– Hey, Kate.
– Hello, Sarah. – Can I grab a quick word?
– Yes, go ahead. I’ve got some concerns about
a child called Kimberley Miller. She lives on the local estate and her
parents are called Darren and Claire. I was just wondering if we could have
a talk about some of the concerns. Yes, sure. Do you want to give me
some of the details? She’s 12 months old.
Her birth weight’s okay. She’s only just about sitting up
and finding it difficult to stand. Her dad’s saying she’s started
to crawl but I’ve yet to see it. How does she present?
Is she a contented baby? Aside from the physical delays, she
doesn’t seem to be interacting well. Every time I’ve been round,
she’s really, really placid. I’ve even called round
at different times to try and monitor her sleep patterns
and something funny’s going on because when I’ve asked the parents
where is she, they always say she’s sleeping. And when they
do bring her downstairs, does she look like
she’s been sleeping? No. I suspect she’s being
left in the cot on her own and without any stimulation. So tell me about her interactions? Is there eye contact
between her and her parents? Does she look at them
for approval or reassurance? No, she doesn’t. When you smile
at her, she never smiles back. This is a real worry.
What do you think the problem is? We need to monitor this closely. Do you think it’s Kimberley’s parents not understanding
her developmental needs or is there something more going on? When I’ve gone to visit Claire
at the family home I’ve noticed bruises on her arms. When I’ve asked her about it
she looks very embarrassed. Another thing
when I visited the family home when Darren is present
in particular, she looks very nervous
and very tense. Have you tried talking to Claire
when Darren’s not around? You need to build up
some trust with her so she feels confident
to talk to you about this. Yes, I’ll go around this week. To be honest, I don’t feel
comfortable about going round because Darren makes me feel nervous.
I don’t think he likes me visiting. Have you thought
about giving Claire a ring? Maybe getting her involved in one of
the groups that we’re running here, one of the ones where you’re involved
so there’s a familiar face. And Darren, too, maybe he could
join one of the fathers’ groups. And when it comes
to visiting the house, I think
you should take Mary with you. I know she’s busy but it’s important
that you feel safe. Yes, I’ll do that. I’m glad you spoke to me about this. We need to monitor Kimberley
quite closely. It’s important we get the right
support in for these parents. And if we can’t meet her needs
on our own, we need to involve other agencies. So what’s the next step? I think we need to look
at the broader picture now. I’m going to contact Social Services
and see if the family’s known to them and if they’ve got a named worker. I think we need to observe them more
in the health centre as much as we can and I’d like you
to focus on the interaction between the parents and child –
eye contact and physical contact and reassurance
that they’re giving her. Thanks for that. Make comprehensive notes
from all your visits, too. Let’s catch up at the end of the week when I’ve had a chance
to talk to Social Services and we’ll make a plan
about what we do next. Thanks for that, Kate.
I feel a lot clearer about things. I’ve got a handle on things
a lot better now.