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


Examination of Witnesses (Questions 620-639)

COLIN GREEN, HENRIETTA HEAWOOD, PROFESSOR JUDITH MASSON AND DR ROSALYN PROOPS

17 DECEMBER 2008

  Q620  Chairman: So it was inter-agency? You all got together to write this.

  Colin Green: It was led by the DCSF.

  Q621  Chairman: So it is post DCSF? It was not Department for Education and Skills—

  Colin Green: It was the DFES. Sorry, it was a DFES-led initiative, but Every Child Matters is a cross-Government programme so there was significant involvement.

  Q622  Chairman: So the common assessment framework comes along at the same time as Every Child Matters?

  Colin Green: Yes. It is part of that.

  Q623  Chairman: I wanted to get that as a matter of fact. We have to move on, but before we do, one of the things that we picked up in the course of the inquiry is the relative scarcity of psychologists and psychological assessment for children. It is particularly worrying for me. How do you know about neglect? You can see if a child has a physical bruise—hopefully you can—but mental scarring and psychological ill-treatment are much more difficult to pick up. In my view, mental cruelty is as damaging, if not more damaging, than physical cruelty. Is the common assessment framework sensitive enough and do you have enough psychological expertise to judge that?

  Colin Green: I think the framework is sensitive enough, but it is an initial overview ideally done by bringing a number of different professionals together—it is not an in-depth assessment. I would expect the school to bring up such things as attendance, response in class and behaviour with other students. At the common assessment framework stage, hypotheses might be reasonably descriptive about why that might be a problem for a particular child, but that should then lead to questions about whether the child needs a more comprehensive assessment with greater expertise. It is partly designed to get an understanding of the child's needs and to work with the parents to address the problems. It has been successfully used in that way but it should also help to identify children who have more substantial difficulties and need more expertise and more depth.

  Q624  Chairman: So when is this common framework assessment administered? Is it to every child?

  Colin Green: No. All Local Authorities are in a process of trying to develop their implementation of this. The idea is that it should be used for children and young people who have been identified by the universal services as having significant additional needs or as being particularly vulnerable. Some authorities say that when a child has been excluded from school, or has been excluded a number of times and is going to enter a pupil referral unit, there should be a common assessment framework because almost certainly that young person or child has a variety of difficulties. In my authority we are trying to see whether we should use it with all those children with poor school attendance, so it is not just with the education welfare service. We are taking a look at why the child is not attending school. That is a key indicator of neglect.

  Henrietta Heawood: The common assessment framework was well intentioned to give other professionals, not social workers, a means of clarifying what the concerns were and linking services up to provide a better service for children. I do not know whether any research has been done into how it is working in practice. Judith might know.

  Professor Masson: No, I do not.

  Henrietta Heawood: It is early days yet. There have been pilot projects and I do not know whether it is entirely universal across the country yet.

  Q625  Chairman: That is very interesting. You have a common assessment framework, but no one knows if it is working.

  Henrietta Heawood: It is very new.

  Colin Green: There has been research done on its implementation, because it was piloted in a number of Local Authorities. That tells you things like whether it has been well received. There are lots of case studies that say that it has made a substantial difference to children and their families. It has been well received by families. It has made a difference to some of the softer stuff about the work force having a common language, which is very helpful, and giving people a common framework to work within. But you have not got population outcomes that would say whether it has had a particular impact on a particular outcome.

  Henrietta Heawood: And we do not know how many children who have been subject to the common assessment framework process have then moved higher up into targeted services.

  Chairman: We have to press on, and Colin is only with us until 11.30 anyway. Paul, over to you.

  Q626  Paul Holmes: This is probably a question for Colin and Henrietta. What is the typical composition of a child protection team? Is there such a thing, or does it vary in every part of the country?

  Henrietta Heawood: A child may be subject to a child protection plan, which is what we used to call "on the register", but there is new terminology since the most recent "Working Together" document. I have brought it as a visual aid.

  Q627  Chairman: We are not allowed to have visual aids, as Hansard cannot pick up on them.

