A report published after a 15-year-old boy hanged himself has said Caerphilly social services staff went “through the motions” and referred the case to other agencies rather than analyse the problems with the teen’s family prior to his death.
The 15-year-old, who is referred to as Child A in the report, was found hanging by a belt from the bunk bed in his bedroom at home. His inquest recorded death by misadventure.
In light of the boy’s death, Caerphilly Safeguarding Children Board, a committee made up of senior managers from organisations who work with families, met and decided to convene a serious case review.
The panel was chaired by a senior manager from Caerphilly Children’s Services.
Although the report, written by children’s social care expert Barry Raynes, concluded the boy’s death could not have been predicted or prevented, there were lessons to be learned.
The report says: “Child A’s death could not have been predicted or prevented. The likelihood of him being involved in: risk taking behaviour of one sort or another, criminal and drug activity, problems with alcohol and limited learning was predictable because of his non?school attendance. Prevention of these problems was attempted but was not successful.
“Workers from all agencies seemed to simplify the problem to one of non school attendance caused by Child A’s failure to come to terms with the death of his father. This single causal, rather linear view of people’s problems ignores the complexity and tapestry of family life. There were many factors affecting this young person’s life and a thorough consideration of these and their interrelationship would have been helpful. My experience of serious case reviews leads to me to conclude that this problem is not limited to Caerphilly.”
The report states that Child A had difficulties at school made worse by the death of his father aged eight. He was referred by teachers to social services when he was ten.
Despite the interventions of professionals, Child A, who was involved in low-level crime, stopped going to school and his mother said he would be home-schooled. There was also concern when the mother’s partner came out of prison to live with the family because of his past drug use.
The report says: “There appears to have been no real understanding of why Child A and his mother were ‘failing to engage’. This may have been because they did not perceive the services that they were being referred to as helpful.
“The failure to view the whole family’s needs and to take account of the mounting evidence of risk taking behaviour by Child A, aligned to the introduction of his mother’s partner into the family, appears to me to be the major failure in this case. Not the lack of resources, not the lack of effort but the feeling that staff are going through the motions of referring to a further agency rather than really analysing what the problem may be.
“Children’s Services had procedures in place for dealing with children ‘in need’ (of additional services) as they accepted Child A was. These were not followed.”
The report recommends extra training for social services staff and and to develop a more effective way of working with families who fail to engage with services.
Caerphilly County Borough Council has been asked by Caerphilly Observer for its response to the report.