Special report: Understanding risk in social care

Social work is easily criticised for being ‘risk averse’ and ‘risk anxious’, and yet we don’t seem to be any further down the road of being more risk sensible, write Tony Stanley and Rob Mills
Social workers work with risk. There is nothing controversial in that. They assess it, manage it, try to mitigate it, and report on it in the many forums and meetings they attend. In family homes, offices, court rooms, and supervision meetings they draw on the language of risk. But the relationship between social work and ‘risk’ is a complex one. Tower Hamlets has adopted the signs of safety approach to bring practice depth to our risk analysis work with children and families. Practice depth will be part of the new requirements by Ofsted, with inspectors mining for analytic and methodological strength in practice. Not only will this methodology help inform the professional judgments we reach, it should enhance the child and family experience of us – both issues featuring more heavily in the revised Ofsted inspection regime from September, 2013.

Social work is easily criticised for being ‘risk averse’ and ‘risk anxious’, and yet we don’t seem to be any further down the road of being more risk sensible. The next practice tragedy will undoubtedly usher in a new round of defensive practises, and risk anxiety will abound. If we are to be braver in practice, and work with risk, we need to understand how risk operates rhetorically and literally. We need to understand how we make sense of risk discourses – that is the sets of meaning that operate beneath the language. To illustrate: If you think ‘risk factors’ are the most important part of risk assessment work, you will set out to find them. You will probably count them up – and this is taking an actuarial or quantitative approach to assessing risk. Conversely, if you think that risk is an idea, a state or a situation that is arrived at through the work done with a family, you will reach a professional judgment in another way – through a qualitative or constructed analysis method. This is a different methodology, and this is the point: we need to understand the practice methodology we use. And, its limits. This is important because it may feel safer, or seem to make sense, to default to a risk factor analysis. The problem is that there is little room for uncertainty. We can’t rule out uncertainty as something our practice needs to accommodate. We need to work with it and feel more comfortable about it because it is a part of every family’s life.   

In Tower Hamlets, supported by the LSCB, senior health and social care colleagues have worked together to bring the Signs of Safety approach to our risk analysis practice. We think this provides an intelligent practice method accessible for the health – social care interface because it is a framework that we can share, talk about, and understand as we work with vulnerable families and risk. Through mapping cases, health colleagues are clearer about what needs to change or happen next to prevent the need to refer to social care. This is also helping facilitate cases moving out of statutory social work to other services because risk is better understood and more robustly articulated. We are working with families to understand and mitigate risk and harm to children, and the practice tools are encouraging more direct work with children. Less time is taken to reach our professional judgments about what needs to happen next.

Working with risk as a constructed idea, that is ‘a state’ that can change and shift when more safety is located and built upon is a tenet of this approach. We think families are worth doing business with – and we start our work from a position that every family has something to bring to the work. Families can tell us about what could help, however small an idea or suggestion. Family group conferences are effective for wider family to challenge risk and harm, and to tell us what is too dangerous.

Confidence and self-awareness will be something the Ofsted new inspection framework will measure us on. Being able to confidently articulate how we reach our professional judgements, and being able to talk to the practice methodology used to inform them will be necessary. It is also ethical. Not being able to do so is not good enough for families.

This year’s alignment of the Ofsted revised inspection regime, severe public service budget cuts, alongside the goal of strengthening our practice makes this is an exciting time for social work. But we have work to do. Being clear that children are safer because of our interventions will be important to inspectors. Ofsted will want to know how we know that the case is progressing. What tells us that children are safer? What tells us that we have made a difference in their lives? We will need to show that we have a grip on every case. Decisions for children do need to be made efficiently, so the strongest risk analysis is needed, and this will be of interest to Ofsted.

The move away from risk assessment to risk analysis work is the right direction of travel; it invites us to think about how we each construct risk, what informs this and in what way this might enable or restrict practice with families. If we believe that families are worth doing business with we need a sophisticated risk analysis toolkit that can involve them. Some staff will still prefer a precautionary and professionally orientated method of risk assessment that is delivered to families. This may feel safer, for them. But this approach can too easily close down family involvement. We argue that the signs of safety toolkit will stand us in good stead for respectful, family intervention practice, and the next visit by Ofsted: two significant players in helping us learn about our practice efficacy.

Tony Stanley is principal child and family social worker at the London Borough of Tower Hamlets Rob Mills is nurse consultant safeguarding children and designated nurse