SWK 2405 2020-21 Summative Assessment: Case study Assignment
Callum is 27 years old. He has a diagnosis of Downs Syndrome with associated, moderate learning disabilities. He lives with his father Mike who is 72 and mother who is 65. Mike used to be in a band before running a small printing and graphics business in the East End of London specialising in promoting events. Valerie was at home most of the time looking after their children but was also involved in fund raising for children with disabilities. Valerie has a history of clinical depression for which she was voluntarily admitted to hospital 20 years ago following a suicide attempt where she stepped out into traffic; luckily she did not sustain any serious injury at the time due to the timely intervention of a member of t he public. She has had no subsequent admissions and her condition is managed using medication. Callum has a brother Freddie who lives around 150 miles away with his partner Tim. Callum and Freddie were close but they now have little contact as Mike refuses to speak to Freddie since he came out as gay following a brief time in the Army. Callum also has a sister Suzy who has three children. Her ex-partner is i n prison having been sentenced for an assault on her. Wesley is Freddie’s friend from school and they both joined the Army together. Wesley has kept in contact with Callum and visited him when he was on leave. Wesley and Suzy have a child together. Callum’s parents undertake all activities of daily living on his behalf, he has no experience of washing, cooking or cleaning. Callum does att end to his personal care needs independently. He has no experience of managing finances and correspondence and has very limited literacy. Callum attends a local resource centre for people with learning disabilities three days a week. He has been going there for around nine years. He accesses no other services or resources in the community and spends the rest of his time at home with his parents.A month ago the local authority received a safeguarding refe rral from the day centre in relation to Callum after he and another service user, James who is 45, were found engaging in a sex act in one of t he resource rooms at the centre. A safeguarding investigation found that both Callum and James had the capacity to consent to these activities but as part of a risk management strategy they have both been offered sexual health education. Theresource centre have told Callum and James that it is not appropriate for them to engage in sexual activity at t he centre although they are encourage to express their affection for each ot her in other ways. Since the safeguarding referral Callum’s parents have refused to let him attend the centre. Mike says he does not believe that Callum understands what James “was doing to him” and he calls James a pervert and makes homophobic comments about him. Mike says Callum is just copying his brother and can’t really be gay. Mike says he will not let Callum attend sexual health education as he isn’t able to understand and doesn’t need to know about sex. Valerie has raised concerns that Callum’s behaviour at home has greatly deteriorated, he is hostile and uncooperative towards her and Mike . Valerie’s mental health has severely deteriorated over recent weeks, she is now unable to complete many tasks of daily living, spends most of her time in bed and on several occasions
has said that she cannot cope with living and does not want to go on. Mike says Valerie has stopped taking her medication and that he has trie d to get her to take it but that she refuses. Callum says he wants to go back to the centre so that he can see his friends and be with James. He also says he wants to get his own flat so that he and James can meet with each other away from the centre and from his parents. Suzy has three children. She met Mick at 16, and quickly became pregnant with Jeremy, who is now 15. They have another child, Kimberly, who is 8 years old. Mick has a history of violent offending and is currently serving a sentence for an assault on Suzy following his last release from prison three years ago. Suzy also has a 2 and half year old Leonora, known as “Lennie” with Wesley. Mick, supported by his mother, has made numerous applications to care for the children or see them. The first was when Jeremy “Jez” was born. During their teenage relationship Mickcoerced Suzy into doing what he wanted and this has continued but the violence increased. She resisted him caring for Jeremy but agreed to Mick seeing him convinced that children should see their father. Mick has not kept to the arrangements, turning up when he wanted and breaching Non Molestation Orders. Maureen Mick’s mother, has tried to keep in touch, sending presents and cards to the children but she never liked Suzy or her family. Suzy has struggled with her own mental health and anxiety since adolescence and she has used alcohol, cocaine, pain killers and ‘legal highs’ to cope. She has been hospitalised following overdoses and although she has been in contact with drug and alcohol services she has not been able to maintain abstinence. Her substance use has impacted upon her mental health and parenting capacity. Over the years the children have been subject to child protection plans due to neglect and emotional abuse. Sometimes, when the situation has improved, a child in need plan has been put in place. When the situation has been at i ts most difficult, Suzy withdraws from the children emotionally, Jeremy acts as a carer to his mother and misses school; Kimberly becomes increasingly withdrawn, stops playing with her friends, no longer talks to her classroom support teacher and has had frequent absences from school. Although, she is capable, concentrating on her school work becomes more difficult and she falls behind. The school have been worried about her weight and the factthat she sometimes does not want to eat . She has been referred to educational psychology and speech therapy. There has been a suggestion that foetal alcohol syndrome may have been a factor in her development although this has never been diagnosed. Kimberly has
