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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:
16 August 2002
Further to your letter of the 20th June 2002 please find attached a submission on behalf of the Southern Area Child Protection Committee, Armagh and Dungannon, Craigavon and Banbridge, and Newry and Mourne Child Protection Panels. There is no objection to this submission being made public by the Committee.
If you require any further information please do not hesitate to contact me.
3.1 Case Recording
3.2 Professional Judgement
3.3 Assessment and Analysis of Information
6. Workforce Issues
9. Lessons Learned
10. General Comments
Northern Ireland Assembly Inquiry into Child Protection Services in Northern Ireland - Submission on behalf of the Southern Area Child Protection Committee, Armagh and Dungannon, Craigavon and Banbridge, and Newry and Mourne Child Protection Panels.
The Southern Health and Social Services Board commissions services and Trusts within its area deliver services to support and protect the children. The Southern Area Child Protection Committee operates at a strategic level to ensure effective inter-agency, multi-disciplinary working in respect of protecting children. The three Child Protection Panels within the Southern Board area take the lead in inter-agency, multi-disciplinary working at operational level.
A holistic perspective is essential to assessing and meeting the needs of children. This must maintain a focus on the needs of the child. Child protection services must be viewed as part of wider support services required for families in need.
Recording of child protection cases, for all disciplines, is a complex and detailed task given the nature of intervention and decision making and the level of contact between professionals and others. The implementation of the Children (NI) Order 1995 has led to significant increase in the detail of information required.
The importance of ongoing monitoring of case files is acknowledged. Case files are routinely accessed within ongoing audit processes.
Following a recent SACPC External Review of Thresholds for Decision Making across the SHSSB (at referral, case planning and child protection stages). management decisions and details of case discussions within the professional supervision arena will be contained on case files. The proposed implementation of a framework for assessment will enable decision making to be made explicit on files.
(iv) Professional Judgement
A number of external factors influence the use of professional judgement, including, the Human Rights Act 1998, Data Protection Act 1998, issues of client confidentiality and consent, policy and procedures and professional codes of practice. Professional judgement within a multi-disciplinary arena enhances child protection systems and decision making. Supervision provides a sound professional framework within which professional judgement can be guided
To address the issue of differing interpretations of thresholds for referral to services SACPC and local Child Protection Panels have compiled "Multi-Agency Guidance for Services to Children in the SHSSB Area". This places services within four levels, ranging from universal services for those to safeguard children. It is hoped this guidance will lead to appropriate and effective identification and referral of all needing support.
(v) Assessment and Analysis of Information
Assessment is the fundamental basis to intervention and action. A complete assessment at either child protection or case planning level must maintain a focus on the child, the capacity of the parent/carer to meet the child's needs and the wider environment. The SHSSB and Trusts in its area, are currently adapting the Framework for the Assessment of Children in Need and their Families into a multi-disciplinary inter-agency approach for use in the Board area. Such an approach will require to be adequately resourced.
The Southern Area Child Protection Committee has recently endorsed the use of a Risk Analysis Model to detail risk in the context of strengths and weaknesses within the family and the likely impact on the child and potential for change.
Multi-disciplinary inter-agency communication is crucial to effective protection of children. The concept of children in need emphases the need for liaison between agencies and disciplines across the entire continuum of family support and child protection. Channels of communication tend to become clear when cases enter the formal child protection arena. Prior to this stage communication, needs to take account of confidentiality, consent from families and children, and Human Rights legislation. Communication is enhanced by the understanding and awareness of different professionals and agencies on appropriate thresholds and differing roles and responsibilities.
Involvement with families and local communities is crucial in prevention and early intervention relating to children in need. The Childrens' Services Planning process provides an integrated approach to strategic planning. This is informed by reference and user groups within local communities. The resultant plans require to be funded on an inter-departmental level to ensure appropriate intervention and protection services can be developed across agencies.
Surestart adopts an integrated approach to family support, and the Wraparound initiative in the Southern Board area, represents a multi-disciplinary approach to meeting the needs of disabled children. Such projects should be expanded and funded on a recurrent basis.
The importance of involvement with individual families and children is fully recognised by professionals working in child protection. Considerable effort is invested in working with families, many of whom are experiencing extreme distress or are hostile to child protection interventions.
(viii) Workforce Issues
The Children (NI) Order 1995 has significantly increased demands on staff. The complexity and level of responsibility attached to working in child protection has resulted in a high turnover of staff, significant difficulties in recruitment and retention of experienced staff and increasing levels of sickness for staff in all disciplines and agencies.
Multi-disciplinary, inter-agency training is fundamental to enhancing existing knowledge and skills within the workforce. It is a key vehicle for keeping staff up to date with practice, research, and developments in legislation, policy and procedures.
The SHSSB and Trusts in its area are committed to prevention and early intervention to support vulnerable families. Resource issues within child care services are detailed in appendix 1 to the main report.
Increasing resource needs must be seen in the context of developments in practice, procedural and administrative demands, and the broader perspective taken towards support services and protection needs within the Children (NI) Order 1995. It is essential that all aspects of this service are adequately funded across all disciplines and agencies.
(xi) Lessons Learned
The need to learn from case management reviews and inquiry reports is fully recognised. Efforts to learn lessons should be placed within the context that risk cannot be entirely eliminated. Responses are therefore in relation to identification and management of risk. Work is ongoing to draft a regional risk framework within which work with families and children can be placed.
(xii) General comments
The negative impact of domestic violence on children must be recognised. It is essential that an effective approach to addressing domestic violence at prevention and protection level is fully resourced.
The publication of the Revised Children (NI) Order Volume 6 'Co-operating to Safeguard Children' will mark the opportunity for further change and development in child protection work. Such developments, however, will require to be accompanied by the necessary resources.
SUMMARY OF RECOMMENDATIONS
n Regional standards and formats should be developed for recording practices in child care cases.
n Recording in child care cases should become an integral part of professional training.
n All agencies involved in child protection work should routinely audit their recording systems. Such audits should be both uni and multi disciplinary/agency in nature.
n Child Protection Panels should inform ACPCs on monitoring arrangements and audits carried out on child protection files.
n Formal professional supervision should be put in place for all professions working with children.
n It is recommended consideration be given to adapting 'Guidance Notes on Management of Cases involving Children', for use by other disciplines.
n A standardised tool for assessing the needs of children should be implemented on a regional basis.
n Additional resources must be made available to support the multi-disciplinary, inter-agency implementation of such an approach. These should be allocated across all disciplines.
n Consideration should be given to developing and resourcing an appropriate mechanism for managing risk posed by those who have perpetrated non-sexual offences against children.
n Agencies and individual disciplines need to take ownership of their roles and responsibility within the child protection process.
n There is a need to explore the roles of the Primary Health Care team within Child Protection, in particular the changing role of family GP's which now needs to be revisited and updated. This should be carried out at both regional and local level.
n Agencies involved in investigation of child abuse must be appropriately staffed and resourced for this complex task.
n Given the complexity and increased workloads in family support and child protection services the role of the Child Protection Nurse Specialist needs to be appropriately resourced and accompanied by specialist uni-disciplinary training.
n Training initiatives should provide Child Protection courses for all professionals including in particular core group members that is, Doctors, Health Visitors and Social Workers. This should include an outline of the role of any specialised posts within the Child Protection process.
n Community based projects of a preventative nature require stable mainstream funding.
n Existing Surestart Projects should be funded on a longterm basis with additional Surestart Projects developed in disadvantaged areas.
n The Wraparound approach to multi-disciplinary services to disabled children needs to be developed with funding secured on a recurrent basis.
n Further consideration should be given to how to provide effective support to enhance the participation of families and children, particularly those who are disabled or from ethnic minorities.
n Workload measurement systems should be developed on a regional basis to determine appropriate level caseloads for all staff working in Child Protection.
n An urgent review of terms and conditions should be undertaken for those employed in Child Protection.
n On a regional basis, career structures should be established to enhance the overall service through providing experienced staff with the opportunity to remain in practice.
n The Department should mandate the establishment of ACPC Training Subgroups within each ACPC with training representation from each of the key ACPC agencies. This would ensure that each agency would have ownership and commitment to child protection training and so reduce the downgrading of child protection training as an optional extra for agencies outside of the Social Services.
n The creation of a Regional Child Protection Training Taskforce, the key function of which would be the dissemination of child protection training issues from, research, audits and lesson to be learnt from past experience of serious case reviews. If this were established regionally key child protection training issues could be standardised across the province.
n With the development of a Regional Taskforce would be the recommendation to establish closer working relationships, and cross fertilisation of best practice, between Board training units, the Departments Child Care unit, and the Colleges and Universities of Further and Higher Education. Joined up structures would facilitate greater standardisation of child protection training. This could be achieved through regular secondments, and placements between Departments.
n Adequate funding be set aside for workload easement with suggestions as to how Boards and Trusts may innovatively facilitate the use of such funding.
n It is recommended that child protection training should be built on the delivery of core courses that would provide staff with key tools for practice. These should include:
- Skills in assessment
- The analysis of risk
- Threshold models for case allocations
- Effective recording, and the sharing of information
- Therapeutic intervention
n The SHSSB would recommend the establishment of a Regional Project aimed at researching the effectiveness of multi-agency child protection training and its outcomes for children.
n All disciplines and services working within child protection services need to be appropriately resourced to carry out this work.
n A regional response needs to be provided to identify unmet need.
n Long term funding needs to be put in place to support a range of family support services.
n The Children Service's Planning process, which takes a strategic approach to planning services on an inter-agency, multi-disciplinary basis, needs to have corresponding funding across Government Departments made available to progress these plans.
n Increasing needs identified within Child Protection, e.g. those contained within forthcoming "Co-operating Safeguard Children" should be fully resourced.
n The SACPC, in conjunction with local Child Protection Panels, should devise and implement a multi-disciplinary, inter-agency protocol in relation to Sudden Unexplained Death in children. This should be formally evaluated. It may also inform the development of a Regional initiative.
n A Regional approach should be taken to dissemination of key lessons learnt from Case Management Reviews and Inquiries into child abuse. This would enable a shift to be made from the traditional culture of blame to one of a more open, constructive learning environment.
n Consideration should be given to establishing regional structures within which lessons from Case Management Reviews and Child Abuse Inquiries could be considered. This might include a Regional Child Protection Task Force, mandated ACPC Training Groups and a Regional Research Team.
n Any resource implications related to recommendations within Case Management Reviews, Child Abuse Inquiries, Inspection reports must be assessed and the necessary funding made available to facilitate meaningful improvements in child protection services.
n The SACPC and Child Protection Panels recommend that risk assessment tools specific to domestic violence are developed.
n Domestic Violence Forums should be adequately funded to progress inter-agency initiatives to address domestic violence
1.1 This submission has been jointly prepared by representatives of the Southern Area Child Protection Committee, Armagh and Dungannon, Craigavon and Banbridge, and Newry and Mourne Child Protection Panels. Those involved welcome the opportunity to provide a contribution to this Inquiry.
1.2 The Southern Health and Social Services Board (SHSSB) has a population of approximately 94,400 children and young people under the age of 19 years. The SHSSB role is to commission services for children and families within its area (inclusive of family support and child protection services) based on assessed need. Statutory functions relating to child protection are in turn delegated to Trusts who deliver services to support and protect children in their area.
1.3 The Southern Area Child Protection Committee (SACPC) is an inter-agency, multi-disciplinary forum operating at strategic level. Its overall aim is to develop and ensure an effective inter-agency, multi-disciplinary approach is taken to protecting children. The SACPC is collectively accountable to the SHSSB, which constituted it. Individual members remain responsible to their own agencies, which in turn are responsible for taking any action falling within their respective remits. The full duties and responsibilities of the SACPC are detailed in the Children (NI) Order 1995, Regulations and Guidance, Volume 6, 'Co-operating To Protect Children'. This document has been reviewed by the Department of Health, Social Services and Public Safety, and an updated version, 'Co-operating to Safeguard Children' is awaited. A Private Members Bill in relation to placing the functions of ACPCs on a statutory basis is presently subject to consultation. This proposes strengthening the role and functions of ACPC.
1.4 There are 3 Child Protection Panels (CPPs) in the SHSSB area. These are based in Armagh and Dungannon Health and Social Services Trust, Newry and Mourne Health and Social Services Trust and, Craigavon and Banbridge Community Health and Social Services Trust. The latter includes representation from Craigavon Area Hospital Trust. The role of Trust Child Protection Panels is to ensure effective inter-agency, multi-disciplinary working at an operational level taking account of local issues. The overall responsibilities of Trust Child Protection Panels are contained within the Children (NI) Order 1995, Regulations and Guidance, Volume 6, 'Co-operating To Protect Children'.
1.5 Trust Child Protection Panels are constituted by their respective Trust Boards and are accountable to those Boards, with members accountable on an individual basis to the agencies they represent. Trust Child Protection Panels are not therefore accountable to SACPC, however are required to work closely with SACPC.
2.1 A holistic perspective is essential to assessing and meeting the needs of children, that is, one, which takes account of the child itself, the family or care situation and the wider environment. A focus must be kept on the child with each viewed as individuals in their own right. It should be recognised that services to protect children cannot be viewed in isolation from wider support services required for families in need. Protection of children is everyone's responsibility, at an individual level, as communities, and agencies and organisations within the statutory, voluntary, community, and private sector. Inter-agency, multi-disciplinary working is therefore a fundamental component of provision of an effective child protection system.
3.1 Case Recording
3.1(1) Case recording is specific to each individual profession, each of which must adhere to agency and professional codes on recording practice while taking account of the SACPC Child Protection Policy Procedures.
3.1(2) Recording of child protection cases is a complex and detailed task given the nature of intervention and decision making, and the level of contact between professionals and others. Recording needs to be given importance within the day to day workload and must be viewed in the context of the complete range of administrative tasks required of staff. The implementation of the Children (NI) Order 1995 has led to a significant increase in the detail of information required and accompanying proformas and reports.
3.1(3) Trusts within the SHSSB recognise the importance of ongoing monitoring of case files to ensure they meet the necessary requirements. Case files are routinely accessed within ongoing audit processes. In 2001 a comprehensive audit of health visiting records was carried out in the SHSSB. Five per cent of all current files were examined. The audit included an examination of records regarding health visitor child protection practice. A user survey was also conducted. Whilst results were positive an action plan has been developed and records will be re-audited as part of an amended supervision policy.
3.1(4) A recent SACPC External Review of Threshold for Decision Making across the SHSSB (at referral, case planning and child protection stages) noted that although it was apparent the necessary process had been followed, the basis of decision making was not explicit on some files. This has been recognised and is being addressed via the proposed implementation of a framework for assessment of children and their families. As a further result of this Review, management decisions and details of case discussions within the professional supervision arena will be contained on case files.
3.1(5) The SACPC have had in place a suite of forms to support the child protection process. These ensure that essential information to protect children is conveyed in a standardised format. During 2000 these forms were reviewed and updated to take account of changes in practice. The revised child protection forms were implemented in June 2000.
3.1(6) Records are subject to an open access policy to ensure the rights of service users within a spirit of working together and transparency. (There are exceptions in situations where there may be a conflict of interest, in such circumstances the needs of the child will be paramount.)
3.1(7) An audit of usage of proformas in relation to the Protocol for the Joint Investigation of Child Abuse, requested by SACPC, was completed and submitted by the three community Trusts in the SHSSB in January 2001. This audit highlighted the administrative complexities related to administrative processes across more than one agency (in this instance the police and social services). This audit related to proformas held on social services files. As a result of the audit, monitoring of Joint Protocol recording has been recommended to senior managers.
3.2 Professional Judgement
3.2(1) A number of external factors influence the use of professional judgement. These include, the Human Rights Act 1998, the Data Protection Act 1998, issues of client confidentiality and consent, policy and procedures and professional codes of practice. Professionals are accountable for their own individual professional judgement and decision making.
3.2(2) While the Children (NI) Order 1995 and its corresponding Regulations and Guidance represents the primary legislation in relation to protecting children, this is accompanied by SACPC Child Protection Policies and Procedures. These do not replace the necessity for professional judgement which dictates how and when policies and procedures are applied. Such judgement is based on values, knowledge, experience, and consultation with others. Professional judgement within a multi-disciplinary arena enhances child protection systems and decision making. Scope for professional judgement is an integral part of the Framework for the Assessment of Children in Need and Their Families recently implemented in England and Wales.
3.2(3) Good quality professional supervision aids and supports professional judgement. Each of the community Trusts within the SHSSB area has recently, or is currently updating supervision policies for social services staff. SACPC, working in conjunction with representatives from the Trusts, has recently implemented a document entitled 'Guidance Notes on Management of Cases involving Children', to assist social services staff across all programmes of care in the identification of potential child care issues. Nursing staff are also finalising a supervision policy to meet their professional needs.
3.2(4) At the outset SACPC has recognised that there are often differing views between a range of disciplines and agencies about when children should receive formal services, what those services should be, and provided by whom. This relates to the whole spectrum of services required by children and families. The SACPC and local Child Protection Panels have just completed drafting 'Multi-Agency Guidance for Services to Children in the SHSSB area'. This model sits well within the confines of the Children's Services Planning process. It was drafted on an inter-agency basis and is applicable to those within the statutory, voluntary, community and private sectors who come into contact with children. It places services within four levels, ranging from universal services to those to safeguard children. Its aim is to assist in determining the level of service appropriate for the child. It is hoped that this will lead to appropriate and effective identification and referral of those needing support.
3.2(5) The recent External Review of Thresholds for Decision Making across the SHSSB took account of the views of a number of professionals involved in identified cases. Following this Review Child Protection Panels and SACPC are completing two further audits. One relates to the formal use of discretion (as defined within the SACPC Child Protection Policies and Procedures) about the need to convene a case conference. The second audit will examine a sample of cases at case planning level to establish clear, standardised criteria to determine when the child's needs should be met within the case planning or child protection arena. It is intended that this will lead to clearer criteria for routing cases via case planning or child protection. It is essential that multi-disciplinary perspectives inform this decision.
3.3 Assessment and Analysis of Information
3.3(1) Assessment is an ongoing process, which must be supported by professional judgement in order to ensure information is appropriately analysed.
3.3(2) The assessment process in relation to children in need is detailed in the Children (NI) Order 1995 Policy and Procedures. Assessment of risk is fundamental to cases in the child protection process.
3.3(3) It should be noted that there have been significant developments in professionals working together to assess the needs of children and families. Co-working between disciplines (involving nursing, social work, etc) is a common feature in completion of assessments and risk analysis.
3.3(4) A complete assessment at either child protection or case planning level must maintain a focus on the child, the capacity of the parent/carer to meet the child's needs and the wider environment. In recognition of this, extensive work has been undertaken within the SHSSB to adapt and move towards the implementation of a framework for assessing the needs of children and their families. This would move practice beyond the DHSS Comprehensive Assessment implemented in 1988, (known as 'The Orange Book').
3.3(5) The formal Framework for the Assessment of Children in Need and Their Families has been adopted within England and Wales. This has been mandated by the DOH. The same assessment has not, as such, been mandated by the DHSS&PS but has been referred to within the draft revised Vol 6, 'Co-operating to Safeguard Children'.
3.3(6) The model has been piloted on a multi-disciplinary basis within each of the three community Trusts in the SHSSB area. It has also been evaluated. Professionally the overall ethos of this Framework was positively received and certain stages of the approach were commended, although the resultant resource implications of compiling a more detailed, multi-disciplinary, inter-agency assessment were highlighted by all disciplines and agencies (nursing, medical, social work, education, etc).
3.3(7) Following the evaluation and a subsequent consultation day, detailed comment about the actual structure of the assessment has been taken into account. The model is now being adapted into stages which allows decision making to be explicit at referral stage, initial assessment stage and core assessment. This includes summarised analysis of the information and consideration of risk. This will also provide clarity on the process of assessment and decision making for recording purposes.
3.3(8) In considering the complexity of risk analysis the SACPC and Child Protection Panels in the SHSSB area have piloted a risk assessment model in collaboration with Greg Kelly of the School of Social Work at Queens University, Belfast. An evaluation taking account of the views of social work, health visiting and medical staff was completed during 2000. The model was useful in helping structure decision making and promoting the discussion of risk in an organised way. An amended 'SACPC Risk Analysis Model' has been fully implemented with effect from May 2001. The SACPC requires that risk analysis will be completed at child protection case conferences to detail risk in the context of strengths and weaknesses within the family, likely impact on the child and potential for change.
