2.5 High Risk, Complex Cases: Procedure and Guidance
- Governance Arrangements
- Panel Objectives
- Panel Membership
- Parental Involvement
- Involvement of the young person
- Purpose of the panel
- Removal from high risk, complex and harder to reach category
- Criteria for high risk, complex case planning
- Harder to reach or difficult to engage
- Impact of family and community life
- Factors to consider
- Impact of the way organisations work
- Impact of young person's immediate circumstances
- Factors which may act as barriers to seeking or receiving assistance from services
- Checklist for good practice
- Challenging behaviour: excluding a young person from a service provision
- Further Information
- Related Policies, Procedures, and Guidance
This procedure and guidance has been produced to help those working with young people in circumstances where a young person is high risk or has complex needs, and may not engage with services that it is felt are needed in order to safeguard and promote their welfare. The lack of engagement may be of the young person’s own volition or influenced by others, e.g. in cases of child sexual exploitation.
The procedure should be applied in cases where all reasonable attempts to engage a young person have failed or where there is a belief that the young person is at high risk of significant harm or that they present a risk of significant harm to others. The Risk Management Pathway flowchart in the appendix provides examples (but is not an exhaustive list) of services or processes through which such cases might be identified.
The protocol is not an alternative to existing case management frameworks and processes, e.g. Child Protection case conferences, Looked After Children arrangements or Care Programme Approach. It should be considered as a ‘next step’ when the existing frameworks and processes are proving ineffective in safeguarding and supporting the needs of high risk, complex, harder to reach young people.
Individual cases discussed through the Complex Case Panel will remain subject to the normal case management procedures.
The Buckinghamshire Safeguarding Children Board (BSCB) has a role in overseeing these arrangements by:
The Complex Case Panel is a senior level multi-agency advice and consultation group. Its function is operational, but it has the ability to recognise wider service or policy gaps so it can make recommendations to the BSCB about strategic work that needs to be taken forward.
A monthly meeting of the Complex Case Panel is held to improve inter-agency risk management of children and young people.
Cases are brought to the panel for discussion by managers, practitioners and clinicians with case responsibility. The panel does not supersede or take over case responsibility, this remains unchanged.
The Complex Case Panel should be chaired by the Service Director in Children and Families, Buckinghamshire County Council.
The Complex Case Panel should include senior management from those agencies/services already engaged or trying to engage the young person. It should also include, as standing members, senior representation from social care, police, health education and the youth offending service (YOS). The meeting should have inclusion of, or access to, a local authority legal advisor.
Chairperson: Service Director, Children and Families or in his/her absence: Director of Children’s Services, Health
Members: Other senior colleagues as required for specific case discussions. Specific invitations should be indicated on the case-referral form (some of these may become core members)
Consideration must also be given to the involvement of parents or other significant carers/family members – by ensuring that their views, information and suggestions contribute to the development of the action plan. This can be either in the meeting itself or by gathering the information beforehand. This must be considered on a case by case basis.
Involvement of the young person
By definition, the direct involvement of a complex or hard to reach young person in the meeting is likely to be difficult. However, efforts should be made to find any direct or indirect method of bringing their views and ideas to the discussion, e.g. involvement and/or attendance of an advocate.
Purpose of the panel
The purpose of the panel is to:
 The police are sometimes in an ideal position to help. They may be the first or only contact with statutory agencies that some vulnerable young people have because of the higher risk of association with criminal activity and vulnerability to crime.
Removal from high risk, complex and harder to reach category
The Complex Case Panel should regularly consider whether they need to keep a child or young person under the review of this group. As soon as the need for these arrangements is no longer required, all involved agencies must be informed.
Agencies must then remove any ‘High Risk, Complex, Hard to Reach’ notification or flag from their communication and recording systems. This will ensure that this priority arrangement remains focused on current selected high-risk cases.
Criteria for high risk, complex case planning
The process seeks to deliver a flexible and holistic multi-agency response for children and young people who have identified multiple needs, whose planned outcomes are not being achieved despite the best efforts of the inter-agency core group, and for whom risks are increasing. For example:
This list is intended to be illustrative, not exhaustive.
Harder to reach or difficult to engage
The terms ‘hard to reach’ or ‘difficult to engage’ can be stigmatising in themselves; sometimes implying that the young person does not want help or is unable to be helped. For each young person affected it is crucial that we aim to understand what it is that prevents effective engagement with them. Without doing so, we are unlikely to find more successful approaches. For example, a young person without cash for necessary transport isn’t going to keep an appointment – and if she/he is now homeless, they probably have not received the letter of appointment in the first place.
