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Committee for Health, Social
Inquiry into Child Protection Services in
Ordered by the Committee for Health, Social Services
and Public Safety to be printed 9th October 2002
WRITTEN SUBMISSION BY:
The Trust's Evidence will be presented under the following headings which reflect the topics outlined in the Committee Clerk's letter of 20 June 2002 and the Terms of Reference of the Inquiry as agreed on 22 May 2002.
These headings are:
2.†††††††† Case Work
5.†††††††† Workforce Issues
6.†††††††† Lessons Learned
7.†††††††† Roles and Responsibilities
8.†††††††† Commissioner for Children
9.†††††††† Child Protection Register
10.††††††† Legislative Context
11.††††††† Resources Available
12.††††††† Current Guidance
13.††††††† General Comments
The key issues identified in the Trust's evidence are as follows:
The Trust includes the highest number of children aged 0-19 of any Trust in the Eastern Health and Social Services Board area. The Trust embarked on an extensive consultation programme within the Trust the results of which are reflected in this evidence.
2.†††††††† Case Work
There is a conflict between maintaining the necessary records and dealing with operational issues. The importance of having experienced and well trained staff is emphasised and the new assessment framework which is being piloted is welcomed.
Communication on an inter-disciplinary and inter-agency basis has been highlighted in almost every case management review. There is a need to emphasise the Child Protection role of agencies other than the Trust and for them to accord Child Protection appropriate priority.
Linkages with parents/carers and children are necessary for legislative, ethical and practical reasons. Participation by the community in Child Protection is the vital ingredient and as much information as possible should be shared with parents/carers and children.
5.†††††††† Workforce Issues
Ideally staff who work together on a multi-disciplinary basis should train together. Supervision is an important aspect of Child Protection work and training needs and difficulties in the recruitment and retention of staff are adding to workforce pressures.
6.†††††††† Lessons Learned
The most striking feature of case management reviews over the past 30 years has been similarity of their recommendations. The focus should be on improving systems rather than on allocating blame.
7.†††††††† Roles and Responsibilities
The Trust has the major statutory responsibility for Child Protection due to the delegation of statutory functions to the Trust. The full participation of other relevant statutory and voluntary organisations in the Child Protection Process is vital for its effective application.
8.†††††††† Commissioner for Children
The Trust welcomes the proposals and hopes that the appointment will focus attention on the needs of children.
9.†††††††† Child Protection Register
The Trust's child protection register is consulted infrequently. IT now enables Trusts' Child Protection registers to be consulted on a regional rather than a Trust specific basis.
10.††††††† Legislative Context
The Children Order and the wide range of associated Guidance, Regulations and circulars are the main legislative context for the Trust. These have created many additional duties and expectations. The view of many staff is that the threshold for statutory intervention is too high.
11.††††††† Resources Available
The Trust is concerned that Child Protection does not appear to be a priority for resource allocation. Many additional requirements and new duties have not attracted additional funds.
12.††††††† Current Guidance
We await the publication of "Co-operating to Safeguard Children" which has been in final draft form for over a year. The final draft contains some flaws and omissions which we would like to see being addressed.
13.††††††† General Comments
We welcome the attention being paid by the Committee to this subject and would be happy to give oral evidence if required.
Down Lisburn Trust welcomes the opportunity to submit evidence to the Committee for Health, Social Services and Public Safety of the Northern Ireland Assembly. The Trust delivers a wide range of Health and Social Services to the population of the Down and Lisburn council areas. The annual budget of the Trust is £110 million and the Trust employs 4000 staff (2,400 WTE). The population of the Trust is approximately 170,000 and this includes the highest number of children aged 0-19 years in each age band and in total of any Trust in the Eastern Health and Social Services Board area. These figures are shown in tabular form as follows:
There are 152 children on the Trust's Child Protection Register and there are about 85 additions to, and deletions from, the register per annum.
In preparation for the Trust's evidence to the Committee's Inquiry the Trust held a series of consultation meetings throughout the Trust for all disciplines and grades of staff involved in Child Protection work in the Trust. These meetings were attended by a representative cross section of staff and resulted in detailed discussion on many aspects of the Child Protection services. Trust staff who were unable to attend these meetings also made a number of written submissions. We are confident therefore that the Trust's submission to the Inquiry reflects the views of a wide range of grades of staff and of disciplines throughout the Trust.
We have noted that the Trust is specifically mentioned in the letter from the Committee Clerk inviting evidence to the Committee because of the fact that the most recent high profile child death occurred in this Trust. We do not believe that any of the comments in this evidence are unique to the tragic death of baby Jasmine and they should not be read in that particular context. A Case Management Review report on this death has already been submitted to the Department of Health, Social Services and Public Safety as required by the regulations.
As outlined in the Terms of Reference of the Inquiry into Child Protection Services in Northern Ireland and in the letter of 20 June 2002 from the Committee Clerk, the Trust's response will be structured under the following headings:
2.†††† Case Work
5.†††† Workforce Issues
6.†††† Lessons learned
7.†††† Roles and Responsibilities
8.†††† Commissioner for Children
9.†††† Child Protection Register
10.†† Legislative Context
11.†† Resources available
12.†† Current Guidance
13.†† General Comments
2.†††††††† CASE WORK
2.1††††††† Case Recording -
Child Protection cases are subject to detailed case recording by all disciplines involved. Professionals involved in the case are expected to provide a detailed report to Case Conferences whether or not they attend. Their day to day involvement is also required to be recorded in detail and minutes are also taken of the proceedings of case conferences. In addition to maintaining case files there is also an emphasis on maintaining details of cases on IT systems which can provide information regarding individual cases and for statistical returns which are required by the Department of Health, Social Services and Public Safety, the Area Board, the Trust and for research purposes.
Families in which there are Child Protection issues frequently move, often across Trust Boundaries. In these circumstances detailed and up to date case records are particularly important as are robust case transfer procedures.
Increased emphasis on case recording, on Data Protection issues and on access to records while entirely justified creates difficulties for Trust staff. Frontline staff face conflicting pressures to maintain their work on a face to face basis with clients while at the same time meeting the increasing requirements to maintain comprehensive manuscript and IT records and there are considerable pressures on administrative staff to provide the clerical and administrative support required. There are occasions when because of pressures on professional and adminis≠trative staff case recording and reports are not as comprehensive or up to date as they or the Trust would require.
2.2††††††† Professional Judgement
Professional judgement is one of the key skills in child protection. It is particularly important in the decision making at the time of receipt of a referral when an initial judgement has to be made as to whether a particular case should be dealt with within the Child Protection procedures or whether the children in need procedures will be applied. The multi-agency assessment framework based on the Department of Health assessment framework (2000) which is currently being piloted is welcomed by the Trust and we believe that this will assist considerably in this area of professional judgement. The Trust also commissioned and funded a major research project " Constructing Child Abuse - Patterns and Possibilities" Spratt (1998) which has also had a major influence on professional judgement about the level of response to referrals within the Trust.
Considerable professional judgement is also required in relation to the decision to place a child on, or remove a child from, the Trust's Child Protection Register. While children on the Child Protection Register are provided with a high level of co-ordinated multi-disciplinary support there is also an increasing emphasis on the provision to those who, while having a high level of need, have not crossed the threshold for inclusion on the Child Protection Register. The key requirements in exercising sound professional judgement are the training, experience and expertise of the key staff involved, access to all relevant information on the particular case and on the issues involved and knowledge of the duties and responsibilities of all the staff involved. In cases where professional judgement is flawed it is often because one of these key components is missing.
2.3††††††† Assessment and Analysis of Information
As outlined earlier, professional judgement is based on the quality and quantity of information available. This underlines the importance of full multi-disciplinary involvement in Child Protection issues. There are occasions when agencies or individuals who may be able to contribute relevant information to a Child Protection Case Conference do not do so either because of conflicting priorities, agency policy or because of fear of the consequences of doing so.
Front line staff also report that because of operational pressures while they may be in possession of considerable information about a particular case they do not have the level of training or the knowledge of all the information available within the Trust or across Trusts or knowledge of theory or research on child protection issues to enable them to properly access or analyse this information.
The assessment framework mentioned earlier will be a major advance in the assessment and analysis of information. There was some disappointment that the framework produced in England and Wales two years ago was not adopted directly in Northern Ireland and there was some concern that this was because of the resource implications of doing so. It is clear however that when the Northern Ireland Assessment framework is adopted that there will be major training and resource implications if it is to be applied comprehensively and effectively.
3.1††††††† Communication and liaison among involved parties
Virtually every case management review in relation to the death of, or serious injury to, a child in recent decades has to some degree focused on inter-disciplinary and inter-agency communications. The integrated Health and Social Services structure assists to some degree with interdisciplinary communication but there remains room for significant improvement. This Trust organizes its community services on a patch basis based on natural communities and community services staff of all disciplines share the same buildings and often the same offices. While this arrangement undoubtedly assists in facilitating informal communication and the sharing of information, the fact that different disciplines share the same accommodation does not necessarily of itself improve communication. It does however provide a framework on which improved communication can be built. The inherent danger of such an arrangement is that information may often be shared or cases discussed in an impromptu and informal manner and that the formal communication structures which would be used if accommodation were not shared may be disregarded. The Trust has developed protocols and procedures in relation to inter disciplinary communication but there is a need to continually reinforce these. There is also a need for multi-disciplinary training to improve the understanding of each discipline of each other's role in the child protection process. Some disciplines may also have differing priorities in, for example, a psychiatrist's concentration on the treatment of an adult patient while the child protection staff may be focusing on the effect of the illness on the children involved. Greater understanding of the role of each discipline, detailed inter disciplinary communication arrangements which are adhered to and a commitment to the child protection process are the key to good communication and liaison among involved parties.
3.2††††††† Communication and liaison among involved agencies
The importance of multi-agency involvement in the child protection process is frequently emphasised. On a number of occasions however this Trust has had to defer case conferences because there was not the required multi-agency attendance. Doctors, Police and staff from the education sector tend to see the Child Protection process as primarily a matter for the Trust staff and yet on occasions Trust staff will tend to defer to the view of other agencies or professionals.
There is a major difficulty in the attendance of General Practitioners at Case Conferences. The attendance rate for some practices at Case Conferences is zero and the overall rate for General Practitioners' attendance is about 5%. The Trust recently participated in a research project in conjunction with General Practitioners to address the matter of their attendance at or contribution to Case Conferences. While General Practitioners receive a fee for attendance at Case Conferences, they may on occasions require locum cover which may not always be reimbursed, they may require longer notice and they also cited such disincentives to their attendance as the lack of availability of suitable car parking arrangements at the venue. General Practitioners also required information to inform their decision about whether or not to attend in person. Clearly this is an issue which will require to be addressed further.
Staff from the Education sector are also a vital component in the Child Protection process especially as they are the main group who have contact with all children and young people throughout their school going years. Trust staff have observed that while a number of schools attach a high priority to participation in the Child Protection process, others find that the pressures on them to address other priorities make it difficult for them to do so. There requires to be an increased emphasis on their role in the Child Protection process within the education sector. This would be assisted by their return to the multi-agency, multi-≠disciplinary training process from which they withdrew in favour of uni-disciplinary, uni-agency training some years ago.
The police are another key component in the Child Protection process and the Trust is proud of the good working relationships which have been built up with the then RUC and now the PSNI over the years. The Joint Protocol requires consultation between police and social services in all cases of suspected child abuse and joint investigation where appropriate. The Trust has valued the joint investigation arrangements and the skill, sensitivity and expertise which the police have brought to this area of Child Protection work. There is a universal impression among Trust staff that because of manpower difficulties the PSNI CARE Units are understaffed and are now only becoming involved in the cases which appear to be particularly severe or where there appears to be the likelihood of a prosecution resulting from the investigation. The Trust does co-operate with the police in those cases which are thought suitable for the taking of video evidence and provides the facilities to enable this to be done and close working relationships have been established between police and Trust staff working in this specialist area. The Trust would hope however that additional police resources might be directed to the area of Child Protection to enable them to apply their investigative skills and legal knowledge to cases which do not proceed to video evidence which appears to have occurred more frequently in the past. Apart from the specialist video evidence training, there is now no Joint PSNI/Trust Child Protection training and this was seen in the past by the Trust as a valuable exercise in sharing differing perceptions of the process and in building up working relationships.
4.1††††††† Linkages with children and parents/carers
The Trust is fully committed to the involvement of children and parents/carers in all aspects of the Child Protection process. The rationale for this is clear and this commitment has both an ethical and a pragmatic basis. Children and parents/carers have a right to be fully informed of, and to participate in, discussions which concern them and also experience has shown that unless children and parents/carers are as fully involved in the child protection process as possible the child protection measures introduced are unlikely to be successful. An example of this would be where there is agreement that an adult who is suspected of abusing a child will only have supervised contact with that child. Unless this arrangement is made with the agreement of all the parties involved, it is unlikely to be adhered to and cannot be monitored on a 24 hours a day 7 days a week basis. There have to be a number of exceptions to the full participation of children and parents/carers in the Child Protection process but the Trust is attempting to keep these to a minimum. These exceptions concern the sharing of information which may lead to a subsequent prosecution, professional discussion about the inclusion of a particular child on the Child Protection register and professional discussion about the formulation of a Child Protection plan. In the latter case however this is shared with the child and the parent/carer and is subject to their agreement.
In the Trust over 75% of Case Conferences are now attended by parents/carers and they are often accompanied by a supporter. A much smaller percentage are attended by children themselves. The Trust did establish an advocacy scheme in part of the Trust which was staffed by people who had been through the Child Protection process themselves and who were given additional training to assist them in supporting those parents/carers or children who found the Child Protection process a daunting or intimidating experience. Although the scheme was widely publicised, there was a poor take up and the Trust has had to review this provision. We are clear however that it provides a useful model for supporting the full participation of parents/carers.
The increased participation of parents/carers and children in the Child Protection process creates a number of challenges. Case conferences have to be chaired and organized in a way which is meaningful and sympathetic to all those attending. These can be an extremely daunting process for parents/carers and for children and the sensitive chairing of these case conferences can add considerably to the time taken. A large amount of time also has to be spent by the chair and the key personnel in preparing those parents/carers and children for the Case Conference and in sharing the information and reports with them whether or not they attend. Time also has to be spent with them after the case conference explaining the decisions and in agreeing the protection plan. A major difficulty posed by the participation of parents/carers or children in Case Conferences is the reluctance of some professionals to reveal relevant information until the time set aside for professional discussion (if any) or to attend at all because of the presence of parents/carers.. This is due to their reluctance to be seen to be sharing negative information about the parent/carer or the child and this remains a major training issue for some professionals. None of these negative effects should however be allowed to diminish the importance of the fullest possible participation by parents/carers and children in the Child Protection process.
Earlier drafts of "Co-operating to Safeguard Children" the DHSS & PS document replacing Volume 6 "Co-operating to Protect Children" included parents in the core group to develop the Child Protection Plan. This has now been dropped in the latest draft but the document in 5.64 is still not clear on this subject. It should be made explicit that parents/carers are not part of the core group formulating the Child Protection Plan which is a professional activity but that they are entitled to have it explained to them and staff should encourage them to work with it.
4.2††††††† Linkages with Local Communities
It is being increasingly recognised that "child protection is everybody's business" and it is clear that community participation in the area of Child Protection is vital. The Trust has recognised this by encouraging Community Child Protection Training and by providing accommodation and a salary for a co-ordinator of the Community Child Protection Training scheme which is managed in partnership with other statutory and voluntary agencies. Child Protection awareness training is provided for groups who organize activities of any type for children and young people and all the training is done by locally based volunteers. To date well over 500 people have received this training and it is hoped that this core group of people within the community will keep growing and lead to a greater awareness of the responsibility of the community in Child Protection. Trust or other professional staff are only in contact with people who may require Child Protection services for a very short period of each day or week and effective Child Protection requires the community to be aware of its responsibilities in the matter, how to recognise that a child may be at risk of abuse or neglect and what to do if they recognise such a situation. The Trust fully supports this initiative and other projects such as Sure Start and parenting programmes which educate the wider public in their responsibilities in Child Protection. While we will underline the resource constraints under which we work later, we are clear that while increased resources to the Trust would greatly assist, no increased level of resources of itself will provide an effective Child Protection service without major community involvement.
4.3††††††† Access by children, parents/carers and local communities to Information
As required by the Children Order, Data Protection legislation and in keeping with our view of openness being an integral part of a Child Protection strategy, the Trust is as open as possible with parents/carers and children during the Child Protection process. Parents/Carers, and children if appropriate to their age, are consulted about the reports presented to Child Protection case conferences and these reports are shared with them. Parents/carers and children are also given leaflets outlining the procedures and purpose of Case Conferences and they are also given copies of the conclusions of case conferences.
5.†††††††† WORKFORCE ISSUES
The Trust has recommenced its multi-disciplinary Child Protection training after a break of a number of years largely due to training pressures arising from the implementation of the Children Order. Initial concentration will be on newly appointed staff of all disciplines for whom working with children and families is a major part of their duties. The demand for this training for staff and their managers has been a constant feature of all training needs assessments in recent years. Of particular concern are the training needs in relation to Child Protection of nurses in A&E departments and for social workers in the Family and Child Care Programme as these staff are most likely to be in a position to recognise cases which require the application of the Child Protection procedures in the course of their day to day work. We are particularly concerned at the lack of specific practical Child Protection training on qualifying Social Work courses because social work staff are required by Departmental guidance and the ACPC procedures to play a central role in the Child Protection process while having little or no formal training on qualifying courses on this role. It is to be hoped that the revised social work training courses will pay considerably more attention to this aspect of their work, especially as the majority of newly trained social workers are likely to be working in the area of Child Protection on qualification. It has been pointed out that it is possible for this to happen at present without these staff having had any practice placements in a child care setting.
Other training priorities will be connected to the imminent introduction of the multi-agency, multi-disciplinary assessment procedures as outlined earlier. This training will involve Trust staff and also those from other agencies such as the education sector who work with children.
The Trust also has a shortage of staff qualified to participate in the Joint Protocol/Video Evidence procedures with the police and a number of additional staff will require training in this area of work. A difficulty arises in that participation in this complex aspect of Child Protection requires staff of considerable skill and experience and these staff are also in great demand for other aspects of Child Protection work.
All of these training priorities also pose operational difficulties because of pressure of work and because of staff shortages in this area of work.
All staff working in Child Protection are provided with regular supervision during which individual cases, the staff member's performance and training needs are addressed. The lack of experience of many staff working in Family and Child care teams pose particular difficulty for those supervising them who are themselves under considerable operational pressure. The recognition of the importance of the supervision of practice as well as managerial supervision, especially in social work, has led to the establishment of a training course on this aspect of supervision.
5.3††††††† Pressures on Staff
Since the introduction of the Children (NI) Order 1995, there has been considerable pressure on staff. This is because the same staff in all disciplines who are undertaking Child Protection work are also required to meet the increased pressures of work with looked after children, children in need and additional court work. It is impossible to underestimate the impact of the Children Order in terms of the workload of the Trust. Of particular significance are cases where legal action is considered necessary in order to protect children. Staff are of the opinion that the threshold for intervention is excessively high. Their practice is subject to a wide range of Guidance and Regulations which accompanied the Order and set out complex and detailed requirements which are required to be met. Of particular significance are the number of court hearings involved in each case, the delay caused by these hearings, the time needed for these court processes which has increased significantly and the increased requirement to involve "expert" witnesses to comply with Court requirements. The recently announced need for the Guardian ad Litem service to operate a waiting list and the requirements of the Guardian ad Litem service in general are additional pressures. The private law aspects of the Children Order also have a significant impact on the ability of the Trust to deliver an efficient and effective Child Protection Service. This is because disputes about the custody of children require considerable assessment, reporting and attendance at court and often involve court directed social work involvement in access arrangements. While such cases are becoming increasingly acrimonious and complex they do not represent major problems in child care or child protection terms but they do represent a significant amount of social work staff's attention which could otherwise be directed towards Child Protection issues.
