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3.7 Non-Compliance

Contents

  1. Introduction
  2. Definition
  3. Agencies Responsibilities
  4. Response


1. Introduction

A feature in many serious case reviews has been a lack of co-operation, resistance, disguised compliance and/or hostile attitude of parents / carers.

When there are child welfare / protection issues, a failure to engage with the family may have serious implications for the safety of the child/ren.


2. Definition

There can be a wide range of uncooperative behaviour by families towards professionals. From time to time all agencies will come into contact with families whose compliance is apparent rather than genuine, or who are more obviously reluctant, resistant or sometimes angry or hostile to their approaches.

Parents may present in a number of ways on a continuum from hostility, through to superficial and ineffective compliance. Behaviours may include:

  • Ignoring advice / role of the professional;
  • Misinterpreting / minimising the child’s needs;
  • Non attendance at medical appointments;
  • Effectively preventing the child seeing the professional (blatant or agreeing to appointment then ensuring it does not occur);
  • Controlling discussion;
  • Preventing meaningful contact with other parent / carer;
  • Moving away;
  • Manipulating and splitting professional relationships;
  • Subverting change;
  • Diverting discussions into arguments over e.g. the agenda;
  • Use of complaints;
  • Evidence of implements of violence (dogs, knives etc);
  • Known history of actual violence;
  • Aggression and threats.

In extreme cases, professionals can experience intimidation, abuse, threats of violence and actual violence.

The child’s welfare should remain paramount at all times and where professionals are too scared to confront the family, they must consider what life is like for a child in the family and discuss this with their supervisors.


3. Agencies Responsibilities

All agencies should support their staff by:

  • Ensuring professionals are trained for the level of work they are undertaking;
  • Publishing a clear statement about unacceptable behaviour by those accessing their services (such as seen in hospitals and on public transport);
  • Providing training to enable staff to respond as safely as possible to risky or hostile behaviour in their target client group;
  • Supporting staff to work to their own professional code of conduct or their agency’s code of conduct when responding to risky or hostile behaviour in their client group.


4. Response

Good Practice

It is helpful to be clear from the outset what is known about the family and parents / carers, so as to assess risks involved and potential strategies e.g. parents with learning difficulties or mental illness may need to have information, advice and expectations conveyed in an alternative way, possibly working with specialist colleagues.

Professionals should be mindful of underlying reasons for parents / carers non-compliance or lack of co-operation which may include domestic abuse, immigration status, fear of statutory services, cultural issues and may need to have information, advice and expectations conveyed in an alternative way, possibly working with specialist colleagues.

Any written multi-agency plan must be reviewed regularly e.g. child and young person’s plan, reviewed at regular multi-agency meetings or child protection conference and use measurable objectives within timescales and specific outcomes, with a clearly stated contingency plan.

Communication should be clear, so as to ensure that non compliance is not caused by any misunderstanding.

Where there are child protection concerns parents / carers will need to understand that lack of co-operation is unacceptable, although there may be some flexibility of the degree and type of co-operation.

It will be helpful to establish trust through active engagement, acknowledging that the family may see things differently and demonstrating a respect for their views, whilst confronting inappropriate attitudes.

All decisions and communications must be recorded clearly and shared.

Staff must recognise when the family is not engaging so as to avoid collusion or avoidance – early recognition of resistance and failure to achieve progress with plans and agreements for the child is critical.

Supervision should be used to explore the dynamics of any hostility or non-compliance and plan how best to address the situation including possible specialist assessments.

A manager/supervisor must be consulted if access is ever denied or appointments repeatedly cancelled and/or ‘forgotten’.

Effect of Non-Compliance or Hostility

Where non co-operation or hostility is an issue it is important to appreciate the significance for the child living in the family i.e. it will enhance the parent / carer’s power and control and the child may fear reprisals if s/he were to speak to professionals.

Professionals may feel extremely vulnerable when visiting hostile families, especially those who challenge effectively and are perceived as a threat and professionals need to recognise and avoid the risk of putting more effort into dealing with the resistance, than addressing the real problems facing the child/ren.

When a professional begins to work with a family who is known, or discovered, to be uncooperative, the professional should make every effort to understand why a family may be uncooperative or hostile. This entails considering all available information, including whether a common assessment/single assessment has been completed and whether a lead professional has been appointed.

