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SESSION 2002/2003 Committee for Health, Social Inquiry into Child Protection Services in Ordered by the Committee for Health, Social Services and Public
Safety to be printed 9th October 2002
WRITTEN SUBMISSION BY: Index Section Description Preface Acknowledgements Overview Section 1 Statute relating
to the Investigative Process Section 2 Procedural
Guidelines for Undertaking the Investigative Process Section 3 Structure of
the Trust Section 4 Structure of
the Programme Section 5 The Child Protection
Team Section 6 The Referral/Procedure Section 7 Scheduled Offenders
- Child Protection Responsibilities Section 8 Case Work Section 9 Professional
Judgement Section 10 Communication Section 11 Workforce Issues Section 12 Linkages Section 13 Linkages with
the Community Section 14 Lessons Learned Section 15 Resources Section 16 Recommendations APPENDICES Preface On a range of indices
of deprivation, abuse, social exclusion and health problems, the child and
youth population of North and West Belfast compares significantly less favourably
with their peers throughout the rest of Northern Ireland. 2,422 children were
Looked After in Northern Ireland in 1999/00, a 4% increase from 1997/98. The
Trust had a Looked After Child population (<=18 years) of 84.8 per 10,000
at March 2000. This is almost 30% higher than the Eastern Health and Social
Services board's figure of 65.5 per 10,000 population. The Trust's number of
children on the Child Protection Register is, again almost double the Northern
Ireland figures, which are 61.7 per 10,000 and 32.2 per 10,000 population respectively.
In total 12% of children Looked After are accommodated in residential homes
(Figures for 2001). The Eastern Health
and Social Services Board's review of Child and Adolescent Mental Health Services
(Point 3.2.6) states "North and West Belfast has the highest risk of children
having a mental health problem". This is graphically borne out by the 1998
statistic that the suicide rate for Northern Ireland is 12 per 100,000 whilst
in North and West Belfast Health and Social Services Trust, it is 19 per 100,000
with an average age of twenty-two years at the time of death. There were 2,511
Child Protection investigations in 1999/00 a rate of 54/5 per 10,000 children
aged under 18. The rate of investigations was highest in North and West Belfast
Health and Social Services Trust (120.4) and lowest in Homefirst Trust (27.5)
(Figures 2001). The Trust records a higher
than average level of children both with a learning and physical disability.
The percentage of children and young people in receipt of Disability
Living Allowance in the Eastern Health and Social Services Board area in 1997
was 3.26%. For children and young people in North and West Belfast Trust, the
figure was 5.31%. Almost half of all children living in North and West under
18 are dependants of claimants of Income Support or Job Seekers Allowance,
compared with the other ten Trusts engaging at about 20% of the population. In addition and inextricably
linked with some of the above statistics, the child and young population of
the Trust have lived in the epicentre of the conflict, with one third of all
troubles-related deaths occurring within this area. No neighbourhood and few
families have been unaffected by the trauma of bitter civil unrest. Recent
research from Hamilton, Smith and Morrissey 2001 has established a link between
deprivation and the detrimental impact of extended exposure to community violence
and the emotional and psychological well being of the North and West Belfast
community. Significant communal conflict across North Belfast in particular
has continued to impact severely on the community as a whole. This submission will
attempt to address the issues raised by the Committee in Sections 1 - 16 enclosed. ACKNOWLEDGEMENTS The Trust would like to acknowledge
the contribution of the following individuals in the development and compilation
of this document.
n
Mrs Teresa McAllister, Assistant Principal Social Worker, Family & Child
Care Programme
n
Mrs Margaret Graham, Primary Care Co-ordinator, Community Nursing
n
Mr Hugh Hamill, Operations Manager, Physical Health & Disability Programme
n
Mr John Growcott, Child & Adolescent Mental Health Services Project Manager OVERVIEW Complexities of Task The development,
structuring and management of Child Protection Services is a particularly challenging
and complex task. It requires a comprehensive understanding of the statutory
framework, an investment in the maintenance of a motivated, well-trained and
highly competent workforce, the availability of an appropriate resource base
and the establishment of an organisational culture and structures, which facilitate
inter-Agency and multi-professional co-operation. Central to the process is
the concept of accountability. The nature of the procedural framework has afforded
a coherent vehicle to regulate and review practice effectiveness. However,
the procedures do not reflect the realities of the operational base. They do
not address workforce or resource pressures, or acknowledge the inherent tensions
at the core of Child Protection work such as partnership and paramouncy, consensus
and the child's best interests. The procedural framework
has become further layered as additional elements of the Child Protection process
are enunciated or
emerge. Their potentiality for best practice has been diluted by an ongoing
narrowing of professional discretion and informed autonomy. The procedures
reflect and have contributed to practice culture of litigousness and defensive accountability,
which militates against the development of meaningful multi-Agency and professional
working. Definitions of child
abuse are rarely transparent and contained. In the area of neglect, in particular,
relatively of values and cultural norms undermine notions of transparent definitions. The absolute wish
to protect children from harm is conditionalised by competing ideological constructs
of the impact of structural deprivation and individual pathological themes.
Current emphasis on participation and inclusiveness have generated the primacy
of consensus in formulating planning for intervention. These competing imperatives
are at the heart of the principles underpinning the Children Order. Social
Work staff are expected to balance and resolve the aspiration of effective,
minimalist intervention to protect children in a context of often significant
residual risk. The pejorative caricaturing
of Social Work practice without an acknowledgement of this context is unwarranted.
There is an absence of an informed, balanced appreciation of the complexity
of the task compounded by an inadequate resource base. 1. Work Force Issues North and West Belfast Trust is committed to excellence
of practice and to the development and promotion of a competent workforce.
In the context of a finite resource base and the impact of structural deprivation
and ongoing violence, it has evidenced an expertise in its balanced, proportionate
management of Child Protection Services. Staff have demonstrated a resilience
and professional pragmatism in coping with the inadequacies of the resource
base and realities of communal violence. They have provided a service to the
local community, which has been externally evaluated in positive terms. The
service is characterised by an unambiguous drive to protect children within
the context of a practice approach, which is eclectic, focused and flexible. In light of the generally critical and misinformed
understanding of the social work task in respect of children and families,
it is imperative that a balanced re-addressing of the achievements and difficulties
of the social work role is achieved. The culture of punitive accountability
without an appreciation of context is clearly impacting on the professions
ability to recruit and maintain staff. While the establishment of
the Social Care Council, registration and enhanced training are welcome, the
potential of such initiatives will not be realised until such times as the
status and attendant terms and conditions of Social Work staff in this field
are reviewed and resolved. 2. Community North and west Belfast Trust has recognised over
an extended period of time the centrality of the community to the management of Child
Protection themes. Local communities reflect the culture, values, uncertainties
and ambivalence of society as a whole. There is an aspirational commitment
to protection of children, which mirrors societal ambiguities - a frustration
with perceived obfuscation, a demand for action within a continuum of retribution
and intolerance of "punitive welfare". The challenge is to establish
and acknowledge the parameters of partnership with the community in Child Protection
and to effectively maximise its supports. The role and expertise of professional
staff in concert with an informed and responsive community is the optimal model
for successful intervention. Central to the community's
pivotal role is its individual and collective acceptance and actioning of its
responsibilities to vulnerable children. 3. Prevention The effectiveness of Child
Protection Services lies in the vibrancy, diversity and inclusivity of their
prevention base. Without an appropriate range of available services which are
accessible and sustainable as required, Child Protection work will inevitably
be reactive, crisis led and "policing" in its nature. Targeted focusing of key
resources on those groups where research and practice wisdom in indicative
of potential needs within a tiered service delivery model will enable the aspiration
of minimalist regulatory intervention in families to be meaningfully achieved
while maximising opportunities to promote children's welfare. 4. Resources Without the availability of an appropriate resource
base, Child Protection Services will continue to struggle to provide
a quality service. It is imperative that the
strategic planning for Child Protection Services is rooted in a coherent, integrated
process of prioritisation and decision-making informed and driven by the expertise
of professional staff in consultation with services users and the local community. RECOMMENDATIONS 1. Prioritising of key service areas to facilitate
coherent, consistent and focused strategic planning. 2. The identification of balanced operational
targets and quality indicators to enable a framework for continuity of service
imperatives to be pursued. 3. Immediate review of regional training and recruitment strategy
incorporating a terms and conditions reappraisal. 4. Relating statutory and attendant procedural
guidance to the resource base in a manner, which facilitates alignment of service
aspirations responsibilities within meaningful budgetary context. Section 1 1.0 Statute relating to the Investigative Process
(Article 66) 1.1 Currently Article 66 of the Children Order
NI (1996) places a duty on the Trust to investigate concerns alleging abuse
of a child. This duty refers to both specific identified children and children
in general within the Trust's locality. The Order uses the 'term' authority
to refer to a Board or a Trust. 1.2 Article 66 (1) of the Children Order sets
out the duties which Boards and Trust have to investigate where it: a.
Is informed that a child who lives, or is found, in the authority's
area:
-
Is subject of an Emergency Protection Order; or
-
Is in police protection; or b.
Have reasonable cause to suspect that a child who lives, or is found,
in the authority's area is suffering, or is likely to suffer, significant harm. The purpose of such enquiries is to enable decisions
about whether or not actions are required to safeguard or promote the child's welfare.
More specifically the enquiries should be directed towards establishing whether:
n
an application to the Courts should be made;
n
or whether they should exercise other powers under the Children Order. When Boards or Trust are conducting enquiries then
any Board or Trust, Education and Library Board, the Northern Ireland
Housing Executive, any special agency or other person(s) directed by the Department
of Health and Social Services are statutorily required to assist through the
provision of relevant information and advice unless to do so would be unreasonable
in all circumstances of the case. Section 2 2.0 Procedural Guidelines for Undertaking the
Investigative Process 2.1 There is an overall recognition that the complexity of
child abuse requires a comprehensive and co-ordinated approach for all
agencies and professional involved with children. "Co-operating to Protect
Children" Volume 6 is a policy and procedural guide for professionals undertaking
the investigative process. The policy and procedures were developed under the
aegis of the Eastern Area Child Protection Committee (ACPC) and provide the
professional framework, which should be operationalised by those working with
children. The document was completed to reflect the following:
n
The Children (NI) Order 1995
n
Co-operating to Protect Children 1996
n
Protocol for Joint Investigation by Social Worker and Police Officers of alleged
and suspected cases of child abuse (1996). 2.2 Philosophy underpinning Child Protection The Co-operating to Protect
Children document Volume 6 illustrates comprehensively the philosophy underpinning
Child Protection as follows: All investigations of alleged/suspected child abuse
must primarily address the needs of the child concerned and must make the child's
welfare the first priority. The following principles should apply to all investigations:
n
The child's welfare must always be paramount; this overrides all other considerations.
n
A proper balance must be struck between protecting children and respecting
the rights and needs of parents and families; but where there is conflict,
the child's interests must remain paramount.
n
Children have a right to be heard, to be listened to and to be taken seriously.
Taking account of their age and understanding, they should be consulted and
involved in all matters and decisions, which may affect their lives.
n
Parents/carers have a right
to respect and should be consulted and involved in all matters, which concern
their family.
n
Actions taken to protect a child - (including investigations) should not in
themselves be abusive by causing the child unnecessary distress or adding to
any already suffered.
n
Intervention should not deal with the child in isolation; the child must be
seen in a family setting. The criminal dimension of any action cannot be ignored.
n
Where it is necessary to protect the child from further abuse, alternatives,
which do not involve moving the child and which minimise disruption of the
family, should be explored.
n
Actions taken by Agencies must be considered and well informed so that they
are sensitive to and take account of the needs of the child's gender, age,
stage of development, religion, culture, race and any special needs.
n
All Agencies concerned with the protection of children must work together on
an inter-Agency basis in the best interest of children and their families.
n
Each Agency must have an understanding of each other's professional values
and accept each other's role, powers and responsibilities. 2.3 The Trust's Child Protection Panel embraced "Co-operating to
Protect Children" Volume 6 and copies of this document are available
on site to all practitioners/managers operating within the Trust area. Operational
procedures (later outlined in this document) wholly reflect and adhere to the
policy/procedures indicated in Volume 6. Section 3 3.0 Structure of the Trust - Family and Child
Care Programme 3.1 The Family and Child Care Programme operational Line Management
structure is as illustrated in Appendix 1. The Programme is overseen
by the Chief Executive, Mr R Black, and the Director of Social Work -Mr N Rooney
and Programme Manager - Ms J Kennedy. Operational responsibility is further
shared by three Principal Social Workers (two designated fieldwork Services
and one for residential care provision). Seven Operational Managers (Assistant
Principal Social Workers) relate directly to the Principal Social Workers.
Nineteen Senior Social Workers relate directly to the Operational Managers
and manage nineteen Social Work teams/projects. 3.2 Location The Child Care teams are
located over a number of venues. The twelve Primary Child Care teams operate
from three sub offices:
n
Shankill Centre (Central)
n
Antrim Road (North)
n
Lawther Buildings (West). Fostering and Adoption Services
are located in Glendinning House, 6 Murray Street, Belfast. Section 4 4.0 Structure of the Programme - Specialisms 4.1 In 1987 the Family and Child Care Programme re-organised
from a generic service to specialist Programmes of care. Within the
Family and Child Care Programme within North and West further specialisms were
introduced. These specialisms involved the establishment of "Prevention" teams
of Social Workers and "Care" teams of Social Workers. The ethos and emphasis
of these specialisms was to enhance the workers knowledge and expertise in
the aforementioned areas and hence improve service delivery. 4.2 "Prevention" Social Workers undertook/take
office duty and complete all initial assessments of referrals. The Workers
would undertake Child Protection investigations and follow through in Protection
Planning. It was anticipated that Prevention workers would also identify and
utilise services aimed at preventing the long-term admission of children into
the care system where possible. When not possible these workers would manage
cases through the Court process under what was then the Children and Young
Person's Act (NI) 1968. If Care Orders were secured on children then case management
responsibility would transfer to colleagues in the respective locality based
care team. 4.3 Care Social Workers would/will operationalise
the Trust's corporate parenting responsibilities with regard to children in
medium/long term care placements either within their extended family, Fostering
resources or the residential base. These children may have been subject to
either Care Orders or voluntary arrangements with parents. 4.4 In 1995/96 in recognition of the following: a.
Evidence gleaned from child abuse enquiries, particular Butler/Sloss
on the Cleveland experience, Rochdale & Orkney. b.
The imminent onset of implementation of the Children Order (NI) 1995. c.
The revision of Joint Protocol procedures and Memorandum of Good Practice. d.
Co-operating to Protect Children. The Trust established a Working
Party to consider how best the Programme would manage the interface between
the service delivery of Child Protection investigations and Family Support
Provision (Children Order (NI) Article 18). This Working Party determined that
it would be appropriate to develop a further specialism within the Programme
and formulate a team specifically to undertake all new allegations of physical
and sexual abuse, severe neglect as well as discharge the Trust's Statutory
Functions with regard to Scheduled Offenders (from a Child Protection perspective). Section 5 5.0 The Child Protection Team 5.1 The Specialist Investigative Child Protection Team was
established in April 1997 following the deliberations of a Trust Working
Party in 1995/96. The purpose of further specialising the "Prevention" Programme
was eightfold; (though not exhaustive): a.
To enhance service provision, ie new investigations would be undertaken
by experienced staff. b.
Promote increased specialist multi disciplinary liaison with other Agencies,
particularly the PSNI and hence enhance 'Joint Protocol' working relationships. c.
Endeavour to centralise specialist trained Joint Protocol Social Workers
who would work "Trust wide" and overarch provision across the three sub offices. d.
Provide strategic information on investigative trends. e.
Assess and service identified investigative needs. f.
Provide consultancy and training for other primary Social Work teams
within the Trust/Programme. g.
To discharge the Trust's role in respect of Schedule One Offenders. h.
To retain experienced staff in this difficult, complex and stressful
area of work by the creation of the Senior Practitioner grade of Social Work
Practitioner. 5.2 Team Structure The Child Protection Team
comprises of eight staff:
n
One Team Manager (Assistant Principal Social Worker Grade)
n
Three Senior Practitioners (Social Workers)
n
Two Social Workers
n
One Team Clerical Officer
n
One Personal Secretary (Part Time for Assistant Principal Social Worker). 5.3 Location The Team is currently located
in Lawther Buildings, Cupar Street, Belfast. They provide an investigative
service for the whole of the North and West Belfast area. 5.4 Joint Protocol Work Initially, all five practitioners
within the team were specialist trained to undertake Joint Interviews re: child
abuse with trained Police Officers. This had led to very close and established
working relationships with the two Police CARE Units who service the North
and West Belfast area, namely Newtownabbey and Woodbourne. However, as research has
focused on further specialising Joint Protocol training only two workers within
the team are currently trained to undertake this very specific format of Joint
Interviews. The Trust has felt this level of training provision to be inadequate
given the volume of investigative interviews undertaken by the Trust comparative
to that of other Trust's in the region. The Trust has made representation to
this end to the Trust Child Protection Panel, the Area Child Protection Panel
and directly to the Eastern Health and Social Services Board. The Trust is
concerned that training provision does not:
n
Recognise the volume of interviews undertaken.
n
Provide for the transition and movement of staff into other fields, ie in the
past year 2001/02 three members of the team have secured promotional positions
within and outside the Programme. 5.5 When the Child Protection Team completes
an initial investigation, the Practitioner following liaison with the Assistant
Principal Social Worker (Line Manager) will decide on a number of potential
options:
n
Transfer to the respective Prevention Teams in the local sub office.
n
Referral to specific therapeutic services, for example, Child Care Centre and
Adolescent Services.
n
Case closure. 5.6 There is a recognition that the remit for
operationalising child protection investigations/services is not exclusively
held by the Child Protection Team. In ongoing current caseloads held by Social
Services specific child protection issues may emerge at any juncture. The lead
responsibility in these situations is undertaken by the Key Worker for that
child/family and the Child Protection Team will: a.
Offer to undertake any Joint Protocol interviews deemed necessary and
appropriate. b.
Act in a consultative capacity for the Key Worker for the duration of
the investigation. 5.7 From 1 July 2001 to 30 June 2002 the Child
Protection Team managed 352 Referrals. 130 were in respect of Sexual Abuse/Inappropriate
sexual activity; 60 were in respect of physical abuse; 90 referrals in respect
of Schedule One Offenders and 60 in respect of Alleged Schedule One Offenders
and 9 others. Referral sources for this
same period are as follows:
n
Social Services 97
n
Probation Board 83
n
PSNI 67
n
Community 37
n
Family/Self 12
n
Community Nursing 11
n
Education 22
n
GP's 3
n
Others 22 Appendix 2 illustrates the
nature/number of Referrals (July 2001 - June 2002). Appendix 3 illustrates Referrals
sources (July 2001 - June 2002). During the aforementioned
period the Child Protection Team undertook 235 Strategy Meetings involving
295 children/young people.
The Team also undertook 42 Joint Protocol Interviews with the Police involving
42 children. Section 6 6.0 The Referral/Procedure 6.1 Office Duty is operational throughout the
Family and Child Care Programme, Monday - Friday, 9.00am - 5.00pm. Out of Hours
coverage is managed by the Emergency Duty Team. North and West Belfast HSS
Trust have line management responsibility for the Social Workers located in
the Emergency Duty Team. 6.2 Referrals to the Child Care Programme are
received from a variety of sources ranging from other professionals, GP's,
teachers as well as directly from the public. 6.3 Upon receipt of a referral the Duty Officer
(Social Worker) will determine, in consultation with their Line Manager, whether
the response will be undertaken by the Prevention Programme or in all cases
of new allegations of physical/sexual abuse, by the Child Protection Team. 6.4 The following procedure, in adherence to
'Co-operating to Protect Children' Volume 6 and Joint Protocol procedures,
is undertaken by the investigating Social Worker:
n
Clarifying referral detail/information.
n
SOSCARE and manual checks to determine if child is previously known.
n
Consultation with CARE Unit (PSNI) re: format of investigation (known as Strategy
Meeting) to determine either a) Joint Agency approach; b) Single Agency approach.
n
Multi disciplinary checks completed.
n
Consent from parents sought to interview child.
n
Interview with child (if parental and child's consent secured)
n
Consideration of need for medical examination (and by whom, for example, Forensic
Medical Officer, GP or Consultant Paediatrician).
n
Convention of Strategy Meeting with professionals involved.
n
Consideration of matter being brought to Child Protection Case Conference.
n
If brought to Child Protection Case Conference the issue of registration is
considered.
n
Case/progress or otherwise reviewed formally on a 3/6 monthly basis.
n
If the child is de-registered, a post de-registration meeting is convened 6
months after de-registration. 6.5 Appendix 4 illustrates a flow chart outlining
the potential path of a referral. Appendix 5 highlights a fictitious
working example of the investigative process re: allegations/concern of physical
abuse. Appendix 6 highlights a fictitious
working example of the investigative process re: allegations/concern of sexual
abuse. Section 7 7.0 Scheduled Offenders - Child Protection
Responsibilities 7.1 Trends and Patterns People who sexually abuse children are diverse
in terms of age, sex, occupation, income level, marital status and ethnic group. At one
time it was believed that sex offenders could be categorised along three dimensions:
n
Those who offend against either adults or children.
n
Those who offend against members of their own family or against acquaintances
and strangers.
n
Those who offend in non-contact ways (for example exhibitionism) or through
bodily contact. There is growing evidence
that a number of offenders offend across these categories. Child abusers may
engage in incestuous, as well as non-incestuous abuse and may target children
of both genders. Offenders and alleged abusers
in general, tend to lead rather transient lifestyles. Hence gauging their numbers
and monitoring their movements is an ongoing difficulty. There is increasing public awareness about Schedule
One Offenders and this awareness usually manifests in a desire for exposure and
expulsion of offenders. Whilst this reaction and the demand for more information
is understandable
at one level, public concern is often based on a fallacy viz that all
offenders present as an equal and immediate risk to children. Practice
reality, clearly, highlights that offenders are not a homogenous (uniform) group in terms
of the risk they present. Public disclosure is only justified as a last resort
for those identified as presenting a significant immediate risk to children;
indiscriminate disclosure and consequent expulsion can actually increase the
risk to children. However, localities and Trusts vary widely in the amount
of supervision, if any, they provide to child sexual abusers once they are
released from jail. 7.2 Trust Obligations re: Schedule One Offenders
- Legislative Background The Trust's primary obligations
are sourced in the: a.
Children (NI) Order 1995. Article 66 places a duty on the Trust to investigate
concerns alleging abuse of a child:
n
Requires Social Services to make enquiries to enable
them to decide whether they should take any action to safeguard and promote
the child's welfare. This duty refers to both
specific identified children and children in general, within the Trust's locality. b.
Children's Evidence (NI) Order 1995. c.
The Sex Offenders Act 1997, which came into effect on 1 September 1997,
obliges individuals in custody or convicted after that date to notify the police
of their name(s), Date of Birth and address (including any subsequent changes).
The Sex Offenders Act 1997 obliges Agencies in statutory contact to advise
offenders of the requirement to register with the police. In relation to the Trust
this applies to offenders: a.
Admitted to hospital on a Hospital Order (with or without restriction);
those placed in hospital on a Guardianship Order, under Part 111 of the Mental
Health Order, and those found guilty by reason of insanity or unfit to plead b.
Young people Looked After under the Children (NI) Order 1995. The Trust has a clear obligation in respect of
protecting children and experience indicates that communities, clearly,
view Social Services as the agency responsible for protecting children from
offenders. Policy Obligations Policy obligations are directed
as follows:
n
"Protocol for Joint Investigation" (1991 and 1996)
n
"Memorandum of Good Practice" (1992)
n
"Co-operating to Protect Children" Volume 6
n
"DHSS (NI) Guidance Circular HSS (cc) 3.96. These policy documents highlight
that the protection of children in the context of convicted and alleged child
abusers is a shared multi-Agency function. They further recommend that
any investigation into alleged/suspected cases of child abuse is sensitive
to the interests and needs of the child and their family. With regard to identified
children, the Trust's role and responsibilities is clear; such cases are dealt
with in accordance with well established child protection procedures - (see
attached diagram "What happens to a Referral" Appendix 4). In relation to concern about
children in general, arising from the activities of alleged or convicted abusers;
the role of the respective statutory Agencies (ie Social Services, PSNI and
PBNI) is imprecise. 7.3 Trust's Operational Response The Family and Child Care
Programme within North and West Belfast Health and Social Services Trust deals
with the majority of referrals relating to offenders.
n
Since April 1997 the Child Protection Team has assumed primary responsibility
for managing offenders' referred to the Child Care Programme within the Trust. The Trust's assessment of
offenders involves:
n
Home visits to offenders and alleged offenders
n
Contact/home visits with victims and offender's family
n
Convening, chairing and participating in multi-Agency risk assessment meetings
n
Attending MASRAM meetings
n
Convening and chairing Child Protection Case Conferences re: offender's family
n
Close liaison with other professionals and Agencies involved with offender. Staff
involved in the risk assessment process seek to apply a formula focusing on:
n
An individual's offending history
n
An offender's modus operandi
n
The outcome of offence focused work
n
Victim(s) demographics
n
Offender's health
n
An individual's current social
context - including housing situation; contacts/associates in local community;
interests; hobbies; social outlets; and location of nearest schools. The formula used by the Child Protection Team for
assessing risk posed by offenders is not used universally throughout
the Trust's programmes, or by other Trusts. The Trust is also involved
in preventative and educational strategies aimed at reducing risks to children
in general. This work is undertaken by staff from the Early Years Team, Training
Unit and the Community Development Unit. Section 8 8.0 Case Work 8.1 Case Work for Individual Social Workers
and Teams Within the Child Protection Team and Prevention
Teams across the Trust, Social Workers carry individual 'caseloads'.
A caseload for a prevention worker may average twenty to twenty five families.
On average five of these families' children may be on the Child Protection
Register and subject to the Child Protection Review process. One to two other
cases may be subject to ongoing care proceedings in the Family Proceedings
Court, whilst two to three other cases may be subject to private law applications
re: residence and contact wherein the Court have directed ongoing assessment
reports from the Social Worker. The remainder of the worker's caseload may
comprise of family support cases inclusive of children's behavioural difficulties,
adolescent difficulties, parental alcohol/substance misuse, etc. 8.2 Management of Cases/Workload - Supervision On average each team comprises
of five workers who relate directly to a Senior Social Worker. The Child Protection
Team members are supervised by an Assistant Principal Social Worker. All first
Line Managers are based on site with their respective teams. An 'open door'
policy permeates throughout the Programme and workers have contact with and
access to their Line Manager throughout the working day. On a four weekly basis
(more often if required) the Social Worker will have formal supervision with
their line manager. This is a 'protected time' for individual contact to consider: a.
Case management of each individual family in receipt of a service. b.
Educational advice re: management of cases. c.
Identification of the Practitioners ongoing training needs and subsequent
servicing. d.
Support - re: attendant stresses associated with the nature of the work. Both the line manager and
Practitioner take a note of 'agreed action plans' within supervision. The Social
Worker's record is usually held in the client's file. 8.3 The First Line Manager also receives supervision
on a four weekly basis from the Assistant Principal Social Worker. A similar
ethos obtains within this working relationship as that referred to in 8.2. 8.4 The First Line Manager's supervisory process
is subject to scrutiny on an annual audit conducted by the Assistant Principal
Social Worker. The outcome of this audit is subject to perusal by the Principal
Social Worker and Programme Manager. 8.5 Case Recording Casework is recorded on standard
Proforma forms, namely R1 - R4's (see Appendix 7). Case recording is maintained
in family files. Looked after children
have separate individual files. The Case Co-ordinator (Senior Social Worker)
will periodically sample case files to ensure both up to date and quality recording.
This process is also audited on an annual basis by the Assistant Principal
Social Worker who will randomly sample case files and provide a commentary
on the findings to his/her respective Principal Social Worker and Programme
Manager. Case files contain Case Conference
Reports/Minutes, Court Reports, Looked After Child documentation, copies of
all/any legal orders, copies of all correspondence and a "Restricted Section".
The designated "Restricted Section" will hold any information that relates
to third parties. Clients have 'open access' to their files and are
made aware of the number (if any) of documents extracted from the restricted
section of the case file. Section 9 9.0 Professional Judgement 9.1 The professional judgement of individual
Practitioners is subject to the scrutiny of both informal and formal supervision
of the Line Manager on an ongoing and regular basis. When a situation/concern
is brought to a Case Planning Meeting, Strategy Meeting or Child Protection Case Conference,
the Social Worker's judgement is subject to overall scrutiny of the
multi disciplinary group/forum. Within these forums information is shared/exchanged
and accountability shared with the core members. Core members usually comprise
of Social Services, Health Visiting professional, Police (if appropriate) and
Educational professionals (if appropriate). Section 10 10.0 Communication 10.1 As illustrated in Sections 2, 5 and 6 in
accordance with statute, policy and procedure, multi disciplinary liaison is
imperative from the outset of an investigation. The Trust strongly is of the
view that Child Protection is the responsibility of all, although is acutely
mindful and aware of the statutory duty vested upon it by statute. In all cases
Practitioners are required to undertake multi disciplinary checks/liaison in
respect of children. The Trust is very mindful of the need to approach the
Child Protection process in as an holistic manner as possible. As well as enhancing
the decision making process the Trust is aware that the resolution of Child
Protection issues require multi agency inputs. 10.2 A variety of forums may be convened in respect
of Child Protection concerns/issues. These forums range from an Initial Strategy
Meeting at the outset of an investigation to a Child Protection Case Conference
wherein a decision is taken on the appropriateness or otherwise of registration.
At all forums service provision and protection planning is identified, formulated
and agreed between the core Agencies present. When particular key agencies
are unable to attend the Social Worker will undertake to contact the individual(s)
to establish their contribution to the forum and views on potential outcomes. 10.3 The Trust recently undertook some research
into the poor attendance at Case Conferences by General Practitioners and are currently endeavouring to
establish a system wherein a GP in the event of non-attendance can contribute
to the forum in writing. 10.4 During multi-Disciplinary Meetings a minute
of the discussion and decision-making is taken by either administrative colleagues
or the Senior Social Worker. These minutes are then disseminated to the key
participants and those invited to attend the forum inclusive of parents. 10.5 For all children whose names have been removed
from the Child Protection Register, a post de-registration meeting with core
professionals is convened six months following de-registration. Section 11 11.0 Workforce Issues 11.1 Presently primary Child Protection Services
are resourced by professionally qualified Social Work staff. All staff within
fieldwork teams have a fully recognised professional Social Work qualification
either CSS, CQSW or Diploma in Social Work. 11.2 Within the primary fieldwork teams there
are a total of fifty-four Practitioners managed by ten Senior Social Workers.
All Senior Social Workers have a minimum of three years post qualifying experience
within the Family and Child Care field. The Programme is serviced by seven
Operational Managers (Assistant Principal Social Workers). All Operational
Managers have a minimum of five years post qualifying experience three of which
must be inclusive of Family and Child Care experience. All staff at Operational
Manager level and below are at varying stages in the completion of their Post-Qualifying
Award both at basic and at advanced levels. The Trust places particular emphasis
upon post qualifying training and actively encourages all new recruits to the
Programme to commence the relevant training to complete their Award. This is
managed through the Trust's Training Team. 11.3 The Child Protection Team is serviced by
five practitioners. Three of these practitioners are a 'Senior Practitioner'
grade. This grade has a minimum experience requirement of two years within
the Family and Child Care Programme. The remaining two workers have each a
minimum of one year's post qualifying experience within the Family and Child
Care Programme before commencement in the Team. 11.4 Research undertaken by CCETSW (now replaced
by the Social Care Council) in 2000 indicated that, potentially, in the forthcoming
years (several) there would be a shortfall of approximately 150 Social Workers
(NISCC). This research indicated that the shortfall was not universal across
all Programmes of Care but located in the Family and Child Care Programme (field
and residential care) in particular locations. North and West Belfast is, potentially
one of these areas/locations. The Trust is very mindful of the recruitment
and induction of new staff within the Programme and reports to the Principal
Social Worker re: the same on a monthly basis. To date, the Trust has not
experienced the anticipated difficulties aforementioned but is mindful
that the pool of recruits responding to ongoing press advertisements is decreasing.
This is, and will be monitored on an ongoing basis. Section 12 12.0 Linkages 12.1 From the outset of an investigation, legislation
and procedural guidance requires the Trust to consult, liaise and inform parents
and carers of children who are subject to contact with the Social Workers.
The Trust is satisfied this is fully operationalised across the three sub offices.
12.2 As with parents, children's views/wishes
and feelings are listened to by Practitioners in as wholly an age appropriate
manner. 12.3 The Trust is currently working alongside colleagues in the NSPCC
to produce 'consumer friendly' information leaflets for parents, carers
and children who have contact with the service. It is anticipated that these
leaflets will advise and inform the respective individuals with regard to the
investigative process and walk them through the different and varying stages
of this process. 12.4 Parents and children (where age appropriate)
and invited formally to be full participants in Child Protection Case Conference.
Parents are briefed by practitioners/Line Managers and the Chair of Case Conferences
on the format, etc of the Conference. Parents are now an integral part of the
Conference and their views and opinions are sought before, during and after
each Conference. Parental attendance at Child Protection Case Conferences are
statistically recorded and audited on both a monthly and annual basis so that
any perceived dips/ blips, etc may be identified promptly and action taken
to rectify if possible. The attendance of children/young
people at Case Conferences is something relatively new to the service. The
Trust has found historically that:
n
When young people requested to attend a Conference, Operational Managers have
accommodated this request.
n
More often than not the experience for the young person, despite appropriate
briefing, was quite overwhelming and on occasions traumatic. Whilst the Trust welcomes
and embraces this new and exciting area of practice, it is cautious with regard
to aspects of implementation to ensure that the young person's attendance at
a meeting is respected and welcomed but that the process in itself is not traumatic/abusive. 12.5 Parents now have a right of appeal against
the decision arrived at by the Case Conference forum in respect of the issue
of registration of their child/ren. This appeal may involve a review of the
decision inclusive of any new information a parent/carer and/or their representative
may present. If still dissatisfied the parent may request that the decision
is re-considered by an independent panel of Senior Managers/Director within
the Trust. 12.6 Service users also have access to two complaints procedures within
the Trust; namely the Health and Personal Social Service Complaints
procedure and the Children Order Complaints Procedure. The Programme has an
Operational Manager (Assistant Principal Social Worker) who undertakes an independent
investigative role in the management of any complaints received. The Children's
Order Complaints Procedure also requires the appointment of a wholly independent
individual who will oversee the investigative complaints process. This individual
accompanies the Operational Manager during the investigation, during interviews,
file perusal, etc and will complete and Independent Report on his/her findings/experience
of the process. 12.7 Trust Child Protection Panel A Principal Social Worker within the Trust chairs
the Trust's Child Protection Panel. This panel meets on a bi-monthly basis and is serviced
by the Operational Manager with responsibility for the Child Protection Team. The panel comprises of multi disciplinary representation
consisting of Consultant Paediatricians, Dieticians, the Child Protection
Advisor for Community Nursing, PAM's representatives, the Inspector of the
PSNI CARE Unit, NSPCC representatives, Trust Children's Services Training representatives,
Educational colleagues from primary and secondary sectors, the Probation Service
Social Worker, colleagues from the Physical Health and Learning Disability
Programmes of Care and two community representatives. This forum is quite active and dynamic overseeing
the implementation and operationalising of Child Protection Policies
and Procedures within the Trust. 12.8 Besides Family and Child Care, other Programmes
within the Trust who work directly with children have fully operational Child
Protection Policies. The responses from Health Visiting and the Physical Health
and Disability Programme of Care have been included below. Health Visiting Casework Health Visitors in their
role as family visitor and health promotion advisor are often the first professional
to identify early signs of the risk factors which may contribute to imminent
concerns regarding the abuse or neglect of a child. Furthermore, their knowledge
of child development can assist in the early detection of failure to thrive. Health Visitors within North
and West Belfast increase visits and contact with families, which they assess
to be 'highly dependent'. This assessment is based on recognised risk factors
such as poor parenting skills and knowledge, lack of extended family support,
young single parent, family isolation, mental health of mother, domestic violence
and other known factors. Such support has been recognised
as invaluable in a recent audit of health visiting services carried out in
partnership with EHSSB. In the audit, family support was identified as one
of the top five activities of health visiting interventions with families in
North and West Belfast. Such activity is not recorded in other areas within
the Eastern Board. The Health Visiting role,
in providing early interventions in relation to child protection, has arguably
not been fully recognised nor valued, year early detection and support visiting
can prevent deterioration and ensure immediate referral to support services if the Health Visitor assesses
there is increased risk to individuals or families. Such intensive visiting
is at the expense of the broader Health Visiting role, eg Public Health and
Health Promotion with the wider community context. As such, services have been
unable to further develop or participate fully in new community initiatives,
eg Sure Start, Teenage Pregnancy Projects, etc. Communication A well-developed and collaborative
relationship exists between Health Visiting and relevant stakeholders in the
area of Child Protection. This involves close working relationships with Social
Services. General practice, local maternity hospitals, Royal Belfast Hospital
for Sick Children and the voluntary sector. Each General Practice has an aligned Health Visitor
and a protocol for the referral of children to the service exists between
hospital Accident & Emergency Departments in relation to the attendance
of children from the area. Linkages Health Visitors refer families
to local support services such as parent and toddler groups, support groups,
etc. Referral for family Support Services, eg Sponsored Day Care, is made by
referral to Social Services who fund these resources. Workforce Issues Training All Health Visiting students
receive training in Child Protection, whilst undertaking basic training at
university. There
has, however, been no formal multi-disciplinary training mechanism established
within the Trust since implementation of the Children (NI) Order. Staff
have received ongoing training in specific aspects of Child Protection, eg
domestic violence, preparation of Court Reports and attendance at Court. In recent years it has become difficult to release
staff to attend training due to the increasing and persistent demands
of workload, coupled with the complexities of filling temporary vacancies (ie
temporary vacancies such as maternity leave are, at times, almost impossible
to fill). Supervision The supervision of casework
is carried out with all Health Visitors regularly by the Trust's Child Protection
Advisor. However, the frequency of this needs to be increased, but until additional
resources become available this will not be possible (ratio 1:40 staff). Pressures on Staff
n
North and West Belfast has difficulty in recruiting Health Visitors. This may
be because it is recognised as a difficult area in which to work due to the
levels of deprivation, civil unrest and the number of Child Protection cases
on Health Visitors' caseloads compared to other areas. The recent report "Caring
Through the Troubles" recommended rotation of staff around areas which are
less pressurised. This is not possible within North and West Belfast, as all
caseloads are problematic.
n
GP Fund-holding necessitated the allocation of Health Visiting resources at
a point in time to all Practices within the area. To date this cannot be reviewed,
yet prior to Fund-holding caseloads were regularly reviewed in relation to
workload. This has resulted in inequity between caseloads, as all Health Visitors
are aligned to General Practices and as Practice population needs change and
vary. Some caseloads now have a disproportionately high number of Child Protection
cases. The service is addressing this at present in anticipation of guidance
from LHSCGs.
n
Implementation of the Children Order has increased the workload of Health Visitors,
all without additional resources. Such work includes:
-
Submission of a written report to all Case Conferences. Reports are shared
with parents prior to the Case Conference. Due to workload pressures
staff report that much of the associated administration is carried out at home
due to other caseload work and peer access to administrative support.
-
Attendance at Court as a witness.
-
Preparation of Court reports.
