Response to Child Death Review Committee report04 December 2020
FREDERICTON (GNB) – A response was issued today by the departments of Social Development and Health to the recommendations of the Child Death Review Committee presented on Nov. 12, regarding the death of a child whose family was known to the Department of Social Development.
“The safety and well-being of children is the highest priority of our department,” said Social Development Minister Bruce Fitch. “We thank the members of the Child Death Review Committee for their important recommendations and, as always, we fully co-operate, and we will act to respond to all of them.”
The review concerned a six-month-old boy who died of complications from acute/subacute encephalitis with other significant factors being an unsafe sleep condition, prematurity, and the child being small for his age. The family was receiving services from the Department of Social Development.
According to the terms of reference of the Child Death Review Committee concerned departments had to respond to the recommendations within 45 days.
Recommendation No 1
The Department of Health should be involved in the care of all infants referred to Child Protection Services or born in a family receiving Child Protection Services upon discharge from the hospital.
RESPONSE: The Department of Health agrees with this recommendation. Public Health currently completes a postnatal screening with parents of all newborns in New Brunswick prior to hospital discharge, or as soon as possible by phone if a hospital screening is not possible. High-risk infants are eligible for the Healthy Families, Healthy Babies intensive home visiting program. Public Health and the Department of Social Development work together to support families with infants under Child Protection Services from birth to two years old. Public Health will meet with the Department of Social Development to determine if there are gaps in the processes and consider potential options to work with partners to address them. Public Health will also review the 2018 Back to Sleep campaign and will promote elements again to remind parents of the importance of infant sleep safety.
Recommendation No 2
The Department of Social Development should recognize that caseload numbers are critical and therefore the case loads should be lowered to meet the needs of the children under their protection and their families.
RESPONSE: The department is committed to continuously reviewing and monitoring case loads with consideration to the complexity of cases and to reviewing other administrative functions to ensure social workers can be fully engaged with families. The department is presently reviewing administrative functions that can be assigned to other professionals.
Recommendation No 3
The Department of Social Development should ensure that, when a medical professional makes a report, this concern needs to be prioritized.
RESPONSE: The department takes seriously all referrals received of alleged maltreatment of children. A referral is assessed and prioritized based on the nature of the information shared by any referral sources including medical professionals. The referrals are assessed and, immediately upon receipt, a determination is made as to the time frame for initiating a response. The response time is determined by the level of urgency or the assessed level of present or imminent threat to the safety of a child.
Recommendation No 4
When Child Protection Services utilizes the Structured Decision Model, it should be used as a guideline only and should never replace clinical judgement, as a strict adherence to the tool does not automatically conclude in decisions that are in the best interest of the child.
RESPONSE: Child protection casework is a very complex process involving the collection, synthesis and analysis of vast amounts of information. Casework decisions are guided using tools such as the Structured Decision Model designed to inform and enhance decision-making throughout the casework process. However, the decisions are not only guided by clinical tools but also based on clinical judgement, experiences, research, as well as direct knowledge of information and observation gathered through interactions with the family.
Recommendation No 5
When a serious concern is brought to the attention of Child Protection Services by a representative of another professional agency, a new intake assessment should be completed.
RESPONSE: The Multiple Response Practice Standards in Child Protection and Family Enhancement Services supports this practice. All information received by the department with concerns about a child is a referral. An intake requires that the situation be clearly documented and assessed to monitor the chronology of the reports and effectiveness of interventions. The department will review the practice standards to clarify and determine when information received by a referral source should be documented in an event or an intake.
Recommendation No 6
A newborn child whose family is receiving Child Protection Services should not be discharged from the hospital until a multidisciplinary meeting takes place and all the appropriate services are in place.
RESPONSE: The department continues to support a collaborative approach and case conferencing with partners as required. Collaborative planning is a guiding principle in the delivery of child protection services to children and families.
Recommendation No 7
Best practices allowing for agencies to share relevant information concerning a child should be applied in the intent of promoting the best interest of the child.
RESPONSE: The department strongly supports the exchange of information. The current Family Service Act allows for sharing of confidential information when it is required to protect the safety and security of a child. The department will continue to work closely with community partners so that all relevant information is shared in matters involving the safety and well-being of children. The department is in the process of drafting new legislation and a review of the confidentiality provision are included in that process.
Recommendation No 8
Following the death of a child, a formal debrief session between the professionals of different agencies involved with a child and their family should take place, and a copy of the minutes should be forwarded to the Child Death Review Committee.
RESPONSE: The department supports the collaborative work being done with our community partner agencies. We will continue to support case reviews and discussions on best practices, so we can learn from one another and reinforce the safety and well-being of children who are mutual clients.
Recommendation No 9
When a family does not have the means to bring a child to a medical appointment, Child Protection Services should make every effort to assure transportation for the appointment.
RESPONSE: The department continuously reviews the needs of the child and family and provide services accordingly. During the investigation process the family support system, as well as informal and formal support in the community, is always considered and encouraged in keeping a child safe.04-12-20