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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:
14 August 2002
The Ulster Community & Hospitals Trust, through the Family & Childcare Programme, delivers Child Protection Services. These services are part of a continuum of provision aimed at working in partnership with children and their families in order to ensure the children reach their maximum potential. However, the needs of the child must be paramount and on occasion the interests of the child must supersede those of the parent.
Every child whose name is placed on the Child Protection Register is subject to a Child Protection Plan which is co-ordinated by a Social Worker. The Social Worker, as part of that responsibility, has regular contact with the child and family and must ensure that the Child Protection Plan is adhered to. Social Workers use a variety of interventions with families, including accessing more specialist services when required, and UCHT works in partnership with voluntary providers to offer a choice of provision to families, where possible.
Working with children who may have been abused cannot happen in isolation and the critical aspect of protecting children is through multi-disciplinary working. This principal is emphasised throughout the Eastern Health & Social Services Board's Child Protection Policies and Procedures which also state that Child Protection is everyone's business. UCHT makes every effort to ensure good communication between the different professionals who come into contact with children. This is achieved through offering Multi-disciplinary Child Protection Training, through regular liaison meetings with other agencies and by taking the lead role in the Local Child Protection Panel and the Domestic Violence Forum as well as having representation at Board level within the Area Child Protection Committee and Joint Strategic Planning groups as part of the Children Services Planning process.
Evidence submitted from UCHT concentrates on the operational aspects of delivering Child Protection Services. It details the structure within which services are delivered and gives attention to local initiatives which respond to assessed need. The submission highlights particular issues such as staff recruitment and retention and the waiting lists for more specialist services which have repercussions for Child Protection work.
The submission also makes reference to various enquiries into the deaths of children which have occurred over the past two decades pointing out that communication difficulties were a factor in most if not all of the eventual tragedies.
Within this submission a number of key issues are emphasised under 'general comments' and reference is made to local research and recommendations arising from it.
1.1 The Ulster Community & Hospitals Trust, (UCHT) is a combined acute and Community Trust. Community services are provided to a population of approximately 140,000 residents in the North Down Council and Ards Council areas. The Trust also manages Lakewood Regional Child Care Centre which provides secure and non-secure specialist child care services to the population of Northern Ireland aged under 18.
1.2 The Health & Personal Social Services (NI) Order (1994) enabled Health & Social Services Trusts to carry out or discharge certain key statutory functions with the approval and on behalf of Health & Social Services Boards. The Order retrospectively amended virtually all the relevant legislation to make this possible.
2. Legislative Background:
2.1 Within the UCHT the Family & Childcare Programme, is responsible for the delivery of Child Protection Services, which are underpinned by the following legislation.
2.2 The main legislation - The Children (NI) Order 1995 has accompanying Regulations & Guidance, which include permissions and restrictions as to what may or may not be done and also requirements on what must be done. Volume 6 of the Regulations & Guidance "Co-operating to Protect Children" covers Child Protection issues and the EHSSB Child Protection Policies & Procedures provide the framework within which agencies and professionals who work with children should operate. They have been written to reflect the requirements of -
2.3 The introduction to the Policy and Procedures states that:
"children are vulnerable to various forms of abuse because of their dependency and immaturity. Primary responsibility rests with parents for the protection of children. However, when parents do not or cannot fulfil this responsibility Trusts have a statutory responsibility and are empowered to take legal action, if necessary, to ensure that children are protected from abuse, neglect and exploitation. However, Child Protection is everyone's business..
individual agencies may have their own procedures to take account of their management and internal liaison requirements but the EHSSB Policy & Procedures are multi-disciplinary and must be followed by all the agencies and individual professionals involved with children".
2.4 It should be noted that the function of Policy & Procedures is to improve and refine systems for identifying child abuse and there is evidence to show that this have been effective in reducing the number of children killed non-accidentally by their parents (Prichard, C 1997, two decades of progress.. an international review of Child Protection services).
3.1 UCHT included Child Protection Services in the restructuring of the Family & Childcare Programme in October 1999. This process arose from the need to ensure that services reflected the changes in legislation, arising particularly from the implementation of the Children (NI) Order 1995, which took effect in late 1996. The structure continues to be reviewed on a quarterly basis by Managers to confirm it remains fit for purpose and the structure keeps evolving in response to developments in childcare practice following Inspection Reports, Priorities for Action and locally identified need. The most recent structural change in April 2002, was a realignment to establish a Permanency Team. Its remit is to make certain that children who cannot return home (in many instances due to irresolvable risks) do not remain in the public care system. This is achieved through placement with extended family, through the application by foster parents for Resident Orders or through Adoption.
3.2 Trusts have written protocols regarding the arrangements for the delegation of statutory functions which includes, among others, providing personal social services for children in need and their families (Article 18) and a duty to investigate "where there is reasonable cause to suspect that the child is suffering or is likely to suffer, significant harm" [Article 66(b)]. There is a line management structure which reflects the statutory function from the Director of Social Services, through a Programme Manager for Family & Childcare, Assistant Principal Social Workers, Team Leaders and Social Workers and also additionally there is a Principal Social Worker with lead responsibility for Quality Assurance, Audit and Reviewing Officer Duties. There are a number of teams operationally responsible for providing various services from Early Years to Adolescent work, Looked After Children, Fostering and Adoption, Children in Need or who are on EHSSB Child Protection Register and subject to a Child Protection Plan.
3.3 Each Trust and/or Board is required to keep a register of every child in its area who is considered to be suffering from or likely to suffer significant harm and for whom there is a Child Protection Plan. The significant harm may be due to physical abuse, neglect, emotional abuse or sexual abuse and each type of abuse can be categorised as potential, suspected or confirmed. "Potential" or "suspected" equates with "likely" and "confirmed" equates with "actual" significant harm.
3.4 Within UCHT there are two Initial Response Teams, with each team having four Social Workers and a Team Leader. The teams provide a dedicated service through the receipt and initial assessment of referrals which are received by the Team Leader from a number of sources. These include referrals regarding Child Protection, however often the reason for referral is general, and can relate to concerns about possible risks or to factors which could lead to risk, which leaves the decision making as to the status of the referral the responsibility of the Team Leader. Reports by the Audit Commission (1994) and messages from research undertaken by the Dartington Social Research Unit (1995) emphasised the failure of the system of Child Protection and its negative impact on the children and families involved. They stressed the need for greater concentration on children in need and the support of their families. The introduction of the Children (NI) Order 1995 posed a significant challenge to Social Work practitioners in establishing a new balance between protecting children and offering support to children and families. Research studies have demonstrated the difficulties experienced across the UK in implementing the family support provisions contained within the legislation (Aldgate and Tunstill (1995), Colton et al (1995), SSI report (1997), Higgins and Pinkerton (2000). There appeared to be a continued trend for Social Work agencies to respond to increasing numbers of reported concerns in relation to children by implementing child protection procedures (Lindsey 1994). In tandem with this situation is the evidence to suggest that an observable pattern existed whereby increasing numbers of referrals were being defined as requiring a child protection response at the point of entry to the system which, in most cases were filtered out again after the investigation was complete (Freeman 1996) and (Jones 1996).
3.5 Consideration of these issues has spawned "the refocusing debate" with provider agencies attempting to review policies, procedures and risk assessment thresholds for decision making in order to better match the service response to assessed need. Local research conducted by Spratt (2000) demonstrated the lack of consensus among Social Work managers and indeed the Social Services inspectorate as to what would constitute a child protection referral. While acknowledging the potential to define more initial referrals as 'enquiries' rather than 'child protection investigations' he noted that the preoccupation with management of risk could incur a situation wherein child care problems received a quasi child protection response. In 1999, John Devaney, an APSW with UCHT conducted "an evaluation of the criteria used in decision making in Child Protection referrals" which showed a need for greater consistency in both the categorisation of referrals as well as the collation of statistics across Northern Ireland.
3.6 The counter argument however is that there is a growing concern that assessing a referral as a "child in need", leading to services based on this criteria, can lead to Child Protection being seen in isolation from Family Support. One of the concerns noted in phase 1 of the inquiry into the death of Victoria Climbíe in England, was that she was classified as a Child in Need, requiring family support services, rather than a Child Protection case. Then, a lack of review of case files - along with many other errors - meant there was little hope of crossing the boundary between the two once a classification was made (Community Care 21st - 27th August 2002, phase 1 of the inquiry). It appeared that when subsequent concerns were raised in regard to Victoria which queried possible abuse, the professionals went back to the fact that this was a Family Support case. Child Protection needs to be seen as part of the Child Care system as a whole with continuous reassessment of cases taking account of subsequent referrals and additional information rather than labelling a case as "Child Protection" or "Family Support". There is a need to see children in need of protection as part of the wider group of Children in Need.
3.7 The philosophy underpinning the UCHT Initial Response Teams is that the earliest possible intervention, appropriately targeted and resourced will prevent the need for long-term social work involvement. The Team provides information and advice and assesses the needs of children and their parents in order to decide whether a family may benefit from ongoing Social Work support. The Team offers support and/or services to families in the short term to address specific issues or problems and also carries out Initial Child Protection Investigations under the joint protocol alongside the Police Service of Northern Ireland. The protocol requires that Social Workers are specially trained with the Police, in joint interviewing and there is additional separate training on video evidence.
3.8 Where it is felt there are Child Protection concerns, Child Protection Policies and Procedures are followed and this may include a Multi-disciplinary Case Discussion or a Multi-disciplinary Case Conference with the latter deciding the degree of risk to a child and whether or not the child's name is entered on the Child Protection Register, in which case the child will be subject to a Child Protection Plan. The Initial Response Team normally transfers the responsibility for the Child Protection Plan to the Trust's longer-term Children & Families Teams. The draft Co-operating to Safeguard Children document states that -
"The use of Child Protection Procedures and the placing of a child's name on the Child Protection Register is likely to impose considerable stress on the family involved. This stress may prove counter productive to safeguarding the child. It is therefore important that registration should only occur when the actual or likely abuse is sufficiently serious to constitute 'significant harm'. Given the lack of precise criteria of what constitutes significant harm, the general rule in deciding whether registration is justified should be whether the abuse is sufficiently serious to justify consideration of the need for Care Proceedings if the Child Protection Plan should prove ineffective".
3.9 There are three Children and Families Teams within UCHT. They have five/six Social Workers and a Team Leader. It is the responsibility of these Teams to ensure that Child Protection Plans are adhered to through co-ordination of the various assessments and ensuring planned services are offered and regularly reviewed. All children whose names are placed on the Child Protection Register are reviewed at least on a six-monthly basis at a Review Case Conference to which all of the professionals involved are invited, as they are to the Initial Case Conferences. The average length of registration varies from case to case although some children remain on the Register for a number of years. John Devaney, an APSW from the Trust has been seconded to complete his PhD. and his research is concentrating on a group of children who have remained on the Register for lengthy periods and it is hoped that the research will inform practice, use of resources and identify possible factors which contribute to children remaining in what are deemed to be situations where they are at risk. In the majority of circumstances, where registration occurs and the Child Protection Plan cannot be implemented, the child can become "Looked After" by the Trust. Subsequently, if the home situation improves sufficiently so that the child is no longer considered at risk from Significant Harm he or she can return home, in other situations a child can remain "Looked After" for longer periods of time and become subject to Permanency Planning.
4. Case Work:
4.1 The Trust operates an open access policy and where possible, service users are asked to countersign records of discussions and decisions. The records are a combination of ongoing recording of face-to-face contact, assessments and re-assessment forms as well as Transfer and Closure forms. The Trust is in the process of piloting the Common Assessment Framework which has been adapted from the DHSS "Framework for the Assessment of Children in Need and their Families". Case Conferences and Case Discussions require reports submitted from the Social Worker who is the Case Co-ordinator as well as reports from other relevant professionals who have knowledge of the family.
4.2 In the analysis of information and making decisions as to future case involvement, Social Workers rely on their knowledge of theory relating to eg; child development, behaviourism, knowledge of parenting capacity and motivational theory as well as theories around family dysfunction and attachment. There is a body of research in regard to Child Abuse from various perspectives alongside Practice Guidelines which have emerged over the years as a result of inquiries into the deaths of children. Social Workers would be very aware of situations where they require more expert involvement and whenever cases do not appear to be progressing for whatever reason, consultations are arranged with relevant specialisms. An example of this might be where a child has been sexually abused, whilst the Social Worker remains the Case Co-ordinator the aspect of individual therapeutic intervention may be referred to the Child Care Centre in Belfast. Social Workers would also be expected to keep abreast of what is considered best practice emerging from Inspection reports and recommendations.
