This at-a-glance briefing pulls together and highlights the learning from case reviews into the death or serious injury of a child where parental substance misuse was a key factor.
It is based on case reviews published since 2010.
Parental substance misuse is widely recognised as one of the factors that puts children more at risk of harm. In these case reviews, children died, or were seriously injured in a number of different ways:
The biggest risk posed to children is that parents, when under the influence of drugs or alcohol, are unable to keep their child safe (i.e. overlay and accidents caused through lack of supervision).
Many of the learning and recommendations contained in the case reviews repeat lessons from numerous other reviews.
There is a clear message about the importance of timely and thorough assessments with regards to all the children cared for by substance misusers. The assessments need to be child-focused. They should present a clear picture of the user’s drug and alcohol consumption, and carers’ usage and behaviour must be properly analysed to understand the risks that this poses to the children. This should include an assessment of parenting capacity.
Where other risk factors are also present (parental mental ill health, domestic violence), the relationship between these factors and a parent’s substance misuse should be taken into account.
Risk assessments should be a dynamic rather than a static (one-off) process, which are reviewed in the light of emerging evidence.
Professionals too often trusted the parents’ self-reporting of their drug and alcohol consumption. Their substance misuse was known about but not seen as excessive or problematic. Some reviews talk about tidy and clean homes and happy and healthy children.
It is important that information is delivered in such a way that parents are able to understand it. Professionals should regularly check that parents have understood the risks and are complying with the advice. Written leaflets are not suitable for functionally illiterate adults.
Some parents said they did not feel that the risks of co-sleeping had been explained in such a way that they had fully understood them, or had taken them on board.
Work with adults often focused on their individual needs rather than their role as parents.
In other cases, the focus was on looking for a holistic family support package, which meant the immediate risks faced by the child were not prioritised, and the needed safeguarding action was not taken.
Professionals working with substance misusing families should check compliance with the issues listed above on every visit/meeting.
New and increased risks include: