Looked-after Children - Children, Schools and Families Committee Contents


Examination of Witnesses (Questions 80-99)

MARGARET DILLON, MARY MACLEOD, ANNE SCARBOROUGH AND PROFESSOR JANE TUNSTILL

26 MARCH 2008

  Q80  Chairman: Graham's question was how we spread that. We know that there are local authorities with a poor track record in that area, as well as good and average ones. How do we spread it?

  Professor Tunstill: The whole raison d'être of the Social Care Institute for Excellence, for example, is to disseminate the knowledge base. That includes both research findings and the views of the people who use services and policy information. There is a plethora of dissemination organisations, which I am sure you make use of. Mary's organisation does a huge amount of dissemination of good practice.

  Margaret Dillon: From my perspective, the dissemination goes to practitioners; the challenge is delivering to the people who actually shape the services—getting their understanding and ensuring that they are learning about what works, so that they feel that they are informed, and getting what the research tells them into the mainstream. Then, when they are looking at how they are going to spend their resources and how to shape services to meet the needs of their locality or their communities, they know what works and therefore spend their money on what delivers the best outcomes for children and their families.

  Q81  Chairman: Are you talking about local politicians?

  Margaret Dillon: I am talking about local leadership, which includes local councillors and politicians, as well as senior staff within local authorities. Our experience is that, where you have stability of leadership and of senior personnel within local authorities, all the inspection regimes will show that you get a degree of stability in shaping services and in improved outcomes for children within that area. Our experience also tells us that, where you have short-term churn and short-term contracts, you are losing expertise, knowledge of the area and a stable work force. In the voluntary sector, within the commissioning and tendering environment, we experience what we could call an unacceptable churn with services and with able, qualified staff who have built up a knowledge base. We enter into three-year contracts; we recruit, train and stabilise a team, who are a good group of staff, delivering excellent services, which all the evaluations and inspection of the contract show—but then the funding goes, so you lose the staff and that knowledge of the community and families. Families like to be able to return to services. They may receive a six-week family support intervention; 18 months later they may have another problem, and the staff group dealing with them will be the same. They can return, receive some advice and move on, but if there is a churn in services, it is very problematic.

  Q82  Mr Stuart: You have talked about the problem; what is the solution?

  Margaret Dillon: I think that there are challenges with effective leadership at senior level within local authorities. I can see Anne nodding. I do not want to fall out with my colleagues—

  Mr Stuart: You do not have to stick together.

  Margaret Dillon: There has been an immense change in local authorities recently with the structural reconfiguration—the rearranging of the furniture. Things then slip off people's agendas.

  Q83  Mr Stuart: I thought that you were also referring to the point that from a local authority point of view, short-term pilots carried out by voluntary groups where the money runs out after a couple of years are not much good and can do more harm than good. The voluntary sector is like the video game with the frog crossing the river by jumping on floating leaves; it has to wait for another leaf to come along. The whole life of the voluntary sector seems to be about having to reinvent itself to fit with whatever the latest pilot is, so it can hop on board and keep everyone in work.

  Margaret Dillon: You would expect me to lobby strongly for long-term contracts with the voluntary sector. We can deliver leadership at local level that is supported by effective training and delivers research into practice. What is important is learning from what research and pilots tell us and getting out there, delivering the services and making the difference for children.

  Q84  Mr Stuart: That is up to local authorities, so why do they not do it? They recognise the problem when it happens to them, but then they give out contracts to you that do the same thing.

  Margaret Dillon: Because they are juggling. Having worked in a local authority, I know what the challenges are. They are juggling with a complex picture of priorities and changing needs across the local authority, not just within the social care services that they deliver.

  Q85  Mr Stuart: As we are talking about different initiatives and whether we should make anything compulsory, what are the circumstances in which the use of family group conferencing should be more widespread? Is there a case for making it mandatory?

  Mary MacLeod: It certainly is in New Zealand. I would like to see us move in that direction. It should be not just the adults in the family and extended family who are involved, but the children. I remember managing what at the time was called a family network meeting for two young children who had been in care for two years. The father was there along with his brothers and sisters, the grandparents and the children's cousins. From the children came the things that nobody else would say, but it was very important that they were said. That enabled the family to come to a decision about what was realistic. Such things might move the whole thinking about children in care being "in care" to care being thought of as "shared care" in the way that we talk about family breakdowns. We should talk about the parents sharing care. Within the children-in-care services, it would be a good idea to think about shared care so that we stop talking about respite care. Families can then be included in thinking about what is the right decision. In my view, family group conferencing is a way to reach that position.

