Examination of Witnesses (Questions 80
- 99)
MONDAY 13 DECEMBER 2004
MR DAVID
BELL, MRS
ANNA WALKER
CB, MR STEVE
BUNDRED AND
MR DAVID
BEHAN
Q80 Chairman: Thank you for that.
David Behan.
Mr Behan: Thank you, Mr Chairman.
We are a new organisation. Just to go on what you as a Committee
know and those things you are learning about, we were created
in April of this year. Our prime function is about improvement
in social care. We have a number of functions that we conduct.
We regulate social care services; we issue licences to operate;
we inspect local authorities; we assess the performance of local
councils, and our star ratings published a couple of weeks ago
is evidence of that. We also have a value for money function.
As a non-departmental public body we report annually to Parliament
on the state of social care.
Q81 Chairman: Which Select Committee
do you normally report to?
Mr Behan: The Health Select Committee.
Interestingly, we host the Children's Rights Director post, which
has been in existence now for a couple of years and continuously
reports on our statutory function. We are under a duty to work
with Ofsted, the Audit Commission and the Healthcare Commission
in legislation that established us. Some 16% of our activity goes
on children's services, the remainder going on adult services.
One of the issues that we have been pursuing as part of our set
up is to re-engineer the way that we operate so that we focus
on the experiences of those people that are using the services—not
the inputs into those services but the outcomes for individuals.
Your invitation was in relation to comments about where are we
and what are the key issues. We too welcome the publication of
Every Child Matters and, as David says, it would be difficult
to put a cigarette paper between us in relation to that commitment.
One of the things we particularly welcome is the opportunity to
focus on improving outcomes for all children, but, in particular,
those children who are vulnerable—the 28,000 that are on
Child Protection Registers, the 61,000 that are looked after by
local councils, and that 300,000 who were defined legally as being
in need under the Children Act. We think it is important that
in the future those children remain the focus of the way that
services are delivered at a local level. The second point we would
want to land is about the importance of connecting children's
services and adult services, particularly around those parents
who are social services' users. 60% of children whose parents
are known to social services are themselves defined as being at
risk, and in over 50% of children on Child Protection Registers
the parents are likely to have a drug, an alcohol or mental health
problem, and in some cases all three. So we must ensure that children's
services are linked to adult services through robust partnerships.
We are also keen that the kind of cultural shift that is taking
place in children's services focuses on attitudes and behaviours
and not overly focuses on structures. So we think it is important
that there are organisational development programmes and support
to staff so that the vision behind Every Child Matters
can indeed be carried through. We think that the development of
the workforce is an essential agenda to achieve the changes described
in Every Child Matters. We know from our performance assessments
of local councils this year that recruitment and retention was
one of the key barriers identified by local managers for achieving
their objectives, so we think that the focus on recruitment, retention
and developing the new workforce is a critical part of the way
that we roll out this agenda. Finally, we also think that services
will change when professional staff are doing the basics well
and doing the basics well together in multi-disciplinary teams.
Q82 Chairman: Thank you for that.
When we have four witnesses it is quite a difficult situation
to manage, so can I ask colleagues to direct their questioning
to one person as the lead questioner? We will play it by ear but
we cannot have a situation where every Inspector answers every
question or we will not get through the remainder of topics that
we need to cover. I want to kick off by saying that a lot of people
think that the government is a little optimistic about the power
and the utility of inspections. It seems that they are putting
in an awful lot of investment in securing the future of our children,
especially vulnerable children, out of an inspectorate regime.
Do we have much confidence that inspection can make a difference?
We did our joint inspection of pre-school, did we not, and it
was abandoned as being ineffective—the two inspectorates
failed to work very well together. Why would four inspectorates
do better than the two that were discarded? Who would like to
start on that one?
Mr Bell: If I may make a start
on that, Mr Chairman? It is actually more than four inspectorates;
there are a number of other inspectorates who have an interest
in children and young people who are working together on this
programme.
Q83 Chairman: Which other ones?
Mr Bell: We have, for example,
Her Majesty's Inspector of Prisons, Her Majesty's Probation Inspectorate;
we have the Magistrates' Court Inspectorate, and so on. So we
have a range of other bodies that have an interest in children
and young people. I do not think any of us here would pretend
that Inspectorates bring about improvement in local services;
it is people who run local services, people who work in local
services that bring about improvement. However, I think we would
say confidently that, in our own ways, individually and I think
now together, we hope to be able to bring about improvement in
a number of ways. For example, we will be able to identify where
services are effective and what they are doing well. That helps
to stimulate improvement, not just in once place but in many places.
We will be able to identify where services are not doing as well—and
we know from our evidence that that can act as quite a substantial
fillip to improvement. I think it is also fair to say that we
act as a mechanism for drawing together the views of users—and
I am sure we will talk about that later as the afternoon goes
on—and helping to find out what people think who are on
the receiving ends of those services, and factoring that evidence
in to our findings. So I think we are not overstating the role
that inspection can play; we believe in it, but we also believe,
as we said earlier, that we need to do it in a different way in
the future, we have to do it in a more proportionate way in the
future, and we probably have to do it in a smarter way in the
future.
Q84 Chairman: If I can push you on
this? There is also a view that here are the standards of local
delivery—the local authority plus the local health delivery,
the Primary Healthcare people and the Acute Trust and so on. Are
they not going to feel that they are crawled over with Inspectors?
One of the most common complaints, even in education, is too many
inspections, too much red tape, "Why can we not get on with
our job?" They now have the Audit Commission competing with
it right across services, and now you have an Ofsted lead in this.
Is there not going to be a fear of delivering anything because
they are being inspected so much? Steve Bundred, do you want to
come in on that?
Mr Bundred: I would like to make
a couple of comments on that. I think from our work we have a
substantial body of evidence that demonstrates that inspection
works. Later this week we will be publishing the latest results
of our Comprehensive Performance Assessments of local authorities,
and I think they will demonstrate that in comparison with the
first assessments that we did in 2002 there has been substantial
improvement. But we recognise also that inspection is a scarce
resource and therefore it needs to be targeted where it can have
most impact. That has been very much uppermost in our minds in
the discussions that we have had with David and his colleagues
about the timetable that we will adopt jointly for the Joint Area
Reviews, which will be undertaken simultaneously with our new
corporate assessments for CPA 2005. So they will be targeted on
the basis of a risk assessment, which we have discussed and which
we have agreed jointly. Our Comprehensive Performance Assessments
2005 and onwards will enable us to very substantially reduce the
level of inspections that we will be undertaking with individual
services. There will be a reduction of some 68% as compared with
what we were doing in 2002-03. It is important also to recognise
that Joint Area Reviews themselves will take the place of a number
of separate inspection regimes which have operated previously.
Q85 Chairman: What is the Joint Area
Review going to do for you, Anna Walker? What do you see it achieving?
How is it going to work? Take us through it.
Mrs Walker: Can I just go back
and very briefly answer the question about whether we think inspection
will make a difference because in our area it can contribute two
things? Unlike my colleagues we have a statutory requirement to
carry out an annual rating of all healthcare organisations in
this country.
Q86 Chairman: Is that the star system?
Mrs Walker: Yes, the so-called
star system.
Q87 Chairman: Are they not abolishing
that?
Mrs Walker: Not the annual rating
but the stars—there is a difference. And we have to do it
annually. That system actually has been successful in driving
some important change through the healthcare service. You can
take it too far but I think healthcare managers generally consider
that it has achieved something. You have to measure what matters—that
is actually the trick—and within our annual rating system
we are measuring and will continue to measure the activities of
healthcare organisations in relation to child protection. I think
that is important for contributing to the work on the Joint Area
Reviews. There is another area where I think that inspection in
healthcare can actually help too. I totally understand the point
about regulation not being too burdensome. We have a wide roving
remit to intervene where there seem to be areas of concern. What
we can perhaps do as a result of that remit is, having looked
to investigate a particular area, to take the learning for that
area—so, for example, on maternity services or some work
we are doing with the youth offending teams, the relationship
between the youth offending teams and healthcare services—and
ensure that we draw the lessons out of that and then measure light
touch but what matters to help the healthcare organisations to
drive improvement forward. So in two ways we can help: measuring
what matters annually and actually learning from investigatory
work we undertake.
Q88 Chairman: Most people, in terms
of the wraparound total coherent service, are more worried about
health than anything else, are they not, because it has historically
been a problem around GPs and getting information and cooperation
from that sort of area? Is that not the case?
Mrs Walker: I am not sure that
it is particularly. The issues that we have been concerned about
in child healthcare have been something to which David drew attention,
which is this question about links between organisations because
healthcare is only one aspect of what children need for well-being.
So this whole question of a child who goes through a period of
healthcare, how that links back into the education system and
into the health of the population as a whole, are actually some
of the really challenging issues that we see. So, for example—and
I am sorry to come back to specifics—we carried out this
investigation into the maternity services at a hospital in Wolverhampton
and there were some real issues in quality of care learning, but
actually the most significant issue went back into the health
of the population. The question is, what can we do with a finding
like that, except work with others, including not just Inspectors
but local authorities and the relevant government departments,
to try to bring about a change?
Q89 Chairman: But it is the case,
is it not, that really frontline, before a child gets into any
institutional setting, it is the Health Visitor and the GP that
will probably have more knowledge of the child in the early years
than anyone else? To what extent are you confident, for example,
that they and you can share the data that they have?
Mrs Walker: You are absolutely
right that there are a lot of healthcare activities that involve
children in a major way but do not concentrate on children, and
one of the issues there is to ensure that those healthcare organisations
or people are actually looking at the needs of children as well
as the needs of adults, and in doing that there are various elements
that we can measure. We have a young patients' survey, for example,
on a regular basis which seeks to get feedback from young patients
about how they feel they are being handled, and we can then feed
that back into the GP's surgery or the relevant Primary Care Trust.
Q90 Chairman: To David Behan, my
last question before we start moving the questions around. In
terms of your attitude to all this, who are you out there to protect?
Are you out there to protect the average child or the vulnerable
child? How do you as Inspectors think about that? Are you trying
to drive a service up for everyone, particularly something that
we identify in education—the average child, who has the
potential to improve their performance in education? Or in terms
of children are we concentrating on—I think it was announced
this morning that 100,000 families in temporary accommodation,
are they the people who will be the focus more than the average
child?
Mr Behan: When this work has been
in development—and our staff have been working together
to develop the approach and methodologies, et cetera—one
of the questions that has been posed is how will Joint Area Reviews
improve the life of a child in Middlesbrough? I am not particularly
clear why we have chosen Middlesbrough.
Q91 Chairman: The average
child in Middlesbrough?
Mr Behan: In Middlesbrough.
Q92 Chairman: The average
child?
Mr Behan: Yes. I am not sure why
we chose Middlesbrough.
Q93 Chairman: Not the vulnerable
child.
Mr Behan: And within that, one
of the areas that has been fertile in discussion is how can we
ensure that we have covered the range of children that live in
Middlesbrough, from the gifted at the one end to those who are
excluded at the other end. So not just the average but children
across the range. So there will be various streams of inquiry
as part of an integrated service Inspection of Children Services.
There will be 10 areas and we will be proportionate in the way
we select the kind of issues we look at, based on the performance
assessment that we anticipate carrying out. So if there is an
issue, for instance, in the safeguarding of vulnerable children
in this authority then that might be a particular stream that
we would pay particular attention to as part of the inspection
process. We are looking to paint across the population of children
in a community, not just one group; but we are concerned to ensure
with those children who might otherwise be excluded, for whatever
reason, that we are clear about how they are performing, we are
clear about what knowledge local councils and local services have
of those children, and to ensure that there are good partnerships
in place working together to ensure that children that are vulnerable
are not being neglected and left out. So we see it painting across
the range but paying particular attention to children, and the
children you referred to in the news this morning are one group
and asylum seeking children are another group. So there are many
groups that we need to attend to through the work. The Performance
Assessment Framework, which is a self-assessment framework which
will be completed by local councils, is designed to identify those
areas that we need to pay particular attention to as part of the
assessment process and will help us to target our resources to
make sure that we are exploring with councils and local providers
those areas where there are particular issues that we need to
attend to.
Chairman: Thank you for that. Helen Jones.
Q94 Helen Jones: We have heard from
all of you that you are all signed up to the process, but the
evidence that we are getting indicates concerns about actually
putting all this into place on the ground. You have different
teams of Inspectors, different professional backgrounds, different
frameworks for inspection; what are you doing to bring all those
together into an integrated framework for inspection, and to train
the staff to operate in that integrated framework? Would David
Bell like to kick off?
Mr Bell: Since we began the work
on 4 August 2003 that is precisely what we have been thinking
about: how do you bring together quite different traditions, different
backgrounds of inspectors, different frameworks, different ways
of doing business? That led us together to publish a framework,
so we published last week a framework for consultation that highlights
the things that we need to cover during Joint Area Review. One
of the virtues, of course, is that we have all been driven by
the specification, the five outcomes for children, and that has
been a great unifier across the work that we have done. So we
have the framework out of the consultation and that, in a sense,
addresses the issue of how together we answer the questions we
have about what happens for a child in a particular area. The
point about training is a good one and in fact we have already
had groups of our Inspectors together and they will be brought
together more extensively after Christmas, to start on the training
programmes together. I think that is a great virtue of this programme,
that people will have an opportunity to train together and to
work together in teams, and we would expect all our inspection
teams to have a range of representations from different Inspectors.
Just picking up on a point that David made, we will not expect
every inspection team and every inspection to cover every conceivable
question that could be asked. It is very important to restate
the point that we will draw as far as we can on existing evidence
that is around. For example, there will continue to be evidence
generated from school inspection about performance of pupils;
there will be evidence drawn from examination and tests results
about the performance of pupils; there is evidence available about
the state of childcare in an area. So we will be able to draw
all this evidence and then, in a sense, decide where we are going
to do fieldwork. When we have decided where we are going to do
fieldwork we then put together a joint team that is able to do
it. So I think we have made very good progress to get a framework
ready for consultation and out, and of course the next stage is
to ensure that our staff are ready to do the job on site for Joint
Area Review from September next year.
Q95 Helen Jones: Thank you for that.
I understand what you are saying about putting together joint
teams, but I would like to ask you a little more about the training
requirements because whenever we have discussed this one of the
things that we come up against, time and time again, is that it
is no good putting any framework in place unless you have the
staff who are able and willing to operate it. Have you made any
assessment of what the training requirements amongst your staff
will be for this; how is it going to be funded; and how long is
it going to take to do, bearing in mind you have to begin in September
next year, have you not? Perhaps David Behan can answer that?
Mr Behan: We have had four pilots
in the autumn of this year, where we have gone to authorities
with the methodologies that have been designed, and they have
been piloted in discussion rather than rolling out the full methodology.
After the New Year we will be taking out the methodologies and
rolling those out. So the staff that are going to be operating
the new methodologies, that David referred to as going out for
consultation last week, will be piloting those in a real setting
in real time. Last week the Inspectors that are going to be coming
together as part of those teams and taking forward the work began
their training sessions. So all these Inspectors that will be
working within this inspection programme from September 2005 have
begun to come together to develop the methodologies and to be
trained in the approaches that are going to be taken. That work
has already begun, so people will be trained by the time they
get to the pilots in the Spring of next year, and then people
will be fully up and running by September of next year. We have
begun to map out the programme so we can look at the resources
required for the programme, to come on to your question about
how many people will be required, so I am clear from the Commission's
point of view of those inspections that we will lead on, along
with David's Inspectors, and those that will support over the
period September 2005 to March 2006; and then the likely resources
we will need from 2006 into 2007 and 2008. So that strategic work
has begun in equipping our Inspectors with the skills—our
collective Inspectors, not the Commission's Inspectors—to
carry out this role. The importance of the pilots obviously is
that the experience that we have of providing multi-professional
teams for inspection, we can learn the lessons from those pilots
and begin to incorporate it into the programme from September
onwards.
