8 August 2002

I write in reply to your letter of 20 June 2002 in which you invite me to submit evidence to the Committee for Health, Social Services and Public Safety of the Northern Ireland Assembly.

I welcome the decision of the Committee to undertake an Inquiry into the current state of child protection services in Northern Ireland. The safety and welfare of children is a matter of great concern to the Catholic Church in Ireland. In 1995 the Irish Catholic Bishops' Advisory Committee on Child Sexual Abuse by Priests and Religious published a report - Child Sexual Abuse: Framework for a Church Response. This Report was prepared at the request of the Irish Catholic Bishops' Conference as a consequence of the fact that incidents of child sexual abuse by members of the clergy had been established. The Report sets out a framework for the way in which the Church should respond if an allegation of child sexual abuse is made. The Report requires that each diocese and each religious congregation should adopt a protocol for responding effectively in the case of alleged child sexual abuse by priests or religious.

I understand that the Catholic Council for Maintained Schools (CCMS) is in the process of submitting evidence to the Committee for Health, Social Services and Public Safety Committee of the Northern Ireland Assembly on this matter.

I believe that this evidence of the CCMS will deal with the key areas which you outlined in your letter and I am confident that it will reflect the views of the Catholic Church in these matters. I trust that this submission will be sufficient to cover the issues that need to be addressed but if you feel that there is some area that still needs to be addressed by the Catholic Church, please do not hesitate to contact me again.

With every good wish.

SEÁN BRADY
Archbishop of Armagh

29 August 2002

I refer to your correspondence dated 20 June 2002 in which you invite the Council to submit evidence on the above matter. The Council considered the issue at its meeting on 28 August 2002 and resolved to respond to the consultation exercise by making the following comments in relation to identified key areas:-

*Communication - It is important to liaise with the Probation Service as that agency is responsible for Schedule 1 offenders. (A number of Schedule 1 offenders on the local Register, having failed to receive regular visits from Probation Officers, have moved house and their whereabouts is currently unknown).

*Workforce Issues and Resources - There is a significant shortage of social workers in Northern Ireland. Social workers are expected to visit each child on their register at least once a month, together with fulfilling other duties. There are simply inadequate resources available to ensure that the regularity of these visits is maintained. There is a consequent need for young people to be encouraged to join the profession and for relevant training to be provided.

It is hoped that the Committee will take the Council's comments into account.

AMANDA MARTIN
Committee Administrator

The following difficulties have been identified for statutory agencies in managing alleged/suspected offenders.

• No means of knowing where they turn up. No tracking system in existence.
• Can only be detected by good luck in many instances.
• Limited ability to seek/obtain co-operation from such persons when they are detected.
• Conflict between child protection and protecting the rights of persons who have not been convicted of any offence.
• Lack of regulation and guidance to enable the protection of children to have paramountcy.
• Solicitors for suspected/alleged offenders sometimes do no seem to take any account whatsoever of possible child protection concerns.
• Gap in process exists between the point when suspect/alleged offenders refuse to co-operate with child protection agencies and the threshold at which it is possible to take legal action to protect children.

The Children (NI) Order 1995 and its associated regulations places a large number of statutory duties on health and social services Boards and Trusts. The needs of children can only be met, if viewed holistically and as changing over time. Consequently, delivering effective Children Services must be seen as the responsibility of a wide number of agencies and professions, which include Social Services, Education, Health and Police amongst others.

The work of a Social Services Agency needs to be described in the context of a continuum of services, which include -

• Family Support
• Early Years Provision
• Child Protection
• Looked After Children
• Foster Care
• Residential Care
• Secure Accommodation
• Adoption Services
• Services to the Courts
• Leaving and After Care

All elements of the service impact upon each other. A service, which does not offer adequate family support invariably, means that the focus of work is more about crisis management than prevention. The probable consequence of this, is more children on the Child Protection Register and more children in the Looked After system. A lack of family support or indeed the non availability, of Foster or Residential care alternatives, means that children are maintained at home "at risk" in less than optimum circumstances, where the risks may not be fully addressed.

Social Work staff will, as part of their daily workload, have responsibilities, which straddle most of these areas of work; Child Protection being but one aspect of their ongoing responsibilities.

Northern Ireland has a population of in excess of 460,000 children and young people comprising approximately 27% of the population as compared with an UK figure of 22%. There is ample evidence of the economic and social disadvantage which many children experience -

• In Northern Ireland 24% of children are dependents of claimants of either job seekers allowance or income support. The figure in England is 15.3%.
• It is reported by Relate (NI) that there are approximately 5,000 divorces or legal separations each year, an increase of 45% over the figure ten years ago. Now 1 in 4 marriages will end in divorce.
• The number of lone parent families continues to rise, with estimates showing during 1990s, this figure rose from 19% of all families to more than 26% at the end of the decade.
• It is estimated that 22% of males and 8% of females consume alcohol significantly above sensible levels. There is a clear correlation between alcohol misuse and violent crime, including domestic violence.

Drug misuse, teenage pregnancy, poor educational attainment and school suspension are unfortunately a regular occurrence for a rising number of the most disadvantaged children in our community. Add to this the ongoing civil strife, with its adverse effects on children and young people, and it can readily be seen, that there are thousands of children who would be viewed as being Children in Need.

Children in Need (as defined by the Children (NI) Order1995) are those children who require services because of their special needs and circumstances. There are three broad reasons for children being defined as Children in Need.

Their health and development (for example, mental health problems or substance misuse) their family circumstances (family stress, abuse by parents and living in social deprivation, for example) and their failure to live up to the expectations of the wider community (e.g. delinquency, truancy).

There are striking consistencies about the general issues that affect these children's lives. Key features are -

• Many come from homes headed by lone parents.
• Financial problems permeate the circumstances of families.
• There is inadequate social support and social networks to provide a cushion against adversity.
• Many parents and children suffer from ill health be this chronic, physical ill health or disability or mental health problems.
• There is a strong correlation with the misuse of drugs and alcohol.

It is in these circumstances, that many children and families seeks help from Social Services and other key agencies. Their needs are numerous and complex and can only be addressed by agencies working together and pooling resources to meet the challenge of producing better life chances for children. Many of these children and families will knock at the door of several statutory agencies for help and assistance.

In 1999/2000, there were approximately 23,600 referrals concerning 16,250 children referred to Social Services in NI, which represents approximately 3.5% of the total population. The main reasons for Social Services involvement were -

• Child Protection (35.8%).
• Child Care Issues (40.1%).
• Children with a disability requiring social care services (8.5%).
• Children likely to experience emotional, physical or development impairment as a result of family breakdown (3.1%).
• Children whose wellbeing is prejudiced as a result of their disturbance (6.8%).

The reality is that as numbers of referrals have risen and the work has become increasingly complex, staff have found themselves increasingly rationing scare resources, deflecting referrals to other Agencies and determining eligibility criteria commensurate with statutory responsibilities and financial constraints.

In 1999/2000, £73m was spent on Children's Services in the Province, which accounted for 16.9% of expenditure on Personal Social Services. Per capita expenditure on children had increased over the previous 3 years by more than £25, to a figure of £158. The figure in England for expenditure in England was £248, or 50% more than the NI figure. Within the NI figure there were very significant differences between Trusts, with figures fluctuating from £97 to £243 per capita.

Given the interconnectedness of the range of services highlighted earlier, it is very difficult to disentangle the percentage spent on Child Protection work. It would be a reasonable expectation that the smaller per capita spend the less likely there is to be an adequate range of preventative services.

If the financial costs are not easily extracted, the long-term consequences for children who suffer serious abuse are more easily recognised -

• Long-term impact on Mental Health. International research shows that adults abused as children have a higher rate of mental health problems, depression and suicidal behaviour. Studies have demonstrated that 47.6% of females referred to mental health services have reported sexual abuse as children. Sexual abuse has been estimated to be present in a high proportion of people with multiple personality disorder. Children who suffer abuse have a greatly increased risk of major depressive disorders in later life.
• The Children's Society have estimated that 42%, of child prostitutes in Great Britain said that their first sexual experience was of abuse, and 72% said that they had experienced conflict in their families.
• The Report of the National Commission of Inquiry into the Prevention of Child Abuse, in its analysis of the costs involved in child protection, makes reference to the "excluded" costs.
• Dysfunctional adults damaged by childhood abuse.
• The incalculable costs to individuals and society of opportunities lost by people unable to function to their full potential in the education system, at work or in their personal relationships, including other relationships with their own children.

Each year the Social Services Inspectorate produces a Report "Key Indicators for Personal Social Services for NI". The most up to date Report gives figures for 1999/2000.

At the 31st March 2000, there were 1,483 children on the Child Protection Register, a rate of 32.2 children per 10,000 aged under 18. The number of children on the Register was significantly higher than the corresponding figure for England of 26.8 children per 10,000 population. That year there were 2,511 Child Protection investigations, a rate of 54.5 investigations per 10,000 population aged 18 and under. Two thirds of Child Protection investigations were carried out by Social Workers, 30% were carried our as joint investigations with the Police and in 2% the Police carried out investigations alone. Almost 50% of all registrations during this period were categorised as "neglect" (47.3%), 33.7% were "physical abuse", 17.9% were "sexual abuse" and 13.5% were categorised under "emotional abuse". During this year, there were 1,067 new registrations and 1,056 de-registrations of the 1,067 new registrations 19.1% were re-registrations.

Sadly, from time to time, children will die at the hands of their parents and carers. The Association of Directors looks forward to the day when this will not be the case, but believes that it is probable, that some children will continue to perish at their parent's hands. The number of child deaths within the UK is one of the lowest in Western Europe and the developed world. For every child who dies, there are hundreds if not thousands, who are supported, protected or indeed rescued by being placed in other family settings.

The spirit of the Children Order is very much that children should be supported to remain within their family, wherever possible. The concept of co-operation and openness with parents is well established. Only when it is not possible to safely maintain the child within his/her family setting, will consideration be given to placing this child in another environment. When this is the case, the emphasis is increasingly to seek to find that child a home for life, which is capable of leading his/her development needs on a permanent basis.

All Trusts want to work in partnership with families. The rationale for this approach is clear both ethical and pragmatically. Children, parents and carers have a right to be fully informed of, and to participate in, discussions, which concern them. Experience has shown that unless children and parents are as fully involved in this process as possible, then Child Protection measures are unlikely to be successful. In some Trusts the level of parental involvement in the child protection process is as high as 75%-80%.

However, the inclusion of children, parents and carers comes at a price -

• The Child Protection Conference has to be conducted in a much more user friendly way, which results in time spent at Case Conferences being almost doubled.
• Chairs of Child Protection Case Conferences and Social Work staff have to spend considerable time prior to, and subsequent to a Case Conference with children, parents and carers.
• On occasions the presence of children, parents or carers impedes the open sharing of information from other Agencies or professionals, who still feel uncomfortable.

Family Support Services need to be capable of offering education, training and support to parents, whilst also bringing education, creative play and support to children. Family Support Services are extremely patchy throughout the Province. The Association of Directors are eager to see a shift in resources away from crisis management to a more preventative approach in keeping with the spirit of the Children Order. To do so, the Association of Directors believe that there needs to be an agreed Departmental threshold for delivering preventative services to children in need.

Children in need and their families live in local communities. The Association of Directors believe that if preventative strategies to deal with Child Protection are to be developed, this can best be achieved by working at local community level. Community based parental education, training and support is crucial. Similarly, consideration should be given to finding innovative ways to help children protect themselves, through access to independent counselling at schools or peer support. Raising awareness of Child Protection issues through training initiatives with local community groups, is a potent way of developing early detection. The community sector has an important role to play here. Unfortunately, all too often, their work is blighted by the lack of stable mainstream funding.

The Association of Directors warmly welcomes initiatives such as Surestart and other locally based partnerships as a means of engaging the wider community, in order to explain the issues, raise awareness and promote action necessary to protect children.

Unfortunately, some children cannot remain at home. In such situations the development of high quality multi- disciplinary assessment is a crucial factor to determining the risk posed by parents, or others, to children. The vast majority of cases, where such decisions are taken, are invariably contentious, causing considerable stress to all involved.

Increasingly, Trust staff are becoming involved in lengthy legal processes, which are confrontational, long drawn out and costly. The reality of this situation is that staff can often spend, on some of these most difficult cases, up to 5 days in Court. There are other hidden expenses for Trusts, such as expert witnesses and legal costs, which have increased significantly, in recent years. Whilst respecting the rights of all citizens to have legal redress, the Association of Directors believe that there is an urgent need for the NI Assembly to review the interface between the Courts and Agencies, such as Health and Social Services, in these matters. The Association of Directors believe that much more emphasis should be placed on developing mediation as an alternative to legal process.

The legal responsibility to protect children rests with Personal Social Services but Personal Social Services do not provide universal services. The needs of children will clearly vary over time and consequently some aspects of that need will rest with other Agencies. Whilst the ethos of joint inter-agency working is well established in Child Protection, what is perhaps less recognised, is that the reality in practice can be somewhat different, even in the context of our integrated Health and Social Services. The belief that Child Protection is everyone's business, in practice, does not appear to be universally embraced.

Experience shows that overall GPs only attend 5% of Case Conferences and some Practices never attend at all. Whilst there are a number of practical issues which might explain this, including the timing of Case Conferences, their length and reimbursement for Locum cover, perhaps more concerning is a study carried out by a Dr Janet Polney published in the Child Abuse Review Vol. 9 2000, which looked at GP attendance in the Western Board and concluded that the resolution of these practical problems would not improve GP attendance. Clearly, there is a major attitudinal change needed, if this is indeed the case.

Similarly, Trusts regularly report the reluctance of some representatives of other professions to fully commit themselves to protecting children. All case management reviews or enquiries into child deaths have highlighted the need for better multi-agency working. It is essential that Agencies who work closely together share common aims.

The Association of Directors believe that much more could be done in this area if there was a robust inter-departmental strategy. We believe that the appointment of a Commissioner for Children's Services, a development warmly welcomed by the Association and the Social Work profession, would do much to enhance inter-departmental working.

Similarly, the Association of Directors believe that the development of a national standard framework, similar to that which applies in the rest of the UK, is to be welcomed. The Association of Directors believe that enhancing the current Children's Services planning process, is the mechanism by which this can be best achieved. In so doing, it would provide a benchmarking framework for measuring performance against standards.

There is much work to be done, if the rhetoric of true child focussed multi-disciplinary work is to be achieved. The Association of Directors would recommend, that consideration should be given, even on a pilot basis, to the development of multi-disciplinary teams to deal with Child Protection issues. There is much evidence within Health and Social Services of such teams being established in areas of less risk. Such a team would include Paediatrician, Psychologist, Social Work staff, Educationalists, and ideally a child or family Psychiatrist. The Association of Directors also believes that Child Protection training, which should be done on a multi-disciplinary and inter-agency basis wherever possible, should be made mandatory for other key professions, who work with children such as Teachers and Health Workers. This training should clearly address issues such as confidentiality as this continues to remain a source of tension.

Child Protection is founded on an exchange of information from different professions and Agencies who know the families. However, all case management reviews or enquiries into children's deaths, over three decades, have invariably focussed on inter-disciplinary and inter-agency failures to communicate.

Little has been achieved in the past 30 years. A review of any complex Child Protection case, is likely to show, that many people had part of the picture but no one had all of it. An analogy could be drawn of people trying to complete a complex jigsaw without knowing the full picture. It is not possible to know what must change to reduce risk if the risk is not fully understood. Risk sharing is therefore a critical issue. The Association of Directors believe that a variety of mechanisms must be piloted to improve this situation. These include -

• The creation of multi-disciplinary teams.
• Investment in IT technology.
• The capacity for professional staff to work alongside each other in facility such as Community Treatment and Care Centres.
• The introduction of agreed standards for recording and common layout and structure of files.

The Association of Directors believe that, both on a uni and multi-disciplinary basis, those involved in protecting children, particularly those deemed to be at greatest risk, must be well trained, have experience and have access to expertise. Where things have gone wrong in the past, it has often been becauseone or more of these components has been missing.

The Association of Directors welcomes the introduction of the new 4 year training programme for Social Work staff. We believe that this new qualification should seek to recognise the specialist nature of Child Protection and this should be reflected in the curriculum and practice experience, which students have.

Regrettably, at present, it is not possible to protect inexperienced staff from involvement in Child Protection cases. Much Child Protection work arises during involvement with children and families for other reasons. Staff need to be sufficiently experienced to pick up these concerns and deal appropriately with them. In recent years the threshold of managing risk at home has risen considerably. Balancing these risks, the rights of children and the rights of family to privacy, requires particular skills. Unfortunately those staff, most notably Senior Social Workers, whose role it is to support and develop these inexperienced staff are themselves frequently subjected to conflicting demands, particularly Court appearances, and as such, are not always as available as one would wish.

The Association of Directors also believe that there should be within the Province an initiative to re-structure salaries in order to keep those with experience and expertise as close as possible to practice. This would involve the increasing use of grades such as Senior Practitioner but also perhaps the introduction of grades such as Consultant Practitioners, which other professions are increasingly embracing.

As indicated above, we believe that there is considerable room for improvement in collaborative inter-agency working. To this end, the Association believe that the Government should establish a clear strategic plan for the protection of children, which should include the responsibilities of other Government Departments in this area.

Members of ACPCs have an important role in promoting the protection of children at a senior level within their organisation. The ACPC Forum provides a vehicle for agreeing common ways of working. In some situations the Association of Directors believe that the representation on ACPCs needs to be reviewed, as those representing an Agency, do not appear to be those who can implement change within that Agency.

