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

Examination of Witnesses (Questions 100-119)


26 MARCH 2008

  Q100  Mr Slaughter: I am very sorry for making a flying visit to the Committee, but I have fallen on my feet by arriving for the part that I wanted to be here for.

  Chairman: You have been watching it on television.

  Mr Slaughter: I want to pick up on earlier comments about finance. I appreciate that there are different types of provision and local circumstances, but I am concerned about consistency across the country. I was not aware of that issue with regard to family support. I was aware of it in other areas of social care—domiciliary care, for example, where there are huge differences in how and what is provided and things such as charges. I am also aware that we had a good level of care in my locality, but now that seems to be changing; there is less provision, or provision is charged for. How much of a factor is that? Are you concerned that there may be areas in the country where there is a lack of provision, expertise or sharing of good practice? Within that, how widespread is charging, and how much is it a factor?

  Professor Tunstill: During my national evaluation of SureStart research, charging seemed to be a significant deterrent to the use of day care. I imagine that in the area of children and families, the major negative way in which charges might impact would be in day care. We know that being able to use day care is associated with a range of positive outcomes for children and parents. Anecdotally, some people might worry that there are children's centres which are being effectively "taken over" by the more affluent middle classes. That will lead to a vicious circle, as not only can the less affluent people in that area not afford it, there is also a deterrent and a stigmatising effect. I work very closely with ATD Fourth World, which is hugely conscious of people living in poor conditions. Those people will feel very uncomfortable going into a children's centre where a charging policy has accidentally skewed the profile of the service users.

  Q101  Mr Slaughter: It is an area that I am becoming familiar with—charging for things like counselling and respite and matters of that kind seems, to give a personal view, to be rather counter-productive. If we are dealing with families who are on the edge, it is a barrier which, apart from any moral considerations, might cost the state more in the long run. How prevalent is that?

  Professor Tunstill: I suspect that it is not very prevalent. It is that paradox of the universal services being high-quality services and being good enough at Level 1 to attract the likes of most people in this room. The danger is that as you go up the continuum, a range of other things kick in—the offer that you cannot refuse or the fear that you might lose your child. I do not think that charging is the problem at that point, but we could do more about capitalising on the money that comes in from parents who are happy to pay for high-quality day care because they have well-paid jobs to go to—I have no idea what happens in Calderdale. However, the issue is inextricably linked with the local employment situation.

  Chairman: I am conscious of the time and there are quite a few sectors, so one more answer to Andy and we will then move on. Does anyone else want to come in on that?

  Q102  Mr Slaughter: I am not necessarily asking you to name names, but are there areas of the country that you have concerns about, simply because of the lack of provision or the lack of quality in provision?

  Margaret Dillon: There is a variability of provision, which is one of the challenges. Where local authorities choose to put their resources, in terms of the services that they are shaping and delivering, will look very different, and that is because needs vary across the country as well.

  Q103  Mrs Hodgson: I have just a couple of quick points to round off the section. You mentioned the pilots that we are moving away from for the seven to 11s and teenagers. Fiona asked this question: if the money is there and local authorities have it, is it all skewed towards children's centres and early intervention rather than towards teenagers and adolescents because of the Government's emphasis on early intervention? I will round in the second part of my question to save time. Fiona asked about it being harder for teenagers and adolescents to hook into the system—how many of those teenagers trying to get into the system are above the radar for the first time? Have they at various points dipped in and out and are therefore not totally unknown to the system, or do you get teenagers—with whom there is no history of intervention—who hit 13 and all of a sudden require help?

  Professor Tunstill: I suspect that there is deficit in knowledge on the part of parents about parenting older children. All the handbooks are about parenting but parents lack confidence. In the papers all this week it has been obvious—at the NUT conference or wherever—that parents are rather iffy about parenting adolescents, that they are frightened of saying no and a whole range of other things. All the evidence shows that youth offender teams work very well because they have been purposefully put together. They are multidisciplinary teams, working with that particular age group in local authorities but, ironically, only of course when they are triggered because adolescents come into contact with the youth offending system. There are some perverse linkages, where you get a really good service but only at the point where you have hit the spot. I am on the management board of Cafcass. We have family support workers who do a supremely good job resolving family conflicts, but you only have a chance of getting one of them at the point at which a court order has been made. It may not have gone through the court hearing, but it is hitting the high spot thing. I am not quite sure where I am taking us on this one, but it is a combination of parents' confidence and systems that perversely reward bad or tricky behaviour and do not offer a service early enough to those who are merely still at the stressed stage.