additional emotional needs relating to her having witnessed her father attack her grandfather and mother many years ago. She was traumatised by the event and ran to alert neighbours to call the police. She has never spoken about what she saw. Kimberly was left with difficulties concentrating at school and has trie d to hurt herself by taking tablets when she was bullied by older children who found out about her father. Suzy and Wesley have known each other all their lives. Wesley was friends with her brother before they he joined the Army together. Suzy’s brother left but Wesley remained and became a senior medic attached the Household Cavalry. He was an active sportsman, playing rugby and volunteering at the Equine Therapy Centre in Wadestone. He was injured on tour 2 years ago. He has an adapted flat which belonged to his parents, uses a wheelchair and has an assistance dog Jessie from a veteran’s charity: he suffered from post-traumatic stress syndrome as a result of his experiences. Prior to leaving the Army, whenever Wesley came home on leave he visited Suzy, Jeremy and Kimberly and her brother Callum. The children loved his visits to them and he has taught Jeremy and Kimberly to swim and ride. Suzy felt less anxious when he was around and this reflected in her care of the children. She relied on him increasingly, especially when Mick was around. Going off on tour Wesley was worried and kept in touch as much as he could. He came home for Lennie’s birth and anticipated serving on one more tour before leaving the Army and taking up a post in the NHS, retraining as a psychologist. Sadly, he was injured in action six months after Lennie was born and returned to the UK for treatment in Birmingham. Although Jeremy has had a close relationship with his maternal grandparents, and when Suzy has been unwell they have stepped in to help care for him and his sister, he has always wanted Wesley to be his Dad. He was devastated and very angry when he was injured. When Kimberly learnt of Wesley’s “accident” she was very distressed. Suzy’s reaction was disbelief at first and then depression and a return to drugs and alcohol, leaving the children to care for Lennie much of the time. When the children were at school, Lennie and Suzy went to a friend’s house. Lennie went to clinic, and was seen by a health visitor,and was taken for her inoculations, but it was usually with Jeremy in attendance. It was noted that she had severely infected nappy ras h and Suzy was given advice. Milestone checks showed low weight gain. Suzy was given a nursery place for Lennie attached to afamily centre two days a week. When Lennie came to nursery she was often late, difficult to settle and hungry, often wearing the same clothes and with a dirty nappy. When the home is visited it was untidy with piles of dirty clothes, a smell of urine, piles of takeaway cartons and no fresh food. Jeremy and Kimberly said that they made lots of mess and would help their mother in future. The Local Authority decided to increase the help by offering a family support worker to go in to the home to help Suzy get t he children to school and to help her improve their living environment and give t he children time out for activities.
The children wanted to see Wesley in his Rehabilitation Unit in Birmingham. Wesley would not see them because of the way he looks and feels, and nothing could persuade him to see anyone at first. His sister Grace was in Germany and she cannot return to see Lennie very regularly but acts on his behalf, keeping in contact with the social worker about her. The situation begins to improve for the children when Suzy gets help from her GP and attends drug and alcohol services. She signs up for a Freedom Course and completes it. The Local Authority is satisfied that the risk has been reduced again and as a result, the children are no longer subject to child protection plans; Suzy’s support is reduced.When Wesley returned to London following his rehabilitation he went to his parents’ home, adaptations were made, and he linked himself with veterans’ charities and began equine therapy for himself. Although, he still had flash backs, his therapists believed that he had make progress and he felt more determined to get back into civilian life as planned. His sister Grace returned from Germany and began working at Nissan. Suzy and the children started to visit him and as the months passed he became more mobile and active again. He applied for a MSE Conversion to Psychology Degree at Kings College University and was accepted. Grace visited monthly, travelling from Northumberland and Lennie stayed over with Kimberly on these occasions. Lennie became increasingly comfortable with Wesley and he managed her care well enough with help. Suzy started to bring Lennie around during the week and sometimes left her for a few hours, sometimes all day.Increasingly, Kimberly came after school to help make Wesley his tea and read to Jessie. One evening before going home, Kimberly said she wanted to stay and was frightened to go home when Mummy was drinking and her friends were there. Wesley tried to reassure her but was surprised as he thought that things were going well. Jeremy usually came over whenever he wanted and spend time doing his homework and playing on the computer with Wesley. Jeremy wanted to be medic like Wesley but told him that it might never be possible now. On the drive over to the stables, Jeremy begins to talk about what has been happening; his friends and how he was in a gang and wants to get out. He wanted to know if Wesley could help him. He said that sometimes they carry knives in the gang. He took Wesley to a site on his phone devoted to knives and weapons and asked Wesley about these. When Jeremy has gone home Wesley went back to the site and within a few clicks was on a page with young people holding knives and guns and describing what they would do with them, he saw Jeremy. Horrified, Wesley tried to contact Suzy, whodenied that Jeremy is in a gang. She said that “it is just teenagers play-acting and taking pictures of each other”. She told Wesley that everything is alright and Jeremy is always studying, and “not running around in a gang”. She sounded slurred on the phone andWesley can hear lots of shouting and laughing noise in the background – Suzy says it is TV.On a Friday evening, after a gap of two weeks, Lennie and Kimberly came around on their own. Jeremy was not with them and Kimberly does not know where he is. Kimberly said they have come