There has been recent discussion about placing ACPCs on a statutory footing in order to strengthen the infrastructure around children. The Association of Directors welcomes the philosophy behind this, but for the present could only give this a guarded welcome because of a concern that there should be clarity of roles and responsibilities. It is important that this proposal is properly considered and analysed. To date, it is unclear how an ACPC with statutory powers, would function alongside Trusts, with their delegated statutory duty for children. Staff require clear lines of accountability and responsibility, if they are to work safely and effectively. This has been noted by numerous child inquiries in the past. The Association of Directors would recommend that this matter be the subject of more debate. The Association of Directors would further recommend that, a nominated Manager or Co-ordinator, with line management accountability, and therefore the capacity to create change within each Agency, should be identified to promote the work of ACPCs.

There are serious difficulties in both the recruitment and retention of Social Work staff within Family and Child Care. A recent study carried out by TOPSS entitled "Workforce Planning for Social Work" indicated that there were 1,939 qualified Social Worker in NI. 75% of these (1,459) were employed in Health and Social Services Trusts. 10% by the Voluntary Sector and a further 9% by Criminal Justice statutory bodies.

The majority of Social Workers within Trusts (56.9%) or 831 staff worked within the Family and Child Care Service. This figure was even greater for the Voluntary Sector at 72.5% or 145 staff. Labour turnover for Health and Social Services was 6.6% and for the Voluntary Sector 8%. The vast majority of Practitioner grade Social Work leavers in Health and Social Services were from the Family and Child Care Programme. 15% of all Social Work posts were vacant as at 31 March 2002.

Trusts have identified a range of issues that have contributed to the problem -

• Unmanageable workloads, especially since the introduction of the Children Order.
• High sickness rates as a result of threats and assaults.
• The nature of Child Protection work itself is distressing and therefore causes stress.
• Lack of resources, for example, residential and foster care placements.
• Social Work terms and conditions have fallen behind comparable professions.

This is a national problem with some Councils in England now actively pursuing recruitment campaigns abroad. In NI, we are currently adversely effected by the fact that a number of our staff are leaving to work in the South of Ireland where terms and conditions of employment are better.

There are a number of factors, which impact upon recruitment -

• The image of the work and the low esteem in which Social Work is held by both the media and Politicians.
• Low pay in comparison with other careers.
• Poor career development and job prospects.
• Particularly for Family and Child Care staff, the ever-threatening possibility of being pilloried in the media if a child dies.

It is therefore clear that a number of initiatives must be taken to address this deteriorating situation.

• An urgent review of terms and conditions.
• The further development of career structures.
• The introduction of workload management systems to reduce the possibility of experiencing burn-out.
• A review of clerical and administrative support in order to target professional time on professional tasks and to deal with the increase in reports to the Court as a consequence of the Children Order.
• A review of the growing bureaucracy associated with Child Protection work.
• The continuation of the recruitment campaign run through the media, begun in 2001.

A number of the issues highlighted above are important also in addressing the retention of staff within the Family and Child Care Programme. There is a clear pattern of burn-out, particularly as staff are exposed to the distressing elements of this work year in and year out, and the inevitably threats and assaults which accompanied it. The result of this is that experienced staff frequently leave the Family and Child Care Programme to go and work in other Programmes of Care. Very rarely do staff from other Programmes seek to transfer into Family and Child Care. This fact needs to be recognised in any re-negotiation of social work terms and conditions.

During the last year, certain events nationally and locally have kept Social Services and Child Protection at the forefront of public thinking. Negative images always gain greater attention from the media than positive developments. This impacts on recruitment and retention adversely. It also impacts on those who use the service. Many children and young people feel stigmatised by the negative images of being in care. Many families do not ask for help that they need because of the negative connotations of receiving assistance from Social Services. If we are to meet the needs of children, we must promote a more positive image of social care and raise the profile of this work nationally and locally. The Association of Directors would welcome the Department, Boards and Trusts working together to produce a more positive media campaign of what Social Work does and how effective it can be in Family and Child Care matters.

The Association of Directors also believe that it needs the support of local Politicians and in particular the Minister, and the Health Committee both to ensure that this aspect of the work is adequately funded and that the importance of the task, and difficulties in achieving it, are recognised and supported.

Earlier in this response, reference was made to the need to standardise definitions and assessments of Children in Need. The area of Child Protection work would be enhanced by greater attention being paid to the development of standardised measurements and a standardised approach to recording. The Association of Directors believe that consideration needs to be given to creating pro-active Child Well-being Indicators that would assist in setting future policy goals and tracking outcomes for children. We also feel that the introduction of the multi-agency assessment framework, which has been piloted in England for some time, should be introduced into NI, as this will assist and guide staff in taking complex decisions. Equally beneficial would be standardised mechanisms amongst Agencies, which would define which children would need to be most closely monitored and mechanisms developed to track them.

The Association of Directors vigorously wants to highlight the paucity of services for children who have been abused. The human cost of abuse is clear in terms of wasted opportunities and tormented lives. There is a need for considerable investment and expertise in dealing on a timely fashion with children who have been abused.

A recent case has highlighted a loophole in the current law, which means that an adult convicted of a very serious physical assault on a child can be lost from the system, on discharge from Prison. There is currently no mechanism, as there is for sex offenders, to track such dangerous individuals. The result of this is that such a person can be in regularly contact with children, without Agencies, such as Social Services, Education, Police and Probation, being aware of this. The Association of Directors recommends that this loophole should be closed.

Please refer back to section 1.4. It should be noted that England on average spends 50% more per capita on Children's Services than NI and in the case of the most poorly resourced Trust in the Province, that Trust is only spending 40% of the English average.

In 1994, prior to the implementation of the Children (NI) Order 1995 the four Boards were invited by the Departmental Children Order Implementation Group to submit estimated costs, to enable Boards and Trusts to discharge the additional statutory responsibilities, which the Order would place on them. The Department took a conservative view of the cost implications of the Order, and considerably reduced the Boards estimates in their submission to the 1995 public expenditure survey. A number of itemised costs were excluded from this bid, including Child Protection, Family Placement and Residential Care. By the year 2000, it is estimated by the four Boards that the actual amount of under resource to implement the Order is£12.1m.

This in fact, is probably not a totally accurate picture because in recent years this under estimation has been compounded by a number of subsequent policy developments and initiatives including -

• Changes in Juvenile Justice.
• Revision of co-operating to protect children.
• Sex Offenders Act.
• National Foster Care Standards and Code of Practice.
• Waterhouse Report entitled "Lost in Care".
• Introduction of the framework of the Assessment of Children in Need and Their Families.

All of which have had resource implications, which have not been adequately addressed.

The Association of Directors in England believe that the general funding position in Child Care is inadequate to meet needs, performance targets and statutory responsibilities. If this is the case in England, how much more relevant is this in the NI context? Looking after the most vulnerable children in our society is not cheap, and nor should it be. Such children deserve quality services to enhance their life chances. With this in mind, the Association of Directors is concerned that an initiative such as Quality Protects which released £885m over a five year period in England and Wales, has not been replicated in NI. It needs to be re-stated that an absence in investment in family support runs contrary to the spirit of the Children Order and also results in crisis management.

The Association of Directors need the support of the Health Committee, in ensuring within our integrated Health and Social Services structure, that the needs of these children and their parents are recognised and financed. The Association of Directors would ask of the Health Committee that it recommends to the Department that it should review the adequacy of funding in the Family and Child Care Programme.

• Family and Child Care Services in NI are mostly delivered in a socio-economic context characterised by poverty and social exclusion. Societal trends such as alcoholism, family breakdown and domestic violence, impact significantly on levels of need and demand. There is a specific context in NI of transition from conflict.
• Services have been subjected to massive pressure arising from -
• Societal trends.
• Under-estimation of operational impact of the Children Order and subsequent under-funding.
• Exclusion of key operational areas from funding calculations.
• Impact of additional legal and policy developments.
• Per capita expenditure on Family and Child Care Services is significantly below the average in English Local Authorities.
• Board estimates of what it would take to fully implement the Children Order were not accepted by the Department in 1994. There has been a consequent significant shortfall in resources to deliver the ethos and philosophy of the Order, disregarding new pressures which have also come into the system.
• It is important that Child Protection work be seen as part of the provision of family support. Particular emphasis needs to be given to working within local communities to develop education, training and support for parents and children alike. Instability in funding the community sector, does not assist this process.
• There is much that needs to be done to improve inter-agency and multi-disciplinary working, particular attention should be paid to -
• All Trusts wish to move to a more preventative strategy. They are hindered in so doing by financial constraints. The absence of prevention invariably leads to crisis management.
• Piloting the introduction of multi-disciplinary Child Protection teams.
• Seeking to achieve greater attendance at Case Conferences from other professionals, most notably GPs.
• Enhancing training opportunities and clarifying the issue of confidentiality for information.
• Work needs to be done particularly with the Judiciary and Magistracy, in relation to Child Care matters coming before the Courts. Attempts should be made to introduce more mediation as a considered substitute for legal process.
• We would recommend that the Health Committee ensures that it takes evidence from others in particularly the legal and medical professions.
• Recognise and value the contribution that Social Work staff in the Family and Child Care Programme make in very difficult circumstances. This would include reviewing issues such as job remuneration, career structure and how the profession is presented.
• In this regard, we would recommend to the Health Committee, that as it has taken evidence from a wide range of senior members of organisations, that it would be appropriate for it to meet front line staff, to hear, first hand, the stories that they have to tell about what it is like to be engaged in this work over a period of time.
• Promoting a more positive image of Social Work by developing a positive media campaign.

In conclusion the Association of Directors welcomes this opportunity to make its submission. Much has been achieved in the Province in supporting, protecting and rescuing vulnerable children. Sadly, from time to time, some children will die and this understandably becomes the focus of attention. It should not, however, detract from the positive work that is going on within the system,. As a whole, despite the financial limitations. The Association of Directors hopes that this review of Child Protection by the Health Committee will ultimately lead to improvements. Not for organisations or Agencies, hopefully for the front line staff who are involved, but most importantly for the children themselves who bear the true cost of child abuse.

Barnardo's is working towards a society where children and young people are free to grow and develop their potential, without fear of violence, abuse or exploitation. Within such a society children and young people would be valued and their rights to protection and physical integrity fully respected.

Certain core principles underpin our work on keeping children safe:

• All children have a fundamental right to protection from abuse and exploitation
• All children have the right to express their views and have these views taken into account
• Children have the same rights to physical integrity as adults and should receive the same degree of protection under the law
• Listening to children is paramount in ensuring their safety
• Children are directly affected by violence between adults, particularly when it involves the adults responsible for their care
• Children and young people cannot be held responsible for their own abuse and exploitation or expected to bear the primary responsibility for their own protection. Whilst there may be steps they can take to enhance their safety, the ultimate responsibility lies with adults
• Our understanding of what contributes to abuse or exploitation of children should evolve in responsible to societal change and in recognition of children's own experiences
• We need to look at children's needs holistically and not define them solely in terms of their abuse
• We need to be aware of how issues of age, gender, race, culture, disability and sexuality impact on our understanding of and responses to keeping children safe
• Whilst all interventions must be child-centred, we need to identify and work with safe and protective adults within children's families and communities
• Keeping children and young people safe must be an integral part of all our work, across all themes
• Joint working is essential for the protection of the most vulnerable

1.2. This Inquiry is very timely for Barnardo's Northern Ireland especially given the input from Barnardo's UK to the Victoria Climbie Inquiry. Following this investigation, Roger Singleton, Barnardo's Chief Executive called for a national 'health check' for all agencies involved in Child Protection (August 2002). He stated

Barnardos Northern Ireland therefore welcomes the invitation to give written evidence to the Committee's Inquiry into Child Protection Services in Northern Ireland

Barnardo's works with seven thousand children and their families every year in Northern Ireland. We provide over twenty-nine distinct services in localities and communities right across the North. We aim to provide excellence in service and maximise influence to affect change for children and young people. Our work is based on the six building blocks that we believe are essential for every child in order to build a positive future. These are:

• A Family that can cope
• Protection from harm
• Emotional, physical and mental health
• Opportunities to learn
• A sense of belonging in the community
• A stake in society

In responding to this inquiry we have consulted with a diverse range of Barnardo's projects, including those working in the areas of domestic violence, family group conferencing, therapeutic intervention with children and young people displaying sexually inappropriate behaviour and young people leaving care.

We would argue that there is a clear need for effective recording systems in this work. Effective recording is essential to ensuring proper planning, assessment and accountability in safeguarding children. The draft document 'Co-operating to Safeguard Children' (2001: 77) states

As an organisation involved in safeguarding children throughout Northern Ireland, Barnardos Northern Ireland have identified recording to be a core standards issue. An integral and critical part of what the organisation does. Getting recording practice right is part of the infrastructure that forms the framework for a safe organisation - one in which children are kept safe. In Barnardo's Northern Ireland an organisational recording policy sets out the clear expectations of staff. Files are read and counter signed by managers on a regular basis and a core standards audit is carried out annually to ensure overall standards are adhered to.

We believe that a clear understanding of what works in child protection practice enhances professional judgement. We would argue that all organisations working with children need to develop an evidence based practice strategy. This enables practitioners to keep informed about research developments and to continue to learn and develop skill and competence. It also allows us to integrate what we learn from research into practice. Barnardos have produced a series of publications around the theme of What Works. The purpose of the series is to establish-

The Northern Ireland Social Care Council recently published a report 'Promoting Research and Evidence-based Practice. From Rhetoric to Reality' (2002: 1). This report noted the need for-

Barnardos Northern Ireland has taken the view that it is important as part of our role in safeguarding children that our practice in this area is guided by an understanding of what works and set in a context of clear outcomes for children. All of our services have written statements of outcomes. We are developing an evidence-based strategy for our organisation and have a number of pilot projects on-going that are concerned with improving practice by developing a clearer understanding of what works.

Barnardo's Leaving Care Project is currently involved in this pilot and is focusing on a child protection issue, specifically parental participation in the child protection process. Project staff (supported by staff from Barnardo's Research & Development team) are using evidence based research to produce guidance for both professionals and parents involved in Child Protection Conferences. The project is particularly interested in researching how best to work with young pregnant women where there are child protection issues and / or domestic violence. The aim is to ensure that the participation of young people is promoted throughout the process and to enhance the staff team's expertise and knowledge in the area.

Barnardo's Northern Ireland would recommend that all organisations working in the area of Safeguarding Children should work within an evidence based practice framework.

There is a clear issue about assessment in Northern Ireland. The Draft guidance 'Co-operating to Safeguard Children' (2001: 10) notes that it is-

We are aware from the experiences of our projects that there is no common assessment framework used in Northern Ireland. As a regional organisation this has posed some challenges for us in terms of training our staff, as we need to take into account a number of different approaches to assessment. The existence of different assessment frameworks has the potential to create local variations in how need is defined and decisions arrived at about intervention. We believe that there is a need to have one assessment method and that all organisations both voluntary and statutory should agree to use it. This would allow for the development of a common understanding of need and a shared understanding of the threshold for intervention. A debate about this amongst all the relevant organisations to seek agreement on this may be necessary.

Barnardo's Northern Ireland would recommend that the DHSS&PS take the lead in developing an agreed method of assessment to be used by statutory and voluntary agencies involved in Safeguarding children.

It is difficult to be clear about how well we are doing in this area of work. Key Indicators (2001) pointed to an increase in the number of children on the register for 1999/00 on the previous year. The same period had seen a decrease in England (Key Indicators, 2001: 57)

It is however, difficult to be sure about why this has occurred. For this reason it is important that we develop information systems that allow all of us involved in this area (both statutory and voluntary organisations) to understand what is happening year on year. The information to be collected should be agreed regionally. Statistics could then be presented that would enable a deeper understanding of how well we are currently performing in terms of protecting children. This would allow for difficulties to be identified and targets to be set for improvement. Without such a management information strategy the child protection system can neither assess its effectiveness nor learn, as it will lack the core information to do so. Such a system should be determined regionally.

We believe that there should be an established set of Child Well-being Indicators for Northern Ireland. Such indicators would draw together all the available statistical data and build on research to fill the gaps. They would be used to-

A set of Child Well-being Indicators would help measure improvements over time and enable the production of regular reports on the state of Northern Ireland's children. This could assist in monitoring progress in Northern Ireland towards full implementation of the UN Convention on the Rights of the Child. The production of an annual report would also be a useful way to educate the general public about the issues facing children and young people in Northern Ireland.

Barnardo's Northern Ireland would recommend that a crosscutting information strategy be developed at regional level led by DHSS&PS

Barnardo's Northern Ireland would recommend the development of child well being indicators for Northern Ireland with progress being monitored through an annual report

A particular issue that needs to be addressed is how the safeguarding system learns about how it is performing. In particular the system for disseminating case management reviews needs attention. To the best of our knowledge the circulation of these reports is limited. As an organisation involved in safeguarding children across Northern Ireland there is no guarantee that we will ever see any of these reports. Neither is there any summary of the issues learnt across a number of reports ever produced. There may well be important lessons for all organisations that are never brought out in a way that allows the whole safeguarding system to learn and change. Clearly this is an area where there needs to be change and a strategy for their dissemination agreed. As an organisation we welcome the inclusion of this issue in the private members bill on ACPC's.

Barnardo's Northern Ireland would recommend the development of a strategy for the dissemination of case management reviews by the DHSS&PS.

Barnardo's Northern Ireland would recommend that the DHSS&PS publish at regular intervals summaries of the issues raised by case management reviews.

It is important that we have a regional strategy for safeguarding children. The safeguarding and protecting of children should be a crosscutting theme in the new Northern Ireland Strategy for the Rights and Needs of Children. We believe that this would be consistent with the concept of putting safeguarding and protecting into a wider context of children's well being. This strategic statement would set out what we are trying to achieve as a society in terms of safeguarding children.

Barnardo's Northern Ireland would recommend that the Northern Ireland strategy for the Rights and Needs of Children should have Safeguarding children as a cross cutting theme.

Although Social Services have a statutory responsibility for child protection Barnardos Northern Ireland believes that all organisations working with or otherwise involved with children should have as a primary purpose a commitment to safeguarding and protecting children and young people. It is important to recognise that the protection of children is a paramount concern for many more organisations than those formally involved in the child protection system. With Childrens Services increasingly being delivered by multi-agency partnerships (for example Sure Start) there is a growing number of statutory, voluntary and community based organisations becoming involved in the direct provision of services to children and young people.

