They need some support and guidance with bringing up their kids, which the social services should be able to provide.
If previous accidents have been reported then the cause of these should be removed or rectified.

Most of the time its common sense that needs to be applied before hairsplitting with several ‘experts’ are started which often ends with nothing done.
If the grandparents are anywhere nearby then their help can also be invaluable.
References :

I was wondering if you are not too busy if you would be able to respond with your professional opinion and course of action regarding the case study?

The Smith Family consists of

David: Father, aged 28, Factory Worker, White British
Clare: Mother, aged 25, Housewife, White British

Children:
Andrew, aged 2, attends local toddler Club
Annie: aged 6 months

Both David and Clare attended special schools for learning disability. David has a lower ability than Clare.

They live in "new Town" whose inhabitants are mainly working class, having been moved from the East End.

The housing association flat that the family live in is sparsely furnished with second-hand items but is mostly clean and tidy. There is no contact with their immediate families but they do have a small circle of friends at a learning disabilities club they attend.

Learning disability partnership professionals are involved with the parents and feel that the two children are loved are cared for albeit at times in a haphazard way.

INCIDENT:

A duty doctor from the local hospital A&E department contacted the out of hours social worker following David and Clare attending A&E with Andrew. Andrew had sustained an injury to the back of his head. The wound had been inflicted by an air-gun pellet.

David admitted accidently shooting his son in the head. The hospital discharged Andrew back into his parent’s care having treated the superficial wound.

The out-of-hours social worker visited the family the same night and was allowed in to the home by the parents. In the lounge , pinned in the corner of the room was a target. Opposite the target was a single armchair in which David usually sat. Allegedly, Andrew was in the kitchen with his mother. David was sat in his chair firing pellets into the target with his air gun . Andrew came running in to the lounge and got hit as he crossed the line of fire.

Now if you were the doctor who had seen Andrew:

What would you do next? What would your course of action and responsibilities be?

also please consider:

What would your initial opinion be taking into consideration David and Clare’s disability?
What course of action would you take to further any investigation? (would you contact any particular services?)
What would you consider to be a "haphazard way" of caring and loving a child?
Does the surgery’s system record any concerns regarding any previous inuries and if so
Would you take a different course of action if you had discovered on your system that any suspect injuries had occurred within the family before?

We as a group are approaching various services and professionals who may be involved with this case (i.e the Police regarding the firearms in the house) and asking them when looking at this case what they would then progress to do.

Many thanks for helping out on this.
as it says in the case study there is no contact with their immmediate family any contact with grandparents is unavailable. This is not a true case but a university exercise foe which I need to ascertain how much involvement the doctor in A&E would have.