Examination of Witnesses (Questions 620-639)|
17 DECEMBER 2008
Q620 Chairman: So it was inter-agency?
You all got together to write this.
Colin Green: It was led by the
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
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 bruisehopefully
you canbut 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 togetherit
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
Henrietta Heawood: It is very
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
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.
It is likely that the core group will include the social worker
as the key professionalthe 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
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
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
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 workthis is what I am
working towards in Coventryis 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 onchanging 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
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
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 wayfrom a child being referred
to social care, right through to their being looked after or having
time in careof 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
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
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 IROsIndependent Reviewing
Officersalso 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 indicatorsthat 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
saidit might have been you, Colinthat 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 worldin
the places where I have worked, we have tried to do thisif
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 feelbullied and pressured to meet
the targetsfor 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.
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
Note by witness: The creation of an electronic record
came about. Back
Note by witness: Relevant book by Tony Morrison: Staff
Supervision in Social Care: Making a Real Difference for Staff
and Service Users. Back