Against this increasingly diverse background Area Child Protection Committee's [ACPCs] are the inter-agency forum with responsibility for developing a strategic approach to child protection. Despite the critical nature of this function ACPCs are not recognised in any statutory provision.

3.2.1 We believe that the Area Child Protection committees (ACPCs) should be placed on a statutory basis and we have expressed support for Patricia Lewsley MLA's Private Members Bill on regulating the role and function of ACPCs in Northern Ireland. Barnardo's UK, in its submission to the Climbie Inquiry similarly argued that ACPCs should be put on a statutory basis. We believe the case for moving ACPCs to a statutory basis to be compelling -

3.2.1.1 The lack of a specific statutory remit and the present constitution of ACPCs can reinforce the view that child protection is primarily a Social Services concern

3.2.2.2 Non-social services agencies may feel that their role on ACPCs to be a secondary concern compared to their own legislative responsibilities. As we have consistently argued in this paper all organisations involved with children and young people need to have their safety and protection as a primary concern

3.2.2.3 The lack of a specific budget for their work makes the work of the Committees totally dependent on resources from other budgets. This inhibits considerably the development of effective strategic approaches to child protection.

3.2.2.4 The role of ACPCs in the handling and dissemination of case management reviews is uncertain. There is currently no clear mechanism in Northern Ireland to ensure that lessons learned in case management reviews are disseminated in order to improve the effectiveness of the child protection system. Potentially we are wasting an opportunity to drive improvements into our system and raise standards.

3.2.3 Barnardo's Northern Ireland believe that the ACPCs should-

3.2.3.1 Become involved in preventive and promotional activities. The ACPC can be proactive in identifying what needs to be done to improve the safeguarding of children. It can also be involved in promoting positively the good work that is done in its area in terms of safeguarding. It can open up a local debate about its purpose and the roles of the various organisations involved in safeguarding. It can become involved in hearing the views of families, children and young people about the safeguarding system.

3.2.3.2 Engage a wider range of the participants involved in the safeguarding task in the local area as members. New multi agency arrangements for delivering services (such as Sure start) have drawn in a wide range of voluntary and community groups into the childcare system. Many voluntary organisations directly provide specialist-safeguarding services

3.2.3.3 The ACPC annual plan can assess how well the local area is performing in terms of safeguarding children and set local targets for improvement across the local system.

3.2.3.4 The ACPC can coordinate (and also directly provide) training related to the needs of individual organisations and an assessment of the local system's needs based on its review of the local performance against the targets it has set.

3.2.3.5 Clarity needs to be reached on the circulation of Case management reviews. ACPC's can play an important role in that process.

3.2.4 In order to do all of this effectively the ACPCs need to receive additional resources, particularly to employ staff. We would agree with the proposal in the proposed Private Members Bill that constituent organisations ought to contribute to its working budget. We have entered one reservation to this and that is in respect of Voluntary Sector members who should be allowed to consider their time as a contribution to the ACPC activity. Voluntary Sector organisations may choose to fund particular ACPC initiatives as part of their public policy role.

Barnardo's Northern Ireland would recommend that Area Child Protection Committees should be placed on a statutory basis.

Barnardo's Northern Ireland are currently involved a research / working group [with NSPCC and DHSS&PS] examining child protection procedures within A&E Departments, including access of the Child Protection Register. Emerging results suggest a lack of uniformity to the level of access across A&E Departments in Northern Ireland. Given that children may and do seek access to medical services outside the area in which they live, it is important that all medical staff have access to the same information, in the form of one register.

Barnardo's Northern Ireland would recommend that there should either be one Child Protection register in Northern Ireland or we should network all the existing registers.

There is a specific issue for us in Northern Ireland to consider and that concerns the movement of dangerous individuals from one jurisdiction to another on these islands. In particular the fact that we share a land border with the Republic of Ireland, which has a very different child care system and administrative systems for safeguarding children is a situation that requires attention. We need to ensure that individuals (whether they are prospective staff or volunteers) who move from one jurisdiction to the other can be adequately checked for their suitability to work with children or young people. We need also to ensure that convicted sex offenders cannot use the border to avoid monitoring of their whereabouts.

However there have also been difficulties officially tracking information within the UK networks - to maximise the protection of children, any NI developments must ensure that arrangements are fully integrated across the two islands as a whole. Movement between jurisdictions can be within the island of Ireland or between Ireland and GB.

In 'Child Protection; Messages from Research' (1995: 52) the issue of participation was highlighted-

In 'The Children Act Now: Messages from Research' (2001: 142) the theme was reiterated-

The underlying message from research is that good outcomes for children are more likely to be achieved if the professionals involved are able to develop a working partnership with parents. Such a partnership needs to be clear about the absolute priority to safeguard the child but within that seeks to work with parents in an open and honest way.

Unfortunately the context in which local communities gain information about the Safeguarding role of organisations such as Social Services is often a negative one. The media coverage of child abuse deaths and associated criticism of Social Services and social work often frames the public perception of safeguarding work. Although both public and professionals are united in their desire to ensure children are safeguarded the combination of a lack of positive news stories about this work and the overwhelming bad press it receives results in a situation in which the public is probably highly sceptical about the effectiveness of much safeguarding practice. We believe that this is a situation that has to change. It is not sufficient to blame the media for only reporting bad news if we as professionals are not prepared to constructively engage with them around a "good news" agenda.

The media could be enormously helpful in explaining the roles all the different agencies play in keeping children safe. The legal context in which they work and the difficulties they face can be debated. Some of the good work that goes on in this area can be highlighted.

We believe that a dialogue with local communities could be a role for ACPCs (provided that the resources are made available for the task). ACPCs could develop a media strategy that promotes their work and the work of the agencies involved in safeguarding children. Moving from information to participation, ACPCs could look at taking feedback from parents involved with the system and parents generally in order to build up a sense of how the public perceive their work and how what they do can be improved based on that feedback. In particular they should develop a participation strategy around the views of children and young people about Safeguarding issues.

Barnardo's Northern Ireland would recommend that -

• The DHSS&PS develop a media strategy at regional level that seeks to promote knowledge about and understanding of the Safeguarding system.
• The ACPCs should develop a media strategy at a local level.
• The ACPCs should develop participation strategies to involve service users and the general public in feedback about the safeguarding system.
• The ACPCs should develop a participation strategy for children and young people about safeguarding issues.

We believe strongly that the views, interests and experiences of children and young people need to be heard in the safeguarding system. We believe and have argued previously in this submission that ACPCs should create a dialogue with children and young people for this purpose. There are examples of good practice in participation in the voluntary sector (and we made reference to one earlier in this submission) and emerging models in statutory services (particularly in relation to Children's Services Planning) that can be drawn on.

There is also within the voluntary sector experience of developing partnerships with families in the way envisaged in research such as 'Child Protection; Messages from Research'. In unpublished research focusing on Barnardos Northern Ireland's Family Centres the researchers (Centre for Child Care Research and School of Social Work, Queens University Belfast, 2001) offered this reflection-

In practice terms Family Group Conferencing offers an excellent process for hearing the views of children and parents in child protection situations. Barnardos Northern Ireland has developed a Family Group Conference pilot project with the Southern Health & Social Services Board, Armagh and Dungannon Trust and the Southern Education and Library Board.

Family Group Conferencing [FGC] is an empowering technique and offers real possibilities for developing partnership and co-operation with families. As we stated earlier we know from the Key Messages document that good outcomes in this kind of work is facilitated by effective partnership between parents and professionals.

FGC assists families in making decisions to care for children and keep them safe. Research into Barnardo's FGC Scheme (Barnardo's, forthcoming) shows not only positive practical results (to date over 137 children have been helped by the scheme) but illustrates the importance of the family led process. Outcomes reflect the findings of several UK research studies in that young people have been prevented from coming into care and young people in care now enjoy greater support and involvement from their extended family. Given that most children whose names are placed on Child Protection Registers remain at home (DOH 'Messages from Research), and that their protection rests with their families, it follows that the extended family and community have a role to play in devising and delivering the protection plan.

Partnership is also essential in domestic violence situations. Barnardo's Domestic Violence Outreach Scheme implements a safety operated approach in which special arrangements need to be put in place regarding communication patterns between the couple and the different agencies involved in the child protection plan. This involves being aware of information, which may and may not be shared with the perpetrator. For example, this has implications for timing and minuting of case conferences. Working sensitively and in partnership with couples as a couple and not separately has also shown to positively impact on child protection. Many couples involved in domestic violence situations remain together, an acknowledgement of this and the offer of 'couples work' facilitates accurate risk assessment of the children. However this must be balanced with the need to give priority to the victim and children within the family and requires specific training for staff.

Unintegrated service provision within domestic violence situations often results in children being overlooked. There is still too little awareness and knowledge of children's views and experiences of domestic violence. Also Boards and Trusts in different areas appear to operate different 'threshold' levels for domestic violence in terms of the children assesses as being in need and requiring support services or being at risk and requiring child protection.

Our work with children and young people who display sexually inappropriate behaviours has also highlighted the importance of working with the young people and their families. Research into the project showed that these young people were frequently children in need themselves and that the support and understanding of the carer is imperative to the success of the work. (Strachan & Montgomery-Devlin, 2002) Thus the emphasis is on working with the young person and their family to overcome the difficulties faced.

Barnardo's Northern Ireland would recommend that funding should be found for services that can demonstrate the ability to deliver good outcomes for children and families in safeguarding work.

Barnardo's Northern Ireland would also recommend the need for a specific model of risk assessment for working with families where there is domestic violence for use across all Boards and Trusts.

There is considerable anecdotal evidence from our services that statutory childcare teams are finding it increasingly difficult to attract and retain experienced staff. This has resulted in a situation where one of the most challenging and complex social work tasks-the protection of children -is often carried out by newly qualified and inexperienced staff. We see this as a reflection of the pressures faced by front line staff in child protection work. There is a lot of good work going on by dedicated staff in difficult conditions. Barnardos Northern Ireland staff have formed an impression from their contact with statutory colleagues of a workforce (both practitioners and managers) that feels under pressure in a system that is on the one hand placing increased demands on them but on the other is not providing them with the necessary resources to respond to the problems they are confronted with. We believe that the pressures child protection staff face are related to-

5.2 The intrinsic pressure of the work itself

5.3 The difficulties in recruiting and retaining staff

5.4 A lack of resources

This is in part related to the inherent complexities of the child protection task. This is challenging work with very vulnerable and sometimes difficult to engage families. This is not made easy by the poor image of social work in general and child protection work in particular. In this respect the recent advertisement campaign by the Social Care Council was a welcome attempt to address the poor public perceptions of social work. There needs to be further action on addressing the poor public image of social work. The intrinsic pressures of the work can be managed by effective supervision, management and training.

The above factors have made it difficult to recruit staff to this type of work. The difficulties in recruiting and retaining staff have a direct impact on the ability of the statutory services to provide a continuity of care to service users. We believe that it is imperative to develop strategies to attract the right quality of staff into this work and once there to keep experienced people in direct practice.

We believe that staff need to be effectively supported if they are to be attracted to and encouraged to stay in this challenging work. Effective support is also critical in ensuring good performance. In Barnardos UK submission to phase two of the Climbie Inquiry 'Monitoring Performance - Performing Well - How will we know when we are?' we argued-

Whilst retaining experienced good staff in this work is not just an issue of salary, we nonetheless believe that it would be beneficial to look at the case for developing a senior practitioner grade for child protection staff.

The intrinsic pressure of the work can be managed and managed in a way that promotes good practice. However in order to do this we believe that it is critical that all organisations involved in child protection work need to have-

A core issue is the quality and reliability of all the staff and volunteers - whatever their specific role. Current PECS rules should be changed to provide access to checks on a much wider range of jobs. Ideally everybody coming to work in a childcare environment should be assessed - not just those with substantial access to children. There are serious issues about people seeking inappropriate access and being considered a 'safe' person through their connections (however loose) with a child care organisation such as Barnardo's.

This is another key factor in contributing to staff pressures. The lack of resources available to childcare staff in general is highlighted in the next section. This situation has led to social services staff taking industrial action such is the concern front line staff have about the resources available to them to do their jobs.

We have many examples from our projects to illustrate the serious implications arising from a lack of resources. Staff within our Family Centres have highlighted the risk to children and young people through the lack of appropriate accommodation. They have cited cases where children and young people have either been placed in inappropriate accommodation, the use of emergency child minders rather than fostering or when children have remained at home even though there were child protection issues.

Lack of resources resulting in long waiting lists such as those for mental health assessment and services are compounding already difficult situations, often with implications for child protection. Often the needs of the child or young person will have escalated during the waiting period and more intensive [often more expensive] intervention is required - stretching resources even further. This vicious circle prevents preventative measures being implemented resulting in further strain on staff and increasing the problems already experienced by children and their families.

Our work with children and young people who display sexually inappropriate behaviour has also highlighted serious issues. Many young people referred to the Young People's Therapeutic Project have been removed from home and placed in residential care, or may already be in residential care alongside vulnerable younger children and adolescents. Such placements are obviously inappropriate for these children and young people as they may place other children at risk or increase the likelihood of themselves abusing their peers. It is essential that the lack of appropriate placements for these young people is addressed.

Anecdotal evidence from our services suggest that the lack of appropriate resources such as the examples above has led to situations in which social work staff feel under considerable pressure managing a high degree of risk in the community. This is consistent with the message in the four Boards paper 'Family and Child Care Services In Northern Ireland (2000: 21) where the point is made-

There has been progress in this area with the Children Matter task force and associated strategy. The lack of resources to address the needs of families is compounding the inherent stress of this work. This contributes in our view to the difficulties of staff recruitment and retention experienced by Trusts. Staff vacancy rates impact on the morale and pressures faced by the team members who manage in under strength teams. It contributes significantly to the pressures faced by team leaders and other operational managers.

This problem can only be addressed by securing the necessary resources to provide the level of service we need to support the complex problems of our most needy families and protect our most vulnerable children.

5.5.1 We need to be sure that all organisations working in the child care system prioritise training in child protection to ensure that children at risk of harm are detected and protected. All organisations that work with or involve children and young people should have, as part of their staff induction process, basic child protection training as a minimum standard. This should focus upon the knowledge, skills and values essential to protecting children and young people and ensuring their overall well being. This should also be linked to the standards and code of practice as laid out by the Northern Ireland Social Care Council. This would allow organisations to be confident that at the point of induction a base line level of information has been established for all staff in terms of their understanding of the organisation's approach to Safeguarding children. This should include organisational requirements and standards, individual roles and responsibilities, external legislation and developments. This needs to be followed up with specialist child protection training appropriate to role. The knowledge acquired in this way must be further developed and refreshed by training and supervision.

5.5.2 We live in an ever evolving and ever changing world and need to learn from the mistakes and lessons from past and current experiences regarding child abuse. Staff at all levels need to be able to explore a range of issues on an on-going basis, for example: management of change, legislation and policy, inter agency working, multi-disciplinary working, new research, new approaches and relationships and partnerships. This could be achieved in one way by organisations creating space and opportunities for groups of individuals (across levels, roles and sectors) to have open dialogue and debate regarding the child protection process. If we are to improve the system for safeguarding and protecting children and young people the opportunity for staff and volunteers to understand and grow relationships cross sectors, would be crucial to finding solutions and effective ways of working and relating. Organisations should consider how learning and development needs should be addressed on an on-going basis and should be open to the range of dilemmas that can exist within the child protection process.

5.5.3 The concept of partnership within the context of child protection needs further exploration and debate and needs to be further informed by on-going research.

5.5.4 It is imperative that funding be available for Post Qualifying Training developments within the voluntary sector. In particular the new Post Qualifying Child Care Programme needs to reflect the voluntary sector role more transparently and give recognition to the valuable and crucial work, which the voluntary sector provides in contributing to the safeguarding and protecting of children and young people.

5.5.5 The new degree in Professional Social Work Training would need to consider and incorporate the same principles as outlined in 5.52 and 5.53 and 5.54. This is crucial to the development and understanding of the relationships between statutory and voluntary sectors. The competency-based model would need to reflect this explicitly.

5.5 6 The development of unqualified staff also needs to be given further consideration regarding skills and practice and how the process of supervision needs to nurture and grow these aspects for staff. Supervision of staff is crucial to effective child protection systems.

5.5.7 Management training needs additional resourcing to provide a range of opportunities and methods of learning and development, particularly for first line managers, whose responsibilities would include, advising, mentoring, and supporting staff through difficult and often traumatic child protection caseloads. (Action Learning Sets would be an example of an alternative model for Learning and Development in this respect).

5.5.8 Learning and Development issues and needs within all childcare organisations need to be given full priority and support by senior management and be made available and accessible for all staff, volunteers and carers.

5.5.9 The importance of listening to children should be a key component in child protection training.

5.6 An understanding of equality and diversity issues needs to be incorporated into training on child protection.

Barnardo's Northern Ireland would recommend that -

• The case for developing a senior practitioner grade for staff involved in safeguarding work as a way of retaining experienced staff in practice is explored.
• The support, supervision and management of staff in this area of work is properly resourced in order to manage the intrinsic stress in this work, ensure quality service and deliver good outcomes for children.

There is considerable evidence that we spend less on Childrens services in Northern Ireland than England. The Social Services Inspectorate /Northern Ireland Statistics and Research Agency publication, 'Key Indicators of Personal Social Services for Northern Ireland' (2001: 28) provides key comparative data. A total of £73 Million was spent on Family and Childcare services in Northern Ireland in 1999/00. The comparable figure for 1997/98 was 61 million.

In terms of comparison with England in 1998/99 the percentage of PSS on Family and Childcare was higher in England (22.7%) than in Northern Ireland (16.5%).

