Infant risk assessment and response decision

Follow this procedure when working with children under two years of age.

Document ID number 1601, version 3, 30 June 2018.

Introduction

The infant response decision approach aims to identify the most at risk infants in the child protection program and determine the service response.

This decision determines if the infant requires an infant response or an infant intensive response. The decision should reflect the assessment of the infant’s level of risk and the level of response required by child protection to address the risk.

This decision can be made at any time from the beginning of the investigation phase until closure if the circumstances warrant it, noting the first mandatory point for this decision is at substantiation. The infant response decision also requires regular review throughout the life of the case, including via mandatory review points which are prompted in CRIS.

See Infant risk assessment and response decision – advice for further information.

Policy

Mandatory decision points

At substantiation, all infants must be classified as to whether they require an infant intensive response or an infant response.

Mandatory review points

Review and update of the infant response decision is required when:

  • a new court order is made
  • the case plan is reviewed
  • a new familial allegation is received
  • a decision to close the case is being considered.

It is not permitted to close a case where an infant requires an infant intensive response. Action must be taken to address the factors leading to the need for an intensive response prior to closing the case.

Service provision

An infant classified as requiring an infant intensive response must:

  • have an allocated case practitioner
  • receive weekly visits from a case practitioner (minimum)
  • have a case conference or care team approach
  • maintain practice leader or principal practitioner involvement
  • have regular case reviews
  • refer to an infant intensive meeting (for consideration to be presented to infant intensive response panel).

Where an infant has been assessed as requiring an infant response

  • the infant must be prioritised for allocation to a child protection practitioner
  • the infant receive fortnightly visits from a child protection practitioner (minimum)
  • a case conference or care team approach considered
  • involvement of a practice leader or principal practitioner considered.
  • the case must be reviewed regularly.

Decision levels

The decision to classify an infant as requiring either an infant response or an infant intensive response is made by a team manager or above.

However, a decision to re-classify an infant from infant intensive response to infant response must have the endorsement of a practice leader or above.

Procedure

Case practitioner tasks

Investigation 

  • See First visit  and other investigation procedures for tasks that must be undertaken in all investigations in addition to those set out here.
  • Use the infant response decision tool to inform what information is to be gathered and what observations should be made for the purpose of risk assessment in relation to an infant.
  • Where there are allegations of physical abuse or neglect, ask the parent or caregiver for consent to conduct a thorough visual examination of the infant.
  • Where the report relates to an infant who is asleep at the time of the visit, request permission to observe the child to check their immediate wellbeing. If the report relates to serious abuse or neglect, request the parent wake the child for a visual examination. If not, make a time for a follow up visit to see the infant awake.
  • Consult your supervisor if visual examination is denied. Record consultation and decisions in CRIS.
  • Arrange a forensic medical examination if visual examination indicates non-accidental injury (from physical abuse or neglect) with parental permission or via a protection application. Contact the Victorian Paediatric Medical Service or local hospital to arrange an examination. See Medical and forensic examinations - advice.
  • Where a non-crawling baby has bruising, unless there is a compelling reason not to, arrange a medical examination.
  • Complete a SIDS safe sleeping and environment assessment and provide parents or carers with information about safe sleeping. (An easy-to-read brochure can be downloaded at: www.sidsandkids.org/safe-sleeping). See SIDS and safe sleeping - advice.

Repeat the SIDS safe sleeping assessment for all places where the child sleeps and revisit assessing the infant’s sleeping arrangements on a regular basis.

  • Undertake a risk assessment to determine the level of concern held for the infant.
  • Make a recommendation to your supervisor regarding substantiation, as soon as you have sufficient information to do so. If substantiating, make a recommendation to your supervisor regarding which infant response decision is required, informed by your risk assessment. Consider using the Infant response decision tool (pdf, 104.38 KB) to assist with this decision making.
  • Record the consultation on the client file. Accurately reflect the purpose of the consultation, and actions and directions arising from the consultation to guide implementation of the actions.
  • Record a rationale or assessment to support the infant response decision, irrespective of the decision made.

Infant intensive response

  • Visit the infant at least weekly to have face-to-face contact with the parent or carer and infant to gather information and assess the progress of the case plan.
  • Record every visit in CRIS using the ‘Client Visit’ note type accessible from the client 360  view page.

The SIDS safe sleeping assessment needs to be revisited regularly. When an infant needs an intensive response, this means checking during each visit until the agreed assessment is that sleeping arrangements are consistently safe.