3.3(9) The Multi-Agency Procedures for the Assessment and Management of Risk posed by Sex Offenders have recently been implemented. It is recognised that these only focus on those who have been convicted of sexual offences. The procedures do not address the management of those who have been convicted of non-sexual offences against children. The difficulty also remains of how to effectively protect children from those where offences have been alleged, there is insufficient evidence to bring criminal charges, yet concerns remain about potential risk to children.
3.a Regional standards and formats should be developed for recording practices in child care cases.
3.b Recording in child care cases should become an integral part of professional training.
3.c All agencies involved in child protection work should routinely audit their recording systems. Such audits should be both uni and multi disciplinary/agency in nature.
3.d Child Protection Panels should inform ACPCs on monitoring arrangements and audits carried out on child protection files.
3.e Formal professional supervision should be put in place for all professions working with children.
3.f It is recommended consideration be given to adapting 'Guidance Notes on Management of Cases involving Children', for use by other disciplines.
3.g A standardised tool for assessing the needs of children should be implemented on a regional basis.
3.h Additional resources must be made available to support the multi-disciplinary, inter-agency implementation of such an approach. These should be allocated across all disciplines.
3.i Consideration should be given to developing and resourcing an appropriate mechanism for managing risk posed by those who have perpetrated non-sexual offences against children.
4.1 The nature and level of multi-disciplinary, inter-agency liaison is clearly specified within the Children (NI) Order 1995 and its accompanying Regulations and Guidance and Policy and Procedures, and is fully reflected within the SACPC Child Protection Procedures. These procedures will be updated in line with the forthcoming revised Vol 6, 'Co-operating to Safeguard Children'.
4.2 Communication between parties and agencies can be affected by demands and increasing workloads on individual professions. The sheer extent of workloads can cause delay in accessing appropriate individuals to provide specific information.
4.3 Liaison between parties and agencies is clear when cases enter the child protection arena. It should be noted that prior to this stage, communication, in the spirit of working with carers and children, needs to take account of confidentiality, the need to obtain consent of families and children, and Human Rights legislation.
4.4 Communication is also enhanced by the understanding and awareness of different professionals and agencies on appropriate thresholds. The work already completed on Multi-Agency Guidance for Childrens' Services and the multi-disciplinary, inter-agency assessment framework enhances this understanding as does ongoing multi-disciplinary inter-agency training.
4.5 The lead in the strategic multi-disciplinary and inter-agency working in child protection is taken by SACPC and Trust Child Protection Panels. The SHSSB has created three designated Professional Support posts, one for each Trust Child Protection Panel. These key posts work at trust level across all disciplines involved in child protection. They ensure an additional resource is available to work within Trusts, alongside SACPC and to action child protection developments. These posts link closely with the Policy Adviser to SACPC. Representatives from each Trust Child Protection Panel also sit as members of SACPC.
4.6 The Children (NI) Order 1995 introduced the concept of Children in Need which places family support on a continuum with child protection. Therefore liaison between agencies and disciplines must take place along the entire continuum.
4.7 The Multi-agency Guidance for Services to Children within the SHSSB Area and the framework approach to assessment, presently being adapted are initiatives to promote positive early and effective communication between professionals. They also enhance understanding of individual professional roles and agencies roles and responsibilities.
4.8 Liaison between Social Services and the Police Service of Northern Ireland is most frequently in relation to the operation of the Protocol for the Joint Investigation of Child Abuse, that is, at investigation stage. Recent changes within the PSNI have led to a reduction in the number of officers presently available within the Child Abuse and Rape Enquiry (CARE) Units.
4.9 The Joint Protocol has also been recently reviewed leading to a more intensive, specialised, competency based approach to training small numbers of selected staff within both agencies.
4.10 The SACPC Annual Report 2001/2002 comments on the ongoing issue of low attendance of GP's of Child Protection Case Conferences. Individual Child Protection Panels have medical representatives and have in place proformas to assist GP's to provide written contributions when they are unable to attend. The changing nature of the GP role prompts the need to consider how they can effectively contribute to child protection processes and strengthen GP communication with all those involved in child protection especially at the early stages of investigation and assessment.
4.11 The establishment of Child Protection Nurse Specialist posts within Trusts has been a particularly positive development in enhancing communication with the Child Protection process. Child Protection Nurse Specialists are core members of case conference. They advise, support and supervise nurses, midwives and health visitors in relation to child protection practice. Their role includes the development and monitoring of nursing policies, and the provision of a nursing perspective to multi-disciplinary and inter-agency initiatives. Additional resources are required to meet the increasing demands of these posts.
4.12 Given the time constraints, it was not possible to obtain a composite view from medical personnel, however a separate contribution provided by the Consultant Community Paediatrician who represents one of the Trust Child Protection Panels on SACPC has been attached. (Please see Appendix 2)
4.a Agencies and individual disciplines need to take ownership of their roles and responsibility within the child protection process.
4.b There is a need to explore the roles of the Primary Health Care team within Child Protection, in particular the changing role of family GP's which now needs to be revisited and updated. This should be carried out at both regional and local level.
4.c Agencies involved in investigation of child abuse must be appropriately staffed and resourced for this complex task.
4.d Given the complexity and increased workloads in family support and child protection services the role of the Child Protection Nurse Specialist needs to be appropriately resourced and accompanied by specialist uni-disciplinary training.
4.e Training initiatives should provide Child Protection courses for all professionals including in particular core group members that is, Doctors, Health Visitors and Social Workers. This should include an outline of the role of any specialised posts within the Child Protection process.
5.1 The value and importance of working with children, parents/carers and local communities is fully recognised. Given that child protection is on a continuum with family support services, involvement with family and local communities is crucial at all stages. They play a fundamental role in prevention and early intervention. The Children Services Planning Process aims to provide an integrated approach to strategic planning of services to children and families. This includes input from reference and user groups from within local communities. The Southern Area Childcare Partnership plays a lead role in supporting families through strategic development of services based on assessed need.
A Community approach
5.2 The role of community based parental education and family support, taken forward in co-operation with the parent or carer, is crucial in a preventative approach to child protection. Community and voluntary providers are often the first point of contact for families and have a role in the prevention of, and detection of, child abuse. Adequate training and support for staff is important. Stable, mainstream funding for community and voluntary sector projects would ensure that non-judgemental and accessible resources are available to families and communities.
5.3 The SHSSB has a comprehensive Community Sector Training Programme in place which uses a cascade training model to work with local community and voluntary groups on child protection issues.
5.4 Surestart is pioneering an integrated approach to family support. The impact of the initiative will be to facilitate "a joined-up" approach to professional working practices and better links between professionals, parents and communities. Surestart funding needs to be secured on a long term basis and additional Surestart projects should be developed in disadvantaged areas.
5.5 The Wraparound initiative recently developed within the Southern Board Area represents a multi-disciplinary approach to meeting the needs of disabled children. An integral part of the Wraparound project (based in each Trust area) is the open and transparent working with children, parents and carers themselves. The Wraparound Project has only attracted funding for a three year period. This approach to working with children and families should be expanded and fully funded on a recurrent basis.
5.6 The above examples of engagement with children and young people, families and communities are built on by initiatives through Child Protection Panels and the SACPC. These are based on awareness raising through local media and information leaflets for the general public. Press articles have included awareness raising regarding domestic violence, punishment of children, supervision of children, child protection and the internet.
Working with Parents/Carers and Children/Young People
5.7 An Open Access Policy is in place to enable users of services to access information on case files.
5.8 Children (NI) Order 1995 Representations Complaints Policy Procedure is also in place within each of the Trusts. This has recently been updated and is accompanied by a range of public information leaflets for parents, carers and young people.
5.9 Requirements to involve parents, carers and children throughout the process of family support/case planning and child protection are detailed within the relevant Policy and Procedures. Good practice requires that parents/carers and children (as appropriate) are encouraged to actively participate in the process, are supported to do so, and have reports shared with them in advance of meetings and can complete proformas. It should be noted that as rule there is a high level of participation by families.
5.10 SACPC working with Child Protection Panels have implemented a proformae with children and young people inputting to case conference. The leaflet for parents/carers on the case conference process has recently been updated. One of the Trusts within the SHSSB area has the facility for parents to have a support person from the Parents Advice Centre accompany them to child protection case conference.
5.11 Families requiring formal interventions of this nature are already under great stress making participation at this stage, and within procedural time frames, particularly difficult. Enabling the involvement of families and children is a complex task for staff concerned.
5.a Community based projects of a preventative nature require stable mainstream funding.
5.b Existing Surestart Projects should be funded on a longterm basis with additional Surestart Projects developed in disadvantaged areas.
5.c The Wraparound approach to multi-disciplinary services to disabled children needs to be developed with funding secured on a recurrent basis.
5.d Further consideration should be given to how to provide effective support to enhance the participation of families and children, particularly those who are disabled or from ethnic minorities.
6 WORKFORCE ISSUES
6.1 Recruitment and retention of qualified staff is the main stay of an effective service to children and families.
6.2 The introduction of the Children (NI) Order has had a significant impact on increasing workloads for staff. This has presented particular difficulties for social services staff working in Child and Family Care programmes.
6.3 The demands of court work have dramatically increased in respect of Care Orders, Article 8, and Freeing applications. This now ordinarily requires provision of additional reports and court attendances in addition to the necessary preparation work. The statutory Looked After Children process has also added increased administrative burdens and professional demands on staff. These, in conjunction with the complexity of and level of responsibility attached to the Child Protection process has led to a high turnover of staff and significant difficulties in recruitment and retention of experienced staff and increasing levels of sickness.
6.4 SACPC, Child Protection Panels and Senior Managers across disciplines are acutely aware of pressures on staff and the agencies' duty of care towards those staff. Family friendly policies have been implemented to assist staff balance home and work demands. These in themselves present
6.5 Staff are dealing with increased procedural requirements, administrative demands, increased time required to work in a meaningful multi-disciplinary, inter-agency way, and increasing expectations from the general public.
6.6 Working within Child Protection, staff are committed to working with the most vulnerable and often disadvantaged members of society. However, this is often at a time of distress and anger for families. Hostile reactions are not uncommon, with staff frequently subjected to verbal and physical threat and assault.
6.7 Such pressures are not specific to Social Services staff and in fact are evident across all disciplines and agencies working with children and families. This is leading to staff electing to work in other programmes of care, other specialist agencies, or indeed in Southern Ireland where attractive financial incentives are in place.
6.8 Quality supervision is central to the support and professional development of staff. Trusts within the SHSSB area have recently revised (or are in the process of) revising their supervision policies. Supervision policies are also being developed for nursing staff. Nonetheless these must be supported by a full compliment of staff, appropriate remuneration, and a safe working environment where staff feel valued.
6.a Workload measurement systems should be developed on a regional basis to determine appropriate level caseloads for all staff working in Child Protection.
6.b An urgent review of terms and conditions should be undertaken for those employed in Child Protection.
6.c On a regional basis, career structures should be established to enhance the overall service through providing experienced staff with the opportunity to remain in practice.
7.1 Since 1990 multi-agency child protection training has been an integral part of SACPC structure.
7.2 Child protection training is supported through a dedicated training post funded jointly by the SHSSB and the Southern Education and Library Board. This unique post and partnership arrangement is the only one of its kind in the Province.
7.3 In order to identify the multi-disciplinary child protection training requirements of staff for the SHSSB annual training needs analysis is carried out in conjunction with the three Trusts Child Protection Panels, the Children and Young Peoples Committee and the objectives, policies and procedures set by ACPC. During this process cognisance is taken of many other factors such as national and regional issues, as well as current research, messages from inquiries and, lessons from Case Management Reviews.
7.4 The delivery of training is provided both in house by the multi-disciplinary child protection trainers and also commissioned through external trainers.
7.5 The provision of such a dedicated ACPC child protection training post is currently in keeping with the proposals outlined in the Private Members Bill on the role and functions of ACPCsi. The organisation of our training programme, content and target audiences are in keeping with the framework for training outlined in the Departments draft document "Co-Operating to Safeguard Children"ii.
7.6 The SHSSB would support this draft framework outline for the delivery of training, which ensures that multi-disciplinary child protection training is seen as a process of building on existing knowledge and skills and not simply a one of training event.
7.7 In the Southern Board area the child protection trainers are provided with the opportunity to be part of key working groups tasked with devising new practice guidelines or amending existing policies and procedures. The training requirements are then directly translated into training courses ensuring that training bridges the gap between policy, procedures and practice.
7.8 Over the past two consecutive years approximately 700 to 800 staff have received child protection training from awareness through to skills training.
7.9 One of the major recurring difficulties in child protection training is the release of staff to attend training sessions. Increasing pressures of work, and the lack of workload easement often denies staff the opportunity to attend training. This does not reflect the commitment of either staff or management to child protection training but highlights the reality of child protection work.
7.10 It must also be recognised that multi-disciplinary training endeavours to offer training to a wide grouping of staff. Inevitably given the numbers of staff involved this has to be targeted. Mechanisms need to be in place to address the uni-disciplinary requirements of staff in all disciplines who come into contact with children and families, such as nursing, medical personnel, PAMS, education sector staff, housing staff etc.
7.11 SHSSB welcomes new arrangements set by the NI Social Care Council for the post registration of diploma students to consolidate learning. This will allow Trusts the necessary mandate to quality assure practice.
7.a The Department should mandate the establishment of ACPC Training Subgroups within each ACPC with training representation from each of the key ACPC agencies. This would ensure that each agency would have ownership and commitment to child protection training and so reduce the downgrading of child protection training as an optional extra for agencies outside of the Social Services.
7.b The creation of a Regional Child Protection Training Taskforce, the key function of which would be the dissemination of child protection training issues from, research, audits and lesson to be learnt from past experience of serious case reviews. If this were established regionally key child protection training issues could be standardised across the province.
7.c With the development of a Regional Taskforce would be the recommendation to establish closer working relationships, and cross fertilisation of best practice, between Board training units, the Departments Child Care unit, and the Colleges and Universities of Further and Higher Education. Joined up structures would facilitate greater standardisation of child protection training. This could be achieved through regular secondments, and placements between Departments.
7.d Adequate funding be set aside for workload easement with suggestions as to how Boards and Trusts may innovatively facilitate the use of such funding.
7.e It is recommended that child protection training should be built on the delivery of core courses that would provide staff with key tools for practice. These should include:
n Skills in assessment
n The analysis of risk
n Threshold models for case allocations
n Effective recording, and the sharing of information
n Therapeutic intervention
7.f The SHSSB would recommend the establishment of a Regional Project aimed at researching the effectiveness of multi-agency child protection training and its outcomes for children.
8.1 As already noted the Children (NI) Order introduced the concept of placing family support and child protection on a continuum. However, while both the SHSSB and Trusts are committed to prevention and early intervention to support vulnerable families this approach must be adequately funded across all disciplines and sectors (social work, nursing, medical etc). It is recognised that resources channelled into prevention services would reduce the number of children and families requiring statutory child care interventions. A paper drafted by the 4 Boards 'Family and Child Care Services in Northern Ireland in 2000' details issues related to funding and resources which require serious consideration within this Inquiry. (Please see Appendix 1)
8.2 It is worthy of note that Priorities for Action has not included consideration of initiatives to improve child care services in the community.
8.3 Reference has already been made to the increased demands on staff. This is reflected in the statistical data which indicates a corresponding increasing demand on Child Protection services across the three community Trusts in the SHSSB area.
8.4 The data which is most readily available relates to child protection activity, however a large amount of work is carried out by a range of professionals who work with cases at case planning levels. This work is equally complex and resource intensive and often goes unrecognised when considering this formal child protection system.
8.5 Information contained in the SACPC Annual Report 2001/2002 indicates a steady increase in child protection referrals.
CHILD PROTECTION REFERRALS TO SHSSB - 1 APRIL 2001 - 31 MARCH 2002
Referrals are indicating increasing levels of complexity with families presenting with multiple difficulties, including for example alcohol dependency, mental health difficulties, domestic violence etc. Data on the child protection process, numbers and categegories of child protection registration in the SHSSB are detailed below.
Initial Case Conferences/Registrations
THE CHILD PROTECTION PROCESS BY TRUST - 1 APRIL 2001 - 31 MARCH 2002
A case conference may have considered more than one child
8.6 The number of children on the Child Protection Register in the SHSSB area over the last five years is outlined below.
NUMBER OF CHILDREN IN THE SHSSB AREA ON THE CHILD PROTECTION REGISTER AS AT 31 MARCH 1998 - 2002
CATEGORIES OF REGISTRATION FOR
CHILDREN ADDED TO THE REGISTER IN SHSSB AREA AS AT
This represents a major resource demand for all those involved in protecting children experiencing or likely to experience significant harm.
8.7 While the demand remains high in formal Child Protection services, there has been significant difficulty in shifting the already limited resources into family support and prevention initiatives.
8.8 The Statutory Childcare Sector works in partnership with the voluntary, community, and private sectors to meet the assessed needs of families and children. Such services are increasingly financed through short term or one-off funding.
8.9 The increased pressures at all points in the service can cause delays in responding to the needs of families, thereby compounding the difficulties for all involved.
8.10 The SHSSB is working with community Trusts in its area to improve existing information systems. A database is being developed, the Childcare Recording Information System (CRIS) to add to data obtained via SOSCARE and manual systems. Trusts routinely record and report on unmet need as required within the Children (NI) Order 1995.
8.11 As practice increasingly takes account of relevant research and evidence there are resultant resource implications. One example of this is the SACPC initiative developing a Child Protection policy in respect of the "The Impact of Domestic Violence on Children". This policy recognises the detrimental impact on children and potential for significant harm for children within families where domestic violence is a feature. This policy based on an increasing body of knowledge strengthens the requirement for a multi-disciplinary, inter-agency consideration of the needs of children experiencing domestic violence increasing the numbers likely to require support as children in need.
8.12 The increasing complexity of needs of those children and young people in the Looked After system also requires consideration. Those with challenging behaviours can often pose a risk to themselves and others. Difficulties arise in the availability of and difficulty in accessing secure accommodation placements for these young people at a time when they are in greatest need.
8.13 The revised draft volume 6, "Co-operating to Safeguard Children" broadens the range of issues which should be considered within child protection. This now includes bullying, child prostitution, domestic violence, abuse of children on the internet. Such developments require corresponding resources to enable child protection systems to effectively intervene and protect the needs of children in these situations.
8.a All disciplines and services working within child protection services need to be appropriately resourced to carry out this work.
8.b A regional response needs to be provided to identify unmet need.
8.c Long term funding needs to be put in place to support a range of family support services.
8.d The Children Service's Planning process, which takes a strategic approach to planning services on an inter-agency, multi-disciplinary basis, needs to have corresponding funding across Government Departments made available to progress these plans.
8.e Increasing needs identified within Child Protection, e.g. those contained within forthcoming "Co-operating Safeguard Children" should be fully resourced.
9 LESSONS LEARNED
9.1 The NSPCC Out of Sight Report makes distressing and dismaying reading, particularly for all those involved in the difficult and demanding work of protecting children. Tragically, key themes are repeated in the recommendations of these reports. Most commonly these relate to poor communication and failures in multi-disciplinary working. Efforts to learn lessons from these tragic events should be placed within the context that risk cannot be entirely eliminated. Responses are therefore in relation to identification and management of risk. The SACPC is currently involved in regional endeavours to establish a risk framework within which work with families and children can be placed.
9.2 It is acknowledged that poor multi-disciplinary inter-agency communication is a recurring theme in the numerous enquiries into child deaths at the hands of their carers. Where the resultant response had been to endeavour to direct communication via stronger more defined procedures it is apparent that this in itself has limitations. Communication must essentially be based on a professional recognition and commitment of the need to do so.
9.3 Structures established via SACPC and Trust Child Protection Panels include increasing levels of audit and monitoring systems for local practice to ensure adherence to procedures. Through analysis of child protection information attempts are made to monitor and identify local trends in child protection and respond to these. The recent external review of thresholds for decision making across the SHSSB (2001) evidences a pro-active response across the three community Trusts to explore varying trends in child protection within the Board area. A detailed action plan has been set in place to address the recommendations. This is now being taken forward.
