Children first: the child protection system in England - Education Committee Contents


4  Thresholds for intervention

158. Whilst the local authority has overall responsibility for child protection, other agencies also have a duty of care, and will be involved in formal child protection intervention. The revised Working Together guidance makes very clear what responsibilities all the relevant agencies have, although serious concerns have been articulated regarding the lack of clarity in respect of child protection roles and duties on various health bodies in the new structures (see paragraphs 194 to 200 below).

159. Our inquiry has considered thresholds for intervention at two different levels under the Children Act 1989: (i) the threshold operated by local authority children's social care for acting on a section 17 referral which invokes the duty of the authority to "safeguard and promote the welfare of children who are in need within their area"; and (ii) the threshold operated by local authorities for acting on a section 47 enquiry where the duty invoked is to protect children who are suffering, or are likely to suffer, significant harm. We have also looked at the threshold for adoption which is discussed later in this chapter.

Are thresholds for intervention set at the right level?

160. Whilst witnesses told us that the section 47 child protection threshold is clear in law,[243] the interpretation of what constitutes 'significant harm' seems to depend on individual and collective judgements and inevitably varies as a consequence. The variation in the application of the threshold by different local authorities was highlighted by different witnesses,[244] and can be seen in the variation of the numbers and proportions of children being made subject to child protection plans in different areas.[245] There is even greater variation in section 17 child in need thresholds, since what is provided, and who is deemed eligible for the interventions and how they are assessed, is even more at the discretion of local authorities.

161. Witnesses told us that from their own observation the thresholds operated by local authorities varied widely.[246] Ofsted agreed that some thresholds were set too high and some too low.[247] John Goldup, was adamant that variation could not be accounted for just by local flexibility, but was "about a falling-off from an accepted standards of service delivery".[248] He explained that where a threshold was set too low "we will find social care services that are overwhelmed with large numbers of referrals, many of which could have been more appropriately dealt with through preventative and universal services working together".[249] Setting thresholds too high could result in some children failing to receive the help they needed, although once a referral is received, councils often pass them on to the family support services such as family centres.

162. The NSPCC reported "concerns that threshold levels can be driven by resource constraints and cuts in spending could place children at further risk".[250] Many others argued that the current financial pressures on local authorities were responsible for an increasing trend towards higher thresholds. A recent survey of 170 social workers by Community Care found 82% believed they were under pressure to reclassify child protection cases as less serious due to budget cuts, increases in referrals and a lack of social workers.[251] Elsewhere, Action for Children similarly found that 80% of social workers thought that "cuts to services will make it more difficult to intervene in cases of neglect".[252] In evidence prepared for us, BASW members also reported that "there is a risk that decisions about children's best interests are made on the basis of cost rather than what they need",[253] and front-line professionals and the Children's Society also supported the view that decisions on intervention were being determined by capacity and resources, rather than solely the needs of the child.[254]

163. Professor Munro noted in her progress report that "local authorities [...] are having to accommodate up to 28% reduction in their funding on average, but estimates of the cuts in children's services vary (ADCS, 2012). The evidence so far is that areas are making significant attempts to protect early and preventative children's services but do not think this can be maintained in the coming financial year because of the level of cuts."[255] In a recent survey 29% of councils suggested that children's services would make little or no contribution to planned savings. PriceWaterhouseCoopers, which conducted the survey, reports that "by far the biggest concern for both leaders and chief executives in terms of achieving their savings targets over the next few years is the challenge of increasing demand for services [...]. The fear for many is that, no matter the level of focus on transforming internal processes and operations, the sheer level of demand within the system (particularly in people-related services) will outweigh the savings that councils can secure in practice."[256]

164. We have seen no hard evidence to back the assertion that thresholds are altered in the light of financial resources or targets but anecdotal accounts suggest that this may have happened covertly and there are real fears that local authorities may be forced down this path. While the range of additional services on offer may be reduced in the current climate, we do not believe that it would be acceptable to anyone, including local authorities, not to offer protection to abused children because of budget constraints. As the NSPCC argued, "Threshold levels should not be about setting targets for children entering care or receiving help, but doing what is best for each individual child".[257]The Minister told us that "The experience of the last year is that despite the increased pressure from numbers, most local authorities have safeguarded their safeguarding budgets more than virtually any other part of their budget".[258] Professor Ward called for "monitoring of the impact of the current economic situation and the likely retraction of some services on the extent to which children are safeguarded from harm".[259] We acknowledge the strenuous efforts made by individual local authorities to minimise the impact of cuts on their child protection services but we are concerned that this position might prove difficult, if not impossible, to maintain as authorities are forced to find further savings in future years. We recommend that the Government commission work to monitor the impact of the current economic situation and cuts in local authority services on child-safeguarding.

165. We also recognise that there is a need for closer monitoring of how thresholds are being applied and any trends in variability over time and between different authorities. The NSPCC argued that there was a role for LCSBs to ensure that all relevant staff and agencies understand and consistently apply thresholds and to develop best practice by working to understand the drivers of variations in thresholds in their area and other comparable areas.[260] We think there is also a role here for the Government and Ofsted. We recommend that the Government commission research to understand the impact of varying thresholds in different areas, and whether thresholds for section 17 and section 47 interventions are too high and/or rising in some areas. The data should be published. Ofsted should also monitor and report on the variation between local authorities' provision and changes over time. LSCBs should use this data to ensure that any variation in their own area is justified by local circumstances.