  Mary MacLeod: What we find is that when children are coming into the age group called tweenies, it begins to become apparent that things have not been wonderful at home. We have been talking about early prevention and the importance of that, but there are a great many more problem families—or families with problems—that are impacting on children than we are picking up. So yes, children do end up hitting the radar because their acting-out behaviour is a response to things that are happening at home that nobody has—

  Q104  Mrs Hodgson: It was not picked up?

  Mary MacLeod: It was not picked up and nobody knew about it. I would not be too blaming about that, because it can be very difficult. One of the studies that I did when I was at ChildLine was about calls from children about parental misuse of alcohol in particular. Children are very frightened of what will happen if they ask for help. They are aware that a juggernaut could hit the family and that then everything would be out of control. Therefore, they involve themselves in ways of managing what is going on in the family that is not good for them, for example, by going to see their auntie at the weekend when things are very bad, or whatever. So, there can be families in which the children have been in quite dire straits, but where it has not been obvious. Behaviour such as running away or getting into trouble is then the first sign of what has happened.

  Q105  Mrs Hodgson: The flash point often occurs in adolescence, I would imagine.

  Mary MacLeod: Yes.

  Q106  Mrs Hodgson: Is the emphasis on more early intervention Government-led, in your opinion? Are we encouraging that? Personally, I think it is right that we should focus on early intervention.

  Mary MacLeod: I think it is quite driven by Government picking up on the importance of the early years. However, children and families can be worked with later, and it would be a great pity if what you are talking about as one batch of funding and resource was to shift there from here, rather than deciding what is needed across the board.

  Chairman: Okay. Sharon, take us on to the relationship of family support to care thresholds.

  Q107  Mrs. Hodgson: It follows on nicely, actually. Is family support primarily a measure to prevent children being taken into care? If that is so, does it not polarise the sort of families who receive that support? So the "children in need" category gets the support rather than the wider group of vulnerable children.

  Chairman: There are lots of shaking heads. Who will start? Anne?

  Anne Scarborough: I go back to my former point that family support is a complex area. It encompasses a lot of different things, so it is needed at many different levels. It is for every family, but the challenge is getting families to understand what support there is for them. There is probably a difference between family support and parenting support. We have talked about the two, and I think that there is a difference between them. As we have just discussed, parenting support for an adolescent is very different to that for a nought to three-year-old. We have found that the gap in numerous services is between the ages of five and 10. That period is crucial in a child's life, from when they are at primary school, but also supporting their transition to secondary school. The points of transition for families and parents are crucial to how they parent and how they support their children. The nought-to-three period is when SureStart and children's centres are provided, normally in connection with health services, because that is when you receive a lot of support for health. In the transition to the next phase, the information and intelligence about families at risk needs to be passed on. Hence, I refer back to pathways and transitions. Passing on the intelligence is the important bit. When a child gets to 11, let us say, and goes off the rails, there is probably, as Mary alluded to, a whole history behind it, but it is only just starting to manifest itself in a particular form of behaviour.

  Professor Tunstill: It is awfully important not to see merely keeping children out of care as an achievement. Care needs to be seen as part of the package of things that help us enhance outcomes for all children. A seminal piece of research done by Jean Packman back in the 1960s and 1970s showed that when parents went with difficulties to what was then social services they were asking for reception into care of often slightly older, more difficult children and were refused it, but not offered anything else. That was a profoundly important study because it showed how valuable a short-term period of planned respite care could be at that point, and that if you were going to avoid it, you needed to offer other things. It is a great sadness that other European countries see things slightly differently, and do not regard it as a badge of failure if a child goes into care. For some children, a care period might be the right thing for them. However, given the other concepts of shared care that we have talked about, care does not need to mean wrapping-up a red spotted handkerchief and going off for ever, but a range of partnerships. The emphasis should not be on keeping out of care per se, but on approaching children on the basis of their individual needs.