9.4 There is a recognition and commitment to take account of research and evidence. This has become an integral part of child care training initiatives and, in fact, has been included in recent policy developments led by SACPC e.g. the SACPC Impact of Domestic Violence on Children includes a separate research section.
9.5 The SHSSB, in conjunction with local Trusts, considers Departmental and SSI reports and develops accompanying action plans to progress recommendations contained within these.
9.6 Child Protection Panels within the SHSSB are alert to individual cases where formal criteria for case management reviews are not met, however, the circumstances of the case warrant consideration at Panel level. This is an attempt by Panels to scrutinise practice at local level.
9.7 The Policy Advisor post to the SACPC and the establishment of the Professional Support posts developed in the SHSSB has assisted bringing up-to-date research and pertinent information from enquiries to local fora and effectively integrating this into local practice.
9.8 It is acknowledged that a case management review has recently been completed within the SHSSB following the death of a child and serious injury to his twin brother, both of whom were subjects of an ongoing inter-country adoption. Following the internal Case Management Review an Independent Enquiry was initiated by the DHSS & PS. The Case Management Review focussed both on the inter-country adoption arrangement and the child protection issues. With regard to the former, the recommendations referred to the need for adherence to procedures, recording issues and communication across the various disciplines. In terms of child protection the review highlighted the need for all professionals to be aware of child protection responsibilities, the importance of communicating post-mortem findings and the need to review the current process. The more formal child protection process was actioned when the second child was injured and, following this, there was evidence of good practice across the various disciplines. In tandem with recommendations relating to the need for improved communication there was also a need to look at notification arrangements within the Trust and from the Trust to the Board and Department. Whilst awaiting the Independent Enquiry report, action has already been taken on a significant number of the recommendations within the Case Management Review, specifically the application of adoption policy and procedures, recording and communication issues. This has been facilitated by training to address particular areas. In addition, work is also progressing on the development of a protocol for instances of Sudden Unexplained Deaths in Children. It is critical that all of the agencies and professionals accept the need for this protocol and play an active part in its formulation. The SACPC and Child Protection Panels in the SHSSB area are committed to improving practice and learn key lessons identified within this Case Management Review. Further action necessary will be taken when the Independent Enquiry is completed.
9.a The SACPC, in conjunction with local Child Protection Panels, should devise and implement a multi-disciplinary, inter-agency protocol in relation to Sudden Unexplained Death in children. This should be formally evaluated. It may also inform the development of a Regional initiative.
9.b A Regional approach should be taken to dissemination of key lessons learnt from Case Management Reviews and Inquiries into child abuse. This would enable a shift to be made from the traditional culture of blame to one of a more open, constructive learning environment.
9.c Consideration should be given to establishing regional structures within which lessons from Case Management Reviews and Child Abuse Inquiries could be considered. This might include a Regional Child Protection Task Force, mandated ACPC Training Groups and a Regional Research Team.
9.d Any resource implications related to recommendations within Case Management Reviews, Child Abuse Inquiries, Inspection reports must be assessed and the necessary funding made available to facilitate meaningful improvements in child protection services.
10 GENERAL COMMENTS
10.1 The SACPC and Trust Child Protection Panels believe that within the present integrated health and social services structure there is already a positive foundation on which to build further improvements necessary to meet the growing demand on the child protection system.
10.2 The SACPC and Child Protection Panels in the SHSSB area have introduced a number of initiatives to improve practice. These include: the Multi-Agency Guidance on Childrens Services; a protocol on the relationship between Adult Mental Health Services, Child and Adolescent Mental Health and Child Protection Services: a Policy on the Intimate Care of Children; Child Protection Policy and Procedures for Disabled Children: and Policy and Procedures on the Impact of Domestic Violence on Children.
10.3 Domestic violence and its negative impact on families is worthy of specific comment. While its impact on children is now being recognised, it is important that this is addressed and resourced in both child protection and family support arenas. It is essential that the necessary risk assessment tools are developed to assist staff consider risk in families suffering domestic violence. The Regional Domestic Violence Forum and the inter-agency domestic violence forums already established in trusts play a crucial role in setting in place structures to address domestic violence. However to effectively progress initiatives, adequate funding is required.
10.a The SACPC and Child Protection Panels recommend that risk assessment tools specific to domestic violence are developed.
10.b Domestic Violence Forums should be adequately funded to progress inter-agency initiatives to address domestic violence
11.1 The SACPC awaits the publication of the forthcoming Revised Children (NI) Order Vol 6 Co-operating to Safeguard Children. This will mark the opportunity for further change and development of child protection work.
11.2 It is hoped that this submission on behalf of the SACPC and Child Protection Panels within its area will assist in informing the Assembly's Inquiry into Child Protection Services in Northern Ireland and contribute to the enhancement of those services.
1 Family and Child Care Services in Northern Ireland - Overview
1.2 Funding - Comparisons with England
1.3 Funding the Children Order in Northern Ireland - Shortfalls
2 Supporting Children and their Families
2.1 Background Briefing
2.2 Requirements Anticipated in 1995
2.3 Emerging Demands 1996-2000
2.3.1 Increased Referrals by Children 'In Need'
2.3.2 Waiting Lists - Identified Unmet Need
2.3.3 Article 8 - Private Law Cases
2.3.4 Children's Services Planning
n Youth Justice
n School Exclusion
n Child/Adolescent Mental Health Service
2.3.5 Children with a Disability
2.3.6 The NI Child Care Strategy
2.3.7 Additional Policy Impacts
3 Keeping Children Safe
3.1 Background Briefing
3.2 Requirements Anticipated in 1995
3.3 Emerging Demands 1996-2000
3.3.1 Operational complexity
3.3.3 Court Work
3.3.4 Impact on Direct Work with Clients
3.3.5 Additional Pressures
4 Children Who are Looked After by Boards and Trusts
4.1 Background Briefing
4.2 Requirements Anticipated in 1995
4.3 Emerging Demands in 1996-2000
4.3.1 General Residential Provision
4.3.2 Specialist Residential Provision
4.3.3 Family Placements - Foster Care
4.3.4 Permanency and Adoption
4.3.5 Leaving and After Care
5 Summary and Recommendations
This paper will present a review of Family and Child Care Services in Northern Ireland. It is submitted as an agreed position, by the four Health and Social Services Boards.
Social Services in Northern Ireland are organised at two levels:
n Commissioning is undertaken by the four Health and Social Services Boards, who carry statutory responsibilities for the planning, resourcing, monitoring and quality assurance of services.
n Service provision and operational management are undertaken by the eleven Community Trusts, which have delegated statutory responsibilities and are accountable to Boards for the management of staff/resources and delivery of services.
Boards and Trusts have developed organisational arrangements to plan and deliver a wide range of Social Services, of which Family and Child Care teams constitute a significant part. The Children (NI) Order 1995 is the legislation which mandates the bulk of Family and Child Care activity.
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 the intersections and overlaps between systems. Whilst the Children Order gives Family and Child Care 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 service.
The paper will examine the areas where Boards/Trusts have core responsibilities, as well as demonstrating the multi-agency dimension. It will be argued that the needs of the most vulnerable families and children in Northern Ireland have created a level of demand for Family and Child Care Services which has significantly outstripped supply. Services are not sufficiently well developed to provide the responses which are required and are under increasing, severe pressure. Parts of the service have been described as in crisis. The paper will concentrate on the three main themes of the Children Order (family support, protecting children, and services for children in care), and will summarise:
n factors contributing to increased need;
n the history of service funding since the introduction of the Order;
n the operational consequences of implementing the Children Order;
n key strategic developments which impact on service provision and planning.
It will draw attention to under-funding, and to funding deficits in comparison with other parts of the United Kingdom. Referring to a range of research sources and policy directives, it will identify areas of need where investment is necessary in order to implement statutory responsibilities, to address social exclusion and to promote the best interests of children and young people as active citizens in the Northern Ireland of the future.
1. Family and Child Care Services in Northern Ireland
Northern Ireland has 463,226 children and young people, who comprise 27% of the total population (compared to 22% in England). Many children and young people in Northern Ireland experience economic and social disadvantages which are likely to bring them within the legal definition of 'In Need', creating entitlement to access to a range of personal social services(1).
n There is ample evidence of the negative effects of poverty and deprivation on life outcomes for significant numbers of children. Evidence, for example, of differentials in infant mortality(2), health risks to children(3), poor educational attainment(4) and school suspension and expulsion(5) point to just some of the disadvantages. At least one child in every four in Northern Ireland (26.5%) was a dependant of claimants of Job Seekers Allowance and Income Support Benefits in 1998/99(6). 23.9% of school children received Free School Meals in 1999/2000(7), higher than in every other part of the United Kingdom. This is the socio-economic context in which Family and Child Care Services are delivered(8).
n It is estimated that 22% of males and 8% of females in Northern Ireland in 1998 consume alcohol above sensible levels(9). This is a growing, culturally accepted, area of concern, with numerous consequences for children. Alcohol abuse has been strongly linked to violent crime and to domestic violence(9). The percentage of those aged 16-24 years drinking above sensible limits is higher and is growing faster than that for those aged 25 years+(10).
n There is a growing level of concern about drug abuse. The WHO study in 1997/98, from a sample of 6574 young people between 11-15 years, estimated that 23% had been offered drugs(10). Police report that the number of drug seizure incidents rose by 29.6% in 1999/00(11).
n Figures from the Northern Ireland Court Service provide evidence of concern about the extent of Family Breakdown. In the year 1997/98, the Courts, under Article 8 of the Children Order, dealt with applications for 2539 Contact Orders (permission), 2179 Residence Orders, 121 Prohibited Steps Orders, 45 Specific Issue Orders(12). It is reported by Relate NI that there are approximately 5000 divorces or legal separations in Northern Ireland each year, which is a 44% increase on 10 years ago. 27% of marriages now end in divorce(13). There is research evidence that children from separated families are more susceptible to a number of disadvantages in emotional wellbeing, health, educational performance, etc.(14).
n In 1997/98, 1408 children in Northern Ireland had to be accommodated in a Refuge because of the experience of domestic violence(15). In 1999, 14456 incidents of domestic violence were reported to the RUC. In 93% of cases, children were present. There is research evidence of strong links between the experience of children of domestic violence and child abuse(16).
n 26% of all families with dependant children in Northern Ireland in 1997/98 were lone parent families(17). This has increased from the 1990/91 figure of 19% of all families. Lone parents are much more likely to experience disadvantages arising from poverty than two parent families(18), and their children are more likely to be 'in need'.
n Northern Ireland has a teenage birth rate approaching 30 per 1000 women. This trend is consistent with the UK trend, which is the highest in Western Europe(19). Research shows that young people with a history of disadvantage are at significantly greater risk of becoming parents in their teens. Teenage pregnancy has been targeted by the Government Social Exclusion Unit as an area of particular concern.
n Northern Ireland is a society emerging from a conflict which continues to have adverse consequences for significant members 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 or less(20). The Bloomfield Report refers to 'secondary' effects(21), to the traumatic and continuing experiences of the 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(22). 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 enuretic clinics. The Children Study suggests that 15.8% of adolescents in the Omagh area were 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. The significance of the Omagh studies and experience is that, for the first time in the history of the Troubles of the past 30 years, the impact of violence has been assessed through community studies and quantified. In 2000, 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 numbers of deaths because of the 'Troubles'(23). The impact of the 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.
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', drugs 'wars' and at a community level, increases in domestic violence, child abuse and other forms of personal violence.
The Government social policy agenda has been based on the objective of promoting social inclusion, with emphasis on early intervention. The Equality Legislation and the Human Rights Act have provided a statutory basis for promoting the rights and needs of children and young people particularly those who are vulnerable(24). Both of these major policy developments will have significant consequences for the effect and nature of family and child care planning and provision.
1.2 Funding - Comparisons with England
The DHSS document 'Key Indicators of Personal Social Services in Northern Ireland' reports that: "A total of £61.4m was spent on Family and Child Care Services in Northern Ireland in 1997/98. The figure for 1995/96 was £56m. Although this represents an increase of 9.7% of money spent in Family and Child Care over the past 3 years, the proportion of PSS expenditure spent on Family and Child Care has fallen, from 17.6% in 1995/96 to 16.7% in 1997/98. England has spent a higher percentage of PSS expenditure on Family and Child Care than in Northern Ireland in each of the last 3 years". (25)
Figure 1 - Per-Capita Expenditure on Provision for Children and Their Families (£)
(Source: SSI 1999)(25)
Figure 2 - Percentage of Expenditure on Provision for Children and Their Families
(Source: SSI 1999)(25)
1.3 Funding the Children Order in Northern Ireland - Shortfalls
In 1994, prior to the implementation of the Children (NI) Order 1995, the 4 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 then built up from Trust level a detailed analysis of the services which 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 estimates in their submission to the 1995 Public Expenditure survey.
Figure 3 - Board and Departmental Estimates re Children Order Funding
(Source: HSS Boards)
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 Placements
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 ad Litem Agency, and not of additional costs to Boards/Trusts.
Since 1995, the Boards have received recurring cumulative allocations amounting to approximately £17m (current prices). Whilst this represents a significant investment in Children's Services, it falls some £9m (current prices) short of the Department's Public Expenditure Survey Bid in 1995, and some £17m (current prices) short of the amount initially identified by the Boards as necessary.
It is important to establish that allocations to Family and Child Care Programmes in Boards have also been subject to financial pressures from other Programmes, and in particular from the Acute Health Services sector. The Eastern Health and Social Services Board has been severely effected in this respect. As Figure 4 (below) demonstrates, not all of the funding allocated to the EHSSB was subsequently transferred into Trust baselines:
n In 1996/97 £16,000 was held by the Board to cover commissioner costs. The difference between the two figures other than this was made up of funding which the Board used to contract with voluntary organisations to provide children's services.
n In 1997/98 and 1998/99 the bulk of the difference between the figures can be accounted for by the difference in monies transferred to the Board to fund the Regional Child Care Centres (Glenmona, Rathgael and St Joseph's) and the cost of actual usage.
The recurrent deficit to the EHSSB in this regard was £815,000.
The remaining differences can again be accounted for by the Board contracting directly with voluntary organisations to provide children's services.
n In 1999/2000 the EHSSB applied £1.449 million recurrently and a further £1.269 million non-recurrently from the programme to cover its deficit. In this year the Board applied this approach pro rata to all of the development money which it received for all Programmes. In this respect Family and Child Care Services were affected, in the same way as other service areas, by the needs of the Board to regain and maintain financial balance.
n To put this matter further into context it is important to appreciate that in 1998/1999 alone the Eastern Board invested £3.6m more than the amount which the regional needs based 2nd Capitation Report would have suggested it invest.
Figure 4 - Allocations (£000) to Boards
and Trusts for Investment in Children Order Services,
(*) This variation has been made up in year 2000/01 and allocated accordingly.
(Source: HSS Boards)
This paper will demonstrate that funding calculations need to be urgently revisited, from three perspectives:
1. The 1995 Public Expenditure Bid excluded key areas which have subsequently proved to be extremely resource intensive i.e.:
n Residential Child Care (note that a portion of the allocation made by the Department has been targeted at Residential Child Care despite its exclusion from the 1995 PES bid)
n Family Placement provision
n Child Protection services
n Medical, paramedical and nursing implications
n Legal costs
2. The original submission by Boards under-estimated the true costs of implementation.
3. This under-estimation has been compounded by a number of subsequent policy developments and initiatives - including
n Changes in Juvenile Justice
n Children's Services Planning
n The NI Child Care Strategy, Children First (including the Pre-School Education Expansion Programme)
n Revision of 'Co-operating to Protect Children'
n SSI Reports (especially Planning to Care 1999 and Fostering in Northern Ireland 1998)
n National Foster Care Standards and Code of Practice
n Sex Offenders Act
n Waterhouse Report - 'Lost in Care'
n Introduction of the Framework of the Assessment of Children in Need and their families.
2. Supporting Children in Their Families
2.1 Background Briefing
The legislative context for Family and Child Care services prior to the Children Order promoted concentration on services to protect children who were assessed as at risk of abuse. The Children Order introduced, for the first time in Northern Ireland, and heavily emphasised, the provision of support for Children In Need. In essence, this placed a statutory responsibility on Boards and Trust to develop personal social services for children who require such support in order to achieve adequate levels of physical, social and educational development. This is a much larger constituency of children and young people than that for which Personal Social Services Departments were previously responsible.
The development of services in this area is crucial for the following reasons:
n To prevent long term consequences for children of adverse experiences such as poor health awareness/ uptake of health services, parental instability, missed education etc
n To reduce the number of children who are potentially exposed to abuse, and/or who require child protection services
n To meet the needs of children successfully at home and thereby to prevent the need for admission to care.
2.2 Requirements Anticipated in 1995
In 1995 Boards requested an allocation of £19.34m (current prices) to implement this part (Part 4) of the Children (NI) Order. This was reduced in the Public Expenditure Survey bid, and was subsequently over-run by pressures arising from other priorities which were excluded from the PES bid - for example, residential care, foster care.
2.3 Emerging Demands 1996-2000
2.3.1 Increased Referrals by Children 'In Need'
Trusts are required to complete an assessment of all children referred as potentially 'In Need'. In the year 1997/98, 13048 children were referred in this category. Figures from Boards suggest that the referral rate is increasing significantly over time - in the period from the fourth quarter of 1996/97, for example, to the corresponding quarter in 1999/00, there was a 69% increase in referrals to the NHSSB, as parents, communities and a range of professionals have become more familiar with the concept and the legislation.
Children, once assessed 'In Need', are entitled to individualised Care Plans (care packages), negotiated in consultation with parents and other professionals, and regularly reviewed. The increasing level of demand for assessment has the consequence of reducing time available for direct delivery of services to meet those assessed needs.
2.3.2 Waiting Lists - Unmet Need
Information received from trusts indicates that there are significant numbers of children awaiting individual service responses in respect of Family Support Services e.g.
(Source: Trust Directors - Unmet Need Return for the Province at 12/5/00)
2.3.4 Article 8 - Private Law Cases
In Chapter 1 of this paper, reference was made to evidence of family breakdown as measured by Court related activity. Whilst the majority of cases involving marital breakdown are dealt with in private law, Courts have expected that Social Services will become involved in the assessment of children's welfare and in the resolution of difficult contact issues. This has been a significant pressure which is explicitly acknowledged in the Children Order Report 1999(28) which states that "It is clear that private law proceedings constitute a considerable workload for HSS Trusts, and that the potential exists for those demands to increase. Delay in providing Courts with Welfare Reports will have implications for Court disposal times". A range of new services to resolve the contentious issues in these cases, such as Contact Centres, have been requested by the Courts.
The above information relates to the provision of direct Personal Social Services, which forms just one aspect of the emerging social policy agenda. The other significant developments are those of:
2.3.5 Children's Services Planning
The agenda for the development of Family Support has been further shaped by the introduction of multi-agency Children's Services Planning for vulnerable children and children in need. The Children's Services Planning Order 1998, which is an amendment to the Children Order, has expanded awareness of the range of children and young people who are in need.
Children's Services Planning has drawn attention to, for example:
n Children/Young people in conflict with the law (Youth Justice)
The Children Order makes explicit reference to a new duty on Board/Trusts to take steps to "encourage children - not to commit criminal offences". (Schedule 2, 8(b)). Children in conflict with the law are therefore regarded as children in need. This is a significant departure from previous practice which gives Trust what is in effect a new area of responsibility for diversion.
The demand on Personal Social Services in the field of Youth Justice has been further emphasised through:
(a) the implementation of the Juvenile Justice (Children) Order, in 1999 which has significantly reduced the numbers of serious offenders given custodial sentences in favour of community based disposals which require intensive care planning.
(b) The Criminal Justice Review Consultation Paper which has proposed that full responsibility for the management of young offenders under 13 years should rest explicitly with Trusts, under their 'Children in Need' responsibilities.
It is anticipated that the provisions of the Human Rights Act will further underline the need for individualised, negotiated, community based programmes for young offenders. Other demands in this area are emerging from the Police led development of inter-agency Juvenile Justice Bureaux and Children's Panels, and from the piloting of restorative justice projects.