Q96 Helen Jones: I understand what
you are saying, and thank you for that, but it raises two questions.
First of all, what are the major difficulties that you have encountered
so far in doing this; and, secondly, do you believe you have enough
time, after the pilots have been undertaken, to evaluate them
properly and to make any changes that you need to make?
Mr Bell: I think it is worth repeating
the point that we have not started out there yet, so it is difficult
to comment. But what I should highlight, of course, is that in
our different guises we have been used to doing some joint work
previously. So, for example, the inspection of local education
authorities has been a joint enterprise between Ofsted and the
Audit Commission, and one of the predecessor bodies to David's
organisation worked with a range of other Inspectorates to do
work, for example, around children safeguarding. We worked with
Her Majesty's Chief Inspector of Prisons on education in prisons;
we worked with Her Majesty's Inspector of Probation to do youth
offending team inspections, as do others. So I think we have some
knowledge—and quite a bit of experience—of working
together. You asked the question about difficulty. I suppose what
you expect of your Inspectors is that they will come with an open
mind and that they will not come along and say, "We have
always done it this way in Ofsted" or "We have always
done it this way in the Audit Commission," but they actually
together try to work up an appropriate methodology. In relation
to the pilots, I think the answer is yes, we do think that we
will have time to make the amendments we require. We are not,
however, naïve because once the programme begins to roll
out in September we also need to be in a position, maybe after
six or seven months—by the end of March 2006 is what we
are planning—to look back over the first set of inspections
to amend. So I think we have a very open mind about how we do
this. At the same time, of course, we have to balance up a legitimate
desire for change with a legitimate desire for a degree of certainty
about how you are going to carry out inspections, because if you
are on the receiving end of one of these inspections I do not
think you would be too happy if we came along and said that we
were going to radically change this, that or the other. I think
the first pilots, before the whole scheme goes live, will give
us a good opportunity to test out and amend as necessary.
Q97 Chairman: How are you going to
choose where you go first, second and third?
Mr Bell: We have taken into account
a variety of factors, and that would include the council's most
recent performance in relation to education or children's social
care; it would take account of the council's most recent performance
in relation to the Comprehensive Performance Assessment; and it
will take account of any other evidence that we have.
Q98 Chairman: Lord Laming's remarks
to this Committee about a particular authority involved in the
Victoria Climbié tragedy, you will take notice of them,
will you?
Mr Bell: We will take account
of all the evidence we have, and if Lord Laming has made observations,
which he did, I am sure that will be fine. What I cannot do this
afternoon—and I do not think any of us would want to do
this afternoon—is to say it is one single piece of evidence,
but I can assure you that this has been risk assessed as well.
We have been quite clear that we need to ensure that the programme
is sensitive to the risks as we assess them together. I think
that has been the other virtue of putting together a joint programme;
we have been able to sit around a table and say, "Where do
you think the particular risks are in relation to one set of activities
against another?" We have had to make a judgment about where
we are going to visit first, where we are going to visit last.
We are going to publish that programme, and I think it is important,
as Steve said earlier, that we publish that alongside the programme
for Comprehensive Performance Assessment, and that is our expected
programme. But you would expect us, I am sure, Mr Chairman, to
have a degree of flexibility there, that if something arose at
short notice we would be able to inspect accordingly.
Q99 Chairman: So you could respond,
say, to a scandalous state of affairs that was reported, or a
whistleblower?
Mr Bell: Mr Chairman, I think
all of us in our different Inspectorates have been used to doing
that in the past already.
Mr Bundred: Not only could we,
but we would think it essential to do so.
Chairman: Thank you. Valerie Davey.
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