In 1999/00 the per capita expenditure on Family and Childcare in Northern Ireland was £158.60 per child. The 1998/99 figures had been £143.10 per child. (source as above: 28)

It is difficult to understand or justify this position, given Northern Ireland's historical levels of deprivation and child poverty. We argued in our introduction that the under funding of Children's Services generally can have a significant impact on child protection work and Key Indicators provides some interesting statistics in that respect. (again same source: 57)

The four Health & Social Services Boards have argued (Family and Child Care Services in Northern Ireland in 2000) that they were considerably under funded for the introduction of the Children Order. Writing in November (2000: 9) they argued-

In their paper the four Boards identify child protection as one of five areas (the others being-residential child care; family placement provision; medical, paramedical and nursing implications; and legal costs) that were excluded from the 1995 Public Expenditure bid (2000: 20).

Additionally allocations to Family and Child Care have also been subject to financial pressure from other programmes particularly acute hospital services. The four Boards paper points out that the Eastern Board has suffered the most in this respect and is illustrated in the table below.

Allocations (£000) to Boards and Trusts for investment in Children Order Services, 1996-2000 (recurrent)

*This variation was made up in 2000/01 and allocated accordingly.

It is clear from these figures that Children's Services have not done well out of our integrated service model and action needs to be taken to ensure that investment allocated for essential children's services is spent in the way envisaged. Barnardos Northern Ireland has raised the issue of spend on children with Ministers and particularly our concerns that money allocated by government for children has been used to fund other cost pressures. The issue brings up important questions about accountability within our current structures and the balance between local autonomy and regional prioritising. We do believe that there is a strong case for protecting money earmarked for essential Children's Services based on the historic under funding of such services and objective levels of need.

The draft 'Co-operating to Safeguard Children' (2001: 10) states that

As we have argued in this paper the reality is that this aspiration is unlikely to be met because preventive services here are under funded. We noted in the first section that over all spend on Children's Services here is below the level of England and that what is released is subject to 'top-slicing' to meet other cost pressures within Boards. Further the Childrens Services Planning process has not been given any additional resources to develop the services needed to meet the needs they have identified.

The contrast with the position in England is striking. In England a raft of new initiatives, which although not specifically targeted at safeguarding children are nonetheless helping to develop a preventive infrastructure that supports communities and parents. As we argued previously such an infrastructure has a significant role to play in safeguarding children. Some of these initiatives have no Northern Ireland equivalents-Quality Protects, Sure Start Plus and Connexions for example. Taking Quality Protects as an example, this initiative is putting an additional £885m into family and childcare services in England over five years from 1999/00; on average this is an extra £15 per child per year.

The new initiatives in England have been made possible by the Comprehensive Spending Review process. Under the Barnett formula each devolved administration receives an automatic share of any funding changes. Base on population percentages this works out as-

However under devolution, devolved administrations have the freedom to allocate this money to local priorities. Even where programmes have been initiated in Northern Ireland there have been issues of funding and implementation.

Sure Start funding in England is equivalent to average of £63 per child under 4 years. Sure Start funding in Northern Ireland is equivalent to an average of £41 per child under 4 years. Sure Start projects in England were given long lead in times to develop their delivery plans, establish their partnerships and build local participation. None of this occurred in Northern Ireland where three months were given to do the same amount of work.

The Children's Fund has also been established in Northern Ireland as an Executive Programme Fund. It is worth an equivalent average of £13 per year per child under 18 years in England. In Northern Ireland it is worth equivalent to average £21 per child under 18. However there have been concerns in the Voluntary Sector about the way the fund has been established. Many of our Statutory Sector partners have argued that the Childrens Fund was created by "top-slicing" their budgets and as such does not represent "new" money. The four Area Children and Young Peoples Committees and Child Care Northern Ireland agreed a joint paper on the delivery of the fund. This proposal would have seen the money delivered through the Childrens Services Planning process in a partnership between Voluntary and Statutory Sectors. There was potential with this fund to develop preventive services. However a different decision was made to deliver the fund in two tranches initially to statutory bids and then to voluntary sector bids. £5.5 million of the Statutory Sector money has been allocated to a capital project for secure accommodation. The evaluation of the impact of this fund on developing preventative and support services remains unclear.

Barnardo's Northern Ireland would recommend that

• There should be a review of the level of resources needed to deliver Children's services
• The NI Executive increases the level of resources allocated to Children's Services.
• That money allocated to Children's Services is ring-fenced for that purpose.
• That the new Strategy for the Rights and Needs of Children is accompanied by a financial strategy setting out how our aspirations for children are to be funded.
• That new government funding initiatives are introduced in a way that allows the Voluntary and Statutory Sectors to maximise the benefits for children through proper consultation, planning and delivery.

That any new structures delivered through the current review of public administration are designed around the principles of accountability, transparency of operation, responsiveness and ability to deliver good outcomes for children.

7.1 Children and young people face a dual risk in the face of recent technological advances. These have facilitated the ease in which child pornography is distributed and increased opportunities to contact and 'groom' children via email, mobile phone and Internet chat-rooms.

7.2 Barnardo's UK are part of a coalition called Children's Charities Coalition for Internet Safety (CHIS), campaigning to make the Internet a safer place for children. We are concerned that the guidelines in sentencing related to child pornography should be made clearer with more rigid definitions available for various levels of offences. At present a judge may impose a sentence of anything between 3 and 10 years without guidance as to what constitutes a very serious offence deserving the maximum penalty.

7.3 Resources must be made available to increase awareness amongst children, young people, their families and the general public about potential dangers arising from Internet use.

Barnardo's Northern Ireland would recommend that clearer guidelines be developed for sentencing related to child pornography.

Barnardo's Northern Ireland also urge that awareness raising measures to protect children and young people from potential Internet dangers are fully resourced and implemented.

8.1 In general we have chosen to inter-weave research on child protection into the narrative of our submission. For this section we have chosen to highlight a few themes from the literature.

Writing in Community Care (14-20 March, 2002: 25) Professor Jane Tunstill reflecting in part on the aftermath of the Climbie Inquiry and the issue of where now for child protection wrote-

In the publication "Child Protection; Messages from Research" (1995: 52) the question was posed as to how best professionals can protect children.

We have tried within our submission to address all of these features.

In 'The Children Act Now: Messages from Research' (2001: 144) the following observation was made in relation to Family Support-

This reflects one of the key themes of this submission. As we indicated in the section on resources family support and preventive services for children are not particularly well funded in Northern Ireland generally and where funding is available (Children's Fund) it is short-term in nature.

'The Children Act Now; Messages from Research' (2000: 147) has also commented on the importance of integrated planning for children in need-

Children's Services Planning in Northern Ireland has been hampered by a lack of funding to deliver on the work it has completed. The Voluntary Sector has invested significant amount of time in the planning process and shown a keen commitment to joint planning. The Children's Fund offered the opportunity to deliver on the plans and on that basis a joint voluntary/statutory sector proposal suggested that the Fund should be administered through the Children's Services Plans process. The decision of the Executive to reject this proposal was disappointing to many people in both sectors who have worked hard to make a reality of joint planning.

'The Children Act Now; Messages from Research' (2000: 147) noted-

This submission has raised a similar question in respect of our system.

In our submission we commented on the importance of knowing if what we did actually worked (evidence based practice) and being clear about what we wanted to achieve for children (outcomes). 'Child Protection; Messages from Research (1995: 44) in reflecting on the issue of how effective is the child protection system noted in respect of outcomes-

A number of key themes run through our submission.

9.1 The safeguarding and protecting of children is a core responsibility for all organisations that work with or involve children and young people. Although Social Services quite rightly have the lead responsibility for child protection the diverse range of statutory, voluntary and community organisations involved with our children and young people necessitates that we develop a wide focus for the debate. It follows therefore that the debate about how best to protect our children is not a debate about Social Services.

9.2 We have to remember that the formal child protection system is part of a wider childcare system. An effective childcare system will protect children and support families by providing a range of preventive services. This enables the Childcare system to focus on child well-being and family support rather than a reactive narrow focus on child abuse. In 'What Works in Child Protection', MacDonald and Winkley (1999: 49) wrote

This message is similarly reflected in both 'Child Protection-Messages from Research (1995) and the 'Children Act Now-Messages from Research' (2001).

The draft document 'Co-operating to Safeguard Children' (DHSS&PS: 9) advocates-

Good quality preventive services for children and their families can tackle effectively many of the underlying stresses that cause child abuse. At the same time we need to ensure that where child abuse has occurred that we are able to respond effectively to protect children. This is not an either/or choice. If we under invest in Children's Services generally then we create a situation in which more children are pulled into the child protection system than need to be there.

8.3 Effective training, support and management of staff involved in child protection work are critical to ensuring good outcomes for children.

8.4 Children's Services have to be adequately funded if we are to safeguard children effectively.

All organisations involved in Safeguarding children should consider recording to be a Core Standard underpinned by clear guidelines and regular management sampling.

All organisations working in the area of Safeguarding children should work within an evidence based practice framework.

Propose that the DHSS&PS take the lead in developing an agreed method of assessment to be used by statutory and voluntary agencies involved in Safeguarding children.

Recommend that a crosscutting information strategy be developed at regional level led by DHSS&PS.

The development of child well being indicators for Northern Ireland with progress being monitored through an annual report.

Recommend the development of a strategy for the dissemination of case management reviews by the DHSS&PS.

Recommend that the DHSS&PS publish at regular intervals summaries of the issues raised by case management reviews.

Recommend that the Northern Ireland strategy for the Rights and Needs of Children should have Safeguarding Children as a cross cutting theme.

Recommend that Area Child Protection Committees should be placed on a statutory basis.

Recommend that there should either be one Child Protection register in Northern Ireland or we should network all the existing registers.

Recommend that the respective Departments in both jurisdictions [Ireland and UK] should work together to harmonise arrangements for the management of offenders and the vetting of all staff and volunteers seeking to work with children.

The DHSS&PS develop a media strategy at regional level that seeks to promote knowledge about and understanding of the Safeguarding system.

The ACPCs should develop a media strategy at a local level.

The ACPCs should develop participation strategies to involve service users and the general public in feedback about the safeguarding system.

The ACPCs should develop a participation strategy for children and young people about safeguarding issues.

Recommend that funding should be found for services that can demonstrate the ability to deliver good outcomes for children and families in safeguarding work.

Also recommend the need for a specific model of risk assessment for working with families where there is domestic violence which is used across all Boards and Trusts.

Recommend clearer guidelines be developed for sentencing related to child pornography.

Urge for awareness raising measures to protect children and young people from potential Internet dangers are fully resourced and implemented.

The case for developing a senior practitioner grade for staff involved in safeguarding work as a way of retaining experienced staff in practice is explored.

The support, supervision and management of staff in this area of work is properly resourced in order to manage the intrinsic stress in this work, ensure quality service and deliver good outcomes for children.

There should be a review of the level of resources needed to deliver Children's Services.

The Executive increases the level of resources allocated to Children's Services and that money allocated to Children's Services is ring-fenced for that purpose.

That the new Strategy for the Rights and Needs of Children is accompanied by a financial strategy setting out how our aspirations for children are to be funded.

That the new Government funding initiatives are introduced in a way that allows the Voluntary and Statutory sectors to maximise the benefits for children through proper consultation, planning and delivery.

That any new structures delivered through the current review of public administration are designed around the principles of accountability, transparency of operation, responsiveness and ability to deliver good outcomes for children.

Alderson, P., Brill, S et al (1996) What Works? Effective Social Interventions in Child Welfare Report of a conference organised by Barnardo's and the Social Science Research Unit held on 11 March 1994 Barnardo's: Barkingside

Barnardo's, Child Poverty Action Group, NSPCC (2001) Our Children, Their Future: A Manifesto for Children in Northern Ireland, Barnardo's: NI

Barnardo's Submission to the Climbie Inquiry (2002) Barnardo's: Barkingside

Barnardo's Press Statement, 15th August 2002

Child Protection: Messages From Research (1995) London: HMSO

De Groot, L (2001) Children at Risk: Some Thoughts from the Treasury HM Treasury: London

DHSS (2000) Family & Child Care Services in Northern Ireland in 2000: A Four Board Perspective

DHSSPS (2001) Key Indicators of Personal Social Services for Northern Ireland 2001

DHSSPS (2001) Co-operating to Safeguard Children Consultation Draft

Department of Health (2001) The Children Act Now: Messages From Research The Stationery Office: London

EHSSB (2001) Position Statement - Family and Child Care Services

Haltermann, S (1995) All Our Futures: The impact of public expenditure and fiscal policies on Britain's children and young people Barnardos: Barkingside

Pinkerton, J., Skehill, C., Spratt, T (2001) A Policy Appraisal of the Existing and Potential Contribution of Barnardo's to the Development of Family Support Within Northern Ireland Centre for Child Care Research & School of Social Work, QUB: Belfast

MacDonald, G with Winkley, A (1999) What Works in Child Protection? Barnardo's: Barkingside

NI Social Care Council (2002) Promoting Research and Evidence-Based Practice: From Rhetoric to Reality NISCC: Belfast

NSPCC Briefing Paper (2001) Monitoring Improvements in Outcomes for children: Developing Child Well-Being Indicators

Strachan, E & Montgomery-Devlin, J (2002) Young People's Therapeutic Project - an Evaluation Barnardo's: Northern Ireland

24 July 2002

This paper has been written in consultation with the Designated Officers Child Protection in Education Group (DOCPEG).

The Belfast Education and Library Board welcomes the opportunity to submit evidence to the Committee for Health, Social Services and Public Safety of the Northern Ireland Assembly regarding Child Protection Services in Northern Ireland.

The Department of Education will be submitting more detailed evidence giving the over arching structures for Child Protection within the education sector.

A Designated Officers for Child Protection in Education Group (DOCPEG) was established a number of years ago to ensure consistency across the education sector in child protection matters. The strategic objectives of the Group are:-

• To develop and maintain the most appropriate policy on child protection;
• To promote best practice by staff who work with children;
• To ensure relevant training is available for staff who work with children; and
• To develop and sustain links with other organisations which can contribute to the promotion of child protection within the education sector.

As the Designated Officer for Child Protection in the Belfast Education and Library Board I would wish to comment on the following key areas:-

I would wish to endorse the introduction of a number of clauses in the draft Education and Library Bill, aimed at strengthening the current child protection arrangements within education.

There is a need to promote a greater emphasis on the prevention of significant harm to children and young people. A useful forum already exists within a number of schools, where a multi agency team meet regularly to develop a co-ordinated approach to pastoral care issues. Members are drawn from education, health and social services. In this way early identification and prevention of significant harm is promoted, furthermore the provision of a named social worker for each school encourages positive working relationships, where education staff feel confident in discussing potential child abuse cases with colleagues in the statutory sector.

On occasions school staff do not feel they have been given adequate feedback on cases they have referred. As teachers are probably the only professionals to see children on a daily basis, it is essential that they have sufficient information to allow them to monitor vulnerable young people. They must be made aware of children who have been placed on the child protection register. This is not always the case.

General Practitioners have a particular role to play, therefore strategies need to be developed to ensure their participation in inter-agency meetings and child protection case conferences.

Some of the Health and Social Services Trusts have adopted a pro-active approach in providing "user friendly" information leaflets and videos for parents and young people, explaining the child protection process. This partnership approach is to be welcomed.

Within education, schools are being encouraged to provide information to parents on an annual basis regarding pastoral care and child protection procedures. It is essential that there are close linkages between the local Health and Social Services Trust Panels and the Area Child Protection Committee (ACPC). A number of schools have experienced parental aggression following child protection referrals being made. It is imperative therefore that liaison takes place between the designated teacher in the school and the social worker prior to informing parents about the school's duty to refer.

Currently Education and Library Boards provide training annually for Designated Teachers for Child Protection and other employees in the Boards. There are also opportunities for education personnel to attend multi-disciplinary training offered by the ACPC.

In order to support the Designated Teachers in their training of staff, a video was produced and issued to every school in Northern Ireland. This training would be enhanced if there was closer consultation and linkage between the uni-disciplinary and the multi-disciplinary training.

It is widely recognised that current resources across sectors are not adequate. There are concerns that social workers are only dealing with the most critical child protection referrals. This leads to frustration for school personnel, who are concerned that, when a referral is made there can be a delay before the case is dealt with.

The recent inspection of the Education Welfare Service by the Education and Training Inspectorate has highlighted the need for the role of Designated Officer within the Board to be reviewed, because of the volume of the work. The majority of Designated Officers carry out this role in addition to being the Head of Service eg. Chief Education Welfare Officer.

In general terms it would appear that when there is an inquiry into case management, concerns are raised around multi-disciplinary working and lack of communication.

As stated earlier schools have a major role to play in relation to reporting and monitoring potential child abuse cases. It is essential that arrangements are in place to allow them to feel confident about passing on concerns to social services and indeed commutating concerns to parents which minimise potential parental violence/aggression.

There are concerns that a growing number of children, who do not reach the threshold of significant harm may be falling through gaps in agencies provision. It is hoped that implementation of the common assessment framework for children in need will address this concern.

MAXINE DEVENNEY
Chief Education Welfare Officer

29 August 2002

The following comments have been received from our craft committees:

• Important to have adequate communication between health professionals - this is not as comprehensive and effective as it should be.
• The concept of protected time for communication between health professionals, nursing professionals and social services is important.
• Possibly could be delivered as part of the LHSCG agenda.
• In areas of deprivation the caseload of health visitors should be reduced therefore increasing the requirement for more health visitors in such areas.

It has also been commented that there are

• Gaps in service provision
• Inadequate funding
• Inadequate admission facilities for children

If you require any further information or clarification please do not

hesitate to contact us.

KATHLEEN JONES
Executive Officer

16 August 2002

Causeway Health and Social Services Trust welcomes the Health, Social Services and Public Safety Committee's decision to undertake an inquiry into Child Protection Services in Northern Ireland. As a Trust we believe firmly that the well-being and protection of children is the responsibility of the whole community within Northern Ireland. This initiative by the Committee is most encouraging and the Trust looks forward to reading the eventual report.