  Henrietta Heawood: Suppose that a child has been made subject to a child protection plan following a recommendation from a multi-agency case conference, then something called a core group is established.[4] It is likely that the core group will include the social worker as the key professional—the Local Authority children's social care social worker. Correct me if I have got that wrong, Colin, but that is normally the case. Her manager will probably be part of the group too, so the immediate line manager is likely to attend the meetings. The health visitor or school nurse will be invited to be part of that core group, as will somebody from school, if it is a school-age child, and representatives from any other services that are being provided, for example if there is a family support worker or the family are attending a special parenting scheme or accessing drug and alcohol services. The idea is that a plan is thrashed out quite carefully to look at what progress needs to be made and what needs to change for the child not to be subject to the child protection plan. It is monitored with regular meetings of the group and reviewed in a review case conference after three months.

  Colin Green: I do not quite agree. It should be everyone who has a part to play in implementing the child protection plan, and that would normally include the parents and the child, if they were of sufficient age and understanding. Certainly, you would want to involve adolescents in a plan about them.

  Henrietta Heawood: Yes. The parents attend the meetings of the core group and then they may see all the workers in it individually at different times and in different settings.

  Q628  Paul Holmes: As for health visitors, Rosalyn, you said in your opening comments that the number of health visitors or the number of visits that they could make to parents was declining. That could be quite dangerous because they are not going to pick up on signs of neglect early on.

  Dr Proops: I think that I may have phrased it slightly differently. Health visitors' practice has changed markedly. They offer a targeted service and are very involved with safeguarding and child protection. I would have thought that, more or less universally, you would find nurses, usually health visitors, at case conferences and involved in the child protection plan. When children reach that threshold, my experience is that health visitors are involved.

  Q629  Paul Holmes: When a child is born, health visitors are not attending every home in the first year or so in the way that they used to.

  Dr Proops: They are key people all the way through from the beginning. Without a doubt, they are key people at the beginning. They often have a process in place locally to establish a relationship with the midwives to pick up on those families or mothers that they may wish to see early. I would not for a moment want to suggest that they are not key to picking up on a targeted group of people who need their support. I suspect that if they were sitting next to me they would say that there is plenty more that they would like to do and that some of the new systems in place restrict them, in part.

  Q630  Paul Holmes: But has there been a decline in the number of visits that they do in the first 12 months after the baby is born?

  Dr Proops: As far as the universal service is concerned, yes.

  Q631  Paul Holmes: But presumably that must mean that there is less chance of them picking up on early signs of problems.

  Dr Proops: We are not good at evidence in that area, because there are more targeted practices, policies and services around, albeit less universal visiting.

  Q632  Paul Holmes: When we were in Denmark, the various professions we talked to said that they take twice as many into care as anyone else in western Europe, and there was discussion as to whether it should be more. They were confident that they were doing the right thing, partly because health visitors visit every child on a regular basis in its first year, and because child care is available for every child, with workers who are graduates, well paid and well-trained. All that is very different to what we have in this country. They were confident that they should intervene more aggressively earlier on because they could pick up the signs much earlier.

  Dr Proops: If you look at our child population, the pre-schoolers receive fewer routine visits now than some years ago. If you look at the numbers of children who are identified through health, a certain percentage of children have consistently been identified in that way, but not as many as others. Whether we are missing them is more difficult to say.

  Colin Green: I just want to comment on this, because in the new world that we are trying to create in children's services, it is important to focus on the wider responsibility for child health promotion. As a director of children's services, I carry responsibilities in that area. The Department of Health issued guidance, earlier this year, on the child health promotion programme. That guidance is good and describes how the system is meant to work, through a combination of universal services for all children and more targeted services for those in need. The way I would like the system to work—this is what I am working towards in Coventry—is for the health visitor to work with the children's centre team. Part of the way in which they reach every child is through how the children's centre works. It is not about very experienced and well-trained health visitors going around and seeing everyone. They influence practice in the children's centre, so that its staff can offer a lot of basic health promotion advice to all parents and will also have the skills to pick up where there are difficulties and bring those issues to the health visitor, as an expert practitioner. It is not just about the health visitor; it is about the health visitor's place in a wider set of services for under-fives, for which children's centres are absolutely key. There has been huge investment in that, and we ought to make more of that investment.

  Q633  Paul Holmes: But as you said earlier, one problem with SureStart and children's centres is that it presupposes that parents take their children there in the first place.

