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 trainingparticularly
of GPs and social workersto 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 areaa 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
agenciesteachers, 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,
andcriticallyenabled 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 perspectivefor 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 tiny1%
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 timesin 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
|