At the outset it is important to highlight that Causeway Trust's response should be read in the context of the comprehensive overview report prepared by the Northern Health Social Services Board. Causeway Trust staff were involved with Northern Health and Social Services Board colleagues in collating that report which will give the Committee a more strategic and structural perspective on this area of work, as well as presenting some very informative statistics about services currently provided.

Causeway Trust is very mindful of the huge volume of information which is likely to find its way to the Committee. It is therefore our intention to keep this report as brief as possible but to present what we consider to be the key themes arising from our experience of delivering services within the field of Child Protection. We are confident that these themes will be reflected in most of the other submissions to the Committee.

Before commenting on the key areas listed in the Committee's letter (20th June 2002), Causeway Trust would wish to highlight its belief that the best protection we can offer to our children is when all the statutory agencies, voluntary organisations and local communities accept that Child Protection is the responsibility of everyone in the community. It must not be left to any single agency to carry. The Committee's inquiry is an important opportunity for this basic but vital message to be articulated and reinforced by the Northern Ireland Assembly.

• Case recording in Child Protection work is generally of a high standard, particularly in respect of Child Protection Case Conferences and reports for the Courts.
• Increasingly Social Work Practice is moving from the initial investigation of allegations/concerns (clarifying what happened to a given child) to an assessment of current vulnerability or risk.
• Work done by Bolton Social Services in this area has been helpful.

Generally this has improved, however, the current issues include: -

• Poor GP attendance at Child Protection Case Conferences.
• Concerns from some medical personnel (including psychiatry) re confidentiality issues, which may inhibit or slow the sharing of information.
• Some Schedule One offenders receive psychiatric help. Assessments of their current risk status are given but are not thought to be based on the Thornton 2000 or other more accredited risk assessment instruments.
• Legal consultations usually occur in Belfast especially if Senior Counsel is involved. A video-conferencing facility (similar to that used in the WH&SSB) would save invaluable time.
• Liaison between Social Services staff and PSNI Care Teams seems to work better in some areas than others. There may be various reasons for this - pressure of work, relationship, personalities, past experience in cases, turnover of staff, and internal office related difficulties on both sides.

• It is not always possible to access therapeutic services for children/families who have suffered abuse.
• There is a dearth in Northern Ireland of the required range of therapeutic care placements for children who have been abused. This leads to inappropriate placements and hugely expensive placements in England, etc.
• An example of good practice - Concern from Community Leaders in Ballycastle re the presence of convicted paedophiles in the community, led to interagency co-operation between Social Services, the police and the NSPCC in putting together the 'Ballycastle Roadshow' to reassure communities, regarding the monitoring of sex offenders in the community, through public meetings'. This interagency strategy appears to have been very effective.

• Training - Causeway Trust recognizes that a key to comprehensive high quality service is sufficient number of adequately trained social work staff. All family and child care staff within Causeway receive training in the recognition and responding to child abuse at an early stage in their employment. The education and training programme is delivered through the Area Child Protection Committee's Training and Development department. Further training in respect of joint interviewing with the police and video evidence interviewing is also provided for the more experienced social workers. As a matter of policy Causeway Trust supports post qualifying training for all social work staff including the Advanced Award in Social Work.
• Supervision - All staff within Family and Child Care receive regular supervision from their team leader. All child protection cases must be discussed at each supervision session, of which a written record is kept. Senior staff within the Family and Child Care directorate are available for consultation advice and support. The Causeway Trust has similar arrangements to all other Trust in respect of professional legal advice.
• Given the Trust's experience of working within this field we would make a number of recommendations in respect of continuing professional development;
• Child Protection Education and Training should be deemed mandatory for key professionals who work in children's services, including health and education.
• Child Protection Education and Training should be organised on a multidisciplinary agency bases when appropriate
• The use of experienced Child Protection Consultants should be considered to assist with professional development for Family and Child Care Pratisiners
• An urgent review of pay and conditions for Family and Child Care staff is essential if the current recruitment and retention problems are to be addressed.

• The Children (NI) Order 1995 was regarded as the most radical piece of Child Care legislation of recent times. It is now evident that at the time of implementation the Department took a very conservative view of the projected cost of implementing this legislation. A number of key areas were excluded from the calculations at that time including child protection, family placement, residential care and medical implications. It is now generally accepted that the four Boards' original submissions were in fact a serious underestimate of the real costs of implementation.
• Furthermore, the serious under funding issue has been severely compounded by a number of subsequent policy initiatives - most of which have been resource intensive. These include:

• A clear message we would wish to give to the Committee is that effective Child Protection Services need to be appropriately resourced and supported.
• Causeway Trust would refer the Committee to the recent Needs and Effectiveness Review conducted in Northern Ireland which we believe indicate that substantial level of investment is required in order to bring children services in Northern Ireland up to the equivalent funding in England.
• Any Child Protection Strategy which focuses on policies, procedures and structures to the exclusion of resourcing will inevitably fail and will further demoralise hard pressed staff.

• All inquiry reports and case management reviews within the U.K continue to reflect similar problems to those identified in the report on the death of Maria Colwell of nearly 30 years ago. Issues of communication between professionals and agencies, over stretched and stressed staff and the need for basic and more specialist training have been recurring themes.
• The Northern Area Child Protection Committee produced guidance for the conduct of the case management reviews within the Board's Area. Lessons from a recent case management review included a review of the Area Child Protection Committee's training programme, provision of further training to facilitate inter-agency working, the production of good practice guidance, the preparation for the implementation of a needs-led assessment framework and a review of resourcing for the Trusts' Family and Child Care teams.
• The placing of Area Child Protection committees on a statutory footing is considered by this Trust to be an important step in strengthening the infrastructure around protecting children.

Causeway Trust would wish to make a number of additional recommendations:

1. The DHSSPS should establish a NI Strategic Plan for the protection of children which should confirm the responsibilities for child protection of all other government departments.

2. The DHSSPS in conjunction with the Area Health Social Services Boards, should review the adeqacy of funding for Family and Child Care Services in Northern Ireland.

3. The DHSSPS needs to develop as part of its Children's Strategy ways to improve investment levels in Family and Child Care. There needs to be more emphasis on earlier prevention and family support - also should be reflected as priorities in Programme for Government.

4. The DHSSPS should with the appropriate bodies review the role of GPs, who are independent contractors, in terms of how to encourage their fuller involvement in the Child Protection system.

MR JIM LOUGHREY
Executive Director of Social Work
Causeway Health and Social Services Trust

1. The general role of the Department is to provide the broad framework for child protection services through the provision of legislation and guidance. This work is carried forward by the Department's Child and Community Care Directorate, which has responsibility for overall child care policy (including child protection), in liaison with the Social Services Inspectorate. The latter is a professional group within the Department which supports Ministers, DHSSPS and other Departments and agencies working in the field of social care.

2. The main legislation dealing with the welfare of children is the Children (NI) Order 1995. The Order is very extensive, covering a wide range of child welfare issues in both the public and private law. In relation to social services, the main significance of the Order lies in the duties placed on HSS Boards and Trusts to safeguard and promote the welfare of children in their areas. In carrying out this duty Boards and Trusts are required to assess the extent to which there are children in need in their areas and to provide a range and level of services appropriate to assessed need. The overall thrust of the Order is that children in need should be brought up by their families, wherever this is possible and consistent with their welfare, and that services should be provided to enable families to stay together. The Order recognises that there are circumstances when children must be taken into care and includes provision for care and supervision orders which may be made by the courts when a child is deemed to be at risk of significant harm. Provisions are also included for courts to make emergency protection orders where action is needed to remove a child from the family home or other location where the child is at risk. All of these orders are generally applied for by HSS Trusts and courts may also make a child assessment order in cases where there are concerns that a child is suffering or likely to suffer significant harm.

3. Although the Children Order provides the legislative context, much child protection work is carried out in the context of guidance rather than law. To coincide with the commencement of the Order in November 1996, the Department published a series of volumes of guidance including "Co-operating to Protect Children". This was designed to provide a framework for inter-agency co-operation which would ensure that child protection arrangements operate in the best interests of children and their families. The guidance recognises that, while HSS Boards and Trusts have statutory responsibilities under the Children Order for the care and protection of children, other agencies are also involved in child protection. These agencies include the police, the NSPCC, the education services, the youth service and the probation service.

4. "Co-operating to Protect Children" addresses the roles and responsibilities of agencies involved in child protection. It addresses the functions of Area Child Protection Committees (ACPCs) as the focus of inter-agency and inter-disciplinary child protection work at strategic level within each HSS Board area, and inter-agency and inter-disciplinary work in relation to individual cases. The guidance also deals with the conduct of child protection case conferences, assessment and planning, the maintenance of child protection registers and the conduct of case management reviews where a case of confirmed or suspected child abuse involves the death or serious injury to a child.

5. The child protection guidance issued by the Department provides the basis for the development of local procedures and protocols. It is intended to be sufficiently flexible to meet local needs. In practice there is a high degree of collaboration and standardisation between ACPCs. The guidance has been revised, and following extensive consultation, is due to be published shortly under the title "Co-operating to Safeguard Children" (CTSC). In addressing the key areas on which guidance is provided by the Department references below are to CTSC.

6. In addition to the functions already outlined the Department is responsible for the operation of the Pre-Employment Consultancy Service (PECS). This permits organisations in the voluntary and statutory sectors to have checks carried out in relation to prospective employees seeking work with children. PECS was established in 1981 following the enquiry into Children's Homes and Hostels occasioned by cases of abuse at Kincora Boy's Hostel.

7. The system was designed so that checks could be carried out against criminal records and the "PECS Register". The Register is maintained by DHSSPS. It is compiled from information provided by voluntary and statutory organisations in relation to workers (paid employees and volunteers) have been dismissed, transferred to other work, or who have resigned in circumstances where it is considered that they posed a threat to children. Checks are also carried out in relation to the list of those banned from working in schools and against similar lists maintained by the Department of Health and the Department for Education and Skills in England and Wales. The system is voluntary and it is left to organisations to decide whether or not to employ an individual. Legislation presently before the Assembly will make significant changes in this area and is discussed at paragraph 53 below.

8. Chapter 8 of CTSC deals specifically with the issue of record keeping. Linked to the keeping of records is disclosure from those records and questions of confidentiality which disclosure raises. For this reason the issue of confidentiality when sharing information with other agencies is also covered by this chapter.

9. As stated in CTSC, well-kept records are essential to good child protection practice. Safeguarding children requires information to be brought together from a number of sources, and careful professional judgements to be made on the basis of this information. CTSC advises that records must be clear, accessible and comprehensive and that judgements made and actions taken should be carefully recorded. Where decisions have been taken jointly across agencies, or endorsed by a manager, it is essential that this is made clear.

10. Relevant information will normally be collated in one place by social services and records should readily provide an incisive insight into any case including:

• The relevant history of the child and family which led to the intervention;
• The nature of interventions, including intended outcomes;
• The means by which change is to be achieved; and
• The progress that is being made.

11. It is also essential that a child's records are transferred promptly to the relevant agency in another locality to which the child and family moves. This, too, is covered in CTSC as is the need for record retention policies within any given agency. These policies should ensure that records are stored safely and can be retrieved promptly and efficiently and this includes records of cases where enquiries do not substantiate the original concerns raised.

12. CTSC openly acknowledges the demands and stresses faced by staff working in child protection and the difficult judgements they often have to make. It is essential, given the complexity of the work they undertake and the implications of getting it wrong, that staff have access to supervision and support from managers on a frequent and regular basis. It is also recommended that supervision sessions, for example, should be recorded in writing, including session content and any decisions made.

13. It is accepted that there are will always be situations when difficult professional judgements will have to be made. However, if a system is in place where clear procedures have been established which are governed by the basic principles of social care and backed by strong supervision and management arrangements, staff will be assisted greatly in their task. Chapter 5 of CTSC provides advice on what should happen where there are concerns that a child is suffering or is at risk of suffering significant harm. As stated explicitly, the chapter is not intended to constitute procedural guidance which should be devised by the ACPC. It does, however, set out the Department's expectations about the ways in which agencies and professionals should work together in the interests of children's safety.

14. The chapter deals with the child protection process from the initial referral to social services through to the formulation of the child protection plan and subsequent child protection review conference. Timescales within which certain actions or stages should have been taken or reached are clearly defined. The chapter also covers a number of very specific issues including interviewing children, dealing with appeals and complaints from parents, pre-birth child protection case conferences and the child protection register.

15. The approach to child protection advocated by CTSC is one which ensures that child protection services are targeted at children most in need of protection from serious forms of abuse. Successful targeting is dependent on accurate assessment of need or risk. CTSC emphasises the need for community Trusts to have assessment procedures in place which enable staff to distinguish children at risk of significant harm from those whose needs can be met by other means.

16. To be able to make an informed assessment of the needs of a child or of the risk to which he might be exposed, CTSC states that staff of all agencies need to be alert to the potential indicators of abuse or neglect. Staff also need to share and to make full use of existing sources of information, including the child protection register. The guidance advises that staff look at the whole picture - not only what has happened to the child, but also the child's health and development and the wider family and environmental concerns.

17. There are certain items of information which are of use to the Department to enable it to make some kind of assessment or analysis of child protection practice. These items, which are listed in Appendix 4 of CTSC, relate in the main to child protection referrals, investigations, case conferences, case management reviews and information on the child protection register. CTSC recommends that this information is included in the ACPC report which should be produced on an annual basis. The purpose of the ACPC annual report is to highlight the strengths and weaknesses of child protection service provision in their area.

18. The Children (Northern Ireland) Order 1995 places a statutory duty on health, education and other services to assist social services with their enquiries. This is in recognition of the fact that safeguarding children depends upon effective information sharing, collaboration and understanding between families, agencies and professionals and this point is made in the opening paragraphs of CTSC.

19. CTSC states that all agencies concerned with the protection of children must work together on an interagency basis in the best interests of children and their families. Hospital Trusts, for example, are advised to have effective communication systems for co-ordinating work between different provider units (hospital, community child health service, school health service) including an efficient system for transferring records.

20. Similarly in the community, it is imperative that there is good communication between GPs, health visitors, practice nurses and midwives about all children about whom there are concerns or adults who pose a risk to children. This point is emphasised in CTSC as is the necessity for primary care professionals to be in no doubt about how to refer a child, about whom they are concerned, to social services.

21. Despite the fact that the police and social services have different functions, powers and methods of working, their functions are complementary and joint investigations and interviewing arrangements by the police and social workers have been established under a joint protocol. CTSC advises that police officers should be prepared to share information and intelligence with other agencies where this is necessary to protect children. Evidence gathered during a criminal investigation, which does not yield a prosecution, may, for example, be of use in deciding if a child needs protection and in preparing for civil proceedings to protect the child. While the DPP must be consulted in cases of this kind, the sharing of information is normally permitted if it is considered to be in the best interests of the child.

22. Another example of collaborative working is that which takes place between HSS Trusts and NSPCC who have created child protection teams and projects to provide specialist services. CTSC makes reference to collaborative working of this kind.

23. The role to be played by members of the wider community is also acknowledged in CTSC. Particular reference is made to community resources including self-help and mutual aid initiatives, support services and advocacy and campaign initiatives. It is recommended that all agencies promote a better understanding of their work and to develop a partnership with the wider community by communicating openly about their work. This includes informing the local community of the services on offer to children in need and their families and also how and when to make contact where there are concerns about a child.

24. A multi-disciplinary, multi-agency approach to child protection is primarily achieved through the four Area Child Protection Committees (ACPCs) which have responsibility for co-ordinating policies and procedures in each Board Area. In addition each community based Trust is required to have a Child Protection Panel (CPP) to facilitate practice at a local level. The roles and responsibilities of ACPCs, structure, membership, funding and accountability arrangements are set out in CTSC. Co-operation between ACPCs is also advocated so that consistency in practice and information sharing can be achieved and duplication of effort avoided. Arrangements in relation to the functioning of CPPs are also outlined in the guidance document.

25. Whilst interagency working is essential to protect children, it is also important that each agency has an understanding of each other's values and accepts their respective roles, powers and responsibilities. Lines of responsibility must be clearly drawn so that the potential for inaction, which might result in a child suffering harm or further harm, is removed. To this end the specific roles and responsibilities of individual agencies are dealt with separately and are set out in summary in the following table:

26. CTSC makes the point that a proper balance must be struck between protecting children and respecting the rights and needs of parents and families. The need to consult with parents/carers is promoted in the guidance as is the need to involve them in matters which concern their families. However, it is clearly stated that where a conflict arises, the child's interests must remain paramount. Family members will, for example, be asked to contribute to an interagency plan to safeguard a child or children. Arrangements must exist within a Trust so that social services staff (as the principal point of contact for children where there are child protection concerns) can be contacted directly by parents or family members seeking help, concerned friends and neighbours, or by professionals and statutory and voluntary agencies.

27. Reference is also made to research findings brought together in Child Protection: Messages from Research which endorse the importance of good relationships between professionals and families in helping to bring about the best possible outcomes for children. This applies also in situations where there is compulsory intervention in family life. CTSC advises that help and encouragement should always be offered to parents to enable them to play as large a part as possible in decisions about their child.

28. The four ACPCs have a public education role to increase community awareness of child abuse and to enable individuals to play their part in safeguarding children. This is referred to in CTSC which also suggests that this can be achieved either by staff of ACPC member agencies directly providing training to community and voluntary groups or by engaging the services of the Volunteer Development Agency which receives Departmental funding for this service (See Paragraph 30).

29. In the late 1980's, the then Department of Health and Social Services commissioned a 3 year programme of training for child protection through the Health and Social Services Boards. This was the first time that training for child protection had been specifically selected for additional funding support. During the 1990's such training developed under the auspices of the Area Child Protection Committees and their training sub-committees to become broadly multi-disciplinary and multi-agency. Details of the ACPC annual training programmes are directly available from them.

