Social and Theoretical Prespectives in Social Work - Case Study Example

Social and Theoretical Perspective of Social Work Morgan, December 2005 The case of Victoria Climbie- Different facets of the sorrow extreme Victoria Climbie was an eight-year- old child from the Ivory Coast who met a very painful episode of injuries at physical and mental level in London in 2000. She died by the cruel manifestations of her aunt and her aunt's boyfriend. The sorrow also presented itself in the form of inefficiency of the system to acknowledge the need of the child. The case of Victoria and the intensity of her sufferings in the last few months of her life were in the knowledge of numerous agencies with responsibility for the protection of children. But the dominant weaknesses present in the structure of the system disabled the enabling of required services to Victoria. After the conviction of Victoria's carers for murder, Lord Laming held intensive inquiry about it in London. The investigative report of Victoria as prepared by Laming consisted of some 400 pages of text. In the time between the arrival of Victoria in England in April 1999 and her death in 2000, Victoria had made her entry to a wide range of services. The services that she visited included the three housing services, four social service departments, and two police child protection teams. In addition, she was twice admitted to hospital. The post-mortem report found evidence of 128 separate injuries on her body. She had been subjected to physical pain by means of a range of sharp and blunt instruments. However, the immediate cause of Victoria's cause was hypothermia. Thus, we might state that a highly cruel and evil manner of dealings was made with Victoria. And despite so much of painful experiences faced by the child, she was left without help from every corner of the crippled system. At the end, Victoria's lungs, heart and kidneys all failed. Dr Nathaniel Carey, a Home Office pathologist with many years' experience, carried out the post-mortem examination. What stood out from Dr Carey's evidence was the extent of Victoria's injuries and the deliberate way they were inflicted on her. He said: "All non-accidental injuries to children are awful and difficult for everybody to deal with, but in terms of the nature and extent of the injury, and the almost systematic nature of the inflicted injury, I certainly regard this as the worst I have ever dealt with, and it is just about the worst I have ever heard of" (p.2). The sorrow reveals that Victoria could have been saved from this tragic end but was not saved due to system fault. There were 12 identified and clear opportunities to save Victoria. These are as follows: 1) Ealing social services, spring 1999 when Victoria arrived in the London borough of Ealing, with her aunt Marie-Therese Kouao. 2) Warnings from a relative Ester Ackah, anonymous call to Brent Social Services. 3) When admitted first time in the hospital Central Middlesex Hospital on 14 July 1999 4) Her visits to Ealing social services.(Failed to identify her individual need) 5) North Middlesex Hospital visits on 24 July 1999. 6) Tottenham child and family centre, there was confusion about the case handling and it had been closed without seeing Victoria. (Communication Gap) 7) Health Visitor follow up.(Communication Gap) 8) Visits to Carl Manning flat (Lack of experience, understanding of the child's need and efforts to help her) 9) First Letter from Mary Rossiter, paediatrician, North Middlesex Hospital to Petra Kitchman, Haringey's child protection link with the hospital for the follow up on 13 August 1999. 10) Second letter from Dr Rossiter's second letter to Ms Kitchman on 2 September 1999 with the details of abuse. 11) Allegation of Sexual Abuse on Manning, 1 November 1999 12) Final visits to Manning's flat when the case was concluded with the note Kouao and Victoria left the place (December 1999 and January 2000). Failure of system, the fault of professionals, and the sufferers are innocent children This is not the only one approach to look at the child abuse cases that hold their presence due to weak systems. Nor is the story of Victoria Climbie the only one of its kind. Several other children have suffered to extremes at the hands of incompetent system. The sorrow of the truth that Victoria was being injured at more than a hundred places on the body weakens ones faith in the existent system ability (Reder, 2004; 1993; Rustin, 2005; The Stationery Office, 2003). System-approach - A method of logic and vision While we deal with the system-centered approach to understand in-depth the case of Victoria we look for investigative results for error in all parts of the system. Thus, we do not hold our focus of attention and preference just within the individual. It is essential to point out here that in the case of traditional investigative means for searching reasons for a problem, the focus of attention was always held on the individual who erred. Thus, the blame was held on the individual and the system was prevented from the effect of recommendations and actions. However, the advancement of knowledge and penetration of more logic has substantially changed the existent scenario and has therefore transferred the focus from the individual to the system. Thus, instead of advocating that a better behavior from the individual would have resulted in a better response, the authority considers that a better system could have acted in a better way. We would say that the application of system approach leads to a more scientific conclusion and helps in the prevention of error to a much