  Margaret Dillon: I support that. Packages of family support can include shared care with a foster carer. Parents often say when they have received that package that the foster carer was immensely helpful in enabling them to understand their child better, and helping them with techniques to manage the child's behaviour back in the birth family setting. That would have been at the request of a parent who said, "I don't think that I can quite cope with Johnny and Jane at the moment. Is there a possibility?" That is voluntary accommodation. We see that as part of the package of support to the family. Unfortunately, a great stigma is associated with the concept of in-care.

  Mary MacLeod: Family support should not only be targeting families who are very troubled or whom we are anxious about. It is important that families whose relationships could be improved can have access to family support. At the moment, you can do that if you have money. You can have counselling for family problems but, unless you have a big problem, it is much harder if you do not have money. It is a big resource issue.

  Q108  Chairman: Is not that one of the problems that we have not talked about today? Is it not the responsibility of the health sector to provide? The amendment to the present Bill that was discussed in the House of Lords was about a duty on health providers to provide the crucial therapeutic care that so many young people need at the time that they need it, rather than just at a crisis point. Is health a failing partner?

  Professor Tunstill: The children's trust evaluation showed that joint commissioning between social care and health was the most complex. The best commissioning partnership was social care and education. Often health is the missing partner. It might play a part in some of the centres that are funded by everyone else, but it needs a much more robust engagement. Services such as child and adolescent mental health services might be the patchiest of any that we have talked about.

  Mary MacLeod: But there are good examples. You might be interested in finding out about the Marlborough Family Service, which is funded jointly by three London authorities across education, health and children's services. It deals with very troubled families, but goes out to schools. It is a beacon service in the country and I am sure that it would be of interest to you. It is in Maida Vale, surprisingly.

  Chairman: Any suggestions of things that we should look at are gratefully received.

  Q109  Mrs Hodgson: Taking into account what Anne said about family support, it is not about just preventing children from going into care. Andy Slaughter spoke about the varying provision of family support across the country. We have looked at the number of children in care. Is there any correlation between those two statistics? Where are good family support services and which local authorities have reduced the number of children in care?

  Margaret Dillon: I am looking for the detail. We, in the Vale of Glamorgan, deliver a crisis intervention service that was targeted specifically on preventing children from coming into care. It commenced in April 2004 and, in nine months to the end of December, 15 successful interventions were made. At that point they had 200 children in care in the vale, and the average length of time for the children being looked after in the Vale of Glamorgan was just over three years. We did a cost benefit analysis of the savings on those 15 children who would otherwise have been accommodated and looked after. The Vale of Glamorgan could see the cost benefit of investing in the intervention service, which reduced the costs of the looked-after population. We have a number of such services giving that evidence—we have a similar one in Merton at the moment.

  Chairman: We have 15 minutes to wrap up the last questions. Is that okay? The people I want are Fiona, Graham and then Annette.

  Q110  Fiona Mactaggart: We talked a bit about commissioning, but a bit sideways. I am just wondering what outcomes commissioning bodies look for from family support services. What are they looking for? Are they asking for the right outcomes when they commission family support services?

  Professor Tunstill: I do not think that I can answer that.

  Margaret Dillon: In our experience, in the last two to two and a half years, local authorities have become more able to be specific about the outcomes that they are seeking. What is problematic is that that tends to be numbers-counting things rather than qualitative measurements about improvements to children's well-being. It remains a complex area to measure the outcomes being sought. With our intensive family support services around antisocial behaviour, you can see more specifically what the outcomes are as a result of those services. They are much more measurable: maintenance of tenancies, reduced complaints from neighbours, improved school attendance from children. Those are much more tangible, whereas a range of other family support services are often much harder to capture in measurements of what you are seeking and in evidence for successful outcomes.

  Q111  Fiona Mactaggart: But things have not got worse. How do you ensure that?

  Anne Scarborough: I would say the same really. If we go out to commission, we would have a fairly rigid contract with whoever we were commissioning. There would be outcomes on it. One of the issues that we have probably not discussed today is the qualitative one, which is the information from the families themselves. When we were commissioning things for children and young people, we asked their views. We certainly did that for our parenting strategy, and got qualitative information. However, it is normally the harder information that we are tasked with—our performance indicators.