When working with uncooperative parents, professionals in all agencies can improve the chances of a favourable outcome for the child/ren by:

  • Keeping the relationship formal though warm, giving clear indications that the aim of the work is to achieve the best for their child/ren;
  • Clearly stating their professional and/or legal authority;
  • Continuously assessing the motivations and capacities of the parent/s to respond co-operatively in the interests of their child/ren;
  • Confronting uncooperativeness when it arises, in the context of improving the chances of a favourable outcome for the child/ren;
  • Engaging with regular supervision from their manager/supervisor to ensure that progress with the family is being made and is appropriate;
  • Seeking advice from experts (e.g. police, mental health specialists) to ensure progress with the family is appropriate;
  • Helping the parent to work through their underlying feelings at the same time as supporting them to engage in the tasks of responsible child care;
  • Being alert to underlying complete resistance (possibly masked by superficial compliance) despite every effort being made to understand and engage the parent/s;
  • Being willing, in such cases, to take appropriate action to protect the child/ren (despite this action giving rise to a feeling of personal failure by the professional in their task of engaging the parent/s).

With the help of their manager/supervisor, professionals should be alert to, understand and avoid the following responses:

  • Seeing each situation as a potential threat and developing a ‘fight’ response or becoming over challenging and increasing the tension between the professional and the family. This may protect the professional physically and emotionally or may put them at further risk. It can lead to that professional becoming desensitised to the child’s pain and to the levels of violence within the home;
  • Colluding with parents by accommodating and appeasing them in order to avoid provoking a reaction;
  • Becoming hyper alert to the personal threat so the professional becomes less able to listen accurately to what the adult is saying, distracted from observing important responses of the child or interactions between the child and adults;
  • ‘Filtering out’ negative information or minimising the extent and impact of the child’s experiences in order to avoid having to challenge. At its most extreme, this can result in professionals avoiding making difficult visits or avoiding meeting with those adults in their home, losing important information about the home environment – managers should monitor the actions of their staff to ensure they pick up this type of behaviour at any early stage – audits of case files on a regular basis will assist in spotting those (very rare) cases where a professional is so disempowered that they falsify records (e.g. records of visits which actually did not take place);
  • Feeling helpless / paralysed by the dilemma of deciding whether to ‘go in heavy’ or ‘back off’. This may be either when faced with escalating concerns about a child or when the hostile barrier between the family and outside means that there is only minimal evidence about the child’s situation.

Action to Take when Non-Compliance or Hostility Recognised

Professionals should report non compliance to their managers/supervisors. and to the lead professional/social worker.

If there are child welfare concerns, the Local Authority Children’s Services team manager should convene a meeting. Sharing agencies’ approaches, in accordance with information sharing arrangements may assist in forming an action plan.

The multi-agency / core group meeting should address the non co-operation in the context of the child’s circumstances. Depending on these circumstances this meeting may be:

Possible strategies to be devised in a written plan include:

  • Joint visiting with colleagues within or external to the agency, (requesting help from Police if there is a physical risk);
  • Exploring the possibility of engaging other non hostile members of the family, if this does not increase the risk to anyone;
  • Specialist Children’s Services (Kent)/Children’s Social Care (Medway) holding a legal planning meeting to clarify options e.g. Child Assessment Order, Interim Care Order.

When there are threats or incidents of violence

Managers have a statutory duty to provide a safe working environment for their employees under the Health and Safety at Work legislation. This includes:

  • Undertaking risk assessments to identify and manage the risks inherent in all aspects of the work;
  • Providing a safe working environment;
  • Providing adequate equipment and resources to enable staff to work safely;
  • Providing specific training to equip professionals with the necessary information and skills to undertake the job;
  • Ensuring a culture that allows professionals to express fears and concerns and in which support is forthcoming without implications of weakness.

Where there are actual threats or incidents of violence they mustbe reported to the Specialist Children’s Services / Local Authority Children’s Services team manager immediately and local ‘Violence at Work’ procedures followed in relation to supervision, support, recording and reporting incidents to the Police.

Any response must take account of:

  • Risks to children and other family members;
  • Personal safety issues for staff.

The experience of violence or threats to staff should be used as evidence of the situation of the family and included in assessments of the child’s circumstances.

Violence towards staff is a multi-agency problem. If one agency has information a parent / carer is known to be violent, it must alert other agencies of the risks posed.

End