putting it onto paper: recording and report writing
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Putting it onto paper: Recording and report writing. Patrick Ayre Department of Applied Social Studies University of Bedfordshire Park Square, Luton email: [email protected] web: http://patrickayre.co.uk. Learning from enquiries. - PowerPoint PPT PresentationTRANSCRIPT
Putting it onto paper:
Recording and report writing
Patrick Ayre
Department of Applied Social Studies
University of Bedfordshire
Park Square, Luton
email: [email protected]
web: http://patrickayre.co.uk
Learning from enquiries
Those who cannot learn from history are doomed to repeat it
(George Santayana)
Learning from enquiries The importance of recording is not always
understood We don’t always think enough about Why?
and Who? Information not accessible Incomplete or out of date Facts and judgments not distinguished Little assessment and analysis Oppressive language Managers not always fully engaged
Comments from ‘Recording with Care’
A Director Says:‘My staff are good at what they do, not what they write down’
A Social Worker Says:'I didn't become a social worker because I wanted to be a typist or a computer programmer. I want to work with people, not waste my time in front of a machine’
On the other hand
A Team Manager Says:‘I couldn't believe the information wasn't there! I kept thumbing through the file, trying to find it. I know we've talked about lots of things in supervision. I just thought it was being written down - but I don't have time to check!‘
Lord Laming says:
‘The case file is the single most important tool available to social workers and their managers when making decisions as to how best to safeguard the welfare of children under their care.’
Framing your writing
You will want to consider the usual questions: How, Who, What, When, Where and Why.
In the planning phase, start with Why (are you writing this)? Who (for whom is it intended)?
For whom are we recording?
Service users Social workers Managers Legal advisers Other agencies Insurers Councillors
Why record? History Support partnerships Provide continuity Facilitate reflection, analysis and planning Support professional development Evidence for resources Management monitoring Evidence for enquiries and investigations Evidence of acceptable standards
Formal reportsMay seem like a chore BUT: Can get everything down (less risk of forgetting
something or missing it out) You can check the information and make sure it is
accurate. You can spend time thinking about how you
express things The other parties will read in advance, so may
spend less time presenting orally:– Should only be asked about disputed parts of the report – The other side may not need to ask questions or may
even fold!
Selling you opinion
What would you look for yourself?
Selling you opinion
What would you look for yourself?
Presentation
Content
Presentation
Make it pretty and easy to read– Neat – Double spaced– One side only– Numbered paragraphs and pages
Language
Good grammar Good sentence construction Simple sentences No unnecessary, unexplained jargon Appropriate tone (formal so no slang, no
contractions, no use of first names for adults)
Sensitively phased (but not watered down)
Content problems
Incomplete
Biased
Conclusions and recommendations poorly argued and justified (or absent altogether)
The chain of reasoning
Facts
Analysis/summary
Conclusions and recommendations
What do they want to know?
Who you are Why you are reporting The facts of the matter The conclusions to be drawn from the
facts
The facts
‘It is the task of practitioners to share, sift, search for and weigh the significance of their information’ (Morrison 2009)
The facts
Family composition (attach a genogram) Background history (family and
individual) Recent events
The facts
Tell the story chronologically without too much editorialising
Facts sufficient support your argument and also to refute counter arguments
First hand evidence is best but give source of any information
Make sure that you have put information as fully and accurately as possible (Checklist: Who, what, when, where, how)
Seeking strong evidence
Information may be: Ambiguous Missing Assumption-led
But can become ‘firm-ground’ if further enquiries are made or it is explored further
Bias and Balance
Include information favourable to the other side as well as that favourable to yours
It is your job to make judgements but: – avoid empty evaluative words like
inappropriate, worrying, inadequate – Give evidence for descriptive words like
cold, dirty and untidy Beware the danger of facts
Bias and Balance
Born in 1942, he was sentenced to 5 years imprisonment at the age of 25. After 5 unsuccessful fights, he gave up his attempt to make a career in boxing in 1981 and has since had no other regular employment
Lies, damned lies and killer breadResearch on bread indicates that More than 98 percent of convicted felons are bread users. Half of all children who grow up in bread-consuming
households score below average on standardized tests. More than 90 percent of violent crimes are committed within
24 hours of eating bread. Primitive tribal societies that have no bread exhibit a low
incidence of cancer, Alzheimer's, Parkinson's disease, and osteoporosis.
In the 18th century, when much more bread was eaten, the average life expectancy was less than 50 years; infant mortality rates were unacceptably high; many women died in childbirth; and diseases such as typhoid, yellow fever, and influenza were common.
Incomplete or out of date
Can you trust a snapshot?
