HSC 11113 Social Work Approaches to Assessing Compromised Health and Development

Case Study

You are working as a social worker in a children and families practice team. The team has received a
call from a local health visitor, Maya Andino. Maya recently saw four-year-old Kelsey Mackie in clinic
for booster vaccinations. Maya was concerned that Kelsey had limited speech and was small for her
age. She discussed this with Kelsey’s mother Chanelle Mackie, who is aged 19. Chanelle agreed to a
referral to a speech and language therapist. Maya was also concerned by how Chanelle talked to
Kelsey: there was little warmth or connection in the interactions between Kelsey and her mother.

On making a follow-up home visit, Chanelle answered the door in her pyjamas and invited Maya in.
There was no sign of Kelsey, and Chanelle explained she had gone for a sleepover with her
neighbour, Ama Yeboah. Ama has a daughter Ashanti, who is a similar age to Kelsey. Ama had
agreed to take both girls to nursery and drop Kelsey home afterwards. As Maya was talking with
Chanelle, they were joined by a young man, who Chanelle introduced as her boyfriend.

Maya visited again two weeks’ later, and again Kelsey was not present, causing Maya concern. She
contacted Kelsey’s nursery who confirmed that Kelsey is often brought and collected by Ama along
with her own daughter Ashanti. The girls are close and Ashanti sometimes talks for Kelsey who finds
it hard to express her own needs, and seems withdrawn at times. Maya is increasingly worried about
Kelsey’s development and the care arrangements. You agree to make a joint home visit, and before
doing so look at the social work records available to you. You find that Chanelle had social work
involvement as a child. She was diagnosed with a mild learning disability and had some additional
support in school. Her attendance dropped off as she got older and a children’s hearing was held.
However, the family stated things had improved as a result of Chanelle’s very violent father leaving
the household. Chanelle, her mother, and her brothers seemed to manage much better as a family,
and eventually the case was closed to social work.

On visiting the home with Maya, Chanelle appears angry at the social work involvement, stating it
never did her any good. She tells you that both she and Kelsey are fine and do not need any support.
Kelsey says almost nothing during the visit, and you find it difficult to engage her in eye contact or
play. You ask Chanelle about her boyfriend, who is not there at the time. She tells you his name is
Zac Stevens, but makes it clear she would rather not discuss her private life with you and Maya. She
tells you it is a causal relationship and he only visits when Kelsey is with her neighbour Ama.
Chanelle says it does her good to have some company as she has few friends in the area. On
returning to the office, you check the records for Zac and become concerned when you read that he
has a number of convictions, including some for violent offences.

You contact Michael Abimbola, a social worker in the criminal justice team who has written a
number of background reports on Zac for the Court. Michael tells you he knows Zac well from his
involvement in the criminal justice system since he was 18, and supervising him on his most recent
12-month community payback order (CPO). He shares some of your concerns about Zac’s
relationship with Chanelle and Kelsey, however he has not seen Zac for six months since Zac
successfully completed his CPO and had found Zac more mature and reflective when he last worked
with him. Zac is now 22 years old, a few years older than Chanelle. Zac had been part of a
neighbourhood gang in his teens. Michael suggested that Zac had been very confused about his
identity and unhappy in his family. Zac grew up with his mother, and does not know his father. Zac’s
home life changed while he was at high school as his mum Faye met a new partner, Stuart and they
went on to have three children together. Zac’s mum and new partner are white Scottish, but Zac’s

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father was Jamaican. Zac knows little more than that about him, but Michael’s opinion was that Zac
felt different and confused as he became older. Zac remained living at his mum’s house throughout
his CPO, but their relationship was strained and she was worried about what impact his behaviour
was having on her three younger children.

Zac increasingly spent time with his friends and Michael observed that the gang provided some
forms of stability for Zac. However, he was often involved in fighting, drinking and later
experimented with a range of street drugs. He regularly truanted from school and was suspended
for fighting numerous times. He left school at 16 with four standard grades. Zac was regularly picked
up by the police, who had tried various strategies but eventually had to charge Zac with assault after
a serious fight. He went on to receive further charges, including three breaches of the peace, an
offence for driving without a licence or insurance, one for behaving in a threatening and aggressive
manner towards a known male and an assault on a girlfriend who alleged he attacked her at home
on one occasion, two years ago. The offence took place prior to the Domestic Abuse (Scotland) Act
2018 being enacted. Zac received this recent 12-month CPO with requirements of supervision and
unpaid work for this offence. He successfully completed his order six months ago and has not come
to the attention of the police in the last two years, since the offence of assault against his ex-partner.
Michael advised he felt Zac had really reflected on his choices and had distanced himself from his
gang friends by the end of his CPO. He had also started a Further Education course in car mechanics
at Edinburgh College which seemed to be going well, his attendance was good and he had done well
in the first round of assessments. He continued to smoke cannabis but there was no evidence of any
other drug use.

Meanwhile, Kelsey’s nursery teacher Louise Jones makes contact with you. Chanelle has had an
argument with her friend and neighbour Ama Yeboah. Chanelle has since been bringing Kelsey to
nursery only erratically and Kelsey has been tearful and tired. She is happy to see her friend Ashanti
and likes to stay close to her. Her speech has made slight improvement, but she is still waiting to see
the Speech and Language therapist. Chanelle publicly shouted names after Ama at nursery drop off,
and has been upset and aggressive with one of the classroom assistants.

You agree with your manager that a full social work assessment of Kelsey’s situation is now required.
At present you are still trying to make sense of the high volume of information you are receiving
from other professionals. Chanelle is avoiding your calls and visits. You remember that Chanelle had
a good relationship with a worker from People First, a Learning Disability organisation who helped
her to set up her own flat and when she was pregnant with Kelsey. Their worker, Emily Taylor,
remembers Chanelle and agrees to go and visit her. Chanelle is pleased to see Emily, with whom she
shares some interests in music and films. However, Emily is concerned by what she sees as a
deterioration in Chanelle’s mental health and coping abilities. The flat is chaotic, Chanelle seems
confused and unhappy and overwhelmed by Kelsey’s needs. Chanelle tells Emily that she is finding
day-to-day tasks difficult. Chanelle did not want to talk about Zac and Emily did not meet him on the
visit. Emily says she is worried that Chanelle’s needs have not been properly assessed as an adult
and she wants to make a referral to the specialist Learning Disability team for this to happen.

While you are setting up a professionals’ meeting in respect of Kelsey, and making a detailed referral
to the adult team for Chanelle you receive an urgent police report. Zac has been picked up at
Chanelle and Kelsey’s home. Kelsey was present in the home at the time, although Zac clearly stated
that he was not living there and had just been visiting. The police had been trying to find Zac to
question him after seizure of a quantity of drugs from an address of a known gang member. Zac was
later charged with possession of a controlled drug. However, this appears to be because he was

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searched by Police prior to interview and was found to be in possession of cannabis. Zac’s
involvement in the supply of drugs has not been established. You contact Michael Abimbola, in the
criminal justice team. They have not yet been asked by the Court for any information but he
anticipates that if Zac’s charge progresses, a social work assessment is likely to be necessary to
inform a report for the Court. Michael explains that he will be going on extended leave for family
reasons so he is unable to work with Zac this time. He agrees to pull together the information he has
from his previous involvement and send this over to you before the meeting regarding Kelsey.
Michael is sorry to see Zac has picked up another charge and been linked to his previous gang again.