166. In addition to a national picture of widely varying thresholds, we heard a great deal of evidence that thresholds were generally set too high, including from front-line professionals and even social workers. Research by Action for Children found that 42% of social workers and 23% of police officers said that the main barrier to intervention was that "the point at which they could intervene was too high".[261] This impression was supported in the oral evidence we heard from a GP, a teacher and a children's centre manager.[262] The teacher, Emma Grove, told us that "a child has to be at immediate risk of danger for it to be picked up".[263] BASW, representing social workers, received "all too frequent reports from our members that thresholds are too high and great efforts are made to avoid care".[264] Children England, the membership organisation for the children, young people and families voluntary sector, agreed, attributing a raising of thresholds to pressure on local authorities to cope with referrals to reduce the number of looked-after children.[265] The NSPCC told us that, though their overall referral action rate was quite high,[266] "we have serious concerns about how some local authorities respond to our referrals".[267]

167. Front-line professionals told us that they struggled to provide the kinds of evidence required by children's social care, even when they knew a family well and had well-founded concerns, and despite evidence that those in universal services are best placed to identify children in need early. Emma Grove told us "It just becomes intensely frustrating, having the evidence, to get to that point" when referrals are finally picked up by children's services.[268] She explained "we do not necessarily have the evidence that social care need and when they go out for a one-visit initial assessment and do some other background checks, if that information does not come up, they say there is no case to answer".[269] Her fellow panellist, Theresa Lane, agreed that there was "a bit of a mismatch" between the "huge amounts of information" gathered by schools and the evidence gathered in a single visit to the family by social workers.[270] She explained that "You have to be very clever with the language you use on the form actually to get them to notice".[271] The witnesses also agreed that it would help if those making referral were involved in decision-making about what action to take.[272]

168. The NSPCC told us that "thresholds into social care need to be such that social care providers are available to help in cases where the data might be quite soft and where the concerns might be, at present, unspecific".[273] Our discussions with children revealed several with experiences of front-line professionals' judgements on their behalf being initially turned down by children's social care.[274] Given that the police, health and education services are the biggest sources of referrals to children's services[275] and that these sectors generally have professionals who already act as filters for the concerns of others,[276] it is all the more worrying that too often 'soft' intelligence from front-line professionals such as teachers or GPs appears not to be used effectively, even when these professionals know a family well. Witnesses accepted that there had to be a system to prevent social care services from being inundated with referrals.[277] It may also be the case that in many of these cases social workers are better able to judge risk and correctly deem referrals not to require children's social care intervention. Nevertheless, the referrals process needs to be able to account for 'soft' intelligence, and get better at trusting the judgement of front-line professionals. Where possible, those making the referral should be involved in decision-making about what action to take.

169. The witnesses from schools also told us of their experience in having to make multiple referrals for the same child.[278] Local authorities confirmed in evidence to us that "a significant proportion [of referrals] are re-referrals"; in the case of Devon it was around 20-22% of referrals.[279] High rates of re-referrals in some areas suggest that children's social care may reject genuine cases, and such levels may also in themselves overwhelm the system. This is supported by academic analysis; for example the Child Welfare Research Unit at Lancaster University conducted an analysis of re-referral data which found that where multiple re-referrals were occurring, this led to ineffective intervention by children's social care, commonly as a result of systemic weakness in multi-agency, multi-provider working.[280] The research found that high re-referral rates were concentrated in children's social care teams with the most serious staffing deficits.[281]

170. It is self-evident that where referrals are dealt with properly the first time, demand overall will be lower because there will be fewer re-referrals and resources will be released to be used more effectively. Until recently re-referral rates were included in the national information dataset which all local authorities had to supply. At present there is no general monitoring of the rates of re-referrals, although Ofsted will ask for the information when inspecting individual authorities. We consider that this should be done in a more systematic way. We recommend that Ofsted monitor the re-referral rates in local authorities and make a judgment whether they are a sign of underlying systemic problems in particular areas.

171. A final concern on the part of frontline professionals was that their referrals were often rejected and that they heard nothing back. Again, this was reported by Action for Children as a message they had heard from teachers and health visitors[282] and was repeated in oral evidence by our panel of professionals.[283] The latter understood that it was in the procedures that the local authority should report back on each referral but called for action to ensure that it happens in practice on every occasion.[284] We did hear of one local authority piloting an automated response to referrals, which might be a useful model.[285] It is clearly good practice for those referring a child to receive a report on what action has been taken. We recommend that children's services initial response (or equivalent) teams be required by their LSCBs to feed back simply and quickly to the person making a referral on whether and what action is taken in response. Ofsted should consider whether local authorities are giving adequate feedback to referrers, as part of its investigations under the new inspection framework.

Common understanding of local thresholds

172. Evidence suggested that there was often poor mutual understanding of children's social care thresholds between agencies within the same area. The Ofsted 2009-10 report on thresholds concluded that, in well-performing authorities, thresholds were understood and "held in common" between agencies.[286] In contrast, the HMCI's Annual Report 2010-11 noted that, in poorly performing local authorities, "seven out of nine inadequate authorities lacked clear thresholds for referrals that were understood by partner agencies, leading to inappropriate referrals and additional pressure and work for social care professionals"..[287] The Local Government Group (comprising the LGA and five other agencies) agreed that "thresholds for intervention can sometimes be a cause of disagreement between agencies".[288]

173. The Local Government Group suggested that "multi-agency teams that bring together all the information about a family are one way that an increasing number of councils are adopting to address some of the challenges faced in making these decisions and that referrals are responded to in an appropriate way. This approach effectively acts as a triage system at an A&E department, and requires experienced staff to assess seriousness".[289] We also heard that, where agencies had co-located locally, joint thresholds were easier to negotiate, and regular intelligence-sharing discussions could be held to help determine which cases required intervention. On our visit to York, for instance, we heard how, following implementation of a new information-sharing model, referrals were being correctly determined at an earlier stage and those becoming child protection cases were fewer and more serious.

174. Other witnesses called for multi-agency training—particularly of GPs and social workers—to improve mutual understanding of thresholds. Dr Quirk accepted that "the lack of understanding about how the other works can cause some conflicts" and suggested this could be addressed "if, during our training, we spent an afternoon in each area—a social worker came and sat in on a surgery for half a day in their training and GPs sat in with a social worker for half a day as part of their training".[290] Nigel King, who has a police background in safeguarding children, also highlighted the need for staff in children's social care, police and health to have the appropriate multi-agency training as well as their own specialised training.[291] We note that Dr Alu of the RCPCH was enthusiastic about joint training but cautioned that "it should be at an appropriate level": pitching it right for one group might risk leaving a group at a lower or higher level disengaged.[292] An alternative approach, brought to our attention by Sue Woolmore, representing the Independent Chairs of the LCSBs, was focus groups "where they bring teachers together in a room with members of the [LCSB] or social workers and find out what life is really like".[293]

175. The Minister told us that he placed "great store by joint agency training" and cited "good examples of CPD centres around the country, where you can go and see a health visitor sitting next to a teacher, next to a GP, next to a social worker, next to a police officer, all being trained in safeguarding measures."[294] We commend greater use of multi-agency training, in particular for GPs, police, teachers and social workers, who were identified as having very different understandings of risk and thresholds. We also encourage LCSBs to take the initiative in finding further ways to enhance mutual understanding between those making referrals and social workers.

Information-sharing between agencies

176. Many agencies may hold information on a particular child or family which, when put together, creates a more accurate picture of the situation. A common theme in evidence, however, was poor information-sharing between agencies, particularly where health services were concerned.[295] GP Richard Quirk explained that the law enabled GPs to share information in child protection cases, but that many GPs were unconfident about the extent to which they could share information and were over-cautious:

A common complaint from social workers is that they are struggling to get information on children and families from the GP. The views of the surgeries are often that they have a duty to protect the confidential information of the patient and to release information would be a breach of trust with the patient. Recent documents from the General Medical Council and the medical defence unions encourage the surgery staff to act in the best interests of protecting the child from harm and therefore to release relevant information (preferably with consent from the child or parent) when appropriate. This message is still struggling to get through and more training of surgery staff is needed to help them recognise when and when not to release information to social workers and other professionals.[296]

177. The Medical Protection Society reported receiving "many queries from members regarding consent and confidentiality where there are child protection concerns".[297] The Society considered that the most common cause of difficulty was "an almost universal assumption by [other] agencies that they have an absolute right to access any [...] records in their entirety", even when only part of the notes is relevant.[298] This suggests that the picture is not as simple as one of over-cautious doctors. The RCPCH stressed that the lack of sharing was not intentional or done with "malice": "it is just that interpretation of balancing the two opposing concepts of confidentiality and information sharing differ between groups" and "interpreting the concept of 'relevant information' is incredibly difficult".[299]

178. The problem is not confined to the health sector. CEOP and ACPO representative, Peter Davies, explained that there could be similar "anxieties among [police]officers around sharing information during active investigations".[300] He recognised, however, that information could be held back unnecessarily "due to poor understanding of what can/cannot be shared" and "the added fear of contravening human rights or data protection laws". Mr Davies agreed that "there needs to be more clarity on information-sharing protocols".[301]

179. Representatives of local authorities pointed out that families and children expected all the agencies involved to have shared information and they identified a need for a "reminder of [the duty to safeguard and promote the child] and expectation of data-sharing".[302] Devon County Council argued for "a starting point of 'if in doubt, share' [which] would certainly redress the balance".[303] Jim Gamble, former head of CEOP, proposed an amendment to the Data Protection Act 1998 "to create a positive duty to actually share information when you believe a person might be at risk".[304] The RCPCH considered that this would be "a very radical solution" and warned that "without further thought it would be difficult to know whether it would be a proportionate response and one that embraces the complexities of the ethical dilemmas that professionals face when assessing whether to share information".[305]

180. It is vital that this problem is addressed. There may be a role for local authorities and LSCBs in clarifying to their partners what the requirements and limitations are around information-sharing. The Devon MASH model of using a 'virtual red box' around information is a useful way of promoting confidence amongst practitioners in information-sharing. Peter Davies also suggested that clarifying the protocols on information-sharing by the police could be taken forward as part of the response to the report by the Children's Commissioner.[306] The Minister told us that "there are not legislative grounds or even data-protection grounds for why data is not being shared".[307] The GMC has also recently concluded a review of its guidance to doctors on Protecting children and/or young people: the responsibilities of all doctors. New guidance was published in July 2012 to come into effect at the start of September.[308] However, this clarity has not necessarily filtered through to the front-line, most particularly to health practitioners but also to the police. We recommend that the Government ensure that the guidance for professionals in all the relevant agencies is absolutely clear about their statutory duties on data protection and data-sharing with regard to protecting children, and that LSCBs take a leading role in ensuring that this guidance is understood and acted upon in their areas.

181. The Medical Protection Society recommended better training in this area to ensure that professionals in other agencies understand what can be expected of doctors.[309] Dr Quirk made the similar suggestion that LSCBs "provide multi-agency training on confidentiality and information sharing so that there is a joint understanding across agencies of when it is appropriate to share information (with or without consent) to protect children from harm".[310] We consider that information-sharing would form an important component of the multi-agency training we call for (see paragraph 175) and that LSCBs should work together to develop and support the provision of such courses. The revised Working Together guidance should reinforce this.

Moving beyond thresholds

182. Academic experts drew our attention to the disjunction between the 10% of children thought to be living with abuse and the much smaller numbers that were accepted as referrals to children's social care. This left "all of these below-the-threshold agencies—teachers, GPs, health visitors—[...] working with child abuse, but they are not allowed to call it child abuse".[311] This is not just a matter of linguistics since it affects access to and availability of services. The sharp divide between those below the threshold for intervention and those above can also stigmatise parents in difficulty in a way that is counterproductive. Professor Munro told us: "Although we need to have a level of suspicion about serious abuse and neglect, we also need to know that most of the families are struggling with a problem which is perhaps poor parenting but is not at the level where we are wanting to turn to the law and compulsion. It is a real problem at the moment that too many families feel scared and that they will be harshly judged rather than helped".[312]

183. Those we spoke to who were responsible for making referrals agreed that more needed to be done to support those children whose cases did not meet the threshold for statutory intervention. GP Dr Richard Quirk commented that "there does not seem to be anything underneath the children's social care child protection system that then can provide support for that family locally"; and he called for further guidance for GPs "to know where to send a child and family next".[313] He considered that in a lot of these cases where children do not meet the threshold, all that was needed was extra support for the parents.[314] Emma Grove, a teacher, similarly identified a gap in provision before families were in crisis in the form of early intervention work by children's social care professionals, "working with schools, with everyone else".[315] A positive example of how this could be done involved groups of schools who were directly employing social workers as family intervention workers.[316]