  Q86  Annette Brooke: I have been lobbied by several academics and I hope that I do not misrepresent their views. I suspect that you will recognise them because they have been reported in The Guardian. The suggestion is that the more universal preventive approach and applying the common assessment framework to far more children mean that there are cutbacks in child protection. Those academics suggest that there is now not so much investigative work and there are problems with bringing in the police and in very serious cases. Getting the balance right between the different services is a dilemma. Do you recognise the scenario that is described by those academics? Should we be concerned about getting the right balance?

  Professor Tunstill: Speaking as someone who would be defined as an academic, I think we need to see academics in the same way as we might see political parties. I do not come to this with a completely open or empty mind. All academics, like other people, have their own value systems and preferences. I am not suggesting that they allow that to taint their work, but nor am I entirely sure that the picture is accurate. The accurate picture of which the Committee is becoming aware is the tendency of assessment and recording to overshadow the chances of good relationship-based social work. I believe that the best safeguarding and the best outcomes for children and their families are more likely to derive from face-to-face contact with skilled social workers in a relationship-based context than what I have seen as a researcher. I see social workers who spend, at a conservative estimate, 70% of their week trapped in front of a computer, entering information within the requirements of the Integrated Children's System. I know that that is contentious. I am aware that the Government have commissioned two studies, neither of which was undertaken by me, the Committee will be relieved to hear. One is positive about such work, while the other is more critical. Face-to-face contact with social workers is an element in the safeguarding system. Local authorities can ensure that social workers are out there. I am sure that those social workers whose authority is represented here, are not trapped in front of computers, but when I took my little safeguarding SureStart team round, and their background was not in social work, in some of the authorities we visited, had I told the team that we were going to a Vodafone call centre, they would have been none the wiser. There are serried ranks of social workers whose lives are now dominated by the Integrated Children's System. That was a good idea when it was at the assessment level, but it has now rather mindlessly transported some of the complexities of the look-after-system into the children-in-the-community-system. I am not arguing against good assessment. The common assessment framework is hugely exciting. Having a lead professional system that does not have to involve a social worker will help bridge the chasm that opens up between Levels 2 and 3. We all share the view that that is the dangerous bit, when children go down the hole and do not come up again. I am not sure that I recognise the picture in quite the terms that have been expressed. There will always be social workers whose obsession is child protection with a capital P, and preferably compulsory child removal if they can fit it in. That was an irresponsible thing to say, and I probably should withdraw it, but we have to be realistic about the different ways in which people define welfare. There will be a continuum of values—this I will not withdraw—about the importance to children of their identity within their family of birth, even if they cannot stay there and be brought up within that family. We talked about shared care, but that does not mean that it all has to be as though a birth family does not exist. I do not take back the diversity of academic views any more than politicians would claim not to have diverse views themselves.

  Q87  Annette Brooke: Anne, do you think that there has been a diminution of the investigative work that took place a year or two ago on severe child protection issues?

  Anne Scarborough: I cannot answer that directly. We have introduced the CAF (common assessment framework) in Calderdale and it is now beginning to bite. The key to any assessment framework anywhere where there are professionals around children is the sharing of information and the dialogue between professionals. The statement of special educational needs system became a bureaucratic nightmare before it started to come out of the tunnel and realised that it needed to do something different. Authorities have now taken that to the next level. With assessment systems we always need a process through the assessment—stages through it. We need the process by which professionals come together. Our special educational needs moderating group is the stage before assessment. It is made up of professionals, including schools, and the dialogue and debate around that is phenomenal. It is of a very high level and matters are well debated so we know that we will have a good assessment process. That is the right place to do that. It is not up to one person to take on work such as child protection; it is for a group of professionals to do that. Sometimes that does not happen as well as it should, because there might not be an appropriate process by which it can work.

  Margaret Dillon: It is important to understand that assessment is a means to an end. What is challenging is to stop the gathering of information and to move into analysis—to ask, "What does this tell us about what we need to do and what we need to provide for this family to make things different for the child in this family?" What is far more important is the intervention—dealing with the question, "Which services are going to make this child safe again within this setting, and when will we know that we have tried and it is not going to work and therefore need to take another sort of action?" There is an increasingly unhelpful over-focus on the gathering of information at the cost of doing the analysis and then moving on to intervention.

  Annette Brooke: Not seeing the wood for the trees.

  Margaret Dillon: Potentially, yes.

  Q88  Annette Brooke: We have touched on this already, but what would you say are the greatest barriers to families accessing the right support at the right time?