  Professor Tunstill: Harking back to the big, university of East Anglia, Government-funded study, commissioning is incredibly influenced by the nature of pre-existing partnerships. In a sense, it holds up a mirror to what the cross-departmental and agency partnerships were like in that local authority. In a sense, it is a sort of virtuous, or unvirtuous, circle. There is a huge tendency for commissioning to be around the targeted—in theory, more countable—bits of the system, rather than about, as we have been labouring to tease out this morning, the need for this broad-based menu of easily accessible services at each level.

  Margaret Dillon: One of the challenges with commissioning is that there has been a phenomenal level of investment in a commissioning structure within local authorities, and within a set of processes and procedures. It is incredibly complex, particularly for the voluntary sector, in terms of delivering pre-qualification tender documentation with incredibly tight timetables. We find that the commissioning arm of the local authority is not necessarily having the right conversations with the referrers to the services—the operational arm—be they health, education or children's social care services. There is a slight and sometimes major disconnect between what is commissioned and what the operations arm of the local authority perceives as the needs in reality. Anne is nodding. There are some challenges with that issue.

  Anne Scarborough: It is a really difficult area. Most authorities are at the starting blocks with commissioning. One of the tensions is about releasing the funding for commissioning. To do that, you have to decommission or decide which of the services you really want. Decommissioning local authority services creates a tension in itself.

  Mary MacLeod: I am not sure whether users—children or parents—are involved in commissioning processes.

  Anne Scarborough: We do ask parents.

  Mary MacLeod: You do.

  Q112  Fiona Mactaggart: There are guidelines in Every Parent Matters about having a commissioning strategy and about a single commissioner for priority services in local authorities. It does not sound to me as though that has made much difference to anything. It sounds like it is the same old story of struggling through and making choices, but sometimes not making them in a way that fits with what is happening on the ground. What recommendation should we make to shift that, apart from engaging children and families and assessing whether things work, which I have heard about?

  Mary MacLeod: Give it time.

  Margaret Dillon: Yes, give it time and share the better practice. Have the right players at the table when understanding the needs of a community and the families within it. Do not have siloed thinking, but have a more holistic approach. Gather the information from all players within the local authority. Anne made a very good point that that should include housing workers, who are often excluded from the social children's welfare agenda.

  Anne Scarborough: It should really come back to the children's trust. Our children and young people's management group is very well versed in knowing exactly what is available in each of the areas within what is the quite diverse, small area of Calderdale. We have that information and we rely on it. It will now go forward into commissioning. Councils are at very early stages on commissioning. For instance, we commission organisations such as Home Start and the Pre-School Learning Alliance and have done for quite a long time. I would say that perhaps our commissioning processes have not been as robust and rigorous as they need to be. Again, this is not about creating a bureaucratic nightmare for people who want to take on contracts. It is about creating a process that gets the service that will deliver for the people.

  Professor Tunstill: It would be a great shame if the commissioning process got into an unhealthy relationship with what I call the "what works agenda". The Government are rightly concerned with a knowledge base for practice, but some things are not amenable to random control trials and evaluation in the most positivist, experimental sense of the word. It would be a great shame—this is very germane to supporting families—if local authorities got to the point of being allowed to commission only services and interventions that have been subjected to random control trials and evaluations. (One example is the Webster-Stratton programme, which is very important in its own right). These are often manualised programmes because, by definition, those are the easiest to evaluate and they appear to produce the magic answer. I am just cautioning that whatever the guidance on commissioning, it must take account of the commissioning of the broad menu and not just the narrow number of programmes that have been subject to what some researchers feel is the only gold standard of rigorous evaluation. It is not the same as the National Institute for Health and Clinical Excellence.

  Q113  Fiona Mactaggart: I am hearing a difficult tension. One of the things that I think all of you said earlier was that you need some expert, quality services that are tried and trusted and that might reach beyond a single authority. You probably need that to be centrally directed to some degree. The system now has a lot of flexibility around how a local authority can decide to spend its money. You talked about bringing people round the table and working it out together, and the system seems to meet that. I wonder whether you want both of those things? Do you want one more than the other? I am not sure that I know.