4.3 An aspect of professional judgement is from previous experience in working in Child Protection and it is through this process that Social Workers form a knowledge of what works with families and they require time and ongoing staff development in order to relate their practice experience to the theory and research within the field of Child Abuse. It should also be noted that in regard to analysis of information and implementing Child Protection Plans, the success or otherwise of the intervention relies on the openness of the family to that intervention. The Social Worker, as the Case Co-ordinator, must also constantly reassess the family's situation as, whilst general risks can be identified, the degree of risk is more difficult to measure accurately and therefore the communication element of the Policy & Procedures is of crucial importance. One of the major problems identified in child abuse inquiries has been the failure of professionals to share knowledge. Complex social problems like child abuse are often associated with imprecise knowledge relying more on experience-based practice; this runs counter to the evidence-based practice prevalent in health care. Ruth Sinclair, Director of Research, National Children's Bureau, has argued that the changing discourse away from the medical diagnosis, from child abuse to child protection, has shifted the balance of power within networks away from health professionals to Social Workers and lawyers
5.1 The recent Health & Social Services Board Child Protection Policy & Procedures states that at times all those involved in children's work need access to specialist advice. No one agency or discipline can undertake the complex task of protecting children on their own. The Procedures are also clear in regard to attendance at a Case Conference and list the various professionals who should always be invited to the Initial Case Conference and as appropriate to the Review Case Conference. Case Conferences are required to identify a Case Co-ordinator, usually the Social Worker, and a core group should also be identified who are the key professionals in contact with the family, with the expectation that they will co-operate in implementing the plan and keep each other informed of any concerns or changes in the family situation. The Procedures are equally clear in regard to confidentiality and that giving information to others either for the health of the patient or the protection of others is not a breach of confidentiality. Whilst some research suggests that inter-agency collaboration in Child Protection can reduce anxiety, professional fatigue and inter-agency conflict (Bennett et al., 1982), other research (White 1989) states that without a fundamental change in attitude and perceptions that various professionals have of each others roles, co-operation and co-ordination between agencies cannot be achieved.
5.2 A significant number of Child Abuse Inquiries have documented that communication difficulties were a significant factor in the eventual tragedies. The DHSS (1982) document Child Abuse - A Study of Inquiry Reports 1973 - 1981, showed that in every report problems occurred in some aspect of communication between individuals and agencies. The Cleveland Report (Butler-Sloss 1988) criticised the multi-disciplinary system stating that disagreements and failure of communication of adults should not be allowed to obscure the needs of children. A more recent study drawing together evidence from 40 reviews undertaken in England 1998-2001 shows that health professionals were the key players in many of these cases and highlighted the necessity for health professionals to work with others in protecting children (Lupton, North & Khan 2001 Pulling Apart. The National Health Service & Child Protection Networks).
5.3 The Policy & Procedures are adhered to in regard to communication by ensuring that all relevant professionals are invited to Case Conferences and Case Discussions. There is an expectation that if the professionals cannot attend that they make contact with the Social Worker or if possible provide a written report. It is crucial that there are representatives from other agencies at Case Conferences both to share information but also to take part in the decision making on Registration. Involvement in the decision making can ensure that the professionals are agreeing to the risk to a particular child and are signed up to the Child Protection Plan. Outside of Family & Childcare staff, there are often difficulties with attendance at Case Conferences by professionals, who have competing demands. The Trust employs a Senior Nurse Advisor in Child Protection to ensure that a priority is given within Health Visiting caseloads to children who are at risk. The Senior Nurse Advisor attends as many Case Conferences as practicable and ensures that in her absence a Health Visitor or School Nurse attends. The SNA provides clinical supervision to Health Visitors in respect of all Child Protection cases. In 2001, the Area Child Protection Committee undertook an audit of GP input into the Child Protection Process which resulted in a proposed proforma for information to aid Child Protection Investigations. The key agencies which require representation at Case Conferences would be: Health Visitors, School Nurses, School or Playgroup representatives, GP's, Police and Education Welfare Officers. Dependant on the individual case other professionals with knowledge of the family will be invited. A Minute of the Case Conference or Case Discussion is circulated to the relevant professionals and this includes the decisions of the Case Conference and the Child Protection Plan as well as when the Plan will be reviewed. Parents also attend Case Conferences, and full participation at both Initial and Review Case Conferences is actively promoted and encouraged.
5.4 Where Joint Protocol procedures are being followed, and the decision has been made that the investigation should be undertaken by Police and Social Services, a Strategy Discussion takes place within 24 hours from referral unless good practice dictates otherwise. There are a number of specific forms which require completion in regard to the various stages of the Joint Protocol. There are liaison arrangements between Family & Childcare Senior Managers and more senior staff within the police. Referrals which are received from education are normally made verbally but are followed up in writing on a referral proforma and teachers are well placed to identify childcare concerns including possible abuse. UCHT employs a co-ordinator specifically to oversee the day to day working of a Pastoral Care Project, retaining contact between the School Nurse, Education Welfare Officer, Social Worker and the school. The project ensures that problems are identified at an early stage and agreement is reached on a way forward. UCHT worked in partnership with the NSPCC in establishing a school counselling service in a number of schools, covering primary, secondary and more specialist education establishments. This initiative commenced in August 2000, following recommendations from a steering group which involved UCHT. An audit of the scheme highlighted the number of children living in homes where Domestic Violence was present which resulted in a Women's Aid worker being resourced as part of the Ards Peninsula Surestart Project.
5.5 Some issues in regard to communication can be raised by other agencies in the light of Human Rights Legislation and Data Protection. This can be a particular problem around situations where there have been allegations of sexual abuse but the alleged perpetrator has not been adjudicated through the court system. It can sometimes lead to difficulties between various Trusts within Northern Ireland in regard to tracking non-adjudicated offenders who may move between different families. The draft "Co-operating to Safeguard Children" document cites case-law (RV Devon County Council) where it was concluded that the interests of the adult may have to be placed second to the needs of the child, however different practices occur and each case is open to legal challenge. Within the EHSSB a review of protocols for transferring cases between Trusts and Boards is underway with specific focus on the information sharing in respect of all Child Protection cases at point of transfer. There are less difficulties when the perpetrator is an offender under Schedule I Children & Young Persons Act 1968 particularly where he or she is subject to the Register of Sex Offenders. In such situations Risk Assessment Meetings involving Social Services, Probation, Police and other relevant professionals are an expectation, using the MASRAM model (Multi-agency Procedure re Assessment Management of Sex Offenders).
6.1 The UCHT is committed to working in partnership with children and families and local communities. In regard to Child Protection the Trust has spearheaded Family Group Conferencing which empowers children and families to make decisions in their lives rather than decisions being imposed by professionals. This method of working originates in New Zealand and involves private family time where families can discuss their difficulties without professionals present. They produce a family plan to resolve the current problem identified and in partnership, usually with Social Services, agree how to make the plan work. This has been used in Child Protection cases with positive results with each Family Group Conference being co-ordinated by one of a group of people trained by the Trust but who are not its employees, and who are from a variety of backgrounds. Family Group Conferencing has been a service provided by UCHT over the past four years.
6.2 Child Protection Case Conferences and Case Discussions called under the Policy & Procedures are attended by parents and by young people when they are in a position to make a contribution. The Trust would have approximately 80% parental attendance at Case Conferences and parents are only excluded in extreme circumstances. Leaflets have been used in the past to explain the various systems and services within Child Protection and these are presently being updated to more adequately reflect the present Policy & Procedures for example a parent's right of appeal to the decisions regarding their child's name being placed on the Register. The Trust also complies with the Children Order Complaints Procedure and parents and children are made aware of their rights under this. There are linkages with the local communities through the Local Childcare Partnership as well as within the Surestart Project in the Ards Peninsula.
6.3 An important aspect of linking with local communities is to raise the profile of Child Protection and that it is everyone's business. In the past Community Child Protection Training has taken place and the Trust would aspire to continuing with this training, the evaluation of previous input would suggest that the training is best delivered in a partnership arrangement between Trust staff and a voluntary organisation. The Trust also has linkages with Ards Development Bureau and Network, North Down Community Network and the East Down Rural Community Network with representatives from the Trust on the management committees.
6.4 The terms of reference for linkages highlights linkages with children, parents/carers and local communities and their access to information. Another important linkage is through inter-agency collaboration in respect of the Area Child Protection Committee which promotes within the EHSSB's area the welfare of children and specifically, protection from abuse and neglect, through multi-disciplinary and interagency co-operation. There is a Trust (UCHT) Child Protection Committee to implement locally the multi-disciplinary Child Protection Policy and Procedures ensuring a high standard of professional practice. The members of the ACPC are accountable to their parent organisations. The EHSSB Children's Services Planning Process also includes a number of joint strategic planning groups, including a group concentrating on Child Protection issues.
7. Workforce Issues:
7.1 The reform of Social Work training is ongoing and the British Association of Social Workers suggests it is demanding considerable work in a very short timescale to achieve a well developed academic and practice curriculum for Social Work. The expectation is that Social Work training will be at degree level with a year of protected practice. At present Social Workers who qualify with a Diploma in Social Work can be in a position where they have relatively little experience in Family & Childcare. This is a particular problem in providing Child Protection Services as the majority of Social Workers in that area are newly qualified. Child Protection work is demanding, complex and stressful and this front line service is being delivered by the least experienced sector of the workforce. More experienced staff tend to move on from Child Protection Work to more specialist areas or Social Work within adult services. The recruitment and retention of staff to the Initial Response Teams and Children and Families Teams who deliver Child Protection Services, has been an ongoing problem for at least the past two years. One Children and Families Team lost four out of six Social Workers in the past year, being replaced with inexperienced staff. A recent recruitment drive, targeted for the end of a Social Work course, managed to elicit seven applicants for ten vacancies. Managers have made enquiries as to the low uptake for job advertisements and a number of reasons and explanations have been cited as to the disinterest in Child Protection work. These range from the level of stress through to better Terms and Conditions offered in eg; Probation and Education Welfare. There are vacancies within teams on a consistent basis, with existing staff having to take on responsibility for the consequent additional workloads. Apart from inexperienced staff dealing with high Child Protection caseloads there are issues for the continuity of the Child Protection Plans. This has also had an impact on court related work where staff have had less involvement over a period of time with the case than the court appointed independent Social Worker for the child, who is there to report to the court on the plans being made by the Trust. To summarise, there are considerable problems emanating from staff shortages as a result of sick leave, resignations and inability to fill vacant posts.
7.2 The Trust has long recognised the problem in regard to staffing within Family & Childcare and has been working on a Recruitment and Retention Strategy however there are only so many incentives that can be offered to staff within the limited resources available. The Trust makes every effort to ensure that staff working in Child Protection services receive appropriate training including access to post-qualifying training. The difficulty is that time out is required in order to undertake training as well as reasonable caseloads which are conducive to applying the knowledge and skills. The Trust ensures that newly qualified staff have Supervision additional to the normal monthly Supervision and a proportion of the ongoing assessment and planning as well as report writing falls to the Team Leader in an effort to ensure that there is safe practice. Consultation with other Trusts, as part of developing a recruitment and retention strategy, showed similar problems in their Family & Childcare services. Evidence would indicate that other Programmes of Care do not experience recruitment and retention difficulties to the same extent.
7.3 As stated earlier, Social Workers who are seeking employment are less inclined to choose Child Protection Work. Alongside the stresses involved in dealing with a vulnerable section of the population there are issues in regard to the level of violence and aggression from service users. The Trust has been looking at a zero tolerance policy however as front-line workers dealing with children at risk, their only safeguard is the involvement of the Social Worker and it is almost impossible to withdraw the Social Work service unless the threshold of significant harm can be proved to the court's satisfaction, in which case there is little alternative to the child becoming "Looked After". Every effort is made within the limitations imposed to ensure that intimidatory behaviour, verbal threats and physical violence is kept to a minimum, the Police are informed of any situation where there is an identified risk to Social Workers and where necessary staff can visit homes accompanied by a colleague or a Team Leader. A Confidential Counselling Service is also available and all situations where there is a potential for violence are subject to a risk assessment.
7.4 The Trust has a Supervision Policy which states that all staff at whatever level in the organisation receive Supervision at least monthly. As previously referred to, less experienced staff would have additional Supervision sessions. The Trust is also committed to ensuring that there are standards in place and has invested heavily in Standard Setting and providing training through NISW (National Institute of Social Workers) for Team Leaders in implementing and monitoring standards. Ten days training was provided over the past year in this area and where possible audits are carried out in regard to implementation of standards with exceptional reporting through to the Programme Manager in situations where standards are not being met due to shortage of staff. Through the work of the Principal Social Worker for audit, a number of standards were locally developed particularly with regard to Looked After Children and Child Protection work. It is hoped by benchmarking these key areas that outcome measures can be developed.
8.1 As referred to under the workforce issues a particular concern is in recruitment and retention of Social Workers in Child Protection work. As a response the Trust has attempted to introduce skill mix to the Programme. Any tasks which do not require a dedicated Social Work service are carried out by Team Assistants who assist the Social Workers with more routine tasks. This includes transporting children to and from parental contact, supervising contacts where required, organising child care for families in order to facilitate parental attendance at meetings and where possible to help with the increased administrative duties. Waiting lists for more specialist services have long been a concern especially for Psychology Services which cover the need for adult psychological assessments on parental motivation to change, child psychology services in respect of offering more specialist therapeutic services to children and providing expert witness services for court related work. There are waiting lists to access Child & Family Consultation Services as well as Adolescent Mental Health Services. UCHT is presently involved in reviewing Mental Health, Disability and Family & Childcare services in an effort to develop a child centred approach across these Programmes. The lack of secure accommodation also has an impact on Child Protection as at times the young person may have been on the Child Protection Register which has led to the increased likelihood of the young person being at risk within the Community at large. The Trust also accesses regionally provided services such as the Child Care Centre or the Young Peoples Therapeutic Project in Belfast and again there can be waiting lists for these services which has an impact on the time period within which resolution can be provided. The particular difficulty within Child Protection work is that as the lead role agency with the statutory responsibility staff have to respond to assessed risk regardless of staffing levels. This has an impact on the time available to deliver services to Children in Need and can also delay the outcome of Child Protection Plans with Social Worker's time increasingly being used in crisis intervention.