-
Attendance at Looked After Children Reviews (LAC).
n
The cumulative pressures of visiting high dependency families including those
on the Child Protection Register is a major cause of the failure to retain
staff. The service would recommend remunerative rewards to attract staff to
the area and retain those already in post.
n
Due to the pressures of work supporting highly dependant families, resources
have been diverted from early preventative work. The service is not resourced
to commission family support when problems are identified at an early stage
and which could be redressed through greater access to services such as Family
Support Workers, Sponsored Day Care, etc. Resources
n
Resources for additional Family Support Services either directly managed by
the Health Visiting Service or with financial capacity to source same.
n
Resources to fund two additional Child Protection Advisors.
n
Resources for specialist Health Visitors/Nurses to undertaken Tier 2 preventative
work, eg Behaviour Therapy.
n
Resources to enhance budgetary
capacity to remunerate staff appropriately (eg Long Service Initiatives,
Deprivation Allowance, Relocation Allowances. General Comments The Health Visiting Service,
for many years, has been delivering a reactive service and has been unable
to proactively deliver a fully comprehensive Health Promotion and Public Health
Service whilst developing innovative practices. This situation will remain unchanged without additional
resources and current Government strategies relating to Public Health
will remain secondary to the priority issues of Child Protection. A managed and adequately
resourced proactive approach to service delivery which focuses on Health Promotion
and Public Health strategies is required if inequities and inequalities are
to be addressed. Physical Health and Disability
Programme of Care Introduction North and West Belfast Health
and Social Services Trust is contracted to provide the Hospital Social Work
Service to the Mater and the Royal Group of Hospitals. This service is managed
through the Trust's Physical Health and Disability Programme of Care.
n
The service fulfils its statutory duties under the Children (NI) Order 1995
in relation to Child Protection for any child or young person up to the age
of 18 admitted to or attending either hospital.
n
Hospital Social Workers adhere to the policies and procedure in relation to
Child Protection in the hospital context, as defined by the EHSSB Policies
and Procedures Volume 1-6.
n
All Hospital Social Work
Staff are professionally qualified, and staff also have a clear supervisory
line. Structure Royal Hospitals Trust
n
Children up to the age of
13 are admitted to the Royal Belfast Hospital for Sick Children. In the Children's
Hospital a team
of Social Workers are dedicated to individual wards and specialisms. The team
consists of one Senior Social Worker who also manages the Maternity
Service and seven Social Workers.
n
Some young people up to the age of 18 with chronic health conditions, eg Cystic
Fibrosis, Leukaemia and renal problems continue to attend the Children's Hospital.
n
Most young people over the age of 13 may be admitted or attend the main Royal
Hospital and adult services. In the main hospital there are two Social Work
teams with individuals dedicated to wards, specialism or directories.
n
In the Royal Maternity Hospital,
a team of three Social Workers provide the service and fulfill statutory
responsibilities of assessment, care planning and Child Protection in relation
to teenage pregnancies and vulnerable babies who may be at risk or "in need". Mater Hospital
n
The hospital Social Work service to the Mater Hospital Trust is provided by
a team of professionally qualified staff consisting of one Senior Social Worker
and five social work staff. Staff are allocated by ward are or specialism.
n
Children and young people at risk may attend Accident & Emergency or be
admitted to the general medical, surgical wards.
n
A dedicated Social Worker provides a part time service to the maternity ward
and has a key role in the identification, assessment and care planning in relation
to teenage girls, high risk pregnancies and babies born who are potentially
at risk or "in need". Service Issues (general) Referrals
n
Referral criteria have been drawn up and circulated to wards/clinic areas to
identify cases that should be referred to the hospital Social Worker. These
criteria prioritise children and young people at risk or "in need" through
physical, sexual and emotional abuse or neglect.
n
The hospital Social Worker may carry initial responsibility for case management,
information gathering, preliminary assessment and liaison with community based
Family and Child Care Services.
n
Community based Family and
Child Care Teams carry lead responsibility for the management of Child
Protection cases.
n
Protocols are in place to determine transfer and case management responsibility
for children or young people admitted to hospital who have been identified
as at risk from all over Northern Ireland.
n
Child Protection cases are managed through: line management supervision; multi-disciplinary
liaison; Strategy Meetings; and Case Conferences.
n
There is operational representation from the Physical Health and Disability
Programme of Care on the Trust's Child Protection Panel.
n
North and West Belfast Trust provide Child Protection training to staff at
both hospitals.
n
An interface group has been established within North and West Belfast Trust
between Family and Child Care, Learning Disability and Physical Health and
Disability to improve communication, review procedures and policies and ensure
better practice in relation to Child Protection across these Programmes of
Care. Royal Hospitals Trust
n
The Children's Hospital is a regional hospital with children admitted from
all over Northern Ireland. Meetings have taken place with other Trusts and
Boards, eg South and East Health and Social Services Trust, to share information
on clarifying procedures; interface issues and communication enhancement in
relation to children admitted to Royal Belfast Hospital for Sick Children and
to the hospital site.
n
Hospital Social Work Managers form part of the Child Protection Committee within
Royal Hospitals Trust, which has been set up to address Child Protection issues
arising throughout the hospital. This committee links to the EHSSB Area Child
Protection Committee and invites representations from Community Trusts as required.
n
The Child Protection Committee
policies and procedures based on the EHSSB guidelines for circulation
to each ward area have been drawn up. The policy defines child abuse; individual
and professional responsibilities; referral procedures; and case management
processes. In addition, the hospital has published a poster and leaflet highlighting
staff's responsibility in the recognition, reporting and professional duties
in relation to Child Protection.
n
Communication has improved
following the establishment of the Hospital's Child Protection Committee
as issues, policies and procedures are brought to the Committee for discussion
or resolution in the form of an action plan or procedure.
n
In the Royal Maternity Hospital,
the hospital Social Workers have drawn up a formal referral proforma,
from Social Services to Community Midwives and Health Visitors, to use in cases
where there is a level of concern with regard to parenting or support, short
of formal Child Protection Procedures.
n
Training - The Royal Hospitals Trust has submitted a Business Case in partnership
with North and West Belfast Trust to the Commissioners for a three-year training
programme, co-ordinated by a Senior Social Worker/Practitioner as trainer for
all staff within the Royal Hospitals Trust to ensure adequate training for
relevant staff. This course will target all staff from domiciliary staff to
Nurses to Doctors/Consultants and Social Work staff.
n
Meetings have taken place to improve liaison with EHSSB Out of Hours Service. Mater Hospital Trust
n
Criteria for referral to Social Services has been drawn up to identify at risk
cases, which have been referred by hospital staff for assessment, intervention
and case planning.
n
A Children's Service Group
established within the hospital has highlighted the need for ongoing training
for staff in key areas viz Accident & Emergency; Day Procedures; and Obstetrics.
The training was provided by the Training Team, North and West Belfast Trust.
n
There is a need to draw up working protocols within the hospital especially
Accident & Emergency to ensure greater compliance with statutory requirements.
n
North and West Health and Social Services Trust intends to draft protocols
with the Mater, in relation to Accident and Emergency by way of ensuring greater
communication and co-ordination between medical/nursing staff associated with
Social Work staff. Community Based Social Care Provision
n
The community teams are staffed by 13 Social Workers, managed by 4 Senior Social
Workers. There is also 4 technical staff (for sensory impairment) attached
to the Programme.
n
The teams provide services for both adults and children.
n
A small but significant number of Child Protection referrals arise each year
within the Programme. These referrals primarily take the form of concerns regarding
dependent children of disabled parents.
n
The Physical Health and Disability teams manage concerns through Strategy Meetings
and Case Conferences.
n
A Working Party comprised
of Child Care staff and Physical Health and Disability staff are currently
drafting a protocol aimed at clarifying the transfer procedures between
Physical Health and Disability and Child Care staff.
n
Staff operate within and adhere to the EHSSB Policies and Procedures Volume
1-6.
n
Trust's standards have also
been set with staff in terms of professional expectations and multi-disciplinary
work in managing Child Protection cases.
n
All Social Work staff within the Programme are fully qualified.
n
The Programme is fully included on Child Protection training offered by the
Trust's Training Unit; the Programme also has 2 Joint Protocol trained workers.
n
There is a clear supervisory
line extant in the Programme; with written records maintained on individual
case consultations.
n
In addition to individual case work, the Programme also provides - directly
and indirectly - (through the community sector) preventative services that
are relevant to Child Protection.
n
The Programme has operational representation on the Trust's Child Protection
Policy. Section 13 13.0 Linkages with the Community 13.1 For a number of years now Social Services
have experienced a dichotomy in its relationship with both the community/society.
Whilst recognising the need for Child Protection Services, society remains
somewhat uncomfortable with the concept of child abuse (- this is currently
being considered in Phase 2 of the NSPCC Full Stop Campaign through the encouragement
of individuals to take responsibility for the reporting of concern/abuse).
The Trust has been very mindful of this unease and have endeavoured to "de-stigmatise"
service delivery and enhance and promote our relationship with the community. 13.2 For a number of years the Trust has endeavoured
to sensitively forge links with many of the community groups. Trust representatives
sit on many Steering Committees of local organisations and focus groups considering
different and varying aspects of service delivery. The Trust also partially
fund many voluntary organisations operational within Trust boundaries and very
much recognise these service providers as our partners in delivering a wider
Child Protection Service. 13.3 Currently the Trust has operationalised Free
Designated child Protection Officer Training, titled "Keeping Safe" for voluntary
groups and organisations within North and West Belfast. This training is managed
through the Trust's Early Years Service and is undertaken by a Designated Social
Worker in partnership with trained volunteers from various voluntary groups.
This training is Free to all voluntary/community groups and has proved particularly
popular. The "Keeping Safe" training heightens awareness of Child Protection
issues and identifies relevant individuals in the local sub offices as contact
to report to or consult with as appropriate. 13.4 The Trust has recently appointed a Senior
Social Worker who has particular responsibility for liaising with schools in
North Belfast. This appointment is in response to the very particular difficulties
experienced in that area during the past sixteen months. The Trust has also
submitted a financial bid to the Department in respect of the establishment
of a multi disciplinary Team in North Belfast to consider and manage the experiences
of families and children following the interface conflicts. 13.5 The Trust has recognised an overall increase
in referrals to the Agency from various community groups within the district,
particularly, since the birth of the respective ceasefires. Operational Managers
are endeavouring to enhance linkages with these groups through ongoing personal
and individual contacts facilitating information exchange, etc. Section 14 14.0 Lessons Learned 14.1 Perhaps, the most significant lesson that
has been embraced by the Trust was that of the Cleveland experience which led
to the introduction and implementation of the Children Order (NI) 1995. This
enquiry and the subsequent legislation ensured the focus of intervention was
upon Child Protection though in partnership with carers, other professionals
and the community. The implementation of the legislation has ensured
that Practitioners and Managers explore all interventions with families and children
(within an appropriate threshold) before a 'care' option is enacted. One difficulty
the Trust has experienced is that when a matter is brought before the Family
Proceedings Court for adjudication in respect of Care Order, care planning
for the children can encounter undue delay as the Court will often wish to
re-visit many of the interventions before it will arrive at an adjudication. 14.2 Neglect Case Management Review In 1996 a Case Management
Review was conducted into the circumstances and management of a neglect case
within North Belfast. This Review was, particularly pertinent as the majority
of children on the Child Protection Register in North and West Belfast are
under the category of "neglect". The Review considered the
response to "neglect" issues and themes in Practitioners work with families.
The Review also considered Practitioners' responses to anonymous allegations.