  Mary MacLeod: I think that because the network of support feels so impenetrable to families, they do not know where to go. That is partly because of some of the system barriers—adult social care, children's social care, health particularly—but it is also about families hitting different thresholds when they approach services. Within social care, the threshold in children's services might be higher than in some voluntary organisations, and in adult social care it might be higher again. Different services are not thinking about the whole family, so I really welcome the social exclusion report and its emphasis on the importance of thinking about families as a whole. There are big issues about supporting families and noting where difficulties might be arising in the prenatal, antenatal and postnatal periods. There particularly, you cannot be thinking about children's services without thinking about child health and health visitor services. The service landscape is very complicated. Margaret talked about services being there and then not being there. Parents and family members get to a point where they have to do something desperate or be in a desperate state before they get noticed. One of the other problems about that service landscape is that it enables responsibility shifting, so that organisations can say, "That's not my role, I don't deal with this." Of course that is very complicated for families, because as far as they are concerned everything joins up inside the family—it just does not out there.

  Margaret Dillon: May I just add to that? In our experience of working with families in crisis where children are on the edge of care, one of the things that families value is that we offer support 24 hours a day, seven days a week. When families are in crisis that does not occur in standard 9-to-5 office hours, it occurs when all the family are together, when they have people over for the weekend, when there is a bank holiday or when money is tight, and that is invariably not when the service is open. Some of the intensive family support services that we offer are there 24/7, and that makes a difference to families, because they can reach for the phone or call for help when they most need it.

  Anne Scarborough: The continuity and sustainability of the key worker is always important. For some families—those with a disabled child, for example—the number of services involved is phenomenal, so they need one point of contact who is somebody they trust, and they need to know what is coming next. Quite often when a family is in crisis—for example, when you have just had your baby and you suddenly find out that it is disabled—you are at your most vulnerable but, equally, you need to know what will happen next and what is in front of you. I think that sometimes professionals have not been happy to say what is in front of families, sometimes because they do not know what will come next, but sometimes because they feel that the family might be too vulnerable. It is important for families to know that, because they take bits in along the way. Among our most successful services are our services for people who are hearing impaired and visually impaired. They pick children up, sometimes before they are born, so that the family knows who they are working with, and they see the family right through to 19 to 25. It might not be the same worker, but it will be the same service. We need to build that into services. What Margaret and Mary said is absolutely key.

  Q89  Annette Brooke: There are so many details that I would like to discuss, particularly with Mary, on health visitors. Obviously, that is because of the report. A burning question for me is whether services are failing in their responsibility towards parents with learning disabilities. I know that Margaret probably has something to say on that.

  Margaret Dillon: What is critical is your point about access. It is about having the right services in the right place at the right time. Mary is right: there are risks with adult services focusing on the adult and often not thinking about whether the adult is a parent. They might be working with a parent with learning difficulties and not necessarily understanding that that adult has family and child care responsibilities, so joining up provision is critical. One of the things that work well for families where there are adults with learning difficulties is having access to a range of support services throughout their caring responsibilities for the child, and those who provide the services not making assumptions that just because the person happens to have a learning disability they will not be capable as parents. Our experience provides evidence that, with support, families where there is an adult with a learning difficulty can care adequately for children.

  Q90  Annette Brooke: Support for parents with learning difficulties is obviously very patchy across the country.

  Margaret Dillon: It is.

  Q91  Annette Brooke: It is tragic to have babies taken away when there are options. Is there some way that we should be aiming for a more universal approach in this area? I mean universal in the sense of across all councils.

  Mary MacLeod: One of the big issues for social workers and local authorities is anxiety about the level of risk. Because they are frightened that something will go wrong, social workers may rush into decisions that the family cannot care for the child. That is bound to continue to be the case if social workers feel that the level of support for families—the 24/7 call-out and all of those things—is not there. I do not know whether any of you have been social workers, but those nights when you cannot get to sleep because you are worrying about whether a baby is safe at home are terrible. I suppose that as a nation that we have to come to a decision about the level of support that is required. Are we prepared to put the money in? Such services are not cheap, and they are generally required for the life of the child. As Margaret said, children can be cared for wonderfully and very lovingly in families where parents have learning disabilities, but most will need support.

  Chairman: I think I will have to call Fiona now. Is that all right? All the Committee want to come in on this section, so I remind Members that we are limited in time.

  Q92  Fiona Mactaggart: I am struck by something that I have been hearing from you. Margaret was talking about how services have been in silos, and Mary spoke just now about responsibility shifting. It seems to me that that is the key to the issue. I am trying to work out in my head what the Government—as opposed to anyone else—can do about dealing with the continuum of ensuring that you do not responsibility shift and do not operate in a silo. That is the question that we need to be able to answer if we are going to be able to produce a report that is of any use.

