Pre-Birth Assessments Procedure

1. Case Accountability

All Pre-Birth Assessments will be completed by Assessment and Intervention Service and allocated to a Social Worker at the first trimester.

If any other siblings are already known to Children's Social Care, and are an open case, the allocated worker from this service will be responsible for completing the Pre-Birth Assessment.

If the expectant mother is a Looked After Child the procedure relating to Pregnant Looked After Young People should be adhered to.

2. Conducting the Pre-Birth Assessment

2.1 Principles

The following principles apply:

Each new pregnancy, where there are, or may be, significant concerns regarding the unborn child, must be the subject of a new Assessment, giving due regard to the history.

The Assessment process should begin as early in the pregnancy as is possible. Workers need to be mindful that the baby may be born earlier than anticipated and should therefore allow sufficient time to conduct the Assessment and put in place the appropriate Birth Plan. During the course of the Assessment the Social Worker should discuss with the Midwife the progress of the pregnancy and any changes to the anticipated expected date of delivery.

Whenever Pre-Birth Assessments are undertaken, the GP should be contacted in all instances. 

2.2 Purpose of Pre-Birth Assessment

The purpose of a Pre-Birth Assessment is:

1. To consider whether additional support is needed to promote good enough parenting and plan accordingly;
2. To determine the extent of risk to the unborn child;
3. In conjunction with other relevant agencies, to formulate a plan in response to this risk.

The depth and type of Pre-Birth Assessment will vary. In some situations, it would be a duplication of previous work to undertake a detailed pre-birth risk assessment as the circumstances may already be well known and little may have changed; in other situations, there may be some significant differences from the past to justify a different approach to the expected child. 

2.3 Scope of Pre-Birth Assessment

In conjunction with the Social Worker's Pre-Birth Assessment it may be appropriate to commission other types of Assessment to be undertaken which will provide a holistic overall assessment of the parent's capacity to parent a new-born child. Such Assessments should be undertaken by the relevant agency/professional if a parent(s) have:

• Suspected drug/alcohol misuse;
• Learning difficulties;
• Psychiatric history;
• Chronic or acute medical conditions which may impact on their physical ability to care for a child.

In conducting the Pre-Birth Assessment the allocated Social Worker must be familiar with the content of the following documents:

1. The historical case files relating to the parents of the unborn child and/or any older siblings of the unborn child;
2. Assessments that have previously been undertaken on the parent(s);
3. Any previous assessments on siblings of the unborn child;
4. Any useful documentation that has been used in relation to Court Proceedings or Child Protection Plans of the siblings;
5. Any other historical information as may inform the Pre-Birth Assessment.

2.4 Avoiding Delay

In Nottingham City Council v LM and others [2016] Justice Keenan emphasised the importance of the following when conducting Pre-Birth Assessments:

1. The Birth Plan should have been rigorously adhered to by all social work practitioners and managers and by the local authority's legal department;
2. A risk assessment of the mother and the father should have been commenced immediately upon the Social Workers being made aware of the mother's pregnancy. The Assessment should have been completed at least 4 weeks before the mother's expected date for delivery. The Assessment should then have been updated to take account of relevant events immediately pre and post-delivery which could potentially affect the initial conclusions on risk and care planning for the unborn child;
3. The assessment should have been disclosed, forthwith upon initial completion, to the parents and, if instructed, to their solicitors to give them an opportunity, if necessary, to challenge the Assessment of risk and the proposed care plan;
4. The social work team should have provided all relevant documentation, necessary for the legal department to issue care proceedings and the application for an interim care order, no less than 7 days before the expected date of delivery. The legal department must issue the application on the day of birth and, in any event, no later than 24 hours after birth (or as the case may be, the date on which the local authority is notified of the birth);
5. Immediately upon issue, if not before, the local authority's solicitors should have served the applications and supporting documents on the parents and, if instructed, upon their respective solicitors;
6. Immediately upon issue, the local authority should have sought from the court an initial hearing date, on the best time estimate that its solicitors could have provided.