The recommendations of this Review were wholly embraced by the Trust. The outcome
and recommendations of the Review were disseminated via the Trust's Child Protection
Panel to Practitioners and Managers. This dissemination occurred via individual
contact and team meetings. The Trust provided and continues
to provide ongoing specialist training on the whole area of neglect and recognition
and management of the same. Independent specialist trainers such as Dr Swann
usually provide the training. Section 15 15.0 Resources 15.1 The Trust has endeavoured to convey in the
cause of this submission how through the re-structuring of the workforce, and
the establishment of a Specialist Investigative Team, it has attempted to address
service delivery in respect of Child Protection through its Practitioners.
The re-structuring move to specialism has, undoubtedly, enhanced Practitioners
skills and multi disciplinary work hence improving the quality of Child Protection
Service. We very much recognise that the quality of our staff is, perhaps one
of the most critical aspects of service delivery in responding to Child Protection
concerns. 15.2 An area of concern for the Trust has been the lack of
secure accommodation beds for adolescents who present with very serious
difficulties and attendant risks to themselves and others. The Trust continues
to address this concern with the Board and Department on an ongoing basis. 15.3 A further area of concern in respect of resource
provision from a focus on protection perspective is the absence of psychological
service provision for abusing/neglectful parents to assess them and implement
programmes of work designated to address their behaviour. Currently Practitioners/Managers
purchase this service privately from clinicians. Section 16 16.0 Recommendations a.
Child Protection Service Planning continues to receive priority recognition
by Central and Regional Governmental planners and funders. b.
The provision of secure accommodation beds receives ongoing priority
for consideration for adolescents at risk. c.
That recognition is given to regionally equitable training opportunities
for staff in respect of Joint Protocol Training. d.
Ongoing consideration is given to successful recruitment and retention
of Child Protection staff, for example:
n
Consideration of expansion of Senior Practitioner
grade.
n
Consideration of terms and conditions of existing
and newly recruited staff. Appendices Appendix 1 Operational Line
Management Appendix 2 Referrals Graph Appendix 3 Referral sources
Graph Appendix 4 Flow Chart Appendix 5 Physical Abuse (Receipt
of a Referral) Appendix 6 Sexual Abuse Appendix 7 R1 - R4 written submission by: key recommendations of the board's response
n
Proposal for establishment of school based care
n
Funding to support a discrete post of Designated Officer for Child Protection
in ELB's in order to develop and enhance INSET for whole school
staffs and to forge closer links between uni-disciplinary and multi-disciplinary
training.
n
Resourcing for administrative support for Designated Officer.
n
The implementation of a common assessment framework for professionals in education
and social services.
n
The appointment of named social workers to schools.
n
Recognition that teachers have a key role to play in developing preventative
work to promote child protection in schools and local communities and in order
to do so they require adequate training.
n
More teacher representation on ACPPS and closer links between ACPPS and ACPC's. The North Eastern
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: -
n
to develop and maintain the most appropriate policy on child protection;
n
to promote best practice by staff who work with children;
n
to ensure relevant training is available for staff who work with children;
and
n
to develop and sustain links with other organisations which can contribute
to the promotion of child protection within the education sector. 1.1 Case Work within the North Eastern Education
and Library Board The Designated Officer for
Child Protection is the Chief Education Welfare Officer; Deputy Designated
Officer is a Senior Education Welfare Officer. There is also a Designated Officer
for Child Protection within the Youth Service and a Designated Officer within
the Library Service. These two officers meet regularly with the Board's Designated
Officer to discuss Child Protection issues. The Designated Officer/CEWO
has a responsibility to respond to queries and give advice regarding the identification
and referral of cases where child abuse is suspected. Each query is logged
along with the advice given and stored in a locked filing cabinet. The Designated Officer has a responsibility for
undertaking an annual audit of the training needs of designated teachers
and for providing the training required on an annual basis. This training is
provided by an external provider purchased by the Board. The Designated Officer has
a responsibility to provide training for Board staff e.g. CASS staff, support
staff, beginning teachers, staff in Colleges of Further Education who are teaching
children of compulsory school age and staff who are teaching children otherwise
than at school. The North Eastern Board wishes
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. 1.2 Communication The Designated Officer for
Child Protection represents the North Eastern Board at Area Child Protection
Committee (ACPC) level and
is responsible for disseminating information from that committee to all Education
Board services. There is a considerable amount of the Designated Officer's
time devoted to ACPC work in terms of attendance at the
n
ACPC Strategic Planning Group
n
ACPC Training Sub Committee
n
ACPC Conference Planning Sub Group. The Designated Officer attends meetings with Social
Services Personnel regarding allegations against Board staff. The Designated Officer provides
guidance and advice regarding the suitability of applicants for posts which
involve direct work with young people and who have committed criminal offences. 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. 1.3 Linkages 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. Circular 99/10 Pastoral Care
in Schools, which is currently being reviewed by the DOCPEG group, provides
advice to schools on this matter. It would also be helpful if there was greater
teacher representation on the Health and Social Services Trust Area Child Protection
Panel. It is essential that there are close linkages between Panels, ACPP and
ACPC. 1.4 Workforce Issues The current situation regarding
the Board's CEWO being the Designated Officer for Child Protection and holding
responsibility for the duties outlined in the above paragraph is unacceptable.
The recent inspection of the Education Welfare Service by the Education
and Training Inspectorate has highlighted the need for the role of Designated
Officer to be reviewed because of the volume of work. The North Eastern Board
would stress the need for the Designated Officer for Child Protection to be
a discrete role thus allowing more time to be proactive and innovative in promoting
Child Protection issues and procedures throughout the Education sector. For
example, the Designated Officer could take the lead role in providing inset
training for all staff in schools whereas at present this is the responsibility
of the Designated Teacher who has received limited training. There is a need for closer
consultation and linkage between the current uni- disciplinary training and
multi-disciplinary training that is provided by ACPC's. 1.5 Resources The North Eastern Board feels that current resources
across the sectors for the promotion of Child Protection are totally
inadequate. 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. Within education there is a need for the Department
of Education to provide resources to fund a separate post of Designated
Officer for Child Protection in order to deliver a coherent package of training
and support to the education community who are one of the first line services
in protecting vulnerable children and young people. Resources are also required
for the provision of administrative back-up for the Designated Officer and
the provision of training materials for inset within schools and the education
sector as a whole. There is empirical evidence that there is a growing awareness
of Child Protection issues within education and an associated increase in the
number of requests for advice on Child Protection matters. 1.6 Lessons Learnt 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 in
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. 1.7 General Comments 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 felt that implementation of the common assessment
framework would address this concern. Whilst it is recognised that
collaboration between the statutory and voluntary sector has enhanced the promotion
of Child Protection across the sectors it is felt that the majority of work
is concerned with responding to cases of abuse. It is therefore imperative
that adequate resources are provided to take forward preventative work with
families and local communities. The Education sector has a key role to play
in promoting this work within schools. The Education and Library
Boards require adequate resources to provide support to school and nursery
school staff to enable them to fulfil this function. WRITTEN SUBMISSION BY: 9 September 2002 I refer to your letter
dated 20th June, 2002 regarding 'Inquiry into Child Protection Services in
Northern Ireland.' I understand that
Ms. Val O'Kelly, Regional Services Manager, Quality Assurance has been in contact
with your Office in this regard. Hereunder are some general comments in relation
to child protection concerns. 1. It would be helpful for the North Western
Health Board to have an up to date list on a regular basis of the relevant
staff in Northern Ireland to whom we should notify any cross border child protection
concerns. The main Board affecting the NWHB would be the Western Health and
Social Services Board. Transfers are often the subject of dispute re ownership
when families or children come across the border often dictated by resource
issues rather than primacy or paramouncy principle. This is something the Committee
could look at in their deliberations. 2. An area that may be of interest to look
at on a cross border basis would be the sex offenders register that has been
established in the Republic of Ireland. I understand there is one in Northern
Ireland for quite some time and how these two registers could work together
across jurisdiction might be useful to look at. 3. This board is in a collaborative arrangement
with the Western Health & Social Services Board and the Southern Health
& Social Services Board in the North through CAWT. The interests and standards
of children including child protection is advanced on a cross border basis
through CAWT Family and Child Care Sub-Group. It might be useful to discuss
these issues at this forum.
PAT DOLAN WRITTEN
SUBMISSION BY: 16 August 2002 I refer to your letter dated 20 June 2002 regarding the above Inquiry. The Northern Health & Social Services Board welcomes the Health Committee's decision to undertake an Inquiry into Child Protection Services in Northern Ireland and is pleased to have an opportunity to present written evidence. The attached report and executive summary have been prepared in consultation with Trust Directors of Social Work and representatives from the Northern Area Child Protection Committee. The report addresses and makes recommendations in respect of the following: n Child Protection Information; n Organisational Framework and Child Protection; n Financial Framework and Child Protection; n Children's Services Planning; n Joint Investigation by Social Workers and Police Officers of Alleged and Suspected Cases of Child Abuse; n Case Management Reviews; n Case Work, Professional Judgement, Assessment and Analysis of Information, and n Workforce Issues. We will be happy to provide any additional information which the Health Committee may require. I trust you will find this helpful.