8.2 The availability of substitute care provision both in residential services and fostering is a well documented problem. In the longer term it is to be hoped that permanency policies will ensure that the need for substitute care can be targeted at respite provision and differentiated residential care which meets the individual needs of the young person. The difficulties in recruiting foster parents is being addressed by a Regional Project Team who are conducting a needs assessment in regard to children who are Looked After and the possibility of enhanced payments for additional fostering skills and increases in allowances to foster carers for difficult to place young people. It is also an aspiration that the resources currently provided to Surestart Projects which offers a range of services to children under four and their families will have an impact on the number of children requiring Child Protection services. It is to be hoped that providing earlier more intensive intervention will strengthen families and communities, reduce the number of children referred onto the Family & Childcare Programme and consequently lead to a reduction of the number of children on the Child Protection Register.
8.3 Trusts are presently progressing a number of priorities for action which impact indirectly on Child Protection Services, that is residential care, permanency, fostering and Surestart, however none of them relate to providing intensive family support services aimed at families where Child Protection concerns are ongoing. The Trust has had to target its services from the more preventive type provision to protection services. Barnardo's Simpson Family Resource Centre which is a contracted service provider to UCHT realigned its services approximately two years ago, in order to take on intensive case work involvement with families where the children are subject to Child Protection Plans. By fast-tracking this Child Protection work it was hoped that the length of time that an individual child's name was on the Child Protection Register would be shortened. To some degree this has happened by ensuring that if the children could not remain safely at home that there was sufficient assessments and evidence of intensive intervention to advise the court of a need for Care Proceedings.
8.4 The Trust also submitted to the Board a proposal for a residential facility in order again, to fast-track families where there are Child Protection concerns, to ensure that these issues are dealt with as quickly as possible in a situation where there is adequate monitoring provided for the children whilst assessments are progressed. Such a residential facility would require both Social Work, Health Visiting and Psychology input, although the day to day assessment could be carried out by Social Care and Social Work staff groups.
9. Lessons Learnt:
9.1 The Multi-disciplinary Training on Child Protection includes referencing recent inquiry findings and Team Leaders in particular are in a situation where they require a working knowledge of messages from research and studies on Child Protection, which can be used through the Supervision process with Social Workers, to facilitate individual assessments. Lessons learnt from the Cleveland Inquiry (1988 Butler Sloss) led to the protocol for joint investigation and staff are encouraged to access post-qualification training in the area of Child Protection including the Child Care Award at Queens University, Belfast. The difficulty remains, however, in having staff in post long enough to complete post qualification and having replacement staff to cover their study leave.
9.2 Social Workers and their Line Managers would ensure that lessons are learnt on an ongoing basis eg; changes in case law and changes in practice are cascaded to relevant staff and Team Meetings occur on a regular basis which provide opportunities for sharing information and updating knowledge. Family & Childcare provide a number of practice placements for students on Social Work courses which encourages a learning culture and there is an annual appraisal system which links to a regular audit of training requirements providing the basis for annual bids to the EHSSB under Children Services Training. There are practical examples where research into local need improves service provision. The most recent example of this is in regard to Domestic Violence.
9.3 Within UCHT, over 30% of the children on the Child Protection Register have experienced Domestic Violence and it is a feature of registration or the primary concern which led to registration. In a significant number of these cases parental alcohol abuse is also a factor. In 1992, The DHSS commissioned a research project aimed at finding more effective ways of dealing with Domestic Violence in Northern Ireland. It identified four priorities to be addressed in tackling Domestic Violence that is to raise public awareness, to challenge seriously the attitudes and behaviour of perpetrators, to improve support and treatment services for survivors and to build a clear picture of the extent of Domestic Violence. The Regional Forum on Domestic Violence was established to co-ordinate efforts towards achieving these aims.
9.4 Patricia Nicholl, Programme Manager for Family & Childcare in UCHT, undertook research looking at Domestic Violence referrals across the Trusts in the EHSSB. One difficulty she encountered was in relation to Management Information Systems used in Trusts and she recommended they should be reviewed in order to ensure that accurate referral information is collated consistently across Trusts. It was also evident at the point of data collection that many Social Work Departments were suffering serious staffing difficulties which may have contributed to some referrals remaining untraceable. It was further recommended that a review of the systems of intaking, storing and retrieving referral information and Social Work records may be required in order to eliminate this potentially very serious matter.
9.5 The study was also reflective of National and International statistics in regard to the preponderance of male offenders and female victims. There was a high correlation of alcohol consumption in referred instances of Domestic Violence and it would be important to ensure that any strategy for the management of Domestic Violence referrals involves appropriate staff from Alcohol and Community Addictions Services who can take a child-centred approach alongside offering therapeutic services to the adult. The range of situations which constitute Domestic Violence appeared to be broad with a need to look at the most appropriate way of differentiating and recording referrals. It was clear that many assessments did not result in services and those which did were under a Child Protection banner. There was evidence of strong links between experiences of Domestic Violence and Child Abuse although this is not a linear relationship. A number of recommendations were made as a result of this research in early 2001 including the development of a specialised Risk Assessment Framework for Domestic Violence in parallel with the new Common Assessment Framework for Children which the Trust is piloting.
9.6 UCHT in partnership with Barnardo's also held a workshop on the London, Ontario Risk Assessment Framework in September 2001 and Barnardo's Simpson Family Resource Centre have undertaken multi-disciplinary training within UCHT on working with Domestic Violence.
9.7 The Local Domestic Violence Forum in the UCHT also commissioned two smaller pieces of research. The first of these was within the Ulster Hospital setting and was conducted by Catherine Reilly, APSW, in the Social Work Department at UCHT. She took a random sample of women attending A&E over the year 2001, as a result of trauma. She looked at the recording made by the medical staff which detailed clinical injuries and causes which included for example, falling downstairs, hit with a baseball bat, attempted strangulation. At no point were women asked if Domestic Violence was a factor or if they had children. This information was cross-referenced with Family & Childcare services in UCHT and South & East Belfast and with the Domestic Violence Liaison Police Officers in those areas. A number of the women were known either to Family & Childcare or to Domestic Violence Police Officers and some of their children were on the Child Protection Register. As a result of this research, recommendations have been made for future protocols. Alongside this a bid was made to the Regional Multi-Professional Audit Group which has provided funding to look at future interventions and data collection. A second piece of research was undertaken by Emma Pybus, Psychology Student on secondment to the Trust. this research elicited the views of a small sample of female service users as to the quality of service experienced. In December 2001-January 2002 NDA Domestic Violence Forum tested a screening tool for Domestic Violence occurrence. The key agencies - Women's Aid, Police and the Initial Response Teams within the Trust, surveyed a sample group of victims of Domestic Violence asking a number of questions geared towards establishing trends relating to children exposed to Domestic Violence. The aim of the project was to test a screening tool in order to establish a database to be used to develop future services. One of the key issues arising from this was the vulnerability of the under 8 year old group in particular who cannot develop safety strategies for themselves. The monitoring tool is now being piloted by the Initial Response Teams, it gives "prompt" questions to guide workers in the initial assessment of Domestic Violence. A significant amount of work has been undertaken to look at a safety orientated approach for women and children living in Domestic Violence.
9.8 The Local Domestic Violence Forum also interfaces with the Trust's Local Child Protection Panel and both the Forum and Panel are chaired by the Programme Manager for Family & Childcare. This interface is a key strategic process arising from recommendations by John Devaney, APSW, from his research on the categorisation of referrals. His research had included looking at how Domestic Violence referrals are initially investigated.
10. General Comments:
10.1 The DHSSHPS Programme for Government has key departmental initiatives which should benefit elements of Child Protection Services.
(a) "Best Practice Best Care" includes proposals for disseminating best practice through the Health & Social Services. It should be noted that at present it is easier to access inquiry outcomes from England than within Northern Ireland, although it is hoped that the DHSSPS will distribute recommendations and lessons to be learnt from recent inquiries in Northern Ireland, including the baby Jasmine case.
(b) An information and communications technology strategy is being developed for the Health & Social Services and Child Protection systems require investment. This would facilitate access to information in tracking individual children at risk as high mobility is a predisposing factor in families where children are more likely to be abused. Information is also required to develop future services and one of the recommendations of the UCHT Domestic Violence Research was better Information Management Systems to ensure referrals are tracked.
10.2 Priorities for Action refers to the need to provide the trained workforce necessary to deliver planned improvement in residential care provision. A similar priority is required for Child Protection Services. This cannot be progressed without recognising and addressing the need for additional incentives to recruit staff to this field of work in sufficient numbers. There is also the need to retain the staff long enough to train them. UCHT have identified and addressed the training requirements of inexperienced staff, however on occasion all of the necessary training has been provided only for staff to resign and join another agency.
10.3 One interview panel convened in December 2001 in UCHT resulted in no one attending for interview. The few applicants emanating from the overall low response rates has inevitably resulted in an enforced lowering of the eligibility for employment criteria. This is a matter of particular concern, as it will impact on the overall quality of the workforce available. This is moving in a contradictory direction to the more specialist and expert nature of the skills required in delivering an efficient and competent service. One suggestion by the UCHT Recruitment and Retention Working Group was for the Trust to look at regrading within teams to appoint one/two Senior Practitioners. This would acknowledge the complexity of the work and provide incentive to remain in this area. The Trust is aware that in some Trusts Senior Practitioners have been appointed in the Joint Protocol and investigative aspects of Child Protection however the ongoing nature of Child Protection work which includes delivering to the Child Protection Plan, co-ordinating the multi-disciplinary input, monitoring the ongoing risk and the involvement in court work where the significant harm threshold is reached, requires highly qualified and motivated staff. Giving evidence under cross examination and coping with the adversarial nature of court proceedings can be stressful and time consuming. Working within a multi-disciplinary framework also requires skills in assertiveness and the need to be viewed by other disciplines as a professional with equal status and knowledge-base.
10.4 Inter-agency and multi-disciplinary communication, despite numerous inquiry recommendations, training opportunities and liaison meetings remains a dilemma. Key factors in successful multi-disciplinary working have been reported to be commitment and willingness, good working relationships, leadership or drive and establishing common aims. The main constraints in collaborative approaches include finding time and resources and the need to clarify issues and definitions. (David Berridge, Research Matters 2002).
10.5 In families where there are child abuse concerns, there is often a difficulty in engaging with the parents who can be unmotivated and at times this requires legal proceedings to ensure that the child is adequately protected. There are concerns in regard to the length of time taken for cases to be processed through the courts. The NI Guardian Ad Litem Agency's Annual Report, 2000-2001 highlights the fact that during the year April 2000 - March 2001 there was an increase in the duration of some proceedings. It showed a further increase of 47 days per case on average in comparison with the previous year which brought the average duration of Care Proceedings to 246 days. The report pointed out that this should be a cause for concern for all involved in public law proceedings.
10.6 Services which address issues of Domestic Violence and Alcohol Addiction are required if any inroad is to be made to the numbers on the Child Protection Register. There is a need for all agencies involved in child care to have an understanding of Domestic Violence and this would extend to personnel involved in court proceedings including the judiciary who may benefit in some instances from awareness raising in Domestic Violence. Alcohol Addiction Services would need to evolve to incorporate a child centred approach alongside the present emphasis on offering support/advice and therapeutic intervention to the adults. One suggested way forward could be to appoint suitably qualified staff within Family & Childcare services.
10.7 It is hoped that a Commissioner for Children may ensure that all service provision gives recognition to possible effects on children and in particular that there is appropriate redress when Multi-disciplinary Child Protection working is not accommodated.
10.8 Appropriately resourced specialist services are required to complement the statutory functions. At present Mental Health Services, including Child Psychiatry and Psychology are difficult to access. This is partially due to such services offering a more universalist provision which results in waiting lists which are not conducive to assessing and implementing programmes in cases where there are Child Protection concerns requiring immediate involvement. In some instances where there are family support concerns which could lead to Child Protection issues, the waiting list results in an early referral to the service becoming more crisis driven before the service is secured.
10.9 The DHSSPS should consider the introduction of mandatory procedures in respect of case management and review of Children in Need cases under the Common Assessment Framework for Children in Need.
10.10 UCHT has introduced an audit system in Child Protection Services, in order to promote consistency of placement and decision making. The DHSSPS could consider regional research and benchmarking of Child Protection services which should encourage consistency.
MISS MARY QUINN (A)PSW
written submission by:
16 August 2002
1. The Volunteer Development Agency is the lead Agency for the promotion and development of volunteering within N.Ireland. The Agency offers support, information and training to organisations which involve volunteers. The agency also has an active policy role and aims to monitor and influence policy that affects volunteers and volunteering.
2. Our Duty to Care is a project within the Agency, with a remit to provide support, advice, information and training to the voluntary and community sector, on good practice for the protection of children. The project is supported by the Department of Health, Social Services & Public Safety.
3. The aim of the work of the Our Duty to Care project is to raise awareness of child protection issues within the community, specifically with organisations and individuals who volunteer to provide activities for children and young people within the community. Most volunteers are members of their local community and therefore awareness of the issues of protection and safeguarding of children which are learnt in an organisational setting, directly benefit the local community and lead to a safer, more child-friendly environment.
4. This project does not directly provide child protection services and this submission will not comment on statutory provision. However we do wish to make informed comment on the issues of communication, linkages and resources.
5. While communication and linkages appear to have improved between professionals, through Area Child Protection Committees and Child Protection Panels, there is still an enormous gap in communication with the local community. In spite of current legislation focusing on supporting families, there remains a suspicion and hostility within the community towards statutory authorities. Our experience is that this is largely based on lack of communication, contact and mutual understanding of roles and responsibilities, especially in relation to social services. Opportunities to share good practice and work together have contributed to changes in attitude which enhance a partnership approach in protecting children, as demonstrated in a quote from a community volunteer involved in Keeping Safe Child Protection Awareness Raising Training - "It made me aware of what child protection teams actually do. It makes you aware that social workers are not just these bad people that you're brought up to think they are."