There are also the pressures on staff which are caused by the lack of availability of suitable residential and foster care placements. While these and the private law pressures outlined above are not directly Child Protection issues, pressure on one part of the child care system has an effect on the whole system and therefore has a direct impact on the Child Protection provisions. This is evidenced by the high levels of staff turnover, the high levels of staff illness, the extreme difficulties in recruitment and retention of experienced staff, the levels of vacancies and staff needing to work consistently in excess of their contracted hours to deliver a wide range of statutory functions including Child Protection services. We understand that there will be a shortfall in the provision of social workers in the near future and that this will impact in particular on the Child Protection services of the Trust. The experience in recent years is that the social work member of the core group in Child Protection cases who is required by Departmental guidance and ACPC procedures to be the case co-ordinator and to pull together the involvement of other professionals is likely to be the least experienced member of the core group. This in itself is an additional pressure and is likely to have a detrimental effect on the level of service being delivered in Child Protection cases. We are of the view that there is an urgent need to review the terms and conditions of all staff working in Child Protection but especially those of social workers to ensure the recruitment and retention of staff with an appropriate level of training and expertise. It is clear that this group of staff have fallen behind in terms of their remuneration and this should be addressed urgently.
6.†††††††† Lessons Learned
Since the seminal report on the death of Maria Colwell (25/3/65 - 7/1/73) the most striking feature of case management reviews/inquiries/reports on the deaths of children has been the common features of their recommendations. Partly as a result of these inquiries detailed procedures have been developed but there remains the need to address the core issues identified by these inquiries. Many of these have already been alluded to above. These issues are record keeping, the need to listen to children, inter-disciplinary communication, staff training and expertise, pressures on staff and the assessment of risk. It is of note that "Learning from past experience-a review of serious case studies" (DOH 2002) concludes that in a sample of 40 case reviews only one of the forty cases scrutinised was seen as highly predictable and only three as highly preventable. While there have been some procedural improvements as a result of the lessons learned from inquiries into the deaths of children which have included the welcome recent publication of the Children and Vulnerable Adults Bill the key messages while universally known have been largely unaddressed. In the media and in other quarters there has been detailed attention to the allocation of "blame" in individual cases and not enough attention paid to the structural, training and resource implications of such inquiries. Deaths of, and serious injuries to, children are essentially the result of adults, usually those known to the child, being guilty of gross immaturity, self indulgence, cruelty and exploitation in relation to the children and this is the central issue which still needs to addressed. As outlined earlier there is still an ambivalence about the responsibility of the community as a whole for the welfare of children and the fact that there is still a debate about whether or not children have the same right as adults not to be assaulted illustrates how far this debate has to go.
There is a need for a wider debate on the failure of "systems", including resources and political and community responsibility, identified in inquiries into child deaths or serious injuries rather than the current focus on the responsibility of particular individuals. This might be achieved by wider publicity being given to the overall lessons arising from the range of case management reviews which have been undertaken over the past 30 years and by a clearer policy being developed on the publication of the reports of such reviews. In this context due regard should be paid to the protection of the rights of individuals whether they are members of the community or members of staff of the agencies involved.
7.†††††††† ROLES AND RESPONSIBILITIES
The Trust is pleased that one of the issues being addressed by the Committee is the roles and responsibilities of the Department of Health, Social Services and Public Safety, other relevant departments and statutory and voluntary agencies including Area Child Protection Committees and Child Protection Panels. A number of the issues of detail which arise in this context will be dealt with under the headings of "Legislative Context", "Resources" and "Current Guidance" later in this submission. In general the Trust views the Department of Health, Social Services and Public Safety as having a role and responsibility in creating the public climate in which Child Protection issues are given their appropriate priority in terms of legislation, resource allocation and constructive community involvement. The Department also has a role and responsibility in the development of necessary additional legislation and guidance which should be undertaken with the fullest possible consultation. We also see an important role and responsibility for the Department of Education and for the Northern Ireland Office in ensuring that Child Protection issues are allocated their appropriate priority by teachers and the PSNI respectively.
While the major statutory responsibility for Child Protection has been delegated to Health and Social Services Trusts, the responsibilities of other statutory agencies in this area should also be emphasised. The major statutory agencies in addition to Trusts with a role and responsibilities in this area Education and Library Boards and the Police Service of Northern Ireland and the role and responsibility of General Practitioners should also be emphasised. We welcome the involvement of the large range of voluntary organizations in the area of Child Protection and we consider that they have a particularly important role in raising the public consciousness of the issues involved and in leading public debate on these issues.
The role of Area Child Protection Committees is clearly outlined in Volume 6 of the Regulations and Guidance "Co-operating to Protect Children" and in the draft "Co-operating to Safeguard Children". We are aware of the current proposals to place Area Child Protection Committees on a statutory basis. We recognise and accept some of the shortcomings of ACPC's identified in the consultation document on these issues. The Area Child Protection Committee is essentially a co-ordinating and policy formulating body for organisations with responsibility for Child Protection and the current shortcomings could be addressed by a greater commitment to the work of the Area Child Protection Committee by representatives of the organisations involved who are of an appropriate seniority. The effectiveness of Area Child Protection Committees could also be enhanced by the allocation of specific funding for the work of the Committee by organisations involved. Putting the Area Child Committee on a statutory basis is neither a necessary or sufficient measure in itself to address these issues and it may in fact be seen to absolve other bodies, especially Health and Social Services Trusts, of their statutory responsibility for Child Protection.
Trust Child Protection Panels have an important role in the operational application and monitoring of the application of Area Child Protection Committee policies and procedures. It is equally important that the work of the Trust Child Protection Panel is allocated the appropriate priority by the organisations involved in terms of the seniority, expertise and commitment of their representatives and in the allocation of specific funding for the work of the panel. We are not clear why the word "Trust" appears to have been removed from the title of these panels as this is of value in outlining the geographical remit of each panel.
8.†††††††† COMMISSIONER FOR CHILDREN
Down Lisburn Trust in an earlier response to the proposal has warmly welcomed the proposals to appoint a Commissioner for Children. Our hope would be that this post will focus attention on the rights and needs of children in our society and we see an important role for the Commissioner in assisting in the co-ordination of the work of Government Departments and Statutory Organisations with responsibility for the various aspects of the lives of children. We would also see the Commissioner as having an important role in the development of an overall strategy for children and we would suggest that the National Children's Strategy "Our Children - their lives" (2000) developed in the Republic of Ireland could be a useful template for the development of a similar strategy in this jurisdiction.
9.†††††††† CHILD PROTECTION REGISTER
The Child Protection Register held by each Trust is an important element of the Child Protection process. A number of aspects of the current arrangements in this regard do however cause some concern to the Trust. The major concern is how infrequently the register is consulted by organisations other than the Trusts in spite of procedural arrangements to enable them to do so. This may be because not sufficient publicity has been given to the arrangements which have been made to enable them to do so on a twenty four hours a day, seven days a week basis. This may also be because consultation of the register inevitably involves further discussion of a particular case with another profession or agency and consultation of the Child Protection Register may be combined with this discussion. A further disincentive to consultation of the Child Protection Register is the fact that each register is Trust specific and it may not be clear which Trust has responsibility for a particular case. The fact that Trust Child Protection registers are now held on computer should facilitate access to the registers on a regional basis rather than on a Trust specific basis and we would suggest that procedural and IT arrangements should be developed to enable this to be arranged. We are not suggesting a regional Child Protection register but that access to all 11 Trust registers should be facilitated. This arrangement would have the added advantage of being able to keep a record of families who move across Trust boundaries and would remove the procedural requirement for a child who moves across Trust boundaries to be placed on both Trust registers pending formal transfer of the case. We are also concerned that current Child Protection register arrangements do not enable the procedural requirements to record all enquiries to the register or to alert enquirers to a child of a different name at the same address to be fully met.
10.††††††† LEGISLATIVE CONTEXT
The key piece of primary legislation under which the Trust provides Child Protection services is the Children (NI) Order 1995 which was implemented in November 1996. The Order is supplemented by seven volumes of detailed Guidance and Regulations. No other aspect of the work of the Trust is subject to such detailed regulation. The statutory functions arising from the Children Order have been delegated to Trusts as a result of schemes submitted by Trusts as required by the Health and Personal Social Services (NI) Order 1964. The primary legislation is supplemented by a wide range of Departmental circulars in the area of Child Care and Child Protection.
The requirements of the Children Order have had a clear influence on the Child Protection activities of the Trust. The major influences are the statutory requirements that;
n Wherever possible children should be brought up and cared for within their own families
n Children should be safe and be protected by effective intervention if they are in danger but such intervention should be open to challenge.
n When dealing with children, courts should ensure that delay is avoided and may only make an order if to do so is better than making no order at all.
n Children should be kept informed about what happens to them and should participate when decisions are made about their future.
n Parents continue to have parental responsibility even when their children are no longer living with them. They should be kept informed about their children and participate whenever decisions are made about their children's future.
n Parents with children in need should be helped to bring up their children themselves and such help should be provided in partnership with parents.
While the Trust enthusiastically supports these requirements, we are concerned that in practice they have led to the threshold for statutory intervention becoming too high, to long delays and frequent directions hearings in the Court process and to the need for staff with a high level of training, experience and expertise to implement these requirements. It is our view that the training and resource implications of the Children Order for the Trust have been significantly under estimated and under funded since its implementation.
11.††††††† RESOURCES AVAILABLE
As outlined above, the Trust is of the view that the resources available for Child Protection services have been considerably and consistently under estimated. We are also concerned that there is no indication that this matter is understood or being addressed. For example, in "Priorities for Action 2002/2003, Planning Priorities and Actions for the Health and Personal Social Services" issued by the Department of Health, Social Services and Public Safety in March 2002, we were pleased to note the sentence "In addition improvements are needed to protect children and vulnerable adults from abuse". We understand however that this refers only to the welcome introduction of the Protection of Children and Vulnerable Adults Bill to place the Pre-Employment Consultancy Service on a statutory basis. In the specific "Actions" listed in the Family and Child Care section, we were concerned to note that none of the ten actions outlined specifically addresses the issue of Child Protection.
Another concern in the area of resources available is that funding through Executive Programme funds and Health and Wellbeing plans specifically excludes Child Protection. We also understand that itemised costs for Child Protection were excluded in the Departmental bid to the Public Expenditure Survey.
We are also concerned that additional developments in the area of Child Protection such as the revision of "Co-operating to Protect Children", the Sex Offenders Act 1997 and the introduction of Multi-agency Procedures for the Assessment and Management of Risk of Sex Offenders and Offenders against Children have not attracted additional funding. The Trust is clear that all the agencies and disciplines involved in Child Protection are under severe resource pressures in the area of Child Protection. This is especially so in the context of conflicting priorities and the other activities required of these agencies. In relation to Family and Child Care Services we have noted with concern that "Key Indicators of Personal Social Services in Northern Ireland 2001" published by the Departmental of Health, Social Services and Public Safety records that the per capita expenditure on Family and Child Care in England is £248.20 while in Northern Ireland it is £158.60 and that this is in the context of 32.2 children per 10,000 on Child Protection Registers in Northern Ireland compared to 26.8 per 10,000 in England.
We would welcome detailed consideration being given by the Committee to resources available for Child Protection on a multi-agency and multi-disciplinary basis and the Trust would suggest that this should not only include financial resources but also consideration of the legislative framework and the infrastructure within which Child Protection services operate.
12.††††††† CURRENT GUIDANCE
The main current guidance on Child Protection within the Trust is Volume 6 of the Children Order Regulations and Guidance "Co-operating to Protect Children" and the associated ACPC Child Protection procedures. The Trust in co-operation with others played a detailed and active role in the compilation of "Co-operating to Protect Children" and it has proved to have been a valuable document in guiding and regulating Child Protection since its publication in 1996. The replacement document "Co-operating to Safeguard Children " has been in its final draft form for over a year and we find it difficult to understand the delay in its publication. We are also concerned that the consultation process in relation to this document was much less extensive and detailed than that leading to "Co-operating to Protect Children " and that Trusts who have the statutory responsibility for Child Protection were not formally consulted on the contents of the later drafts except through their membership of the ACPC. While we consider that the final draft is a considerable improvement on earlier drafts we consider that there remain some considerable defects and omissions. Among our specific concerns about the final draft (12/6/01) of "Co-operating to Safeguard Children" are the following:
3.42††††† While we welcome the emphasis on the clear role for the education services in Child Protection we do not consider that it will always be necessary or appropriate for the School to be involved in the preparation of the child protection plan where a school-age child is subject. We also consider that the term "principal or his nominee" may be better than "school".
4.14††††† We support the need for guidance and protocols on all the items outlined in this section although it is difficult to understand why some of these require local ACPC protocols rather than being included in the guidance. For example the decision making process for registration is included in the list of items for local protocols although it would not appear to require local variation.
4.18††††† We consider that the title "Trust Child Protection Panel" should be retained to denote the geographical area of responsibility of the panels.
5.54††††† The details of those invited and of quorums should be specified in the guidance as they have no particular local application.
5.50††††† This section should include a requirement for the chair of the case conference to meet with family members before initial case conferences to explain the processes.
5.51††††† This section should explicitly state that reports are required from those invited whether or not they attend.
5.84††††† This provision could lead to a child's name being on the Child Protection Register of two Trusts at the same time thereby giving an over estimation of the number of children on Child Protection Registers.
10.3††††† Because the Trust has statutory responsibility for Child Protection (HSS (cc) 4/89 (Supplement No1 31/3/95) the Trust should have responsibility for instigating a case management review. This should include individuals with particular expertise from outside the Trust.
10.4††††† The decision as to whether or not a case management review should be conducted should not be a matter for the Chair of the ACPC who does not have statutory or operational responsibility for this area of work.
The Trust looks forward to the publication of "Co-operating to Safeguard Children" which we hope may deal with the matters outlined above before publication. The publication of the guidance would remove the current uncertainty of the status of the current guidance and of its successor.
13.††††††† GENERAL COMMENTS
The Trust warmly welcomes the attention being paid by the Committee for Health, Social Services and Public Safety of the Northern Ireland Assembly to the important topic of Child Protection services in Northern Ireland. The Trust hopes that the Committee's inquiry will lead to an increased profile for Child Protection Services, increased public and multi-agency attention to the issues involved and a consequent improvement in the protection services being delivered by the Trust and others to vulnerable children in our community. The Trust would be happy to give oral evidence to the Committee and to provide any clarification of our written submission which is required.
written submission by:
16 August 2002
1††††††††† Introduction - Role of the Board
2††††††††† Nature of relationships between Board/Trusts
3††††††††† Planning for children in the EHSSB
4††††††††† Protecting Children - the Committee Structure
5††††††††† Protecting children - context, facts and figures
6††††††††† Workforce issues
8††††††††† Operational issues
1.†††††††† Primary and secondary legislation relating to children
2.†††††††† Index of vulnerability
3.†††††††† Eastern ACPC Training Framework
4.†††††††† Eastern ACPC Action Agenda 2002-2003
The Eastern Health and Social Services Board (EHSSB) welcomes the opportunity to present written evidence to the public inquiry into child protection services in Northern Ireland. We wish to start with stating the values and principles that underpin our work:
Children and young people matter in this Board's area. We believe that every child or young person has a right to respect as a unique individual of equal worth to others. In fulfilment of that right, every child or young person should have the opportunity to grow up and develop to the best of his/her full potential, physically, intellectually, emotional and spiritually. In order to achieve their optimum potential children and young people have primary needs that are required to be met; for food, shelter, protection from harm, stimulation, encouragement, a sense of culture and religious identity, education and healthcare.
There has been discussion between the Board and the Eastern area Trusts with regard to submissions to the Inquiry. This is the response from the EHSSB. Trusts will be providing their own submissions which will reflect operational and local issues.
Section 1: Eastern Health and Social Services Board (EHSSB)
This Section sets out the role of the Board; its commissioning responsibilities, its main providers and its commissioning budget for children's services.
The Eastern Health and Social Services Board is the largest of four Boards established in Northern Ireland by Government in 1973. During the 1970's and 1980's, the role of all the Boards was to both provide for and manage the entire spectrum of statutory health and social services across their respective areas. Throughout that time, the Eastern Board was responsible for the management of every health and social services facility within its area - from the largest acute hospitals to the smallest rural clinics and social services centres.
During the late 1980's, Government embarked upon a series of important reforms to the National Health Service. These reforms changed the way in which health and social services organisations were managed both nationally and here in Northern Ireland. Among the biggest changes to emerge from this process was the new role accorded to health and social services boards - and a different and clearer relationship between them and their front-line care services. The Board delegated their social services statutory duties to the 4 Trusts in the EHSSB in March 1994 and therefore the primary duty to provide services and safeguard and promote the welfare of children in the Board's area rests with Trusts.
Today, nearly half the population (673,357) of Northern Ireland live within the† which covers the council districts of Ards, Belfast, Castlereagh, Down, Lisburn, and North Down.
A great many people of all ages require a diverse range of health and social care services. Knowing what they need, planning and securing services for them, and paying for those services are today the responsibility of the Eastern Board. This role is referred to as "commissioning" of care services on behalf of the people served by the Board. The Board employs 227 staff and is responsible for the expenditure of £626.969 m on healthcare and personal social services and related services purchased (2001/2002).
In the 2002 baseline service and budget agreements, £41.8m will be used to commission a range of family and child care services in the Board's area.
Commissioning of Services
Delivering the best care services to the community is at the heart of the Board's business. We do this by:
n setting the strategic direction of the Board within the overall policies and priorities of the HPSS, define its annual and longer term objectives and agree with Trusts plans to achieve them;
n assessing what children and families need;
n negotiating service level agreements with organisations and agencies which directly provide services;
n arranging services that are readily accessible;
n ensuring that these services are delivered to high standards;
n overseeing the delivery of planned results by monitoring performance against objectives and ensuring corrective action is taken as necessary;
n planning and developing new services;
n demonstrating value-for-money on all services in terms of financial control, financial planning and strategy;
n ensuring that high standards of corporate governance and personal behaviour are maintained in the conduct of the business of the whole organisation. Ensuring there is effective dialogue between the Board and the local community and its plans and performance and that these are responsive to the communities needs.
The Board's business therefore involves the 'commissioning' of a comprehensive range of care services on behalf of the community. This has involved the Board in commissioning contracts for care services with
n Health & Social Services Trusts;
n Voluntary Organisations;
n Organisations in the private sector
It is these organisations which directly provide care services to the people who live in the Board's area.
The main providers of care are:
Royal Hospitals Trust, 274 Grosvenor Road, Belfast, BT12 6BP
Belfast City Hospital HSS Trust, 51 Lisburn Road, Belfast, BT9 7AB
Mater Hospital HSS Trust, 45-51 Crumlin Road, Belfast, BT14 6AB
Green Park Healthcare HSS Trust, 20 Stockman's Lane, Belfast, BT9 7JB
Hospital and Community Health and Social Services
Down Lisburn HSS Trust, Lisburn Health Centre, 25 Linenhall Street, Lisburn, BT28 1LU
Ulster Community and Hospitals HSS Trust, Health and Care Centre, 23-25 Regent Street, Newtownards, BT23 4AD
Community Health and Social Services
North and West Belfast HSS Trust, Glendinning House, 6 Murray Street, BT1 6DP
South and East Belfast HSS Trust, Knockbracken Healthcare Park, Saintfield Road, Belfast, BT8 8BH
Northern Ireland Ambulance Service, Headquarters, Knockbracken, Healthcare Park, Saintfield Road, Belfast, BT8 8BH
Principal Aim of the Board
The principal aim of the Board is to make real and lasting improvement to the health and welfare of local people.
We know from our work that despite major advances in health and social care over recent years, many problems still remain. An increasing number of children in NI suffer both real and relative poverty and recent reports from Save the Children Organisation demonstrate that child poverty is higher in NI that in rest of UK. Our children have the poorest standards of dental health in the United Kingdom, a rise in mental illness in children and young people is evident (1 in 5 children and adolescents now have a mental health problem). Cancer and heart disease are each year killing hundreds of people within the Board's area - with the majority of deaths in socially deprived neighbourhoods. Teenage pregnancy is more common in poorer areas than in more affluent areas. These are just some of the problems the Board, Trusts and Government must address if we are to make further advances in public health and welfare over future years.
The overall standards of public health prevailing within the Board's area is more fully described in the Annual Reports of the Director of Public Health. These are available through the Department of Public Health Medicine & Nursing at the Board.
1.†††††††† Comparative spend in Northern Ireland with Great Britain. The SSI document on Key Indicators indicates that the NI HPSS spend in 1999/2000 was £73 m on family and child care services. Information recently available from the Department indicates that best guestimates of per capita expenditure demonstrated a spend of £70 less per child per capita in NI compared to England. This under funding must be seen in the context of other UK policy initiatives which have not been read across to NI, i.e.
n Quality Protects Initiative - £885 m in England for 5 years from 1999-2000 with no NI equivalent.
n Sure Start - £449 m x 3 years which is the equivalent of £63 per child under 4. In NI the equivalent figures are £7.8 m over 2 years or £41 per child.
n Children's Fund - £13 per child under 18 in England compared to £21 per child in NI. However, much of the money in N.I. is for project capital developments when funding is essentially required recurrently for mainstream family and childcare service provision. Underfunding of investment in mainstream family and childcare services is resulting in difficulties in developing a more long term range of frontline appropriate preventative services.