Youth Justice provision will also be addressed in Chapter 4 of the paper on residential care. This is one prominent area where Personal Social Services Departments have been mandated by the Children Order to undertake, and are faced with, because of legal and policy developments, significant responsibilities in an area in respect of which no provision has been made for resourcing.
n Children who are Excluded/Suspended from School
It is a central contention of the Government's Social Exclusion agenda that, with appropriate inter-agency support, schools can make a difference to outcomes for pupils with a range of difficulties. There is evidence of significant overlaps between children excluded or suspended from the school system, and children known to Social Services Department, Probation Departments, Police and Health Professionals. National Research has estimated, for example, that truants are more than three times more likely to offend than non-truants(31).
A study commissioned by DENI, published in 1999, estimated that, in the year 96/97, 2631 pupils were reported as having been suspended from school in Northern Ireland(32).
n Child and Adolescent Mental Health Services
The accessibility of high quality assessment and treatment programmes for children who have significant emotional, behavioural, psychological or psychiatric needs is an issue which effects all of the children/young people described in this paper. Epidemiological studies have shown repeatedly how common mental health problems are in children, and that severe disorders can give rise to devastating handicap in later life(33). Research has suggested that, in the UK, 50% of young offenders on remand, and 30% of those sentenced, suffer from diagnosable mental disorders(34).
On 31/1/00, Directors in 10 of the Trusts estimated that 603 children were on Child and Adolescent psychiatric waiting lists, and 14 were in adult mental health and learning disability hospitals(35). Waiting lists have often developed as the result of the lack of services offering earlier intervention when needs were less pressing.
The current under-provision (there are only 6 inpatient adolescent beds) in Northern Ireland has led to highly inappropriate placements of children and young people in adult psychiatric environments.
In addition, Children's Services Plans have addressed the needs of children and young people who are Homeless, and the needs of Young Carers.
2.3.5 Children With a Disability (including Sensory Impairment, Physical Disability and Learning Disability)
A highly significant area is that of Children with a Disability, who are explicitly defined as Children In Need in the Children Order. It has been estimated that 35 children per 1000 of the under 16 population in Northern Ireland have a disability (compared to 32/1000 in GB)(36).
Children/young people with a disability are entitled to a multi-disciplinary assessment and, if necessary, a co-ordinated care package of specialist services tailored to meet their individual needs.
The Children Order emphasis that Children with a Disability are Children First requires that a child's needs be met within families and communities, for example, children with learning disabilities and other complex needs are no longer admitted to continuing care hospitals, but are supported at home by their carers through a repertoire of services.
The development of services acceptable to families is currently the subject of work undertaken in each of the Children's Services Plans, and represents a significant challenge for statutory agencies and a significant commitment of resources. The regional prevalence rate suggests that in the region of 15,000 children potentially may be entitled to a child in need assessment. At present, only a fraction are known to Personal Social Services Department. The task of agreeing a regional model for establishing and maintaining Registers of Children with a Disability is under way. When completed, this will further emphasise the profile of this group.
Children with disabilities and other complex needs, as children in need, with the associated services pressures, have not been universally included in the funding of Child and Family Services. Children and young people with disabilities and mental health problems continue to be integrated within adult programmes of care. The aspirations contained in the Children Order set out clear ambitions for services for children with disabilities and other complex needs, which have not been strategically factored into the development and resourcing of services.
2.3.6 Children First - the Northern Ireland Child Care Strategy
As part of the wider social policy framework, the Northern Ireland Child Care Strategy emphasises the availability of high quality affordable child care for children aged 0-14 years, in every neighbourhood. This development, managed through inter-agency Childcare Partnerships, is placing emerging demands on Personal Social Services:
(a) Boards and Trusts have a statutory responsibility to register, inspect and support child care provision. The Departmental Circular HSS (cc) 2/99 has identified good practice standards which Trusts are attempting to implement. The rapid expansion of services is placing unexpected considerable demand on Registration and Inspection Units.
(Approximate) Child Care Provision - Child Care Partnership figures 1999-2000
In the case of childminding alone, one Trust in the WHSSB estimates that assessment and registration requires 17 hours of staff time, with a further 5 hours of staff time required for annual review(37).
(b) A considerable amount of funding in this area has historically been of a short-term nature. In the Childhood Fund for example, approximately £30m was made available to develop Early Years Services. These are services with long-term funding implications. Finance for development has also been made available from other sources such as NIVT and District Partnerships. Boards and Trusts will be under considerable pressure to maintain these services once existing funding has ceased.
It is noted that Northern Ireland continues to fall seriously behind in respect of investment in programmes introduced in England and Wales to combat the effects of poverty and social exclusion on children e.g.
n The Sure Start programme is substantially better financed, and was introduced considerably earlier, in England and Wales.
2.3.7 Additional Policy Impacts
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 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. They are well integrated and accepted within local communities experiencing high levels of social disadvantage.
As these time-limited funding arrangements come to an end, organisations are increasingly turning to Boards and Trusts to provide mainstream financial support. While additional monies may be made available by the European Union, an increasing number of projects will need core funding. This issue does not only apply at local level, but also at regional level - examples of major voluntary organisations which could be affected include: Parents Advice Centre, NICMA, NIFCA, NIPPA, Children's Law Centre, NSPCC, Homestart, Barnardos, Relate, Women's Aid.
Policy developments in the areas of Community Development, Health (Health Action Zones, Healthy Living Centres) and Targeting Social Need also require inputs from Boards and Trusts. Investment in partnerships, needs assessment projects and in new service developments undoubtedly have the potential to strengthen services which support and are acceptable to families.
3. Keeping Children Safe
3.1 Background Briefing
A key statutory responsibility of Boards and Trusts is related to the protection of children and young people. Each Board has established an Area Child Protection Committee to monitor and develop its child protection services. These are inter-agency committees, emphasising the need for maximum collaboration in this area of work. The core professionals mandated by the legislation to implement the extensive regulations are Social Workers in Family and Child Care Programmes.
Researchers have openly acknowledged the difficulty of accurately measuring the incidence of child abuse (38). Studies are much more specific, however in identifying long-term consequences for children who suffer serious abuse.
In Northern Ireland, 3264 child abuse investigations were undertaken in 1998, of which 65.4% were carried out by Social Workers and 32.4% jointly by Social Workers and Police. There were, on 31/3/98, 1386 children on child protection registers, representing 30.1 children per 10,000 under 18 years. This compares with a figure of 28 per 10,000 in England(45).
3.2 Anticipated Requirements in 1995
Collectively Boards anticipated requiring £3.27m (at current price levels) to enable them to effectively discharge their responsibilities for child protection under the new legislation. In the event, the DHSS did not release any monies specifically for this purpose.
3.3 Emerging Demands 1996 - 2000
In the period since initial implementation, the Children Order has generated the following increases in demand in respect of child protection work;
3.3.1 Operational Complexity
The Child Protection process is complex and resource intensive. Procedures, which are based on legislation and Departmental policy, and which are mandated by each Area Child Protection Committee, set out detailed guidance on how to manage:
n Investigations (including joint Social Work-Police protocol)
n Initial Child Protection Case Conferences
n Parental consultation and involvement/participation of children
n Decisions about registration
n Comprehensive family assessments (recently revised and updated)
n Child Protection plans
n Review Case Conferences
n Decisions about de-registration
Children on Child Protection Registers attract high levels of co-ordinated service. Research indicates that the majority remain in their families and communities(46).
Child Care Managers estimate that the time needed to carry out Child Protection procedures has, at least, doubled since 1995 because of additional procedural guidance, and emphasis on parental and child participation.
The number of children on Child Protection Registers, whilst significant, should not be read as the only measure of activity in this area of work. The 'refocusing' agenda signalled by the DHSS study 'Child Protection - Messages from Research'(48) has led to greater emphasis, where possible, on managing family and child care cases, without resort to the formal Child Protection procedures. Area Child Protection Committees, following departmental guidance, have taken strategic decisions to try to raise the threshold for Child Protection Registration, and to promote family support services which are preventative rather than reactive. Trusts report that services are increasingly demanded for children and families with high levels of need, but who have not crossed the threshold for Child Protection registration. Professional judgements are no less complex in this area. Whilst such cases do not warrant the same level of procedure as cases on the Child Protection Register, the time needed for direct input with clients and for case planning, can be considerable .
It is important to note that the retraction in residential care places (see Chapter 4) has also impacted on risk management in the community, in that numbers of children who require residential care have to be supported at home pending identification of an appropriate placement.
3.3.3 Court Work
Where it has been necessary to instigate legal action in order to protect children, it has become evident that the time needed by social workers for the Court process has increased significantly. In the period 01.04.97 to 31.03.98, Courts made 60 Emergency Protection Orders and 324 Care and Supervision Orders. The legal process can be protracted - during the above period, the average disposal time in Family Proceedings Courts was 9.7 weeks(49). The attached Case Summary is not regarded as untypical. There have also been significant cost pressures for legal support, including the use of expert witnesses.
3.3.4 Impact on Direct Work with Clients
The increased demands on social work time arising from processing child protection cases and cases in the court system, reducing time available for direct work with children who have experienced abuse.
3.3.5 Additional Pressures
The demands outlined above are directly related to the operation of the Children Order. Resource implications have arisen for a number of other developments which would not have been anticipated at the time when Boards were making their preliminary calculations. These include:
Management of Sex Offenders
There have been a number of developments in respect of therapeutic programmes for young abusers, and each Board has developed projects. In the SHSSB for example, the Juvenile Perpetrators Project has worked with almost 100 young abusers in the past 3 years. This work is intense, with the programme taking a minimum of 6 months, and a proportion still being engaged after 2 years. The issue of the management of adult sex offenders in the community has attracted a high public profile recently, drawing attention to the complexity and sensitivity of the issues.
As already indicated, awareness of the links between child protection and domestic violence has been heightened, increasing the risk profile of families where such patterns exist. Trusts have developed Inter-Agency Domestic Violence Forums, in order to ensure that collaboration is well developed. Area Child Protection Committees have also drawn attention to the links between domestic violence and child abuse.
4. Children Who Are Looked After by Boards and Trusts
4.1 Background Briefing
2354 children were Looked After in 1997/98, 10% fewer than in 1995/96 (51). The rate of Looked After Children per 10,000 in Northern Ireland (at 51.1) remains higher than in England (at 47.2).
The provision of services to children who are in care is another key statutory responsibility of Boards and Trusts. For the majority of children, 'care' refers to placement with a foster family (64%) or in a residential unit (11%). The Children Order also provides for children to be placed with relatives or friends who will be subject to formal assessment and approved as foster carers. A number of children (21%) are placed at home but subject to Care Orders and continued monitoring by Trusts. Children Order Regulations and Guidance have greatly expanded the range of procedures associated with the management of the Care System. Trusts have estimated an increase in staff time by a factor of three, compared to pre-Children Order requirements.
Children enter the Care System whenever it is no longer possible to maintain family life. The majority of such children bring with them complex and traumatic experiences associated with abuse, separation, loss etc. Most are able to go home within 12 months, but in 1997/98 for example, one child in every five (21.8%) had been in care for more than three years(52). Regional and national research studies have recorded the vulnerability of young people who have had to grow through adolescence in the care system, to:
n Substance and drug abuse(53)
n Mental health problems(54)
n Involvement in crime(55)
n Teenage pregnancy(56)
n Poor emotional health(57)
The Quality Protects Policy, whose introduction in Northern Ireland is expected, is based on the realisation that services for children and young people in care need to be greatly improved and resourced. Attention is drawn to the extent to which Northern Ireland has fallen behind in England and Wales, where this policy has been operational from several years. 'Quality Protects' is part of a concentrated drive to address the deficits described above, by providing additional investment in services which are linked to specific targets and outcomes. The effectiveness of this approach has been demonstrated in England.
This section of the paper will look at five key themes relating to the operation of the care system:
n General residential provision
n Specialist residential provision
n Family placements
n Leaving and After Care services
n Adoption - permanency planning
4.2. Anticipated Requirements in 1999
Board submissions in respect of residential care and family placements were excluded from the Departmental submission for funds to the Public Expenditure Survey 1995.
Very soon after the advent of the Children Order 1999, it became clear, as had been anticipated by Boards, that there were to be significant implications and pressures arising from the requirement to satisfactorily respond to the needs of Looked After Children.
4.3. Emerging Demands 1996-2000
4.3.1 General Residential Provision
The introduction of the Children Order coincided with major downsizing of the voluntary residential child care sector. This culminated in the Department undertaking a regional review of residential child care leading to the publication of 'Children Matter' (SSI 1998). This report has been approved by the Minister of Health, Social Services and Public Safety as providing the definitive agenda for future development and provision of residential child care. It concluded:
n there was insufficient number of places to meet demand;
n urgent action was required to expand provision;
n the lack of differentiation within homes led to resident population in each home with conflicting needs. At best this resulted in unsatisfactory living conditions for children and at worst situations where their protection and well being was compromised;
n the lack of specialist provision resulted in a range of inappropriate placements for children with psychiatric needs, those with a disability and those at risk of offending;
n children and young people should be looked after as close to their home as is possible;
n provision should not be located on campus sites.
In response to Children Matter, the four Boards in collaboration with Trusts prepared a detailed plan which outlined an integrated approach to implementation across the four Health and Social Services Boards. There was a very clear acknowledgement of the pressures being faced by Trusts which can be listed as:
n Inability to admit children to care when required.
n Lack of choice of placements to meet children's needs.
n Inappropriate placements.
n Children having to share rooms inappropriately.
n Rise in number of serious untoward incidents in children's homes.
n Inability to access secure accommodation.
n Inability to protect adequately children who are absconding.
n Inability to control violent and aggressive children.
The four Board report concluded on the need to increase the level of child care places by approximately 30% from 352 places to 453. This paper detailed the way forward over the next five years and provided costings which showed a minimum capital requirement of £25million and revenue requirement of £10.5million.
The Trust Directors have provided details on unmet need as at the end of May 2000 which reinforces the urgency for action and resources.
(*) Accommodation in Regional Child Care Centres
(Source: Trust Directors)(58)
It is noted that the Department of Health, Social Services and Public Safety has now established a Task Force to take forward the implementation of 'Children Matter'.
4.3.2 Specialist Residential Provision
A further area of particular concern has been the lack of specialist provision for young people with mental health difficulties and those with a learning disability and challenging behaviour. The "Caring for Young Minds" (QUB) (59) report indicated that increasingly young people were being admitted to adult wards as a result of lack of age appropriate provision.
There is evidence of an increasing number of young people with a history of offending who are beyond parental control and whose needs cannot be met by community based alternatives.
The needs of these children are placing additional strains on mainstream residential childcare services which are already under considerable stress in the discharge of statutory responsibilities. In the longer term these needs should be appropriately met through the implementation of the proposals for the development of residential childcare services based on locally differentiated and specialist models and through other community based alternatives. However until these models are fully implemented there is an urgent need to secure interim arrangements which will provide a response to the needs of such young people and will ensure as far as possible their safety and well-being.
With regard to children with a disability it is recognised that they are extremely vulnerable and the current configuration of provision falls far short of meeting their needs. As stated in Children Matter, there remains a need to carry out a detailed study on demand and requirements, particularly in order to avoid inappropriate hospital placements.
Children with a disability availing of respite are deemed to be Looked After within the legislation. They are therefore subject to LAC Review procedures etc., similar to children in residential or foster care. This brings particular safeguards but also consequent resource implications which have not been adequately recognised within Children Order allocations to date.
4.3.3 Family Placement - Foster Care
As with residential child care this service area was not accepted for inclusion in the Departmental submission for PES funding.
The original submission from the four Health and Social Services Boards included a substantial bid for Family Placement amounting to circa £1.8million. The order has resulted in a significant impact on the workload of foster care teams.
n Requirement to undertake annual reviews of foster carers.
n The impact of quality living standards.
The pressures and demands on the service is reflected in the numbers of children waiting on family placement.
September 1999 - 143
January 2000 - 290
May 2000 - 303 (61)
Trust staff report that the needs of children seeking admission to Care are becoming more complex. The level of demand should not be underestimated and is reflected in the recruitment and retention of foster carers. Research indicates that effective recruitment and retention requires dedicated support workers for foster parents, and better training to assist in the management of children with complex needs. Issues are also emerging which merit the development of remuneration systems linked to payment for skills. There is a strengthening lobby which argues that the fostering services need to move from a voluntary to a professional basis.
The demand for services, as well as pressures for retention and recruitment have necessitated that foster care payment rates have been increased at the rate of 4% per annum over the past three years. The only source of funds has been finance diverted from the implementation of the Children Order. There remains a shortfall in rates payable to foster carers in Northern Ireland in contrast with the United Kingdom.
There is a recognition that foster care and residential care are inextricably linked. Recent allocation letters from DHSSPS have emphasised the need for the further development of both services in tandem.
Finally, UK National Foster Care Standards and Code of Practice for Foster Care Recruitment, Selection, Training and Support were launched in 1999. The implementation of these documents is proving to have significant financial implications for Boards and Trusts.
4.3.4 Permanency and Adoption
There is consensus about the need to plan intensively for children who come into the care system, so that those children who will not be able to return to the care of their parents can be identified quickly, and so that permanent, long term, family placements can be identified. Research demonstrates that adopted children enjoy better long-term outcomes than children in Care (63).
Emerging evidence from the current SSI inspection of adoption services suggest that there are children for whom permanency planning has been less than adequate. There remain many children within the Looked After system where permanency needs could have been met through adoption. Reports have highlighted:
n children with multiple placements
n 'drift' in care
n problems with obtaining freeing orders, which places significant demands on social work time and associated legal costs.
Adoption work is resource intensive. There is a need to radically revise methods of recruitment, assessment and preparation for prospective adoptive parents. This is reflected in recent government pronouncements, particularly from the Prime Minister. There is a need to enhance support services for adoptive parents post adoption. Better counselling services to address the needs of birth parents are required. As the characteristics of adopted children change, and children with more complex needs are adopted, family support, therapeutic and recovery services will be needed. The adoption allowance scheme needs to be extended. Finally inter-country adoptions are increasing considerably in numbers. While charging for assessments may address some of the funding issues associated with this, a considerable amount of scarce expert social work time is required to carry out assessments. Furthermore the implications of any subsequent breakdown in placement or need for services will be felt by the host Trust.
It should also be noted that the Children Order enables permanency to be established through the granting of Residence Orders to, for example, long-term foster carers. The loss of financial support, under the current system, however, is a deterrent.
The development of a pro-active quality adoption service requires investment, and the service is currently under review by the Social Services Inspectorate. Proposals for the development of a regional service should be examined.
4.3.5 Leaving and After Care
It is only within the past few years that greater recognition has been afforded to the rights and needs of young care leavers. As the research studies referred to in the opening paragraph of this chapter indicate, Boards and Trusts have to be concerned about improving outcomes for Looked After children. As Corporate Parents they have clear responsibilities for preparing the young people for independent living and supporting them in the transition to adulthood, and it is anticipated that this will be emphasised in terms of specific monitoring and outcome targets on the introduction of 'Quality Protects' in Northern Ireland.
A survey of HSS Trusts in 1999, revealed that between 1996 and 1999 a total of 665 young people aged 16 - 18 became care leavers. 164 of these young people were aged 16 (25%)(64).
The Children Order places a responsibility on Trusts to provide support to care leavers up to age 21, and beyond in exceptional circumstances. The development of these services has been uneven across the four Boards. In some areas responsibility for Leaving Care and Aftercare is not designated whilst in others there are specific teams to provide this services. The expertise in these teams has resulted in the ability to identify a series of complex needs of these young people in areas such as:
n Financial support
n Training and employment
n Social and emotional support.
Voluntary organisations representing young people and foster carers in Northern Ireland - for example, First Key, VOYPIC, NIFCA - have emphasised the need for investment in high quality support services, and the issues have been given government recognition and endorsement in the Children (Leaving Care) Bill which is being progressed through Parliament. Whilst the Bill may not be immediately enacted in Northern Ireland, Care Leavers are entitled to expect the same standards and level of provision which apply elsewhere. The implications will include the following measures:
n Regulations to be made placing a duty on local authorities to provide general assistance to those 18-21 year olds, either in kind or in cash.
n The appointment of a Personal Adviser for each young person.
n Authorities must keep in touch with these young people until they reach the age of 21 (or 24 if the authority are helping them with education and training).
n Authorities will be required to make available a wide variety of places including accommodation with associated support and training opportunities, supported lodgings, house shares as well as independent and semi-independent flats.