greater extent. In addition, an improvement in the system results in the assurance of omission of repetition in error. The system approach also holds its validity because of the accepted fact that human errors are not random in nature but on the contrary are predictable when applied to a wider context. In the case of Victoria, the care was not being provided by the professionals in a care-delivering profession. The question that comes to mind in this context is that why at all did the individuals who were supposed to deliver care failed at the time of its most essential need The individuals who choose from their desires point of view to be in a care delivering profession are not expected to what they did Why at all the tragedy of Victoria's case occurred on earth The application of system approach here can not only help in reasoning out the cause of Victoria's tragedy but can also if properly implemented assure a confident roof of protection to all other children. Thus, with the aim to prevent what could not be prevented in the past, we address the present situation with the application of system approach. Behind the occurrence of human error breathes many a times with prominence cognitive systems, computers, and hindsight (Woods, 1994) Throwing investigative light to Laming report (Laming, 2003) The front-line staff of the key public services were all employees. They acted on behalf of the organisations which employed them. Those in senior positions in such organisations carry, on behalf of society, responsibility for the quality, efficiency and effectiveness of local services. I believe that several of those in such positions who gave evidence to this Inquiry, either did not understand this, or did not accept it. Front-line staff may well have a different perception of the organisation they work in from that of their senior managers. Based on the evidence to this Inquiry, the differences could only be described as a yawning gap. The failure to grasp this was undoubtedly the fault of the managers because it was their job to understand what was happening at their 'front door'(p.4). The evidence of system failure in the form of management deficiencies finds its prominent place of existence in the case of Victoria. An inadequate managerial supervision which was evident in Ealing, Brent, and Haringery, the police team, and the NSPCC Child and Family Centre in Tottenham represents a significant inefficiency in the in the system as a whole. Thus, an addition of managerial supervision in the system as a whole can certainly help locate the presence of loopholes in the individual job practice and thereby take required actions to improve the quality of service provided. This is crucial also to prevent the re-occurrence of cases like Victoria elsewhere. The condition of Brent as presented by the Laming report is a deplorable one. The absence of managerial control resulted in the omission of the knowledge of the quality and type of service provided by the practitioners in the organization. For example, Victoria was not seen discussing her problems alone with any professional and this fact was not very much in the knowledge of the staff. This really represents a very sorry picture of the norms and rules set and practiced at the managerial level in the organization. Communication breakdown in the administrative process holds its dominant existence in the occurrence of child abuse problems (Falkov, 1996; Brandon, 1999; Sinclair and Bullock, 2002; Lord Laming, 2003). The problem in communication has been reported to hold its existence in child abuse cases in several developed countries (Alfaro, 1988; NSW Child Death Review Team, 2000). The understanding of communication has also held its prominent existence in the problems as related to several other areas in UK (Carson, 1996; Walshe and Higgins, 2002). Thus, the acceptance of understanding communication in child protection networks has an age-old area of notice. The importance of communication has been thus presented in the problems whose origin and existence was greatly related to the persistent communication problem. It therefore becomes even more essential for us to consider the gap in communication that was evident and prominent in the case of Victoria. System-approach - More detailed application to the case of Victoria Climbie It is not to the handful of hapless, if sometimes inexperienced, front-line staff that I direct most criticism for the events leading up to Victoria's death. While the standard of work done by those with direct contact with her was generally of very poor quality, the greatest failure rests with the managers and senior members of the authorities whose task it was to ensure that services for children, like Victoria, were properly financed, staffed, and able to deliver good quality support to children and families. It is significant that while a number of junior staff in Haringey Social Services were suspended and faced disciplinary action after Victoria's death, some of their most senior officers were being appointed to other, presumably better paid, jobs. This is not an example of managerial accountability that impresses me much (p.4). There exists a prominent need to provide a ground for better understanding of human behavior. We certainly can pinpoint the behavior complexity and the professional inefficiency in an individual but this cannot help control the prevalence of mistakes. Thus, correction required is more at the system level than at the individual level. The system approach therefore holds a very scientific and well-studied form of activity and applicability. In the