2.†††††††† The Board would recommend that the Department seek to review the totality and adequacy of funding for family and child care services in NI with an emphasis of funding of all levels of the continuum of service provision i.e. prevention to protection.
3.†††††††† The Children's Strategy should ensure that tackling poverty features as a key part of the Departmental agenda.
Section 2: Nature of Relationships between Boards and Trusts
This Section sets out the complex nature of relationships between Boards and Trusts drawing attention to: (1) commissioning, (2) the delegation of statutory functions (3) developmental work being undertaken by the 4 Boards.
Commissioning Social Services in Northern Ireland are organised at two levels:-
n Commissioning is undertaken by the four Health and Social Services Boards that carry the statutory responsibilities for planning, resourcing, monitoring and quality assurance of services.
n Service provision and operational management are undertaken by the eleven community trusts that have delegated statutory responsibilities and are accountable to Boards for the management of staff, resources and delivery of services as indicated above.
The Delegation of Statutory Functions
Personal Social Services are planned and delivered in the context of a complex and changing set of primary legislation.
The Health and Personal Social Services (NI) Order 1994 enabled Health and Social Services Trusts to carry out or discharge certain Statutory Functions delegated by Health and Social Services Boards. Boards have a responsibility to monitor the discharge of statutory responsibilities delegated by Boards to Trusts and are responsible to its residents for any failure in the discharge of its statutory responsibilities.
Primary legislation is interpreted and supported by an array of statutory and non-statutory rules and regulations, codes of practice and guidance documents, policy and procedures documents, which elaborate on statutory issues. These are also expected to be met.
Although the majority of statutory functions concern the social work profession, some relate to the medical and nursing professions while a significant number are administrative in nature and, as such, are corporate Trust responsibilities.
Primary legislation relating to children is listed in Appendix 1. Those in bold contain functions which are delegated to Trusts. This list is added to by key current circulars, guidance and directions which come from the Department of Health, Social Services and Public Safety.
In August 2001, in growing recognition of the need for consistency in approach across Northern Ireland, a task group was formed by the Association of Directors of Social Services (ADSS) to review the discharge of statutory functions. The remit of the task group was: "To produce a report for the consideration of the ADSS which sets out;
n A comprehensive and up to date list of legislation and key Departmental policies and guidance for Trusts to use when updating their current schemes (for the exercise of delegated statutory functions).
Detailed proposals for a framework for future Annual Reports from Trusts to Boards in respect of the discharge of delegated statutory functions, together with proposals as to how these reports can be linked in with other monitoring activities"
A proposed draft framework has now been produced. The aim of the framework is to:
n Ensure consistency of approach in order to facilitate the making of comparisons between Trusts
n Enhance the quality, relevance and usefulness of Annual Reports by identifying the priority areas to be monitored through this process and then setting specific information requirements in respect of each of these areas;
n Facilitate additional or amended information requirements being added in the future.
Trusts will be required to present an Annual Report to the Board on how it has met the statutory functions delegated to it. The Annual Reports should provide a summary of the Trusts' performance against requirements set out in the Trust's Scheme for the Exercise of Delegated Statutory Functions. This should include any significant changes in performance and any area where statutory functions are not being discharged effectively with the reasons for this, along with any implications for clients and remedial actions taken.
Role and Responsibilities of Directors in relation to the care and Protection of Children
1.†††††††† A new Circular CC3/02 was distributed to all Executive and Non-Executive Directors of Boards and Trusts in the Board's area at the end of June 2002. This Circular highlights the role and responsibilities of Directors in relation to the care and protection of children in our area. Directors have concerns about the level of funding allocated to the service if the responsibilities set out are to be upheld fully. A tripartite meeting (Department, Boards and Trusts) to more fully examine and discuss the responsibilities is required.
Section 3: Planning for Children in EHSSB
This Section discusses the arrangements in place for planning for children, the population of children, the planning framework, the index of vulnerability which helps us to identify those children in greatest need and finally a commentary on the effects that a society emerging from conflict has on children.
Children's Services Planning Structure
The Children's Services Planning Structure is complex as shown in the diagram below.
The roles and responsibilities of each group are outlined below.
Children and Young People's Committee (CYPC)
A Committee of Senior Officers directly nominated by the Chief Executive Officers of the key agencies involved in the provision of services to children. It oversees multi-agency planning and ensure the Children's Services Planning process links to individual agency plans.
Area Child Protection Committee (ACPC)
In existence prior to the introduction of Children's Services Planning, the ACPC is responsible for developing a strategic approach to child protection. ACPCs are required to develop multi-agency business plans in respect of family support and child protection. The business plan as it relates to vulnerable children and children in need is wholly integral to the Children's Services Plan.
Childcare Partnership (CCP)
The CCP is a multi-sectoral group responsible for developing and progressing a strategy to improve childcare services for all children aged 0 - 14, including vulnerable children and children in need. The Childcare Plan, whilst not wholly integral to the Children's Services Plan, has significant areas of overlap.
Joint Strategic Planning Groups (JSPG)
JSPGs are tasked with taking forward multi-agency strategic planning for the individual needs group. This includes agreeing planning frameworks, overall aims, objectives, key needs/planning indicators, targets and linking these to individual agency plans.
A group of agency Information Officers, who are responsible for collecting, collating and analysing information in relation to the provision of services and outcomes achieved by their agencies. Their task, is to ensure that the various strands of information can link together in a coherent way to inform Children's Services Planning.
A group of agency Children Services Planning Officers who are responsible for developing their individual agency commissioning or business plans. Their task is to ensure that the Children's Services Plan 2002 - 2005 is integral to each agency's business plan.
On the surface, the structure outlined above, may seem overly bureaucratic. However the agenda is large and complex, and the CYPC believes that a holistic approach to addressing the needs of children and young people is required, which must be both multi-agency and multi-professional. It is self-evident, that the links between the three main bodies i.e. the Children and Young Peoples Committee, the Childcare Partnership and the Area Child Protection Committee is critical. That is why, the chairships of these groups are held by senior social services staff.
The population of children aged 0-19 years in the Eastern Health and Social Services Board area is 191,430. This is based on the 2000 population mid-year estimates. These are detailed below according to locality.
The current best estimate of the number of children and young people who are in need or who are vulnerable, i.e. at risk of social exclusion should services not be provided is as follows.
All Children & Young People†††††††††††††††††††††††††††††††† 191,430
Vulnerable Children†††††††††††††††††††††††††††††††††† 47,000 - 55,000† (estimate)
Children in Need (including)††††††††††††††††††††††† 8,000 - 12,000† (estimate)
n Children who have left car
n With disability
n In conflict with the law
n Emotional, behavioural, psychiatric
n Excluded from school
n Young carers
Children Looked After and in need of rehabilitation††††† 1,500
Children on Child Protection Register†††††††††††††††††††††††††† 900
Service Planning Framework
An approach to analysing need has been adopted by the Eastern Area Children and Young People's Committee (CYPC) who over the past three years have built on a framework developed by Professor Pauline Hardiker. She suggests that there are four levels of need, which are responded to by different types of services.
Level 1: represents the State exercising its responsibility to the whole population to provide mainstream health care and education. It also includes re-allocation of resources, increased rights, and improvements in the situation of disadvantaged people through community development.
Level 2: represents support for children who are vulnerable through an assessment of what their need is, and via targeted specific services provided by education, health, social services, the police and the voluntary sector.
Level 3: represents support to families or individual children and young people where there are chronic or serious problems. It is provided through a complex mix of services which usually need to work together well in order to provide the best support.
Level 4: represents support for families and individual children or young people where the family has broken down temporarily or permanently where the child or young person may be looked after by social services, in youth custody or prison or as an in-patient for instance due to disability or mental health problems.
It is widely acknowledged, that early intervention i.e. the provision of basic care such as early years services, produces positive outcomes in terms of children not needing more specialist services at a later date. The aim of the higher levels of support (3 and 4) is to affect the family situation positively, so that the family can be supported by Level I services (and therefore no longer need specialist services) alongside the mainstream population.
The different levels of services responding to need can, through this model, be thought about separately, but their inter-dependence is also clearly demonstrated.
Index of Vulnerability
In order to better plan for vulnerable children and children in need, the CYPC has developed a child-focused Index of Vulnerability (Appendix 2) to identify areas of high social need, in which children are most vulnerable and most likely to be at risk of social exclusion. The Index of Vulnerability is made up of a number of indicators: those relating to housing, those relating to parents, and those relating to education, skills and training. The CYPC believe that continued use and analysis of this index will help to target resources better in the future.
Emerging from Conflict
Northern Ireland is a society emerging from a conflict which continues to have adverse consequences for significant numbers of its children and young people. It was estimated in 1997 that 26% of those who had lost their lives in the troubles were aged 21 years of less.
The Bloomfield Report "We will Remember Them" (1998) refers to secondary effects, to the traumatic and continuing experiences of children and families of people who have been killed or injured.
Two major studies carried out by Sperrin Lakeland Trust following the Omagh Bomb has mapped the consequences for one community of a major atrocity. The experience of the Trust in addressing the consequences of the bombing reveals the wider poisoning effects of the tragedy with, for example increased family discord, alcohol use and referrals of children to eneuretic clinics. The children's study suggests that 15.8% of adolescents in the Omagh area were still traumatised 15 months after the bombing. The study into the impact on younger children found even higher levels of distress. Such findings can be multiplied many times over in a Northern Ireland context.
The significance of the Omagh studies and experiences are that for the first time in the history of the troubles of the past 30 years, the impact of violence on a community has been assessed, studied and quantified. In the year 2002, in the Eastern Board area, very many children and young people have spent formative years in environments where confrontation and violence have been endemic. Electoral wards with high deprivation scores predominate amongst those with the largest number of deaths because of the troubles. The impact of conflict on the lives of children and young people has not yet been fully examined or understood, but clear examples of outcomes such as youth led violence are emerging.
The effects on children, young people and the community in general is detailed both in a statistical sense and through the eyes of staff working in North and West Belfast Trust, through a report called "Caring Through the Troubles" (Smith, Morrisey, Hamilton 2001). This report confirms the particular impacts on children and young people and its consequences.
Whilst the transformation to a non-violent society is at an early stage, it is expected that rather than a move from political violence to no violence at all, a new pattern of violence will emerge reflected in increased crime related violence, inter-gang conflicts, territorial wars, drug wars and, at a community level, increases in domestic violence, child abuse and other forms of personal violence.
All of the above issues, affect to a lesser or greater extent all the geographic areas within the Eastern Board.
1.†††††††† Lack of interdepartmental co-ordination of planning for children's services has led to difficulties e.g. Department of Education not appearing to have bid for educational supports for looked after children from the Children's Fund. The issue of co-ordination will require further consideration by the Department and with more realistic timescales agreed in advance to support the bidding process. The concomitant administration associated with Children's Fund bids and maintenance of projects will also require adequate resourcing. The Board welcomes the re-establishment of the Interdepartmental Group on children to facilitate the work on a Commissioner for children and young people and the development of the Children's Strategy.
It is, however, important that the existing co-ordinators and planners involved in the delivery of children's services continue to advise, plan and inform the above group of progress made against their annual review of their Board's Children's Services Planning targets and objectives, agree the priorities for funding and assist in setting the agenda for the interdepartmental work.
2.†††††††† The Executive/DHSS&PS need to recognise the associated cost and consequence of the "Troubles". It is necessary to find a way to recognise the increased costs with associated funding. Top-slicing mainstream funds would be our recommendation.
Section 4: Protecting Children - the Committee Structures
This Section describes the role and function of the ACPC, some concerns that have been raised about its work, discusses the proposal for an ACPC bill and the work of the Trusts Child Protection panels.
The Area Child Protection Committee
Inter-disciplinary and inter-agency work is an essential process in the task of protecting children from abuse. The experience gained by professionals in working and training together has succeeded in bringing about a greater mutual understanding of the roles of the various professionals and agencies and a greater ability to combine their skills in the interest of abused children and their families. The recognised joint forum for developing, monitoring and reviewing child protection policies is the Area Child Protection Committee (ACPC).
Whilst primarily the responsibility of EHSSB, the Area Child Protection Committee comprises representatives of the key agencies with responsibility for children.
The purpose of the ACPC is to ensure that there is an agreed framework within which adequate protection and support can be provided to children in the Eastern Health and Social Services Board who may be suffering, or are likely to suffer, significant harm through ill treatment or the impairment of health or development. This is achieved by the ACPC working to ensure effective co-operation between agencies and professionals responsible for protecting children from abuse and neglect.
The aim of the ACPC is to work to safeguard and promote the welfare of children and to protect them from abuse and neglect, in partnership with parents wherever possible.
The ACPC is expected to:
n Promote and safeguard the welfare of children throughout childhood
n Ensure that the affect of any intervention is more positive to children than no intervention, in terms of the immediate safety and welfare of children
n Promote conformity of interpretation of legislation, regulations and guidance
n Develop standards of competence and conduct for those undertaking child protection processes
n Provide accessible, reliable and co-ordinated guidance for child protection processes.
The overall role of the ACPC is to develop a strategic approach to child protection within the overall Children's Services Planning process.
The ACPC is accountable to the Health and Personal Social Services Board which constituted it. The ACPC members are accountable to the agencies that they represent which, in turn, are responsible for taking any action properly falling within their respective remits. Each agency accepts that it is responsible for monitoring the performance of its own representative.
Member agencies of ACPC are:
n Relevant professional groups in Health & Social Services Board
n Relevant professional groups in Health & Social Services Trust
n Child Protection Panel
n Education & Library Boards
n Council for Catholic Maintained Schools
n Police Service Northern Ireland
n Probation Board Northern Ireland
n The armed services where there is a large service base in the area
n Other agencies and professionals as necessary.
Member agencies at the ACPC are represented by senior staff with responsibility for policy development and implementation. They should have been given delegated authority to make decisions relevant to child protection on behalf of their agency.
There are concerns expressed about the ACPC. These are:
n The competing demands on individuals who attend from their own agencies is immense. Consequently their capacity to take on additional work is often restricted
n ACPCs do not have any executive authority. What authority they have comes from their member agencies. Consequently their authority arises from their ability to influence organisations in the network
n A belief amongst some of the member agencies and professionals that child protection is the responsibility of social services. This can lead to a lack of commitment to the work of the ACPC
n A lack of funding to carry out the work of the ACPC. This is particularly relevant in the area of training in child protection. Each agency or profession is responsible for its own training. Competing demands for limited resources, however, can result in child protection training being of lower priority.
Proposed ACPC Bill
In England and in particular the inquiry into the death of Victoria Climbie has recognised that the functions of ACPCs need to be based on statute. Ms Patricia Lewsley, MLA, and NSPCC have been working on a Private Members Bill on the regulation of ACPCs. The Bill builds upon the remit of ACPCs as set out in 'Co-operating to Protect Children' and it's revision 'Co-operating to Safeguard Children'.
It is anticipated that one recommendation from this Inquiry will be to place the remit of ACPCs on to a statutory basis. Whilst this is of importance it is also necessary to clarify the responsibilities of each agency and each professional who has a remit for children's services with regards to child protection. If the ACPCs, and the Boards as the primary agencies for the functioning of these, have the responsibility for the quality of services to protect children then they must have the authority to require the member agencies to comply with the policy, procedures and standards developed by ACPC.
This would give greater ownership and commitment from partner agencies. For ACPCs to carry out their tasks effectively they need to be appropriately funded, as are Children and Young Peoples Committees and Childcare Partnerships.
Trust Child Protection Panels
The role of the Child Protection Panels (CCP) in Community Trusts is to implement locally the Area Child Protection Committee policy and procedures ensuring a high standard of professional practice.
The Child Protection Panel is accountable to the Trust although its members are accountable to the agencies they represent. Each agency accepts that it is responsible for monitoring the performance of its own representative.
The Child Protection Panels are sub-committees of the ACPC and are represented by their chairperson on the ACPC.
Membership of the Trust CPP includes managers and practitioners from those agencies on the ACPC.
n Health & Social Services Trusts
n Education & Library Boards
n Council for Catholic Maintained Schools
n Police Service Northern Ireland
n Probation Board Northern Ireland
n General Practitioner.
1.†††††††† The Board welcomes Ms P Lewsley's,MLA, Private Members Bill to place ACPC's on a statutory footing as a key way of improving the Child Protection System in Northern Ireland. A higher profile for the work of the ACPC would mean that the input of each agency toward the common goals would be more visible. The statutory status would also demonstrate this vital work is a priority for the Government. We would urge Government to place ACPCs on a statutory footing and provide the necessary funding to support this important work.
2.†††††††† Calculation of child abuse and neglect rates can be difficult because of difficulties with definitions thresholds and measurements. There is a need for consistent and cross cutting information between Departments on child protection and information on the wider welfare of children in NI.
3.†††††††† Standard setting:
Recent publicity surrounding scandals in England have shaken public confidence in child protection services. The introduction of clinical and social care governance arrangements form a core element of the Department's document Best Practice Best Care. The Board welcomes the establishment of an Authority to carry out the regulation of services and monitoring of the HPSS. We are pleased that standards and guidelines will be developed by one agency. This will ensure that organisations and staff delivering services and service users and carers will be clear about the standards of care delivered.
4.†††††††† It is also felt that the regulation of Child protection Panels should be considered in the future in view of the linkage between ACPCs and Trust Child Protection Panels.
5.†††††††† In the light of a recent case review in the Board's area we would recommend that all Trusts should audit and monitor their adherence to ACPC policies and guidance on child protection on a regular basis.
Section 5: Protecting Children - Contexts, Facts and Figures
This Section discusses contexts, facts and figures around protecting children. It addresses firstly the legal context for service provision, it then describes the social and political context within which the services operate including issues such as societal expectations and assessment of risk. It provides data about the numbers of children and activities associated with the protection of children.
The primary legislation and Statutory Rules and Orders under which services for children are provided is identified in Appendix 1.
The Children (NI) Order 1995 (Children Order) is the key legislation which underpins our work. It brought together public and private law which relates to children.
It is based on the concept of "parental responsibility" which parents retain even when a child is looked after by a Health & Social Services Trust. Parents are given specific rights under the Children Order. These include the rights
n To being involved in plans for their children
n To attend Court proceedings with regard to their children
n To maintain contact with their children.
Trusts are required to provide services to support families and children when children have been assessed by social services as being in need. "In need" is defined in Article 17 as a child who is
a)†††††††† unlikely to achieve or maintain, or have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by an authority under this Part;
b)†††††††† his health or development is likely to be significantly impaired, or further impaired, without the provision for him of such services, or
c)†††††††† he is disabled.
Health and Social Services have a duty to provide some services and powers (discretion) to provide others.
The two key duties in respect of children in need are:
n To safeguard and promote their welfare
n To promote wherever possible their upbringing by their families.
Support for children in need and their families is a key function of social services. These services should be provided in partnership with the family. The Children Order recognises that social services are not the only provider of services for children and encourage co-operation and collaboration with other agencies. The requirement to assist is given in Article 46 (2).
A body whose help is so requested shall comply with the request if it is compatible with that bodies own statutory or other duties and obligations and does not unduly prejudice the discharge of any of its functions.
The Children Order contains a legal framework for the protection of children. It introduced the concept of significant harm against which the requirement for legal intervention is measured. When social services are informed that a child is, or is at risk of, being abused they have to investigate the child's circumstances (Article 66).
Whilst Social Services have the primary responsibility for safeguarding and protecting children this cannot be done without the co-operation and collaboration of other agencies that work with children. The close working together by police, health services and social services is essential if children are to be protected.
Where, after investigation, social services believe that a child is at risk of significant harm and should be removed from his/her carers they can make application to the Court for a number of different orders.
a)†††††††† Child Assessment Order (Article 62)
b)†††††††† Emergency Protection Order (Article 63)
c)†††††††† Care Order (Article 50)
d)†††††††† Supervision Order (Article 54)
Social Services have to satisfy the Court that the child has or is likely to suffer significant harm, that his/her parent is not able to satisfactorily ensure his/her safety and well-being and that it is in the child's best interest for an order to be granted. Parents are represented, as well as the child, during Court hearings and social services can be challenged on their evidence.
In 1982 UK Government ratified the UN Convention on the Rights of the Child. The convention covers a large range of issues which relate to children. Article 6 requires Governments to protect children from serious harm (the right to life). Article 3 requires Government to ensure the protection and care of children in order to safeguard their well being.