6. In the long term, children will only be well protected if the families and communities in which they live are safe and child-friendly. This can only be achieved by close co-operation and understanding between communities and those statutory authorities tasked with the responsibility of child protection. However, there is little provision for the enhancement and development of this partnership within the statutory structures. The membership of Area Child Protection Committees and Child Protection Panels includes the main statutory agencies and a number of large voluntary agencies, but does not include representation from grassroots community groups( See Co-operating to Safeguard Children). Some Health & Social Services Trusts have recognised this need and do include local community representation on Child Protection Panels, such as the North & West Belfast Trust. This good practice should be an integral part of policy and procedures.
7. The main focus of the work of child protection services is on intervention when children are in need of protection. While this is entirely necessary, a shift of focus to public education, awareness raising and prevention strategies would ultimately reduce the need for the same levels of intervention. An understanding of child protection issues and everyone's role and responsibility in safeguarding children in the community would lead to a better working partnership between all the agencies, groups and individuals who impact on the life of children.
8. As a result of the above, resources are also focused on intervention work and the vital work of prevention of abuse and community development is under-resourced. We would recommend that a higher priority should be given to public education and to programmes which will have a long-term impact on the quality of life for children, such as parenting programmes.
9. In summary the Volunteer Development Agency would hope that the enquiry will give serious consideration to ways in which the wider community can be more actively included in the provision of child protection services and to the promotion and support of prevention programmes and the enhancement of child-friendly communities.
written submission by:
1.1 The Western Education and Library Board welcomes the opportunity to make a submission to the Committee for Health, Social Services and Public Safety of the Northern Ireland Assembly in relation to Child Protection Services in Northern Ireland.
1.2 The Child Protection Support Service of WELB works in close partnership with all of the statutory agencies in pursuance of the Board's duty to promote and safeguard the welfare of all children within its area. The priority objectives of the Service are:
2. CHILD PROTECTION WITHIN THE EDUCATION SECTOR
2.1 The Board's Designated Officer for Child Protection is a member of DOCPEG(Designated Officers for Child Protection in Education Group) which was established to promote consistency of strategy, policy, procedures and practice throughout the education sector. This group is inclusive of the Department of Education, the 5 Education and Library Boards and the Council for Catholic Maintained Schools.
2.2 DOCPEG is currently undertaking a review of the guidance contained in Circular 1999/10 (Pastoral Care in Schools - Child Protection). The revised guidance will take account of impending changes in education law aimed at strengthening the current child protection arrangements within education.
3. WELB RESPONSE TO KEY ISSUES
3.1.1 There is concern that schools are increasingly being asked to assess the relative significance of presenting concerns in terms of the need for Social Services to undertake a child protection investigation. This is contrary to the guidance contained in Co-operating to Protect Children Volume 6 (Children (NI) Order 1995) and where categorical advice to schools has been not to investigate. Consequently, there is need for agreement between all partners on the range and scope of discreet preliminary enquiries and on what constitutes investigation.
3.1.2 In many instances, schools have concerns that a family's circumstances are adversely affecting a pupil's behaviour or performance in school, or the pupils welfare in general. The school is unable to secure support for the family from Social Services unless a child protection referral is processed. Consequently, there is a need for proactive prevention strategies to be undertaken as casework which if significantly resourced could lead to a reduction in terms of reactive, investigatory work.
3.1.3 There is evident distress/concern on the part of educational professionals who are in daily contact with children in need whose development and welfare are perceived as being progressively undermined. They are witnesses to the damaging effects on children of moving towards and across the threshold for significant harm before help is available.
3.1.4 Additionally where child protection referrals are accepted, the school's perception in some instances is that the child's welfare is not noticeably enhanced.
3.1.5 The perception of professionals in education is that refocusing is towards child protection rather than family support which runs counter to the principles and philosophy of the Children Order.
3.1.6 There are concerns about consistency even within a single trust with respect both to the timeliness and nature of the response by Social Services to a presenting concern.
3.1.7 ELB services such as Education Welfare are increasingly addressing gaps in family support services through a range of projects including:
3.2.1 Because of their daily contact, schools play a vital role in supporting and monitoring vulnerable children. They are often inhibited in their supportive role by a lack of information/feedback post-referral or at times of family crises. A protocol for the sharing of information or feedback loop would ensure that the pastoral needs of the child are being appropriately addressed within the school.
3.2.2 Designated Teachers/Deputy Designated Teachers are the key professionals at school level, and continue to be supported by the Child Protection Support Service in their evolving role and challenge. Recent research within WELB has confirmed their increasing confidence and professionalism and their willingness to be pro-active both in case conferences and core-group working. The centrality of their role as active partners in the child protection process needs to be acknowledged. The formalisation of an information sharing protocol which is inclusive of designated teachers would be most welcome.
3.3.1 Partnerships between the Board, schools, parents and the local community are actively promoted and are considered to be an area of strength.
3.3.2 Communication with parents about the school's child protection policy and procedures is a DENI requirement (Pastoral Care in Schools: Child Protection DENI 99/10).
3.3.3 Within school, there is encouragement for children to seek support/make a complaint and this is actively promoted through the provision of a preventative curriculum. Parents are informed that their children are availing of such programmes.
3.3.4 Linkages with Social Services departments would be significantly enhanced by the provision of a designated social worker to a school or group of schools. At present, linkages are promoted by the involvement of relevant local social work staff in designated teacher training.
3.3.5 There is strong representation from the education sector on Child Protection Panels and on a diverse range of Children Services Planning Groups.
3.3.6 Within WELB, good partnerships have been established with NSPCC and Sperrin Lakeland Trust in the context of the Schools Counselling Service Project. Early evaluations of the project have been positive and indicate a potential for developing the Service to include a wider group of schools.
3.3.7 As an employing authority, the Board has concern about the lengthy nature of PSNI/DPP procedures in respect of educational professionals who have been suspended on full pay pending the outcome of child abuse investigations. There is concern about the lack of feedback regarding progress in such investigations and the inordinate delay, particularly at DPP level, in expediting/making directions in such cases. This has very significant implications for Board resources which could more appropriately be channelled into preventative services.
3.4 WORKFORCE ISSUES
3.4.1 WELB employs a full-time, permanent advisory/support officer who devises and delivers a wide range of training programmes for designated/ deputy designated teachers, school principals, Boards of Governors, parent groups and the full spectrum of education sector staff whose work involves contact with children. The support officer also represents the Board on a range of interagency forums.
3.4.2 Within Social Services, there are significant workforce issues. There appears to be a very high turnover of staff within the child care discipline with the consequent problem of relatively inexperienced social workers addressing very complex cases and carrying unacceptably heavy caseloads. These pressures inevitably lead to stress and illness among social work staff. A local trust has recently been involved in a work to rule in order to highlight these issues. These workforce issues are so pressing that the trust has recently found it necessary to devise interim priority categories for caseload allocation.
3.5.1 There is general recognition that resources across all sectors are inadequate.
3.5.2 Resources within Social Services departments would appear to be critically lacking. The current level of resourcing means that only the most urgent cases are being prioritised for intervention. This has implications for the morale of Social Services staff and perpetuates recruitment and retention problems which can lead to a demoralising spiral.
3.5.3 The balance of resource allocation at present is disproportionately towards Child Protection rather than preventative services. This runs counter to Children Order principles and philosophy.
3.6 LESSONS LEARNT
3.6.1 Public inquiries/case management reviews have frequently identified deficiencies in information sharing within and across professional boundaries as critical failures in individual cases. The Board would highlight the need for schools to be recognised as active partners in the child protection process, and for schools to have confidence that their concerns about individual children can be acknowledged and responded to at the earliest possible stage.
3.6.2 The Board would highlight the urgent need for more effective support for all professionals working in the area of Child Protection. By its very nature, the work is emotionally stressful and demanding. These stresses are further compounded by the resource issues already identified.
3.6.3 The balance between preventative and reactive services needs to be urgently redressed. The principles and philosophy of the Children Order relating to early intervention and family support services have not and cannot be realised within existing resources.
4 GENERAL COMMENTS
4.1 The Board would wish to acknowledge the progress that has been made post Children Order in developing the knowledge and skills of designated teachers and other education sector staff in promoting and safeguarding the welfare of children.
4.2 The Board also wishes to acknowledge the partnerships that have developed with Social Services and PSNI personnel. through uni-/multidisciplinary training initiatives, and children services planning groups.
4.3 There is a need to develop specialist child protection strategies/services for children with disabilities who are known to be highly vulnerable to abuse and whose needs are very significantly under-represented within current child protection services.
4.4 Child Protection Services also need to address specific issues relating to culture and ethnicity.
written submission by:
15 August 2002
Section 1.0 Introduction
Section 2.0 The Context
Section 3.0 Structural Arrangements
Section 4.0 The General Legislative Framework
The Legal Framework to Protect Children from
Section 5.0 Child Protection Services
Achieving the Balance
Section 6.0 Case Work
Section 7.0 Communication
Working Together - Information Sharing
Section 8.0 Linkages
Communicating with Children and Families
Section 9.0 Workforce Issues
Section 10.0 Resources
Funding of Family & Child Care Services
Section 11.0 Case Management Reviews
Number of Case Management Reviews in
Section 12.0 General Comments
Appendix 1 Northern Ireland Measures of Deprivation
Appendix 2 Top 50 Electoral Wards within the WHSSB
Appendix 3 Organisational Structures
(b) Foyle Health & Social Services Trust
(c) Sperrin Lakeland Health & Social Care Trust
INQUIRY INTO CHILD PROTECTION SERVICES IN NORTHERN IRELAND
1.1 This document describes the Structural, Legislative and Service issues in relation to the delivery of Child Protection Services in the Western Health and Social Services Board area. It is a composite response on behalf of the Board and Foyle and Sperrin Lakeland Trusts to Mr Hughes' letter of 20 June 2002.
2. The Context
2.1 It is important to consider the context within which Child Protection Services are currently being delivered in the Western area before addressing the specific points raised by the Inquiry.
2.2 An examination of the four Health and Social Services Boards reveals that the Western Board has the highest proportion of children within its population. The 1999 mid year Estimates show that 30.5% of the Board's population is under 18 years of age compared to the Northern Ireland figure of 27.4%. The Board administers an area of almost 5000 square kilometers from Limavady in the North to Enniskillen in the South. Notwithstanding the low population density and corresponding remoteness in many areas, the Board and the Trusts have been instrumental in implementing many excellent schemes in promoting inclusivity. In this context the Board and the Trusts work in partnership with the various voluntary organisations in developing services in the community.
2.3 Five District Councils operate within the Board's area: Derry, Limavady, Strabane, Omagh & Fermanagh.
The population of the Western Area in the age range 0 - 17 years is 84,910 and the various age groups across the District Council areas are reflected in Table 1.
Table 1: Nos and Ages of Children and Young People in each Western District Council Area
(Source: NISRA Mid-Year Estimate)
Deprivation in the WHSSB
2.4 The Programme for Government highlights that in Northern Ireland there is one of the youngest populations in the European Union and that unacceptable proportions of children live in conditions of poverty with over a quarter of children coming from households dependent on Job Seekers Allowance or Income Support. It acknowledges the close relationship between family poverty and higher infant mortality, poor levels of general health and increased risk of social problems. Deprivation in Northern Ireland is now measured by the Noble Index which sets out a series of different measures (or "domains") of deprivation. Included at Appendix 1 is a number of the deprivation measures with their regional markings according to District Council areas. In the league of deprivation as reflected in the Noble Index, the most deprived area in Northern Ireland is the Strabane District, Derry ranks third, Omagh seventh, Limavady eighth and Fermanagh eleventh.
2.5 The Child Poverty measure which is a sub-section of the Income Domain within the Index, ranks wards according to the percentage of children under 16 in families that claim the following means tested benefits of Income Support, Job Seekers Allowance, Family Credit and Disability Working Allowance. The measure identifies Shantallow East in Derry as the most deprived ward in Northern Ireland in relation to child poverty followed by Brandywell and Creggan South ranking second and third most deprived. Appendix 2 identifies the top 50 electoral wards within the WHSSB together with their ranking.1
Targeting Social Need, Equality and Human Rights
2.6 The 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 1998 have provided a statutory basis for promoting the rights and needs of children and young people. All children have an equal right to protection from harm and a right to the same standards of service. Cultural factors neither explain nor condone abuse or neglect and it is acknowledged that children from all backgrounds can be abused or neglected.
Model for Assessing Need and Supply
2.7 The current best estimate of the number of children and young people who are in need or who are vulnerable, i.e., at risk of social exclusion were services not to be provided is conveyed through the following diagrams extracted from the Children's Services Plan 2002-2005.2
Figure 1: Children & Young People who are in need, or are vulnerable
in the Western Board
Children and Young People in the WHSSB Area
2.8 The approach to analysing need adopted by the Western Area Children and Young People's Committee over the past three years has built on frameworks developed by Hardiker3.
Level 1 represents services provided to the whole population for example health and education.
Level 2 represents support for children who are vulnerable through an assessment of need. Services are targeted to individual children, with parental support, and are provided in statutory and voluntary settings for example home visiting services and community based Family Centres.
Level 3 represents support to families, including children and young people, where there are chronic or serious problems, for example parenting difficulties, domestic violence, child protection issues.