5. Summary and Recommendations
This paper has demonstrated the key characteristics of Family and Child Care provision in Northern Ireland. It has been argued that:
n The proportion of the 0-18 year old population in Northern Ireland is significantly higher than in England.
n There is evidence that more children and young people live in circumstances characterised by poverty and deprivation than in other parts of the UK.
n Factors such as trends in alcohol misuse, changing patterns in family organisation, and greater awareness of the extent and impact of domestic violence have impacted significantly upon levels of need and demand.
n Levels of disability are higher than the UK average.
n The transition from conflict is a unique feature, and the consequences for children and young people are not yet fully understood or documented.
The Children Order 1995 greatly expanded the responsibilities placed on Social Services Agencies. The paper has drawn attention to a number of areas where demand for Family and Child Care Services has outstripped supply, and when the quality of service is unable to meet need - in particular attention is drawn to:
n Serious under-provision in residential care
n Serious pressure on fostering services
n Serious pressure on statutory fieldwork services
n Deficits in family support provision.
The situation has been compounded by policy developments which have occurred since the Children Order was introduced, including:
n The need for youth justice provision
n The need for core funding of voluntary and community organisations in order to sustain early years/ family support provision.
n The paper has argued that funding for Family and Child Care Services in Northern Ireland has been inadequate, on the basis that:
n Board estimates in 1995 of the cost of funding the Children Order were not accepted, and were subject to revised, downward estimation in the 1995 PES bid. Key services only were excluded.
n Subsequent allocations have fallen short of the 1995 PES bid.
n Per-capita expenditure of Family and Child Care Services in Northern Ireland has fallen below the rate in England, as has the percentage of total expenditure over a number of years.
n Key areas of service development have not been funded.
n Important national policy initiatives have either not been introduced in Northern Ireland, or have been introduced late and with diminished funding.
5.2.1 Urgent Review of Children Order Funding
There should be an urgent review of the funding requirements for implementation of the Children Order over the next five years. This should be undertaken by an appropriately convened Task Group.
5.2.2 UK Policy Initiatives
There should be a review of social policy initiatives which have been introduced in England and Wales, but which have either been delayed, or which have not been made available, in Northern Ireland.
5.2.3 Quality Services for Looked After Children
A commitment is required from the Department of Health and Social Services and Public Safety, to produce urgent proposals to drive up quality, governance and accountability for children in Care. The need for a Northern Ireland version of 'Quality Protects', with additional resources tied to targets and outcomes, is being emphasised.
5.2.4 Children Matter
A major drive to secure the capital and revenue resources to ensure that 'Children Matter' is implemented, and to achieve real additionality, is required.
5.2.5 Youth Justice
A commitment is required from Government to review the impact of recent legislation and policy developments in Youth Justice, with particular emphasis on the reduction in NIO provision, and the consequent demands on Board/Trust Family and Child Care Services to provide additional services. An appraisal of organisational arrangements to promote integrated service delivery is strongly indicated.
5.2.6 Foster Care
There needs to be a comprehensive review of foster care provision, in order to develop a strategic approach geared to the assessment needs of children and young people over the next 10 years.
5.2.7 Early Years
A commitment is required to promote and sustain Early Years Services as a means of breaking into the cycle of deprivation on families, by means of:
(a) An urgent review of the potential effect of withdrawal of European Funding on services.
(b) A review of Sure Start funding arrangements in comparison to England, and a commitment to develop this initiative.
(1) The Children Order states that a child shall be taken to be 'in need' if (Art. 17):
(a) "he is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision for him of services by an authority ..
(b) his health or development is likely to be significantly impaired, or further impaired, without the provision for him of such services
(c) he is disabled."
(2) Article by Dr Henrietta Campbell, Chief Medical Officer, NI in 'Promoting Health', Nov '99
(3) The Health Behaviour of School Children in Northern Ireland, WHO 1997/98
(4) Rutter & Madge 1976, Pilling 1990
(5) Kilpatrick et al, DENI, 1999
(6) SSI Paper 'Children in Northern Ireland - An Overview' 2000
(7) DENI Statistics (28.07.00)
(8) Child Protection - Messages from Research, HMSO 1995
(9) Reducing Alcohol Related Harm in Northern Ireland, DHSS Project Team, June 1999
(10) The Health Behaviour of School Children in Northern Ireland, WHO 1997/98
(11) Chief Constable's Report 1999/2000
(12) Children Order Report, DHSS, 1999
(13) Relate Northern Ireland - Annual Report 1998-99
(14) Divorce & Separation - The Outcomes for Children, Joseph Rowntree Foundation 1998
(15) NI Woman's Aid Federation Statistics
(16) Briefing Paper - Domestic Violence and Child Protection, Western ACPC, June 2000 - (unpublished)
(17) SSI Paper - Children in Northern Ireland - An Overview 2000 (unpublished)
(18) The Institute of Fiscal Studies 1995 found that 75% of children growing up in lone-parent families were living in poverty, compared to 18% from 2 parent families.
(19) Population and Trends No.95 Spring 1999 ONS
(20) Fay, Morrisey, Smith, 1997 'Mapping the Troubles'
(21) Bloomfield Report 'We Will Remember Them' 1998
(22)  Omagh Community Study 1999 &  The Omagh Children's Study 1999 - Sperrin Lakeland Trust
(23) Fay, Morrisey, Smith, 1997 (page 46)
(24) See Getting It Right - the State of Children's Rights at the end of the 20th Century, SCF 1999
(25) Key Indicators of Personal Social Services in NI, SSI 1999, p14.
(26) Report of the National Commission of Inquiry into the Prevention of Child Abuse - NSPCC publication 1997
(27) The Report of the National Commission of Inquiry into the Prevention of Child Abuse 1997 notes that "there are substantial funds that, at least in principle, could in part be transferred to support the prevention of abuse. On the other hand, it is also evident that until preventative work can be better established, it would be unacceptably risky to diminish formal child protection work. Inevitably this means that some extra resources will be required in the short term to enable the necessary preventative work to develop" (page 13).
(28) Children Order Report 1999, DHSS
(29) RUC - Chief Constable's Report 1999/2000
(30) SSI Paper - Children in Northern Ireland, An Overview 2000
(31) Kilpatrick, Barn, Wylie, The 1996/97 Northern Ireland Suspension and Expulsion Study, DENI
(32) Home Office Research Study 145, (1995)
(33) Graham PJ (1996) in Childhood Epidemiology, British Medical Bulletin
(34) Youth Crime Update, Fact Sheet No.6, British Youth Council 1999
(35) SSI Paper - Children in Northern Ireland - An Overview 2000 (pages 33-36)
(36) Policy, Planning and Research Unit, 1992,DHSS
(37) Figures from Sperrin Lakeland HSC Trust
(38) Child Protection - Messages from Research HMSO 1995
(39) Palmer et al (1990)
(40) BLISS (1984)
(41) Harrington, Fudge, Rutter, Pickles, Hill (1990)
(42) One Way Street, Children's Society 1999
(43) 'The Fundamental Facts -- All the latest facts and figures on Mental Illness' The Mental Health Foundation 1999
(44) Childhood Matters - The Report of the National Commission of Inquiry into the Prevention of Child Abuse, NSPCC 1997
(45) Key Indicators of Personal Social Services for Northern Ireland - SSI 1999 p35-36
(46) HMSO Studies in Child Protection 1995 - 'Child Protection - Messages from Research'
(47) Sperrin Lakeland HSC Trust figures Augus 2000
(48) HMSO Studies in Child Protection 1995 - 'Child Protection - Messages from Research'
(49) Children Order Report 1999
(50) Case Study - supplied by Foyle HSS Trust
(51) Key Indicators of Personal Social Services, SSI 1999
(52) Key Indicators of Personal Social Services SSI 1999
(53) Saunders & Broad 1997
(54) Audit Commission 1999
(55) Graham & Bowling 1995
(56) Garnett 1992, Pinkerton & McCrea 1996
(57) West 1995, Canham 1997, McCann et al 1996
(58) Trust Directors, Summary of Unmet Need 2000
(59) QUB ' Caring for Young Minds'
(60) SSI Paper - Children in Northern Ireland - An Overview 2000
(61) Trust Directors Summary of Unmet Need 2000
(62) SSI - Fostering in Northern Ireland - Children and Their Carers 1998
(63) Permanency Planning for Children; Adoption - Achieving the Right Balance HSS Circular May 1999
(64) Children in Northern Ireland - An Overview 2000
The Medical/Child Protection Interface
I would wish to make the following comments from the perspective of my role as Consultant Community Paediatrician with a specialist interest in Child Protection.
The investigation of alleged child abuse should be multi-professional and co-ordinated to minimise distress to the child and family.
The principle aims of a full medical assessment in suspected child abuse are to:
n Establish the need for treatment
n Provide information which might support the allegation, as well as, in due course, sustain care plans and criminal proceedings
n Offer reassurance to the child and family
n Plan ongoing health care
Roles and Responsibilities of Medical Staff
General Practitioners: The first point of contact is often the General Practitioner. They may be involved in the detection and notification of suspected abuse, or they may be asked to make a judgement on the accidental versus non-accidental nature of presenting injuries. Depending on the level of their expertise they may either give a clinical opinion, or refer onward to the Consultant Paediatrician for a further opinion, if the child is in urgent need of medical attention Accident and Emergency may be used.
They often have a great deal of information on the family, but may find it difficult to divulge this, as it will have subsequent difficulties for relationships with the family, and there are concerns about disclosing family information because of confidentiality.
Forensic Medical Officers (FMO): are employed by the Police Service of Northern Ireland particularly in relation to gathering forensic evidence in child sexual abuse.
Physical Abuse or Emotional Abuse/Neglect requires specialist assessment.
Forensic Medical Officers should conduct examinations jointly with an appropriately trained Consultant Paediatrician - acute or community, using up-to-date equipment etc.
Accident and Emergency Staff: may be presented with a range of children from physical abuse to burns, fractures Non Accidental Injury, unexplained child deaths etc. They usually work closely with the local Consultant Paediatrician in child protection but they must have a high index of suspicion to child protection issues and junior staff need training as they often work single-handed at night.
Junior Medical Staff: also first point of contact and need training and supervision.
Staff Grades/Associate Specialists in Community Child Health: currently they often act as Core Members at Case Conference. They need to be up-to-date with procedures, the interpretation of medical issues etc and have an importance liaison role with Social Services and the Child Protection Nurse Specialist.
The roles of the various Doctors are often not clear.
Trusts should have a named Paediatrician for child protection with this role well understood and accepted by all relevant professionals. It would seem that there has been resistance to the implementation of this in Northern Ireland and this Doctor must be considered as a key stakeholder within a truly multi-disciplinary service.
The role must, of course, be resourced and I believe that this person would be key to liaising and communicating with General Practitioners within the process but especially inputing to the case planning stage and case conferences.
Routes of referral for children suspected of having been abused
Children suspected of having been abused can be referred for medical assessment in a number of ways often depending on the initial professional involved.
Social Services usually refer children directly either to their General Practitioner or a named Consultant Paediatrician (when a decision would be taken on timing of assessment - either immediate or within a few days, depending on the particular concerns)
General Practitioners may refer children to a variety of professionals
n Accident and Emergency Departments immediately
n Consultant Paediatrician following direct discussion
n Acute Hospital Paediatric Unit following discussion with SHO/Registrar on-call.
PSNI will usually ask for assessment by a FMO and examination is usually carried out in CARE Unit suite or by a GP in their own practice premises. Occasionally PSNI may request input from a Consultant Paediatrician.
Consultant Paediatricians may ask for a second opinion from a colleague in certain circumstances. They may ask, or have arrangements with PSNI, for joint medical assessments with FMO if they think forensic samples may need to be taken. This request may be facilitated by the FMO or refused depending on the geographical area or the particular FMO involved.
There is therefore a lack of clarity about appropriate referral pathways for various professional staff which needs to be addressed to avoid assessments being carried out by inappropriate professions, needing repeated or being conducted at inappropriate times for children and their families when they could be delayed. The referral process should not depend on who sees the child first but on the nature of the concerns and needs to be applied consistently.
Setting for examination of Children
Children suspected of being abused are examined in a number of venues:
n GP surgery
n Hospital Accident and Emergency Department
n Acute Paediatric Unit
n Community Child Health Facility
n PSNI CARE Unit
Regardless of the location of the facility it is important that it be child-friendly and non-intimidating. In particular cases of CSA an Accident and Emergency Department is not appropriate. Specific units do exist for assessment of children throughout Northern Ireland but as there is currently no standard requirements for professions can be reluctant to utilise them for a variety of reasons.
Facilities/Equipment for Assessment of Children who are suspected of abuse
A child-friendly facility is vital with opportunities for the child to play and feel as relaxed as possible and privacy issues for the child and family provided for.
In cases of physical injury it will be important to have access to a haematology laboratory for coagulation studies, radiology facilities and medical photography for documenting injuries. (Although problems exist if the case is subsequently subject to legal proceedings as only police photography is admissible in Court - the Consultant Paediatrician has therefore to predict this at an early stage and involve PSNI before any decision about likelihood of deliberate physical injury has been made).
In cases of possible Child Sexual Abuse additional facilities should be available. It is considered good practice for a permanent record (still photographs or video) of the genital/anal findings to be obtained. These images are usually obtained via a colposcope. This is desirable for the following reasons:
n It allows a permanent record which can later be viewed by other colleagues/experts for the purpose of second opinion in clinical circumstances or legal proceedings thus preventing any need for repeated examination of the child.
n It can be accessed for peer review of cases.
n It can be used for teaching purposes for medical staff.
Obviously all of the above is dependent on informed consent of the person with parental responsibility and the child if appropriate.
Assessment of Children with possible Sexually Transmitted Diseases
This is an area of practice with considerable difficulty. The prevalence of Sexually Transmitted Infections (STI) in sexually abused children depends on the prevalence in the "abusing" population but studies in the UK estimate 2-13% sexually abused children developed STI.
The detection of STI in children is of vital importance as failure to treat can lead to long-term complications for the child and presence of infection may be used as corroborative evidence in legal proceedings.
Currently FMO's do not take bacteriological/virological swabs or samples for STI. A pre-pubertal child may be referred to adult GUM Clinic to obtain samples. This is entirely unsatisfactory, as it requires a further examination in facilities which are not child-friendly.
Consultant Paediatricians also have difficulties investigating for STI. Most hospital microbiology laboratories do not procedures for fulfilling chain-of-evidence requirements so if an STI is discovered there are difficulties presenting this as evidence in legal proceedings and some of the microbiological techniques used to not fulfil evidential requirements. These issues need addressed on a Regional basis.
Standards for follow-up of non-organic failure to thrive need to be agreed as these children constitute the largest category in the child protection registers in Southern Health and Social Services Board. Clear pathways for paediatric monitoring and follow up of these vulnerable children need to be developed. This is the clear remit of a Consultant Paediatrician with expertise in child protection.
Fabricated or Induced Illness
Royal College of Paediatricians and Child Health publication in February 2002 outlines clear procedures for medical assessment and evaluation where such problems are suspected.
There are significant training issues for all staff. The level of their training should be appropriate to the relevant professional i.e. Social Worker will need a different level of training to the Consultant Paediatrician.
In summary I believe that there are significant issues for doctors that need to be considered. These include resources and training. The training should involve health visitors and social workers who need to know and accept the role of the designated doctor concept, as I believe it would lead to better multi-disciplinary communication which seems still to be the basis of many case management reviews and inquiries in child protection.
DR MINA HOLLINGER
WRITTEN SUBMISSION BY:
9 August 2002
Thank you for your letter of 20 June 2002 inviting the Board to submit evidence to the Committee in relation to its Inquiry into the above matter.
I enclose for the Committee's attention a response prepared by Board Officers. Unfortunately, because of the timescale specified, it has not been possible to submit this response to our Board for approval. We would wish to reserve the right therefore to submit any additional views as a result of discussions at the relevant Board Committee which meets in early September.
IRENE M KNOX
This submission has been prepared by the Chief Education Welfare Officer who acts as the Board's Designated Officer for Child Protection and by the Adviser - Services for Children and Young People who is the Deputy Designated Officer and has a responsibility for Board policy and training in the area of child protection. These 2 officers deal with the majority of concerns relating to child protection which are received by the Board. The SELB welcomes the opportunity to contribute to the Northern Ireland Assembly's Inquiry into Child Protection Services in Northern Ireland as it is conscious of the important role the education sector plays in protecting children. This response is structured in line with the requirements outlined in the letter of 20 June 2002.
The Board endorses the introduction of a number of clauses in the draft Education and Libraries Bill, aimed at strengthening the current child protection arrangements within education. However, it has concerns about the proposed introduction of the Needs Led Assessment framework across the 4 Health & Social Service Boards without additional funding attached to it. We feel that it may create additional pressures for fieldwork staff in terms of the amount of information which has to be collected and then analysed and acted upon within a specified time-frame. In addition, Designated Teachers and other Education staff will require further training in order to implement the new framework effectively.
Evidence from 2 pieces of research by the SELB into Designated Teachers' Experiences of making a Referral conducted in 2000 and 2001 highlighted the fact that whilst communication and partnership working between education and social care has improved, there is still room for improvement in terms of who needs to know specific information. Time is a critical factor for all professionals working in this area. A small scale pilot carried out in the Craigavon and Banbridge Trust area in 2001 (the School Liaison Project) where each school had an designated social worker and there was regular liaison between school, education welfare officer, social worker and health professional identified the clear benefits of multi-agency working. However, it proved too costly of time and resources to be able to sustain the project.
Since the introduction of DENI 1999/10, teachers have become more open and 'upfront' with parents when they have concerns despite the evidence that, in a small minority of cases, this has provoked parental anger and verbal abuse.
Schools have positively welcomed the opportunity for consultation with Social Services prior to making a referral which the Trusts working within the SELB area have afforded them. The fact that the SELB's area is not co-terminus with that of the SHSSB is an additional area of complexity in making links with appropriate health and social service professionals. In addition, links with the Interlink Project have been made and have proved invaluable in seeking to ensure the safety and welfare of pupils in school when a young person known to pose a risk remains in mainstream education. (The Interlink project is an NSPCC - managed project within the SHSSB area which deals with young people aged 10-18 who have a sexual behaviour problem.)
5. Workforce Issues
At the present time, the trusts operating within the SELB area (Armagh and Dungannon, Craigavon and Banbridge, Homefirst and Newry and Mourne) appear to be under-resourced and short-staffed. They seem to have difficulty in recruiting and maintaining staff in Family and Childcare teams as the work is perceived to be very stressful. Because of staffing issues, they are often able to respond in the short-term only to the cases which are most critical. This situation is both frustrating and demoralising for education staff, in some cases, who feel they have made a genuine referral and yet no action appears to be have been taken.
In terms of issues for Designated Teachers, one respondent in our research last year pointed out that the role of Designated Teacher was one of 20 she held within the school! This represents an extreme case but Designated Teachers generally have a number of roles to fulfil apart from their teaching duties. There is a fairly constant turnover of staff due to early retirement/promotion opportunities and therefore there is an ongoing need for staff training as new appointments are made.
There is limited understanding of the pressures on teaching and social care staff faced by the other profession. The board tries to address this in its uni-disciplinary training by inviting senior social workers to participate in the training sessions and for them to explain the social work process to education staff. Similarly, we provide training for residential social workers, childcare social workers and indeed foster carers on educational issues such as the curriculum framework, the proposed changes and Suspension and Expulsion Policies. This helps to create a better understanding of the pressures faced by other professionals.
Core funding for childcare and child protection work and services appears to have decreased in real terms as funding for specific short-term projects becomes increasingly available at regional level. This process of erosion is extremely detrimental to the welfare of children and families as the shortfall in the basic human and financial resources used to provide services to meet the needs of families means that those needs are not able to be met. Preventative work can not always be a priority and yet the thrust of the Children Order legislation was to place a strong emphasis on early intervention.
7. Lessons Learnt
The sharing of appropriate information with the appropriate personnel as the need arises remains the critical link in promoting children's welfare.