  Mary MacLeod: I would love to be really helpful and give you the answer, but I think it is a hard one—it is tricky. The social exclusion task force report "Think Family" that I mentioned before is a step in the right direction. There is Government support for the current project with local authorities called Narrowing the Gap. There is no magic bullet, but Government obviously need to set guidance and protocols that will say thresholds have to be the same. One simple thing for adult social care might be noticing whether an adult coming in for support about drug or alcohol misuse or whatever has been asked, "Are you a father or mother?" or, "Are you responsible for a child?"

  Q93  Fiona Mactaggart: Are you saying that that question is not automatically asked?

  Mary MacLeod: It is not automatically asked. Margaret says it is the same with adult psychiatric services. Drawing from my own experience, as a social work student in an adult psychiatric hospital I dealt with a father going through a schizophrenic episode. I have to confess that the child at home, who it emerged had anorexia, I did not see. I really did not see—that is the kind of perspective in operation. Your perspective is that this is your focus and you do not necessarily think more widely. It is a matter of training and box-ticking protocols as well—but joint protocols. I think that there can be a shift.

  Professor Tunstill: I think that Government are doing quite a lot. There are various measures that could be built on. The CAF is a huge step in the right direction, putting flesh on the bones, where you actively engage, in a whole network, a variety of workers who see themselves as sharing the responsibilities for safeguarding, as we said earlier. I think that safeguarding is a much more helpful concept than the narrow one of child protection, because it is something that people can relate to and see at various levels. I think that that is going on and that the key challenge would be encouraging people to engage in the CAF and not to lose their nerve just as it gets to a Level 2 or 3. How one does that, I do not know, but it is the key thing in the frame. We have talked about the continuity of contact with people—whether they are social workers, early years workers or whoever—so that they do not immediately flunk it and opt out, or make the wrong sort of referral at the Level 2 to Level 3 category. Part of that is about training, part about Government messages and I guess part about putting money into child and adult mental health services and a whole range of things that can make the most enormous difference at any one point in time—but if they are not there, the differences are really negative.

  Q94  Fiona Mactaggart: Does this issue link? What you were talking about—I have heard it in comments the other witnesses have made—is that there is a potential hole between Levels 2 and 3 that people can disappear into, and we need to find ways of bridging that. I think that that is what I am hearing, which in a way connects with the question about a continuum of longer-term work with families and being able to intervene in crises. That is also part of the between Levels 2 and 3 story. How can we get that continuum working better? I have heard lots of, "That is what we need to do." I have heard, "It's hard." I have heard that there is no magic bullet. But you have to know better than we can know how we can get that working better, and I have not yet quite got it.

  Margaret Dillon: I could give you a description of a family in one of our intensive family support services. Those services work with families that are socially excluded, are in the antisocial behaviour category or are living on very problematic estates where there are lots of complaints and where they might be at risk of losing their tenancies. Those are the families who are at risk of homelessness, and the children are at risk of being accommodated. One family who were referred to one of our services had nearly 30 different agencies engaged with them, but were still in that kind of mess, so the service sat down and did what was almost a mapping exercise. It worked out what all of the statutory professionals were doing with members of the family, who needed to be doing what and what was the focus of what needed to happen to allow change for the family. The service slimmed down and identified the needs, was much clearer about who was going to do what, delivered a range of services with the intention of building on the family's strengths, so that the family worked on what worked for them and were able to move forward, stabilise their lives and tenancy and remain within the community. We did that with a multidisciplinary team so that we could deliver the services from a multidisciplinary group and so get the holistic approach within the team. We did not have a range of agencies across the locality all sending in people to deal with housing welfare, educational welfare, special needs and the support for children and adolescents. They were very well known, but the situation had become intractable.

  Q95  Chairman: Thirty agencies went down to how many?

  Margaret Dillon: Four.

  Q96  Chairman: Could you give us a list of those 30 agencies, because that would be very useful for us?

  Margaret Dillon: Yes.[3]


  Q97  Fiona Mactaggart: It sounds as though that family illustrates another issue regarding adolescents. A lot of what we have been talking about relates to intervention with very young children. It seems from the evidence that we have had that there is a gap affecting adolescents and that they are seen, as this family clearly was, to be antisocial and a social problem for their neighbours. It sounds to me as though it is the adolescents within that family who are at risk of criminal justice interventions.

  Margaret Dillon: Absolutely.

  Q98  Fiona Mactaggart: Did they have services that met their needs as part of early intervention? It seems that we are not bad at provision up to the age of seven, but from seven onwards we seem to get worse. These young people suddenly stop being children and start to be something else—something rather feral and aggressive—that we are angry about. I wonder whether you have any suggestions about how to deal with that.