When a young person does not engage with what is believed to be the necessary support, staff can feel powerless to help – and sometimes agencies have closed the case, leaving the young person even more vulnerable.
The Biennial analysis of Serious Case Reviews 2005 to 2009 revealed that a common factor in Serious Case Reviews was that local services just did not know what to do with the child/young person involved. By the time of the incident that led to a Serious Case Review being undertaken, agencies appeared to have run out of helping strategies (Brandon et al 2008). It was found that many of these young people had a long history of agency involvement, but that their specific needs and distress were often missed or were too challenging, or expensive, for services to meet.
Research with young runaways has indicated that thresholds for responding to maltreatment were seen by professionals as higher when young people reached the age of 15 (Rees G et al 2010).
Most of the older adolescents in the Biennial analysis died from suicide. Typically they had experienced a history of abuse and neglect, coupled with environmental factors such as domestic violence, parental mental health issues and poverty (Hindley et al 2006). Many were self-harming and misusing substances. Numerous placement breakdowns, running away, going missing, dangerous sexual activity, including exploitation, were common features too.
These young people might have been amenable to help if they had been offered the right approach (Finkelor D 2008).
In Buckinghamshire, there have been similar findings from Serious Case Reviews involving the tragic deaths of young people. At several stages in their lives, these young people were viewed as harder to reach or difficult to engage for a range of different reasons. This guidance has therefore also been produced to help embed the specific lessons learned locally (see Serious Case Reviews on the BSCB website).
Impact of family and community life
The extent to which parents and the community encourage young people to engage with the wider community and available services will impact on their confidence to make the most of opportunities and these services. We need to understand the young person’s ability to engage within the context of the experiences they may have inherited from their family and community, particularly in relation to fear and distrust of formal organisations.
Factors to consider
Factors to consider include:
These factors are likely to have some bearing, directly or indirectly, on the young person’s ability to view agencies as a source of help or not. If the young person is not disengaged from their own family or community, then efforts to support may need to reassure those people who are more influential first.
Impact of the way organisations work
While it is important to acknowledge that young people and families can make it hard to engage, professionals play an important part in this and must be aware of the factors which contribute to the process of engagement. ‘Workers can become paralysed by their own fears and anxieties, which can lead to the assessment process remaining incomplete’ (Brandon et al 2008).
People could be hard to reach because they think an organisation does not care about them, does not listen or even is irrelevant to them (Wilson 2001).
Agencies can spend too much time deciding on who is the most appropriate team to offer a service. This uncertainty and delay of input is likely to impact on the young person or family’s interest in accepting the support and therefore causing them to become difficult to engage with.
Organisational features that can undermine engagement:
Impact of young person's immediate circumstances
Common features of ‘harder to reach’ young people include:
Factors which may act as barriers to seeking or receiving assistance from services
Factors that may act as barriers to seeking or receiving assistance include:
‘We must recognise that the young person may be hard to reach in some contexts or locations, but not in others. The real critical part is matching the right solution to the right person. We need to be flexible with what we do, we need to coordinate things better and we need to work better together.’ Hendry (2007).
Checklist for good practice
The following tips are good practice for working with any young person and may seem obvious. However, lessons from Serious Case Reviews and recent research indicate that for harder to reach young people, these practice issues remain significant:
Challenging behaviour: excluding a young person from a service provision
There are times when a young person’s behaviour may pose a risk to others and exclusion from the service needs to be considered.
Where the young person themselves is also viewed as being at risk of significant harm, a temporary exclusion should be the ultimate sanction until a Risk Management Meeting is held to develop a multi-agency action plan.
When working with young people who have already been excluded from a number of provisions in their lives, a permanent exclusion can reinforce a position of hopelessness. Consequently, a Risk Management action plan needs to be in place to direct any further decision making.
- Brandon M. Understanding Serious Case Reviews and their Impact: A biennial analysis of serious case reviews. Department for Children, Schools and Family. 2009.
- Evans J et al. Second Chances: re-engaging young people with education and training. Barnado’s. 2009.
- Dudley Libraries. Hard to Reach Young People – Their Reading Futures. 2001.
- Frankham J et al. School exclusions: Learning partnerships outside mainstream education. Joseph Rowntree Foundation. 2007.
- Hendry T. Working with Hard to Reach young People – A Practical Guide. Scottish Government. 2007.
- Millward L et al. Evidence for effective drug prevention in young people. NHS Health Development Agency. 2004.
- Pain R, et al. ‘Hard to Reach’ Young People and Community Safety: A Model for Participatory Research and Consultation. Home Office. 2002.
- Rees G et al. Safeguarding Young People: Responding to young people aged 11 to 17 who are maltreated. The Children’s Society. 2010.