30. With the implementation of the Children (NI) Order 1995, additional funding was allocated to cover all aspects of training linked to the Children Order, including the development of children's services and of course child protection services. As part of the Children Order training strategy for the region, Child Care Northern Ireland (an umbrella organisation for the voluntary child care sector) operates an annual training programme funded by the Department targeted at the full range of child care voluntary agencies. Child protection issues are part of this programme. The Department also provides funding to the Volunteer Development Agency (VDA) for the Our Duty to Care Project. This project provides support, information and training to organisations in the voluntary and community sectors. This includes training on the use of PECS. Funding has been made available to VDA for this purpose from 1995. A total grant of £115k was awarded for 2002/03.

31. As indicated in CTSC, effective child protection depends on the knowledge and judgement of all staff working with children. It is essential, therefore, that staff have ready access to appropriate and relevant training to help them develop their knowledge base and their hone judgement making skills. It is recommended in CTSC that staff in direct contact with children should receive training on:

• The legislative framework;
• Policy and procedures;
• Predisposing factors, signs and symptoms of child abuse;
• Information sharing; and
• Co-operating with other agencies, disciplines and the family to safeguard children.

32. In addition to single agency or professional training, it is also essential that staff can avail of inter-agency training programmes to enable them to develop a shared understanding of the respective roles and responsibilities of different professionals leading to more effective working relationships. CTSC indicates which groups should be able to avail of inter-agency training. These range from those who work directly with children to those who have strategic and managerial responsibility for children and families.

33. The ACPC is responsible for taking a strategic overview of the planning, delivery and evaluation of the inter-agency training strategy required to promote effective practice. It is the responsibility of each ACPC not only to identify training needs but also to ensure that these are met and reviewed. This is normally achieved through an ACPC sub-committee with specific responsibility for training. However, ACPCs are also required to have training as a standard item on the ACPC agenda.

34. While the strategic responsibility for training rests with the ACPC, each employing organisation has a responsibility to resource and support inter-agency training. This includes the provision of staff with relevant expertise to sit on the training sub-committee to releasing staff to attend inter-agency training courses.

35. CTSC provides a training framework which outlines three stages of training matched to the depth of involvement of the staff concerned. This framework details the key outcomes which should be achieved having completed each training stage.

36. Ministerial approval to reform social work training was sought and granted with the result that a new graduate level training programme will commence in September 2004. The reform was considered necessary given the increasing complexity of family and child care work and identified deficits in professional practice. Among the issues which will be covered as a priority by the curriculum include:

• partnership working (with a strong emphasis on agency co-operation)
• assessment (with greater focus on holistic assessment of need and risk)
• communication (establishing better mechanisms for communicating which includes communication with children)

It is also intended that at the end of their degree course, social work graduates will be required to complete a pre-registration year in the field.

37. As indicated above, it is essential, given the complexity of the work undertaken by staff working in the child protection arena that they have access to supervision and support from managers on a frequent and regular basis. CTSC makes this point and goes on to indicate the kind of supervision arrangements that an organisation should have in place. Supervision should as a minimum include:

• Scrutiny and evaluation of work carried out;
• Assessment of the strengths and weaknesses of the practitioner;
• Provision of professional development and pastoral support;
• Ensuring that practice is soundly based and consistent with ACPC procedures;
• Ensuring that practitioners fully understand their roles, responsibilities and the limits of their professional discretion and authority;
• Identifying the individual's training and development needs.

38. Anecdotal evidence, both here and in GB would support the belief that child protection services have a negative image and are associated with failures to adequately protect children from harm and that there is a reluctance amongst qualified staff to become involved or to remain in the child care sector. The Department supports both post-graduate and employment based social work studies in an effort to ease pressures on the workforce. In addition the Department has recently commissioned a study of the social services workforce. Early indications from this, as yet, unpublished study, suggest that there is a more rapid turnover of staff in the child care programme than in the adult programme of care. This suggests greater pressures on staff in the child care programme generally.

39. Additional resources for children's social services are provided to Board's on a capitation basis. The allocations do not differentiate between child protection and children's services generally. The amounts allocated are as follows:

The overall effect is that since 1996 / 97, the year in which the Children Order came into operation some £23.5 M of additional recurring funding has been provided by the Department. This does not account for other funds for children's services provided under EPF or the Children's Fund. In terms of expenditure per capita the most recent comparison with England indicates that expenditure lags behind (the figures for 2000/01 indicate expenditure of £179.7 per child here as compared to £254.0 in England). Despite some recent narrowing of the gap and increased funding here and in England (as a result of the 'Quality Protects' initiative) the gap has remained fairly static and undoubtedly arises from pre-existing expenditure patterns.

40. CTSC states that a case management review should be commissioned by the ACPC when a child has died and it is suspected that abuse may have contributed to the death (including cases of suicide). Consideration is also to be given to commissioning a case management review following serious injury to a child, where is considered that abuse may have been a contributory factor. A case management review is a multi-agency review of the way services to a child and family have or have not been provided. The emphasis is upon what lessons can be learned about the way professionals and agencies have worked together to safeguard children and to plan any necessary changes to inter-agency working and thus provide better safeguards for children. Case management reviews are not enquiries into how a child died or who was culpable as such matters fall to the coroner and the criminal courts to determine.

41. CTSC makes some changes to previous guidance, notably in that responsibility for conducting a case management review rests with the relevant ACPC rather than the HSS Trust responsible for the child. However in broad terms the aims and objectives of a case management review remain the same. Case management review reports are forwarded to the Department. Since 1986 there have been 10 such reports, 9 of which related to the death of a child. The reports have been used to inform Departmental guidance on child protection, including CTSC. Preliminary consideration of some recent review cases, for example, would suggest that CTSC will require amendment. Changes are likely to be made to chapters dealing with record keeping and supervision.

42. In addition the Department has shared the recommendations on relevant inquiries in GB with Boards / Trusts. For example, the relevant findings of the Tribunal of Inquiry into abuse of children in the former North Wales County Council areas of Gwynedd and Clwyd (the 'Waterhouse Inquiry') were the subject of a survey of Boards and Trusts with follow up meetings with senior staff in Boards and Trusts. This process was designed to ensure that the relevant messages from the Inquiry were taken on Board.

43. The Department is currently reviewing how the dissemination of information gleaned from case management reviews might be improved. One approach which is being considered is the establishment of a child protection review group comprising representatives from all of the key statutory and voluntary agencies, including representatives from different disciplines. The group would be responsible for examining case management review reports, ensuring effective communication of the findings of case management reviews and making recommendations as to further action - for example the conduct of an independent inquiry.

44. The following comments are intended to provide some information on child protection in terms of the scale of the problems faced and actions currently being undertaken.

45. At 31 March 2001 there were 1,414 children on the child protection registers. Of this number 718 (50.8%) were girls and 696 (49.2%) were boys. The total number of children on the child protection registers represents a rate of 31 children per 10,000 of the under 18-year old population. This is substantially higher than the corresponding figure for England (24), however there are considerable local variations both here and in England. Caution is also needed in drawing conclusions from differences in the relative numbers on child protection registers. For example, since a child who is on a child protection register has a child protection plan, a lower number may be due to differences in standards and other factors and cannot be used in itself as an indicator a greater number of children at risk.

46. In relation to the ages of children on child protection registers just over 4 in 10 (574) were aged 5-11 years, with 6.9% under 1 year old and 5.1% aged 16 years or over. A higher proportion of girls (30.2%) than boys (24.4%) were 12 years old or older. Almost three-quarters of children (1,027) on child protection registers were aged under 12.

47. The category of abuse under which each child is registered is decided at the child protection conference. When agreement is reached that protection is necessary each child is recorded as being in an abuse category which provides the most accurate picture of the situation. The four main categories used are - neglect, physical abuse, sexual abuse and emotional abuse. In general terms 'neglect' means the actual or persistent or severe neglect of a child from exposure to any kind of danger, including cold and starvation, or persistent failure to carry out important aspects of care, resulting in significant impairment of a child's health or development. 'Physical abuse' refers to actual or likely deliberate physical injury to a child, or wilful or neglectful failure to prevent physical injury or suffering to a child. 'Sexual abuse' refers to actual or likely exploitation of a child. 'Emotional abuse' relates to actual or likely persistent or severe emotional ill-treatment or rejection resulting in severe adverse effects on the emotional, physical and/or behavioural development of a child. As all abuse entails some level of emotional ill treatment and this category is therefore used where emotional abuse is the main or only form of abuse. There are also a number of mixed categories for more complex cases, e.g. 'neglect and physical abuse' and 'physical and sexual abuse'.

48. The following is an analysis of the categories of abuse as at 31 March 2001.

The main points to note are that 37% of children were on the register by virtue of 'neglect' only; 24% for 'physical abuse' only; 14% for 'emotional abuse' only; 13% for 'sexual abuse' only and 12% for more than one category of abuse. One in two (775) children on the register were assessed as potential cases of abuse, 39% were cases of confirmed abuse with the rest being cases of suspected abuse. Of the 546 cases of confirmed abuse 54% were categorised as 'neglect only'.

49. It may be noted that, over the period 1999 and 2001 the number on child protection registers fell slightly from 1463 to 1414. The proportion of children registered under 'sexual abuse only' decreased from 17.3% (253) to 13.4% (189) whilst the proportion of children registered under 'physical abuse only' increased from 20.9% (306) to 24% (340). Of those on the registers at 31 March 2001, 52.4% had been registered for between 6 months and 2 years and almost 20% had registered for 2 years or more.

50. Child protection work is closely allied to the development of services. Although not all children taken into care by social services are in the high-risk category the development of children's services is crucial to child protection. The key areas to which priority is being given on a regional level relate to the development of residential, foster care and adoption services. The intention is to create improvements in the quality of services and in the range of placements for children in need of help.

51. In October 1998 the Report by the Department's Social Services Inspectorate into the state of residential care - "Children Matter" - highlighted the shortfall in residential care provision and the lack of facilities to meet the varied needs of children looked after by social services. A Task Force comprising senior officials from the Department and the four HSS Boards (now supplemented by representatives from HSS Trusts, the voluntary sector and the NIO) has been involved in implementing "Children Matter". Phase 1 of the Task Force Regional Plan sets out a programme of 22 projects aimed at providing 77 additional and 70 replacement places by March 2003. Phase 2 will address such issues as developing residential services for children with psychological and psychiatric needs; the development of non-secure alternatives to secure accommodation and the need to structure residential services for adolescents in liaison with voluntary sector interests.

52. In relation to fostering services steps are being taken to expand the number and types of foster carers available to look after children in a family context in line with the Code of Practice on the Recruitment, Assessment, Approval, Training, Management and Support of Foster Carers and the National Standards for Foster Care. In addition, as a means of securing permanency for children in care, it is intended that adoption services should be developed with a view to having at least 4% of children looked after by social services adopted.

53. The Department has introduced into the Assembly a Protection of Children and Vulnerable Adults Bill". The broad intention of the Bill is to place the existing PECS system on a statutory basis and to enhance the arrangements. The Bill is extensive and includes provisions which will - place duties on child care organisations to make referrals of those who pose a risk and who meet certain specified criteria and impose duties on organisations to carry out checks on prospective employees. The Bill also sets out offences of working, or applying to work, with children whilst on a list of those deemed unsuitable to work with children held by the Department or whilst on a list held by the Department of Education of those deemed unsuitable to work in education related employment. In addition, it is anticipated that a Private Member's Bill will be introduced shortly which will place the functions of ACPCs on a statutory basis. The Bill is likely to provide for specific funding for ACPC work.

54. Following an Assembly debate in July 2001, which called for greater public awareness of PECS, a group comprising representatives from DHSSPS, Department of Education, Health and Social Services Boards and Trusts, Education & Library Boards, NSPCC, Barnardo's, VDA and Community Sector Training was established. The group has produced a booklet which is aimed at organisations in the statutory, voluntary and community sectors. The booklet contains practical advice and guidance for organisations including information on good employment practices, child protection policies, dealing with allegations of abuse and the operation of PECS. Approximately 30,000 booklets will be published and widely distributed by October 2002.

55. As already noted child protection sits in the wider context of social services for children and in the context of the work of other Departments and agencies. The work of ACPCs is already an integral part of Children's Services Plans at Board level. The fundamental aim of children's services planning is to ensure the delivery of services which will promote and safeguard the welfare of children. It is recognised that there have been developments elsewhere, notably the 'Quality Protects' initiative in England. In broad terms 'Quality Protects' clarifies the role of local authorities in the provision of children's services. It also sets out objectives covering care placements; child protection; life chances for looked after children and children in need; leaving care; children with a disability; responses to children assessed to be in need and resource management.

56. As already noted the Department is already involved in work in relation to developing residential and foster care services, the revision of child protection guidance and procedures and new legislation in this area. Some of the issues addressed in Quality Protects programme are being addressed including the needs of young care leavers which is the subject of a Bill currently before the Assembly. However, it is recognised that there is a need for a broader strategic approach to the provision of services for children and their families. Important areas to be covered will be in relation to the response to be made to children assessed to be "in need" or who are looked after by a HSS Trust. The importance of preventative measures which will reduce the risk to children and the need for them to be taken into care will also be covered. Work has been carried out on a consultation document for a Strategy for Children's Social Services to be issued later in the year.

57. SSI regularly conducts a programme of inspections and consults organisations outside the Department and groups and directorates within the Department on the Roll Forward Inspection. The programme for the next 3 years (2001 - 2005) has been agreed with Minister and includes:

• services for children with disabilities
• social work in mental health services
• social work services for people with sensory impairment
• social care services for carers

58. In advance and in preparation for inspections, SSI produce detailed standards and associated criteria for use in each inspection. These standards are produced in collaboration with the statutory, voluntary and independent providers. Guidance to assist organisations conduct their own audit and to quality assure their practice is also made available. Work on the development of standards in relation to child protection services will commence in Spring 2003 with a major inspection of these services planned for the coming year.

Introduction + Background

Roles and Responsibilities of Medical Staff assessing children for possible abuse

Routes of Referral for Children suspected of having been abused

Setting for examination of children

Facilities / equipment for assessment of children suspected of having been abused

Other Issues of Concern to Paediatricians

Recommendations

References

Abbreviations

1.1 I am Dr Alison .F.Livingstone MBChB, MRCP ( Paeds ). I am Lead Consultant Community Paediatrician for Homefirst Community Trust. I am a member of Homefirst Child Protection Panel. I currently chair the Child Protection Focus Group.

1.2 Child Protection Focus Group ( N.Ireland ). This group was initiated informally 2 years ago by a group of senior paediatricians and includes representatives from each of the four Health Boards with an interest in child protection. We currently have 12 members (Consultant Paediatricians, Associate Specialists and SCMO's) and meet every 3 months to review best practice and guidelines in the area of child abuse and provide peer support and advice.

1.3 Group members are regularly involved in the assessment of children for possible physical abuse, sexual abuse, neglect and/or emotional abuse within their respective NHS Trusts. Children can be referred for a paediatric opinion by social services, police or other medical. nursing and PAMS colleagues. We are also involved in regular teaching for junior medical (and other professional) staff in recognition and management of child abuse.

1.4 The investigation of alleged child abuse should be multi-professional and co-ordinated in a child-friendly setting to minimize distress to the child and family.

The principal aims of a full medical assessment in suspected child abuse are to:-

• Establish the need for immediate treatment
• Provide information which might support the allegation as well as, in due course, sustain care plans and criminal proceedings
• Offer reassurance to the child and family
• Plan any ongoing healthcare

The paediatric assessment of the child following an allegation of sexual abuse should be seen not only as an investigation, but as a therapeutic experience which may help to start the process of healing ( de San Lazaro, 1995 )

2. The following are issues which we think are important for the committee to be aware of and consider in the context of this inquiry. These issues are presented entirely from a paediatric perspective

• Roles and responsibilities of medical staff assessing children for possible abuse needs clarification.
• Routes of referral for medical assessment of children suspected of being abused needs clarification for all professionals involved.
• Standards for the clinical setting for examination of children should be devised.
• Standard facilities/equipment for examination of children suspected of being sexually abused should be available throughout N. Ireland.

3. Children suspected of having been abused are currently assessed by a number of different medical professionals each with different training, experience and focusing on different aspects of a case.

• GP
• Forensic Medical Officer
• Consultant Paediatrician
• A+E Consultant
• Junior medical staff in Paediatrics , A+E or General Practice

3.1 GPs may discover possible signs of abuse during routine consultation. They may be asked to look at a particular injury to assess if this is an accidental or non-accidental injury or may be asked to examine the genitalia when symptoms or signs may be suggestive of abuse. Depending on a GP`s level of training ,confidence or experience they may either make a clinical judgement or refer to a Paediatrician or A+E for a further opinion. The GP is often dealing with the whole family and may have vital information on family history or social circumstances but can also find it difficult to approach this subject in a family they know well and will have on-going care for.

3.2 Forensic Medical Officers (FMO) are employed by the PSNI to assess children for evidence of abuse with a view to establishing if a crime has been committed and linking that crime to a perpetrator by means of evidence detection. In some areas in N. Ireland (eg. Foyle Trust and some areas of SHSSB ) FMO`S work closely with Paediatricians and joint examinations involving both professions are carried out. This is mostly in the context of child sexual abuse. In other areas this practice is variable or non-existent. FMO`s experience/training in assessing children (including general paediatric knowledge/developmental assessment) varies throughout N.Ireland. On-going medical follow-up of the child, if required ,would not be carried out by the FMO (unless they happen to be the child's GP). FMO`s often work as GP's and examinations carried out by them, either alone or jointly with a Paediatrician, may have to be conducted outside of normal surgery working hours to facilitate their other clinical commitments .