8. General Comments
n The links between the DHSS&PS and DE need to be made more explicit and apparent if children's welfare is to be promoted. The evidence of 'joined up thinking' between the 2 departments in the interest of children is not evident. If partnerships have not developed at the top, it is unrealistic that they should develop elsewhere in the system.
n The SELB would like to express its concern about the disparity between the number of children on the Child Protection register in the 4 Health and Social Services Boards.
n There appears to be some variation in what constitutes "significant harm" and 'thresholds' between the 4 Trusts which operate within the SELB area. There is also a discrepancy between how Social Services and education staff view 'risk'.
n In terms of good practice, we feel it is appropriate to draw your attention to the model operating within the SELB area in developing child protection policy and training pathways for education staff. Designated Teachers (and Deputy Designated Teachers) and other education staff receive uni-disciplinary training in child protection from the SELB's specialist staff at Foundation and Intermediate levels (a 2 x day followed by a 1 x day course). Those members of staff are also available to provide training at whole school/whole service level for all board staff. In addition, in each Teachers' Centre area, a Forum for Designated Teachers meets once a term to update practice and to discuss issues of common concern. The senior social worker or an invited speaker from a related discipline may attend. In addition, the SELB has its own Child Protection Committee, a sub-committee of its Education Committee, which meets once a term and consists of representatives of the key agencies involved in child protection which includes schools. The committee discusses issues of immediate concern, receives reports from different agencies and services and advises the Education Committee on all matters pertaining to child protection.
As the SELB contributes 50% of the salary costs of the multi-disciplinary trainer in child protection employed by the SHSSB, education staff then proceed to a variety of courses offered by the trainer in a multi-disciplinary setting. All of those who have an interest and involvement with child protection work (uni-disciplinary trainers, multi-disciplinary trainer, youth service personnel with responsibility for child protection, the Designated Officer, Cass staff with a responsibility for Pastoral Care) meet approximately 6 times per year to ensure consistency of approach, to promote joined up thinking and to share information and new developments. These initiatives are primarily funded from the SELB's Children Order budget as is day 1 of the Designated Teacher training and the substitute cover (half a day) which is allocated to schools to facilitate attendance at case conferences, case reviews and from September onwards Looked After Children reviews. For the third year running a research project into how the referral process is working is being undertaken. This year, at the request of the SACPC, we are undertaking research with teachers and social workers on the introduction of a new form, the CPR4, used by education staff when making a child protection referral.
All of these initiatives assist in taking forward the work of Child Protection within education. As the SACPC in its Annual Report breaks down the referral statistics into various headings, we are able to monitor the number of referrals made each year by the education sector. They are rising year on year.
1. There is a need for an increase in direct funding for core child protection services. In addition there needs to be a strategic plan in place to determine what direction childcare and child protection services will take over the next 3-5 years.
2. Structures need to be in place in each board which facilitate and promote ongoing communication and liaison between all the professionals and agencies (including education).
3. Stand alone training on a one-off basis is not sufficient training for Designated Teachers. An integrated programme of uni-disciplinary and multi-disciplinary training is essential to promote effective practice in child protection.
If the Committee for Health, Social Services and Public Safety of the Northern Ireland Assembly wishes to hear directly from practitioners and officers of the SELB in relation to this area, the board would be prepared to nominate representatives to present evidence in person.
WRITTEN SUBMISSION BY:
14 August 2002
1.1 The Soldiers, Sailors and Airmen Families Association - Forces Help, known as SSAFA Forces Help is a registered charity, incorporated by Royal Charter to relieve need, suffering and distress amongst serving and ex-service men, women and their families.
1.2. The Soldiers and Sailors, Families Association as it was first called was founded in 1885 by Major James Gildea, of the Royal Warwickshire Regiment for the purpose of looking after the wives and families of soldiers going overseas to form the Second Egyptian Expeditionary Force. As the organisation grew, volunteers were recruited to establish a visiting service to the home of servicemen's families to assess their need and ensure appropriate help was given quickly.
1.3 After the formation of the Royal Air Force the association title was amended to include them, and the term 'SSAFA' emerged. The final change in title occurred when the organisation amalgamated with the Forces Help Society in 1997 to become SSAFA Forces Help.
1.4 Since its inception as a voluntary organisation in 1885 SSAFA evolved to incorporate a uniformed District Nursing Service in 1892. Interestingly the first nurse was employed in the Curragh Camp, Dublin in 1892 before sending "SSAFA Nursing Sisters" to all major Garrisons both home and abroad. Later a Health Visiting Service was formed to provide families serving abroad with support which they would normally receive from the United Kingdom authorities. In 1963 the Ministry of Defence recognised the need for qualified Social Workers to help with complex social and family problems facing service families. There are now professional Social Workers in Units, Garrisons and Air Force Bases in Northern Ireland, Great Britain and overseas.
2. SSAFA Forces Help in Northern Ireland
2.1 In Northern Ireland the military environment becomes a way of life not only for soldiers and airmen but also for their spouses and families. A service person's job affects theirs and their families' social and personal life, meaning that they must live within the constraints of the security situation. The cumulative effects of a variety of stressors are thus enhanced by the military scene and under some drawbacks in using outside agencies.
2.2 SSAFA Forces Help initially provided on Social Work advisor to Military Headquarters, Northern Ireland until 1993 a decision was taken to pilot a scheme whereby professional Social Workers from the field of family and child care would work alongside and supervise unqualified Welfare Workers. This agency is known in Northern Ireland as the Personal Welfare Service.
2.3 The Personal Welfare Service, Northern Ireland consists of a Co-ordinator, equivalent to an Assistant Principal Social Workers, five Social Workers at Senior Practitioner level, and one Social Worker, all of whom are supplied by SSAFA Forces Help and adhere to the legally defined code of ethics for Social Workers. They offer a professional service direct to the military chain of command and to any soldier, sailor, airmen and service family in Province. Professional staff also bear responsibility for supervision and development of three Occupational Welfare Officers.
2.4 Personal Welfare Teams are located in Lisburn, Ballykinler, Omagh, Londonderry and RAF Aldergrove and are co-ordinated from Headquarters Northern Ireland.
2.5 This service is provided in line with some key points of principle from the Armed Forces Overarching Personnel Strategy:
n To recognise that the provision of welfare support to dependant families is a key factor in the well being of the serving person.
n To provide appropriate, timely and confidential specialist welfare support (including proactive and preventative services), directed by professionally qualified full-time staff, for service personnel and their dependant families.
n To ensure that families of service personnel's needs are taken into account .. so that they are not disadvantaged in comparison with their civilian counterparts ...
2.6 Given that most service families are removed from normal support resources coupled with fears of seeking local community support they are undoubtedly in danger of being disadvantaged. SSAFA Forces Help, therefore, in line with the personnel strategy endeavours to respond sensitively to their needs whilst bridge building between them and local agencies.
3.1 Whilst SSAFA Forces Help offers a generic social work service, our client community consists of a young married population with a large proportion of pre-school and pre-teen children. Many incoming referrals, therefore, impact directly or indirectly on the well being of those children. A copy of our Statistic Returns Forms is attached at Annex A.
3.2 In the two year period 1 January 2000 to 31 December 2001, a total of 2771 referrals required response from the service. In the categories of health, relationships and child care there were 1102 referrals with 272 of those specifically dealing with child care issues and 58 being child protection investigations.
3.3 All potential child protection investigations are referred to Social Services. The names of those placed on the Child Protection Register are transferred to the Military Child Protection Register which is compiled and maintained by SSAFA Forces Help Co-ordinator on behalf of Headquarters Northern Ireland.
3.4 The current Northern Ireland Military Register was opened in May 1994. One hundred and twenty-five children have been registered to date. Twenty-five names having been added since 1 December 2000.
3.5 SSAFA Forces Help conducts the service under the Northern Ireland Children Order (1995) where specific reference is made to the organisation's role under "Arrangements for Armed Forces".
3.6 Casework is governed by the organisation's Procedures Manual in two volumes. Volume One - Professional Issues and Volume Two - Administrative Issues.
3.7 Volume one of the Procedures Manual outlines our Principals and Practice including Child Protection Procedures for both Army and RAF, Domestic Violence Policy, Record Keeping and Access to File, Confidentiality Policy, Complaints Police and Supervision and Appraisal Policy.
3.8 Individual Case Files are maintained by use of the following: Set of Case Records; Referral Form; Initial Assessment; Agreed Client Work Plan; Contact Record; District Contact Record; Review Form and Closing Transfer Summary.
3.9 All policies relating to referral intake, assessment of need, case recording and professional practice closely follow those upheld by the Northern Ireland Social Services Trust with whom each SSAFA Force Help Social Worker liases with closely.
3.10 Social Workers with SSAFA Forces Help in Northern Ireland tend to be recruited locally thus ensuring that professional practice is replicated in line with local legislation.
4.1 Regarding Child Protection issues for Armed Forces the instruction for liaison with SSAFA Forces Help is detailed in the Northern Ireland Children Order (1995).
4.2 With SSAFA Forces Help's tendency to employ locally recruited Social Workers with three years post qualification experience in family and child care, many natural networks with statutory and voluntary agencies are already in place.
4.3 These networks are extended in the first three months of employment in accordance with SSAFA Forces Help orientation policy. Through this, new staff must undertake self introductions to all of the following in their area of responsibility, Schools, Health Visitors, Social Services Departments as well as become members of Local Domestic Violence Forums, and Child Protection Committees.
4.4 In January 2002, the Northern Ireland SSAFA Forces Help Social Work Co-ordinator and a military representative met with Child Care Services in each Trust to raise awareness of our organisation and discuss how we could work together more effectively. The aspirations for formal co-working was expressed by each Trust.
4.5 Potential communication difficulties exist when Social Workers do not have full appreciation of the system in which a military family lives. There continues to be mistrust of the military by some local Social Workers who wrongly think that information is being withheld and that military personnel will protect their families from outside agencies if challenged.
4.6 It is important to continue to extend communication between SSAFA Forces Help Social Workers and local Social Services offices as some Social Services mistakenly believe that SSAFA Forces Help carry statutory responsibility for the military community. Consequently local Trust can be slower to respond when a referral is received or are reluctant to allocate resources and services to military families, especially when it is thought that these families will move on within a short time frame.
4.7 It is hoped that some more formal mechanisms for working together could be put in place, otherwise there is a potential for a gap in protection of children in military families, especially as SSAFA Forces Help is very limited in resources.
5.1 SSAFA Forces Help/Personal Welfare Service undertakes the following links:
n Between statutory agencies and military personnel
n Between military chain of command and families
n Between families and statutory or voluntary agencies
n Between military personnel serving in Northern Ireland and their extended families in Great Britain or other parts of the world
n To produce services for military families being posted from Northern Ireland to other places through the wider branch of SSAFA Forces Help
5.2 With SSAFA Forces Help emphasis placed upon the preventative element of social work such linkages are vital as is advertising the service.
5.3 SSAFA Forces Help/Personal Welfare Service advertise the service through a Forces monthly families newspaper and on British Forces Radio as well as daily networking with military welfare personnel.
5.4 Staff are invited to speak about their work at a variety of military events including a Northern Ireland Welfare Seminary hosted once year by Personal Welfare Service.
5.5 Last year SSAFA Forces Help Special Needs Advisor from Central Office, London visited the province to chair a two day special needs event for carers and welfare staff.
5.6 Whilst SSAFA Forces Help has a generally high profile within military circles, it is never certain that those who really need the service are aware of what support we can offer or if they come forward for help.
5.7 With only five Social Workers and three Welfare Workers serving all of the Northern Ireland military population, the service is fully stretched. Any increase in linkage therefore creates further demands on an already under staffed resource.
6. Workforce Issues
6.1 Given that each Personal Welfare Service team is located in isolation from others, SSAFA Forces Help places much emphasis on maximising team support and supervision.
6.2 Supervision contracts are made between Line Managers and each field worker, with formal supervision sessions being held once a month. Supervisions is minuted by the Line Manager and signed by both parties.
6.3 Supervision for the Northern Ireland SSAFA Forces Help Co-ordinator is provided by Director of Social Work, SSAFA Central Office, London on a quarterly basis, is minuted by Director Social Work and signed by both parties.
6.4 Support is offered through staff team meetings held every two months to include both field workers and administrative staff.
6.5 From Personal Welfare Service conception in 1994 to 2001 referrals had risen by 500%. This rise continued to be managed by the original number of fieldwork staff until March 2002 when an additional Social Worker was appointed to Lisanelly Barracks, Omagh.
6.6 This extra workers has alleviated some pressure, however since taking up post in Omagh, seventy referrals have been made in four months in that location alone.
6.7 Pressures on SSAFA Forces Help and Personal Welfare Service stem from the following sources:
a) Continual growth in referral rate, leading to workers being fully stretched at all times.
b) Time and distance spent travelling between office base and area covered reduces hours available to clients.
c) Volume of incoming referrals reduces time available to develop community support and prevention projects.
6.8 Unavailability of Military Welfare Workers for 25% of any year increases the presses on the Social Worker in each area. Similarly any gap whilst awaiting replacement causes an unacceptable reduction in the service provided.
6.9 SSAFA Forces Help is a member of the Voluntary Organisation Forum who provide access and support for our workers to undertake the Post Qualification Award in Social Work. Four SSAFA Forces Help Social Workers in Northern Ireland have already completed Post Qualification Modules.
6.10 Other training is accessed through local Trusts and independent training opportunities.
6.11 North Down and Ards Community Trust have recently initiated a training partnership with SSAFA Forces Help, which promises to be of great benefit.
7.1 SSAFA Forces Help in Northern Ireland is financially resourced from Central Office, London, which also takes responsibility for professional and legislative support.
7.2 Paragraph 6 outlines our access to training resources through local trusts. The downside to this is that except for North Down and Ards Community Trust, no formal mechanisms exists. Individual Social Workers rely on using personal contact for invitations to local training events.
7.3 The most obvious scarcity in resources lies in staffing, which, given the demands posed by the geographical extent of each individual's patch, is inadequate.
7.4 To overcome these demands additional staff are required to cover Palace Barracks, Holywood and Mahon Barracks, Portadown. Currently there is no agreement to funding for this.
8. Lessons Learnt
8.1 With military families frequent movement from one area to another, some fall through the safety net. SSAFA Forces Help could be used in formalising a tracking system for families where there is potential for child abuse or neglect so that maximum support and protection can be provided.
8.2 We also experience inconsistencies between Trusts as to their response time (eg 7 day assessment time scales), their order of priorities and working relationships with CARE units.
8.3 Often, Looked After Children enlist into the Forces or marry Forces personnel from the age of 17 years onwards. These young people have additional problems in coping with military life. In tandem with social Services SSAFA Forces Help could alleviate many difficulties both by the Leaving Care Planning Meeting and in After Care support. There is potential to develop partnership in this area.
8.4 Recently SSAFA Forces Help in Northern Ireland have been involved alongside Military Police with investigations into soldiers accessing child pornography from computers. Whilst these crimes may be manageable for the duration of the soldiers posting to Northern Ireland there is a potential to loose track of him/her with successive postings to other countries. This points to a gap in child protection which could be formalised via SSAFA Forces Help.
8.5 Civilian Courts in Northern Ireland liase with Social Services when dealing with cases of child abuse. It appears that the same links do not exist when alleged abusers are tried by Court Martial. Improvement in communication is required here as service personnel who are likely to have abused children may be found not guilty and move on to abuse again.
8.6 There is also a need for co-ordination of tracking potential abusers or needy families who are part of this mobile community. SSAFA Forces Help could contribute to this.
9. General Comments
9.1 SSAFA Forces Help is a registered Adoption Agency in Great Britain. Currently negotiations are underway to extend this service to Northern Ireland. When in place military families will have the opportunity for swifter assessment as well as not being disadvantaged by their frequent change of address.
9.2 SSAFA Forces Help Social Work Service in Northern Ireland is continually evolving and developing. During the past nine years of its existence alongside military welfare workers, we have continued to strengthen our service in preventing abuse and neglect to children living in the military community. In addition to the liaison role and attendance at child protection conferences, there is, however, much potential for SSAFA Forces Help to adopt a more formal role on behalf of Social Services eg undertake initial child care assessments, children in need assessments, parenting assessments, fostering and adoption assessments and in planning for Looked After Children who enlist or marry into the Navy, Army or RAF.
9.3 There are 8789 Forces wives and children living in Northern Ireland all of whom potentially require social work support. The task of supporting, identifying need and prevention of abuse or neglect is being managed province wide at present by five Social Workers and three Occupational Welfare Workers. Further resources are required to enable us to reach those who need support most and to initiate preventative projects such as positive parenting; self esteem groups; domestic violence management; child protection awareness.
9.4 Although it is accepted that Community Resources are under extreme pressure, under Anti-Discriminatory Practice families should have equal opportunities for provision and support. The military system should not been seen as an option to provide resources as an alternative to Statutory Provision.
9.5 A SSAFA Forces Help Social Worker assigned to each military base would enable our service to liase more proactively with local Trusts to the extent that "working together" could be practical in a literal sense to take some pressure from other family and child care social work teams.
9.6 Not only would such working together ensure that Professional Child Care Standards are maintained. It would also service to uphold the Forces Personnel Strategy that families of service personnel are not disadvantaged in comparison with their civilian counterparts.
August 6, 2002
Thank you for your invitation to submit evidence to the Committee for Health, Social Services and Public Safety concerning the above. Because Strabane District Council does not have a strategic role in child protection we are unable to provide evidence relating to the categories outlined in your letter.
Strabane District Council has produced good practice guidelines for those involved in delivering summer scheme projects. It is also currently developing a child protection policy, which is currently in draft form.
I have enclosed both for your information. They will hopefully provide the inquiry with an indication of how child protection applies to our work..
The Community Relations Department of Strabane District Council provides a Summer Scheme for a number of registered community groups from throughout the Strabane District. The Summer Scheme involves providing a range of sports, leisure, arts and crafts activities for children for two hours a day five days a week during the month of July. Children between the ages of 7 and 18 years participate.
This Code of Practice is designed to ensure that children participating in the summer scheme are provided with proper care in accordance with legislation and best practice.
It is also recommended that the community groups should ask the Department of Health and Social Services (DHSS) Pre - Employment Consultancy Service to carry out a check on any of its volunteers who have substantial access to children. Further information can be obtained from
Child Care Unit
THE LEGAL CONTEXT
The ratification of the UN Convention on the Rights of the Child by the British Government, along with the influence of legal opinion and pressure groups, ensured that a number of key principles informed the new Children (NI) Order 1995.
There are five key principles (5 Ps):
PARAMOUNTCY - The fundamental principle in child care law and practice that the welfare of the child must always be the paramount consideration in decisions taken about him or her.
PARENTAL RESPONSIBILITY - This principle is that parents have responsibility to children rather than rights over them. There may be situations where a number of adults share this responsibility with one or both parents.
PREVENTION - This principle is about preventing situations arising where children are separated from their families and providing services to keep the children within their families and to promote health and welfare.
PARTNERSHIP - The basis of this principle is that the most effective way of ensuring that a child's needs are met is by working in partnership. This means that the provision of services must take account of the parents' views
PROTECTION - The principle is that children should be safe and should be protected by intervention if they are in danger.
In practical terms this means that there is a legal duty to provide a safe environment for children and young people, where their welfare is of paramount importance. There should be good lines of communication with parents or carers who should be informed and consulted about any decision affecting their child. Parents equally have a responsibility to ensure that their children grow and develop in an environment safe from harm.
The Northern Ireland Human Rights Commission suggests that there is an opportunity for a Bill of Rights in Northern Ireland to draw upon provisions in the UN Convention which have not yet been properly implemented here under the terms of the Children Act 1989 or the Children (NI) Order 1995. These potential developments must also be taken into account at the appropriate time.
The children's welfare and development will be paramount in formulating programmes.
Children will be treated and respected as individuals whose rights will be recognised and respected, and whose needs, including special educational needs, will be catered for.
Parent's responsibility for their children will be recognised and respected.
The values derived from different backgrounds - religious, racial, cultural and linguistic - will be recognised and respected.
The role of parents as the first educators of their children will be respected.
Parents will be made aware of, and given easy access to, information about services, policies and procedures.
Children may be placed in the care of Summer Scheme Providers (note 1), during the course of some activities. Summer Scheme Providers will assume responsibility for children from when they are placed in their care until their parents or other responsible person collects them. Summer Scheme Providers act in loco parentis while children are in their care. Therefore, they must show a degree of care which is commensurate with their role which, in some cases, because of specialist knowledge, may be a higher duty of care than that expected of a parent.