Section 75 of the Northern Ireland Act 1998 and the Human Rights Act 1998 provide a further statutory basis for promoting the rights and needs of children. All children have the right to be protected from harm, regardless of age, race, religion, cultural beliefs or disability. They should all have equality of access to services.
Social and Political Context
The expectation within society and legislation is that the parent is responsible for their children and that the state will only intervene where the parents are not able to fulfil their responsibility for care and protection of their children.
Society expects professionals and agencies in the area of child care to be able to assess and identify those families where children may be at risk and to ensure their safety. This is a complex task for a number of reasons:
n The balance between the rights of the child and those of adults rights
n A universal agreement about when "family support" becomes "child protection"
n The most effective way of assessing need and providing support
n An agreement about "good enough" parenting
There have been changes in Government policy with regards to family support and child protection. In the 1970s and 1980s these were two distinct areas of work. In the 1980s and 1990s there was a move to "re-focus" child protection and see it as part of a continuation of family support.
Assessment of Risk
The assessment of risk to children focuses on indicators and pre-disposing factors which could identify those parents who may have difficulties in providing acceptable levels of care to their children. These take into account a wide range of factors;
The difficulty facing professionals when assessing risk to children is that whilst most parents who abuse and/or neglect their children have many of these indicators and pre-disposing factors many others who would have the same indicators do not abuse or neglect their children. The reason for this is not clearly understood (see also Section 8 regarding assessment issues).
Every child needs and deserves nurturing from their families and communities. A safe community where children can live and grow among caring adults, however, does not just happen. It is created by individuals who are committed and determined to shape that safe community.
Child Protection Statistics at Year End (March 2001)
The volume of child protection work remains high in the Eastern Health and Social Services Board area. The table below shows trend data 1996-2001.
The above reflects the continuing trend for fewer child protection referrals to be referred to Case Conference following investigation. This is the result of much better targeting and decision making processes. This shift to a more sensitive and focused approach means that Case Conferences only occur when there is a high degree of certainty regarding the case. This, in turn, has led to a higher proportion of Initial Case Conference decisions to place a child on the Child Protection Register.
The more targeted approach that has developed, has also resulted in a gradual increase in the proportion of child protection concerns that result in registration, even though the number of referrals is falling.
For the two years 1999-2000 and 200-2001 there were a total of 1409 initial case conferences and 4040 review conferences. This means that on every working day in the Eastern Health and Social Services Board area there are on average eleven Child Protection Case Conferences taking place.
Number of Children Registered Each Year
This table shows the number of children who have been registered on the Child Protection Register from 1998-2001. It also shows the % from that total, the number who had previously been taken off the register and who were being re-registered. It is not possible at this point in time to identify how long the children's name had been on the register before removal and how long the period was before re-registering as this data is not collected.
There are two views on the relevance of the number of children who are re-registered as being at risk of abuse. One is that involvement in the child protection process is stressful and, therefore, children's names should only be on for the period of high risk. The re-registration is an indication of successful monitoring and assessment of children in need. The second is that the first period of registration was not of sufficient length to make sufficient change in the families circumstances and, therefore, the risk of abuse had not reduced to a level that was safe for the child. Further research is required on this issue.
1.†††††††† We would urge the Department to commission research on thresholds and criteria for entry and re-entry into the child protection system to ensure consistency across NI.
2.†††††††† Given the current socio-political context, the committee may wish to review the balance between the rights of parents and the rights of children (see also comments about human rights legislation, time pressures and the court processes in Section 7).
Section 6: Workforce Issues
This Section discusses workforce issues initially focussing on the number of qualified social workers and turnover of staff. It then describes the importance of training and makes reference to the ACPC Training framework contained in Appendix 3.
One of the most significant influences on the delivery of safe child protection services is the availability of qualified and experienced staff.
The recruitment and retention of social workers with the necessary knowledge, skills and experience in children services and child protection in particular is essential if we are to protect children in our community.
In 2000, research undertaken by CCETSW showed an anticipated shortfall of 150 qualified social workers over the next few years. Whilst the shortfall would be across all areas of social work the family and child care services would have the greatest shortfall.
Research completed by the Training Organisation for Personal Social Services revealed the following information about social work staff.
Qualified Social Workers (31/3/2001)1939
†††††††††† HSS Community
Staff Turnover per year
†††††††††† HSS Community
The majority of leavers from social services were practitioner grade social workers from family and child care services.
63% of social work vacancies in HSS Trusts were in family and child care services.
The social workers who are recruited into family and child care services are, frequently, newly qualified and with little experience of this area of work. Many have no experience of child protection and no training in this specialised area of work. This places additional pressure on other staff in the social work teams and Team Managers who have to give added supervision to staff. The committee may wish to access a recent Unison Report (June 2002) which gives information on current pressures in social work.
The Board is committed to the recruitment and retention of a highly qualified and experienced staff resource in family and child care services. There does, however, need to be a regional strategy to ensure that the most vulnerable children in our community receive a high quality service.
Consideration should be given to a career structure that rewards knowledge, skills and experience in social workers. The current career structure encourages social workers to seek promotion through the management structure. This results in the least experienced social workers being frontline staff.
Training of Staff Involved in Child Protection
Training is critical to maintaining and embracing knowledge and skills. This sub-section discusses the current position.
Child Protection Training is delivered to staff on an on-going basis addressing policies and procedures, assessment and specialist training on specific areas of practice. A significant aspect of child protection training relates to Joint Protocol and Video Evidence Interviewing and there have been significant revisions to both training content and the staff targeted recently. Training is provided on uni and multi-disciplinary basis and where appropriate is provided on a multi-agency basis.
Through the commissioning process and delivery of training there are on-going issues about the accessibility of training for staff due to operational pressures and having to give priority to meet service demands.
The Board is ensuring that it meets its targets in respect of the P.S.S. Training Strategy at Post Qualifying and Advanced level and is applying this strategy to Child Protection Training and Accreditation. Its intent is that staff working in the field of child protection will acquire competence requirements in the Post Qualifying Framework as a benchmark of safe practice.
The Eastern ACPC has developed a training framework to facilitate the development of training and inform the commissioning process for all relevant agencies in targeting training needs in child protection. The frame-work (which is set out in Appendix 3) will be developed further to develop quality assured training programmes and provide greater opportunities for joint commissioning of training between agencies.
1.†††††††† We would urge the committee to link its current enquiry to the work of the Human Resources Sub-Group considering professional salaries, terms and conditions and the range of initiatives suggested to recruit and retain staff. We would wish to ensure that social work is given its rightful place among the professions and is remunerated accordingly. Any initiatives proposed by the sub-group should be adequately funded. This may help retention within the social work profession.
Section 7: Resources
This Section considers the resource issues from a number of angles: increased responsibilities under the Children Order and the shortfall in additional funding received to meet these responsibilities. Trends and the impact of other policy developments are raised, as are emerging demands, the impact of short term funding, the time pressures on social workers and court work.
It is important to establish that Social Services Departments draw their clients from society's most vulnerable groups. Such clients are typically located at the margins of systems such as health, education, training etc., or in intersections and overlaps between systems. Whilst the Children Order gives Family and Childcare teams a number of core legal responsibilities in respect of vulnerable children and young people the needs of such children and young people are often too complex to be met by a single agency. All agencies have responsibilities in this area. This has been recognised in Government policy with increasing emphasis on the importance of multi-agency collaboration in both delivery and planning of services.
New Responsibilities under Children Order
In 1994 prior to the implementation of the Children (NI) Order 1995, the four Boards were invited by the Departmental Children Order Implementation Group to submit estimated costs of enabling Boards and Trusts to discharge the additional statutory responsibilities which the Order would place on them. A common framework for presenting the costs was developed. Each Board built up from Trust level a detailed analysis of the services that would be required on the ground. There was considerable discussion regarding these submissions between Boards and the DHSS. The Department took a conservative view of the cost implications of the Order and considerably reduced the Board's estimates in their submissions to the 1995 Public Expenditure Survey.
An additional £17m was allocated by the Department for the implementation of the Children Order. This, however, fell short of the estimated cost by £17m.
Whilst the injection of new money over the last seven years has been welcomed it has not met the requirements of child protection services. Funding through Executive Programme funds and Health and Well-being Investment Plans exclude child protection services. An added problem is that a significant amount of new funding is of a short-term nature which makes long term planning of services more difficult.
In the Departmental bid to the Public Expenditure Survey the following areas containing itemised costs identified by the four Boards were excluded.
n Child Protection
n Family Placement
n Residential Care
n Medical Implications
It should also be noted that monies identified in the Departmental bid for legal processes took account only of the cost of the Guardian and Litem Agency and not of additional costs falling to Boards and Trusts, which have been considerable.
Impact of Policy Development
This underestimation of resources required has been compounded by a number of subsequent policy developments and initiatives, including;
n Children's Services Planning
n Children First, The NI Childcare Strategy
n Changes in Juvenile Justice legislation
n The anticipated revision of 'Co-operating to Protect Children'
n National Foster Care Standards and Code of Practice
n Sex Offenders Act 1997
n The introduction of Multi-agency Procedures for the Assessment and Management of Risk of Sex Offenders and Offenders Against Children (MASRAM)
n Framework for the Assessment of Children in need and their Families
n Equality and Human Rights legislation
The National Commission of Inquiry into the prevention of child abuse estimated, in 1997, a cost to the public purse in the region of one billion pounds per year. This is an estimate of the cost of direct state intervention involving all of the necessary agencies and indirect costs of longer-term outcomes for children. Comparative figures for Northern Ireland are not available but it is evident that safety-net services such as child protection assessment and monitoring, the legal processes and the provision of residential and foster care are extremely expensive.
Emerging Demands 1996-2002
A number of emerging pressures or demands have been noted which are highlighted below.
n Increase referrals by children in need - waiting lists for secure accommodation beds
n Waiting lists - unmet need
n Article 8 - Private law cases
n Children/Young people in conflict with the law - Offenders (Youth Justice)
n Children who are carers
n Children who are excluded/suspended from school
n Child and adolescents in need of mental health services
n Children First - The Northern Ireland Childcare Strategy
n Deficiencies in the arrangements for looked after children
n Lack of policies and procedures for leaving care and aftercare programmes
n A continued need for in-service training
n New Corporate parenting duties toward children
Impact of Short Term Funding
There are Increasing expectations in the voluntary and community sector of core funding from Boards and Trusts in relation to other services. The European Union Special Support Programme for Peace and Reconciliation, for example has enabled a wide range of voluntary and community groups to develop high quality services for children in need and their families. These projects to a large degree have embraced targeting social need and community development approaches. As these time limited funding arrangements come to an end organisations are increasingly turning to Boards and Trusts to provide mainstream financial support. There are many other examples of short term funding initiatives.
Pressures Impacting on Time Availability
(A)†††††† Social Worker
The increasing complexity of child protection work is placing additional demands on social work time. In 2000, Sperrin and Lakeland HSS Trust identified the time committed by social workers to child protection work. This averaged 24 days per year per case. Using this figure EHSSB would require approximately 82 social workers to meet the minimum standards required in child protection. This does not include the time required by team leaders and assistant principal social workers. It also excludes the time commitment of other professional involved in this area of work.
It has been estimated that the time required to meet the requirements of the child protection processes has almost doubled since 1995.
(B)†††††† Court Work
Where the assessment of risk to a child indicates that social services need to remove the child from home this has to be done through the courts. The increasing demands of this process use a considerable amount of social work time.
Court reports have become more detailed in order to show how the child reaches the 'significant harm threshold'. Court reports can be 25-30 pages long. They have to clearly show how the Order will benefit the child.
Court hearings are taking longer as parents contest the applications and more 'expert witnesses' are called. The average disposal time for public law cases in Family Proceedings Courts has risen from 9.1 weeks in 1997 to 16.8 weeks in 2000. This has had a considerable impact on the cost of staff time and the consequent legal costs for Trusts.
The impact of Human Rights legislation, particularly Article 8, the right to family life, has led to increasing requests for Court Welfare Reports and the need for assessment of the quality of parenting and parental contact.
The four Boards have recently designed and conducted a survey to identify court work costs and levels of activity. The Children Order Advisory Group has developed a questionnaire to examine the issue of delays in hearings.
1.†††††††† The Board would urge that the Children Order Advisory Committee continue to work with Boards and Trusts to resolve a range of issues concerning public and private law issues involving children and families on an inter-agency basis.
2.†††††††† When the Children Order commenced there was an assumption that the number of looked after children would decrease over time. This has not happened in NI or in England and for planning purposes it must be assumed that the number of looked after children is likely to remain around the 2500 figure for the next 5 years. This emphasis the need for continued resourcing to meet appropriately and safely the needs of these children.
3.†††††††† The Guardian ad Litem Agency has recently put Boards on notice that they will be operating a waiting list. This is likely to have serious consequences for children and families in not having reports completed in a reasonable timeframe and delays in court hearings.
4.†††††††† Projects supported by short term funding need to be annually reviewed and be evaluated against a set of key indicators and expected outcomes. A discussion is required regionally concerning the level of funding needed to mainstream or sustain the services deemed to essential to support children and families in the community.
Section 8: Operational Issues
This Section considers a wide range of operational issues, looking firstly at the important aspect of assessment. It then goes on to consider social work structures, support services and recording. Working together, communication, parental involvement and the need for information leaflets is then discussed. Some issues to do with involving the community are considered and finally there are sub-sections on the learning from care management reviews and public enquiries.
Social workers are asked to make extremely difficult decisions and whilst all are trained and qualified social workers their range of experience can differ widely.
The problems of increasing referrals, insufficient resources and concerns about adverse criticism and liability are all linked to decision making. It is important that there should be consistent and accurate decisions about which referrals should be investigated as child protection, which children may need to be removed from home and which families need the most intensive service provision. Social workers need tools to help make accurate and reliable assessments about need and risk to children.
Concern had been expressed that there was not in place one assessment methodology or tool which could be used by all agencies with an interest in children's welfare. Each agency and each trust was using their own assessment tools and methods.
In order to rectify this, a multi-agency framework for the assessment of children in need will be introduced. This work is based on the Department of Health framework (2000) and Best Practice in Northern Ireland. The document has been developed by the key agencies working in Children's Services. There has been wide consultation about the indicators of need and thresholds for intervention. This part of the work should be completed by September 2002. The document will also include a recording format and a model for the analysis of risk.
At a regional level the four ACPCs are working to develop a strategy for the management of risk. It is anticipated that this work will be completed by the end of 2002.
Social Work Structures
The structure for the provision of social work services varies from Trust to Trust. Some Trusts have specialist child protection teams and others have social work teams that manage a range of types of cases. Further information will be provided by the Trusts in their submission to the inquiry.
Support Services to Children in Need of Protection
Trusts can provide a range of services to support children in need and their families. The Children Order identifies these as 'advice, guidance and counselling', 'assistance in kind or cash', and 'accommodation for any child in need'. Accommodation can also be provided for 'another person on order to protect a child'.
Many clients in family and childcare and in particular in the area of child protection are 'unwilling' clients in that they do not want or welcome social services intervention into their family. Trusts, however, still have a duty to investigate concerns about children and provide services to safeguard their well-being. This is a difficult area of work and social workers need skills in listening and communication if they are to build good relationships with parents and children.
Every child known to social services should have it's own social work file. The purpose of the file is to give a record of all social work activity with regard to that child. They should show the assessment process and reason for action taken. Information received about a child from a third party should also be recorded.
Given the workloads carried by social workers and the pressure of statutory duties there are times when files will not be fully up-to-date. The requirement to provide services has led to the reduction in some areas of administrative support staff and this also has resulted in delays in ensuring files are kept up-to-date.
A good working relationship between those professionals working with children and families is a critical requirement in protecting children. This leads to good communication. All enquiries into child abuse have highlighted a breakdown in communication as a key factor in cases of serious child abuse.
There has always been reticence about sharing information between agencies because of the issue of confidentiality. Recent legislation on data protection and human rights have compounded this issue. If an agency or an individual does not wish to share information this legislation can give justification to their decision.
One of the principles underpinning the multi-agency guidelines for the assessment of children in need is that parents and children, where of sufficient age and understanding, will be involved in the assessment and decision making. It is expected that they will be aware of information which is shared between professionals about them and their children. An information leaflet and a form which gives consent for information relevant to the care of their children being shared between professionals is being designed by the working group.
All those working with children have information that will assist the assessment of need and risk for children. The information known to each individual may not appear significant but it is only by sharing this that a full picture of the family and child be developed and an assessment of risk made. The main forum for sharing information are the case discussion, strategy meeting and child protection case conference. It is, therefore, of importance that those people invited to these meetings should attend. In practice, full attendance at these meeting is rarely achieved. Recent research by the ACPC has identified a number of difficulties for GP attendance and work is ongoing to resolve these.
There are issues about the timing and venues of case conferences. Given the competing demands on the professionals invited to the meeting it is not possible to meet all of these.
Decisions made at case conferences are based on the information that is shared at them. If key professionals do not attend then a full assessment of the potential risk for a child cannot be made. Decisions based on incomplete information are not safe.
If attendance at a case conference is not possible, then written reports are requested. There is, however, anxiety and some reluctance from some professionals to put the information about a family in writing. One reason given for this is that parents will be at the case conference and people are concerned about the damage that may be done to their relationship by the sharing of information in front of parents. There is also the fear of litigation if parents challenge the decision of the case conference.
The Children Order identifies partnership with parents as one of its key principles. All parents and children, if they are of sufficient age and understanding are fully involved in the assessment of need and/risk of their children. They are invited to and encouraged to attend case discussions, case reviews and child protection case conferences only in exceptional circumstances is their attendance refused, e.g. where their attendance will remove the focus from the child, their behaviour is aggressive or violent, or they are under the influence of alcohol or drugs.
The attendance of parents at case conference can cause additional difficulties for the management of the conference. Where there are difficulties between parents they will have to attend the conference separately. There is also the possibility that the focus moves to the parents needs away from those of the child.
Parents receive the record of case discussion and case conferences.
Leaflets giving information about the child protection process and the case conference are being revised by the ACPC. These will cover topics such as the assessment process, the case conference and medical examination (with particular reference to sexual abuse).
The ACPC is funding work in the community on raising awareness about child protection issues. This is taking the form of training for community groups in the recognition of child neglect and abuse and what to do if they have concerns about a child.
The NSPCC is running a successful campaign to raise public awareness of child abuse. It is important, however, that members of the community who have contact with children should be aware of less 'dramatic' forms of abuse. They need to know that a number of 'low' concerns from different people can build up a picture of neglect and possible abuse and that this information should be shared with social services for full investigation.
Organised Abuse Enquiries
Since 1998 the Eastern Board has had a standing multi-agency Strategic Management Group (SMG) to oversee the intelligence gathering, investigation and processes around large scale or organised abuse enquiries. This group is chaired by the Director of Social Services of the Board.
This group has built up a body of knowledge and skills which will or could be useful to other facing such enquiries. The methodologies and processes used are among the best in the United Kingdom.
North/South of Ireland Interface
A number of children have been placed in residential and boarding school placements in NI which has posed a challenge for staff in terms of cross-border work, child protection education on a North/South basis and children's strategies for child protection in both jurisdictions. The management of sex offenders and cross-border vetting arrangements are issues that require further discussion.
Case Management Reviews
Case Management Reviews are arranged when a child has died and abuse or suspected abuse may have contributed to their death or where following serious injury to a child it is believed that abuse may be a contributory factor.
"Learning from past experience - a review of serious case studies" (June 2002 DOH), sampled 40 serious case reviews to explore:
n the case review process
n change in policy in practice at local level
n lessons for policy in practice at a national level.
Amongst the summary of their findings were the following.
"Compared with findings from earlier research, fewer children in this study had their names on the Child Protection Register (18%), carers were older (average age 25.8 years at birth of child) and more likely to have mental health problems (45%) and there were fewer schedule 1 offenders (3%) living in the households."
"Several common situations were found among the children and families. Among these were the young age of the children, histories of emotional neglect and poor care, parent's mental health problems and domestic violence. However, these were not universal and frequent observations, such as extensive previous Social Services involvement were refuted."
"Knowledge of common background factors has limited predictive value when applied to a general population of vulnerable children. Only one of the forty cases scrutinised was seen as highly predictable and only three as highly preventable."
"Health professionals were the most likely to have been previously involved with children and families. Twelve of the forty children were completely unknown to Social Services."
"Concerns expressed in the reviews included inadequate showing of information, poor assessments, ineffective decision making, lack of inter-agency working, poor recording and a lack of information on significant males."