184. It was implicit from other evidence that the concept of section 17 child in need 'thresholds' for receiving a service was not useful. Action for Children identified "a tendency for some children and families to 'bounce' in and out of services" with services "in place for a short time and then withdrawn when the urgency recedes".[317] Barnardo's also argued that "use of the term 'threshold' detracts from the reality that children often move across thresholds for intervention at different times. From our work we know that many children will need a greater level of intervention some times more than others, but they will always need a continuum of services".[318] Barnardo's reported that, to address this reality, "Some local areas have used the concept of stepping up or down, rather than a case being 'open' or closed'".[319]

185. An increasing number of local authorities are not using thresholds to determine whether or not a family received a service, but are integrating their structures and assessment processes to provide some kind of service to all children referred to them. We saw this for ourselves on our visits to York and Doncaster and heard similar messages from local authority witnesses. The Leeds DCS, Nigel Richardson, told us that he "struggled" with the term "thresholds" and that services in his authority had been reconfigured to provide a multi-agency response to "concerns about [...] children", whatever the level.[320] Similarly, the Strategic Director, People from Devon County Council argued that "thresholds can be very unhelpful to us" and that "key for me is the integration model, intervening earlier and getting people really working on the child and their family at an earlier point".[321] This new focus on outcomes and on a multi-agency, whole systems approach eliminated "the difficult conversation we have historically had about thresholds [...] because actually you are dealing with a child, the concerns and who is best placed to do what with an increased confidence in an area".[322]

186. We came across local authority children's social care services working with different models, but what many had in common was that they had co-located different agencies. These included MASH (multi agency safeguarding hub) arrangements in which the MASH operates as gatekeeper and all the agencies populate a MASH form with information from their records before taking a decision on action. The experience reported from this change and others like it, including the Integrated Pathway and Support Team in Tower Hamlets, was consistently positive. We were told that it had improved decision-making, developed joint understanding, and—critically—enabled an early conversation between professionals about the risk of a particular case. Both Leeds and Devon told us that staff working in these arrangements felt "a lot safer in their decision-making now" and that the "whole idea [...] is about putting confidence back in the professional safeguarding network".[323] Sharing intelligence between agencies in this way allows them to draw more effectively on the 'soft' intelligence discussed earlier. Rory McCallum of Devon County Council explained that "within the MASH, there is an unfettered information-sharing process that goes on, which allows us to pool all of that intelligence to make a more accurate and improved decision as to what that response needs to be".[324]

187. In Doncaster we visited a hub which had successfully included the police within the partnership. Devon County Council, which had done likewise, told us that one of the benefits of co-locating with the police was that it overcame some of the difficulties in information-sharing.[325] From the police perspective, Peter Davies of CEOP and ACPO described co-location as "best practice" as it "creates a strong foundation for better and more trusting relationships", although he cautioned that "co-location is not always necessary and effective information-sharing can be done virtually".[326] In oral evidence he spelled out the benefits in terms of comparing data, "a shared, understood way of assessing risk and a shared approach to the task", as well as "cultural benefits with agencies understanding each other better".[327] He emphasised that "Child protection is a collective, partnership-based, multi-agency endeavour. It cannot be done as a single agency".[328]

188. Ofsted endorsed the benefits of integrated, co-located, services, rather than children's social care operating as a 'gateway' to services.[329] It told us that "inspection has found that such arrangements can deliver better responses to children and young people at the early stages of trying to understand their needs and best next steps".[330] In oral evidence John Goldup explained that partnership working overcame the "siege mentality" which easily developed when child protection was "a discrete area of work, isolated from the wider range of services".[331] The Minister predicted that "I would expect to see a version of MASH operating in most local authorities around the country before long anyway, simply because it is the most effective way of getting those partners to work together quickly and efficiently".[332]

189. We were impressed by the evidence we saw of the change in attitude, coupled with a change in structures, which is leading some local authorities to abandon the concept of a threshold for services in favour of a more integrated model in which all children receive appropriate help: what was described to us as the "you never do nothing" principle.[333] York children's services operate a similar "no wrong door" policy which means that all cases are examined and offered support.[334] Early indications are that models where a front-door triage service is conducted by social workers in conversation with other partners, before any decision is taken on what action to take in response to a referral, is proving effective in directing referrals appropriately, reducing caseloads, and enabling some service to be offered to all children in need, at different levels.[335] This is not a silver bullet to solve all problems. Indeed, one of the consequences to emerge from the evaluation of the Devon model is that workloads for early help teams have increased and that a better range of services is needed at this preventative tier.[336] That, however, is not an argument against moving in this direction and we strongly encourage all local authorities to consider the merits of moving to multi-agency co-location models. For best practice, this should include co-location of local police child abuse teams with children's social care.

SECURING EARLY INTERVENTION FOR CHILDREN

190. For those children below the threshold for intervention, the CAF is intended to help professionals work together to identify additional needs of children and young people aged under 19. In some ways it has been successful. For example, one of its purposes was to introduce a common conceptual understanding and language around child assessment. Nevertheless, evidence to us suggested that the CAF is not being used consistently as it should be to secure early intervention for a child. Steve Walker from Leeds City Council told us:

One of the problems with CAF is that in many authorities it got very closely linked with thresholds. The way that you evidenced that a family needed a service from children's care was to complete a CAF in a particular way. The other thing that happened was that, rather than becoming a tool that facilitated a discussion and assessment around a child and family, it became a mechanism by which I on my own can fill something in and send it in as a referral to see whether I get a better response than sending in a letter or making a phone call. [337]

Front-line professionals concurred that in practice the CAF was being filled in by each professional separately with the result that it was not being used as a single assessment form;[338] and that it was not being used as an assessment tool necessarily but in order to make a referral.[339] In addition, it is not universal practice to use it: Dr Quirk admitted that "the majority of GPs in England would not know what the CAF stood for and do not use it".[340]