system approach we locate the essential element that held its deficiency in the practitioner in the organization. We then focus our attention on the organization as a whole. This is because it is the duty of the organization to get the work done rightly by all the professionals working therein. A reason for system approach also arises as an essential step for contribution of positive aspects to the society and prevention of repetition of mistakes not at the individual level but at the organization level. Woods (1994) has provided an illustration of the human performance in the form of a diagram. As depicted from the essential features of the illustration we find that the actual level of performance as achieved can be grouped into three layers: a. Factors in the individual b. Resources and constraints c. Organizational context Some of the important factors that hold the responsibility of the quality of human performance are as under: 1. Knowledge 2. Attention 3. Strategy The case of Victoria to hold a place of knowledge in the mind of practitioners required good communication practices in the system. An interaction between professionals working in the system could have certainly resulted in a better response to the problem. Thus, the knowledge of the problem is an essential perquisite to address it. In addition, the case of Victoria held the drawback of insufficient number of staff members. Also, the training and skills that holds essential place for providing good quality of service was lacking in the staff members. An incompetent team of workers in a poorly managed organization was thus a significant contributor to the observed child abuse case. Another important feature that should have been included is the emotional wisdom. The practitioners are required to add the intensity of emotions to the work that hey are involved in. Investment of emotions to a job that deals with providing care to children shall certainly show profit in the quality of service provided. The practitioner also should address to the problem of burnout and exhaustion with a proper stand. A soft heart and a responsive behavior by the social workers in a system can certainly help the penetration of benefit in any society. The social workers have been mocked several times in the past history for being overly good in the delivery of care. However, the feeling of kindness and emotional love were some how lacking in the case of Victoria. Victoria had made a very clear representation in the team of workers and general public but was even then neglected and ignored. The attention for helping her was somewhere missing and each of the professionals were very busy in their own set of goals to be performed. An emotional attachment with the desire of providing crucial service to the society could have really helped fire the sufferings of Victoria. The attention held its lacking phenomenon in the case of Victoria also because the social worker was overloaded with work. She had almost one-third extra cases than the maximum number allowed. Thus, the social worker held the problem of dealing with more cases than any human brain can handle. We would also like to mention here that the social worker that was to have an investigative look at the case of Victoria had absolutely no experience in the field. In addition, the managerial team connected to the social worker was not confident of even the literacy of all the staff members. This became one of the reasons for the failure of recognition of need for Victoria. It is also important to mention here that the limitation in essential resources had set a limit on the quality of service being provided by the concerned professionals. In the case of Victoria the limitations in resources presented itself mainly in the form of time and pressure. One important area of conflict for the investment of resources was the one between care and control services to be provided. Thus, the professionals were required to decide between the prevention and treatment of the prevalent child abuse cases. An investigative eye to the family matters of every child certainly reduces time as resource available for dealing with the cases of child abuse already in knowledge and at hand. Another area that marked its presence in the consumption of significant amount of time was the amount of paperwork that was required to be done for maintenance of quality. The paperwork since recent times is seeing a steep rise in its importance and workload induction. The practitioners therefore are advised to be strategic in their approach and more adherent to the pre-planned means of time saving essential ways. An increase in the time by means of proper time management can certainly help them recruit quality within their area of practice. The case of Victoria also presents a substantial need for administration of information processing tool for better efficiency. However, it is important to consider that the information-processing tool should not impair the process of acceptance of contradictory observations as compared with those presented in it. The organizational culture also holds partly the responsibility of the neglect projected in the child abuse cases like that of Victoria. The duty of the practitioners should be to concentrate both on the support of families as well as on the protection of children. The report of Victoria brings to notice that the front line staff was working in a very negative condition and therefore there was prominent need for betterment of the organizational culture. The responsibility of this act falls on the shoulders of the management and therefore puts