  Mary MacLeod: I would say both. You lose a lot of knowledge if you do not support the national services. A lot of those services are voluntary sector or third sector and there must be some central discussion and thinking about how that support is delivered alongside a localist agenda. With regard to the parenting strategies and services commissioners, it is very early days. They have just been set up and parenting strategies are only now being developed. It is too early to say that it is not working; with help, it will work and it will deliver more and better than was previously the case.

  Chairman: We are running out of time, so I will call Graham and Annette. Unfortunately, Prime Minister's questions is close upon us.

  Q114  Mr Stuart: Margaret, you touched on some work in Glamorgan. Do we need more economic analysis of the impacts of different local authority approaches?

  Margaret Dillon: Yes, absolutely.

  Mary MacLeod: May I draw your attention to one piece of economic analysis by Leon Feinstein? He looked at the outcomes of children's offending in a number of authorities. Some had only the educational maintenance grant, but some had particular youth offending support. He found that where both were present in authorities, there was a better outcome for children—fewer children were offending and they were getting out of offending more quickly. That kind of analysis would be hugely helpful to local authorities in planning services. We need to look at the impact of a number of different interventions that seem to be disparate, but might actually work together to give a better outcome.

  Professor Tunstill: Just a point of information: there is a large review called The Costs and Consequences of Child Abuse, which is being set in train at the National Institute of Economic and Social Research. It will try to pull together all the different bodies of knowledge and show the short, medium and long-term consequences of what not addressing problems in families leads to down the line. It is under a range of headings—housing, the economy, everything in the world.

  Q115  Mr Stuart: What is the right ratio for spending on children in care and family support?

  Mary MacLeod: It depends where you are. If you start off by aiming for prevention, once you begin to provide good preventive services, you begin to find those children that we were talking about—the ones that we get to only in adolescence. For a period of time, you have to invest very heavily in both before you see the reduction in spending on children in care that you would hope to achieve by increasing preventive services.

  Q116  Mr Stuart: So where do you aim to get to? You said that it depends where you are, okay, but what is the end point? What should the ratio be?

  Mary MacLeod: I would like to see more family support.

  Mr Stuart: At the moment the average is three to one or, in some places, 10 to one.

  Professor Tunstill: Yes, there has to be more support. Mary is right; there needs to be an interim period of double-track funding. We tried hard with the last Government in the '90s to argue that we needed some short-term, double-track funding for what we were doing. Yes, if push comes to shove, that is where the emphasis must be, but I do not think that it is as mutually exclusive as we may think.

  Q117  Mr Stuart: The economic analysis in my previous question is what will be needed to convince people. I have one last question. I am going off at a tangent, but should the same assessment that is used before removing a child from the parents, namely that of safety, be used for grandparents, uncles, aunts and those in the immediate family, in accordance with the presumption that, if children cannot be with the parents because of a safety issue, they should be with immediate family members rather than having the decision about what is in their best interests in the broadest sense handed over to the social worker?

  Mary MacLeod: If you are asking whether we should be doing more about kinship care, the answer is yes we should. I think that most people would say that that is where you start. You would start looking there, and a way of doing that is through family group conferencing. Kin who do take on that responsibility are often poor, and get different allowances from what is provided to foster parents, and that is a huge disincentive, particularly for the grandparents who did not ever think that they would be parenting their grandchildren. They will need more support and we cannot just wash our hands and say, "Well that is the family and that is fine."

  Q118  Mr Stuart: What about the threshold, because grandparents could be willing to take the child on, but the social worker's opinion might be that that is not the best place for the welfare of the child? Should we create a higher threshold that they need to be in danger before the presumption is that they are put with kin, rather than wherever else the social worker wants to put them?

  Professor Tunstill: That is a terrible trick question. However, there has to be an assumption, subject to all the financial caveats that Mary has just laid out, that a different threshold would be incorporated within one's wider kinship network, but that is not to say that the local services should forgo all their responsibility. Although I am not yet a grandmother, I guess that I would come down on the side of expecting to be seen as the first port of call to look after any grandchild who happened to get to the point of being formally taken into care, without having every aspect of my life combed over.

  Q119  Mr Stuart: Is that a yes?

  Professor Tunstill: I think it is a yes. I think that I am on your side and that it is a lower threshold.

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