Lessons of Public Inquiries
The inquiries into cases of serious abuse have found a number of common features. These are described below:
n The requirements that those professionals who work with children and families should not only have expert knowledge and skills in child protection but also the training to carry out their work. They require appropriate levels of supervision and support. Quality of staff with the knowledge and skills to make difficult decisions is required and staff needs to be properly supervised by confident, competent managers in all agencies.
n In several instances of assessments of need and risks Social Services have classified referrals expressing concern for the safety of children made by members of the public or by Health Visitors as "children in need" rather than "children at risk". This emphasis the need for clear communication and sharing of information about children and families between professionals and agencies.
n The need to involve parents in the assessments of need and gain their views of the support they need in caring for their children.
n Accurate records are essential when assessing risk to children.
n Research indicates that it is not the structure of current inter-agency child protection systems that is at fault in relation to preventable child abuse deaths. Rather the problem lies in the continual failures in the implementation of the systems particularly the lack of systematic evidence-based assessments of initial safety needs of e.g. infants who receive suspicious injuries and assessments of the risks of the recurrence of injuries.
1.†††††††† A number of tragic cases in the Eastern Board highlights a need for the ACPC to look at how to handle the reports produced by case management reviews and the involvement of key agencies and professionals in the consideration of case management reviews at a regional level. The Board welcomes the proposal by the Department of an independent case management review group and we would urge that Board representatives are members of such a group for this to be effective. Review reports should be widely available as a professional education document.
2.†††††††† The quality of inter-agency child protection practice in relation to investigation, assessment, case management, monitoring and provision of family support needs to be subject to new specific national child protection standards.
3.†††††††† There is a need for the development of structured assessment protocols to give greater consistency, reliability, validity in formulating evidence based recommendations to court regarding vulnerable children and their siblings.
4.†††††††† In the light of recent case reviews we would recommend that the Trust Child Protection nurse specialist role should be enhanced to ensure improved professional support, supervision and training.
4.1††††††† Primary Legislation
n Children and Young Person's Act (NI) 1968;
n Family Law Reform (NI) Order 1977;
n Matrimonial Causes (NI) Order 1978;
n Judicature (NI) Act 1978;
n Domestic Proceedings (NI) Order 1980;
n Child Abduction (NI) Order 1985;
n Education and Libraries (NI) Order 1986;
n The Adoption (Northern Ireland) Order 1987 (SI 1987/2203 (NI 22));
n Criminal Justice (NI) Order 1991;
n The Children (Northern Ireland) Order 1995 (SI 1995/755 (NI2));
n The Children (Northern Ireland Consequential Amendments) Order 1995 (SI 1995/756);
n Children's Evidence (NI) Order 1995;
n Children (Allocation of Proceedings) Order (NI) 1996
n The Family Home and Domestic Violence Order 1998 ( as amended by Article 5 of the Criminal Justice (NI) Order 1991);
n Criminal Justice (Children) (NI) Order 1991;
n The Adoption (Intercountry Aspects) Act (NI) 2001 (c. 11);
n The Family Law (NI) Act 2001
4.2††††††† Statutory Rules and Orders
n Magistrates' Courts (Children and Young Persons) Rules (NI) 1969 No 221;
n Conduct of Children's Homes Direction (NI) 1975 as amended by HSS (CC) 2/88, HSS (CC) 3/94 and HSS (PPRD) 3/95;
n Matrimonial Causes Rules (NI) 1979 No 89;
n Education (Special Educational Needs) Regulations (NI) 1985;
n County Court (Amendment No 3) Rules (NI) 1989 No 307;
n Rules of the Supreme Court (NI) (Amendments No 6) 1989 No 343;
n The Adoption Agencies Regulations (Northern Ireland) 1989 (SR 253);
n Health and Personal Social Services (Assessment of Resources) Regulations (NI) 1993 and subsequent amendments;
n Health and Personal Social Services (Assessment of Resources) Regulations (NI) 1993 and subsequent amendments;
n The Northern Ireland Guardian Ad Litem Agency (Establishment and Constitution) Order (Northern Ireland) 1995 (SR No. 397);
n The Adopted Persons (Birth Records) Regulations (Northern Ireland) 1995 (SR No. 484);
n The Adopted Persons (Contact Register) (Fees) Regulations (Northern Ireland) 1995 (SR No. 485);
n The Guardians Ad Litem (Panel) Regulations (Northern Ireland) 1996 (SR No. 128);
n Definition of Independent Visitors (Children) Regulations (Northern Ireland) 1996 (SR No. 434);
n The Emergency Protection Order (Transfer of Responsibilities) Regulations (Northern Ireland) 1996 (SR No. 434);
n The Adoption Allowance Regulations (Northern Ireland) 1996 (SR No. 439);
n Contact with Children Regulations (Northern Ireland) 1996 (SR No. 444);
n The Representations Procedure (Children) Regulations (Northern Ireland) 1996 (SR No. 451);
n The Children (Private Arrangements for Fostering) Regulations (Northern Ireland) 1996 (SR number 452);
n The Arrangements for Placement of Children (General) Regulations (Northern Ireland) 1996 (SR No. 453);
n The Children (Parental Responsibility Agreement) Regulations (Northern Ireland) 1996 (SR No. 455);
n The Review of Children's Cases Regulations (Northern Ireland) 1996 (SR No. 461);
n The Placement of Children with Parents etc. Regulations (Northern Ireland) 1996 (SR No. 463);
n The Foster Placement (Children) Regulation (Northern Ireland) 1996 (SR No. 467);
n The Child Minding and Day Care (Applications for Registration) Regulations (Northern Ireland) 1996 (SR No. 468);
n The Employment of Children Regulations (Northern Ireland) 1996 (SR No. 478);
n The Disqualification for Caring for Children Regulations (Northern Ireland) 1996 (SR No. 478);
n The Children's Homes Regulations (Northern Ireland) 1996 (SR No. 479);
n The Refuges (Children's Homes and Foster Placements) Regulations (Northern Ireland) 1996 (SR No. 480);
n Children (Public Performances) Regulations (Northern Ireland) 1996 (SR No. 481);
n The Children (Secure Accommodation) Regulations (Northern Ireland) 1996 (SR No. 487);
n The Children (Prescribed Orders - Isle of Man and Guernsey) Regulations (Northern Ireland) 1996 (SR No. 528);
n The Criminal Investigations and Procedures (NI) Act 1996;
n The Inspection of Premises, Children and Records (Schools Providing Accommodation) Regulations (NI) 1996;
n Children (Admissibility Of Hearsay Evidence) Order (NI) 1996;
n Family Proceedings Rules (NI) 1996;
n Juvenile Courts and Assessors for County Courts (Amendment) Regulations (NI) 1996;
n Day Care (Exempt Supervised Activities) Regulations (NI) 1996;
n Magistrates' Courts (Children (NI) Order 1995) Rules (NI) 1996;
n Magistrates' Courts (Domestic Proceedings) Rules (NI) 1996;
n Magistrates' Courts (Children and Young Persons) (Amendment) Regulations (1996);
n The Children (1995 Order) (Amendment) (Children's Services Planning) Order (Northern Ireland) 1998 (SR No. 261);
n Inspection of Premises, Children and Records (Children Accommodated in Schools) Regulations (NI) 2000 (S.R No. 179).
4.3††††††† Guidance and Directions from DHSS or Predecessor
Services for Children and Young People in Northern Ireland: Recruitment of Staff, Interim Modification of the Selection and Appointment Procedures and the Establishment of a Pre-employment Consultancy Service HSS (GEN1) 6/83;
n Provision of Information to and a Complaints Procedure for Children in Residential Care and their Parents HSS(CC) 2/85;
n Child Abduction (NI) Order 1985 Circular HSS (CC) 4/85;
n Responsibilities of Health and Social Services Boards in Surrogacy Cases Circular HSS (CC) 1/86;
n Education of Children with Special Educational Needs - Duties of Health & Social Services Boards 1987: Circular HSS (Mental Handicap) 2/87
n A Guide to the Adoption (NI) Order 1987 (DHSS (NI) 1988);
n Protecting Children - A Guide for Social Workers Undertaking A Comprehensive Assessment (HMSO, 1988);
n Monitoring of Residential Child Care Services (HSS(CC) 6/83) as amended by Circular HSS (CC) 2/88;
n Grading of Residential Childcare Staff Circular HSS (TCC) 2/91 (SE 194);
n Working with Child Sexual Abuse - Guidelines for Trainers and Managers in Social Services Departments (DOH, 1991);
n Adoption of Children from Overseas Circular HSS(CC) 4/92 and Supplement Number 1;
n Hague Convention on Adoption: Adoption (Hague Convention) Act NI 1969 Circular HSS (CCB) 9/78 as amended by Circular HSS (CC) 4/94;
n Adoption (NI) Order 1987: Health Service Registration of Adopted Children Circular HSS (CC) 2/90 as amended by Circular HSS (CC) 4/94;
n Release of Prisoners Convicted of Offences Against Children in the Home A1087/1978 - Circular HSS (CCB) 7/78 as amended by Circular HSS (CC) 2/94;
n Mentally Handicapped Children: Short Term Respite Care In Children's Homes (unnumbered closed dated 4/2/94);
n Adoption (NI) Order 1987: Implementation Circular HSS (CC) 3/89 as amended by HSS (CC) 4/94;
n The Children (NI) Order 1995: Regulations and Guidance Volume 1: Court Orders and Other Legal Issues ISBN - 0337 -37080X;
n The Children (NI) Order 1995: Regulations and Guidance Volume 2: Family Support, Child Minding and Day Care ISBN - 0337 - 370818;
n The Children (NI) Order 1995: Regulations and Guidance Volume 3: Family Placements and Private Fostering ISBN - 0337 - 370834;
n The Children (NI) Order 1995 Regulations and Guidance Volume 4: Residential Care ISBN - 0337 - 370834;
n The Children (NI) Order 1995: Regulations and Guidance Volume 5: Children with a Disability ISBN - 0337 - 370842;
n The Children (NI) Order 1995: Regulations and Guidance Volume 6: Co-operating to Protect Children ISBN - 0337 - 370850;
n The Children (NI) Order 1995: Regulations and Guidance Volume 7: Sections Accommodating Children ISBN-0337-23669;
n An Introduction to the Children (NI) Order 1995;
n SSI Quality Living Standards for Services : Children Who Live Away From Home;
n SSI Code of Practice on the recruitment, assessment, approval, training, management and support of foster carers;
n Protocol for joint investigations by Social Workers and Police Officers of alleged and suspected cases of child abuse;
n Guide To The Adoption Allowance Regulations (Northern Ireland) 1996;
n Adoption Law and Procedures - Effects of the Children (NI) Order 1995 HSS (CC) 4/96;
n Interagency Guidance on the Release of Persons Arranged or Held in Connection with Schedule 1 Offenders Against Children or Young Persons Under the Age of 17;
n Circular HSS (DMHU 1/97 - Guidance for the Health & Personal Social Services Implementation of the of the Notification Requirements of the Sex Offenders Act;
n Co-operating to Protect Children - A Guide for Health and Social Services Boards on the Management of Child Abuse HSS (CC) 4/98;
n Procedures for the Assessment and Management of Risk of Sex Offenders Against Children; N.I. Manual of Inter-Agency Guidance.
n Inspection and Monitoring of Residential Childcare Services - Circular HSS(CC) 1/98
n Children Services Planning Guidance (July 1998)
n Registration and Inspection of Childminders Advice and Good Practice - Circular HSS (CC) 3/99
n Standards in Day Care Services: Modern Apprenticeships in Childcare - Circular HSS (CC) 2/99
n Revised appendix 3 of volume 6 of the Children (NI) Order Regulations Guidance - "Co-operating To Protect Children" - Armed services arrangements for child protection HSS (CC) 1/99;
n Payment of fees for Registration and Annual Review of Registration of Registered Children's Homes†††††††† Determination (NI) 1999 HSS (CC) 4/99;
n A guide to inter-country adoption practice and procedures/The inter-country adoption procedures (1 March 1999);
n Permanency Planning for Children: Adoption: Achieving The Right Balance (May 1999);
n Checking Background of Staff Employed in Residential Childcare Settings Including Staff Supplied by Employment Agencies - circular HSS(CC) 1/00;
n A guide to using the Pre-Employment Consultancy Service (April 2001);
n Amendments to Pre-employment Consultancy Service (Unnumbered Amdts 1,2 & 3);
n Memorandum of Good Practice on Video Recorded Interviews with Child Witnesses for Criminal Proceedings. Home Office/Department of Health (undated).
EASTERN AREA CHILD PROTECTION COMMITTEE
A core function of the Eastern Area Child Protection Committee is the identification, of inter-agency training needs and taking a strategic approach to the delivery of training programmes to meet interagency and multi-disciplinary requirements. In order to do this the Training Sub-Committee of the ACPC has developed a Training Framework on the basis of the 3 stage approach outlined in Co-operating to Safeguard.
The following framework describes the training to be covered to meet the needs of different staff across the various agencies at three levels: Basic, Foundation and Specialist.
Basic Training is for all staff involved in contact with children to provide them with an understanding of child protection and their role in relation to it.
Foundation Training is for those staff in agencies who are involved in delivery of services to children who may be at risk of significant harm. It is assumed that staff targeted for Stage II training will already have some understanding of the areas covered in Stage I. Where there is deemed to be any shortfall in knowledge and understanding of Stage I it is anticipated that agencies would address this on a uni-disciplinary basis.
Specialist Training is for staff directly involved in the investigation, assessment and intervention to protect children considered to be at risk and in need of protection.
Each stage of the training framework training breaks down to the areas to be covered within each level, the expected outcomes and the specific groups of staff considered appropriate for each level of training. The framework also identifies some of the existing training programmes currently being delivered / being developed.
It is envisaged that the total training framework is used:
n to enable agencies to identify the areas of training relevant for staff within each agency
n to identify gaps in training
n to modify, refine, or update existing training programmes
n as a tool to plan training delivery on an inter-agency/cross Trust basis
n to inform the development of training modules to meet general and specific training requirements on a collaborative basis that are consistent and quality assured as appropriate.
Through the entire process the ACPC will maintain a strategic overview of child protection training, identifying the consistency and standards applied to training delivery, plan for future training requirements and identify opportunities for inter-agency training initiatives based on collaborative working and joint commissioning.
The following Core Values should underpin all training at each stage of the framework, incorporated into training programmes as appropriate.
n Paramountcy of child - safeguarding and promoting the child's welfare
n Working together in an open and honest way and involving children and their carers
n Respecting the uniqueness and dignity of children and their carers and working in ways which recognise their ethnic origins, religious beliefs and individual circumstances.
n Recognition of the inequalities that can exist between service users, professionals, organisations and the wider community
EASTERN AREA CHILD PROTECTION COMMITTEE
Action Agenda - 2002-2003
written submission by:
1.†††††††† Background to Family Group Conference Forum (NI)
2.†††††††† Background to Family Group Conferencing
3.†††††††† What is Family Group Conferencing?
4.†††††††† Model of practice for Family Group Conferencing in Child Protection
5.†††††††† Evidence from Research
1.†††††††† Background to Family Group Conference Forum (NI)
1.1††††††† The Family Group Conference Forum is a voluntary organisation that developed from a conference and a series of workshops held in 1997. Issues which emerged for Northern Ireland included the need to:
n Raise awareness of the process
n Support application to practice
n Integrate into organisational procedures
The outcome resulted in the emergence of the Family Group Conference Forum (NI).
1.2††††††† The aim of the Family Group Conference Forum (NI) is to promote an inclusive understanding of and support for Family Group Conference and Restorative practice.
1.3††††††† The objectives are to involve families, individuals, organisations and communities in order to:
n facilitate an exchange of information;
n discuss and share key ideas and issues;
n help clarify the interface between interested parties in relation to one another;
n to access, share and maximise resources; and
n to identify, support and promote the development of good practice.
1.4††††††† Principles within which the Forum operate include:
n An organised Forum that is open to those interested in the above aims and objectives
n Multi Disciplinary in working across both boundaries and borders
n Supporting practice and research developments
n To work together and form national and international alliances
n To ensure partnership in practice development and between organisations.
1.5††††††† The Forum provides training through conferences and workshops to promote best practice in family group conferencing. It also organises open forum meetings, which offer support and an opportunity to share experiences and ideas for practitioners and managers.
2.†††††††† Background to Family Group Conferencing
2.1††††††† Family Group Conferences originated in New Zealand, and was a response to the Maori population's growing criticism of the number of Maori children in state care.
2.2††††††† As a result of a ministerial inquiry that was critical of the New Zealand Department of Social Welfare's failure to involve Maori families in decisions about the States care of their children, the Family Group Conference model was devised as a method of involving families in the decision making process in a way that reflected the Maori culture and the importance of the extended family in that culture.
Family Group Conferencing was subsequently the underpinning concept in the Children, Young Person and Their Families Act, 1989 in New Zealand.
2.3††††††† Family Group Conferencing has since developed internationally in a large number of countries becoming part of countries child welfare systems, either as mainstream practice developments or as pilot projects. The model has thus been put to the test in such diverse settings as Australia, Canada, Israel, Norway, South Africa, Sweden, the UK, the USA and the Republic of Ireland.
2.4††††††† Within the UK interest in Family Group Conferences began in 1990 when the Family Rights Group became aware of this way of working with families. They promoted the model, encouraging and supporting practitioners who were keen to explore the concept. From this a number of Social Services Departments established Pilot Projects including Essex and Hampshire County Councils.
2.5††††††† In Northern Ireland there is considerable interest and projects have been developed by Barnardo's in Partnership with Armagh & Dungannon Trust; Ulster Community and Hospitals Trust and Homefirst Trust. The project in the Ulster Community and Hospital Trust is now part of the Trusts core childcare service.
3.†††††††† What is Family Group Conferencing?
3.1††††††† Family Group Conferencing is a family centred decision making process involving a wide network of family and friends.
3.2††††††† It is used when major decisions need to be made to ensure the safety or well being of a child or children.
3.3††††††† It is predicated on the principles of inclusion and partnership with families and adopts a strengths based perspective.
The Family Group Conference approach endeavours to bring together the knowledge, skills and resources of both formal (professional/agencies) and informal (family/community) systems within the child's network.
3.4††††††† Through the work of an Independent Co-ordinator these two systems are brought together. Families are encouraged to take up the responsibilities of decision making, while the role of the State is to facilitate and to assist were appropriate in resource family plans and decisions.
3.5††††††† The underlying principles of Family Group Conferences are that:
n The child's interests and welfare are paramount.
n Children are best looked after within their families. Services should seek to promote this whenever possible.
n Working in partnership with families is beneficial for children.
n Families provide identity, roots and continuity, beneficial to children.
n Families are able to make good decisions about their children given the opportunity and information to do so.
3.6††††††† In Child Protection Procedures, Child Protection Case Conferences are a key decision-making forum and a formal mechanism for professionals and families to interact. Studies suggest that families very often experience these Case Conferences as a disempowering process in which professionals are perceived to be the 'experts', the focus of the process is problem orientated, and decisions and plans are made by professionals and imposed on them.
3.7††††††† In contrast, Family Group Conferences are a family led process; the family are perceived as their own experts, information is provided by professionals and considered by the family who then make decisions and plans for the considering of the professionals.
3.8††††††† Given that most children whose names are placed on Child Protection Registers remain at home, and that their protection rests with their families, it follows that families have a role to play in devising a protection plan rather than having to implement one devised by professionals.
4.†††††††† Model of practice for Family Group Conferencing in Child Protection
4.1††††††† Family Group Conferences are structured decision making meetings. The conference is made up of the main family group including the child, their family, and extended family and any significant others who the family see as important in their lives (these may not be blood related).
This group of people will meet in "private time" to reach a plan of care and protection for their child or children.
4.2††††††† The professional's role is to produce information for the conference and to assist with the plan after the conference. This model emphasises and encourages the skills and expertise of all those involved with the child and allows families, who know themselves best, to come up with their own solutions to whatever difficulties are around for them at that time.
Family Group Conferences are and can be used whenever a plan or decision needs to be made about a child.
4.3††††††† Family Group Conferences do not replace statutory child protection procedures, rather they can provide another avenue that may lead to a solution that had not been considered before, or one that is smoother or quicker to achieve. They can look at the issues of Permancy of placement, strengths of the child and family and other areas of importance.
There are differences however from the way the work is usually progressed.
There are two different roles within the model, one is the role of the family's social worker and the other is the role of the co-ordinator.