3.3 Consultant Paediatricians are often asked to assess children for possible abuse by other professionals or may discover signs and symptoms of possible abuse during routine assessments/consultations. Most general paediatricians will assess physical injuries or neglect but a small number of paediatricians in each Board Area assess children for possible sexual abuse. These Paediatricians have an advanced level of training and experience and participate in continuing professional development in this area. They are trained to assess the findings in the context of the child's level of development. They have training in the legal issues involved but do not usually have formal forensic medicine training (and cannot therefore take forensic samples). The Consultant Paediatrician liases closely with social services, the FMO when possible, and the Primary Care Team and will be responsible for on-going medical review if necessary.

3.4 A+E Consultants may be asked to assess children with possible physical injury either by Junior A+ E Staff , when parent presents a child, or if a child is referred by a GP. The A+E Consultant will often refer to a Consultant Paediatrician for a second opinion. A+E Consultants in general would not be experienced in examination of possible sexual abuse (apart from one Consultant in RBHSC A+E Department).

3.5 Junior medical staff are often asked to assess children for possible abuse or come across possible signs and symptoms in there routine work. This is because they are at the "frontline" and provide first on-call out of hours medical cover in A+E, General Practice or Paediatrics. Consultant Paediatricians emphasise that the diagnosis of abuse (though often multi-disciplinary) should only be made with involvement of a senior medical staff member who is always contactable for an opinion.

3.6 There are thus a variety of professionals who may be involved. There is a need for clarity within N. Ireland as to the core skills and case dependant skills required to assess children for each category of abuse suspected and in which particular circumstances. These skills will determine the nature of professional designated to carry out the assessment. There is also a need for medical professionals involved in the assessment/management of child abuse to gain a greater understanding of each professions training and degree of expertise within each area. In some regions in the UK it is standard practice in cases of severe injury or where sexual abuse is alleged for a joint paediatric-forensic examination to be organised. This practice needs evaluation within the context of N. Ireland.

4. Children suspected of having been abused can be referred for medical assessment in a number of ways often depending on the initial professional involved.

(a) Social services usually refer children directly either to their GP or a named Consultant Paediatrician. Where necessary (if forensic examination required) a strategy meeting/discussion will be called involving police. This will decide who will be present at the examination and where and when it will be conducted.

(b) GP's may refer children to a variety of professionals

• A+ E Departments immediately
• Consultant Paediatrician following direct discussion
• Acute Hospital Paediatric Unit following discussion with SHO /Registrar on-call.

(c) PSNI will usually ask for assessment by a FMO and examination is usually carried out in CARE Unit suite or if also a GP in their own Practice premises. In some areas if joint examination occurs this may be within Child Health premises. Occasionally PSNI may request input from a Consultant Paediatrician.

(d) Consultant Paediatricians may ask for second opinion from a colleague in certain circumstances. They may ask, or have arrangements with PSNI , for joint medical assessments with FMO if they think forensic samples may need to be taken. Currently this request may be facilitated by the FMO or refused depending on the geographical area or the particular FMO involved.

4.1 There is therefore a lack of clarity about appropriate referral pathways for various professional staff which needs to be addressed to avoid assessments being carried out by inappropriate professionals, needing repeated or being conducted at inappropriate times for children and their families when they could be delayed. The referral process should not depend on who sees the child first but on the nature of the concerns and needs to be applied consistently.

5. Children suspected of being abused are examined in a number of venues :-

• GP surgery
• Hospital A+E Department
• Acute Paediatric Unit
• Community Child Health Facility
• PSNI CARE Unit

5.1 Regardless of the location of the facility it is important that it be child-friendly and non-intimidating. In particular for cases of CSA an A+E Department is not appropriate. Specific units do exist for assessment of children throughout N. Ireland but as there is currently no standard requirements professionals can be reluctant to utilise them for a variety of reasons.

6. A child-friendly facility is vital with opportunities for the child to play and feel as relaxed as possible and privacy issues for the child and family provided for .

6.1 In cases of physical injury it will be important to have access to a haematology laboratory for coagulation studies, radiology facilities and medical photography for documenting injuries (Although problems exist if the case is subsequently subject to legal proceedings as confusion exists over admissibility of hospital photography as evidence in Court - the Consultant Paediatrician may therefore have to predict this possible outcome at an early stage and involve PSNI before any decision about likelihood of deliberate physical injury has been made).

6.2 In cases of possible CSA additional facilities should be available. It is considered best practice (both nationally and internationally) for a permanent record (still photographs and video) of the genital/anal findings to be obtained. These images are usually obtained via a colposcope. This is desirable for the following reasons:-

• It allows a permanent record which can later be viewed by other colleagues/experts for the purpose of second opinion in clinical circumstances or legal proceedings thus preventing any need for repeated examination of the child.
• It can be accessed for peer review of cases.
• It can be used for teaching purposes for medical staff .

Obviously all of the above is dependant on informed consent of the person with parental responsibility and the child if appropriate .

6.3 Paediatric Colposcopy equipment is similar to that used in Gynaecology practice but requires to be purchased separately as specific recording equipment is needed, it needs to be available in a child-friendly facility and there will be specific legal requirements for storage of material.

6.4 The supply of such equipment is variable throughout N. Ireland. Currently WHSSB have facilities and SHSSB have 3 sets of equipment. Both NHSSB and EHSSB (including RBHSC) have no equipment and this needs addressed urgently. Consultant Paediatricians in Homefirst/United have recently raised this as an issue with Homefirst Trust Equipment is available at the PSNI CARE Units .

This important issue is highlighted in "Guidance on Paediatric Forensic Examinations in Relation to Possible Child Sexual Abuse" - April 2002 (enclosed).

7.2 This is an area of practice with considerable difficulty. The prevalence of STI in sexually abused children depends on the prevalence in the "abusing" population but studies in UK estimate 2 - 13 % sexually abused children develop STI.

7.3 The detection of STI in children is of vital importance as failure to treat can lead to long-term complications for the child and presence of infection may be used as corroborative evidence in legal proceedings.

7.4 Currently FMO`s do not take bacteriological/virological swabs or samples for STI. A pre-pubertal child may be referred to adult GUM Clinic to obtain samples. This is entirely unsatisfactory as it requires a further examination in facilities which are not child-friendly.

7.5 Consultant Paediatricians also have difficulties investigating for STI. Most hospital microbiology laboratories do not have procedures for fulfilling chain-of-evidence requirements so if an STI is discovered there are difficulties presenting this as evidence in legal proceedings and some of the microbiological techniques used do not fulfil evidential requirements. These issues need addressed Regionally .

8.1 RCPCH Standing Committee on Child Protection circulated model job descriptions for both designated and named paediatricians in June 2000. This concept has not been introduced in all Trusts in N. Ireland. No additional funding has been identified and where it has been implemented no identified time has been ring-fenced in order to organise training , develop liason/communication with GP`s , setting standards etc..

9.1 These children constitute the largest categories on the Child Protection Register and there is a need to agree standards for follow-up. Clear pathways for paediatric monitoring of vulnerable children such as Looked After Children and those placed for adoption must be agreed.

There is a clear need for multi-agency protocols/guidelines in the management of such cases. Some Trusts in England already have such protocols in place.

RCPCH produced guidelines in February 2002 for medical evaluation of children in whom there are concerns. There are training issues for paediatricians, primary care and social services arising from these valuable guidelines

The Child Protection Focus Group would recommend the establishment of a DHSSPS Working Group to devise a Regional Policy on medical evaluation of child abuse to specifically address:-

• Roles + responsibilities of medical staff.
• Routes of referral.
• Standards for clinical setting for examination.
• Standards for facilities/equipment

The Working Group should include representation from:-

Social Services, General Practice, Paediatrics, FMO, A+E, PSNI, CAMHS/Child psychology and Department of Genito-urinary Medicine.

Members of the Child Protection Focus Group would be delighted to have the opportunity to provide oral evidence to the Committee if requested.

The following Paediatricians have supplied comments included in this report:-

Dr Mina Hollinger (Consultant Community Paediatrician - Newry & Mourne Trust)

Dr Paula McAlinden (Consultant Community Paediatrician-Armagh & Dungannon Trust)

Dr Deirdre Walsh (Consultant Community Paediatrician - Causeway Trust)

Dr Mark Rollins (Consultant Paediatrician - Causeway Trust)

Dr Daphne Primrose (Consultant Community Paediatrician - S& E Belfast Trust)

Dr Kim Troughton (Consultant Community Paediatrician - Homefirst)

Dr Joanne Nelson (Consultant Community Paediatrician - N & W Belfast Trust)

Dr Nan Hill (Consultant Community Paediatrician - S & E Belfast Trust)

"Guidance on Paediatric Forensic Examinations in Relation to Possible Child Sexual Abuse" Produced by The Royal College of Paediatrics and Child Health and The Association of Police Surgeons - April 2002

"Physical Signs of sexual abuse in children" second edition - Royal College of Physicians. London 1997

"The Joint Paediatric-Forensic Examination in Child Abuse" J.Y.Q Mok: Child Abuse Review Vol. 7: 194-203 (1998)

"Model Job Description: NHS Trust named paediatrician for child protection" RCPCH Standing Committee on child protection June 2000

"Model Job Description: Local Authority designated doctor for child protection" RCPCH Standing Committee on child protection June 2000

"Fabricated or Induced Illness by Carers" RCPCH February 2002

SCMO: Senior Clinical Medical Officer

PAMS: Professions Allied to Medicine

FMO: Forensic Medical Officer

CSA: Child Sexual Abuse

GUM: Genito-urinary Medicine

RCPCH: Royal College of Paediatrics and Child Health

CAMHS: Child and Adolescent Mental Health Services

In the proposals for "A Protection of Children and vulnerable Adults Bill" consultation document there are serious issues that concern all of society. In 2.16 of the document 12 month or more detention are the only way a disqualification order can be made. This seems a bit strange given the spate of suspended sentences or alternative sentences for less than 12 months. In 4.5 there are many non-regulated organisations working with and for children who do not have to report but can dismiss workers with no follow up. These issues raise concerns.

(i) Funding for projects like "Keeping Safe Child Protection" a preventative and awareness raising into child protection and prevention for community/voluntary groups. This training is free to the groups but difficulties arise when groups have to close to enable the staff to attend the training, which has a negative impact on the community.

(ii) Funding for community groups, voluntary groups who are the main providers of preventative work in our area. It appears from a community perspective that more funding goes into crisis management and little for prevention as in playgroups, after-school clubs, youth clubs, parent & toddler etc. The more funding that goes into prevention the less protection will need both in terms of interventions and actual protection.

Having an understanding of confidentiality issues and need to know information where community groups designated officers report and record events and activities to social services. This is not always the case when social services refer a child/family to our services. Community groups do not want too much information, but if a family is stressed it would be helpful to know as we could put into place programmes that would reduce the stressor's and or relieve some of the factors which produce the symptoms such as respite, a place to unwind etc.

Children not having information at their level of understanding, parents not understanding or having the information available on who to contact or where to turn to. This running alongside the high turn over of staff whereby relationships and trust cannot be built up which impacts upon the child and family along with damaging relationships between social services and the community.

Social Workers should as part of their training have a placement in community/voluntary run schemes to get to know and understand the views of parents, children and the community along with some positive public relations within the community.

In January 1999 the government launched the first 60 Surestart programmes in England, this was to provide better holistic services designed around the child and family and eradicate child poverty within 20 years by helping to break the inter-generational cycle of poor children's under-achievement and poverty of aspiration.

In the North the Surestart programme was announced in late 1999 with the programmes being administered centrally by DHSS and co-ordinated by the local Childcare Partnerships. The proposed programmes were to be supplied to the Partnerships by April 2000.

This is a multi-agency partnership of health, social services, education voluntary and community groups targeted at children 0 to 4 years and their parents. The services will be located in the Falls and Clonard ward areas of Belfast in various settings, The Frank Gillen Centre, Roden Street Community Complex, Clonard Youth Club, Cathedral and St Peters Nursery Schools along with Albert St. Healthy Living Centre.

For Clan Mor the partners (a consortium of groups from the voluntary, statutory and community sectors) came together in January 2000 and set about drawing up programmes and a proposal along with doing research and surveys of parents.

Our programme was going to try to address:

• speech and language and the resultant behaviour problems for children age 0 to 4;
• provide quality crèches;
• provide facilities for parents to enable parents have respite, seek advice, go on courses and improve their own self worth;
• provide family support; and
• provide signposting to specialist services.

Clan Mor was to do this through offering:

• high quality Crèche facilities in the Frank Gillen Centre, Roden Street Community Development Group, Clonard Monastery Youth Centre, St Peters Nursery and Cathedral Nursery;
• courses for parents with befriending services and family support along with time-out facilities;
• a Speech and Language and a Health Visitor to assist parents and staff in each of the above centres;
• a signposting service to specialist services where needed; and
• a communication network area wide for information and support for everyone.

Through the hard work and dedication of everyone we came up with a proposal and in particular thanks to Danny and Wendy; the proposal was drawn up.

Unfortunately we were rejected on a number of grounds but the primary one was the programme was not very strong and needed worked on. This was as a result of the timescale involved (over the Easter Holidays) and the amount of work involved.

We re-submitted our revised proposal and thankfully were successful.

We have come a long way in two years. The programme is getting ready to start.

We have our Management Committee.

We have the co-ordinator.

We have the Crèche workers and the Health Visitor is being recruited along with the Family Support Worker and Volunteer Co-ordinator, peer educators and the administrator.

One of our problems has been the lack of response for the post of Speech and Language and this aspect of the programme will need to be revisited and perhaps revised.

We need to see clearly what the roles and responsibilities of each partner are.

We need to move the programme forward.

We have and will continue to have teething problems and these can be ironed out with the continued good will and understanding of each partner.

Albert Street will not be ready until the end of April so we need to work around this.

We have waiting lists in the community crèches so everything is ready there and once the children attend then we can work on the programmes for the parents and offer them the help, advice and support this programme is based on.

We need to look at registration of the crèches and the resultant recommendations from this.

We need to focus on what other initiatives are in the area like HAZ etc.

This is a team effort and we rely on the support of each valuable member to make it the success we know it can be.

Case recording/record-keeping has been a controversial and much debated subject within our organisation particularly in relation to child protection issues. Record keeping and report writing are serious matters and very relevant to the working lives of health professionals engaged in the care of children and families in the community. Record keeping has traditionally been viewed by busy and over-stretched practitioners as less of a priority than other aspects of their practice involving practical support and intervention for vulnerable families. However they are increasingly becoming aware of the necessity of allocating time to this important area of their work. The importance of keeping accurate concise and contemporaneous records has been highlighted in various inquiries into child protection cases. Failure to do so has frequently contributed along with other factors in poor outcomes for children. From the health professional's perspective it has often led to disciplinary action been taken against them and indeed some nurses have been struck off the professional register as a consequence of poor record keeping.

Maintaining good case records is dependant on a number of factors. Initial training should be multidisciplinary particularly in relation to child protection. This should enhance understanding of individual roles and responsibilities in relation to this area of work among key individuals with responsibility for child protection. However, in terms of documenting in case records and report writing community nurses should have clear guidelines during their initial training and delivered in a uni-professional setting to ensure that their specific input in this area is recognised and supported. Regular updating is also an important aspect of ensuring practitioners are familiarised with new information, legal aspects and guidelines pertaining to child protection.

Community nurses often express concern relating to documenting negative observations about child protection issues and sharing these with parents. There is clearly a need for specific training and support in this area for nurses to feel more confident in confronting parents about matters of concern in a constructive and sensitive manner. Nurses must receive regular clinical supervision to allow them to reflect on practice, receive informed objective advice and address areas of concern in a safe environment.

Presently there is no regional standard for child protection documentation guidelines. This is also true of storage, location and duration of storage for child protection files. We therefore recommend the standardisation of child protection guidelines and documentation at regional level. This could be co-ordinated through R.U.A.G. (Regional Users Advisory Group), which is responsible for advising on documentation.

Professional judgement is something that all health visitors and community nurses have to use regularly in the course of their work. However it must be backed by appropriate training, regular updating of knowledge and skills and clinical supervision. The designated Child Protection Nurse Specialist should carry out clinical supervision on a regular basis, either in a group setting or on an individual basis. However, the maintenance of confidentiality is important if cases are being discussed in peer group supervision sessions.

Audit should be an integral part all health service provision and could enhance record keeping and ultimately improve services in this area if it is carried out in a 'no blame' culture.

There should also be a designated Child Protection Nurse Specialist based in each Community and Acute Trust to offer advice, support and ongoing training on child protection issues to nurses and health visitors.

Regional protocols should be implemented in relation to standardising the use of the Multidisciplinary Framework Assessment Document in child protection. This would help reduce ambiguities in relation to roles and responsibilities for health professionals engaged in this area of work. Currently there appears to be wide variations in the way it is used within Trusts. It appears that in some Trusts this assessment tool is used effectively with comprehensive input requested and given from members of the core group dealing with a particular child protection case. Conversely, in other Trusts there is minimal input from professionals other than social workers. This may be due to a very narrow view by some social services personnel that child protection is the sole responsibility of social workers.

Guidelines should be regularly reviewed and updated in tandem with changes in legislation and lessons learnt from child protection enquiries. This should be the remit of those professionals from health visiting, social services and users who have a specific role in child protection and could be drawn from a sub-group of the Area Child Protection Committee (ACPC).

Communication in relation to child protection has often been fraught with difficulties. Lack of communication amongst professional has often been cited as a contributory factor in past child protection inquiries.

Undoubtedly this situation is beginning to change but as yet there is no room for complacency.

Health visitors and nurses often complain about the lack of notice given to them about attendance at child protection meetings, court requests for reports or court attendance as witnesses. There also appears to be a lack of clarity about who is responsible for notifying nursing and health visiting staff when a decision is made requiring them to be present in court or provide a witness statement. Central Services Agency should take lead responsibility for notifying the relevant Child Protection Nurse Specialist and or relevant community nurse manager in the Trust concerned if community nurses are required to input to the legal arena. This would ensure that effective communication systems are in place with the ultimate aim of improving outcomes for children within the child protection process.