191. The Munro Review proposed a new duty on local authorities and statutory partners be introduced to "secure the sufficient provision of local early help services for children, young people and families". Munro recommended that this duty should:

  • specify the range of professional help available to local children, young people and families, through statutory, voluntary and community services, against the local profile of need set out in the local Joint Strategic Needs Analysis (JSNA);
  • specify how they will identify children who are suffering or who are likely to suffer significant harm, including the availability of social work expertise to all professionals working with children, young people and families who are not being supported by children's social care services and specify the training available locally to support professionals working at the frontline of universal services;
  • set out the local resourcing of the early help services for children, young people and families; and, most importantly;
  • lead to the identification of the early help that is needed by a particular child and their family, and to the provision of an "early help offer" where their needs do not meet the criteria for receiving children's social care services.[341]

The Government rejected this recommendation, stating in response to a parliamentary question that "We have engaged with partners in ADCS, health, police and education and have concluded that we do not need a new statutory duty to deliver early help and that there is sufficient existing legislation to realise Professor Munro's recommendation".[342]

192. Enver Solomon from The Children's Society told us that the Government's decision represented "a missed opportunity" and that "services will not always come in early to avoid cases reaching crisis point will not happen in the way that the Government collectively and all those working in this area would like to see".[343] He was supported in this by Dr Shade Alu of the RCPCH,[344] and we heard a similar plea from the LSCB Independent Chair in Tower Hamlets for policy clarity from Government about what they expected authorities to provide by way of 'early help'.[345] In oral evidence, Rory McCallum from Devon County Council argued that "an early help duty would have been beneficial in allowing a bit of leverage in the system to bring people around the table for that cohort of troubled families" who are neither on child protection plans nor consenting to work with professionals through the Common Assessment Framework model.[346] On the other hand, his counterpart from Leeds did not consider that he needed an additional duty to ensure that his authority continued with the early help which was already under way.[347]

193. The Minister told us that a further duty was unnecessary, given the "duties on all partner agencies to co-operate to improve children's well-being under section 10 of the Children Act 2004", but he agreed that "certain partners need to take their interpretation of that duty rather more seriously than some have".[348] He considered that the "LSCBs are one of the means of making sure that everybody is stepping up to the mark".[349] We believe that it would help to incentivise the provision of a service to all children in need and clarify its priority emphasis on early intervention in an increasingly crowded policy field if there were a statutory duty of an 'offer of early help', as recommended in the Munro Review. We recommend that the Government reconsider its rejection of the need for a statutory duty to secure the provision of early help by a range of partner agencies.

Child protection and health reforms

194. During the course of our inquiry, fears were expressed from different quarters, including health agencies, about how child protection structures will operate under NHS reforms. In a letter to the medical journal The Lancet in February 2012 calling for changes to the health and social care bill, 150 paediatricians, backed by the RCPCH, expressed concern that the reforms would adversely impact child protection. It stated that:

Safeguarding of children will become even more difficult when services are put out to competitive tender and organisations compete instead of cooperate. Children who are vulnerable, neglected, or abused will inevitably slip through the net.[350]

195. The RCPCH told us that practitioners reported a diminution of numbers of designated leads: for instance, one individual was covering two named doctor and one designated doctor posts.[351] The Designated Professionals' Network wrote that designated leads were being required to cover both child and adult safeguarding.[352] Others, including witness Dr Richard Quirk and the NHS Confederation, cited similar concerns about restructuring.[353] The LSCB Chairs also raised questions about how the new Health and Wellbeing Boards will oversee reforms to child protection and how the boards will relate to LSCBs.[354]

196. In oral evidence in May this year, Dr Alu of the RCPCH told us that she and colleagues remained concerned about the health reforms. Asked whether there had by then been clear guidance from the Department of Health as to where child protection would sit in the new health landscape, she replied "a brief answer: no". Dr Alu called for the introduction of a statutory duty of early help on health agencies because "if things are not in statute, certainly from a health point of view [...] a lot of the time those things do not happen."[355]

197. Professor Munro's 2011 Report recommended that "Government should work collaboratively with the Royal College of Paediatrics and Child Health, the Royal College of General Practitioners, local authorities and others to research the impact of health reorganisation on effective partnership arrangements and the ability to provide effective help for children who are suffering, or likely to suffer, significant harm".[356] The Government accepted this in principle, but said it wanted to "go further and establish a co-produced work programme, to ensure continued improvement and the development of effective arrangements to safeguard and promote children's welfare as central considerations of the health reforms".[357] Despite this, Munro's 'One Year On' review expressed similar concerns. It explained that "there are also concerns that the reduced guidance in Working Together to Safeguard Children happening at the same time as the radical reform of the health service may lead to a loss of attention being paid to safeguarding children in the health sector".[358]

198. In our final evidence session the Minister pointed to recent changes that had been made to clarify the position, including in the revised draft Working Together statutory guidance. He told us that these added up to "a whole series of conditions at the heart of the health reforms that must be complied with, and that have safeguarding stamped all over them".[359] He also saw the new Health and Wellbeing Boards as presenting a "really exciting opportunity" to bring different agencies together to make "sure dangerous behaviours can be avoided, that young families are safe and have the parenting skills, and that we are promoting public health measures on a local basis".[360]

199. We welcome the reassurance offered by the Minister about the impact of the Government's health reforms upon child protection but all the evidence to us strongly suggests that more needs to be done to provide clarity and shore up confidence. There is a real and urgent fear amongst health professionals in child protection and their partners about the place and priority of child protection in the reformed NHS. The Department of Health urgently needs to clarify where and how safeguarding and child protection accountabilities will work under the new structures, in particular in the new clinical commissioning groups and Health and Wellbeing Boards, and how these bodies will relate to LSCBs. It should also confirm its continuing commitment to the role of named and designated doctors and nurses for child protection.

200. To ensure that priority is given to the child protection in the new structures and to provide a point of contact with the LCSBs, we recommend that one of the chairs of the Health and Wellbeing Boards be nominated as a national lead on safeguarding children.