Supervision and Support of Staff / Volunteers
Good management of any organisation requires making sure that everyone in the organisation is clear about what they are trying to achieve and about what their roles are. You must consider whether everyone in your organisation knows what the responsibilities of management and the responsibilities of the employees and volunteers are.
Regardless of whether workers in your organisation are paid employees or voluntary workers, it is important that there are clearly defined procedures for reporting incidents or accidents, making complaints or referring matters of concern, which everyone is fully aware of.
Summer Scheme Providers need to ensure that:
1. That volunteers and staff are familiar with all policies and procedures
2. That they are aware of what is expected of them in terms of behaviour
3. That there are opportunities for managers to observe volunteers / staff interacting with children
4. That there are formal and informal opportunities for volunteers / staff to express concerns or anxieties
5. That there are formal structures for supervision and support of volunteers / staff
6. That there are support structures in place for those leaders who do report concerns, and for colleagues in the case of an allegation against a leader.
7. Only staff / volunteers over the age of 18 will be considered in assessing whether adequate provision is being made. No one under the age of 16 will be employed in the formal supervision of children.
1. Be competent and qualified
2. Be positive, enthusiastic and cheerful
3. Reinforce the principles of play
4. Give feedback in a constructive and encouraging manner
5. Involve parents as much as possible
6. Recognise that they themselves are human and will not get it right all the time!
Above all, leaders should recognise the importance of fun in children's activities. Children should not be treated as mini-adults and their needs should be recognised at all stages. In addition the leader is in a unique position of trust and this position must be maintained with integrity at all times.
Behaviour of Leaders (see also Code of Behaviour)
The leader should:
1. Maintain the highest standard of personal conduct and support the principles of fair play
2. Respect the rights, dignity, and worth of every human being. Specifically the leader should treat everyone equally regardless of sex, age, ability, ethnic origin, religion or political persuasion. In this regard, the leader should ensure that all are given sufficient opportunity to participate in the activity.
3. Be responsible for setting and monitoring the boundaries between a working relationship and friendship with participants. This is particularly important when the leader and participant are of opposite sex and / or when the participant is a young person
4. Realise that certain situations or friendly actions could be misinterpreted by the participant or by outsiders and could lead to allegations of misconduct or impropriety.
5. Encourage the participants to adhere to the spirit of the rules. Furthermore, the leader must not encourage or allow participants to violate the rules and should actively seek to discourage such action
6. Never exert influence over a participant in order to obtain personal benefit or reward
7. Be watchful of all situations, particularly bullying, which may occur
(i) child to child
(ii) group to child; and
(iii) adult to child
8. Have enjoyment of the activity as a priority
9. Encourage two - way communication with participants
10. Prohibit swearing or other inappropriate language, signing or behaviour
Supervision of Children
1. Leaders in charge must be satisfied that those workers and adults who accompany group parties are fully competent to do so.
2. Children must be supervised at all times.
3. Children must not be left unsupervised at any venue whether it is indoors or out of doors.
4. Leaders should know at all times where children are and what they are doing.
5. Any activity using potentially dangerous equipment should have constant adult supervision.
6. Children will be safer if supervised by two or more adults
7. Dangerous behaviour by children should not be allowed.
Adult / Child Ratios
Levels of supervision must be adequate whether at the organisation's venue or on a journey / visit. Therefore, when deciding how many adults are required to supervise, leaders must take into account a range of practical matters.
1. The number of participants in the group
2. The nature of site / venue
3. The activities to be undertaken
4. It is important that each individual supervisor knows the responsibilities he / she is expected to bear
5. It is recommended that no journey / visit should be undertaken without a minimum of two adults in attendance, one of which must be a worker. Bus drivers should not be considered as supervisors.
6. Where a party consists of children of both sexes, both male and female supervision should be provided unless otherwise agreed
7. The standard recommended ratios are:
0 - 2 years
1 member of staff to 3 children
There should be one additional staff member
8. It is for the leader in charge to exercise his / her professional judgement in deciding the level of supervision taking into account the guidance as stated above.
9. The ratio of staff and volunteers to children with disabilities is dependent on the needs of the individual child.
It is important that activities are planned in such a way that no leaders are working in isolation, for their own protection as well as for the protection of children.
In terms of safety it is also important to ensure that:
1. There is a suitable ratio of staff to children depending on the particular activity
2. Activities are suitable to the age and ability of the children participating. This is particularly important where there may be a wide range of ability and disability.
3. That activities take place in suitable venues
4. That there is first aid expertise available and a proper first aid kit available
5. That everybody participating in the activity understands the rules
6. That all equipment has been checked for safety and suitability for the maturity of participants
7. That there is a book / form available for recording accidents or injuries
8. That parents are informed of their responsibilities with providing suitable equipment and collecting children after activities
9. That all activities have a register of participants
It is equally important that everyone appreciates that your organisation does not have the sole responsibility for the protection of children in your care. Other people, primarily their parents or carers, also have responsibility in relation to the children with whom you come in contact.
There are a number of reasons why you should establish and maintain contact with the parents of children involved with your organisation.
Parents have the primary responsibility for the care and upbringing of their children and have a wealth of knowledge about their lives and their emotional, physical and cultural needs. Generally, the most effective way of ensuring that children's needs are met is by working in partnership with their parents or carers.
This means that you should take steps to encourage the participation of parents as much as possible in your organisation. The different degrees and levels to which this can be developed may range from the representation of parents on management committees to actual participation in day-to-day activities. Some basic things that you should at least consider would include:
1. Knowing who the parents, carers or others with "parental responsibility" of all the children are.
2. Obtaining parental consent for all activities.
3. Having a record of the name, address and contact number of all parents / carers.
4. Making sure all parents and carers have an awareness of your child protection policy and reporting procedures, devising a complaints procedure for parents and carers and making sure everyone knows about it.
1. Bearing in mind the potential for accident, organisers / providers of all activities have a duty to ensure there is adequate insurance cover in place and to give advice on what personal accident cover might be appropriate.
2. All organisations should ensure that adequate insurance cover is in place to cover the activities of the group, leaders and participants. Away trips should be included in such cover.
3. Adults transporting children in their cars should be familiar with the provisions made in their motor insurance policy in relation to acceptable numbers and liability.
1. All organisations involved in providing summer scheme activities should have first aid expertise available for all sessions. They should have a proper first aid kit, including gloves for each open wound injury and sponges to be used on a once-off basis only
2. Injuries, including minor ones, should be recorded, with a note of the action taken
3. Parents / guardians should be notified of all injuries which their children incur within an activity
4. All activities should be governed by a clear and widely known emergency action plan
5. Leaders must ensure that the conduct of the games and the implements used are in accordance with the rules
6. Children should be taught the rules of the game. Many rules are there for safety
7. Parents / guardians have the responsibility for ensuring that their children get to and from sessions safely.
Code of Behaviour for Coaches, Volunteers, Helpers and Officials
These guidelines have been produced to help protect anyone working with young people during summer scheme activities and should be followed at all times.
Adult - Child relationships should be:
n Entered into by choice
n Open, positive and encouraging
n Defined by a mutually agreed set of goals and commitments
n Respectful of the creativity and autonomy of children
n Defined by an ethical code of conduct relating to interaction and bullying
n Carried out in a context where children are protected and where their rights are promoted
n Free from verbal, physical, emotional or sexual abuse
n Respectful of the needs and developmental stage of the child
n Aimed at the promotion of enjoyment and individual progress
n Respectful of the roles and responsibilities of leaders
n Governed by a code of ethics and good practice
(Code of Ethics & Good Practice for Children's Sport in Ireland)
Leaders are responsible for setting and monitoring the boundaries between a working relationship and friendship with participants. The leader must realise that certain situations or friendly words and actions could be misinterpreted not only by the participant, but also by outsiders motivated by jealousy, dislike or mistrust, and could lead to allegations of misconduct or impropriety.
1. Always be publicly open when working with children. Avoid situations where you and individual children are completely unobserved.
2. If physical contact is necessary, it should be done openly. Care is needed, as it is difficult to maintain hand positions when providing manual support if the child is constantly moving. Some parents are becoming increasingly sensitive about touching children and their views should always be carefully considered.
3. Where possible, allow parents to take responsibility for their children in changing rooms. If groups are to be supervised in changing rooms, always ensure that adults work in pairs and that gender is appropriate. If travelling to an event is necessary, make sure that the parents give verbal (preferably written) permission. Parents should be asked to ensure that children are collected on time.
4. Where mixed groups participate in activities away from home, at least one male and one female adult should always accompany them.
5. All should respect the rights and dignity and worth of all participants. Specifically leaders must treat everyone equitably and sensitively within the context of their activity and ability, regardless of gender, ethnic origin, cultural background, sexual orientation, religion or political affiliation.
6. Members working with children should hold appropriate qualifications in coaching, leadership, officiating etc. Leaders should also ensure that they are working at a level commensurate with their qualifications.
7. Adults should ensure that the activities which they direct or advocate are appropriate to the age, maturity and ability of the participant e.g. they should not break rules on suitable competition for age groups. Sessions should include clear progressions and coaches should keep a clear record of all sessions undertaken, clearly planning for future sessions. It is advisable to keep a training / coaching diary. Make sure all participants know to inform the coach of any injury or illness before, during or after the activity.
8. Adults should always promote the positive aspects of the activities and never condone rules violations; bad sportsmanship or use of prohibited substances.
9. Adults should consistently display high standards of personal behaviour and appearance as well as appropriate dress, language and respect for equipment and facilities. It is not acceptable for adults responsible for children to consume alcohol. Adults should never encourage children to drink alcohol.
10. Adults should never overtly criticise participants' or officials' judgements or use language or actions, which may cause the child to lose self-esteem or confidence. All members must also be aware that as a general rule, it does not make sense to:
n Spend amounts of time alone with children away from others
n Take children alone on car journey, however short
n Take children to your home
If it should arise that such situations are unavoidable they should only take place with the full knowledge of someone in charge in the Club and / or a person with parental responsibility for the child.
Leaders and helpers should be aware that normal car insurance does not cover them for transporting participants to and from events.
All leaders and helpers should try to be on time; and inform an appropriate person if ill or unable to attend an activity session.
Leaders should NEVER!
n Engage in rough physical or sexually provocative games including horseplay
n Share a room with a child
n Permit or engage in any form of inappropriate touching
n Permit children to use inappropriate language unchallenged
n Make sexually suggestive comments to children, even in fun
n Allow allegations made by a child to go unchallenged, unrecorded or not acted upon
n Do things of a personal nature that a child can do for themselves
n Agree to meet a child on your own
If you accidentally hurt a child or cause distress in any manner, report the incident. If the child appears to respond in a sexual manner to your actions, misunderstands, misinterprets something you have done; report the incident to a colleague supported by a brief written report of the incident as soon as possible. Parents / carers should be informed of the incident.
These guidelines apply to all persons who are engaged in work either as a paid employee or as a volunteer with a group or organisation registered with Strabane District Council's Summer Scheme. The terms "LEADER" and "SUMMER SCHEME PROVIDERS" are used for convenience.
In these guidelines the term "CHILD" is as defined in The Children (NI) Order 1995, i.e. any young person under the age of 18 years.
PRINCIPLES OF GOOD PRACTICE
All Voluntary Organisations Working With Children Should.
1. Promote the general welfare, health and full development of children and protect them from harm of all kinds
2. Recognise that children have rights as individuals and treat them with dignity and respect
3. Raise awareness of what children are entitled to be protected from
4. Adopt and consistently apply a thorough and clearly defined method of recruiting and selecting staff and volunteers
5. Plan the work of the organisation so as to minimise opportunities for children to suffer harm
6. Develop effective procedures in responding to accidents and complaints
7. Establish links with parents and other relevant organisations
Children's Right to Self - Protection
Do children in your organisation know that they have the right.
Figure 1 - Responsible Leadership
Figure 2 - Reporting Procedures
STRABANE DISTRICT COUNCIL
CHILD PROTECTION POLICY
Strabane District Council is responsible for ensuring that a safe environment is provided at all times for children who take part in Strabane District Council activities or use Council facilities. This means employing people, either directly or indirectly, who are suitable for working with children and making sure that users of Council facilities do the same. The policy sets out suitable child protection arrangements for employees and others who come into substantial contact with children. It outlines appropriate action and reporting procedures for child protection. The policy also includes monitoring and evaluation arrangements.
Under the Recreation and Youth Service Order (Northern Ireland) 1986, Strabane District Council provides a range of indoor and outdoor community and leisure provision. It also engages a range of external service providers and community and voluntary groups through its Community Services grant aid programmes and other initiatives to help fulfil its statutory remit of enhancing the quality of life and wellbeing of local residents. Council amenities are also open to the public for hire. These facilities and activities bring its employees into direct daily contact with members of the public, including children.
Strabane District Council already has a Code of Practice of Summer Scheme Providers and this policy will expand on this to include all Council provision where substantial contact with children is involved, as well as the activities of groups that use Council facilities.
Strabane District Council will work in partnership with parents, statutory and other stakeholder organisations to ensure that the welfare and protection of children in its care is paramount. It will do this through effective prevention and appropriate and timely intervention. In doing so, Strabane District Council embraces the UN Convention on the Rights of the Child.
Strabane District Council has a duty to care to the users of its premises under the Health and Safety at Work (Northern Ireland) Order 1978, the Occupiers' Liability Act Northern Ireland 1957 and under the law of tort.
Under the children Northern Ireland) Order, 1995, the Western Health and Social Services Board (Trust) has a statutory duty to ensure the welfare of a child.
The objectives of the policy are:
1. To put in place clearly defined procedures for referring, reporting and dealing with incidents relating to child protection.
2. To ensure that child protection responsibilities are fully understood and complied with.
3. To ensure effective selection, supervision and training of employees and those employed by other organisations on child protection issues.
4. To put in place appropriate and timely referral and reporting arrangements with statutory and other agencies dealing directly with child protection.
In this policy, the term "child" is any person under the age of 18 years.
Child protection means protecting children against abuse and non-accidental injury.
Child abuse means physical injury, emotional abuse, bullying, sexual abuse and severe neglect.
WHO DOES THE POLICY APPLY TO?
The Child Protection Policy applies to all Strabane District Council employees, especially those who work directly with children. The term employee of Strabane District Council includes anyone who works full-time, part-time, seasonally, on-call, on a student placement or as a volunteer.
The policy also applies to external service providers. This includes organisations running programmes on behalf of Strabane District Council. It applies to community and voluntary groups taking part in Council programmes or receive grant aid support from Strabane District Council's funding programme. Those who hire Strabane District Council facilities and premises should also read this policy.
All those working with children should respect the rights and dignity and worth of all participants. Every child must be treated equitably and sensitively within the context of their activity and ability, regardless of gender, ethnic origin, cultural background, religion or political affiliation, and, in the case of older children/young adults, sexual orientation.
The following rules should be followed at all times by any person working with children, be it employees, volunteers, club member, instructor or external service provider. They are to ensure that incidents involving child protection are prevented from occurring. They are also designed to protect employees with children in their care.
1. Maintain a strict working relationship with children. It must be realised that certain situations or friendly words and actions could be misinterpreted not only by the child, but also by observers motivated by jealousy, dislike or mistrust, and could lead to allegations of misconduct or impropriety.
2. Be watchful of bullying, which may occur
n child to child
n group to child; and
n adult to child
3. Be vigilant for signs of child abuse.
Employees must not:
1. Engage in or permit any form of touching, unless appropriate to the sport. [i] In exceptional circumstances, such as where the child needs first aid, physical contact should be done openly, with another colleague present.
2. Be alone with a child on any occasion. This includes taking a child alone on a car journey, however short, or to an employee's home.
3. Engage in rough physical or sexually provocative games, including horseplay.
4. Share a room with a child.
5. Permit children to use inappropriate language unchallenged.
6. Make sexually suggestive comments to children, even in fun.
7. Allow allegations made by a child to go unchallenged, unrecorded or not acted upon.
8. Do things of a personal nature that a child can do for themselves. In an emergency situation, or where these tasks have to be done to, say, very young children or children with disabilities, parents should be fully informed.
9. Agree to meet a child on their own.
It is recommended that no journey / visit should be undertaken without a minimum of two adults in attendance, one of which must be a worker. Bus drivers should not be considered as supervisors.
Where a party consists of children of both sexes, both male and female supervision should be provided unless otherwise agreed.
The recommended ratios are:
0 - 2 years 1 member of staff to 3 children
2 - 3 years 1 member of staff to 4 children
3 - 7 years 1 member of staff to 8 children
8 years and over 2 members of staff (preferably one of each gender) for up to 20 children
Always ensure that adults work in pairs and that gender is appropriate in changing rooms. If travelling to an event is necessary, make sure that the parents give verbal (preferably written) permission.
Strabane District Council will share any significant information about employees' or others' behaviour deemed to be putting children at risk of harm with police and social services.
Every case will be decided on its own merits and a decision as to whether there is cause for concern will be based on the balance of probabilities, rather than conclusive proof. Decisions will be based on opinions formed reasonably and in good faith.
Employees must fill in an Incident Report Form (appendix 1) and report incidences or concerns to the designated Child Protection Officer where:
1. They accidentally hurt a child or cause distress in any manner.
2. A child appears to respond in a sexual manner to employees' actions, misunderstands or misinterprets something they have done.
3. They suspect that a child is being bullied.
4. They have concerns over the propriety of other activities or suspect that a child is being abused.
5. A child itself tells them that there is abuse occurring.
In this case they should:
n React to the child with belief
n Inform them that someone else will have to be informed.
They must not:
n Inform parents: this is the job of the police/social services.
n Promise to keep the matter secret.
n Interrogate the child or ask leading questions.
n Speak to anyone against whom allegations are made, even if this is a colleague.
Head of Culture, Arts and Leisure
The Head of Culture, Arts and Leisure will be responsible for:
n Managing the overall Child Protection Policy.
Community Support Officer and Leisure Services Officer
The Community Support Officer and Leisure Services Officer will be responsible for:
n Co-ordinating and monitoring the Child Protection Policy
n Ensuring that all relevant employees are fully trained in and understand the Child Protection Policy.
n Making sure that employees follow the prevention and intervention rules of this policy.
n Monitoring and controlling situations were over-friendliness of employees could lead to misconceived allegations.
n Providing the Head of Culture, Arts and Leisure with a regular monitoring report on the Child Protection Policy, including outcomes of investigations and bringing to her immediate attention those of a disciplinary or referral nature.
n Conducting a further investigation on any incident for disciplinary purposes.
n Sharing any significant information about employees' or others' behaviour deemed to be putting children at risk of harm with police and social services.
n Ensuring that external service providers, organisations that hire Council premises and grant aid recipients comply fully with the Child Protection Policy.
n Gathering information on reports of Child Protection incidents and referring these to the Head of Department of Culture, Arts and Leisure .
n Advising employees and others of the Child Protection Policy and its intervention procedures.
Human Resources Officer
The Human Resources Officer will be responsible for:
n Advising on the disciplinary procedure that may result from an investigation by either the Child Protection Officers or management.
n Ensuring that all employees of Strabane District Council have successfully passed a PECS check.
External Service Providers
External service providers must show that they comply with the Child Protection Policy by signing a compliance declaration form (appendix 2). This includes a declaration that a DHSS Pre-Employment Consultancy Service (PECS) check has been carried out on those who will have substantial access to children (appendix 3).
Grant Aid Recipients
Grant aid recipients must show that they comply with the Child Protection Policy by signing a compliance declaration form. This includes a declaration that adequate child protection checks (PECS) have been carried out on those who will have unavoidable substantial access to children.
Organisations that Hire Council Facilities
All those who hire or use premises or facilities of Strabane District Council must complete and sign a declaration that they comply with this policy and that adequate child protection (PECS) checks have been carried out on those who will have unavoidable, substantial access with children.
Spot checks will be carried out on organisation to ensure that they have carried out child protection checks on employees. Those that are deemed not to have done this will be suspended from using the premises.
Strabane District Council will balance the right to confidentiality with the legal principle that the welfare of the child is paramount. It aims to protect both the rights of the child and of the alleged perpetrator by ensuring that only those who need to know are given the relevant information.