to stay this time. They tried calling Suzy but she does not answer her mobile. Grace helped make the children’s teas and Wesley played with Lennie, whilst Kimberly asked to dosome reading with Jessie. Kimberly often confided in Jessie first when she did not want talk about something that she was worried about, and Wesley and Grace began to suspect that this may be one of those occasions. They went to her room to call her for her tea and found Kimberly sobbing on the bed with Jessie beside her. She was telling Jessie that her Mummy went gone away in the cab. Kimberly said she that she did not know where Mummy had gone and that Mummy had wanted to take Lennie but Jeremy would not let her. She said“Mummy’s sick” …”she sleeps down all day and we can’t wake her up”… “lots of Daddy’s friends come over and they shout all the time and smoke and drink”…”they’re alwaysdrunk”. Kimberly then said “Mummy said that she is going away for a while and we have got to stay with you and Wesley because you will look after us” …” Jeremy has gone to his friends but he will come to stay as well …he promised”. Speaking to Kimberly with Jessie, Wesley and Grace hear more about what has happened. Kimberly said that she had to stay with Mummy’s friends Pauline and Rob and their friends, when Mummy went away last time.She said that she did not want to go back and wanted her Mummy. She says that Patricia shouted at her and hit her with a coat hanger when she saw Rob coming out of her room. She had marks on her arms and legs. She said that Patricia locked her in a dark room with monsters and would not give her any food. She said that she was worried about her sister then and now her hamster at home …..”I could not carry the cage”. Grace and Wesley tried to call Suzy but her phone is dead.Wesley contacted Children’s Services who asked him to hold onto the children until they made enquiries. He learnt that Jeremy has been picked up by the police and had asked for Wesley to go to the police station. Jeremy refused to have his mother attend and in any event she could not be found. Wesley explained that he needed to stay with Kimberly and Lennie and asked for the children’s social worker to attend. Jeremy had been picked up by the police after he was caught by the school caretaker after hours at his school in the IT laboratory with a group of young people. They had broken in. Nothing had been damaged except for a window, or taken, but when the police arrived Jeremy and his friends become confrontational. They set off the water system: IT equipment was damaged (£ 25K worth of damage) and a policewoman was pushed over and hurt in the fracas that ensued. This is the second time the school’s equipment had been replaced, and the school wanted a prosecution. What was worse was that Jeremy was found with a Stanley knife and cocaine hidden in the frame of his bicycle. He said he was forced to carry drugs in the gang.Two hours later Suzy arrived at Wesley’s door with Pauline and a waiting car, and wanted Kimberly and Lennie to come home with her. She was drunk and crying. Wesleyrefused. Pauline and her partner screamed racist abuse at Wesley and Grace, anddemanded that Suzy’s children are returned to her. The police were called and Suzy and her friends continued to demand that Kimberly and Lennie are returned to Suzy. When the police arrived Kimberly was crying and refusing to let go of Wesley and
Jessie, and Grace explained that t he Wesley is Lennie’s father. The police looked around the property: Kimberly was screaming and Lennie was in a cot crying. The police decided after consulting with the emergency social worker that they need to take police protection and the children are taken to an emergency foster carer. The following Monday, Children’s Social Care decided what they should do next. Initial checks revealed that Robert had convictions under the Sexual Offences Act 2003 for on line grooming, controlling child prostitution and involvement in child pornography, and sexual assault o f a child. He was on the list of adults who pose a risk to children. Suzy insisted that the children were returned to her care as she had done nothing wrong and a phone call was received from Mick’s solicitor wanting to know what Social Services was doing. Wesley consulted a solicitor for Jeremy and was also advised to get some legal advice in relation to Lennie. There has never been any doubt that he was Lennie’s father but he has never seen her birth certificate and has assumed he was on it. The Local Authority decided to take action. Wesley applied to care of Lennie and this was initially opposed by the Local Authority. Wesley decided that if Suzy was not able to care for all the children, he would put himself forward. When members of Mick’s family met they had a lot of concern about Wesley, because of his disability and history of PTSD. The Local Authority were concerned that he refused to see the children at one stage and although he kept in touch with Suzy he was not aware how bad things had got. He was very angry with the Local Authority for leaving the children with Suzy and could not understand why they did not do more when he was in hospital in Birmingham. Mick said that when he was released he wanted to be assessed. His mother came forward to care for the children with his sister so that t hey were not in foster care. They lived locally in Romford, but only wanted to take Kimberly and Jeremy. Mick thought that the children should be with their mother but if they cannot be they should be with family and later he wanted to be assessed. Suzy wanted Kimberly and Jeremy with her but agreed that Mick’s sister Debbie could care for them if she was assessed. Lennie moved to another foster carer with Wesley’s agreement. He visited her three times a week at a contact centre and then at the foster carer’s home. Kimberly and Jeremy moved from the emergency foster carer after two weeks. Kimberly talked to her mother on the telephone before she went to her Aunts and asked if she could go home and go to Wesley’s again. Suzy wanted Kimberly and Jeremy to see her with Lennie and Mick’s sister agreed to this. Kimberly and Jeremy wanted to see their mother but also wanted to see Wesley and he shared some of the sessions. It started well and the children enjoyed seeing Suzy and she was thoughtful bringing Kimberly’s hamster for her. Kimberly told her mother about how much she missed her and asked if she was going away again. Suzy did not always attend and Wesley was left feeling he has to explain.