MARY B WILMONT (MRS) EXECUTIVE
SUMMARY 1. INTRODUCTION n Of the 425,000 people living within the Northern Board area, 112,377 are children under the age of 18. n The Board in its role of Commissioner is required to assess the health and social care needs of local people, plan, secure services to meet these needs and monitor quality and effectiveness. n There are different populations of children who can be identified according to their different levels of vulnerability and requirements for services. 2. CHILD PROTECTION INFORMATION n Data collected within HPSS in Northern Ireland is based on reported cases of abuse. n The Area Child Protection Committee needs to improve monitoring data sets by including cross-cutting information. n During the year ended 31 March 2002 6.9% of referrals to social work child care teams were for child protection reasons. n The Child Protection Register contains the names of children for whom there are currently unresolved child protection issues and it represents an aid to monitoring and management of child protection. n Child protection activity is focused upon those children who are most likely to be at risk of significant harm. n There has been a 68% increase in child protection registrations since 1997-1998 and a corresponding increase of 45% in de-registrations. RECOMMENDATIONS The DHSS&PS should collaborate in the development of consistent and agreed cross-cutting information data sets on child protection which measure real improvements in children's lives as well as unmet need. 3. ORGANISATIONAL FRAMEWORK AND CHILD PROTECTION n HPSS structures impact directly on arrangements for planning and delivery of child protection services. Until 1993 Boards had responsibility for meeting all social services statutory requirements. These duties were transferred to Health & Social Services Community Trusts under the health and personal social services Northern Ireland Order 1994. n Schemes for the Delegation of Statutory Functions were approved by Area and Trust Boards to discharge certain key statutory functions on behalf of Boards. The Northern Board continues to carry a strategic residual responsibility for ensuring that Schemes reflect sound and effective working procedures and that they are adhered to by Trusts. n The existence of Trusts as separate legal entities creates a permanent tension in relation to ultimate responsibilities and monitoring arrangements. n Effective child protection work depends on good inter-agency relationships and linkages across organisational boundaries. RECOMMENDATIONS Reform of HPSS organisational structures should deliver: n Dissolution of separate commissioning and delivering organisations n Reduction in the number of such organisations n Co-terminous boundaries between Health & Social Services organisations and other key agencies such as Education and Library Boards and the PSNI n A continuation of bodies such as Childcare partnerships and Children and Young People's Committees. 4. LESSONS FROM INQUIRIES n Inquiries have shown that it is important to look at organisational perspectives and the factors that contribute to systems failures as well as the failures of individuals to discharge their responsibilities to children. n Organisations need to take responsibility for developing a culture of learning and for addressing problems. RECOMMENDATIONS DHSS&PS should develop a strategic plan for child protection which sets out clearly the responsibilities of other Government departments for safeguarding children from harm. 5. LEGAL FRAMEWORK AND CHILD PROTECTION n The legal framework to protect children from harm is primarily provided by the Children (Northern Ireland) Order 1995 and accompanying Regulations and Guidance. n The Children Order places a general duty on every authority to safeguard and promote the welfare of children by providing a range and level of personal social services appropriate to those children's needs. n The philosophy underpinning the Children Order is that this duty is a shared responsibility for all those agencies which provide services to children. RECOMMENDATIONS The Assembly Health, Social Services and Public Safety Committee should consider how Article 46 of the Children (Northern Ireland) Order could be amended to strengthen multi-agency co-operation in safeguarding the welfare of children. 6. FINANCIAL FRAMEWORK AND CHILD PROTECTION n The Department took a very conservative view of the cost of implementing the Children Order and reduced considerably the Boards' estimates. n The Needs and Effectiveness Review found that the spend per head of child population in 1999-2000 was 51% greater in England and 11% greater in Wales than in Northern Ireland. n The proportion of the personal Social Services budget devoted to the Family and Child Care Programme of Care is lower than in England, (16.9% in Northern Ireland in 1999-2000 compared to 27.6% in England), despite our younger population profile. n A substantial level of investment is required in order to bring children's services in Northern Ireland up to the level of funding in England. n A range of short-term funding measures has enabled voluntary and community groups to develop high quality services for children in need. As these time-limited funding arrangements come to an end organisations are increasingly turning to Boards to secure mainstream financial support. n The statutory sector is becoming increasingly reliant on short-term funding to develop core statutory services to meet the requirements of new legislation and policy initiatives. n It is good sense to invest in effective and accessible services that seek to reduce the level of abuse and neglect and provide children and families with a range of therapeutic supports. RECOMMENDATIONS The Assembly Health, Social Services and Public Safety Committee should take action to increase the proportion of the Personal Social Services budget devoted to the Family and Child Care Programme of Care in line with funding levels elsewhere on these islands. The Assembly Health, Social Services and Public Safety Committee should assess the impact on statutory Social Services arising from short-term funding arrangements. 7. CHILDREN'S SERVICES PLANNING n The Northern Area Children and Young People's Committee is responsible for setting out a coherent strategic direction in relation to services for children in need and vulnerable children, based on shared objectives agreed by all participating agencies. Significant progress has been achieved. n Under-investment in prevention and family support services has significant consequences for the protection of children. The Board has been active in addressing deficits, but gaps still remain. n Children's voices need to be heard. Planning services in partnership with children and families is integral to Children's Services Planning. n The Northern Childcare Partnership is the Children's Services Planning sub-group which deals with early years and family support. n The Northern Health & Social Services Board has lead responsibility for the establishment and effective functioning of the Northern Area Child Protection Committee, (ACPC). n The function of the ACPC is to develop a strategic approach to child protection within the overall children's services planning framework. n The ACPC is an advisory and co-ordinating committee, collectively accountable to the Northern Health & Social Services Board. Membership includes senior representatives from a range of organisations with an interest in child protection. n The ACPC is pivotal to child protection but it does not carry a statutory remit. n The ACPC is not directly funded by the DHSS&PS on a recurring basis. Funding was secured from the Northern Health & Social Services Board to establish the post of Training and Development Officer and to set up the multi-disciplinary training programme. n In addition to their other responsibilities, the Chair and the Training Officer take responsibility for advising on child protection matters, co-ordinating and supporting the work of task groups. n Member agencies do not contribute financially to the work of the ACPC, although some agencies make a small contribution towards training course fees. RECOMMENDATIONS The DHSS&PS should increase the level of investment in prevention and family support and this should be reflected as a priority in the Programme of Government. The infrastructure around child protection should be strengthened by placing Area Child Protection Committees on a statutory footing. The DHSS&PS should ensure that the Area Child Protection Committee is properly resourced to discharge its functions. 8. TRAINING AND CHILD PROTECTION n The ACPC has a well established multi-disciplinary training programme drawn up annually. Regular monitoring is undertaken in relation to attendance by discipline and effectiveness of training. n An average of 550 staff attend ACPC training annually. The pattern of uptake varies across agencies and professional disciplines. n Findings from a recent survey of General Practitioners in the Northern Board area showed that 70% of GP's surveyed identified a need for child protection training particularly in relation to the recognition, diagnosis and referral of abuse. RECOMMENDATIONS The DHSS&PS should collaborate with Area Child Protection Committees to develop a regional child protection training strategy. Child protection training should be deemed mandatory for all professionals who work with children. 9. NORTHERN IRELAND PROTOCOL FOR JOINT INVESTIGATION
BY SOCIAL WORKERS AND POLICE OFFICERS OF ALLEGED AND SUSPECTED CASES OF CHILD
ABUSE n Social Services, Police and NSPCC are the agencies which carry statutory responsibility for investigating alleged or suspected cases of child abuse. n Recent research into professional practice has shown that there is a need to improve the quality of practice in video interviewing for evidential purposes. n Specialist training in joint investigative interviewing has been targeted to small numbers of experienced social workers and police officers. A model for assessment and evaluation of all video evidence interviews has been developed and a revised regional training plan is being implemented. n The medical component in the investigation of child abuse is extremely important. n There is considerable variation in practice in relation to the conduct of medical examinations of children. n The Committee would welcome the establishment of a regional working group to prepare guidance on medical examinations. RECOMMENDATION The DHSS&PS should establish a regional working group to develop regional policy and guidance on medical examination of children. 10. CASE MANAGEMENT REVIEWS n Case Management Reviews are an important way of learning lessons in order to improve practice in all agencies. n During 1999 the Committee produced and endorsed guidance for the conduct of Case Management Reviews and subsequently conducted a Case Management Review, using the revised guidance. n Recommendations from the Case Management Review conducted by the Committee are being implemented through an action plan which was drawn up and endorsed by all member agencies. n The Committee welcomes the DHSS&PS intention to establish a Child Protection Review Group. n There is a need to strengthen and improve the functionings of Area Child Protection Committees. RECOMMENDATIONS There should be a statutory duty placed upon DHSS&PS to disseminate key findings from Case Management Reviews. DHSS&PS should ensure that funding is available to Area Child Protection Committees to cover the cost of conducting each Case Management Review. 11. CASE WORK, PROFESSIONAL JUDGEMENT ASSESSMENT
AND ANALYSIS OF INFORMATION n Case work should be conducted within the framework of ACPC policy and procedural guidance. n The core knowledge and skills required to identify and assess levels of need in children also need to be part of all training courses for professionals who work with children. n Competent, trained, supported and supervised staff working within an agreed policy and procedural framework are essential requisites for the development of sound professional judgement. n Professionals who are concerned about a child need to be able to contribute to a multi-disciplinary assessment and as appropriate, refer to an agency where this can be placed in the context of other information. n The Assessment Framework [i] provides a systematic approach for gathering and analysing information about all children. n A co-ordinated approach to the development of the Assessment Framework needs to be underpinned by regional guidance and there needs to be an acknowledgement that this will be resource intensive. RECOMMENDATIONS DHSS&PS should develop regional guidance to ensure a co-ordinated approach to the implementation of the Assessment Framework. A pilot study should be undertaken to determine the time and human resources required to produce assessments to the requirements of the Assessment Framework. 12. WORKFORCE ISSUES n All staff working with children must have the necessary skills, knowledge, support and experience to discharge their responsibilities in a professional manner. n We welcome the proposal that social work training will now take 4 years. Newly qualified social workers will be more adequately trained to take on this complex work at the point of qualification. n First line managers have a key role in providing professional supervision for staff involved in child protection work. n Although strategies are being put in place to increase the supply of newly qualified social workers, retaining experienced practitioners in professional practice is equally important. RECOMMENDATIONS All agency in-service training programmes should provide training for managers who have responsibility for providing professional supervision of staff involved in child protection work. Resources should be provided by DHSS&PS to establish Senior Social Worker Practitioner posts in Health & Social Services Trusts to promote the development of good professional social work practice in child protection. 1. INTRODUCTION Just over 425,000 people live within the Board's area, which covers the Council boundaries of Antrim, Ballymena, Ballymoney, Carrickfergus, Coleraine, Cookstown, Larne, Magherafelt, Moyle and Newtownabbey. There are 112,377 children under the age of 18 living in the Northern Health and Social Services Board area (see Table 1). Almost 55% (60,914) of these children live in a rural area. Table 1: Population Statistics Based on the Census 2000 Mid-Year Estimates
Figure 1 details the distribution of the under 18 population
of the Board throughout the District Council areas. Children And Young People Who Are In Need, Or Are Vulnerable n The Northern Board, in its role of commissioner, is required to assess the health and social care needs of local people, plan and secure services to meet these needs and monitor quality and effectiveness. Measuring the extent of need is a complex process. There are different populations of children who can be identified according to their different levels of vulnerability and requirements for services. The following diagram, which has been reproduced from "Framework for Assessment of Children in Need and Their Families" (DOH) [ii] , details the current best estimates of the number of children in need and children who are vulnerable in this Board's area. The diagram also shows how the different levels of need, support and services fit together into the overall population of children.