2.5 Older Siblings

If older siblings are still subject to on-going proceedings or if care proceedings have been completed within the last 6 months and there is a likelihood of further legal proceedings in respect of the new baby, careful consideration needs to be given as whom would be the appropriate worker to undertake the Pre-Birth Assessment. There will be a balance of factors including:

• The value of having a worker to undertake the assessment who has a detailed knowledge of the history;
• The quality of the relationship between the worker and the expectant mother;
• The wishes and feelings of the expectant mother;
• The value of having an independent view to present to the Court.

If there is any indication that the baby when born has a disability then the Children with Disability Service should be made aware so that consideration can be given to any on-going service provision from that service.

3. Conclusion of the Pre-Birth Assessment

3.1 Pre-Birth Planning Meeting

Before the child has been born and irrespective of the outcome of the assessment and the future plan there should always be a Pre-Birth Planning Meeting between Family Support and Child Protection and key professionals to agree how to manage any risks identified including contact between parent and child. This applies to Children in Need, those in need of protection and those subject to care proceedings. This meeting should be chaired by the Team Manager responsible for the case. This must take place no later than the end of the second trimester.

Any request to initiate for care proceedings must be made at Legal Gateway Panel – the Social Worker and Team Manager are required to attend Panel to seek approval for proceedings or the initiation of the Public Law Outline Process.

At the conclusion of this meeting, the Birth Plan should be completed and shared will relevant professionals including the Emergency Duty Service and a copy retained on the child's file. The Birth Plan must state the local authority's plan and whether or not the child can remain in the care of its parents.

If the local authority plans to initiate care proceedings in respect of the child the Birth Plan must be explicit about the arrangements for placement with foster carers/connected persons and whether or not the address of the placement is to remain confidential and not disclosed to parents.

3.2 Pre-Birth Assessment Outcome

The Pre-Birth Assessment will determine whether:

1. The expected child is a child in need; if so, the parents should be signposted and referred on to the appropriate support services, as indicated above;
   
   or
2. Whether the threshold for a child protection Strategy Discussion or Pre Birth Child Protection Conference has been reached;
   
   or
3. Whether there is a need for legal proceedings / whether there is a need for the child to be removed from parent's care.

Where the Assessment and indicators of need indicates a lower level of concern, it may be sufficient to signpost or refer the parent(s) to appropriate community based services - such as Early Support.

Where on-going services are required, and a number of differing agencies are involved, but the concerns do not meet the threshold for convening an Initial Child Protection Conference (ICPC), the Team Manager responsible for the case should give active consideration to convening a multi-agency Child In Need Meeting.

Where it is identified that an Initial Child Protection Conference may be required, discussion should take place with the Child Protection & Review Unit to jointly determine the timing of the conference. The conference should take place sufficiently early for plans to put in place and to progress further work. The Child Protection Conference should be convened no later than 6 weeks prior to the expected date of delivery.

However, there are some situations where it may be helpful to delay a conference - e.g. Pending the outcome of further specialist assessments or where it is felt that, with further work with the parent(s), a conference may ultimately prove not to be necessary. If this is the case then the rationale for delaying the Child Protection Conference must be clearly recorded on the child's file and specified in any subsequent report prepared by the Social Worker.

Where an early ICPC is thought to be needed, it is that team's responsibility to convene and prepare for the meeting. The worker maintains case accountability for the child following birth and will work with the family until the permanence planning is determined by the court or the child is no longer considered to be in need.

When the assessment indicates that Care Proceedings are necessary, the allocated social worker will present the case to the Legal Gateway panel for permission to initiate care proceedings.

4. Recording Assessments

Where a referral is received by the Duty and Advice Team / Front door, this will be entered into Liquid Logic and transferred to Assessment and Intervention Team for allocation within the first trimester.