Jeremy was worried about both his mother and his impending trial. He found it very difficult and kept coming back to see her to check she was alright and not drinking with her friends. Afterwards, he would go to Wesley’s house. The children did not settle and after three months their aunt said that she could not look after them any longer as this is all taking too long to sort out. She conceded that t hey were more set tled after they have seen Lennie and Wesley. He continued to see the children and they asked to see him at his flat and to see him compete. His parenting capacity was assessed and he had a psychiatric assessment. His sister Grace remained in the North East but made enquiries about a transfer to Nissan London Head Office. Suzy collapsed and was admitted to hospital following a drink and drug overdose afte r initial engagement with the Local Authority during which a parenting assessment and specialist psychiatric assessment was completed. It was recommended that she undertake a residential detoxification and recovery programme followed by rehabilitation together with a therapy programme. Following Suzy’s relapse the Local Authority re-assessed and took the view that there is little prospect of her being able to care for the children in the immediate future and permanent plans need to be made for them. The Local Authority think that the most realistic option is that Jeremy stays in foster care until he becomes independent and that Kimberly and Lennie are adopted together. If they cannot be adopted together Kimberly should be fostered separately. Mick wants Kimberly and Jeremy to go to his mother, so that he can care for them when he comes out of prison. He wants to be assessed. Wesley wants all the children to live with him and is prepared for Suzy to see the children but not for her to be more involved in their care. Suzy wants the children to come home after she has completed her programme; she supports Wesley’s care of them in the interim. The children want to stay with Wesley and see their mother and grandparents but not their father. If Jeremy cannot go to Wesley or go home, he wants to stay with one of Wesley’s Equine Therapy volunteer colleagues. He has known them from before Wesley was injured and used to volunteer. Jerry used to be in the Army before working for the NHS as a mental health nurse manager and his partner Jasmin is as an accountant. Jasmin wants to foster now that their two children have gone to University. They have made it known to the Local Authority that they will offer respite to Wesley and be available if he has to go back to hospital for surgery and rehabilitation. Jeremy does not want his sisters adopted and wants to be close to grandparents and mother. Questions: Please answer all the questions below making reference to the legislation, case law and relevant guidance. Please consider how human rights and ethical decision making impact on the social workers responsibilities and responses. (4000 word limit)
1.What would have been the process of the mental capacity assessment mentioned inthe case study? What should be carried out and what should be considered?
2.What were the safeguarding duties of the Local Authority in relation to Callum as a vulnerable adult?
3.If Valerie is assessed under the Mental Health Act 1983, what is the role and responsibilities of the Approved Mental Health Professional?
4.What responsibilities does the Local Authority have to identify and meet the care needs of Callum and his parents?
5.What responsibilities does the Local Authority have when the children were cared for by Suzy and how was this managed under the legislation?
6.How would you ensure that the children were safeguarded when presented with the events described in the case study? Please make reference to the immediate and medium term.
7.What were the duties of the Local Authority when the children were placed with alternative carers to their mother? Please distinguish between care provided byfoster carers and relatives.
8.What were your responsibilities to Jez as a young person when arrested and interviewed. What recommendations would you make to court as to sentencing and why?
9.The LA plan to apply for a placement order for the younger children. What does this imply and what implications follow for all of the children, and their mother? What other options are there and how might these be achieved?
10.Having recently graduated in veterinary science Jez approaches the LA aboutsupport for a Post Graduate Diploma in Veterinary Clinical Practice at LondonUniversity. How can he be helped?
11.Reflecting on the feedback you received from your role play presentation, whatlearning do you take forward into statutory practice?