Information handling Picking out the important from a mass of
data Interpretation Decoyed by another problem False certainty; undue faith in a ‘known fact’ Discarding information which does not fit First impressions/assumptions Too trusting/insufficiently critical Distinguishing fact/opinion
Department of Health (1991) Child abuse: A study of inquiry reports, 1980-
1989, HMSO
Fact or opinion?1. There are inadequate play and stimulation
opportunities available. 2. The bruise and swelling are consistent with hitting his
head on the door. 3. This is the first incident of abuse to the child. 4. The flat is unsuitable for bringing up a young child. 5. Mrs Green is good at keeping her flat tidy. 6. Experienced professionals are better at dealing with
child protection issues.7. Children who were abused usually become abusers. 8. The child said his dad hit him. 9. I saw Peter playing with his toys when I last visited. 10. Mrs Green does not display appropriate parenting skills
when relating to her son
Assessments
Assessment work is complex and emotionally demanding
Collation and analysis of large bodies of information from multiple sources
Continuous series of mini-decisions about what to collect, how to collect
Each mini-decision has an impact on the assessment
Assessment Pitfalls
When faced with an aggressive or frightening family, professionals are reluctant to discuss fears for their own safety and ask for help
Attention is focused on the most visible or pressing problems and other warning signs are not appreciated
Parents’ behaviour, whether co-operative or uncooperative, is often misinterpreted
Not enough weight to information from family friends and neighbours
Not enough attention is paid to what children say, how they look and how they behave
In Cleaver, H, Wattam, C and Cawson, P Assessing Risk in Child Protection, NSPCC, 1998
Child centred assessment
The purpose of assessment is to understand what it is like to be that child or young person (and what it will be like in the future if nothing changes)
Assessment pitfalls
Rule of optimism
Start again syndrome
Natural love
Cultural relativism
Too much
not enough
Analysis
Studies (and SCRs) highlight problems in the quality and level of analysis
Assessments too static and descriptive, resulting in an accumulation of facts that are not analysed in a way that offers an explanation of the situation (Brandon 2008)
But what is analysis?
You have gathered lots of information but now what?
All you need to do is ask yourself my favourite question:
“So what?”
You have collected all this data, but what does this mean, for the young person, for the family and for the authority?
Analytic thinking
‘a conscious and controlled process using formal reasoning and explicit data and rules to deliberate and compute a conclusion’ (Munro, 2007)
‘Analysis should be seen as acting like a good secretary keeping a check on the products of intuition, checking them for known biases, developing explanatory theories and testing them rigorously’ (Thiele, 2006)
Intuition and Analysis
Intuitive thinking – unconscious process that allows the integrations of a large amount of information to produce a judgement in an effortless way
Gut feelings: ‘take advantage of the evolved capacity of the brain and are based on rules of thumb that enable us to act fast and with astonishing accuracy’ (Gigerenza, 2007)
Intuition versus Analysis
It is the combination of intuitive and analytic modes that produces the kind of evidence-based practice by which social work knowledge establishes its relevance, expertise and authority
Morrison 2009
Decision making, intuition and bias
‘Often a decision is made first and the thinking done later’ (Thiele, 2006)
As humans, we resort to simplifications, short cuts and quick fixes!
We reframe, interpret selectively and reinterpret.
We deny, discount and minimise We exaggerate information especially if vivid,
unusual, recent or emotionally laden and We avoid, forget and lose information
Good assessments are... Clear about the purpose, legal status and potential
outcomes Based on a clear theoretical framework Clear about context and value base Collaborative and promote accessibility for service
users Based on multiple sources of information Value the expertise and understanding service users
bring to their situation Clear about missing information
Good assessments… Identify themes and patterns Generate and test different ways of understanding the
situation Give meaning to themes, using knowledge based on
experience/research Lead to an evidence-based conclusion Use supervision to assist reflection, hypotheses and
objectivity Are able to record and explain outcomes Are reviewed, updated & amended in light of new
information
Learning from Past Experience Major themes from SCR reviews of the 90s:
Collecting and interpreting information
Importance of comprehensive family assessments, especially male figures
Failure to give sufficient weight to relevant case history
Understanding thresholds, especially the importance of neglect and emotional deprivation and the need to accumulate evidence
Learning from Past Experience Major themes from SCR reviews of the 90s:
Collecting and interpreting information
Importance of comprehensive family assessments, especially male figures
Failure to give sufficient weight to relevant case history
Understanding thresholds, especially the importance of neglect and emotional deprivation and the need to accumulate evidence
Learning from Past Experience Major themes from SCR reviews of the 90s:
Collecting and interpreting information
Importance of comprehensive family assessments, especially male figures
Failure to give sufficient weight to relevant case history
Understanding thresholds, especially the importance of neglect and emotional deprivation and the need to accumulate evidence
Assessment and analysis Suspected injuries and unconfirmed bruises over
limbs - not explained. Previous history of abuse by older sibling - off Child
Protection Register Single mother and new boyfriend Concern by school staff about negligence in hygiene,
clothing and school attendance Growth at the third centile - no medical reason Uncle visiting - ex-convict Mother was abused as a child Financial problems - on social security
Assessment and analysis
“He is a young boy who is confused about his current situation. Until the child care planning meeting confirms the long-term future plans for him he will effectively remain in limbo. This is affecting his ability to feel secure. He is noticeably anxious at school on Mondays prior to contact at home and he therefore learns very little on that day. By Wednesday of each week he calms down again”
Conclusions and recommendations
Problems:
Unsupported assertions or judgements
Inability or unwillingness to analyse and draw conclusions
Conclusions and recommendations
Summarise the main issues and the conclusions to be drawn from them. (The facts do not necessarily speak for themselves; it is your job to speak for them.)