4.4†††††† Role of the Social Worker
It is the social workers role to discuss the idea of a FGC with the family, explaining the process to them. They then, with the family's agreement, complete a referral form and process it.
Prior to the FGC, the social worker prepares a report that includes the agency's "bottom line" in terms of the child's safety for presentation at the conference. The social worker should also remain in the vicinity during the conference should the family require clarity or further information and be prepared to agree the plan upon completion by the family.
Agreement should be immediate unless clearance is needed due to costs etc, and if this is the case a date, no later than a week, should be agreed for a reply to that. Following the FGC it is the social worker's job to aid the carrying out of the plan, especially those tasks etc, that Social Services have signed up to.
4.5††††††† Role of the Co-ordinator
It is the job of the co-ordinator to convene and manage the Family Group Conference process.
The co-ordinator will meet initially with the social worker to identify the agency's concerns and to obtain the "bottom line".
The co-ordinator will then meet with the immediate family and child or children and identify the greater family circle and friends that they would wish to be involved in the conference. As it is crucial that all attend the FGC the co-ordinator will ensure that the date, time and venue is suitable and that they all agree to be there, including the social worker (this is usually out of office hours e.g. evenings or weekends).
Preparing the family to participate in FGC is another task for the co-ordinator, insuring that all whose who are to attend understand the process and issues to be addressed. The Co ordinator also has the right to exclude someone from the meeting if absolutely necessary to guarantee a safe environment. This may be because there is a threat of violence or that someone is inebriated (this person could have their contribution made in another way).
Generally, the co-ordinator does a major amount of preparatory work with everyone who will be attending the FGC.
Families who live great distances away are also encouraged to attend and financial assistance may be necessary to achieve this.
The co-ordinator visits each one who will be attending, where possible, only those who live out of the country are usually telephoned.
At the conference the co-ordinator makes sure that all the relevant information is shared, including all those resources available to the family with any waiting times etc. The "bottom line" for Social Services is stated and clarified if necessary. The family can ask for any other information and seek clarity at this point. They are then left with the task of coming up with a plan. All the professionals leave and only the family and their friends remain to achieve this, they can of course call the professionals back in at any time to aid the discussion by providing information or whatever they feel they may need to come to a conclusion.
The co-ordinator is then called back, along with the social worker to hear the family's plan. If the plan is not approved consideration is given to minor adjustments which can take place immediately by having a further period of "private time" or if it may need a considerable period of time and the family think that a plan can be achieved, then it may be agreed that another FGC is arranged sometime in the very near future. The social worker may need to have the plan ratified at the Child Protection Case Conference but should be able to agree the plan in principle as long as the child is not at risk of significant harm.
It is also the job of the co-ordinator to arrange a Review FGC to take place in a few months time.
4.6††††††† Stages of a Family Group Conference
††††††††††† STAGE 1
Identify family and friends
Prepare everyone for the FGC
Agree date, time, and venue
††††††††††† STAGE 2
Professionals share their concerns
Statutory duties and responsibilities explained
The relevant sources available
Family have an understanding of the decisions they can make
Any other decision-making forums, which will have an impact, are made know
††††††††††† STAGE 3
Private Family Time
Co-ordinator and Professionals leave the room
Family have tasks to complete:
n to agree a plan which meets the needs of the child/ren and addresses any concerns that have been raised
n to agree any contingency plans
n to agree their part in the implementation, monitoring and review
††††††††††† STAGE 4
Agreeing the Plan
Professionals and the Co-ordinator meet with the family to consider the plan, agree who has responsibility for carrying out specific tasks and to negotiate any resources needed.
The plan will be agreed by the professionals if it addresses the concerns that were outlined at the information giving stage and that it does not put any child at risk of significant harm.
Contingency plans, monitoring and reviewing arrangements are also agreed at this time.
It is essential at this time to have an understand about what will happen if parts of the plan are not carried out or if agreed resources are not provided. The Co-ordinator will send everyone a copy of the plan.
4.7††††††† The model itself is very clear and straightforward and should be seen as an approach to planning and decision-making, which calls upon the skills, the experience and the expertise of the wider family as well as those professionals involved.
4.8††††††† The principles of Family Group Conferences are very much in line with the Children (NI) Order 1995, along with the aim to reduce State care and to ensure that families take up their responsibilities. It is more of a community approach and more empowering for users.
5.†††††††† Evidence from Research
5.1††††††† The following are two examples of research into the effectiveness of Family Group Conferencing, the first a summary of work in England and Wales and the second a summary of three pilot projects in Northern Ireland.
5.2††††††† A Research Study on Family Group Conferences in Child Welfare
The study, funded by the Nuffield Foundation, provided a detailed examination of 80 Family Group Conferences in England and Wales carried out in four social services departments in 1995 and 1996,
The conferences succeeded in involving extended family, often in difficult circumstances. They had generally good outcomes and high levels of satisfaction from all participants. To achieve this the model required careful implementation, good preparation, skilful work and continuing support.
5.3††††††† The Process
Family Group Conferences have been used successfully with the full range of child welfare problems including child abuse and neglect.
There is no indication that the families are any 'easier' or the children any less at risk than in other cases.
A wide range of family members have been involved in the decision making and many have offered resources to help and support the child.
The pivotal co-ordinator role requires interpersonal, group and organisational skills to negotiate family attendance and participation at the meetings, a process which can be very time consuming and demanding.
5.4††††††† The Outcomes
Out of the 80 Conferences, 74 produced agreements that were fully acceptable to professionals and families as being in the best interests of the children.
There are indications that children are more likely to have a placement with extended family, and that the placement is more likely to be stable, following a Family Group Conference.
The professionals involved think the children are protected by the plans and there are indications of a reduction in re-abuse rates.
Staff thought that the Conferences contributed to savings in a number of areas which would cover the direct costs of running them.
5.5††††††† View on the Model
Family members are very satisfied with the process, although they find it stressful and difficult.
Almost all the professionals involved expressed support for the model, but around one third of social workers appear reluctant to refer families for a Family Group Conference.
The project initiators were clear that introducing Family Group Conferences into a selected part of social work practice needs careful planning and preparation over at least a year, plus ongoing training, feedback and staff support.
Plans that social workers thought would otherwise have been made, just over half were thought to have cost less as a result of the meeting, and only 4 (out of 74) to have cost more.
"Families come up with all sorts of plans that are not in our frame of reference really. I think I'm much more adaptable to think "Yes, why not, it could work.""
5.6††††††† The Family Group Conference model provides a structure but each one is unique to each family. The venue for the meeting is chosen in consultation with the family, as is the date and time, the language of the meeting and the facilities such as refreshments and child care arrangements. In this way, cultural differences can be acknowledged and respected. Most of the Conferences were held on 'Neutral territory' such as community centres, almost half of the meetings were held outside normal working hours, and half of the Welsh conferences were held in Welsh. The majority of participants approved of the process of the Conferences.
5.7††††††† Outcomes, Costs and Benefits
n Family members were generally happy with the plans and satisfied that they were being carried out.
n Monitoring of plans was usually carried out by social services, sometimes in conjunction with family members or other agencies.
n Comparing the implementation of these major decisions with information available on plans made through other processes suggests that the implementation rate is reasonable.
n Placement plans were carried out and remained stable in three quarters of cases.
n Of the 99 children, 39 were being looked after at the time of the Family Group Conference.
n The outcomes for this group were compared to those in care studied elsewhere: a very similar proportion of the group remained looked after but those that returned home were more likely to be placed with relatives or friends and were less likely to move on subsequently.
n There were child protection concerns for 44 of the study group, the majority being cases of neglect but including concerns of physical and sexual abuse.
n Registration rates suggested similar levels of concern to the population going to child protection conference.
n De-registration rates, and the low incidence of re-abuse, indicate that the children are well protected by the plans made.
n Social workers reported being satisfied that the children were at least as well protected as they would have been; two thirds thought they were better protected as a result of the Conference.
n Each Family Group Conference costs around £400 to £600, more if there are high travel costs, or needs particular to the family, e.g. for an interpreter.
n These costs are likely to be met by the potential savings in state services; for example court costs may be avoided, child protection procedures may not be needed, demand for some form of care may be reduced.
n Most social workers involved made clear reference to benefits resulting from the Conference - not only from the plans but also the better communication and understanding that was established between all the participants.
n Family members were also very positive about the benefits of the process and three quarters or more would choose to have another Family Group Conference in similar circumstance, whilst acknowledging that it was not an easy option.
5.8††††††† Northern Ireland Context
In Northern Ireland the development of Family Group Conferencing has been progressing since the conference in 1997.Ulster Community and Hospitals Trust began a Pilot Project in July 1998. Barnardo's, in partnership with the Southern Health and Social Services Board started a pilot in 2000 and Homefirst initiated a pilot project in March 2001.
Evaluation and research findings from these pilots are still at an early stage of development but initial evidence shows similar outcomes as produced in England and Wales.
To date the number of Family Group Conferences in support of children that have been successfully completed are:
Ulster Community and Hospitals Trust††††††††††††††† 22
Homefirst Trust††††††††††††††††††††††††††††††††††††††††††††††† 15
Of these cases 26 involved children on the Child Protection Register. 9 cases involved children in the care of Trusts and in 12 cases there was a risk of family breakdown. The remaining ten cases have been in relation to family support including 3 cases where there has been the death of a parent.
The outcomes of these family group conferences have included:
n Children being removed from the child protection register
n Children returned home from alternative care to their parents or extended family
n The development of positive shared care arrangements which increased the amount of family contact for children in care
n The avoidance of care proceedings and a reduction in the need for social work involvement.
Feedback from family members and children involved in the conference has been generally positive and include:
n "Family Group Conferences are a good way of making sure a child is kept within the family by getting friends and family together to sort problems out."
n "The atmosphere during the family conference was relaxed."
n "Everyone was listened to and shown respect."
n "I found the whole dynamics involved in the actual meeting very emotional and very powerful."
n "We could not have survived without the Family Group Conference."
††††††††††† Child/Young Person:
n "I felt wanted - I knew that if all my family didn't care about me then they wouldn't be there."
n "The family conference helped. You get to say what you think."
n "We were able to sort some things out you know differences between the two sides of the family."
n "My mummy and nanny weren't talking too well but since the meeting they have been."
n "It doesn't make you feel as small and inferior - we were all more on the same level. It gives you a goal to do and you have to think about how you are going to achieve it - it motivates and gives you a bit of determination."
Professionals have also viewed Conferencing in a positive light.
n "Family were able to pull together their own strengths and resources and make a plan that was right for them."
n "A positive resource for Social Workers in respect of resolving issues/reducing risk/working in partnership with families/empowering families."
n "FGC allows Social Workers to explore family options in a new and non-threatening manner."
n "FGC offers real 'power sharing' with families."
(a)††††††† Family Group Conferencing should be promoted as a way of working positively with families to better secure the protection and well being of children
(b)††††††† Family group Conferencing should be included in the teaching syllabus of Social Work Training and that of allied professionals
(c)††††††† Service users should be involved in the development of the service
(d)††††††† Funding should be made available on a permanent basis and all Trusts within Northern Ireland should have the opportunity to develop this way of working
(e)††††††† Family Group Conferencing should be included in the Child Protection Policy and Procedures of each Health and Social Services Board, so that its use is offered to every family at Case Conference
1.†††††††† Family Group Conference Forum (NI)
1.1††††††† The Family Group Conference Forum (NI) is a voluntary organisation.
1.2††††††† The aim of the Family Group Conference Forum (NI) is to promote an inclusive understanding of and support for Family Group Conference and Restorative practice.
1.3††††††† The Forum provides training to promote best practice in Family Group Conferencing. It also offers support and an opportunity to start experiences and ideas for practitioners and managers.
2.†††††††† Background to Family Group Conferencing
2.1††††††† Family Group Conferencing originated in New Zealand in response to a ministerial inquiry which was critical of the New Zealand Department of Social Welfare failure to involve Maori families in decisions about the states care of their children.
2.2††††††† Family Group Conferencing was subsequently the underpinning concept in the Children Young Person and Their Families Act 1989 in New Zealand.
2.3††††††† Family Group Conference has developed internationally, becoming part of many countries Child Welfare systems. It has been put to the test in Australia, Canada, Israel, Norway, South Africa, Sweden, United Kingdom, United States of America and Republic of Ireland.
2.4††††††† In Northern Ireland there is considerable interest, projects have been developed by Barnardos in partnership with Armagh and Dungannon Trust, Ulster Community and Hospital Trust and Homefirst Trust.
3.†††††††† Family Group Conference Model
3.1††††††† Family Group Conferencing is a family centred decision making process involving a wide network of family and friends.
3.2††††††† It is used when major decisions need to be made to ensure the safety or well being of a child(ren).
3.3††††††† It is predicated on the principles of inclusion and partnership with families.
3.4††††††† The principles of Family Group Conference are very much in line with the Children (NI) Order 1995, which endeavours to reduce State Care and ensure that families take up their responsibilities.
3.5††††††† The role of Independent Co-ordinator whose remit it is to engage family members and professionals in the process is perceived by both family and professionals as a crucial part of the process.
4.†††††††† Child Protection
4.1††††††† Child Protection Case Conferences are a key decision making forum. The perception of many parents is that for them it is a disempowering process. There is a expectation from professionals however that they (parents) agree and implement protection plans advised by professionals.
4.2††††††† The majority of children whose names are placed on Child Protection registers live at home. Their day to day protection rests with their families. If the family are to be the key people in implementing a protection plan it is important for them to have a role in devising the plan.
4.3††††††† The comparison between a Child Protection Case Conference and a Family Group Conference highlights that an Family Group Conference provides families with a sense of ownership of the difficulties. It is perceived by them to be an empowering process acknowledging that they have knowledge and skills which are valuable.
4.4††††††† Family Group Conference has potential to change the relationship between families and professionals from an often adversarial and conflictual one, to one in which both parties work together positively to protect children.
4.5††††††† The model is founded on the belief that family, in its widest sense is more motivated then any other social institution to care for and protect its own children.
5.1††††††† A study funded by the Nuffield Foundation provided a detailed examination of 80 Family Group Conference's in England and Wales carried out in 1995 and 1996.
5.2††††††† Family Group Conference's succeeded in involving extended family and generally good outcomes and high levels of satisfaction from all participants.
5.3††††††† Family Group Conference's have been used successfully with the full range of child welfare problems including child abuse and neglect.
5.4††††††† The pivotal role of Independent Co-ordinator required interpersonal, group and organisational skills to negotiate family attendance and participation at the conference, a process which is time consuming and demanding.
5.5††††††† Out of 80 Family Group Conference's 74 produced agreements that were fully acceptable to professionals and families as being in the best interests of children.
5.6††††††† Professionals involved thought the children were protected by the plans and these were indicators of a reduction in re-abuse rates.
5.7††††††† These were indications that children were more likely to have a placement with extended family and that the placement was more likely to be stable.
5.8††††††† Professionals involved thought that the Family Group Conference's contributed to savings in a number of areas e.g. less likelihood of admission to case, which would cover the direct costs of running them.
5.9††††††† Family members expressed satisfaction with the process although found it stressful and difficult.
5.10††††† De-registration rates and the low incidence of re-abuse suggested that children were well protected by the plans made.
5.11††††† In Northern Ireland evaluation and research findings are still at an early stage of development. However initial evidence indicates similar outcomes as those produced in England and Wales.
5.12††††† In total 57 Family Group Conference's have been completed by the three Trusts - Ulster Community and Hospital Trust, Homefirst Trust and Armagh and Dungannon Trust in partnership with Barnardos.
5.13††††† Of these cases 26 involved Children on the Child Protection Register. The outcome of these Family Group Conferences have included:
n Children's names being removed from the Child Protection Register
n Children returning home from alternative care to their parents or extended family
n The avoidance of care proceedings and a reduction in social work involvement
(a)††††††† Family Group Conferencing should be promoted as a way of working positively with families to better secure the protection and well being of children.
(b)††††††† Family Group Conferencing should be included in the teaching syllabus of Social Work Training and that of allied professionals.
(c)††††††† Service users should be involved in the development of the service.
(d)††††††† Funding should be made available on a permanent basis and all Trusts within Northern Ireland should have the opportunity to develop this way of working.
(e)††††††† Family Group Conferencing should be included in the Child Protection Policy and Procedures of each Health and Social Services Board, so that its use is offered to every family at Case Conference.
written submission by:
I am responding to your request for comments on the proposed Inquiry into Child Protection Services in Northern Ireland by the Committee for Health & Social Services and Public Safety of the Northern Ireland Assembly in relation to the effectiveness of current service provision.
This response has been prepared with the assistance of key staff who are healthcare professionals with a background in Midwifery, Health Visiting, Child and Adolescent Psychiatry, Children's Nursing and Social Services with a present remit to manage nursing and social care at delivery level for a client group of children and young people. This Trust is particularly aware of its responsibility to promote the welfare and protection of children and young people. This commitment to the welfare of children requires that all personnel having contact with children whether in a hospital or community setting have training in Child Protection awareness.
Children's Services - Green Park Healthcare Trust
Green Park Healthcare Trust currently provides children's services in the specialties of Orthopaedics, Rheumatology, Child and Family Psychiatry, Spinal Cord Injuries, Neuro-Rehabilitation and a Children's Respite Service. The majority of children treated at Green Park Healthcare Trust are by planned admission.
This response addresses the general areas in respect of legislation and training as applied in Green Park Healthcare Trust. Two specific areas are responded in text, namely Part A - Children's Units and Part B - Child and Family Psychiatry.
Legislation - General
Practice in relation to child protection issues in Green Park Healthcare Trust is informed by both the Eastern Health & Social Services Board Guidelines and the Trust's own local policies. The current Child Protection Legislation provides a framework of statutory legislation for infants, children and young people under the age of 18 years.
Training - General
Local training in awareness of child protection has more recently been undertaken by a Senior Social Worker from South and East Belfast Community Trust. South & East Belfast Community Trust hold a Service and Budget Agreement with Green Park Healthcare Trust for the provision of Hospital Social Services.
Multidisciplinary Child Protection Sessions are facilitated by the senior social worker twice yearly and are well attended. These sessions encompass Legislation and Policy, signs and symptoms and provide staff with the opportunity to explore how best to deal with child protection issues in the Hospital environment.
There is also basic Child Protection awareness raised during induction of all new staff to the Trust and this is also provided by the senior social worker.
Training, support and guidance is readily available to Trust staff through informal structures, by contacting the Social Work Department.
Part A††††††††††† Legislation - Children's Units
The principles underpinning the philosophy of care in the Children's Units are also informed by the Guidance of Professional Practice for Nurses, Midwives and Health Visitors in relation to the Children (Northern Ireland) Order 1995, published by the Department of Health and Social Services Central Nursing Advisory Committee with regard to Guidance on Roles and Responsibilities (P28). The hospital based nurse has specific responsibilities to:
n Maintain a safe environment for the child
n Complete the parent held child record if available
n Establish reciprocal liaison systems with Community Nursing and to notify Health Visitors and/or Community Paediatric Nurses of attendance at hospital of all children under 18 years.
n Ensure that there is an agreed procedure for obtaining and recording information about the child and his/her family from other agencies; for example, details about decisions concerning the future care of the child, who should have contact, any legal order in force and the names of the Health Visitor and Social Worker.
n Ensure ready access to Child protection procedures including access to the Child's Protection Register.
n Inform the child's Health Visitor of any referral to Social Services.
n Nursing staff will liaise with Social Services to make application for necessary statutory functions.
The children's units at Musgrave Park Hospital has good liaison and support from the hospital's Social Services team, which has proven to be very effective. Out of hours support is provided by the social services team based at Knockbracken Healthcare Park.
The established pattern of following Best Practice within the Children's Units informed by the policies and guidance referred to previously, has proven to be effective in achieving optimal outcomes.
Social services carry out regular exit audits with the users of the service which helps to inform and develop service delivery and planning.
Being conscious of our responsibility to ensure that those delivering nursing care in the children's units have the prerequisite knowledge and understanding to promote the welfare and protection of children in their care, one ward manager and a significant number of nurses, healthcare assistants and nursery nurses have accessed a course in Advanced Child Protection which is validated by the Open University. It is our intention to continue to access this course on behalf of other staff wishing to avail of it in the units.