Thresholds for removing a child to care

201. Figures as set out earlier in this report (see paragraphs 37 to 39) show an upward trend in the number of children being taken into care over recent years. It should be noted, however, that the numbers are not unusually high when looked at from a historical perspective—for example, taking into account population size, in 1980 care numbers in England were about a third higher than now at 95,000 (78 per 10,000 under 18) compared with 65,520 in 2011 (58 per 10,000).[361]

202. Part of the recent increase in the number of care applications may be the impact of the 2009 Southwark judgement (which made local authorities responsible for providing accommodation and support to homeless 16 and 17 year olds). However, the single most important factor is likely to be the response to the death of Baby P (Peter Connelly) in 2008. There is clear evidence that levels of Section 31 applications made by English local authorities rose in the wake of the publicity around this case. Research by Cafcass identified a "sharp increase" of 37% across England during the three weeks immediately following publication of the Serious Case Review in November 2008.[362] However, Section 31 applications had already begun to rise in the period from July to September 2008, as seen in the following chart.

Figure 1: Total number of Section 31 applications in England, April 2007 to December 2009

203. Research by NFER for the Local Government Association concluded that by heightening public and professionals' sensitivity to child protection issues, the Peter Connelly case may have led to improvements in detection and reporting of neglect and abuse. The NFER also suggested that changes in demography and in parenting capacity might have further contributed to the trend; respondents to their survey drew attention to the potential for economic recession to increase stress on families. The view of most research participants was that the present level of Section 31 applications will be sustained in the future.

204. It has been suggested that, in the wake of cases like Baby Peter, local authorities and social workers have become more risk-averse and lowered their thresholds for taking children into care. John Hemming MP described the trauma caused by taking children into care.[363] Other submissions also claimed that children are too readily taken from their families. Campaigning group Parents Against Injustice (PAIN) estimated that between 10% and 20% of cases where children are removed from their families are false positives where innocent families are subjected to unwarranted intervention.[364] Journalist Florence Bellone suggested that "if the social workers come just before the weekly shopping and open an almost empty refrigerator, they write that the family is starving the children".[365] This is contradicted by a survey conducted by Cafcass of Children's Guardians which found that the majority considered the commencement of care orders in those cases to have been appropriately timed, and that local authorities had not lowered their thresholds of concern at which applications were made.[366]

205. On the other hand, there is a growing body of evidence to suggest that thresholds need to be lower. Witnesses from the courts found little or no evidence of inappropriate removal of children and many instances where earlier removal would have been appropriate.[367] This is backed by academic research: Professor Ward noted that "there is substantial evidence that many children remain for too long with or are returned to abusive and neglectful families with insufficient support". [368]

206. A brake on the number of children taken into care could be the widespread belief that care damages children. Professor Ward told us of "a great fear of taking children into care; there has been a lot of adverse publicity about the care system, even, though, in fact, the evidence suggests that maltreated children do better in care than if they remain at home or return to their families and continue to be maltreated".[369] Research evidence is clear that care is not of itself damaging,[370] but that consistently poorer outcomes for children in care are more likely due to the conditions and damage done to those children before care. The NSPCC argued that "studies show that outcomes for looked after children are often better than for those who remain in damaging family situations; there is thus a need to tackle the widely held belief that care is damaging to children".[371]

207. Permanence and stability are recognised as the key factors in success for children in care. Sadly, in evidence to us Professor Biehal cited research which shows that delay in removing children who could not be safely supported at home reduced the chance that they would find a stable placement. Late admission to care was also significantly associated with poorer outcomes for the children.[372] Other studies have confirmed the importance of timing when children are separated from their families: Professor Ward's recent work showed that intervening early was critical to a child's long-term success.[373] The 2010 Loughborough study found that "the main causes of delay were an almost universal expectation that children would be able to remain with their birth parents".[374] Whilst parental capacity to change is key to decisions about a child's long-term care, the evidence is that some parents could not change even if they wanted to.[375] A study by Professor Elaine Farmer at the Centre for Family Policy and Child Welfare at Bristol University found that in almost half the cases where children returned home from care, particularly over the age of 10, they were neglected or abused during the return.[376] Martin Narey described this research as "compelling", and concluded "This is not a system that is being reckless about taking children into care. It is a system that is too optimistic about the capacity to improve".[377]

208. The balance of evidence is heavily in favour of care being considered as a viable, positive option at an earlier stage for many children. In this context, we note with concern suggestions that local authority thresholds for removing children to care are too variable. Enver Solomon of the Children's Society claimed that "in terms of entry into care, you can talk about more than 150 different approaches to thresholds rather than consistency".[378] Some variation in the number and proportion of looked-after children is inevitable given the very different circumstances in which local authorities work but we recognise that this variability in itself might feed into suspicions that the threshold for intervention is too low and that local authorities are interpreting the law as they choose. We welcome the research by Cafcass into applications for care orders and recommend that this work be repeated on a regular basis. An assessment of the reasons behind the local variability in care applications is needed. We also believe that it is essential to promote a more positive picture of care to young people and to the public in general. The young people to whom we spoke were generally very positive about their experiences, including those who had spent time in children's homes. This is backed by academic research on outcomes. Ministers should encourage public awareness of the fact that being taken into care can be of great benefit to children.

Thresholds for adoption

209. Adoption has been the subject of much recent professional and policy debate, with Martin Narey and others calling for greater, and earlier, use of adoption. The Government has also brought forward proposals for increasing the number of adoptions, in part by speeding up the associated court processes.[379] Supporters of the Government's policies have argued that adoption should be seen as a more positive option. For example, Martin Narey told us "Adoption is only ever for a minority of children in care, but for those for whom it is appropriate it can be transformational [... and it can] give a neglected child the sort of upbringing that we like to think we gave our kids".[380]

210. There are some who strongly oppose this view. For example, John Hemming MP argued that "the child protection system in England is particularly obsessed with adoption", and that Government provides perverse financial targets for increasing the number of adoptions. Mr Hemming told us that children are "being removed at birth for inadequate causes".[381] He estimates that there are "around 1,000 a year" instances of "forced adoption", defined as "adoption where the parents' consent is dispensed with, or "wrongful adoption".[382] He argued that the thresholds for taking children into care were inconsistent and also inconsistently applied:

For example, section 38 of the Children Act on interim care orders allows a child to be taken into care if there is a belief, not necessarily that there is evidence. The interim care order threshold is much lower than the final care order threshold, and frequently during care proceedings the threshold changes from the start to the end of the proceeding.[383]

211. We received a number of other submissions, often from individual parents or relatives or those representing them, which also alleged that children were being (routinely) removed from their families for negligible and unjust reasons. Many of these told us their very difficult personal stories. We are grateful to them for sharing these experiences in order to assist our inquiry.