  Colin Green: But that is part of what we, and I, need to work on—changing how children's centres work, so that they are much more conscious of the total population for whom they are responsible and whom they are not reaching. For example, we could put similar effort into identifying who does not take up the three and four-year-old offer as we put into identifying who is not in post-16 education, employment or training.

  Q634  Paul Holmes: After the Victoria Climbié inquiry, an integrated children's system was set up. That computerised system was intended to ensure that all the different agencies could pick up on what was going on and talk to one another. There is now a lot of evidence on that issue. According to a University of Lancaster study, many social work practitioners said that 80% of their day was spent in front of a computer filling in tick boxes, rather than doing child protection work. Is that true?

  Colin Green: First, the integrated children's system is not a computer system: it is a practice system.

  Q635  Paul Holmes: It is not a computer system?

  Colin Green: Let me try to make this very important distinction. What the system integrated was the assessment framework, which is a very sound framework for assessing and understanding children's needs, and a set of records for looked-after children. That is what it integrated so that there was a whole end-to-end way—from a child being referred to social care, right through to their being looked after or having time in care—of assessing needs, planning for that child, looking at how to take forward implementation, and reviewing that, in a comprehensive set of records. That system was to be supported by electronic means, which is where the computer system comes in. I just want to make the distinction between the practice system describing how social care was to do the job and its implementation through ICT. I want to say three things about this. First, the ICT implementation has clearly been hugely problematic for many Local Authorities and their practitioners. The systems are clunky and difficult to operate and have a number of significant flaws. Secondly, the practice system is complex. There are issues about how far it is over-complex, but it essentially replicated the expectations set out in the Government guidance. When we drill down into some of the information requirements, particularly for children in care, which is where the greatest body of information is required, we can see that it is stuff that any parent should know, but because they are in public care we need to make a written record of all those dental appointments and the medical history that parents might carry around in their heads. That creates a significant administrative load. Those are two key distinctions. Thirdly, we need to distinguish between what is administration and what is proper, accurate recording that enables us to understand what is happening. We have heard about the importance of chronologies and of being able to look at events in a family over time, but we can only do that if we have a decent record.

  Chairman: It should not take 80% of your time.

  Colin Green: No, but I caution against saying that we do not need sophisticated recording systems for those very complex cases. My final point is that that came out[5] because the evidence from inquiries over the past 20 years showed that people were often unable to use their records to inform assessment and judgment in hearings, partly because they were faced with a four-volume-or-more paper file, often not very well kept, out of which they could extract very little detail.


  Q636 Paul Holmes: Before I put a question to Henrietta, I would like to mention that Professor Sue White of Lancaster University has reported that all the practitioners she interviewed expressed frustration at the amount of time they spend at the computer, claiming that the system regularly took up 80% of their day. The British Association of Social Workers issued a press release on 21 November in which it criticised the systemic obsession with inputting information into a database at the expense of time spent with children at risk.

  Henrietta Heawood: Exactly, and having to spend so much time using an unwieldy system is a very real concern for our members. You referred to Sue White's research, and she offered two arguments. Is it because the system is new and difficult to implement, or is it a design fault in the whole thing, and is it fit for purpose for child protection? We are just not sure. It is very time consuming, and glitches in software really frustrate people. I have heard stories of people inputting data into the system for an entire morning, only to discover that they were not able to save it, because the document was on a shared network system and was opened by an administrator who was doing some other work to it. Only the first person who opened the document could save anything. The social worker was not aware that it was a read-only version and did not realise that they were wasting an entire morning. That is an anecdote, but that is what it is like, and that is why people get so frustrated. The worry is that the system is in many ways a useful management tool because it gives managers all sorts of information about who is doing what, and is that really becoming the overriding intention, rather than developing a better understanding of the lives of children, which is what I thought it was originally meant for? It is not entirely bad if it is there to help support practice, analysis and assessment and bring things together. It is quite prescriptive, so different types of assessment in different parts of the country would perhaps disappear more if everyone were looking for the same things. However, social workers tell us that it is so prescriptive that they cannot think, because they do not have any space to use their professional judgement. They have to fill in those boxes all the time, and working out whether children have been to the dentist may not be what they should be doing. The IROs—Independent Reviewing Officers—also have to input data into those forms electronically. The social worker's line manager is meant to sign off the bits that have been done by the social worker, but that is not always done, because the line managers do not have time.