General comments in relation to Child Protection issues pertaining to Northern Ireland
There has been a plethora of inquiries following failures to prevent a child's suffering and death, most notably since the early 1970's. The messages from research findings are:-
n The importance of training and supervision for all those having a responsibility for child protection is a major priority.
n Collaboration of the various agencies involved with the welfare and protection of children is also vital to optimal working practice as is:-
n Co-operation between the agencies having a remit for children. This is essential to facilitate the sharing of information in relation to social and health factors, incidents, culture and family relationship problems, which impact upon the welfare of the child.
n Co-ordination of the roles and responsibilities of all the agencies statutory and voluntary, with a remit for the welfare and protection of children and young people must have paramountcy particularly, in the preventive interventions, which are required to protect children and to support their families.
Most families with children at risk of physical, emotional, sexual abuse and/or neglect are likely to come into contact with numerous agencies as they tend to suffer multiple disadvantages, social and educational exclusion, poverty and health problems. The Children (Northern Ireland) Order 1995 recognises the vulnerability of children whether or not there are child protection concerns and requires utilisation of the framework of assessing children in need and of implementing services to include Home Help, counselling advice, laundry services and other resources and assistance to support the child and family and to prevent the child suffering harm.
The recognition of children in need and the timely support given to families is potentially the most effective preventive measure in reducing the risk factors to vulnerable children. It is in this area that the multi-disciplinary agencies have an ideal opportunity to co-operate with the assessment of the child in need to collaborate with the utilisation of resources and to be proactive in co-ordinating the implementation of services provided by statutory and voluntary agencies.
n There is a general reluctance to acknowledge that children are at major risk of harm, particularly in relation to sexual abuse.
n Children undoubtedly suffer more in the context of social unrest and being vulnerable in our society.
n The process of communicating vital information pertaining to vulnerable children and their families uni-≠professionally and multi-professionally is inconsistent as is the recording of such information and this needs to be urgently addressed.
n We are aware that young people are at risk of abuse particularly, young people with a disability. They often present with self-harming behaviours, and/or chemical dependencies and may be perceived as difficult adolescents. Adolescents generally do not have good health care provision and this should be taken into consideration in relation to the protection of children and young persons.
Child protection should be given a higher profile with appropriate powers and resources to facilitate robust systems of working to implement policies, interventions, surveillance, evaluation and research. Ideally this remit should be Department-led by a Commissioner for Children's and Young Persons Services.
Other issues for consideration in relation to the welfare and protection of children in Northern Ireland are:-
n Awareness of the impact of domestic violence on children in Northern Ireland; the research findings, the role of professionals, and voluntary and charitable organisations in addressing same.
n Population movement particularly related to social unrest; the effects on vulnerable children/families and the problems associated with monitoring this group.
n The welfare and protection of the children of travellers, illegal immigrants and asylum seekers who are now known to be a significant group in Northern Ireland.
n The Register of Children with a Disability project. This has good potential for planning strategies, allocating resources and meeting the needs of a particularly vulnerable group. However, this Register will not be totally inclusive, as it requires parental/guardian consent for inclusion. The Register will not be a singular Northern Ireland one, but consist of Registers held by individual Trusts throughout the Province.
There are inconsistencies at present in relation to same, as a child with a disability is deemed to have special needs, yet can be excluded from the Register because consent is deemed optional. This is a particular cause for concern as it is recognised that children with a disability are at greater risk of harm.
Part B - Child & Family Psychiatry
The Child and Adolescent Centre is the regional child and adolescent mental health inpatient unit within the Province.
Case Work and Communication
Most of our children's admissions are planned. During admission, request meetings and pre-admission meetings with professionals and families, there is opportunity to access any relevant information or involvement with any of the statutory bodies who would have a vested interest in each individual case. As part of the admission procedure, a risk assessment is carried out to determine the level of supervision required for each child.
There is close liaison with the referring team and the inpatient centre. An integral part of the assessment and treatment process is the involvement of families from the initial referral through to discharge. Each child is allocated to a key worker who will liaise directly with the child, his/her family, significant other, and any outside agencies involved.
It is an essential part of the process to identify any restrictions on visiting, this is done in collaboration with the family, child and others involved.
The staff within the Child and Family Centre have access to child protection workshops; all staff have access to copies of the Children Order Guidance and Regulations (1995).
The Centre has guidelines on child and staff protection issues and staff have the opportunity to avail of debriefing sessions and informal clinical supervision.
In terms of recruitment and retention, staff within the unit have been lost to the growing development of community child & adolescent mental health services. The recruitment 'pool' is very small and lack of additional training in this field further impacts on the quality and numbers of available staff to recruit.
The Centre has become increasingly dependent on 'agency' back-up.
There is frequent opportunity to discuss workloads with others within the multidisciplinary team and the Centre's social worker is available to provide guidance and updated information regarding child protection procedures.
written submission by:
16 August 2002
Health and Social services Councils have the statutory responsibility to represent the views of the users of health and social care services. There are four Councils in Northern Ireland reflecting the geographical areas covered by the four Health and Social Services Boards. This response to the Committee's Inquiry into Child protection is made on behalf of all four Councils. A number of the comments made will also be reiterated in our response to the Committee's request for submissions in relation to the Protection of Children and Vulnerable Adults Bill since, in our view, they are relevant to both discussions.
The Councils welcome the opportunity to make this submission and commend the Committee for its initiative in setting up the inquiry. Since our remit to represent service users covers the full spectrum of health and social care services we do not claim to have specialist knowledge of this particular area of children's services. Our comments reflect those issues of which we have become aware in the course of carrying out our generalist role of representing the interests of service users to agencies responsible for commissioning and providing services.
Effective child protection services require a commitment to interagency working from all the organisations with a part to play in this vital work as well as skilled and effective leadership. In our view this leadership should continue to come from the Health and Social Services Boards within the context of the Area Child Protection Committees (ACPCs). The Health and Social Services Councils have already made public their support for a proposal that ACPCs should be placed on a statutory basis with ring fenced funding available to support their activities. We believe that the potential for ACPCs to contribute to the protection of children is compromised by their inability to require the attendance of the relevant agencies, their need to compete for funding with other services, and the absence of a structure to ensure the implementation of their recommendations.
The view of the Councils is that the proposed Protection of Children and Vulnerable Adults Bill on which the Committee is currently consulting has the potential to improve our ability to protect children. It will introduce more rigorous systems for ensuring that those who are known to present a danger to children are excluded from childcare employment. However, for the legislation to be effective we need all-island systems for checking the suitability of persons seeking to work with children. Close co-operation with the Department of Health and Children in Dublin is essential to ensure that those who would seek to harm children do not exploit the existence of the two legislative and administrative systems on the island of Ireland.
The effectiveness of the proposed Bill will be compromised if a section of the 1997 Police Act is not enacted for Northern Ireland. Part V of that act allows for police intelligence which has not resulted in a successful conviction to be shared as part of the police suitability checks. While this is current practice in England and Wales the PSNI have at present no legal basis for advising the DHSSPS in this respect.
The Councils support the plans announced last year for the introduction of the office of Children's Commissioner, and would recommend that the office be established without further delay. While the Health and Social Services Councils have a remit to represent the interests of service users including children, we have neither the resources, the professional expertise nor the legislative powers to enable us to act as an effective watchdog in relation to children's services.
The Committee's correspondence refers to the Baby Jasmine case in Down Lisburn Trust area. The Committee may also be aware of the reports of the criminal proceedings in relation to the Briggs case in Craigavon that appeared in the media in January of this year. In this case the Southern Health and Social Services Council was unable to gain access to the information necessary to monitor the effectiveness of the services provided by the two Trusts in the area in protecting the Briggs baby. The Council has no automatic right to receive the reports of the series of reviews carried out on the case. The enhanced powers envisaged for the Children's Commissioner should ensure that any lessons to be learned from such tragedies are made public, and applied throughout the service.
There are additional problems at present in ensuring that lessons are learnt from cases of abuse dealt with in family courts as opposed to the criminal justice system. Such cases are necessarily held in camera, and whilst the Guardian ad Litem has the duty to represent the interests of the child during the court proceedings there is no system for ensuring that any deficiencies in child protection procedures identified during the court proceedings are remedied. This problem might be partially resolved by giving statutory powers to ACPCs as discussed above, but additional monitoring responsibilities might be placed with the office of the Children's Commissioner.
If the Committee requires any clarification of the issues we have raised we would be happy to oblige.
VAN DER LENDEN
written submission by:
1.1††††††† Include Youth promotes best practice with young people at risk of social exclusion. We achieve this through the development and promotion of resources, the provision of training, information and support of practitioners and organisations. We also undertake activities which attempt to influence public policy and public awareness locally and nationally.
1.2††††††† Include Youth promotes the development of positive choices and opportunities for vulnerable and challenging young people whether in the community, residential care or custody. Include Youth promotes the use of community alternatives to care and custody for children and young people.
1.3††††††† Amongst the young people at risk with whom, and on whose behalf Include Youth works are young people from socially disadvantaged areas, those with a learning disability, those with special needs, those who have been truanting, suspended or expelled from school, those from a care background, those who have had a negative parenting experience, young people who have committed or are at risk of committing crime, misusing drugs or alcohol, undertaking unsafe sexual behaviour or other harmful activities, or of being harmed them≠selves. Therefore child protection policy and practice is a subject, which impacts day and daily on their lives.
1.4††††††† Include Youth therefore welcomes the opportunity to give written evidence to the Committee's Inquiry into the current state of child protection services in Northern Ireland.
2.†††††††† CHILD PROTECTION - EVERYONE'S RESPONSIBILITY
2.1††††††† It is our strong contention that all citizens living in Northern Ireland have a part to play in protecting our children. We, however, believe that government has both a pivotal role and responsibility in ensuring that adequate legislation, structures, services, policies, and practices exist to safeguard our children and young people. And, while we recognise the primary role which social services and DHSSPS plays in this area, and welcome the Committee's decision to conduct an Inquiry into the area of child protection services, we are firmly of the view that state responsibility extends across all government departments and agencies. In addition we believe that partners in the voluntary and community sector also play an important part in safeguarding children and young people.
2.2††††††† Include Youth would suggest that a more strategic, well co-ordinated and multi- disciplinary approach is required to ensure that all children living in Northern Ireland are protected from all forms of abuse and neglect.
2.3††††††† We are aware that a number of voluntary organisations have made submissions concerning general child protection provisions, and have commented on policies, practice, services, and other matters concerned with the Department of Health, Social Services and Public Safety and its pivotal role with regard to child protection. In the interests of avoiding duplication, Include Youth has therefore decided to focus specifically on child protection needs of older children, those who are involved in the criminal justice system, children who are involved in prostitution or other forms of sexual exploitation, and those who are subjected to paramilitary violence or threat.
3.†††††††† INTERNATIONAL HUMAN RIGHTS STANDARDS
3.1††††††† It is also appropriate to place our response to the Committee's Inquiry into child protection services in the context of existing international human rights standards. International human rights standards give children an absolute right to protection from ill-treatment, torture, neglect and physical, emotional and sexual harm. (Article 19 UNCRC, and Article3 European Convention on the Rights of the Child). In addition, international rules specifically provide that the youth justice system should uphold the rights and safety, and promote the physical and mental well being of children. (Rule1 UN Rules for the Protection of Children deprived of their Liberty 1990 (UN Rules) and Rule 5 UN Standard Minimum Rules for the Administration of Juvenile Justice 1990 (the Beijing Rules)
4.†††††††† DOMESTIC LEGISLATION AND CHILD PROTECTION
4.1††††††† In terms of domestic law, policy and practice, both the Human Rights Act 1998 and the Children (Northern Ireland) Order 1995 contain protection for children reflective of international standards. Section 6 of the Human Rights Act requires public authorities to act in compliance with rights enshrined in the European Convention if Human Rights. Article 3 of the ECHR prohibits torture, inhuman and degrading treatment or punishment. The Children (Northern Ireland) Order (1995) is the main piece of legislation dealing with the protection of children from abuse in Northern Ireland.
5.†††††††† OLDER CHILDREN
5.1††††††† The Key Indicators of Personal Social Services in Northern Ireland for 2001, compiled by the Northern Ireland Statistics and Research Agency and the Social Services Inspectorate, reveal that in 1999 / 00 almost 75% of children on the Child Protection Register were aged 11 years or below. (Table 25, page 58). However, there appears, we would suggest to be somewhat of a reluctance to categorise older children as 'at risk' for the purpose of placing them on the child protection register, with only 3.7 of all those placed on the register being aged 16 or over and just over one fifth of children on the child protection register aged between 12 and 15.
5.2††††††† Many of the young people that Include Youth come into contact with and on whose behalf we work fall into older age brackets. It is our experience that in many of these cases issues of child protection are involved. We would therefore ask whether enough is being done to safeguard our older children from child abuse as defined in the Children (Northern Ireland) Order 1995 as including neglect, emotional abuse, physical injury and sexual abuse.
6.†††††††† CHILD PROTECTION ISSUES FOR CHILDREN INVOLVED OR AT RISK OF BECOMING †† INVOLVED IN THE CRIMINAL JUSTICE SYSTEM
6.1††††††† There are a number of child protection issues, which are given rise to when one looks at the whole area of young people who are involved or at risk of becoming involved in criminal activity.
6.2††††††† When a child comes into contact with the juvenile justice system, he or she can potentially become engaged with numerous agencies. However, as justice and policing matters remain reserved under the Northern Ireland Act 1998, these agencies fall under the jurisdiction of the Northern Ireland Office and other Whitehall Departments. Include Youth therefore welcomes the decision of the Committee to include children who offend or are at risk of offending from the terms of reference of its Inquiry. These are often some of the most vulnerable children in our society, who have suffered multiple forms of disadvantage, abuse and exclusion. It is vital that adequate child protection measures are in place to safeguard all our children, not just those who are perceived to be 'deserving' or 'good'.
6.3††††††† The current operation of the juvenile justice process would appear to create a number of difficulties regarding child protection. Despite a number of legislative opportunities the age of criminal responsibility has not been raised and remains at 10 years of age a level that contravenes international human rights standards, particularly the 'Beijing Rules' (United Nations Standard Minimum Rules for the Administration of Juvenile Justice). In addition the United Nations Committee on the Rights of the Child has also recommended that the age be raised. Furthermore, in domestic terms both the Criminal Justice Review Group and the Northern Ireland Human Rights Commission have suggested that the age of criminal responsibility be raised.
6.4††††††† Notwithstanding this, current law means that children as young as 10, can be arrested and detained by the police, held on remand currently in a juvenile justice centre, brought before a youth court, and receive a range of sentences which will necessitate involvement with a number of agencies including juvenile justice centres and Northern Ireland Probation Board.
6.5††††††† Clearly it is essential that all agencies that come into contact with young people in the justice system have child protection policies which operate in practice to provide open, transparent, accountable, accessible and fair systems to deal with any allegations of abuse.
7.†††††††† CHILDREN WHO COME INTO CONTACT WITH THE POLICE
7.1††††††† It is Include Youth's understanding that no overall child protection policy currently exists within the Police Service of Northern Ireland. This we believe is a serious omission. We understand that a child protection policy exists specifically for use within Community Involvement Branch, and that a Joint Protocol operates between the PSNI (through the Child Abuse and Rape Enquiry - CARE Unit) and Social Services when a young person makes and allegation of a child protection nature. We are further led to believe that a number of guidelines and internal documents exist in relation to this matter, and we submit that it is in the public interest that such documents should be in the public domain. Include Youth is firmly of the view that this is not sufficient, and that an overarching child protection policy should be developed as soon as possible. Children who wish to make a complaint against a member of the PSNI must have confidence in a system which is accessible to them, transparent, thorough and independent in conducting its investigation and maintained by well trained staff.
8.†††††††† CHILDREN IN CUSTODY
8.1††††††† Older children in custody also experience specific problems with regard to child protection issues. Currently in Northern Ireland young people up to the age of 17 are detained in juvenile justice centres. However, young males aged 17 and upwards are held at a Young Offenders Centre, which forms part of the adult prison service. In addition, female children as young as 15 have been held in custody at Maghabery prison. This is a clear breach of human rights.
8.2††††††† Moreover we are unclear as to whether any child protection policies exist for the Northern Ireland Prison Service, Hydebank Young Offenders Centre or Maghabery Prison. Include Youth as an organisation wishes to see an immediate end to the housing of children in adult penal facilities. However, we also contend that while the current system remains at the very least appropriate child protection policy and practice must underline any treatment of the young people in question. We recommend that the Committee seek clarification in this matter with the Northern Ireland Prison Service.
8.2††††††† Concerns also exist regarding child protection issues for young people detained in juvenile justice centres. Such concerns have been highlighted in a number of investigations by the Social Services Inspectorate (for example Report on the Inspection of Lisnevin Juvenile Justice Centre, 1999), and more recently by the Northern Ireland Human Rights Commission in its report entitled 'In Our Care - Promoting the rights of children in custody' 2002.
8.3††††††† 'There has been longstanding concern that allegations made by boys in custody of a child protection nature have not in the past been properly investigated (In Our Care, Page 3). The Northern Ireland Human Rights Commission's research, which was hampered by the Commission's lack of effective investigative and enforcement powers, also highlighted the fact that the child protection procedures currently in use in the centres are out of date. It further found that contrary to international standards there is no independent complaints mechanism for children in custody.
8.4††††††† Moreover, the current operation of the child protection process gives cause for concern and 'may compromise the safety of children in the centre and does not meet the standard of prioritising the child's best interests.' (In Our Care, Page 87) When boys from Lisnevin make allegations of a child protection nature these are not investigated by the Police CARE team but are delegated to uniformed officers. This results in inadequate measures for the protection of children. The Commission recommended that an expert independent investigation should be established by the Juvenile Justice Board to review the child protection process including the roles of police and social services, and that the findings should be made public.
8.5††††††† Include Youth understands that the Northern Ireland Office and the Juvenile Justice Board are currently updating child protection policies in line with recommendations from both the Social Services Inspectorate's and the Northern Ireland Human Rights Commission, as part of the on-going changes which are taking place within the Juvenile Justice Estate. We would suggest that the Juvenile Justice Board should be invited to provide evidence to the Committee in this regard.
9.†††††††† SEXUAL EXPLOITATION OF CHILDREN AND YOUNG PEOPLE
9.1††††††† The sexual exploitation of children through their involvement in prostitution and in the production of pornography is not a new phenomenon, however it is a subject, which has remained in the shadows until quite recently. In the last few years, the sexual exploitation of our children has emerged as a more public and political issue. At a Conference organised jointly by Include Youth and South and East Belfast Trust in 2001 entitled 'Out of the Shadows - Young People and Sexual Exploitation through Prostitution' participants heard of girls and boys as young as 11 years old involved in prostitution working either on the streets or offering sexual services to adults in hotels or other accommodation. The Conference heard further of a proposal for a Belfast based project 'Tackling the Sexual Exploitation of Children Project (TASEOCH)' which represented a partnership between EHSSB, S&EBHSST, and the then RUC, and which would draw significantly on work carried out by the Multi-Disciplinary Steering Group in Nottingham. This project proposed a strong inter-agency approach with a variety of players including Health Board and Trusts, Education and Library Board, Housing Executive, GP Forum, Probation Board, RUC /PSNI, voluntary agencies and relevant street / community agencies. Importantly the project would be underpinned by two core philosophies, which recognise that children involved in prostitution and pornography are (a) victims of exploitation and abuse, and (b) should be regarded as children in need of services and / or protection.
9.2††††††† However, it is unfortunate that to date no appropriate resource allocation has been made available within Northern Ireland to fund this project or anything similar which would provide co-ordinated services to these vulnerable young people.
9.3††††††† In addition it is unclear how many young people are being and have been abused in this way, and also who is perpetrating these offences.
9.4††††††† Include Youth would suggest that the criminal justice system's approach to the apprehension and prosecution of those who abuse and sexually exploit children through prostitution should be reviewed. For example, the reliance of these abused and vulnerable children as witnesses is problematic - perhaps a more creative use of the information could be examined, for example evidence provided by a child could present grounds for the issuing of warrants etc and when sufficient evidence became available to lay charges, it would not be necessary for the prosecution to rely on the child witness (this could result in it being in the public interest to drop charges which relied solely on the child's evidence, and instead lay similar or equally serious charges against a defendant which have arisen as a result of more protracted investigations instigated by the evidence provided by the child); the issue of children's immunity from prosecution in situations that are actually abusive should be carefully discussed.
9.5††††††† It is clear that a strategic approach is required to safeguard these very vulnerable children who are sexually exploited through prostitution. Such an approach must provide clearer systems which serve to protect and support the victims and apprehend and convict the abusers.