Level 4 represents support to families or individual children and young people where there is a high degree of risk and intensive help or long term support is required. The child's name may be on the Child Protection Register or the child may be Looked After by the Trust.
2.9 The aim of the higher levels of support (Levels 3&4) is to affect the situation in the family, positively, so that the family can be supported through Level 1 services alongside the mainstream population.
Figure 2: Hardiker Grid - Continuum of Services
2.10 Social Services within each Trust provide a continuum of services, frequently in conjunction with other agencies as reflected in the above grid.
2.11 An advantage of the Hardiker model is that it enables planners to consider each of the levels separately, but also clearly demonstrates the inter-dependence between the levels. An effective range of preventative services at level 2, for example, will impact on the number of families entering level 3. Children at level 4, requiring rehabilitation home, will be very dependent on access to good services at levels 3,2 & 1. The Western Area Children's Services Plan 2002 - 2005, therefore, has approached Family Support through the promotion of services at each level, in a co-ordinated way.
Referrals made to the Family & Child Care Programme
2.12 During the year ended 31 March 2002 the Family & Child Care Programme in Foyle Trust dealt with 2628 referrals, i.e. 1962 Child Care and 666 Child Protection. In Sperrin Lakeland there were 79 Child Protection referrals and 1973 Child Care referrals giving a total of 2052. It is interesting to note that in Foyle Trust the number of Child protection referrals accounted for 25.3% of the total referrals whereas in Sperrin Lakeland Trust the Child Protection Referrals represented 4% of the total referrals.
2.13 The statistical data in Table 2 was supplied by Foyle and Sperrin Lakeland Child Protection Panels for their respective areas and included in the Western Area Child Protection Committee's Annual Report for year ended 31 March 20024. The information has been derived from Soscare but it is recognised that the system has many limitations. It is, however, envisaged that the current Soscare programme will be replaced by a Person-Centred client Information System (PCIS).
Table 2 : Child Protection Data
* 666 Referrals in respect of 544 Children; some children were referred on more than one occasion.
3. Structural Arrangements
3.1 The organisational structure delivering Child Protection Services within the WHSSB area is shown at Appendix 3a.
3.2 The Board
3.3 Provision of services for children in need of protection need to be tested against standards contained within Co-operating to Protect Children and the Western Area Child Protection Committee's Child Protection Policy & Procedures. It is, of course, important that the standards are understood by the children and their parents as well as those responsible for providing the services. The Board has mechanisms in place for monitoring such provision for example an audit of child care practice was undertaken in one locality in Foyle Trust in 1999, an audit of foster care during the year 2000 and a Board wide child protection monitoring exercise was undertaken in 2001.
3.4 The Trusts provide:
3.5 Trust structures are included at Appendices 3b and 3c.
3.6 The infrastructure for the delivery of Family & Child Care Services at Social Work Team level within the Trusts is as follows:
Foyle Trust: Two Child Care Teams in Riverview locality
(The decision to appoint a second Senior Social Worker in three localities in Foyle related to the span of control)
Sperrin Lakeland Trust: A Child Protection Team and an
Adolescent Team in Fermanagh Sector
Child Protection Policy & Procedures
3.7 The procedures under which the social work teams in the Family & Child Care Programme operate are laid out in a detailed Child Protection Policy and Procedures Handbook produced by the Western Area Child Protection Committee5. The Western Area Child Protection Committee (WACPC) is a multi-disciplinary body chaired by the WHSSB's Service Planner for Family & Child Care Services. Its role is to develop a strategic approach to child protection within the overall Children's Services Planning process. The Committee meets on five occasions during the year to address its functions, which include co-ordinating, developing, monitoring and reviewing child protection activity. The Statutory Agencies in the Western area and NSPCC have representatives on the Committee. Foyle and Sperrin Lakeland Trust each have a Child Protection Panel to facilitate practice at local level. The Child Protection Panel is accountable to the Trust which constituted it and is chaired by the Programme Manager/Community Services Manager who has responsibility for child protection in the Trust. The Chair of the Child Protection Panel is a member of the WACPC and reports to it on Child Protection work within the Trust.
The Northern Ireland Manual of Multi-Agency Procedures for the Assessment
3.8 The above manual outlines clear procedures for the assessment and management of sex offenders. A central key objective of the Multi-Agency Procedures is to minimise as far as possible the risk of harm to children and adults, by focusing on the opportunity presented by those convicted of such offences.
3.9 In the Western Area, the Area Sex Offender Risk Management Committee (ASORMC) has been operational for one year. The Committee, which is chaired by PBNI's representative on WACPC, meets at least once per month. It is responsible for ensuring that offender risk assessments are completed and that risk management plans are revised on a regular basis. The experience, thus far, suggests that the process has provided a great level of sharing of information and co-ordination of work, which has resulted in more effective risk management planning. Risk assessments and risk management plans in respect of sex offenders form part of the overall assessment of a family situation with a view to informing future Child Protection plans and actions, which are required to protect local communities.
Regulation of Area Child Protection Committees
3.10 The role of the WACPC is recognised as an important part of the Child Protection System and particularly in relation to co-ordinating Child Protection Policy and Procedures.
3.11 Recently, NSPCC has been working with Ms Patricia Lewsley MLA, with regard to a Private Member's Bill on the regulation of ACPCs. The need to place the functions of ACPCs on a statutory basis has been recognised in England were the Victoria Climbie Inquiry, in particular, has highlighted the weaknesses of ACPC powers and functions.
3.12 In Northern Ireland a recent case involving a child has been subject of an Inquiry. It is expected that one of the recommendations of the Inquiry will be an enhanced role for ACPCs in ensuring collaboration between agencies and professionals with responsibility for Child Protection work.
3.13 In broad terms the Bill is intended to build upon the functions and remit of ACPCs as set out in the draft "Co-Operating to Safeguard Children"6. NSPCC has summarised the key areas as follows:
3.14 The WHSSB responded positively to the Consultation Document on 4 July 2002. It is expected that the Proposed Bill, when introduced, will go some considerable way to strengthening the role and functions of ACPCs.
3.15 It is also felt that the regulation of Child Protection Panels should be considered in the future in view of the linkages between ACPCs and Child Protection Panels.
Services for Children & Families
3.16 The Family & Child Care Programme in each Trust provides services for children under 18 years and their families. The main services provided by the Programme are:-
This paper will, of course, focus on Child Protection Services
4.0 The General Legislative Framework
4.1 Prior to the establishment of Foyle and Sperrin Lakeland Trusts in 1996, the WHSSB had a duty and responsibility for meeting all social services statutory requirements. The Health and Personal Social Services (NI) Order 1994 made provision for these duties and responsibilities to be delegated to Health and Social Services Community Trusts. Consequently, Schemes of Delegation of Statutory Functions were drawn up and following approval by the DHSS, the WHSSB authorised both Foyle and Sperrin Lakeland Trusts to exercise these statutory functions with effect from 1 April 1996. The Scheme of Delegation includes statutory child care functions under the Children (NI) Order 1995. The Board, of course, retains a strategic residual responsibility for the functions involved.
The Legal Framework to Protect Children from Harm
4.2 The Legal Framework to Protect Children from harm is primarily provided by The Children (NI) Order 1995, which became law on 4 November 1996. The Children Order and its associated Regulations and Guidance, particularly Volume 6 "Co-Operating to Protect Children" soon to be replaced by "Co-Operating to Safeguard Children" emphasises the importance of assessment and support at home for the vast majority of children.
4.3 All practitioners engaged in Child Protection work are required to be familiar with the legal provisions and ensure that actions taken comply with current legislation. Staff are encouraged to seek legal advice in cases of complexity or whenever Court action is a possibility.
4.4 The following important principles are contained in the Children Order and must be kept in mind by agencies engaged in protecting children:
Duty to Investigate Child Abuse
4.5 Article 66 of The Children (NI) Order 1995 sets out the Health and Social Services Trust's duty to make inquiries regarding children who live or are found in their area, who are subject to Emergency Protection Orders, in Police Protection or where the Health and Social Services Trust has reasonable cause to suspect that a child has suffered or is likely to suffer significant harm. Where the Trust has already been granted an Emergency Protection Order in respect of the child, the Trust shall make inquiries to decide what action should be taken to safeguard or promote the child's welfare.
4.6 The inquiries should be directed towards establishing whether the Trust should make a Court application or exercise any other powers available under The Children (NI) Order 1995 with respect to the child. In cases where the child is already the subject of an Emergency Protection Order but not accommodated by the Trust, consideration must be given to accommodating the child if this is in his best interests.
4.7 Whilst primary responsibility for protecting children rests with Social Services, actions taken are in collaboration with the other Agencies involved. Close co-operation and co-ordination of Police and Social Services actions are essential in all Child Protection Investigations.
5.0 Child Protection Services
Achieving the Balance
5.1 Child Protection is one area of work in which daily dilemmas over the nature and extent of protection are faced. There are many indicators which may raise concern about risk of harm from child abuse and neglect. Risk of harm refers to the likelihood that a child or young person may suffer physical, sexual or emotional harm in relation to what has been done (physical, sexual or emotional abuse) or what has not been done (neglect) by another person, often an adult responsible for their care. Environmental factors (such as poor accommodation and low income) may also contribute to the risk of harm.
5.2 Many Case Management Reviews undertaken following the deaths of children, for example Rikki Neave in Cambridgeshire, have highlighted the difficult balance to be struck between the protection of children, the rights of parents and the wish of social work staff to assist families through the Family Support Policy and Procedures.
5.3 Evidence from research and enquiries consistently state that Family Support and Child Protection processes need to operate in parallel if better outcomes are to be achieved for both children and their families. During the mid-late 1990s social work practitioners and their managers in both Trusts indicated that children and families were driven into the Child Protection Service by rigid application of the then Child Protection Policy and Procedures with little consideration given to the Family Support route.
5.4 The WACPC has endeavoured to raise the threshold for Child Protection Registration and to promote Family Support Services which are preventive 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. While 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 is considerable.
5.5 The three year Child Care Plan for 2002-2005 under the auspices of the Western Area Child Care Partnership outlines a range of Family Support Services which will meet the needs of all families and children in the Western Board area. Funding has been provided for six Sure Start Projects located in Irvinestown, Strabane, Ballymagroarty/Hazelbank, Shantallow, Dungiven and Lisnanelly/Strathroy in Omagh. These are inter-agency projects which provide a wide range of services to help meet the identified social, health, educational and emotional needs of children from birth to three years and their families.
5.6 The linking of Family Support and Child Protection processes is illustrated in diagrammatic form in Figure 3 .
Figure 3 - Linking Family Support and Child Protection Processes
5.7 The five thresholds are Referrals, Strategy Meetings and Article 66 Investigations, Child Protection Case Conference, Registration and Looked After Arrangements.
Review of the Discharge of Statutory Child Care Functions
5.8 During 2000/2001 a Review of the Discharge of Statutory Child Care Functions by FHSST7 was undertaken. In their study of case files, the Reviewers identified 4 cases which, in their view, should have been dealt with under the Child Protection Procedures but were not or efforts made to work outside the Procedures continued for longer than was reasonable given the levels of risk indicated. The Reviewers also saw two cases where the procedures were instigated but key protection issues did not appear to have been considered. In light of these findings they suggested that the Refocusing Approach should be revisited with a view to ensuring that children at risk of significant harm are not being left unprotected. It should be noted that the Reviewers also suggested that there may be a need for clarification and improvement of the WACPC Child Protection Policy and Procedures. The Procedures will in fact be revised, on a Regional basis, following publication of "Co-operating to Safeguard Children".
6.1 Schedule 2 of the Children Order identifies the types of support that Trusts can provide. These range from "advice, guidance and counselling", "assistance in kind or cash", "accommodation for any child in need" and "provision of accommodation for another person in order to protect a child", to specific provisions such as home help, laundry facilities or attendance at a Family Centre. Families whose children's names are on the Child Protection Register tend to receive a high level of service with the exception of those who decline offers of support.
6.2 Although some families are resistant to social work involvement, the Trusts still have a responsibility to assess the needs of children and to offer services to help them. The traditional social work skills of listening, empathy and attention to the different levels of communication that people use are essential in developing relationships with clients that can lead to a shared understanding of needs and a commitment to a plan to help the child and family. The importance of the professional relationship in difficult areas of work is widely recognised and was emphasised in "Messages from Research"8. Social work staff, in consultation with other members of the multi-disciplinary caring team, encourage and facilitate family members in caring for their children in difficult circumstances, for example physical safety issues, domestic violence, persistent neglect and developmental delay.
6.3 A new file structure was introduced in April 1990 in order to facilitate access to records. The H&PSS Access to Manual Personal Records Policy and Procedure and the Review of Structure of Social Work Case Files were revised with effect November 1996 with a view to improving recording and enabling social work staff to share as much information as possible with clients.
6.4 Whilst social work staff endeavour to prioritise recording in respect of Child Protection Work the Report of the Review of the Discharge of Statutory Functions by Foyle HSST (June 2001) noted that standards of recording in case files were very variable. The Report also indicated that the reasons for decisions taken in respect of children at risk of significant harm were not always evident. Social Workers often feel so pressurised by their statutory duties that they are unable to pay proper attention to the files and consequently recording does not always reflect the quality of work undertaken. Almost all case records in Foyle Trust are handwritten. It is, of course, recognised that good case recording is an essential component of safe and effective social work practice and it must be accorded a high priority. At this juncture Foyle Trust has implemented special measures to deal with recording deficits.