Define objectives as well as actions Draw conclusions from the facts and
recommendations from the conclusions Explain how you arrived at your conclusions
(Have you demonstrated the factual/theoretical basis for each?)
Conclusions and recommendations In drawing conclusions be aware of the
extent and limitations of your own expertise. Conclusions may be supported by research
(Don’t go outside expertise; be careful with new or controversial theories; be aware of counter arguments)
Your recommendation should usually be specific (not either/or)
Remember: conclusions may be attacked in only two ways– founded on incorrect information– based on incorrect principles of social work
Inaccessible information
‘it may be that a contributory factor in the failure of various professionals involved in Victoria’s case to read the file was that the information was not presented in a sufficiently convenient and accessible way...This is one of the reasons why I regard the inclusion in any case file of a clear, comprehensive and up-to-date chronology as absolutely essential’
Inaccessible information
Files very long
Records very badly structured
Patterns missed and ‘chronic abuse’ overlooked
Capturing chronic abuse
Judging the quality of care is an essential component of any assessment but how well do we do it?
Judgements subjective and prone to bias
Intangible: Difficult to capture and compare
High threshold for recognition
Cumulativeness and acclimatisation
The pattern of neglect: atypical
The pattern of neglect: typical
Intervention Intervention
The pattern of neglect
'G ood enough' level
Intervention Intervention
The pattern of neglect
Intervention Intervention
'G ood enough' level
Intervention ceases
A pattern of decline
Cumulativeness
T h r es h o ld f o rin te r v en tio n
SEXUAL
ABUSE
PHYSICAL
ABUSE N
EGLECT
NEGLECT
NEGLECT
Failure of cumulativeness
T h r es h o ld f o rin te r v en tio n
SEXUAL
ABUSE
PHYSICAL
ABUSE
NEGLECT
NEGLECT
NEGLECT
NEGLECT
What’s the problem?
Chronic abuse and the principle of cumulativeness Incidents scattered through files
The problem of proportionality
Acclimatisation
Inclusive recording
How would I feel if this was written about me?
What would a lawyer make of this?
Managers not fully engaged
No comprehensive recording policy
No reading and signing of files
No recording of decisions and advice/instructions on files
Inadequate auditing
Micromanaging assessment and reporting
Format: Endless predetermined tick boxes and text boxes
Content: Repetitive and disaggregated
Concept: Routinised and mechanistic
Purpose: Well, what is the purpose?
?Understanding what it is like to be that child, and what it will be like if nothing changes
Micromanaging assessment and reporting
Recording guidelines
Be clear about the purpose of the record
Describes what has happened, what you have done and why
Complete and contemporaneous
Distinguish facts from opinion
Remember to be accurate, relevant and concise while still providing a complete record.
Use clear and unambiguous language.
Recording guidelines
Demonstrate assessment and judgment Use language that is respectful. Give due consideration to diversity issues Sign and date each piece of written
information, including messages. Be aware of confidentiality. Indicate who or where the information has
come from.
Involve service users at all stages
Managing the task Recognise importance, not just for the
agency but for the service user or carer. See recording as an integral and important
part of your practice. Plan your recording. Allocate time to record
and minimise interruptions and diversions. Record information as you go along. Don’t let
it build up! When planning a significant contact with a
family or individual include recording as part of your time allocation.
Legal underpinnings Data Protection Act 1998: Guidance to Social
Services, Department of Health, March 2000
Children and families should be:– informed of their right to access their records– encouraged to contribute to records and check
their accuracy – informed about information held about them and
when that information is to be shared with others– reassured of confidentiality and that their records
are kept in a safe, secure place
Confidentiality
All personal information is confidential Need to know One purpose Disclosure without consent
– to protect children, individuals or the public – to prevent, detect or prosecute a serious crime– to meet legal requirements, such as a subpoena.
Inform service users of disclosures Security of data
Framework for Assessment of Children in Need and their Families
‘a systematic way of analysing, understanding and recording what is happening to children and young people within their families and the wider context of the community in which they live’
( DH 2000)
Framework for Assessment
Framework for Assessment
Framework for Assessment
Stresses the need for interagency co-operation
Builds on responsibilities under section 47 of the CA 1989
Based on the following:
Legislative basis Protocols/procedures Lead responsibility Involvement of child and family Information sharing
Principles Child-centred Informed by child development theories Ecological in approach Equality of opportunity Involvement of child and family Builds on strengths as well as identifying
difficulties Interagency approach A continuous process (not single event) Grounded in evidence-based knowledge