  Chairman: It looks as if you did not agree with all of that, Colin.

  Colin Green: I think that we have to be cautious about it and that there is a relationship between that and two other things. One is the development of the work force so that they understand the tools that they are using. I absolutely agree that we have been driven down a rather technical approach to practice, which gets translated into a tick-box approach rather than something that allows people to look at it as a tool to be used in their work with children and to pick and choose to some extent what to do within it. The second thing is that performance indicators are part of what is being collected. In a sense, the pressure on Local Authorities to collect that information and perform in relation to it can become over-dominant. The indicators, certainly in some areas, are not outcome-focused; they are about how well certain processes have been done.

  Q637  Paul Holmes: Christine Gilbert, the head of Ofsted, appeared before the Committee last Wednesday, and said that Ofsted had done a paper-based assessment of Haringey that said that it was an excellent council on children's services and all the rest of it. It turned out that that data was either a lie or filled in completely inaccurately; take your pick. Is that linked to the obsession with filling in tick boxes rather than looking after children?

  Colin Green: I do not know whether the Association of Directors of Children's Services or the Local Government Association commented. So much for Local Authorities rides on what can be quite fine gradations of performance on some indicators, so of course there is organisational pressure to perform in a particular way. They are only indicators—that is all they are. They do not tell you the outcomes for the children. They need to be used with care, not in a deterministic way, as a means of judging how Local Authorities are doing.

  Q638  Paul Holmes: I think that Henrietta said—it might have been you, Colin—that there were cases in which the social work manager had signed-off on something to say that it had been done when it had not been. Haringey had excellent paperwork saying what a great job was being done, but when the proper inquiry was done recently, it was a disaster area. It was the exact opposite of what the tick boxes said.

  Colin Green: In an ideal world—in the places where I have worked, we have tried to do this—if people do the right things to try to improve what they achieve for children and young people, their performance indicators should follow behind. What can happen under pressure is that they end up chasing the indicator, not focusing on the outcomes for children and young people.

  Henrietta Heawood: Something has gone wrong along the way. Performance management becomes the absolute thing to strive after, rather than quality assuring. The quality of the work being done is not in the boxes being ticked; it is in how well people have done it. Social workers must have enough emotional and physical space in their heads and lives, if they are to work with child abuse and difficult, dangerous families, to cope with the work. They do not want to be crying into their tea because they cannot cope with the computer. It sounds ridiculous, but that is how people feel—bullied and pressured to meet the targets—for the reasons that Colin gave. It is important that a Local Authority manages to meet its targets, and we are not unsympathetic to the position in which managers find themselves. They are stuck between a rock and a hard place. They want to support their staff but, equally, they have to try to meet the targets. That is very difficult. Social workers at the bottom are the people who have to produce the work and do the things that meet the targets. They also have to interact with families who neglect, abuse or sexually abuse their children. It is tough, demanding, emotional work. They need the space to do it, and they need good supervision, not supervision along the lines of "Have you done this or that within seven days?" Models for supervision are promoted by Tony Morrison, who is a wonderful child care expert. I do not know whether the Committee has heard from him, but he has developed a model for staff supervision when working in child abuse. He is a long-term ex-NSPCC person, and has developed a very good model for supervision that staff need.[6]

  Chairman: We would like to feed that into our inquiry.

  Q639  Mr Stuart: Following Haringey, the chief inspector said that she was writing to the chief executive of the council to ask them to promise further that they had reviewed the data and they were all accurate. However, you are saying that distortion of data is systemic and that, because of overwhelming pressure to meet the targets, people will at the very least tend to do it.

  Colin Green: I am not saying that. I am saying that what can be measured gets measured, and that is what we are performance-managed on. That, of course, affects the behaviour of the organisation. People do respond and complete honestly the returns that these are based on. However, the fact that they are so critical changes people's behaviour and the organisation's behaviour, because that is the message about what is important.


4   Note by witness: Whether or not a child is made subject of a child protection plan (in place of being put on what used to be the child protection register) is the result of a Case Conference. Back

5   Note by witness: The creation of an electronic record came about. Back

6   Note by witness: Relevant book by Tony Morrison: Staff Supervision in Social Care: Making a Real Difference for Staff and Service Users. Back


 
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