6.5 Sperrin Lakeland Trust is also experiencing difficulties in maintaining case records and files.
6.6 Both Trusts believe there is inadequate administrative support available to Teams to maintain files in an orderly and up to date manner. With few exceptions the majority of Case Conference minutes are not distributed within 14 days, which is the standard set in the WACPC Child Protection Policy & Procedures. Frequently minutes are not produced for 3-4 months and this is most unsatisfactory. In order to address this difficulty the Board in 2000-2001 invested £135,000 and continue to keep this situation under review.
6.7 There is no doubt that the effective protection of children depends crucially on professionals exercising their professional judgement. The Board and the Trusts strongly believe that professional judgement must be rooted in evidence based practice. There are two important aspects that need to be considered. Firstly; assessments, judgements and decisions in individual cases must be based on clear and demonstrable evidence about the particular situation. The "Assessing Needs and Risks in Work with Children and Families" Multi-Disciplinary Framework Document9 launched in the Western Board area in May 2000, was designed to allow such evidence to be systematically gathered and recorded. Secondly; evidence based practice means applying findings from research to a particular case for example the impact of particular caring practices on children or the particular types of intervention. Social work staff and other members of the multi-disciplinary team, whilst anxious to keep abreast of current research and best practice, find it difficult to do so because of workload demands.
Assessment and Analysis of Information
6.8 The Multi-Disciplinary Assessment Framework referred to in Section 6.7 was developed in the Western Board area in order to have a systematic approach to gathering and analysing information about individual children and their families taking into consideration different types and levels of need. It is acknowledged that the Western Board's Assessment Framework is not as detailed as the Department of Health Framework for the Assessment of Children in Need and their Families recently implemented in England and Wales.
6.9 Practitioner Staff involved in completing initial and comprehensive assessments, using the Framework Document, require a substantial knowledge base with regard to the three inter related domains:
6.10 Each of the three domains has a number of critical dimensions as shown in Figure 4.
Figure 4: Assessment Framework
6.11 The interaction of the various dimensions requires careful exploration during assessment with the aim of understanding how they affect the child or children in the family. The resulting analysis informs planning and action to secure the best outcomes for the child.
6.12 In the course of the initial assessment social work staff will consider if the child is a "child in need" or if there is reasonable cause to suspect that the child "is suffering, or is likely, to suffer significant harm" (Article 66 of the Children Order). Following the initial assessment, social work staff will decide on the next course of action. This may be no further action, provision of services or a further assessment which may include an Article 66 inquiry. The family, the original referrer and other professionals and services involved are advised of the action that has been taken, consistent with respecting the confidentiality of the child and family concerned and without jeopardising further action in respect of child protection concerns.
6.13 A Multi-Professional Audit of Child Protection Activity, based on the minutes of 33 Initial and 31 Review Child Protection Case Conferences, was undertaken in 199810 It revealed that whilst social work reports prepared for and submitted to Conferences outlined relevant background information, details of social work involvement and concerns for the attention of the Conference, few reports demonstrated evidence of risk assessment or details of Child Protection Plans. It was, however, gratifying to note that the small number of reports which did address these areas reflected high quality standards of recording and knowledge of child development as well as coherent analysis of risk and protection factors in family dynamics.
Working Together - Information Sharing
7.1 In England and Wales during the 1980s and 1990s the repeated failures of professionals working together and communication problems were highlighted in many inquiries into child abuse. The Report entitled "Paul, Death through Neglect"11 published on behalf of Islington ACPC in 1995 identified as an area of concern the fact that important information about the history of the family went unrecognised or unreported.
7.2 Paragraph 8.5 of the Final Draft of Co-Operating to Safeguard Children, April 2002 states:
"Research and experience have shown repeatedly that keeping children safe from harm requires professionals and others to share information about:
Often, it is only when information from a number of sources has been shared that it becomes clear that a child is at risk".
7.3 Paragraph 8.7 advises that:
"Professionals can only work together to safeguard children if there is an exchange of relevant information between them."
Child Protection Process
7.4 The current system is structured in a manner designed to secure effective liaison between the parties, e.g. Social Worker, Health Visitor, General Practitioner and Police and indeed other Agencies in discharging responsibilities in relation to the many complex child protection cases that have to be considered. It is helpful to think of the child protection process in chronological terms taking into consideration the distinct purposes that the various meetings have and how they contribute to ensuring a child's protection12. An Information Leaflet outlining the procedures for professionals was produced by the ACPC in 1998.
7.5 Whenever there is reasonable cause to suspect that a child is suffering, or likely to suffer significant harm, the first meeting professionals may have is a strategy meeting, the purpose of which is to plan the investigation. In addition to Social Work Staff and Police Officers, other professionals who may have important information are invited to attend.
7.6 The next meeting which is likely to be held in the protection process, following an initial assessment, is the Initial Child Protection Case Conference which should take place within 15 working days of the child protection referral. The Initial Case Conference enables information to be shared and evaluated including the outcome of the Social Work, Police and Medical investigations undertaken. A decision is made on whether or not to place the child's name on the Child Protection Register.
7.7 The Multi-Professional Audit referred to in Section 6.13 established that the attendance patterns at Initial Case Conferences revealed the predominance of social work involvement and low levels of participation from other professionals involved in child protection apart from Health Visitors, Nurses and Education Services. This Audit also found that while there were high levels of parental participation, parents were only included in part of the Conference and not the entire meeting. There were very low rates of attendance by children and young people across both Trusts.
7.8 If the Initial Child Protection Case Conference decides that a child's name should be placed on the Child Protection Register, it is then required to appoint a Co-Ordinator who should be a Social Worker from the Trust concerned. It also nominates a Core Group and formulates an Inter-Agency Child Protection Plan. In general, a Core Group comprising those members of the Multi-Disciplinary Team who work directly with the child and family, meets on a regular basis, usually monthly or bi-monthly, to discuss progress and action in response to particular issues of concern. In the first three to six months of registration, the work of the Core Group is quite intensive because of the necessity to complete a Comprehensive Assessment which is presented by the social worker to the Assessment Review Case Conference held three months after the Initial Child Protection Conference. Sometimes there are delays in completing Comprehensive Assessments which have then to be submitted to a subsequent Review Case Conference. Reasons for the non-availability or delay in submitting a Comprehensive Assessment noted in the 1998 Multi-Professional Audit were that a period of time in excess of three months was required and difficulties were encountered in engaging parents.
7.9 The final type of meeting which takes place in the child protection process is the Review Case Conference which is convened at least every six months or earlier where any professional has cause for concern that the Child Protection Plan is not addressing the ongoing or changing risks to the child. As well as identifying significant and relevant changes in a family's situation since the previous Case Conference, it evaluates the Child Protection Plan, examines levels of risk and decides whether a child's name can be removed from the Register.
Evaluation of Risk
7.10 The Multi-Professional Audit (1998) recommended that Trusts should review the way in which risk is evaluated. It noted that the low rate of completion of comprehensive assessments for Reviews and the low rate of formalised multi-professional contributions (reports) at Initial Case Conferences resulted in a professional reliance on Social Work assessments largely to the exclusion of other professional contributions. A re-audit undertaken in 1999/2000 indicated that risk assessments continue to pose a challenge for both Trusts.13 The re-audit identified exemplars of good practice which included:
7.11 The area of Risk Assessment and Risk Management will be addressed by the Board and both Trusts in the forthcoming review of the Assessment Framework Document described in Section 6.8 - 6.11. There is also a Regional Working Group co-ordinated by the Chairman of the Southern Area Child Protection Committee developing a Framework for the Management of Risk in Child Protection.
7.12 Since The Children N.I Order was introduced on 4 November 1996, the judgement of whether a child is suffering or is likely to suffer significant harm has become central to a wide range of decisions in the field of child protection, yet nowhere in the Order or "Co-operating to Safeguard Children" is the whole phrase defined, nor is comprehensive guidance given about how it should be applied in practice. Recognising the difficulties which this posed for staff working with children and families throughout the administrative area of the WHSSB, the WACPC has requested its Policy and Procedures Sub-Committee to devise guidance on significant harm and thresholds for action.
General Practitioner Attendance at Case Conferences
7.13 It has to be conceded that there are difficulties in securing General Practitioner attendance at Case Conferences. There is much evidence that GPs nationally are poor attenders at Child Protection Case Conferences mainly because of other tasks of higher priority. Timing, inconvenient location and lengthy Conferences also contribute to non-attendance. The Study by Dr Janet C Polnay published in Child Abuse Review, Volume 9 (2000)14 confirmed that for many GPs, Case Conference attendance is just not a priority and attendance will not improve by overcoming the practical issues. Suggestions that could increase attendance and improve communication between GP and Social Worker include better telephone contact, clear guidance as to the information required in reports from GPs and child protection training being incorporated in both under graduate and post graduate medical education. It should also be noted that whilst the formal structure provides the communication links, so often the informal contacts play an important role as well.
7.14 "Effective Multi-Disciplinary Practice in Child Protection - The Challenge of Delivering an Effective Service"
The purpose of this Research Project is threefold:
7.15 The WACPC believes that it is important to hear the views of professionals who are involved in the delivery of child protection services to the community particularly what works well in the process and what areas need to be improved on. To facilitate the research, the Trust Child Protection Panels organised for the Researchers to meet uni-professionals focus groups and to observe Core Group Meetings. The initial findings of the project can be grouped under three specific headings: systemic issues, management of risk and other professional views of Social Workers.
7.16 These issues include the perception that the Child Protection Process is crisis led. In addition, issues of how to deal with the concept of neglect have emerged as have the difficulties experienced by professionals attending Core Groups and Case Conferences. Whilst Core Groups have generally been considered helpful, questions have been raised, for example in relation to their purpose, the involvement of families, the professional level at which chairing should be held as well as administrative issues such as responsibility for minute taking and length of minutes.
Management of Risk
7.17 The issues emerging in this area relate to the definition of risk, the need for clarification on "thresholds" for intervention, the definition of "significant harm" and the balance to be achieved in the refocusing debate between prevention and protection.
Perception of Social Workers by "Other Professionals"
7.18 Other professionals hold the view that Social Workers are very committed to their work, that they strive for high standards and that they are child and family focused. However, other comments refer to Social Workers being newly qualified, vulnerable and subject to high levels of staff turnover and sickness rates which lead to an inconsistency of service for clients.
7.19 Although the Researchers will develop these aspects more fully in their final Report, they have identified some themes emerging as central to the research. These include:
7.20 The researchers have indicated that staff commented favourably on the training they had received especially when multi-disciplinary audiences attended training events.
It is expected that the Project will be completed by the autumn of 2002.
8.0 Linkages - with Children, Parents/Carers and local Communities and their access to information
Communicating with Children and Families
8.1 Encouraging children to share their difficulties, wishes and feelings is a skilled social work task. It is important that they are afforded an opportunity to express their views in an age appropriate manner and not necessarily in a formal interview environment. Social Work Staff use, for example, drawing, play, materials and stories to help children communicate their views and have suggested that a computer programme similar to Viewpoint for Looked After Children should be available to children within the Child Protection Process.
8.2 If there are concerns that a child has suffered or is likely to suffer significant harm, clear assessments of the parents and the family as a whole are vitally important, for example, parenting assessments, family history, how parents see the needs of the child/ren and growth charts. Failure on the part of the family to keep health appointments and their reluctance to facilitate Social Workers visiting the home are matters of concern which have to be addressed.
Working in Partnership with Children and Parents
8.3 The Board, ACPC, Trusts and Child Protection Panels strongly support the principle of working in partnership with children and parents/carers. It is, however, important to be clear about what partnership means in the context of child protection.
8.4 The Board and the Trusts recognise that partnership does not mean always agreeing with parents or always seeing a way forward which is acceptable to them. The focus has to be on the child and what is best for him/her. For the Agencies involved in child protection in the Western area, partnership with families means:
Parental and Child Participation
8.5 Many Social Workers feel that parents are given priority over children in the matter of attendance at Child Protection Case Conferences. Furthermore, they feel that they do not have sufficient time available to prepare both parents and children for the Case Conference. Whilst supportive of attendance by both children and parents, Social Workers and their Managers believe that there should be a clear proviso that attendance is so managed that it does not prejudice the Trust's ability to make the best decision on safeguarding the children.
8.6 The Community Education Sub Group of the Western Area Child Protection Committee is submitting a funding application to the Children's Fund for the development of a diary/address book written "by parents for parents" containing family support and other advice and information.
8.7 On 6 May 1999, the Young Independent's Group (Leaving and Aftercare Group) presented the "Not Going It Alone" Conference in Derry. This was an excellent example of client participation.
Young People's Reference Group
8.8 One of the recommendations of the second Multi-Professional Audit of Child Protection Activity undertaken in the Western area in 1999/2000 was that consideration should be given to examining ways in which children could be empowered to become more meaningfully involved in the Child Protection Process. Under Children's Service Planning the WACPC intends to establish a Young People's Reference Group in order to become more attuned to the views of young people who have experienced the Child Protection System.
Access to Information
8.9 A Leaflet entitled, "Children, Who Cares?" provided by the WACPC in 1996, the message of which was 'Child Protection is Everyone's Business', was widely circulated throughout the Board's area. This document was designed not alone to attract the attention of parents and children but also other professionals and, of course, the general public. A laminate card which contains relevant contact numbers has also been widely distributed.
8.10 In 1999 two booklets, "A Guide for Families" and "A Guide for Children and Young People" were produced. Whilst considered helpful at the time, feedback from Social Work Staff indicates that the documents need to be revised.
