Children, Families and Adults Directorate Children and Family Services Management Action Note 19 - Discretion and Professional Judgement – the Decision Model Procedure (DMP) CONTEXT Decision making in children’s services is often complex. Decisions are required in difficult circumstances often with conflicting information, differing professional views and competing interests. These decisions are subject to intense scrutiny and challenge. Using a common Decision Model Procedure (DMP) helps us to exercise discretion and professional judgement, safely. The DMP improves decision making by ensuring that decisions: Are based on our values Demonstrate our shift from blaming to learning Reduce risk aversion Support frontline managers and practitioners when faced with complex situations. The DMP helps us to understand why we have not achieved the outcome we wanted and to learn form those experiences. In using the DMP decision makers will receive the support of the organisation in all instances where they can demonstrate that their decisions were assessed and managed reasonably using the procedure in the circumstances existing at the time. This will apply where the decision does not achieve the intended outcome or even where harm results from their decisions and actions. ACTIONS . Action Required Managers and Supervisors Responsible 1. The Decision Model Procedure remains an essential tool for All CFS Children and Family Services. When making a significant Supervisors decision all managers and practitioners will use DMP outlined below in Appendix A. 2. The supervisor’s decision and rationale which is embedded within Mosaic episodes incorporates the key elements/ stages of the DMP. All significant casework decisions and the Emma rationale are recorded within Mosaic as part of the appropriate Trethewey/ workflow. Other casework decisions can be recorded within the Tina Flowers supervision record or in case notes. 3. The DMP can be used to review decisions and to debrief staff where decisions and actions have not achieved the intended Management Action Note 19: Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 outcomes or where harm has resulted. Supervisors can use it Supervisors in supervision to review decisions and actions taken. In every case CFS Heads of the model stays the same but supervisors can review what Service questions and considerations were applied to each stage. SUMMARY The DMP is suitable for all complex decisions. It can be applied to critical incidents and planned operations, by an individual or teams of people, and to both operational and non-operational situations. Decision makers can use it to structure a rationale of what they did during an incident, what they took into account and why. The DMP has at its core the vision and values of Children’s Services. It keeps the approach simple and recognisable. It uses a common process and language. It has application across the whole organisation. It provides a basis for more detailed reviews of decision making Jack Cordery Service Director Children and Family Services 23 March 2012 Refreshed: January 2017 Review: January 2018 Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 2 Appendix A CHILDREN AND FAMILY SERVICES THE DECISION MODEL PROCEDURE Introduction 1. Our decisions are often complex and are always subject to intense scrutiny and challenge. This Decision Model Procedure (DMP) has been adopted by the Children and Family Services with the aim of promoting discretion and professional judgement and to support frontline managers and practitioners to make difficult decisions when they face conflicting factors, competing interests and different professional views. Frontline decision makers will receive the support of the Senior Leadership Team in all instances where they can demonstrate that their decisions were made using the DMP, taking account of the circumstances existing at the time. This will apply when the decision does not achieve the intended outcomes and even where harm results from their decisions and actions. 2. Using the DMP helps to improve decision making by making sure that decisions are based on our values; a logical method; transparency; and professional accountability. The DMP reinforces our commitment to learning not blaming. It helps decision makers to understand why they have not achieved the outcome they wanted in some cases and to learn from those experiences. Supervisors are expected to review decisions, using the DMP as a critical reflection tool, in case discussion and supervision reflecting on what questions were asked and what considerations where applied at each stage. Principles 3. The following guiding principles underpin the Decision Model: a. The willingness to make decisions in circumstances of uncertainty (risk taking) is a core professional requirement of all members of Children and Family Services; b. Maintaining or achieving the wellbeing and safety of a child or young person is a primary consideration in risk decision making; c. Risk taking involves judgement and balance, with decision makers required to consider the value and likelihood of the possible benefits of a particular decision against the seriousness and likelihood of the possible harms (giving consideration to unintended consequences of any action); d. Harm can never be totally prevented. Risk decisions should, therefore, be judged by the quality of the decision making, not by the outcome; e. Taking risk decisions and reviewing the risk decision making of others in a multi-agency context is difficult so account should be taken of the information available at the time, the dilemmas faced, conflicting factors and professional differences; Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 3 f. The standard expected and required of members of the Service is that their risk decisions should be consistent with those a body of colleagues of similar experience and competency would have taken in the same circumstances (common sense); g. Whether to record a decision is prescribed as part of some episodes (eg. completion of an assessment or enquiry) but in others this is a risk decision itself which should be left to professional judgement. This decision should take into account the likelihood of harm occurring and its seriousness; h. To reduce risk aversion and defensive practice and to improve decision making, the Service encourages a culture that learns from successes as well as failures. Sound risk taking should be identified, celebrated and shared; i. Since good decisions depend upon quality information and an openness to consider different perspectives, decision makers should always take into account the information provided by other agencies and the views of members of the public and other professionals about those who pose risk or those who are vulnerable to the risk of harm; and j. Members of the Service who make decisions consistent with these principles should receive the encouragement, approval and support of their Service. The Decision Model 4. In addition to using the DMP to determine their actions, decision makers may also find it useful for structuring the rationale behind their decisions. Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 4 Mission and Values 5. Our mission and values will always be at the centre of our decision making and professional practice: ◆ Our mission is to protect the most vulnerable children and young people living in Cornwall from significant harm, to support the educational inclusion of those children and to close the gap in outcomes between them and their peers. ◆ Our first consideration will be the lived experience of the child, taking into account their wishes and feelings, involving them fully in decisions about their lives, promoting their rights to family life and to education. ◆ We will work together with the child and others to understand the reasons for their behaviour, so that we can support positive change. We will stick with them and we will not give up. ◆ We will act with integrity, honesty, empathy and respect, showing fairness and courage in everything we do. ◆ We will work with birth families, the child's wider network of family and friends, communities and other services, listening to their views, building their trust and confidence, making every effort to understand and meet their needs. ◆ We will use discretion, professional judgement and common sense to guide us and we will be accountable for our decisions and actions. We will respond to wellfounded criticism with a willingness to learn and to change. ◆ We will not be distracted from our mission through fear of being criticised. In identifying and managing risks to children we will seek to reduce the risk of significant harm and achieve better outcomes. ◆ We will be professional, calm and focused in undertaking our statutory and professional duties at all times and in all the circumstances we face. ◆ Our commitment is to deliver a service that we and those we serve can be proud of, which promotes positive outcomes for vulnerable children and which reduces the risk of harm. Procedure 6. The DMP provides a values-based tool to provide a simple, logical and evidencebased approach to making decisions: Mission and values Throughout the decision making process you should ask yourself: ◦ is what I am considering consistent with our mission and values? ◦ am I taking into account all aspects of our mission and our values? ◦ what does the child or young person expect of me in this situation? Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 5 ◦ what does the Service expect of me in this situation? Stage 1: Gather information and intelligence During this stage the decision maker defines what is happening or has happened and clarifies the source and reliability of the information (taking account of significant events in the child's life to this point and all connected persons): ◦ ◦ ◦ ◦ what precisely is happening/has happened? what is the source of the information? how reliable is this information? what more do I need to know? Stage 2: Assess the risk and develop a working strategy This stage involves analysis of the information available to you, weighing the needs, risks and resources, establishing more precisely the source and nature of the risk to the child: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ do I need to take action immediately to protect the children? what could go wrong? (and what could go well?) what is the likelihood of the perceived harm? what is the impact of the perceived harm? is the level of risk acceptable? can the risk be managed? what are the strengths and protective factors? what is the understanding and attitude of the parents/carers? who else can help to manage the perceived risk? am I the appropriate person to deal with this? Develop a working strategy to guide you through the next stages, reflecting on what you are trying to achieve and on the risk of unintended consequences for the child. Stage 3: Consider powers and policy This stage involves considering legal duties, statutory guidance and policies might be applicable to this particular situation: ◦ ◦ ◦ ◦ what are my legal powers in this case? what statutory guidance do I need to take into account? which service policies or guidance apply to this situation? is there a clear rationale for acting outside of policy in this case? Stage 4: Identify options and contingencies This stage involves careful consideration of all the different ways the decision maker could respond to the situation in order to achieve the best outcome possible in all the circumstances with least risk of harm: Options ◦ what options are available? ◦ what options have I discounted? ◦ have I taken into account the risk of unintended consequences for the child? Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 6 ◦ can I explain my rationale for choosing the preferred option? If you have to account for your decision, will you be able to say it was proportionate; legitimate; necessary; and ethical? Will you be able to explain that it was reasonable in the circumstances facing you at the time? Contingencies ◦ what will I do if things do not happen as I anticipated? Stage 5: Take action and review what happened This stage requires decision makers to make and implement appropriate decisions. It also requires decision makers to review what happened as a result of their decision and to be prepared to implement the contingency if the outcome is not achieved: Action ◦ implement the option you have selected ◦ does anyone else need to know what you have decided? ◦ record what you did and why ◦ what happened as a result of your decision? ◦ was it what you wanted or expected to happen? If the situation persists go through the DMP again as necessary. resolved review your decisions using the DMP. If the situation is Review ◦ what lessons can learn from how things turned out? ◦ what might you do differently next time? Recording What Was Done and Why 7. Decision makers are accountable for their decisions and must be prepared to provide a rationale for what they did and why. In some circumstances the need to record the decision within an episode is prescribed, in others it is left to the decision maker's discretion. Whatever the circumstances, the Service recognises that it is impossible to record every single decision and that not all decisions need to be recorded. In most cases professional judgement should guide whether of not to record the rationale, as well as the nature and extent of any explanation. The record should be proportionate to the seriousness of the situation or incident. Reviews and Debriefs 8. The DMP is ideal for examining decisions made and actions taken, whether by a supervisor, informal investigation or formal inquiry. Those undertaking a review or debrief should consider the following questions: Values • How were the Service mission and values, risk and protection of human rights kept in mind through the decision making process? Information • What information was available? Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 7 • Was all the available information taken into consideration? • Was any information missing? Assessment • What factors (potential benefits and harms) were assessed? • Were strengths and protective factors taken into account? • Was a working strategy implemented and was it appropriate? Duties • What legal duties, statutory guidance and policy were considered? • Was the action taken compliant with those duties and guidance? • If policy was not followed was this reasonable in the circumstances? Options • How were options identified? • Were all available options considered? • Were any options discounted too quickly? • How were the feasible options assessed? Action and Review • Were decisions proportionate, legitimate, necessary and ethical? • Were decisions reasonable in the circumstances facing the decision maker at the time? • Were decisions and the rationale for them recorded as appropriate? • Were decisions monitored and reassessed where necessary? • What lessons can be taken from how the decisions were made and the outcomes? For Supervisors • Have you recognised and acknowledged instances of initiative or good decisions (were they passed on to senior managers where appropriate)? • Have you recognised and challenged instances of poor decision making? Even where the outcome was not what was hoped for, if the decision taken by your supervisees was reasonable given the circumstances using the DMP, they deserve your support and that of the Service. Jack Cordery Service Director March 2012 Management Action Note 19 – Restoring Discretion and Professional Judgement – the Decision Model Procedure (DMP) – Version 3 – January 2017 8
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