The designated Child Protection Nurse Specialist should also sit on the ACPC in each Board to ensure that nursing is fully represented. This should serve to ensure effective communication in both directions and improve partnership working.

GPs are often missing from child protection proceedings. Again it may reflect the past perception of the narrow role that health professionals were expected to play in this area. However, new legislation rightly puts a stronger emphasis on the broader responsibility of all those health and social service professionals who work with families to play their part. However, this situation will not improve significantly until health professionals/GP's are given ownership of this process and are equally represented in decision-making in child protection at strategic level.

Surestart schemes will hopefully play a part in improving the life chances of children in disadvantaged areas and may help reduce child abuse and neglect. However, these schemes are limited at the present time to 23 and are mostly confined to urban areas. Children of families living in rural areas where few of these schemes exist are often further disadvantaged because of poor transport infrastructures making access to services difficult.

There is clearly a need to review current service provision in terms of health visiting and school nurse services. In the present system the emphasis has been on counting contacts as opposed to a needs led service approach. The ways in which services have been organised have not always supported nurses and health visitors to work flexibly to tackle local health problems or encouraged them to work in partnership with others in teams to address the causes of ill health.

The 'Investing for Health' public health document highlights the need for a partnership approach and joined up working with a wide range of stakeholders to improve the population's health. Health visitors and school nurses have a key role in contributing to this process.

Currently parenting programmes are run in most Trusts by health visitors for new parents but there is a need for coordination of this type of service to avoid duplication. It is important to work with others including local parents, community groups and other statutory agencies to ensure that that these courses are acceptable to parents. They should also be evidenced based and accessible to all parents who need them.

Parents suffering from mental health problems require the skills and expertise from a range of disciplines in assessing effective parenting. GP's and health visitors have a key role in supporting parents with mental health problems and need to be fully involved in assessment and case planning in child protection cases.

The ad hoc nature of other services provided by health visitors that are important in reducing child abuse including behaviour clinics and postnatal depression intervention should be governed by regional guidelines to ensure a standard approach.

Health visitors and school nurses must not only work with individuals and families but also with communities. Their knowledge of local needs based on their health needs assessments and community profiles can contribute to the Local Health and Wellbeing Improvement Plans in the new Local Health and Social Care Groups. These plans will form the basis for improving health and targeting services in which community nurses and health visitors will play an integral part. However, they will need support, leadership and additional resources to make this transition.

Currently the school nursing service here is grossly underfunded. Although some enthusiastic school nurses are involved in innovative practice most of there efforts are currently concentrated on immunisation clinics and screening programmes due to large caseloads and inadequate training opportunities. In other parts of the United Kingdom school nurses are involved in successful programmes to reduce teenage pregnancies, alcohol/drugs programmes, promotion of healthy eating, involvement with 'looked after' children and drop in health clinics for teenagers. A high teenage pregnancy rate, psychological difficulties that may be exacerbated by the 'Troubles' and alcohol and illegal substance abuse at an early age are just some of the problems that our young teenagers are exposed to in Northern Ireland. There is a clear need for school nurses to be recognised for the potential contribution they can make in partnership with others to making a difference in these areas and ultimately improve the life chance of children and young adults here.

If the health service is to play an active role in partnership with others in earlier identification and intervention to support children in need the health visiting and school health service needs to be strengthened.

In recent years the demand in terms of the higher level of health visiting and school nursing intervention required by families of children in need has continued to grow. In tandem with this extra pressure in terms of clinical input is the burgeoning of activity related to comprehensive assessments, report writing and attendance at case planning, looked after reviews, case confernce meetings and court attendances.

The child welfare and family support component of the work of health visitors and school nurses has increased significantly since the introduction of the Children NI Order. Whilst this work continues to escalate it has not been resourced through Children Order funding. The enhancement of the role of the health visitor outlined in the policy document " Supporting Families" has not been translated into policy action in Northern Ireland. These evidence based policy developments are essential if the aspiration of "Co-operating to Safeguard Children " document that emphasises the shared responsibilities of services, professionals, and the wider community in safeguarding children and promoting their welfare is to be realised.

Resources need to be ring fenced for the early preventative work and family support that can be provided by health visitors, school nurses, midwives and other non-stigmatising services in the community.

The Multi-Disciplinary Assessment Framework Document should be standardised throughout Northern Ireland. Health and social services professionals frequently assess similar aspects in child protection cases including parenting abilities, child development and the need for social support. Utilising this framework could enhance understanding of roles, provide more accurate statistics of thresholds of need, promote better working arrangements and avoid duplication.

More cooperation is necessary between ACPC's in sharing information in relation to previous child protection cases where mistakes have been made in order to help prevent similar events recurring. Poor communication between professionals involved and inadequate record keeping are just some of the problems that tend to re-appear in the various case inquiries that involve child death or serious injury. However the rhetoric around better communication and cooperation must now be backed with clear policies at regional level and adequate funding to make the business of safeguarding children a priority for all.

1.1 The Council for Catholic Maintained Schools (CCMS) welcomes this 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 across Northern Ireland.

1.2 The Council considers child protection to be of paramount importance and has assigned a number of roles to senior officers in the organisation to contribute to the development and implementation of the policy and procedures.

1.3 CCMS is also represented on the Designated Officers for Child Protection in Education Group (DOCPEG) as well as being represented on each of the Area Child Protection Committees.

2.1 Within the Education Sector the work of DOCPEG is crucial in promoting consistency of strategy, policy, procedures and practice amongst the partners in the Education Sector namely the Department of Education, the five Education and Library Boards and the Council for Catholic Maintained Schools.

DOCPEG's Mission Statement reads as follows: -

2.2 Underpinning the mission statement is the following objectives: -

• to develop and maintain the most appropriate policies on child protection;
• to promote best practice by all staff who work with children;
• to ensure relevant training is available for staff who work with children;
• to co-operate and contribute to the delivery of training to the Teacher Training Universities; and
• to develop and sustain links with other organisations which contribute to the promotion of child protection within the Education Sector.

2.3 DOCPEG have considered and responded either as individual organisations or as a public sector grouping, to key documents in the recent past including: -

• Review of Sex Offenders Act 1997
• Co-operating to Safeguard Children Guidance and EQIA
• Submission to the Consultation exercise on the Commissioner for Children
• Model Policy on the Use of Reasonable Force
• The Protection of Children and Vulnerable Adults Bill

2.4 DOCPEG is currently engaged in revising the contents of Circular 1999/10 (Pastoral Care in Schools - Child Protection) based upon impending changes to legislation.

3.1.1 There is concern that some schools have been asked to undertake a more investigative role in the referral process where staff of some Social Service offices have requested the school designated teacher to ascertain the significance of their concerns before making a formal referral. This is contrary to the guidance contained in Co-operating to Protect Children Vol 6 (Children (NI) Order 1995) and where general advice to schools has been 'don't investigate'. Consequently it is clear that there is need for agreement between all partners on the range and scope of discreet preliminary enquiries and what constitutes investigation.

3.1.2 In some instances a school may have concerns about a family's circumstances which are adversely affecting a pupil's behaviour or performance in school but are not able 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 case work which, if significantly resourced, could lead to a reduction in terms of reactive investigatory work.

3.1.3 Some concerns have been raised by schools regarding the differing nature of responses and advice from social workers to particular cases often from the same office within an individual Trust area. The production of a timely and staged intervention process could alleviate some of these difficulties.

3.2.1 Schools and Education personnel would welcome the development of a protocol or information loop which would feedback relevant vital information about cases to ensure that the pastoral needs of the child are being addressed within the school. Currently schools who make referrals are kept in the dark as to what is happening and generally receive no feedback.

3.2.2 The roles of the Designated Teacher and Deputy Designated Teacher within schools are central to the development of effective pastoral care programmes and procedures in schools however some schools consider that this is not fully recognised by some Social Services personnel. As the formalisation of a protocol or at least some discussions on an inclusive involvement of Designated Teachers in the communication loop would be welcomed. This would ensure a balanced input for the Education Sector personnel into case conferences which are sometimes called on an ad hoc basis where the input of Education personnel is sometimes limited or non-existent.

3.3.1 The Council considers partnership between the Education Sector, Social Services, Parents and Young People themselves to be crucial.

3.3.2 The Council welcomes the proactive approach adopted by Trusts in providing information leaflets and videos on child protection issues.

3.3.3 The link between Education and Social Services personnel is formulated through representation on the various Area Child Protection Committees however it is essential that key linkages are extended to local areas.

3.3.4 Another useful linkage is NSPCC who as a voluntary organisation has engaged in partnership with the South Eastern and Western Education and Library Boards and CCMS in piloting a school's counselling service to a number of controlled and maintained schools. Preliminary evaluations would indicate the potential for developing the service in order for more pupils to benefit from this counselling service. However 'mainstreaming' of such provision would be resource intensive and require significant 'joined up' thinking from all partners.

3.4.1 The Council has undertaken a general awareness training programme for all professional officers employed by the Council and has a network of trained Designated and Deputy Designated officers based in the five Diocesan Education Offices who offer advice and support to Catholic Maintained Schools in relation to Child Protection issues.

3.4.2 The Council does not have a specific training remit for teaching or non teaching employees but plays an important strategic role in DOCPEG's training programme. The Council commends the work of the Education and Library Boards in developing, delivering, and securing training for all school personnel.

3.4.3 The Council observes that within Social Services there are particular workforce issues such as heavy case loads for relatively inexperienced Social Workers and given the complexity of many issues this often results in unacceptable time delays.

3.5.1 Recruitment and retention of experienced Social Workers is crucial to the delivery of effective services and the current level of resourcing means that only the most critical of cases can be prioritised for action. Ideally schools would wish to see a Social Worker assigned to a cluster of schools and any referrals would be processed through a specified Social Worker.

3.5.2 The current inadequate level of resources leads to a more reactive and overburdened service.

3.6.1 When reflecting upon case management the most important lesson which has been learnt is that multi-disciplinary work requires 'effective communication' strategies so that schools can feel confident in working with Social Services, Care Units and others in the protection of children. Schools should be full partners in the protection process.

3.6.2 Personnel working in the field of Child Protection also require professional support and this should be addressed as a matter of urgency.

3.6.3 Early intervention and holistic family support from all partners is vital if the culture and manner of dealing with sensitive issues is to be enhanced.

3.6.4 Some thought needs to be given to developing provision for culturally sensitive issues such as ethnicity and disability.

4.1 Currently Child Protection Services are being administered on minimum financial and human resources with employers such as the Education and Library Boards and CCMS undertaking a variety of functions which require dedicated and discreet professional work.

Appropriate finances and human resources need to be secured if there is to be a comprehensive system of child protection where all children can be safe, secure, and valued.

12 August 2002

• Social work files are kept in the Social Work Department. The files contain recording of work undertaken including interviews with parents, child (where appropriate), liaison with hospital and community staff, other agencies etc. Files also contain copies of any correspondence received/sent, relevant reports eg medical, social work reports for case conference/case plan meetings, minutes meetings etc.
• The Social Work Department operates an Open Access Policy with regard to clients files, in line with other Social Services Departments. A Restricted Section is used for sensitive third party information eg where the informant's identity is not to be disclosed, where information is confidential and relates to someone else but has a bearing on a case involving a client.
• The Social Worker has at times been invited to also write in the medical and/or nursing notes eg significant information with regard to child protection issues ie when the child is the subject of legal proceedings, a child's name is on the Child Protection Register, highlighting relevant recommendations from Case Conferences/Strategy Meetings etc. At other times medical/nursing staff record feedback received from the Social Worker.
• Social work staff are all professionally qualified. Consequently professional judgement is influenced by the training received prior to qualification and subsequent to qualification through the Southern Health & Social Services Board Multi-disciplinary Child Protection Training Programme, which addresses the need to update knowledge and skills training.
• Our professional judgement is based on skills of assessment including gathering, sharing and analysis of information, making use of the knowledge, expertise and skills available from the multi-disciplinary team within the hospital.
• Under the present structure, CAHGT does not have Delegated Statutory Authority, therefore while hospital social work staff work professionally within the principles and requirements of the Children NI Order 1995, they do not have statutory powers. Close professional working relationships exist with Board wide community based social work teams in the investigation of child care concerns and in the provision of services and support to families.
• In making professional judgements social work staff are guided by the policies and procedures of the Southern Area Child Protection Committee. Additions to the S.A.C.P.C. Manual over the past few years have helped to inform our practice eg Impact of Domestic Violence on Children Risk Analysis Model, Policies and Procedures with regard to Disabled Children.
• Involvement by hospital based Social Workers is short term. Direct contact with children and their families occurs at ward and clinic level or by telephone. We are not in a position to provide follow up intervention post discharge for a variety of reasons eg we do not have statutory powers, we have no control over provision of practical services and we need to be available to provide a hospital base service to meet the demand from a variety of clinical areas within short time scales.
• The current social work team has some staff members who have wide ranging experience in child care practice at both community and hospital level and this experience has proved very beneficial.

• Communication/liaison has benefitted from the fact that an identified social worker has responsibility for the social work service to specific wards/clinics. This facilitates the sharing of information/opinions/assessments and encourages non social work staff to discuss any concerns they have re child care issues with a social worker with whom they have established a working relationship.
• The hospital social worker liaises closely with professional colleagues in the community eg social workers, community midwives, health visitors (the latter either directly or via Hospital Liaison Sister)
• The Hospital Social Worker is a frequent attender at community based case conferences/case plan meetings/strategy meetings and this helps in the flow of information between hospital and community staff in Child Care Cases.
• Within the hospital the Social Work Department has been involved in Child Protection Awareness training for non social work staff (including medical/nursing/PAMS) This also helps to develop better communication as it has addressed issues of roles and responsibilities.
• Community social work staff use the hospital social worker as a resource to help their understanding of how medical/disability issues impact on children and their families and to seek clarification from medical staff re diagnoses/prognoses etc.

• The Social Work Service is accessible to parents/carers and children (where appropriate given age and developmental stage) through face to face contact in wards or clinics. If ward staff identify the need for social work involvement parents will be advised. If there are no child protection concerns and parents/carers decline offer of contact with the Social Worker to discuss family support, this will be respected.
• Parents/family members can initiate contact with the Social Work Department by requesting to see the Social Worker or by telephoning the Social Worker.
• At present the same Social Worker is responsible for the Maternity and Paediatric Departments which has provided continuity of contact for families at the Ante-Natal, Post-Natal stages and beyond.
• As part of the Social Work Service to families the Social Worker provides information and the opportunity for referral to a range of support organisations eg Social Services Teams, Home Start, N.I.M.B.A., Family Fund, Downs Syndrome Association, A.S.B.A.H. etc. Recently the Social Work Department has produced a visual information system for parents giving information and contact numbers on 30 organisations offering advice and support to families of children with Special Needs. This system has been replicated and is located in all the clinic areas visited by the Child Development Centres Therapy Teams. The system will be expanded as further information is obtained on other organisations.
• The Hospital Social Worker working in the Paediatric Department attends the meetings of the Area Task Group within the Southern Health & Social Services Board Wraparound Project. This has helped to promote linkages with the Support Organisations associated with Wraparound.

• The Head of Social Work Department submits a yearly training needs analysis for the team to the Southern Health & Social Services Board's Training Department.
• Social Work staff have attended Southern Health & Social Services Board training courses organised by the Boards Multi-disciplinary Child Protection Training Team.
• Attendance at other courses/conferences has been curtailed due to Trust Restrictions on payment for these.
• Work-load relief is not adequately provided for Social Work Staff who are Practice Teachers and who provide practice placements for social work students. Feedback from Course Tutors has been consistently very positive and the Hospital Social Work Department is regarded as providing highly valued practice placements.
• The Hospital Social Work Team consists of nine qualified Social Workers who are managed and supervised by one person who is a Team Leader/Head of Department. The Head of Department is also responsible for the planning, development and delivery of the service and she contributes to monitoring and planning on a broader basis within the Trust eg with regard to Discharge Protocols.
• The Team provides a service to patients of all ages and from all programmes of care. Social Work staff have to respond to an ever increasing referral rate within short time scales due to the acute nature of the work and the need for effective and efficient discharge planning. The team strives to maintain an effective level of service during periods of staff reduction. This creates additional pressures on staff as they try to cope with both the increased volume of work and the diversity of it.

• The Hospital Social Work Team would view the established close working relationships with medical/nursing and PAMS staff as a significant resource in enabling them to provide a hospital based Social Work Service to children and their families.
• The hospital team has no direct control over support services available to families upon discharge. However the social work staff have access to a wide range of organizations both statutory and non statutory and would facilitate familys' use of these resources through a process of referral and liaision.
• Service provision is not always initiated by the organisations providing support, at the time of referral to them due to for example, waiting lists for initial assessment by the organisation, uncertainty about eligibility for the service or about threshold criteria for intervention, lack of trained staff or suitable volunteers.
• Hospital social work staff would seek to identify and prioritize the familys whose needs are most urgent and advocate for them accordingly.

• It is essential that there is open and honest communication between

• Child Protection and ensuring the welfare of children should be the concern and responsibility of all professional staff who should be aware of and adhere to Child Protection Policies and Procedures and legislative requirements.
• Accurate recording is essential and it needs to be clear and informative.
• Professional roles and responsibilities need to be clear and agreed particularly given our own position where we do not have delegated statutory authority in Child Protection Cases.
• Training is vital to ensure that staff maintain and develop the knowledge and skills needed to promote the welfare and protection of children. Training should continue on both a unidisciplinary level and a multidisciplinary level. Doctors should be encouraged to participate more in multi disciplinary Training Sessions

• Further development of support services to parents of young children through the non statutory sector as many families find this more acceptable particularly if there are no immediate child protection issues.
• Further development of Respite Services to families with children who have Special Needs, particularly children with complex needs.
• Re-evaluation of the career structure and salary scales of Social Work Practitioners in order to reduce the loss of experienced social work staff within Child Care Services.

Greater participation of the medical profession in multidisciplinary Child Protection Training.