"Keeping Our Children Safe"
8.11 During the year ended 31 March 2002 the Community Education Sub-Committee of the WACPC produced a Strategy Document entitled, "Keeping Our Children Safe". It proposed a number of projects in relation to raising awareness within the wider community of the need to safeguard children. Included within the Strategy are the following elements:
8.12 Consideration has been given to the resources required to action the above aspects of the Strategy and it is anticipated that these projects will be taken forward in the current year.
9.0 Workforce Issues
9.1 The WHSSB's Position Statement (December 2001) refers to research published by the DOH in Dublin 2000, undertaken by McKeown, which examined the key influences that determined success in relation to therapeutic outcomes across a broad range of health and social care interventions. He found that the two most significant influences which determined success were: firstly, the individual himself and the network of social support he had; and secondly, the quality of the relationship between the worker and the individual. This is of particular significance for social work and the positive outcomes which social work interventions have for families. Social Workers in Family & Child Care are committed to high standards and frequently experience situations when the availability of resources precludes them from delivering the package of care which they have assessed to be in the best interests of the child and his/her family. There are particular stresses in Family & Child Care relating to the magnitude of the decisions which have to be reached and the feeling of personal responsibility for carrying those decisions through, including answering to the Court. Therefore, while Social Workers may prefer to work in Family & Child Care, they choose to seek posts in other Programmes of Care and in other Agencies including the Western Education and Library Board, Probation Board Northern Ireland and in the Republic of Ireland because the terms, conditions and work demands are more favourable.
The Training Organisation for PSS in Northern Ireland - Workforce Supply
9.2 Findings from a Workforce Planning for Social Work Project undertaken on a Regional basis by The Training Organisation for Personal Social Services in Northern Ireland [TOPSS(NI)] revealed information in relation to Workforce Supply which included:
75.2% (1,459) were employed in Health & Social Services Community Trusts
10.3% (200) in the Voluntary Sector
9.1% (176) in the Criminal Justice (Statutory) Sector
3.4% (65) in Education Welfare
2.0% (39) by the Guardian Ad Litem Agency
8% (117) in Health & Social Services Community Trusts
6.6% (12) in the Voluntary Sector
1.7% (3) in the Criminal Justice (Statutory) Sector
9.3 Social Workers and their Managers in both Trusts report that threats, conflict and assaults are part of their day-to-day work. In the year 2000/01 the sickness rate in fieldwork services in Foyle Trust peaked at one point at 10%, at present it is 7.5%. The Occupational Health Unit in Foyle Trust has commented on the stresses and pressures that are experienced by fieldwork staff.
9.4 Both Trusts have a policy of providing cover for staff on sick leave. Despite strenuous efforts, however, it is not always possible to recruit staff because of a shortage of suitably qualified Social Workers as reported earlier in this Section.
Recruitment and Retention Issues
9.5 The high level of staff turnover and the impact of unfilled posts places additional demands on Senior Social Workers and Assistant Principal Social Workers. The difficulty in recruiting suitably qualified staff has necessitated Foyle Trust securing the services of Agency staff for periods of 3-6 months. Whilst the selection procedure is the same as for all Social Work posts in Family & Child Care, the situation has a very real impact on the continuity of delivery of services to children and families.
9.6 The Board and the Trusts will be re-examining working conditions and staffing levels so as to redress any factor which would militate against long stay development.
Training and Supervision
9.7 Training and supervision of staff remains high on the Board's agenda as is clearly outlined in the Social Services Training Team's Training Programme details of which can be found on a dedicated website : www.westcare.org.uk. The following relevant themes were the subject of courses, seminars and development days organised by the Social Services Training Team last year:
9.8 There were 3682 units of training delivered under the Post-Children Order training budget last year (1 unit of training = 3 hours of training for one person or its equivalent). This training was provided free at the point of delivery.
9.9 The Western Health and Social Services Board has one Assistant Principal Social Worker involved in multi-disciplinary child protection training and post-implementation Children Order training. This training officer is also the Chairperson of the Regional Trainer's Group which seeks to co-ordinate training activity across Northern Ireland. This has achieved a number of successful outcomes not least of which has been greatly increased level of co-operation between child protection training officers.
9.10 On occasions there are problems in relation to staff booking on courses and then having to cancel at short notice. This is not a reflection of the commitment of either staff or managers to child protection training, but rather highlights the demands of child protection work.
9.11 Social Services Training Team works closely with the Social Work department at the University of Ulster (Magee Campus). This includes delivering child protection training to under-graduate and post-graduate students undertaking the Diploma in Social Work. It is hoped that this input will increase awareness among social work students of the need that Family and Childcare services have for new members of staff.
9.12 Child protection is everyone's business and the Social Services Training Team has also been actively involved in training Trust staff to work more closely with community groups, as well as providing child protection training directly to the voluntary and community sector. Both activities are co-ordinated under the auspices of the WACPC Community Education Sub Group that is chaired by the Assistant Principal Social Worker (Training).
9.13 The Supervision Policy is directed mainly at practitioners rather than middle and senior managers although it is recognised that they, too, need appropriate oversight, support and development. However, having highlighted the extreme pressure that Social Work Staff are currently experiencing, arrangements for supervision are patchy. In a number of Teams, formal staff supervision takes place infrequently with some Social Work Staff acknowledging that they have supervision every 3-4 months. Senior Social Workers/Team Leaders are also under considerable pressure covering cases due to staff sick leave and vacancies and, therefore, cannot find the time for supervision. Where possible, Team Leaders offer a consultation service to their staff.
Demands and Prioritisation
9.14 The ACPC and the Child Protection Panels in Foyle and Sperrin Lakeland Trusts accord high priority to effective child protection practice despite the considerable pressures and challenges within the Family & Child Care Programme. Each child whose name is on the Child Protection Register has a Case Co-Ordinator (Social Worker), an identified Core Group and a Child Protection Plan, the purpose of which is to ensure the child's safety and well-being.
9.15 One of the key issues for Social Workers in this area of work is trying to identify the level of significant harm likely to be experienced by the child. Clearly this has an implication for risk assessment and risk management as referred to in Section 7.10. The volume of work currently undertaken means that many Social Workers have to balance the roles of surveillance and monitoring with offering family support and therapeutic input. Indeed it is a matter of concern for both Social Work Staff and Managers that pressure of work and the sheer weight of many responsibilities to be attended to often precludes them from undertaking therapeutic work required by children and families in the Child Protection Process.
9.16 Foyle Trust has, for some time, operated a procedure whereby staff are not expected to work in excess of their contractual 37 hour working week. A protocol exists to cover working extra hours in emergencies. The Northern Ireland Public Service Alliance (NIPSA) has recently requested each Community Health & Social Services Trust to agree and implement this procedure and protocol.
9.17 There were 248 unallocated child care cases in Foyle Trust and 89 in Sperrin Lakeland Trust at the end of the financial year. Senior Social Workers/Team Leaders in each Trust endeavour to manage waiting lists.
9.18 Clearly it is not possible to meet all the needs of children and families in the Western area and as expectations rise, demand will continue to outstrip resources. It is therefore necessary to develop a model that will target resources to those in greatest need. The Board and Foyle Trust, having taking cognisance of the findings of the Report of the Review of the Discharge of Statutory Functions in the Family and Child Care Programme, established a Project in order to examine Case Prioritisation and Case Load Management Models. Consequently, a "Thresholds for Intervention" Model is in the process of being devised with a view to providing some consistency of approach. A Caseload Management System is also in the process of being devised. Both Models should make a significant contribution to ensuring quality, focused work within manageable caseloads thereby making the Family & Child Care Programme a more attractive environment in which to work and retaining the right calibre of staff in sufficient numbers. The allocation of monies from the WHSSB for the appointment of a Senior Social Work Practitioner in each Team is also recognition of the demands and complexity of some of the tasks that have to be undertaken.
Funding of Family & Child Care Services since the introduction of The Children (NI) Order 1995
10.1 Attention was drawn to the extent to which provision for Statutory Child Care Services in Northern Ireland had been under funded since the introduction of the Children Order in a paper developed by the four Boards (December 200015). It estimated that while approximately £17 million additional funding had been allocated by the Department this still fell £17 million short of the amount initially identified by Boards as necessary. The area of Child Protection was not recognised as an area in which significant additional costs would be incurred as a result of the Children Order. The original submission by the four Boards under estimated the true costs of implementation because the exercises were undertaken without a full understanding of the practical implications of the Order.
10.2 The real cost implications have become apparent since implementation and have been driven by changes in policies, procedures and practices across a wide range of disciplines and organisations including social work, the Guardian Ad Litem Agency and the Courts. As indicated in the WHSSB's Position Statement the limitation in funding has been further exacerbated by a number of additional policy developments and initiatives which are welcomed from a professional development perspective but which require additional funding. These include:
10.3 Whilst the injection of new monies over the past seven years has been helpful and has enabled significant progress to be made in terms of the development of services, it does not meet the requirements of implementing the Children Order. The lack of investment has had an impact on Child Protection. There are occasions when it is difficult to identify resources to meet all of the components of the Child Protection Plan; furthermore, it has been suggested by Trust social work managers that if sufficient foster care resources were available, younger children in some instances would be Looked After rather than being with their families and potentially at greater risk
10.4 The DHSSPS Document "Key Indicators of Personal Social Services in Northern Ireland 2001/02" reports that a total of £73 million was spent on Family & Child Care Services in Northern Ireland in 1999/00.
10.5 In terms of expenditure England has correspondingly spent a higher percentage of PSS expenditure on Family & Child Care than in Northern Ireland in the years 95/96 to 97/98 as reflected in the table below.
Table 3 - Per capita expenditure on provision for Children and Families £.
Increases in Demand
Child Protection Registration
10.6 The four Board Paper reported that the Children Order had generated a number of increases in demand in respect of Child Protection work. Sperrin Lakeland Trust, in the year 2000, tracked staff time and estimated that a 10 month period of child protection registration required a commitment of approximately 280 hours from Trust staff in the Family & Child Care Programme. This involved a Social Worker for 20 working days on one case during that 10 month period. Inputs from other professionals were not included. Child Care Managers estimate that the time needed to carry out the child protection process has, at least, doubled since 1995 because of additional procedural guidance and emphasis on parental and child participation.
10.7 Where it has been necessary to instigate legal action in order to protect children, the time needed by social workers for the court process has increased significantly. The points below extracted for the WHSSB's Position Statement identify some of the key issues:-
10.8 Two questionnaires were developed to consider Court issues, one was issued by the Children Order Advisory Delay Sub-Committee to examine delays in hearings. The second, Monitoring of Court Work Costs and Levels of Activity was issued by the Assistant Directors Group Family & Child Care Services.
10.9 The case example below provided by Foyle Trust and taken from the "Four Board Paper" is not regarded as untypical.
Case Example - Social Work Diary - Court Process
Three children, aged between 2 months - 3 years, required emergency protection and the formal intervention of the legal process
10.10 This example records the legal process only, which is considerably more protracted than would have been necessary in similar circumstances prior to the introduction of the Children Order. It does not reflect the time needed for work with the children (including the Looked After Children procedures), negotiation with the parents, consultation with other professionals, consultation with legal advisors, consultation with the Guardian ad Litem, preparation of Court reports and Care Plans - all of which need to be carried out in advance of each Court Hearing.
Designated Senior Nurse with responsibility for Child Protection in Sperrin Lakeland Trust
10.11 Scarce finance has, so far, precluded the appointment of a designated senior nurse with responsibility for child protection in Sperrin Lakeland Trust.
11. Case Management Reviews
Number of Case Management Reviews in Western Board Area
11.1 Since 1991 there have been two Case Management Reviews in the WHSSB area - one in respect of a baby who sustained a serious injury as a result of having been abused and one in respect of a young person who died following a tragic incident. A third such Review is in the process of being completed under the auspices of the Western Area Child Protection Committee.
11.2 In both of the former Case Management Reviews the Review Report, whilst shared with the WHSSB and the Department, was not distributed to other Trusts in the interest of confidentiality. There is no doubt that the wider distribution of Case Management Review Reports to other Trusts and relevant agencies would create useful learning opportunities and definitive action.
Case Management Reports
11.3 A Seminar held on 23 March 2000 for WACPC and Trust Child Protection Panel Members addressed issues of accountability and disclosure with regard to those who might have an interest in Case Management Review Reports for example the child and his/her family, staff, the general public and the media. These are difficult interests to balance taking into consideration the need to maintain confidentially in respect of personal information, the need to secure full participation from the different agencies and perhaps other constraints such as when criminal proceedings are pending. The Seminar's Facilitator, Mr Richard White recommended an Executive Summary, the content of which should be suitably anonymised in order to protect the confidentiality of the family and others.
11.4 It is noted that the Consultation Draft on the proposed ACPC Bill advises that the DHSSPS should be required to establish and publicise arrangements for the consideration of Case Management Review Reports, the wider dissemination of key findings and publication of overview reports at appropriate intervals. These proposals together with the Department's initiative in relation to the creation of a high level Child Protection Review Group, are positive developments and are to be welcomed.
11.5 NSPCCs Out of Sight Report16 has drawn attention to the increasing number of sudden Infant Deaths and recommended the establishment of Child Death Review Teams.
12. General Comments
12.1 The Board and both Trusts, in pursuance of their child protection responsibilities are committed to providing the best possible service for children in need of protection. It is undoubtedly a complex and sensitive area of work. Whilst it is recognised that the Child Protection Policy & Procedures are, in the main, well focused, regrettably some of the measures are not always put into practice chiefly because demands outstrip both staffing and service provision. It has already been indicated in this Submission that child protection referrals demand Social Workers attention and a significant input in time. It has also been demonstrated that the commitment that Social Workers have to make to child protection work often results in other important work being deferred.