212. The majority of academic and other witnesses who commented on this issue reported that there was no evidence to support the belief that "forced adoption" was widespread. For example, Professor Ward told us that she had not come across the issue of forced adoption "in any of the research that we have undertaken on babies in the care system, on very young children likely to suffer significant harm. I am not aware that it has come across on the Adoption Research Initiative either".[384] The Children's Society concurred.[385] It was accepted by both these witnesses and by Martin Narey that there were occasional instances of injustice.[386] Mr Narey estimated that "the proportion would be tiny—1% or 2%", but he considered that "it would be wrong of me to say that there are none that are inappropriate".[387]

213. Witnesses agreed that even if the Government achieves its aim of increasing the number of adopted children, this would only ever affect a small proportion of children in care. Professor June Thoburn told us that "the scope for increasing adoption as a route out of care is limited", and she pointed out that the UK already places more children from care with new parents (not relatives) than is the case for any other country.[388] In particular, adoption is unlikely to be an appropriate or viable option for older children, sibling groups or those who do not want to be adopted.[389] The vast majority of such children will always be in foster placements and will not be adopted.[390]

214. The Adolescent and Children's Trust (TACT) emphasised that "the most effective way of protecting children in care and developing resilience is by seeking permanence whenever possible" and that long-term foster care may be the best option for older children, especially if they have siblings and other extended families with whom they wish to maintain a relationship.[391] Special Guardianships and residential care were also presented as good options for some children, again particularly for older children.[392] Anthony Douglas from Cafcass told us that special guardianship has been "enormously successful" in giving "certainty to children over where they live until they are 18 and [...] certainty to carers that they can make their own decisions about parenting".[393] John Hemming told us that, based on official statistics, "Permanence has gone up in the last few years each year, it is just that SGCs and residency orders have gone up, whereas adoption has gone down".[394] Witnesses stressed that the value of these alternatives should not be lost in the focus of debate upon adoption and that the quality, stability and availability of these placements needed to be addressed.[395]

215. The importance of permanence and stability is underlined by the shocking evidence we received of the number of times some children move in the course of their time in care. It is clearly damaging to children to move from one form of care to another frequently; and yet we spoke to children who had moved multiple times—in one case up to 16. Martin Narey told us that he had "met countless children who have had 24 or 25 foster placements and 21 or 22 different schools".[396] He added: "We would never dream of doing this to our children and for some children the very best option for them is [...] high quality residential care".[397]

216. We endorse the Government's current policy emphasis on increasing the number of children adopted, speeding up the process and facilitating foster-to-adopt arrangements. Adoption is clearly the preferred route to permanence and stability for some children. However, the same goal can be achieved by other means and it is vital that the Government and those in local authorities continue to concentrate effort and resources on prioritising stability in placements for all children, whether through long-term fostering, Special Guardianship or residential care. We would welcome greater debate on policies which might bring this about and greater encouragement from Government for these alternative solutions. In particular, while we recognise that an artificial limit on the number of times a child can be moved within the system would be unworkable, there should be increased emphasis in central guidance aimed at limiting the disruption and damage caused to vulnerable children by frequent changes.

217. We have listened with sympathy to concerns about widespread 'forced adoption', and to the very personal and moving stories that often lay behind them. It is evident that there are rogue misjudged cases with terrible consequences for those involved. This should not happen and those affected are right to fight against such injustice. Nevertheless, the weight of research evidence, matched by evidence to our inquiry, concluded that that the balance tended to lie with authorities not taking children into care or adoption early enough, rather than removing children from their parents without due cause. We note that the Minister spoke of "work in progress" to look at "what further safeguards we might be able to institute whereby there is a sort of appeals mechanism".[398] This would have to be balanced against the further delay to a permanent solution for the child which would inevitably occur as a result.[399] An appeals mechanism against "forced" adoption is an interesting idea and we look forward to examining the Minister's proposals when they are published.


243   See for example, Q465 [Enver Solomon] Back

244   See for example Q1 [John Goldup], Q464 [Phillip Noyes] Back

245   Department for Education, Characteristics of children in need 2011-12: Statistical First Release (October 2012) Back

246   For example, Ev 218 [Barnardo's], Ev 238 [Professor Ward] Back

247   Q39 [John Goldup] Back

248   Q1; Q24  Back

249   Q39 Back

250   Ibid Back

251   Community Care (2011), "Social workers forced to leave children in danger as cuts hit child protection", http://www.communitycare.co.uk/static-pages/articles/child-protection-thresholds-survey/ Back

252   Supplementary evidence from Action for Children Back

253   Supplementary evidence from Action for Children Back

254   Ev 238 [TCS]; Qq142-3 Back

255   Munro progress report, paragraph 3.14 Back

256   http://www.pwc.co.uk/government-public-sector/publications/the-local-state-we-are-in.jhtml  Back