  • Arrange a case conference or establish a care team for every infant requiring an intensive response. noting for some infants, where there are limited or no professionals involved, referrals may need to be made as a priority in order to establish a care team.  
  • If the child is Aboriginal, invite ACSASS to the care team and consult at all significant decisions.
  • Document all relevant information shared and all risk issues identified at the meeting on the client file and the agreed action plan.
  • Circulate the action plan to all participants, including those who were unable to attend.
  • Schedule a practice leader or principal practitioner discussion.
  • Create a record of the discussion on the client file to ensure that the purpose of the consultation, actions and directions arising from the consultation are accurately reflected and to guide implementing the actions.
  • Review the case on a regular basis and include risk issues, action plan and case plan direction.
  • Review the infant response decision at all mandatory review points.
  • Review the response status upon receipt of any new information which may increase or decrease risk and during any case direction discussion with your team manager or supervisor.
  • Summarise the case history, risk assessment and case plan to present to the internal infant intensive response meeting, using the infant intensive response meeting template.
  • Following the meeting, upload the meeting template to CRIS including the outcome provided

The internal infant response meeting, held monthly assists in case review, updating risk assessment and determining if the infant requires presentation to the external infant intensive response panel.

Remember not to upload the minutes of the meeting, in its entirety, onto a client’s file.

  • Refer the infant to the infant intensive response panel if agreement is reached to do so at the infant intensive response meeting.
  • If the child is Aboriginal, invite ACSASS to the infant intensive response panel.
  • Summarise the reasons for the referral to the infant intensive response panel, using the infant intensive response panel template.
  • Following the panel, upload the panel template to CRIS including the outcome provided.
  • Record a rationale on CRIS when recording an updated or new infant decision response.

For infant response required

  • Visit the infant at least fortnightly to have face-to-face contact with the parent or carer and infant to gather information and assess the progress of the case plan.
  • Record every visit in CRIS using the ‘Client Visit’ note type accessible from the client 360 view page.
  • Consider arranging a case conference or establishing a care team for every infant, noting for some infants, where there are limited or no professionals involved, referrals may need to be made as a priority in order to establish a care team.
  • If the child is Aboriginal, invite ACSASS to the care team.
  • Consider scheduling a Practice Leader or Principal practitioner discussion.
  • Review the case on a regular basis and include risk issues, action plan and case plan direction.
  • Review the response status upon receipt of any new information which may increase or decrease risk and during any case direction discussion with your team manager or supervisor.
  • Record a rationale on CRIS when recording a new or updated infant response decision.

Supervisor tasks

  • Check all mandatory tasks are completed and the assessment of risk for infants is continually reviewed.
  • Confirm a forensic medical examination is undertaken (either with parental consent or through a protection application) for a child under two years of age where visual examination suggests non-accidental injury.
  • Confirm a baby with bruising who is not yet crawling is medically examined (unless there is a compelling reason not to).
  • For all cases involving an infant requiring an infant intensive response, obtain the endorsement of a practice leader or principal practitioner prior to re-classifying the infant as requiring an infant response.
  • Follow up with the practitioner to confirm the infant intensive response template is completed for all infants classified as requiring an infant intensive response, in preparation for the internal infant intensive response meeting.
  • Participate in the internal infant intensive response meeting to assist in case review, updating risk assessment and determining if the infant requires presentation to the external infant intensive response panel.
  • Follow up with the practitioner to confirm the infant intensive response panel template is completed for all infants being referred to the infant intensive response panel.

Team manager

  • Endorse a decision to categorise an infant as requiring either an infant intensive response or infant response. See Infant risk assessment and response decision – advice for further information.
  • Allocate any infant requiring an infant intensive response that day or during the next business day.
  • Review an infant response decision made by AHCPES (with substantiation decision leading to an afterhours protection application) the following business day, update if necessary, and allocate that day where an infant intensive response is required.

Practice leader or principal practitioner tasks

  • Participate in case conferences and provide consultation to assist assessment and case planning when requested and as required.
  • Endorse decisions to re-classify infants from infant intensive response required to infant response required.
  • Participate in the internal infant intensive response meeting to assist in case review, updating risk assessment and determining if the infant requires presentation to the external infant intensive response panel.
  • Participate in the infant intensive response panel as required.

Area operations manager, principal practitioner or deputy area operations manager (CPP 6) or above

  • Establish and maintain the infant intensive response meetings and panels for your area, meeting no less than monthly.
  • Chair the infant intensive response meetings and panels.
  • Determine the composition of panels based on your area as relevant to the client group and local service arrangements.

Panels are chaired by the child protection area operations manager or a senior practitioner at CPP6 level.

  • Confirm all members of the panel are clear about their role on the panel in providing advice and direction to assist in the progression of case practice.
  • Arrange for minutes to be taken at each meeting and panel, including decisions made and any recommendations made on case progress.
  • Endorse and distribute minutes to panel members, your counterparts not on the panel, and the Area Director within two business days.

After Hours Child Protection Emergency Services (AHCPES) staff

  • When conducting an outreach visit after hours that results in a protection application by emergency care, make an infant response decision in CRIS at the point of substantiation.
  • Use the infant response decision making tool and your professional judgement to make the most appropriate decision on whether the infant requires an infant response or infant intensive response. 

On the following business day, the division will review the decision made by AHCPES and update as deemed necessary, as the decision should be in line with the case plan which is the division’s responsibility. 

Related procedures

 

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