the system as a whole at a question mark with respect to quality provision. Thus, in the light of system failure we pointed the important areas where the breathes of imperfection were most prominent in existence. The approach also presented the essential steps that can help assure improvement. Victoria was a girl- A feminist view on the report's preview So we might rightly state that the constitution always had laws, the protection was always considered to be important, and steps of improvement had always been in its potent pace, then what happened to the effectiveness' of justice on the face of a child We agree, that the case of Victoria does set a lesson to be learnt, but were these lessons half-learnt from the past experiences of protruding unjust ways on children. First of all a child, then a girl; was this the reason of no helping hand being forwarded at the hour of prominent and most obviously visible need We as citizens of free United Kingdom, if fail to provide protection to children do not deserve freedom. The social workers had a prominent need to look into the matter at the hour, which could have saved the child. We might state that even today the infliction of exploitation on girls or women, on weaker sections (child), and on those who hold not the voice to fight is high. The unfortunate face of the society that reveals itself naked in the present context is that the present society too breathes the same depth of imperfection as ones it did. Enhancement of education, increase in technology, speed in delivery of messages all are futile if the voice of those who suffer remains unheard until their death. The developed UK has witnessed the sorrow of severe child abuse cases since past 30 years. A good way to bring to knowledge whether or not a change in the child abuse scenario has taken place in the recent years can act as a good judge of the prevalent condition. This can be scientifically done by conducting meta-analysis of all the studies previously available on the child abuse cases (Reder et al., 1993; James, 1994; Corby et al., 1998; Reder and Duncan, 1999; Munro, 1996; 1999; 2002; Sanders et al., 1999; Arthurs and Ruddick, 2001; Sinclair and Bullock, 2002). These studies on child abuse bring to knowledge that it is difficult to say that a change in time has led to a positive change in the protection of children. In addition, the reports have pointed that essential lessons are not learnt from the happenings in the history of child abuse cases (Dingwall, 1986; Stevenson, 1989). It is important to note that though women form one-half of the world population and contribute almost two-third of the world's work hours, they are subjected to poor representation of resources and essential responsibilities (Peterson et al, 1993). Gender thus has become a model with pre-defined associated expectations. The characteristics and responsibilities associated with gender are different in different societies. However, the gender relations have always been a subject of commentary, since the age-old days (Sigel, 1996). Even after the globalization by virtue of the western companies (mainly USA) (Allen, 2000), the issue of gender differentiation remains somewhat indifferent to difference. Some also view prevalent practice of acceptance of gender difference as being associated with the presence or absence of sexual identity of being a male (Sweeney, 2004). Even in the holy environment of teachings and preaching in the school and church, the differentiation in gender exists to its entirety. Dr. Sandra Harley (2003) examines that women even in the academic circle are being considered by a vision of disapproval or invisibility as compared to men. Thus, women bear the commodity of neglect because of the possession of less physical strength and the other male linked physical patterns and attributes. Christine Sylvester (Rosow et al, 1994) has also agreed upon this. She points out with regret to the prevalent situation that the field of International Relations has deliberately ignored the participation of women in its essential discussions. Considering the case of Victoria from the feminist point of view, we gain substantial base of it being another exploitation of women section of the society. The sorrow does not end here, the practice and participation of unjust ways in dealing with the feelings of women as always is on its own essential route of existence. Changes in this matter are inexistent or negligible to be attributed as being done. As we have seen in the case of Victoria, neither the teacher of school, nor the preacher of the church had taken any...absolutely any steps to save the girl...just because she was a GIRL.. Conclusion We might therefore state that the main problems that hold their prominent accountability in the Victoria's case was a significant rate of practitioners failing on the grounds of fulfilling their most essential attributes of responsibility. This had originated the reason for communication gap and weak interpretation of the information. We might state that the professionals at the managerial level hold the responsibility of these prevalent deficiencies in the organization. It is therefore essential to set corrective measures on the grounds of system rather than individual. Application of strict and proper norms and rules can certainly help eliminate this essentially unethical mode of practice on common grounds. Considering the importance of the important elements demanding control at system level we held the focus of our attention to the system approach in preference. Another important contributor to the tragedy that occurred