Strabane District Council Code of Practice for Summer Scheme Providers
Western Education and Library Board Child Protection Guidelines
Child Care Northern Ireland Our Duty to Care
NSPCC Child Protection Helpline
Northern Ireland Childline
Appendix 1 Child Protection Incident Report Form
Appendix 2 Compliance Declaration Form
Appendix 3 Pre-Employment Consultancy Service
Pre-Employment Consultancy Service (PECS) is a service which aims to help organisations working with children or with adults with a learning disability to check prospective employees and volunteers. it does this by giving them a means of access to any information held by the police or the DHSSPS which might have a bearing on their suitability.
WRITTEN SUBMISSION BY:
Submission Prepared by:
Mr R H Williamson, Executive Director. Mr Williamson has 30+ years' experience in the area of child and family care including 6 years as professional advisor to an Area Child Protection Committee.
Mr Stephen Knox, Training & Development Manager. Mr Knox has over 20 years experience of working in the child welfare field, much of it in the area of developing therapeutic responses to child protection concerns.
PART I The Role of NIGALA in Child Protection
Statutory Duties Para 1.1
Staff Development Para 1.2
Current Trends & Implications for Resources Para 1.3
Agency Links Para 1.4
PART 2 Proposals for Change in Child Protection Arrangements
Overview Para 2.1
A Proposal for Structural Change Para 2.2
Area Child Protection Committees Para 2.3
Regional Role Para 2.4
Voice of the Child Para 2.5
Care Planning Para 2.6
Consistency in Child Protection Arrangements and Practice Para 2.7
Summary of Recommendations
The Northern Ireland Guardian ad Litem Agency (NIGALA) welcomes the opportunity to provide a written submission to this inquiry, the terms of reference of which are as follows:-
"To inquire into the arrangements in place in Northern Ireland to protect infants, children and young people under the age of 18 from physical, emotional and sexual abuse and neglect; and to determine if child protection services are meeting the welfare needs of children and protecting them from significant harm.
Regard will be paid to the:-
n role 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;
n role of the Commissioner for Children;
n role and use of the child protection register;
n legislative context within which child protection services operate;
n resources available for those services; and
n current guidelines."
This paper will begin by setting out the role and remit of NIGALA in respect of child protection arrangements and then go on to address a number of the more salient issues relating to the future of child protection in Northern Ireland.
PART I - The Role of NIGALA in Child Protection
1.1 Statutory Duties
The role of NIGALA is encapsulated in the Agency's Mission Statement as follows:-
"To advise the courts of children's wishes and feelings and to independently represent and safeguard the interests of children in specified public law and adoption proceedings in Northern Ireland"
Specified Public Law proceedings refer to proceedings specified under Article 60 (6) of the Children (NI) Order 1995, and under Rule 4.3 (2) of the Family Proceedings Rules (NI) 1996/Rule 2 (2) of the Magistrates Courts (Children (NI) Order 1995) Rules (NI) 1996. Almost all these proceedings are initially brought to court because a Trust believes that a child is suffering, or is likely to suffer significant harm. Thus the need for court sanctioned protection of a child has been recognised by the applicant Trust. The Guardian ad Litem's job is to safeguard the child's interests throughout the duration of the court proceedings, ensuring that the child's voice is heard, and an appropriate plan (if one is required) which meets the needs of the individual child is in place.
Similarly under Article 66 (2) of the Adoption (NI) Order 1987, the Guardian is charged with safeguarding the interests of the child in:-
n all adoption applications
n applications to free a child for adoption.
n applications to revoke an order freeing a child for adoption.
n applications for a child to be adopted abroad.
The Guardian ad Litem is therefore involved with children or young people at a time in their lives when their future is being determined and when their vulnerability is most evident. Most of these children will have experienced significant trauma in their lives, where action to protect them has been necessary.
In safeguarding the interests of children in specified proceedings, the Guardian plays a central role in the management of the case through the court proceedings. Key tasks of the Guardian in Children Order cases include:-
n appointing a Solicitor for the child.
n ensuring the child's views are made clear to the court.
n inspecting Trust records.
n avoiding delay.
n making a recommendation to the court on the appropriate order (if any) required, based on thorough investigation of the circumstances, and assessment and analysis of the information available.
In performing his role as the independent representative of the child, the Guardian will ensure that there is ongoing liaison with the Trust Social Work staff and will interview all other professionals relevant to the application as well as the child, his parents and any other relevant persons. If, during the course of his involvement with the child, the Guardian becomes aware of any previously unknown child protection concerns, he should follow the guidance detailed in the Agency's Child Protection Policy, as ratified by the NIGALA Board.
1.2 Staff Development
All Guardians have access to a detailed in-house training programme and opportunities to engage in further study are encouraged and supported. Guardians receive regular supervision and annual appraisal.
1.3 Current Trends and Implications for Resources
The period from 1st April 2001 to 30th June 2002 has seen a rise in cases allocated to Guardians of 18% compared with the previous 15 months. Much more significantly, allocations to Guardians of Care Order applications have risen by a dramatic 60%, involving over 50% more children. This is indicative of considerable child protection activity on the part of the Trusts seeking to bring these cases to court. It is the view of NIGALA, that while not all of these applications result in the granting of Care Orders, the actions of Trusts at the time of application were, in the main, appropriate. Such a rise in activity has stretched the resources of NIGALA beyond its limits, as is undoubtedly the case for the Trusts. In order to manage this situation, NIGALA has reluctantly had to introduce a waiting list while continuing to bid for increased funding to ensure the service to children is not undermined.
1.4 Agency Links
The Agency has sought to take a proactive role in relation to issues affecting the welfare of children before the courts. Formal liaison arrangements with all the Trusts have been established, providing a forum for discussion of matters of mutual concern and interest between NIGALA Senior Managers and Trust Senior Managers. The Agency has also promoted debate and discussion on key topics relating to child protection. In May 2001, NIGALA co-hosted a major conference entitled "Exploring Significant Harm", to which key personnel from the judiciary, social care and medical fields contributed. In addition, the Agency is represented on the Children Order Advisory Committee.
PART 2 - Proposals for Change in Child Protection Arrangements
The Northern Ireland Guardian ad Litem Agency is a regional service and consequently is in the privileged position of having an overview of social work practice and trends, as far as these pertain to public law and adoption proceedings. The Agency recognises the significant pressures Trusts find themselves under in seeking to deliver the highest possible standards of service and indeed is currently experiencing similar pressures with regard to fulfilling its mandate. Nevertheless, the need to ensure that as individuals, groups, organisations and as a society, we have proper arrangements in place to protect children from abuse is imperative.
While the abuse of children is an age old phenomenon, awareness of the problem at all levels of our society has increased dramatically over the last forty years. Successive child abuse inquiries have highlighted failings in the child protection system and the residential care of children, and questioned the state's capacity to intervene sufficiently in family life, while at other times, heavily criticising the authorities for intervening too intrusively.
Inquiries have focused on child deaths, eg. (Maria Calwell 1973, Jasmine Beckford 1984, Tyra Henry 1984, Kimberley Carlisle 1986, and currently Victoria Climbié); the residential care of children, eg. (Hughes 1986, Waterhouse 2000); and on the actions of the authorities regarding suspected sexual abuse (Cleveland 1987, Orkneys 1992).
While the inquiry into the death of Victoria Climbié has yet to report, previous inquiries have consistently highlighted:-
n poor inter-agency communication
n lack of proper assessments being carried out
n inadequate multi-disciplinary responses
n a failure to focus on the child
The Climbié inquiry has sparked a debate on whether and to what degree the current child protection arrangements need to be overhauled. On the one hand, Dale et al (2002)¹ assert that it is not the structure of current systems that is at fault, but the failure to implement systems and the lack of systematic evidence-based assessment. On the other hand, questions are being asked as to the need to reinvent the child protection system and perhaps whether a single national agency to deal with child protection matters needs to be established. In the light of this debate, it is clearly timely that all organisations have the opportunity to consider what changes might be appropriate in Northern Ireland.
2.2 A Proposal for Structural Change
Over the last twenty five years there has been a massive investment in policies and procedures in child protection designed to ensure co-operation between disciplines and the sharing of all relevant information. Departmental guidance, (currently "Co-operating to Protect Children") has been gradually developed over the years: the four Area Child Protection Committees, in turn, produce their localised policies and procedures to ensure optimum protection for children from abuse. Much has been achieved since the mid 1970's, especially in the area of inter-disciplinary co-operation. It is an unfortunate fact that there is no public recognition of all of those instances when things go right, but when the small minority go wrong, there often follows public opprobrium accompanied by media vilification. Nevertheless, the continuing weaknesses in the current child protection system which include, inter-disciplinary barriers to shared information, lack of clarity of roles and responsibilities of other professionals, resourcing problems and inability to recruit and retain the appropriate calibre of staff, suggest that it is no longer adequate to attempt to fine tune or modify the present system.
Proposal. The Minister for Health, Social Services and Public Safety has published proposals² for modernising hospital services and reforming the organisational structures of the Health and Personal Social Services. These proposals at the time of writing, are issued for consultation. There is therefore an opportunity to restructure services in a way which would help to break down the barriers to inter-disciplinary co-operation and offer clarity as to the extent of responsibility carried by each discipline. A reduction in the number of HSS Trusts would facilitate effective networking between organisations in the delivery of services. The establishment of a Children's Division in each of these HSS Trusts with fully integrated social work, nursing and medical services including psychiatry, child psychology and speech and language therapy services is now proposed.
Recently in England and Wales, the spending review white paper Opportunity and Security for All indicated that the government planned to "pilot children's trusts which will unify at a local level the various agencies involved in providing services to children". Planned to become operational by the end of 2003 it is envisaged that the trusts could include partnerships in any area "where social care, health and education services need to work together" and that their services would include child protection. In Northern Ireland there are excellent protocols in place with the education authorities and the police with regards to inter-disciplinary co-operation in dealing with child abuse. Article 46, Children (NI) Order 1995 provides for "co-operation between authorities and other bodies in the exercise of functions relating to Part IV of the Order ie Support for Children and Their Families. A similar provision incorporated in Part VI of the Children (NI) Order 1995, ie The Protection of Children would reinforce the status of the current protocols. This would provide a sound basis for partnership between the proposed Children's Divisions and organisations such as the Police Service (NI), the NI Housing Executive and the Education and Library Boards.
2.3 Area Child Protection Committees
There are currently four Area Child Protection Committees ie one per Health and Social Services Board. In a future structure which may have a reduced number of HSS Trusts and the potential for the four HSS Boards to be abolished (perhaps to be replaced by a single Regional Authority), it could be argued that each HSS Trust's area should have an Area Child Protection Committee. This would make the strategic work of the ACPC more responsive to local need. It would also ensure that the work of the ACPC was more open and accessible (currently different professionals often comment that they are not aware of who is representing them or even what work is being undertaken by an ACPC). The various organisations constituting the ACPC would thereby be made more accountable for their actions not only to the Regional Authority but to the public for whom they provide a service. It is recommended that the Area Child Protection Committees should be placed on a statutory footing with clear lines of accountability and a greater clarity of purpose.
2.4 Regional Role
A key element of governmental response to child deaths (as a result of child abuse) over the last 25 years has been to develop ever more detailed procedures in order to maximise multi-disciplinary co-operation and, at the same time, to increase the regulatory framework within which professionals work. The effort to close down all conceivable loop-holes has given rise to ever more complex procedures and paradoxically increased the chances of professionals falling foul of procedures. This has given rise to "defensive" child protection work and, for many social workers in particular, there is a propensity either to leave child and family care or not come into it in the first place.
Government has a responsibility to create a more positive climate within society within which our children may be better protected from child abuse and within which professional staff may be better supported. This role of government in educating the public regarding child protection matters should be part of the wider Children's Strategy which is currently being drafted by the Office of the First Minister and Deputy First Minister.
Child protection is everybody's business. A Northern Ireland strategy in child protection would offer a vision of the future which could be embraced by the public and professionals alike. Goals could be set which encourage imaginative thinking and encourage collaborative working. The DOH Quality Protects Programme in England and Wales is an excellent example of objectives being established by government to improve the life chances of vulnerable children with on-going funding of projects at a local level being linked to positive results. A similar programme should be established in Northern Ireland.
Finally, it is imperative that 'best practice' guidance is widely disseminated among all of the disciplines involved in child protection work. Individual Case Management Reviews carried out consequent to the death or serious injury to a child where child abuse may have been the causative or contributory factor, will produce recommendations which may be of benefit beyond the area of the HSS Trust. A Review Group at Departmental level should distill the key messages from Case Management Reviews, Public Inquiries and Caselaw in order that this vital information could be disseminated throughout Northern Ireland on a regular basis.
2.5 The Voice of the Child
One area that requires close examination is that of the rights of the child in child protection arrangements. Article 12 of the United Nations Convention on the Rights of the Child states that:-
1. "States parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child.
2. For this purpose, the child shall, in particular, be provided with the opportunity to be heard in any judicial and administrative proceedings affecting the child, either directly or through a representative or an appropriate body in a manner consistent with the procedural rules of national law".³
There is now general agreement amongst many academics and child protection professionals that there should be much greater involvement of children and young people in shaping the child protection system. It is argued that the views, interests and experiences of children and young people need to be clearly and explicitly represented in child protection policies and procedures. Corby (2000)4 makes the point that
"many child protectionists are convinced that the assertion of children's rights is a key mechanism for reducing child abuse generally".
NIGALA agrees with these views and recommends that:-
n children and young people should be involved in the development of child protection policies and procedures.
n child protection policies and procedures should reflect a clear child focus, and should be supported by guidance on assessment similar to the Department of Health's Framework for the Assessment of Children in Need and their Families', which places the child at the centre of the process; and
n policies and procedures should establish clear mechanisms for communicating the views of the child at all stages of the child protection process from the initial case conference to deregistration, where appropriate.
2.6 Care Planning
One of the most important functions of the Guardian is to scrutinise a Trust's proposals as to how the welfare of a child is to be promoted following the granting of a Care Order. The care plan, presented to the court, should include detail of how the full range of a child's needs are to be met, what living arrangements are most appropriate and what support the child requires. The Guardian's role ends on the completion of the proceedings and therefore he has no further remit in ensuring that the plan agreed at court will be implemented by the Trust.
This issue of the implementation of care plans received considerable attention recently in the Court of Appeal in England and Wales as a result of its deliberations in Re W&B where a local authority failed to carry out key elements of its plan to rehabilitate two children with their mother. Essentially the Court of Appeal ruled that in all cases before a final Care Order is made, thought must be given as to which elements in the care plan are so fundamental that they require starring. If these elements are not fulfilled, the Guardian and the court should have a power to review the case. While the House of Lords overturned the Court of Appeal's decision, Lord Nicholls, in his judgement, did recognise the need for "urgent consideration" as to "whether some degree of court supervision of local authorities' discharge of their parental responsibilities would bring about an overall improvement in the quality of child care provided by local authorities".
In its consideration of child protection arrangements, NIGALA urges the committee to address this issue to ensure that children's welfare is promoted before, during and after court proceedings.
2.7 Consistency in Child Protection Arrangements and Practice
The creation of a consistently effective child protection system has been complicated by 3 fundamental elements. These 3 elements - the definition of child abuse; the increasing complexity of child protection work; and the threshold for intervention, are like shifting sands and make the operation of a consistent service across the province a most difficult task. Each of these elements require examination:-
(a) Definitions - the 1995 publication by the Department of Health, "Child Protection, Messages from Research"5 notes how society continually reconstructs definitions of child maltreatment. Jane Gibbons' summarised the situation saying that "as a phenomenon, child maltreatment is more like pornography than whooping cough. It is a socially constructed phenomenon which reflects values and opinions of a particular culture at a particular time". One has only to look at the changing definitions over time in government guidance and social work literature to realise the elusive quality of the concept.
(b) Complexity in child protection work - child protection work today is almost unrecognisable from that of 40 years ago. The "discovery" of child abuse focused on the physical abuse of children, known more specifically at the time as "baby battering". Over the subsequent years, the existence of neglect and particularly the sexual abuse of children in our society, have focused the minds of professionals and become firmly embedded in the psyche of the public. More recently the association of domestic violence with child abuse has significantly influenced practice and the threat to children's safety as a result of technological advances such as the internet is yet another factor to be considered. Recent years have also seen major changes in both domestic and international legislation, which have dramatically increased (for the better) the range of factors a professional must take into account when dealing with child protection issues.
The context in which child protection practitioners now find themselves, then, is one where society's perception as to what constitutes child abuse continuously evolves and the knowledge and skill required to do the job is becoming increasingly complex. A stable, mature workforce is required. In responding to this situation, it is essential that the Department plans a workforce strategy specifically in relation to child protection. This strategy must include the following key elements:
n ongoing support
n attractive conditions of service
(c) Thresholds - There are a number of points at which the application of consistent thresholds in the child protection process are particularly problematic. Two of these are:
(i) The threshold which sparks a child protection inquiry and
(ii) The threshold which determines the placing of a child's name on the child protection register
Spratt (2000)6 found that there was considerable disagreement between senior social workers as to what constitutes a child protection referral. When it comes to placing children's names on the register there are significant variations in rates of registration between Trusts. Mostyn (1996)7 found that:
"the chance that a child will be placed on the register depends on definitions and interpretations which vary in different parts of the UK and on thresholds determined by local circumstances, practice and resources".
While Gordon and Gibbons (1998)8 did not find evidence to support fears that decision making in child protection is so unreliable that local aspects of the system rather than children's needs determine their placement on protection registers, the Northern Ireland figures show that rates of registration vary considerably across Trusts from 61.7 children per 10,000 aged under 18 in North & West Belfast to 6.00 children per 10,000 aged under 18 in Craigavon & Banbridge, (Key indicators of Personal Social Services for Northern Ireland 2001).9
Given the variations in both initiating child protection inquiries and the rates of registration, and while allowing for the influence of demographic factors, this issue of the application of more consistent thresholds must be addressed. These initiatives may include :-
(i) commissioning of relevant research which will assist in
(ii) development of evidence based practice and in the production of
(iii) improved guidance on decision-making which, in turn, would provide a baseline for
(iv) system of monitoring at a local and regional level
Summary of recommendations
n Establishment of a Children's Division in each new HSS Trust with fully integrated social work, nursing and medical services including psychiatry, child psychology and speech and language therapy services.
n Amendment of the Children (NI) Order 1995 to include an Article in Part VI. Protection of Children mandating co-operation between organisations involved in combating child abuse ie an Article similar to Article 46 which relates to Part IV, Support for Children and their Families.
n An Area Child Protection Committee is established in each of the new HSS Trusts.
n Area Child Protection Committees should be placed on a statutory footing with clear lines of accountability and a greater clarity of purpose.
n A Proactive role for government which includes:-
(i) A vision of child protection which may be embraced by all and contained within the proposed Children's Strategy.
(ii) A public education remit.
(iii) Establishment of a comprehensive programme aimed at encouraging imaginative thinking and collaborative working: objectives set to improve the life chances of vulnerable children with on-going funding of projects at a local level being linked to positive results.
(iv) A Review Group charged with distilling the key messages from Case Management Reviews, Public Inquiries and Caselaw and responsible for dissemination of this information.
n Urgent steps to be taken to ensure compliance with the UN Convention on the Rights of the Child and Human Rights legislation by providing mechanisms for children to be more included in decision making:
(i) children and young people should be involved in the development of child protection policies and procedures;
(ii) child protection policies and procedures should reflect a clear child focus, and should be supported by guidance on assessment similar to the Department of Health's Framework for the Assessment of Children in Need and their Families, which places the child at the centre of the process; and
(iii) policies and procedures should establish clear mechanisms for communicating the views of the child at all stages of the child protection process from the initial case conference to deregistration, where appropriate.
n Review of boundaries of responsibilities between the Health and Social Services Trusts and the courts in relation to the discharge of corporate parental responsibility
n The development of a multi-disciplinary workforce strategy which must include the following key elements:
- Ongoing support
- Attractive conditions of services
n Initiatives should be taken to address the variations in practice regarding the interpretation of the appropriate criteria for (a) undertaking child protection inquiries and (b) placing children's names on the Child Protection Registers. Initiatives may include:
(i) commissioning of relevant research which will assist in
(ii) development of evidence based practice and in the production of
(iii) improved guidance on decision-making which, in turn, would provide a baseline for a system of monitoring at a local and regional level
[i] Sports where touching is not appropriate include swimming. Sports where touching is appropriate is gymnastics
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