257   Ibid Back

258   Q791 [Tim Loughton] Back

259   Q53 Back

260   Ev 221 Back

261   CP62A Back

262   Qq107, 143 Back

263   Q143 [Emma Grove] Back

264   Supplementary evidence from BASW, para 27 Back

265   Ev 82 Back

266   Qq 210-11 Back

267   Q214 Back

268   Q143 [Emma Grove] Back

269   Q147 Back

270   Q146 Back

271   Q144 [Theresa Lane] Back

272   Q183-4 [Emma Grove] Back

273   Q422 Back

274   See Annex 6 Back

275   Q522 [jennie Stephens] Back

276   Q181 [Theresa Lane] Back

277   Q 178 [Emma Grove] Back

278   Q141  Back

279   Qq 548, 551 [Rory McCallum] Back

280   Ev 52 (Lancaster University)  Back

281   Ibid Back

282   Supplementary Evidence from Action for Children, p3 Back

283   Q105 [Theresa Lane]; Q144 [Dr Quirk]; Qq157-8 Back

284   Q159 [Emma Grove] Back

285   See Annex 3 Back

286   Ofsted, Annual Report of Her Majesty's Chief Inspector of Education, Children's Services and Skills 2009/10, HC 559, Session 2010-12, p176  Back

287   Ofsted, Annual Report of Her Majesty's Chief Inspector of Education, Children's Services and Skills 2010/11, HC 1633, Session 2010-12 pp.144-145 Back

288   Ev w100 [Local Government Group] Back

289   Ev w100 Back

290   Q173 Back

291   Ev w3 Back

292   Q689 [Dr Shade Alu} Back

293   Q596 Back

294   Q826 [Tim Loughton] Back

295   Ev w124 Back

296   Ev w7 Back

297   Ev w12 Back

298   Ev w12 Back

299   Ibid Back

300   Ev 228 Back

301   Ev 228 Back

302   Q519 [Nigel Richardson] Back

303   Ev 212 Back

304   Q34 Back

305   Ev 225 Back

306   Ev 228 Back

307   Q843 [Tim Loughton] Back

308   http://www.gmc-uk.org/guidance/news_consultation/8411.asp Back

309   Ev w13 Back

310   Ev w7 Back

311   Q55 [Dr Brandon] Back

312   Q745 [Professor Munro] Back

313   Qq 109, 108 Back

314   Q110 Back

315   Q114 Back

316   Q137[Theresa Lane]; information gathered on visit to York  Back

317   Supplementary evidence from Action for Children Back

318   Ev 182 [Barnardo's] Back

319   Supplementary evidence from Action for Children Back

320   Q523 Back

321   Q526 [Jennie Stephens] Back

322   Q527 [Nigel Richardson] Back

323   Q511 [Rory McCallum]; Q514 [Nigel Richardson], Back

324   Q504 Back

325   Q518 [Rory McCallum] Back

326   Ev 227 Back

327   Q642 [Peter Davies] Back

328   Ibid Back

329   Ev 176 [Ofsted] Back

330   Ibid Back

331   Q2 Back

332   Q842 [Tim Loughton] Back

333   Q514 [Nigel Richardson] Back

334   See Annex 4 Back

335   NFER (2011), Devon multi-agency safeguarding hub; a case study report, http://www.nfer.ac.uk/nfer/publications/LGMX01/LGMX0.pdf Back

336   Ibid Back

337   Q538 [Steve Walker] Back

338   Q117 [Theresa Lane] Back

339   Q118 [Emma Grove] Back

340   Q119 [Dr Quirk] Back

341   Munro (2011), Munro review of child protection: final report, a child-centred system, Recommendation 10 Back

342   Written PQ, Tuesday 13 December: http://www.education.gov.uk/munroreview/downloads/PQ.pdf  Back

343   Q432 Back

344   Q701 [Dr Shade Alu] Back

345   See Annex 3 Back

346   Q530 Back

347   Q532 [Nigel Richardson] Back

348   Q827 [Tim Loughton] Back

349   Ibid Back

350   http://offlinehbpl.hbpl.co.uk/NewsAttachments/PYC/lancet.pdf Back

351   Ev w195-6 Back

352   Ev w172 Back

353   Ev w7-8; Ev w163 Back

354   Q599  Back

355   Q701 Back

356   Munro Review, Recommendation 8 Back

357   Government Response to the Munro Review, p.18 Back

358   Munro Progress Report, p11 Back

359   Q825 [Tim Loughton] Back

360   Q826 [Tim Loughton] Back

361   Cliffe, D. With Berridge, D. [1991], Closing Children's Homes: An End to Residential Childcare?, London: National Children's Bureau, Chapter 1 Back

362   CAFCASS, The Baby Peter effect and the increase in x31 care order applications. Available at; http://www.cafcass.gov.uk/pdf/Baby%20peter%20summary%20report%20FINAL%202%20Dec.pdf  Back

363   Q342 Back

364   Ev w75 Back

365   Ev w30  Back

366   Ibid Back

367   See for example Q754 [Judge Crichton] Back

368   Ev 179 Back

369   Q104 [Professor Ward] Back

370   Q 341 [Martin Narey]; Ev 200 [NSPCC] Back

371   Ev 200 Back

372   Ev 204, citing Biehal, Ellison, Bakes et al 2010 Back

373   Ward H., Brown, R., Westlake, D., Munro, E. R., Infants suffering, or likely to suffer, significant harm: A prospective longitudinal study Back

374   Ibid, Infants suffering, or likely to suffer, significant harm, p.4 Back

375   Q84 Back

376   Farmer, E R G (2009). "Reunification with birth families", Schofield, G and Simmonds, J (Eds.) The child

placement handbook. London, BAAF, cited in Ev w 106. Back

377   Q410 [Martin Narey] Back

378   Q434  Back

379   Final Report; An Action Plan for Adoption (2012), Department for Education Back

380   Ev 164 Back

381   CP01 Back

382   Qq370, 371 Back

383   Q339 Back

384   Q81 Back

385   Q485 Back

386   Q81 [Professor Ward]; Q485 [Enver Solomon];  Back

387   Q377 Back

388   Ev w102 Back

389   Ibid Back

390   Q 487 [Enver Solomon] Back

391   Ev w203 Back

392   See for example Qq353, 356 {Martin Narey] Back

393   Q780 [Anthony Douglas] Back

394   Q348 [John Hemming] Back

395   Q487 [Enver Solomon and Kate Wallace] Back

396   Q356 Back

397   Ibid Back

398   Q793 Back

399   Ibid Back


 
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Prepared 7 November 2012