The Graded Care Profile (GCP ) Report to Scrutiny Topic Group 8/06/10

1. The Graded Care Profile(GCP)Report to Scrutiny Topic Group 8/06/10

2. Background • When professionals undertake an assessment in a child welfare or child protection context, it is vital that they should be able to make a reliable judgement about the quality of the care being received by the children involved. • The findings of serious case reviews (nationally and locally) repeatedly suggest that this is something which professionals do not do very well. The judgements they make can be highly subjective and prone to bias.

3. Tackling Neglect • In order to achieve a consistent and systematic approach to assessing and responding to neglect across more agencies have been turning to the graded care profile. • The GCP is an assessment tool devised by Dr Om Prakash Srivastava, a consultant community paediatrician and designated doctor for Luton Teaching Primary Care Trust.

4. What is the Graded Care Profile? • The graded care profile is a tool based on psychologist Maslow’s hierarchy of needs. • The tool allows practitioners to explore four areas, or “domains” of care - physical care, safety, love and esteem – and to judge the parenting which they observe against simple predetermined criteria. • The results of the assessment are entered on to a summary sheet which pinpoints those areas of deficit which require further attention.

5. Domains of Care Stimulation Approval Disapproval Acceptance Sensitivity Responsivity Reciprocity Overtures Selfactualisation Esteem Loveandbelongingness Present and absent Safety Physicalneeds Nutrition. Housing, Clothing, Hygiene and Health Maslow, A. 1954

6. How do we know it works? • Srivastava and colleagues from the local safeguarding community and the University of Bedfordshire have been evaluating the use of the graded care profile since its adoption by Luton Area Child Protection Committee in 1999 and have been impressed with the results achieved. • For many users, the most important aspect of the tool’s success has been the fact that it can be employed by practitioners from any agency involved in child welfare. The profile gives the agencies a common language, a common frame of reference. • Another advantage often cited during evaluations is the profile’s user-friendliness.

7. How do we know it works? (2) • It is easy to learn and it has been found that experienced practitioners need as few as two hours’ training to become competent in using it. • They find it so easy to apply in practice that it can be used by parents and carers to rate themselves and to identify their own difficulties, and by children to assess the parenting which they receive.

8. How do we know it works? (3) • The structure of the assessment process means that strengths are highlighted alongside weaknesses, and areas of concern are identified sufficiently precisely to allow intervention to be targeted specifically at areas of weakness, which can result in considerable resource savings. • For example, family centres can expect to stop receiving rather vague referrals asking for generalised “parenting training”. Instead, the graded care profile provides them with a concise analysis of the care being given which allows them to devise shorter but more intensive programmes.

9. Easier reassessments • In theory at least “assessment is a process not an event” but, in reality, busy workers often see assessment as a task to be completed once before moving on. The graded care profile makes periodic reassessment easy. • It was designed to be used by workers to make a baseline assessment at the beginning of intervention and then to be reapplied regularly to gauge progress. • This is an aspect of the tool which families have found particularly helpful, as it has provided them with specific targets to aim for and a clear idea of what it is they are trying to achieve and how they will be judged.

10. When do you use it? Can be done: • Concerns about parenting • Child exhibiting problems • Children in Need of Protection • Children in Need • Programme of Intervention • Any other concerns

11. Users • Health visitors • School Nurses • Social Workers • Family Centre Workers • Education Welfare and school support workers

12. Uses • Pre-referral assessments • Snapshot assessments • Contribution to CAF • Contribution to Core Assessment (parenting capacity) • Self-assessment (parents and carers) • Young person’s assessment of parenting • Tool for setting goals • Tool to facilitate discussion

13. Implementation of GCP in Hertfordshire • Two teams in CSF Social Care (Stevenage Assessment and Broxbourne Locality) will pilot the GCP along with a cohort of Health Visitors working in partnership with these area teams. The focus at this stage will be on early intervention. • In addition, Hertfordshire Police will work alongside the pilot teams to effectively use the criminal justice system in parallel with the child protection process.

14. Timeline • July 2010 - GCP guidance and toolkit to be signed off • September 2010 - teams involved in the pilot to be trained (funding identified) • September 2010 – pilot projects go live • December 2010 - mid-point review • March 2011 – End of pilot evaluation • East Anglia University is working with Luton and Dr Prakash Srivastiva on evaluating the GCP and Herts might be a part of the evaluation work.