Recommendations for Improving the Service
12.2 It would be helpful if the following areas could be considered:
(i) An integrated, co-ordinated and strategic approach to Family Support along the lines outlined in the Hardiker model to be adopted at both regional and local levels. Recent developments such as Children's Services Planning, Investing for Health, the formation of Child Care Partnerships and the emergence of improved databases about need, have created conditions which now make it a feasible project. (Section 2.7-2.11)
(ii) A revision of the present computer system is fundamental to good management and record keeping. Any proposed development in this sphere should provide for a database that will lend itself readily to the relevant statistical data about activity and need, so that standards can be compared and outcomes measured (Section 2.13).
(iii) ACPCs being placed on a statutory basis in terms of strengthening the infrastructure around the Child Protection System. (Section 3.10-3.14)
(iv) Ways of encouraging and strengthening General Practitioner participation. (Section 7.13)
(v) Efforts to be made to establish liaison with the media at both a local and regional level. In view of the adverse criticism that the service has experienced in recent years, a more pro-active approach should be employed. This might reasonably be secured by the establishment of a Group representing the Department's Child Protection Review Group and ACPCs. (Sections 8.11 & 11.3)
(vi) A reappraisal by the Department and the Board of the current adequacy of funding for Family & Child Care Services with particular reference to the Noble Index levels of deprivation. (Section 10.1-10.5)
(vii) Distribution throughout the Region of recommendations and learning points from Case Management Reviews with a view to applying the lessons in a sustained and consistent manner. (Section 11.1 & 11.2)
Northern Ireland Measures of Deprivation:
Income: Measures extent of income deprivation, count of families in receipt of means tested benefits.
Employment: This measures enforced exclusion from work, counts those unable to work through unemployment, sickness or disability.
Local Extent: Proportion of an LGD's population living in the wards which rank within the most deprived 10% of wards in N.I).
Local Concentration: This measure defines "hot spots" by reference to the percentage of the LGD's population.
Average of Ward Ranks: Population Weighted Average of the combined multiple deprivation measure ranks for the wards in a LGD.
Average of Ward Scores: Population Weighted Average of the combined multiple deprivation measure scores for the wards in a LGD.
NB RANK 1 = MOST DEPRIVED AND RANK 26 = LEAST DEPRIVED (I.E THE LOWER THE RANK HE MORE DEPRIVED THE AREA)
Fifty Highest Ranking Child Poverty Measure Wards Within WHSSB
Organisational Structure Outlining Child Protection Services in the WHSSB
Foyle Health & Social Services Trust
Sperrin Lakeland Health & Social Services Trust
1. WHSSB Position Statement - Family & Child Care Services, Dec 2001
2. Children's Services Plan, Western Area Children & Young People's Committee 2002 - 2005
3. Hardiker (1992) The Social Context of Family Life
4. Western Area Child Protection Committee Annual Report, Year ended 31 March 2002
5. WACPC Child Protection Policy & Procedures, Nov 1998
6. Draft Co-Operating to Safeguard Children
7. Report of the Review of the Discharge of Statutory Child Care Functions by Foyle H&SST, June 2001
8. Child Protection Messages for Research, 1995 HMSO Publication
9. Assessment Framework, May 2000 (WACPC, Foyle CPP and Sperrin Lakeland CPP)
10. Multi Professional Audit of Child Protection Activity: WACPC 1998
11. "Paul, Death through Neglect" Inquiry report published on behalf of Islington ACPC 1995
12. Good Practice in Child Protection - A Manual for Professionals - Edited by Hilary Owen & Jacki Pritchard
13. WACPC Multi Professional Audit, August 2000
14. General Practitioners and Child Protection Case Conference Participation: Child Abuse Review, Volume 9: 108 - 123 (2000)
15. Family & Child Care Services in Northern Ireland in 2000 - A Four Board perspective
16. Out of Sight, NSPCC Report on Child Deaths from Abuse, 1973 - 2000
(i) The Western Health & Social Services Board and Foyle and Sperrin Lakeland Health and Social Services Trusts are grateful for the opportunity that has now been afforded them to reflect on child protection services as they are currently administered within their areas.
The document that follows begins by outlining the context in which the service is provided including the relevant child population and the levels of deprivation within the WHSSB area. It takes into cognisance targeting social need, Equality Legislation and the Human Rights Act 1998 and the Model for Assessing Need and Supply that has been adopted under Children's Services Planning within the Western area.
(ii) In order to give a measure of child protection activity, information concerning child care referrals, child protection referrals, investigations, child protection case conferences and child protection registration is illustrated in Table 2.
(iii) Section 3 considers the structural arrangements and it is clearly evident (see Appendix 3a) that the Board and the Trusts have espoused, not alone, the multi-agency approach but place a high value on partnership involvement in delivering child protection services. The Western Area Child Protection Committee, which is a multi-agency child protection forum has a pivotal role in developing policy, procedures and services for children in need of protection. The Board is aware of the significance of this role and, in this context, fully supports ACPCs being placed on a statutory basis.
(iv) The Western Area Child Protection Committee's Child Protection Policy and Procedures, based on the Department's guidance contained within Co-operating to Protect Children, are in place to ensure the safety and wellbeing of children. They are an essential part of the management of the child protection process.
(v) The Children (N.I.) Order 1995 provides the legal framework to protect children from harm. If at any time during the referral or assessment process, it is apparent that a child may be at risk of suffering significant harm that cannot be prevented by voluntary measures with the co-operation of the child's parents or carers, consideration must be given to the use of legal measures to secure the child's safety.
(vi) The Board and the Trusts wish to support children in their families and communities because this is where their roots are, the place to which the majority will return and the base from which they can most satisfactorily grow into adult life. Families are supported in conjunction with universal services provided by colleagues from health and education as well as community group involvement. Efforts are now being made to ensure that services provided by the Trusts are focused on the assessed needs of children and their families with a view to achieving positive outcomes.
(vii) Whilst social workers recognise the need for efficient recording and its value in relation to the work undertaken as well as in any subsequent investigation, unfortunately pressure of work and limited administrative support sometimes precludes this action from being implemented.
(viii) The exercise of professional judgement is crucial to ensuring that the best possible arrangements are made for children. The judgement that a child is or is not at continuing risk of significant harm must be based on an analysis of the evidence obtained and the assessment carried out.
(ix) It is vital that all available from each agency is shared and evaluated and that any gaps identified are resolved. The Board and the Trusts recognise the value of close inter-agency communication in relation to ensuring good practice and the observance of Policy and Procedures throughout the child protection process. Risk assessment with regard to significant harm or the likelihood of it is an area of work that is being further addressed in a number of fora.
(x) The benefit of working with children, families and local communities is fully recognised the Board and Trusts strongly support the principle of working in partnership with children and families but there must be a clear understanding of what partnership means in the context of child protection.
(xi) The high level of staff turnover and the impact of unfilled posts obviously places additional demands on Managers. Further consideration is being given to working conditions and staffing levels in order to address factors which would militate against any deterioration in the service. The initiative taken by the Board and Foyle Trust in responding to the Report of the Review of Discharge of Statutory Functions in Family and Child Care is a very welcome one.
(xii) Effective child protection depends on the knowledge and judgement of all staff working with children. It is, therefore important, that staff with different levels of responsibility have the opportunity to avail of relevant training for example in relation to the legislative framework, child protection policy and procedures and assessment. An Assistant Principal Social Worker in the Social Services Training Team is involved in multi-disciplinary child protection training and post Children Order implementation training.
(xiii) Taking into consideration the complexity of the work associated with child protection some of which is summarised in points (viii) & (xi) above, it is regrettable that Managers, mainly because of pressure of work, have not always been able to provide supervision other than in a consultative capacity.
(xiv) This report highlights the increasing demands on staff. Following the introduction of the Children (NI) Order 1995 there was an expectation that services for children and families would receive dedicated and sufficient resources to enable a wide range of services to be developed. Such provisions were envisaged as assisting and more effectively meeting the requirements of children in need including those in need of protection. Clearly the investment made available, although welcomed, has resulted in an inability to meet the full requirements of the Children Order. Investment, or lack of it, in one part of the system clearly affects another.
(xv) In those circumstances where Case Management Reviews are undertaken it would be helpful if executive summaries could be made available in order to create useful learning opportunities and afford definitive action.
(xvi) In conclusion the compilation of this report has been a most useful exercise in concentrating our minds not only on certain shortcomings but also the many positive features of our child protection service.
written submission by:
Northern Ireland Women's Aid welcomes the invitation to submit evidence to the committee for Health, Social Services & Public Safety of the Northern Ireland Assembly in undertaking an inquiry into the current state of child protection services in Northern Ireland. We believe this will be an important and vital step in recognising the rights and needs of children and young people to live in a society free from harm.
Northern Ireland Women's Aid is the leading agency tackling domestic violence in Northern Ireland. It provides temporary accommodation and support to women and children who experience domestic violence. There is a 24-hour helpline in operation 365 days per year dealing with approximately 15,000 calls. Children represent the majority of occupants in our refuges at any particular time, each year Northern Ireland Women's Aid would accommodate at least 1500 children and 1000 women. Women's Aid have always recognised the effects domestic violence can have on children and young people and have endeavoured to establish and build upon services which respond to need in protective and creative ways.
A wide range of research has shown that the majority of children from families where domestic violence is present will witness abuse. Indeed, Hester at al (2000) note that witnessing domestic violence to their mothers can have a detrimental impact on children, tantamount of emotional abuse or psychological mistreatment.
Various research studies have further highlighted links between child protection issues and domestic violence and argued that where one is present there is co-existence of the other. Scottish Women's Aid (2002 ) note in a study of 111 cases of child abuse dealt with by the NSPCC, in 69% of the cases where the father was the perpetrator, he was also violent towards the mother (Hester & Parson 1998).
Monica McWilliams and Joan McKernan's research into domestic violence in Northern Ireland in 'Bringing it Into the Open' (1993) further highlighted the above, when they note, 'this research has found that homes where men are violent to their wives often become dangerous places for children as well.' (1993: 37)
Northern Ireland Women's Aid have long recognised that supporting and protecting women is most often the best form of child protection. Research has continuously highlighted the need to provide support and intervention for all survivors of domestic violence, both adults and children. Children may experience all areas of abuse directly, beginning within the womb, to indirectly where children can be used as weapons to further the abuse of the mother. They can be used as a pawn to collude with the abuse of the mother verbally or physically. This burden placed on children can be great to bear. The experiences of children are often overlooked. Domestic violence is a breach of children's human rights and can, in the absence of appropriate support, have a huge impact on the lives of children and young people.
We would subsequently like to take this opportunity to highlight some of the issues we experience on an ongoing basis, in relation to the children we work with both in refuge and aftercare projects, in accordance with the following key areas in relation to the Child Protection inquiry.
Providing services for children who have been affected by domestic violence is the responsibility of all agencies. Northern Ireland Women's Aid Federation endeavour to ensure that a high quality, multi-agency service is made available for children and their families. However, the effectiveness of services providing child protection at times needs to be questioned. The key issues highlighted after consultation with groups throughout Northern Ireland include:-
No-one agency can totally support a family, particularly in cases of domestic violence where the protection of survivors, the prevention of further abuse and the prosecution of perpetrators will depend on effective inter-agency work. According to Saunders and Humphreys (2002: 44) this is as important for the children as it is for the mothers. It is essential that professionals working with these children have a good understanding of the dynamics of domestic violence and its likely impact on the behaviour and health of both the child and the mother.
Northern Ireland Women's Aid Federation believe with appropriate protection and support many mothers who are being abused by their male partners can be enabled to protect their children. Hester et al (2000:124) note that 'as the Social Service Inspectorate report on domestic violence and social care points out, 'those who are concerned about child abuse would do well to look to towards advocacy and protection of battered mothers as the best means to prevent current child abuse as well as child abuse in the future (Stark and Hitcroft 1985: 147).
Practice in relation to domestic violence varies between childcare professionals. There are examples of positive as well as negative practice. It has been the experience of Northern Ireland Women's Aid that when good training provision and open communication between agencies is developed this leads to good practice and a better outcome for families living with domestic violence. Families may then move on from social services support completely.
CONCLUSIONS AND RECOMMENDATIONS
Support is a vital factor in influencing how children survive and cope with abuse. Northern Ireland Women's Aid Federation welcomes and supports the inquiry by the Committee for Health, Social Services and Public Safety 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'.
In conclusion we would urge the Committee to recognise that there is a definite need for all agencies involved in the area of child protection to provide effective support interventions for children and their mothers who experience domestic violence. Such agencies need to make themselves aware of the complexities of domestic abuse by undertaking specialised Women's Aid training. Women's Aid has long experience of training in this area for voluntary and statutory bodies including PSNI. The policies and procedures must be developed and put in place to ensure that children and their mothers are receiving the support and information they need.
The existing knowledge we have within Northern Ireland into this area needs to be properly recorded and developed through effective research, which will adequately take into account the experiences and perspectives of children and young people. Children and young people need to be consulted.
All children and young people who have experienced domestic violence, whether living in refuge, having moved on from refuge or who have never lived in a refuge, have a right to quality support. It is largely through listening to children, young people and women that we can begin to understand the effects of domestic abuse on children. It is hoped that the issues highlighted in this paper will provide awareness of issues specific to children and young people who experience domestic violence . These need to be addressed by the inquiry, recognising the rights and needs of children to live in a society free from harm.
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