Assessment Team to the receiving Child and Family Team. In this circumstance, the purpose of the assessment is to provide a first - stage analysis as to the nature and extent of the concerns; this may often be primarily based on historical factors rather than being the product of a detailed piece of work with the expectant parent(s). The speedy transfer of work can be helpful in enabling the receiving team to become familiar with the issues at an early stage and to avoid duplication of work.
Where it is identified that a Child Protection Case Conference may be required, discussion should take place with the Child Protection Unit to jointly determine the timing of the conference. Where possible, the conference should take place sufficiently early for plans to put in place and to progress further work. However, there are some situations where it may be helpful to delay a conference - e.g. pending the outcome of further specialist assessments or where it is felt that, with further work with the parent(s), a conference may ultimately prove not to be necessary;
Where an early CPCC is thought to be needed, whilst the case is still held within the Assessment Team, it is that team's responsibility to convene and prepare for the meeting. Liaison should occur with the receiving Child & Family Team who will be invited to attend the meeting. The transfer point for the case will be immediately subsequent to the CPCC.
When the assessment indicates that Care Proceedings are necessary, this would ordinarily be a task undertaken by the Child & Family Team. The exception to this may be when a case has only come to the attention of the Assessment Team very late in the pregnancy. In this circumstance, if it becomes clear during the work of the Assessment Team that Care Proceedings are necessary, the Assessment Team would initiate these, following the processes and undertaking tasks that are outlined within the procedure document Protocol for the Transfer of Work

2. Where Concerns are Identified Regarding an Unborn Child and there is Ongoing Social Work Involvement from Children's Social Care from Part of the Service other than a Child and Family Team

Where the mother is looked after, the procedures contained within (Pregnant Looked After Young People Procedure) will be followed.
In other circumstances, the procedures as below will be followed:-
It is the responsibility of the case holder to raise a referral and undertake an initial assessment. This should be completed in an early stage in the pregnancy, in order to engage services as is necessary.
The purpose of the Initial Assessment is to determine whether, on the basis of the caseholder's knowledge of the parent(s) to be and their history, the expected child is likely to be a Child in Need to whom services should be offered via the Department or other agencies, or is potentially a child who will be at risk of significant harm.
Where the assessment indicates a lower level of concern, it may be sufficient for the caseholder to signpost or refer the parent(s) to appropriate community based services - such as Sure Start, Sure Start Plus, or Family Centre.
Where on-going services are required, and a number of differing agencies are involved, but the concerns do not meet the threshold for convening a Child Protection Case Conference, the caseholder should give active consideration to convening an inter-agency child in need support meeting.
If the initial assessment indicates that the unborn child may be at risk, or subsequently is felt to be at risk, then the case holder should give consideration to convening a Strategy Meeting to plan further action. The case holder's line manager would ordinarily chair this meeting. In some cases, it might be appropriate to consult with the Child Protection Unit re. chairing responsibility. Where it is thought that further intervention may be necessary from a Child & Family team, the relevant team manager should be invited to attend.
The Strategy Meeting will, in most cases, determine the remit of a Core Assessment and which team will take a lead role. Other professionals who might contribute to a Core Assessment should be invited to this meeting.
The lead role would ordinarily be undertaken by a Child and Family Team within the area based on the parent'(s') home address. The caseholder will ordinarily provide the receiving Child and Family Team with the following information:-
1. a chronology
2. any assessments that have been undertaken on the parent(s)
3. any previous assessments on siblings of the unborn child
4. any useful documentation that has been used in relation to Court Proceedings or Child Protection Registration of the siblings
5. any other historical information as may inform the core assessment
The Core Assessment will determine whether the expected child will be viewed as a Child in Need in which case services will be mobilised as indicated above, or a child who potentially meets the threshold for Child Protection Registration or care proceedings.
Where the outcome of the Core Assessment indicates that the threshold for child protection registration is likely to be met, the case holder will discuss with the Child Protection Unit with a view to a Child Protection Case Conference being convened.

3. Where Concerns are Identified Regarding an Unborn Child and there is Ongoing Social Work Involvement from Children's Division from a Child and Family Team

1.	Case responsibility will ordinarily be retained by the area that has responsibility for the older sibling.
2.	The exception to the above, in line with the transfer policy on geographic grounds, is: when the family have moved address to an area served by a different geographic team and any previous legal proceedings have been concluded and there are no plans to rehabilitate the older sibling
3.	In this instance, case responsibility for the unborn child will transfer on a planned basis to the Child & Family area for the new address, following the process outlined in Section 2, Where Concerns are Identified Regarding an Unborn Child and there is Ongoing Social Work Involvement from Children's Social Care from Part of the Service other than a Child and Family Team..
4.	If older siblings are still the subject of on-going Care Proceedings, consideration has to be given to whether proceedings will be required in respect of the unborn child and, if so, whether to consolidate these Proceedings
5.	Where the previous history indicates that there is a likelihood of further legal proceedings, careful consideration needs to be given as who would be the appropriate worker to undertake this pre-birth assessment. There will be a balance of factors including:- The value of having a worker to undertake the assessment who has a detailed knowledge of the history The quality of the relationship between the worker and the expectant mother The wishes and feelings of the expectant mother The value of having an independent view to present to the Court.
6.	Where it is deemed to be helpful to have an independent view, local arrangements exist on each site so that this assessment can be 'contracted out' to a worker based within another Child & Family Team. The case holder from the originating team and his/her SCM will have responsibility for co-ordinating this Core Assessment, The caseholder and the SCM should be kept informed as to the progress of this assessment.
7.	The Core Assessment will determine whether :- the expected child is a child in need; if so, the parents should be signposted and referred on to the appropriate support services, as indicated above or whether the threshold for a child protection strategy or case conference has been reached or whether there is a need for legal proceedings

ICS/Recording Assessments

It is acknowledged that pre-birth assessments do not neatly fit into assessment timescales of 7/35 days;

In order to meet the expectations of the Framework, the following should apply:-

where an initial/core assessment is undertaken by the Assessment Team, this will be entered into the system and follow the usual procedures as relate to all cases
the core assessment will usually be completed within the Assessment Team; additional follow on work undertaken by child and family teams will be regarded as a specialist assessment and, as such, will not be recorded on ICS
where the need for an assessment is identified from other parts of the service, the team identifying the need for the assessment should raise a new referral, ensure that this is entered on to ICS and complete an initial/core assessment as required.
Where the assessment will continue beyond the 35 day timescale, because there is a need to monitor/continue work as the pregnancy progresses, this will be viewed as a 'specialist assessment'. The relevant SCM will ensure that the core assessment is ended on ICS within 35 days.