10.††††††† PARAMILITARY VIOLENCE
10.1††††† It has long been recognised that there is both a formal and informal justice system operating in Northern Ireland. In this jurisdiction quite often offending by young people can result in those young people becoming the victim of paramilitary threat and / or attack. In a consultation exercise conducted by Include Youth in 2001 in relation to the establishment of a Children's Commissioner, all of the young people we spoke to cited fear of paramilitary attack as one of the biggest worries in their lives. In a Young Person's Behaviour and Attitudes Survey, compiled by OFMDFM in 2001, 53% of 11 - 16 year old children questioned considered paramilitary violence to be a significant threat to their personal safety. Significantly, of those young people questioned in the OFMDFM Survey only 6% had actually experienced being threatened by paramilitaries. However, in 2000 NIACRO'S Base 2 Project, which provides a crisis intervention service to those under paramilitary threat, recorded 121 referrals from children aged between 11 and 18 years who presented as under threat of physical punishment from paramilitary organisations. Furthermore, in the same year there were 26 reported casualties involving young people under the age of 20 that paramilitary type shootings, with a further 39 casualties occurring as a result of paramilitary type assaults. (RUC Central Statistics Branch).
10.2††††† Clearly such attacks or threat of attack result in 'significant harm' being caused to the young person, and the physical, psychological and emotional effects can last a lifetime. We acknowledge that this issue is regularly debated within the wider context of Northern Ireland constitutional politics. However, Include Youth believe that the focus of this debate should shift to adopt a more child-centred approach. We strongly contend that the issue of paramilitary threats, shootings and assaults on young people is without doubt a child protection matter, and must be approached by all relevant agencies as such.
11.††††††† RECENT CHANGES
11.1††††† A number of legislative changes in recent years will undoubtedly impact upon the issue of child protection. These include the introduction of the Commissioner for Children and Young People Bill, and the Justice (Northern Ireland) Bill which received Royal Assent in July 2002. In addition proposed changes to the Juvenile Justice Estate mentioned earlier in this paper have the potential to impact upon child protection matters affecting children in custody.
11.2††††† Include Youth have real concerns that the Commissioner for Children and Young People Bill in its current form provides only very limited assistance to children in the criminal justice system. We are further worried that often children and young people who offend or are at risk of offending, and who are generally some of the most vulnerable and marginalized children in our society, do not appear to be afforded the same rights and protections as other children. We will continue to advocate for a Commissioner who will promote and protect the rights of all our children. In a similar vein we are delighted to add our voice to the Committee's Inquiry to help ensure that the child protection needs and rights of children in the criminal justice system are given the same priority as every other child living in Northern Ireland. Anything less creates a two-tier system, and serves to reinforce the message to children, their families and others that they are not as 'worthy' of the same protection as 'good' children, and is utterly unacceptable.
12.1††††† In conclusion, Include Youth are delighted that the Health, Social Services and Public Safety Committee have undertaken this Inquiry, and hope that out of this will emerge a more strategic and co-ordinated, multi-disciplinary, child-centred approach to safeguarding all children from abuse, harm and neglect, supporting victims of abuse, and dealing appropriately with the perpetrators. Furthermore, it is essential that such provisions must exist for the protection of all of our children, including older children, those in the criminal justice system, those who are sexually exploited through prostitution and pornography and others who are subject to threat and attack form paramilitary organisations. Systems must be put in place which are open, transparent, accessible and independent. Proper resources and political will must be applied to better ensure the safeguarding of all our children. The Committee's Inquiry represents an important positive step in this direction and Include Youth would be happy to continue to contribute to this debate by providing oral evidence to the Committee.
written submission by:
SUMMARY OF RECOMMENDATIONS
1.†††††††† That this enquiry should be welcomed as an initial step in a much wider public debate as to how children can be better protected from harm.
2.†††††††† That much more information, including qualitative and longitudinal research needs to be collected in order to accurately assess the extent, nature and impacts of all forms of child abuse in N.I. relative to the services that currently exist to prevent or deal with it.
3.†††††††† As a consequence of further consultation, discussion and information collation an Assembly led multi-agency and cross-sectoral strategy should be developed with the purpose of generating a 'zero-tolerance' attitude to child abuse with robust targets for its reduction/eradication. The Children's Commissioner and the Children's Unit should have a key role in driving forward this strategy.
4.†††††††† As part of the above strategy that there should be a much greater emphasis on preventative work and actions with the role of those best placed to engage parents (such as community and voluntary organisations) recognised and resourced as an inherent part of the overall strategy.
5.†††††††† All persons who have regular contact with children to have mandatory child protection training of a sufficient duration to ensure that they are equipped to recognise and act upon the signs and symptoms of child abuse that are relevant to their particular occupation. This training should be required to be updated at appropriate intervals.
6.†††††††† Appropriate and long-term funding to be sourced as a matter of urgency for organisations and services that provide counselling and support for all persons (adults and children) who have experienced child abuse.
7.†††††††† A review of the procedures, systems and 'culture' of statutory child protection services to ensure that a more effective partnership approach is developed with non-statutory organisations.
8.†††††††† Increased and appropriate resources for meeting the needs of specific groups of children and their parents in the area of child protection, for example, children with disabilities or whose parents do not speak English.
9.†††††††† As part of the overall strategy a comprehensive review of the entire judicial system with the intent of redressing the imbalance between adults rights and children's rights.
10.††††††† Positive parenting and children's rights should be a standard element of every child's school curriculum.
INTRODUCTION TO ORGANISATION
Inner City South Belfast Sure Start (ICSBSS) is one of 23 Sure Start programmes operating in N.Ireland. The purpose of all Sure Start programmes is to prepare children for school and by targeting areas or communities that experience social and economic disadvantage reduce the inequalities in outcomes that are experienced by many children starting from a very early age. ICSBSS has been fully operational since April 2001 and works with 0-4 year olds and their families in the Taughmonagh, Village, Sandy Row, Donegall Pass, Markets, Lower Ormeau and Ballynafeigh areas as well as Chinese families with pre-school children across all of South Belfast. Our services include childcare, home visits, befriending, special needs support and a range of health and education focussed activities. Parents either refer themselves to ICSBSS or are referred with their consent by a variety of agencies and professionals such as Health Visitors and Social Workers.
Sure Start programmes are universal in nature, that is, the services are available to any family with a pre-school child in a geographical area. The purpose of this is to reduce stigma and reinforce positive parenting. Many parents who therefore avail of our services are very motivated and concerned about their children's well-being. However, we also work with many families who require a lot of support and who for a variety of reasons are not able to meet all their children's developmental needs. ICSBSS work with a significant number of families who have involvement with Social Services or whose children are (or were) on the 'at risk' register. ICSBSS has a strong community development ethos with each community being represented on its Board of Directors. All of the staff while being qualified and experienced in child development and work with families are 'lay workers' in the sense that they are not from a professional background such as health visiting. As a consequence much of the suspicion that exists in many inner city communities of statutory provision is removed. Gradually parents have accepted the value of the outreach service and have taken up regular visits in the home (or one-to-one work in a nearby community facility) to discuss their child's development and ways to promote their learning through play. Trust built up over time along with the confidential and non-judgemental approach has meant that many parents have felt able to discuss concerns, behaviours and experiences that they have often never disclosed before. This can then be the first step towards addressing problems or on occasions asking for Social Services input when they become aware that their children may be at risk from their own or another person's actions or inaction. The organisation attempts to liase with all agencies involved with a family and staff have attended case conferences, prepared reports, provided respite care etc. In summary, the organisation has been involved in child protection issues within a very broad context from general preventative work to situations where children have been, or are being, abused and neglected.
RESPONSE TO TERMS OF REFERENCE
There are a number of points relevant to this enquiry that we would like to make based on the knowledge and experiences built up within this project.
1.†††††††† GENERAL CONTEXT
Becoming a parent often causes adults to reflect on their own childhood and as a consequence many parents are now trying to come to terms with abuse in their own past. It would seem to us from the parents we have worked with that those who grew up without being a victim of neglect, physical, sexual or emotional abuse (or a combination of these) at some stage in their childhood are actually in the small minority. There may be a number of factors that would explain these high levels but since most of the parents never officially reported their abuse it would seem to point towards the view that there has been a large incidence of hidden abuse in N.I. society. Hopefully, given advances in child protection measures such as the banning of corporal punishment in schools and strategies to reduce risk in other institutional settings children are in less danger from certain types of harm but there are also factors which could help to contribute to increased abuse such as misuse of the internet and the greater 'sexualisation' of children by society generally. On balance there appears to be no valid reason to believe that if child abuse was so prevalent 15 to 30 years ago that much has changed today. The cost to children, adults and society generally of failing to protect children now and also dealing with the legacy of past abuse is huge. Not before time, there is currently some general debate about the costs to society of 30 years of conflict and what needs to be put in place for victims of the troubles and for healing to take place. A similar process needs to occur in relation to the protection of children and ICSBSS therefore welcomes this public enquiry as a first step towards this end.
2.†††††††† INFORMATION REQUIREMENTS
The first essential component of protecting children from significant harm is to identify the extent to which currently children are being exposed to harm. Much more has to be done to identify the nature and scale of the problem before a strategic response can be developed to increase the protection of children. The systems that are currently in place seems unable to produce the type and depth of information required. For example, Social Services were not able to give ICSBSS up to date and accurate figures on the number of children on the child protection register in the areas where we work. Neither can the system seem to able to track allegations of abuse and the subsequent response to these, for example, what percentage are investigated by the police, how many are then taken to court by the DPP, what is the conviction rate, what are the sentences imposed and how does this cross-reference with the age of the child, relationship with the offender, type of abuse etc. Ongoing monitoring and tracking systems should be set in place so that children are less likely to 'fall through the net' and targets such as increased percentage conviction rates can be set. Other more qualitative or longitudinal information may also be required, for example, it would be useful to be able to identify the costs of abuse in relation to both individuals and society generally before deciding the level of resources that should be made available to prevent it in the first place. There is some anecdotal evidence that a 'post-code lottery' exists in relation to the types of intervention available to protect children and this factor also requires research.
3.†††††††† STRATEGIC RESPONSE
What is essential is that there is a completely new societal culture of 'zero tolerance' of child abuse as at present the message seems to be that it is at the very least tolerated if not even acceptable. Perceptions are often as important as reality and to give just a few examples, when the public see child abusers getting shorter sentences than people who have offended against property, there are minimal and poorly funded services for children and adults seeking help in order to recover from abuse and Social Workers are striking because they cannot maintain the present workload there are indeed very mixed messages going out to society (and potential abusers). With devolution, the introduction of a Commissioner for Children and a Children's Strategy there would seem to be a great opportunity to grasp what is one of the most complex, difficult and long-standing problems in our society. ICSBSS would therefore like to see a government led strategy to protect children and reduce the levels of all forms of child abuse. Any such strategy should include targets and performance indicators and be cross-departmental and cross-sectoral engaging the widest range of agencies and resources possible including the community and voluntary sectors. The strategy would need to be widely promoted to raise awareness and reinforce the responsibility of all people who have contact with children to be actively involved in their protection.
There needs to be an increased emphasis on prevention as opposed to reaction. While there may be some indicators or early warning signs of potential risk it is impossible to identify exactly which children require protection and from whom. Therefore it is a valid response to put in place support mechanisms for all families as a key element of prevention. The community and voluntary sector or specialised programmes such as Sure Start have demonstrated that they can engage families and help parents to develop their skills or cope with crises. However, this type of non-statutory activity is almost always reliant on short-term funding which severely curtails its potential and limits the development of the expertise/capacity required to deal effectively with what is a very sensitive area.
As part of an overall strategy everyone who is involved with children should have child protection training with priority for key target groups such as doctors working in Accident and Emergency Departments, GP's, dentists, solicitors etc. Training should be tailored to the particular occupation so that there is increased awareness of the possible signs of abuse that might be observed in their routine contact with children. Where possible training should include input from people who have experienced abuse or agencies working with people who have been abused. Training for professionals working in local communities such as Health Visitors and Social Workers should include input from the community and voluntary sectors so that increased co-operation and partnership can be developed (particularly in relation to prevention) in the future.
Mainstream resourcing to an adequate level for organisations and services that provide support and counselling for children and adults who have experienced abuse is a matter of urgency. Currently, there are long waiting lists for the provision that is available and there is inequality of access to this limited provision e.g. for people living in rural areas. One of the most frustrating situations for ICSBSS staff is that after many months of working with a parent and gradually helping her arrive at the decision that she needs counselling or support to come to terms with her own childhood abuse (which is often affecting her ability to parent her own children) to find that this help is not readily available. Likewise, parents who have reported that a partner or member of the family has been abusing their child/children are offered little in the way of support for themselves. Caring for frequently disturbed children while at the same time coping with the Social Services and legal processes and often with the disapproval of the wider family or community is highly stressful. The stress of course increases the trauma for the children and other parents get the message that it is better not to involve statutory services in the first place if they also have concerns.
To increase the effectiveness of child protection work there is a need for statutory services to work in genuine partnership with non-statutory services that are (or could be) engaged with the same families. There are 'grey areas' around the issue of confidentiality and sometimes a perception on the part of community organisations that they are not considered sufficiently trustworthy to be told what is often crucial information. If information sharing is seen as a one-way process then gradually it will come to a halt altogether. The appointment of designated child protection officers within organisations does not always seem to have eliminated this problem especially when there are frequent changes in social services staffing resulting in difficulties with building and maintaining good inter-agency working relationships. A second area that is problematic is that non-statutory workers or indeed parents themselves often feel that their views of how the situation could be dealt are not really listened to and it is only the decisions of the Social Workers that count. At the other extreme when a community organisation agrees to accept a referral from Social Services that is considered 'low risk' that is often the last contact they have with the team leaving a residual feeling of being 'dumped upon' and a reluctance to accept other referrals in the future. A real difficulty for many community and voluntary sector organisations and individuals is around reporting concerns, not because they are disinterested or reluctant to 'put themselves on the line' but because past experience has taught them that, particularly in hard to evidence allegations such as emotional abuse or neglect, that there is no positive outcome and instead any involvement with the child and its parent/s ceases.
8.†††††††† WORKFORCE iSSUES
There are certain groups of children such as those from ethnic minorities families for whom adequate personnel resources such as bi-lingual social workers are simply not available. Due to the small number of families some thought should be given to employing bi-lingual staff across a number of Health Trusts or even Board areas.
9.†††††††† LEGAL SYSTEM
The balance within the entire legal system still appears to favour adults over children. The number of cases that are 'turned down' by the DP because of 'a lack of evidence' is alarming. In such situations parents and children are given minimal explanation that retraumatises the child who is left feeling that they are not believed. Even if the legal process does result in a conviction the sentences do not reflect the crime. It is essential that as part of a strategic response to child protection that a thorough review of the investigation and judicial processes is undertaken with recommendations as to children's rights can be better protected.
10.††††††† YOUNG PEOPLE
There is a still a perception that some young people are considered culpable in their own abuse, for example, child prostitutes and those being threatened with, or victims of, so-called punishment beatings or shootings by paramilitaries. When children (sometimes as young as 9 or 10) have been threatened with beatings/shootings there has appeared to be no sense of urgency amongst the authorities to move to ensure their protection or even as would happen in other situations to place them on the child protection register. There also needs to be a much higher priority given to children who it is alleged have abused or are involved in bullying other children. As part of creating a new culture of child protection we would suggest that all children have the opportunity to learn about positive parenting and children's rights within the standard school curriculum.
written submission by:
19 August 2002
I am Jacquie Ritchie, Co-Ordinator of Kids 'n' Kin Sure Start, North Belfast, Ardoyne and Oldpark areas. Our project is based in one of the most troubled areas of Northern Ireland. I endeavor to do cross-community work in my area; that is not always easy. A common denominator for all families in this area is that their children are all equally effected by rioting, protesting, a heavy police/army presence, anti-social behavior, poverty, unemployment, low educational attainment, alcohol and drugs abuse and lack of services generally
The aim of our project is to enhance the quality of life for all 0-3 year olds, providing a coordinated childcare service, which is based upon the principles of prevention, and partnership, which seeks to combat the effects of long-term poverty and unemployment. To promote social inclusion and community confidence, as well as producing positive, sustainable, educational, health and social outcomes.
Our project is unique in that we can offer a holistic childcare and child development package - A Mother & Toddler Unit at Kids `n' Kin headquarters, full - time childcare from 0 to Pre - School in The Wishing Well Family Centre and Phab Cedar Ave, plus After-Schools in both venues. We also conduct home visitations through Home Start, a project that helps families in crisis and Lifestart who work with the parents to promote child development through a comprehensive educational programme.
THE SURE START PROGRAMME
Sure Start is part of the Government's strategy for children and is aimed at giving everyone a good start in life.
The key principles of Sure Start are:
n Co-ordinate, streamline and add value to existing services for young families in local communities, including signposting to specialist services;
n Involve parents;
n Avoid stigma;
n Ensure lasting support;
n Be sensitive to particular families' needs; and
n Promote participation of all local families.
The programme aims to:
n Improve health by supporting parents in caring for children and promoting children's health and development.
n Improve the ability to learn by encouraging stimulating play, improving language skills, and the early identification and support of children with learning difficulties; and
n Improve social development by supporting the development of early relationships between children and parents, good parenting skills, family functioning, and early identification and support of children with emotional, learning and behavioural difficulties.
Your Terms of Reference:-
A small amount of places are reserved for Social Services in all our organisations but as you can appreciate funding is quite limited. Social Services referrals are vague in that it would be helpful if we knew more about the child/families background/history. If this was happening we would be aware for example that the family requires Counselling, Home Respite, Job Club, After-Schools for older children. We tend to help families in a holistic manner in order to breakdown barriers impinging on the families potential.
We would also not be aware if the child is registered on the Child Protection Register. We are not privy to such information. We are asked within our Monitoring and Evaluation Guidelines (as per our Service Agreements) to measure this information and record children coming off The Register as an impact of Sure Start but we cannot do this for reasons stated. We fully understand confidentiality between Clients and Social Workers, our own Policies are quite stringent also, but we feel Sure Start Projects should be allowed this information, as working on a cross-departmental preventative strategy is the ethos of Sure Start.
When a child starts to access our services e.g. A childcare place, we encourage parents/carers to attend courses, Job Club etc and recommend Services for older children. The parents/families then begin to avail of community facilities, information and training. Ongoing training for parents includes good practice childcare and child protection issues. The parents and wider community then become more aware of what child protection means e.g. A lot of parents would not be aware of mental abuse or the fact that hitting/ smacking children is a form of abuse, it is in some homes considered a part of child rearing as it 'did not do them any harm'. It is learned behavior and unfortunately considered good discipline. Sure Start tries to educate those parents who take this attitude to change their approaches and obtain a better insight into all areas of child development.
Commissioner For Children
A Commissioner for children must be appointed as soon as possible. The 8 Sure Start projects in The Eastern Health Board have done and are continuing to do extensive lobbying. It has become apparent that Politicians and Party Manifesto's are very lacking in Children/Childcare - it appears that children do not become important until they statistically become part of the schools system. A child's education begins the minute it is born. 0-3 years are the most important years of a child's education. All children deserve the best possible start and life and a qualitive equal 0-3 years programme. It is vital that a Commissioner is appointed to represent our children in the political arena. Children as well as adults have rights and deserve a voice.
CHILD A - was visiting a swimming pool on a Saturday morning, quite early, around 10.30am. The child was happily swimming and playing. The child's father was reading a paper and having coffee in the viewing area. The viewing area looks down on the swimming pool, but one would have to lean over at quite an angle to view those swimmers directly beneath.
The child's father noticed a large man acting rather strangely. The only children in the pool were a group of girl guides with their leaders and his son. The man in question, after much observation by the child's father seemed to be using a camera, underneath his coat to record the children.
The child's father was very alarmed and reported it to a member of staff and left the premises rather hastily with his son.
On returning home the father was not happy with his actions as the member of staff appeared to be connected to the canteen and there was no other senior staff there. The father decided to ring the police. The police took a note of the incident but did not get back to him.
On the Monday morning the father rang the head of Child Protection of Leisure Services who dealt with the area. The officer assured the father that the police and himself would go through CCTV records of the morning in question. The description the father gave was very detailed as he had a while to study the man.
No one has let the father know what has happened since. The father, through acquaintances in that area has since discovered that the man in question was arrested two weeks ago as part of an internet pedophile ring.
Apart from not keeping the father informed of proceedings it seems that there is a lesson here for all Leisure Services. The use of cameras should be strictly forbidden unless prior permission has been given e.g. Birthday Party, Summer Scheme and Family Memories.
I hope your inquiry takes this on board. Digital photography takes seconds to send down the Internet. It is frightening to think children are so vulnerable.
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