  Margaret Dillon: This goes back to an earlier question on pilots and short-term funding, because the funding stream for the children's funds, which will come to an end at the end of this month and move into mainstream local authority budgets, was very much targeted at the five to 14-year-olds; it was deliberately intended to reach out to those groups of children who had needs and needed support to avoid failing at school, to get them to attend school and not to get into trouble with the police or the community. A lot of those services are going to the wall. We have closed a number of those services in the past 18 months because the ringfenced funding is soon to end. So, there is a gap and we remain concerned about that.

  Q99  Fiona Mactaggart: Local authorities still have the money.

  Margaret Dillon: They have the money, but they have significant challenges about how they spend their money, which we recognise. One of the things that NCH is exploring with a number of partner local authorities is whether there is a way of doing more with children's centres so that they are not just focused on the very young. That will look at whether a range of services and outreach work could be delivered from within a children's centre, because the centres are in communities and those little children who attend or are involved almost invariably have older siblings, as families do not just come with an 18-month-old and a three-year-old. Families come with an age range of children, and those children come in all shapes and sizes.

  Professor Tunstill: I just want to say two things about taking away the age restriction around children's centres. First, I think that children's centres should be opened up, so that they take account of the fact that families have children of different ages. Secondly, I think that very clear messages should be given, both to professionals and parents, that problems are likely to be episodic. It is very difficult at the moment—professional training has partly aggravated this—to have a system that gives you permission to go in and out of it. There was always an expectation that a service will deliver the silver bullet within a particular time period; all will be well, that is it and if it is not, either the service has failed or the parent is deficient. One message that politicians could give to service planners, local authorities and everybody else about the reality of need in families, is that it is episodic. You may go in and out of a system, but some families will need an ongoing offer of long-term support. It is not that they will be in the system all the time, but they need to know, as we probably know from our own networks, that they can go and access those services when they need them. In this country, there has been a situation, aggravated by social work theory in some cases, where services are "task-centred", "brief-focused" or all of those words that somehow make it not permissible to go in and out of the system. That is a very simple thing; I do not know how you get the message across, but it is a powerful message.

  Chairman: Mary, and then some quick ones, because I am conscious that I have to move a little.

  Mary MacLeod: I will be very quick. Thinking about what Government can do, one thing that is really important is cross-departmental work, because departmental agendas can conflict. There also must be some thinking about what the appropriate targets are, because if you are thinking of children aged eight and above and teenagers, the world outside also has an enormous impact on how a family copes. It is not controversial to say that. For families raising children in social housing as it is now, it is much more challenging to prevent children getting into trouble, because of the housing and the local environment. Local authorities and Government need to think about regeneration and about the impact of housing and locality on families' capacity just to maintain themselves and to keep their children out of trouble. I do not think that I would argue for more structural change. Although I come from Scotland and I think that the children's hearing system there is a very good one and that we have a problem in having welfare and justice divided in the way that they are in England, if you go and look at the results in Scotland for families I do not think that you will find that they are enormously different to the results in England. So I do not think that structural change will do it. However, sharing targets and sharing funding might help.

  Anne Scarborough: I was going to add, from a practical viewpoint, that that is certainly where most local authorities are now. One of the things said at the beginning was the importance of having pathways, so that you know what your continuum of support is within a local authority. You know the families that are likely to be at risk, and therefore you can predict what kind of services you are likely to need in the future. You cannot predict some services that you will need, because sometimes you have families that come into an area and you have to do something different for them. However, if you can achieve that continuum, you can go through the commissioning part, which is what I think we are coming to now. In some respects, I suppose that local authorities do not really want to build new services as such, if those services are already out there and they are rigorous, robust and good enough to support what they want to do as a local authority. That is where we would be coming from. One of my newest best friends, as it were, is housing. Housing can give me a lot of intelligence about which families are likely to be at risk of losing their tenancy, or which families are at risk of costing the council enormous amounts of money because of the way that they leave their houses. Hopefully, within the next few years we can start to have an impact on that. We have to look at intervention projects in housing, which will hopefully prevent escalation. That must be sustainable because, as people have said today, we can not just put in an intervention and hope that it will work, because families come back. That must be built into what we do with our budget and resources and those services must be developed. That is where we need to be.

  Chairman: I want to take a point from Andy on this. We will come back to the issue if we have time at the end, as we are dealing with a vitally important section. Andy, if you would like to come in briefly—Sharon will lead us on this matter, and then you can do the next section.


3   See Ev 53 Back


 
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