on Victoria was the mind-set preference for help and care to the male at priority and entirety. Victoria being a girl had gone through real tough time because of the performance of professionals in a system so weak. Considering the significant inefficiencies in considering genders as equal, we decided to consider the tragedy of Victoria's case through feminist point of view as well. The conclusion as drawn from the feminist point of view is that each life is valuable whether of a child, women, physically challenged, old age people or deprived section of the society. They should be respected and have all rights to live with dignity. Differentiation on grounds of gender and preference on the level of power, the depictions of helping on the base of choice is worth no help at all. This tyranny inflicted on the women body needs to meet its own end. The society that endangers the dignity and joy of female even as a child...certainly needs strict revision and better adherence to goodness. The case of Victoria is thus a representation of the unjust prevalent in the rich society of UK. References Alfaro J. (1988) What can we learn from child abuse fatalities A synthesis of nine studies. In Protecting Children from Abuse and Neglect: Policyand Practice, Besharov DJ (ed.). Charles C. Thomas: Springfield, Illinois. Allen, T. and Thomas, A. (eds.) (2000) Poverty and Development into the 21st Century. Milton Keynes: Open University Press. Arthurs, Y. and Ruddick, J. (2001) An Analysis of Child Protection 'Part 8' Reviews Carried out over a Two-Year Period in the South-East Region of the NHS. South East Regional Office, Department of Health: London Brandon M, Owers M, Black J. (1999) Learning How to Make ChildrenSafer: An Analysis for the Welsh Office of Serious Child Abuse Casesin Wales. University of East Anglia/Welsh Office: Norwich. Carson D. (1996) Structural problems, perspectives and solutions. In Inquiries After Homicide, Peay J (ed.). Duckworth: London. Corby, B., Doig, A., Roberts, V. (1998) Inquiries into child abuse. Journal of Social Welfare and Family Law, 20, p. 377-95. Dingwall, R. (1986) The Jasmine Beckford affair. Modern Law Review, 49, p. 489-507. Falkov A. (1996) Study of Working Together 'Part 8' Reports. Fatal Child Abuse and Parental Psychiatric Disorder: An Analysis of 100 Area Child Protection Committee Case Reviews Conducted Under the Terms of Part 8 of Working Together Under the Children Act 1989. Department of Health: London. Harley, S. (2003) Research Selectivity and Female Academics in UK Universities: from gentleman's club and barrack yard to smart macho. Gender and Education, 15(4), p. 378-87. James, G. (1994) Study of Working Together 'Part 8' Reports: DiscussionReport for ACPC Conference 1994. Department of Health: London. Lord Laming. (2003) The Victoria Climbie Inquiry. Report of an Inquiry by Lord Laming (chairman) January 2003. The Stationery Office: London. Munro, E. (1996) Avoidable and unavoidable mistakes in child protection work. British Journal of Social Work, 23, p. 193-808. Munro, E. (1999) Common errors of reasoning in child protection work. Child Abuse & Neglect, 23, p. 745-58. Munro, E. (2002) Effective Child Protection. Sage: London. Peterson, V. and Runyan, A. (1993) Global Gender Issues. USA: Westview Press Inc. NSW Child Death Review Team. (2000) 1998-99 Report. New South Wales Child Death Review Team: Surrey Hills, NSW. Radford, L. and Tsutsumi, K. (2004) Globalization and Violence against Women-inequalities in risks, responsibilities and blame in the UK and Japan. Journal of Women's Studies International Forum, 27 (1) p. Reder, P. and Duncan, S. (1999) Lost Innocents: A Follow-up Study of Fatal Child Abuse. Routledge: London. Reder, P. & Duncan, S. (2004) From Colwell to Climbi: Inquiring into fatal child abuse. In: The Age of the Inquiry (eds N. Stanley & J. Manthorpe), pp. 92-115. Brunner-Routledge, London. Reder, P., Duncan, S. and Gray, M. (1993) Beyond Blame: Child Abuse Tragedies Revisited. Routledge: London Rosow et al (eds). (1994) Reginas in International Relations: Occlusions, Cooperation, and Zimbabwean Cooperatives in The Global Economy as Political Space. London: Lynne Rienner publishers. Rustin, M. (2005) Conceptual analysis of critical moments in Victoria Climbi's life. Child and Family Social Work Sanders, R., Colton, M. and Roberts, S. (1999) Child abuse fatalities and cases of extreme concern: lessons from reviews. Child Abuse & Neglect, 23, 257-68. Sigel, R. (1996) Ambition and Accommodation. Chicago: University of Chicago Press. Sinclair, R., and Bullock, R. (2002) Learning from Past Experience-A Review of Serious Case Reviews. Department of Health: London. Stevenson O (ed.) (1989) Child-abuse inquiries and public policy. In Child Abuse:Professional Practice and Public Policy. Harvester Wheatsheaf: Hemel Hempstead. Sweeney, B. (2004) Trans-ending Women's Rights: The Politics of Trans-inclusion in the Age of Gender. Journal of Women's Studies International Forum, 27 (1), p.77-80. Tong, R. (1992) Feminist Thought: a comprehensive introduction. London: Routeledge Ltd. Laming (2003) The Victoria Climbie Inquiry: report of an inquiry by Lord Laming. [Accessed on 18 January 2006] http://www.victoria-climbieinquiry.org.uk/finreport/finreport.htm accessed 18 January 2006 Sinclair R, Bullock R. (2002) Learning from Past Experience: A Review of Serious Case Reviews. Department of Health: London. The Stationery Office (2003) The Victoria Climbi Inquiry Report. The Stationery Office, London. Walshe K, Higgins J. (2002) The use and impact of inquiries in the NHS. BMJ 325: 895-900. Read More