2. CHILD PROTECTION INFORMATION Data collected within HPSS in Northern Ireland is based on reported cases of abuse. However, recent research by NSPCC into the likely prevalence levels of child abuse estimated that: n 7% of children suffered serious physical abuse as children at the hands of their parents; n 6% suffered serious neglect; n 6% had suffered multiple attacks on their emotional well-being; and n 1% suffered sexual abuse by a parent with a further 3% suffering sexual abuse at the hands of a relative or someone known to them. This study also shows that much of this abuse was not reported. The Children's Services Planning framework has facilitated the development of inter-agency mechanisms for sharing aggregated information for planning purposes. The Area Child Protection Committee needs to build on these developments to improve monitoring data sets by including cross-cutting information across agencies. Data sets which measure unmet need and real improvements in children's lives also need to be developed. 2.1 Referrals During the year ended 31 March 2002 there were 5,868 referrals to Social Services Child Care Teams. Of these 6.9% were for child protection reasons. Figure 3 details the child protection referrals to Social Services Child Care Teams over the last five years as a percentage of all child care referrals. The rate has remained constant over the time period. This is consistent with the numbers of children on the Child Protection Register, as detailed in Figure 4.
Source: DHSS&PS Children Order Returns 2.2 Child Protection Register The Child Protection Register is an administrative tool. It contains names of children for whom there are currently unresolved child protection issues and for whom there is an inter-agency Child Protection Plan. It represents an aid to monitoring and management of child protection. Decisions regarding registration reflect, to some extent, the operation of local protocols, professional judgement and the influence of socio-economic factors. Figure 4 details the number of children on the Child Protection Register at 31 March each year over the last five years. There is an apparent rise in numbers between 1997/98 and 1998/99 and subsequent years. However ,since 1998/99 the figure has remained constant.
Source: DHSS&PS Children Order Returns This apparent stability does not reflect the significant increase in activity as illustrated in later diagrams. It must be remembered that child protection referrals represent only 6.9% of all referrals to Child Care Teams. Significant numbers of vulnerable children and children in need also receive services through multi-agency case plans designed to support families, promote children's well-being and prevent abuse. Child protection activity is, therefore, focused on those children who are most likely to be at risk of significant harm. Table 2 provides a comparison of children on the Child Protection Register per 10,000 of the under 18 population in the Board with Northern Ireland and England. While the Northern Ireland figure is higher than in England, the Board rate is lower overall.
Source: DHSS&PS Children Order Returns 2.3 Sources of Referral Figure 5 details sources of child protection referrals. The figures suggest that almost half of the referrals originate in Social Services. It would be reasonable to assume that a proportion of these referrals are secondary referrals made by a social worker following an initial assessment of the child's needs. Further work is required to track these children through the system so that the primary source of all referrals can be more accurately reflected.
Source: NHSSB Children Statistical Indicators 2.4 Child Protection Investigations The following tables examine the statistics regarding child protection investigations. Table 3 shows that there has been an increase in the number of investigations since 1997/98 (44%). This represents a significant investment by the workforce in assessment activity, although this is a lower rate per 10,000 under 18 population in comparison with the Northern Ireland average.
Source: DHSS&PS Children Order Returns Table 4 details investigations by Joint Protocol; Social Workers and Police Officers.
Source: DHSS&PS Children Order Returns 2.5 Outcome of Child Protection Investigations Table 5 shows that a high percentage of children who enter the child protection system require a child protection plan to ensure their safety.
Source: NHSSB Children Statistical Indicators 2.6 Children Who Were Subject to Initial Case Conferences Table 6 shows that there has been a 28% increase in the number of children who are subject to an initial case conference. This is consistent with the 44% rise in investigations (see Table 3 above).
Source: DHSS&PS Children Order Returns 2.7 Registrations, De-registrations and re-registrations Registrations The following tables (7-9) represent a 68% increase in registrations over a five year period and a corresponding increase in de-registrations of 45%. Although the number of re-registrations is small, it is concerning to note that it does represent a 67% increase. These figures overall confirm the significant increase in activity which represents the extent of staff time and resources dedicated to investigation, assessment, planning, support and review within the child protection system.
Source: DHSS&PS Children Order Returns 2.8 Registrations During the Year by Category of Abuse The following tables (10-11) detail the registrations during the year by category of abuse. The figures show a high increase in the number of registrations under the category of emotional abuse. This may be indicative of the underfunding in family centre services, where early prevention and therapeutic services could be provided for these children. There is also an increase in the registrations under physical abuse, but this is insignificant compared to the increase in registrations under emotional abuse. The number of registrations
under the category of sexual abuse has been declining since 1999/00.
Source: DHSS&PS Children Order Returns RECOMMENDATION The DHSS&PS should collaborate in the development of consistent and agreed cross-cutting information data sets on child protection which measure real improvements in children's lives as well as unmet need. 3. ORGANISATIONAL FRAMEWORK AND CHILD PROTECTION 3.1 HPSS structures impact directly on arrangements for planning and delivery of child protection services. DHSS&PS has a lead role in child protection. The scale and complexity of the task requires a coherent mandate from Government reflected in legislation and level of resourcing. This is essential to achieving good outcomes for children and their families. However, within a health - dominated agenda, child protection receives less attention in Government publications than other health and social care related issues. Arrangements for the protection of children are set within an integrated Health & Social Services model based on the premise that a single body of Health & Social Services professionals would facilitate effective communication and collaboration. Health & Social Services are different entities and placing them under an integrated structure does not automatically guarantee good communication or effective multi-disciplinary working. Competition for scarce resources does not assist effective working relationships. Despite progress in establishing multi-disciplinary training programmes, differences in professional priorities, perspectives, culture and style remain. 3.2 A vast range of legislation, statutory rules and regulations govern the provision of Social Services for children and families. Until 1993, Boards had responsibility for meeting all Social Services statutory requirements. In 1994, these duties and responsibilities were transferred to Health & Social Services Community Trusts under the Health & Personal Social Services (Northern Ireland) Order 1994. Schemes for the Delegation of Statutory Functions were approved by Area and Trust Boards to discharge certain key statutory functions on behalf of Boards. The Northern Board continues to carry a strategic residual responsibility for the functions involved and for ensuring that schemes reflect sound and effective working procedures and that they are adhered to by Trusts. The Board monitors compliance by Trusts with the requirements for the discharge of delegated statutory functions and identifies any corrective action necessary. However, the existence of Trusts as separate legal entities creates a permanent tension in relation to ultimate responsibilities and monitoring arrangements. 3.3 Much time and effort is invested by both Boards and Trusts in overcoming the difficulties created or exacerbated by an HPSS structure established to facilitate an internal market that does not sit easily with the discharge of statutory responsibilities arising from the Children Order, including those in respect of child protection. Effective child protection work depends on good inter-agency relationships and linkages across organisational boundaries, as well as links between children's services and staff who work with vulnerable adults who are also parents. The Directors of Social Services in the 4 Health & Social Services Boards have established a working group to prepare comprehensive guidance for Trusts which will ensure a common approach across all Trusts to reporting on professional activities in relation to the delegation of statutory functions. This group has almost completed its work and is now considering, in light of Circular CC3/02, (role and responsibilities of Directors for the care and protection of children), what further reporting mechanisms may need to be put in place to meet the requirements of the Circular. 3.4 "Delivering Better Services" and the forthcoming review of Public Services in general may provide the opportunity to ensure that the future HPSS structure delivers: n Dissolution of separate commissioning and delivering organisations; n Reduction in the number of such organisations; n Co-terminous boundaries between Health & Social Services organisations and other key agencies such as Education & Library Boards and the PSNI; n A continuation of bodies such as Childcare Partnerships and Children and Young People's Committees which are proving to be effective in providing comprehensive community based services from a range of agencies and voluntary organisations. RECOMMENDATION Reform of HPSS organisational structures should deliver: n Dissolution of separate commissioning and delivering organisations n Reduction in the number of such organisations n Co-terminous boundaries between Health & Social Services organisations and other key agencies such as Education and Library Boards and the PSNI n A continuation of bodies such as Childcare Partnerships and Children and Young People's Committees. 4. LESSONS FROM INQUIRIES Many inquiries into child abuse have highlighted failures in working together and communication problems across agencies. They have attempted to explore reasons why procedures are not followed, children are not listened to and why significant information is not acted upon. Individual's failures to discharge their responsibilities to children may be due to a combination of factors such as incompetence, poor quality training, supervision and support. However, Inquiries have also shown that it is important to look at organisational perspectives and the factors which contribute to systems failures such as, organisational change, insufficient training, reduced staffing levels, fatigue and stress and failure to comply with procedures. Organisations need to take responsibility for developing a learning culture as opposed to one of blame. Where an organisation is aware that planning for children may be exposing them to longer term dangers or harm, the organisation needs to take responsibility for addressing the problem. The Utting report, "People Like Us", also emphasised the need for delegated authority at every level to be matched by exacting comparable accountability and action to be taken to monitor the discharge of statutory functions. RECOMMENDATION DHSS&PS should develop a strategic plan for child protection which sets out clearly the responsibilities of other Government departments for safeguarding children from harm. 5 LEGAL FRAMEWORK AND CHILD PROTECTION 5.1 The legal framework to protect children from harm is primarily provided by the Children (Northern Ireland) Order 1995 and accompanying Regulations and Guidance. The Order sets out a clear direction in relation to multi-agency working and communication and it places a statutory duty on Health & Social Services Trusts to investigate where they have reasonable cause to suspect that a child is suffering, or is likely to suffer, significant harm. Investigations are carried out by Social Services with the assistance of other agencies and professionals, particularly Police, Health and Education. Social Services also carries lead responsibility for managing key parts of the child protection service such as convening and chairing Child Protection Case Conferences and maintaining the Child Protection Register. Child protection is therefore a core responsibility of social workers who are asked to make crucial judgments which affect the safety and well-being of children. Although Social Services carries statutory responsibility, social workers rely on the assistance and co-operation of other professionals and agencies in the recognition and investigation of child abuse and in the implementation of child protection plans. 5.2 Effective child protection services must aim to prevent abuse as well as identify and deal with abuse when it has occurred. The Children Order, while recognising that some children will need to be protected from their parents, sees parents and the wider family as the primary agents for children's welfare in most circumstances. Article 18 places a general duty on every authority to safeguard and promote the welfare of children by providing a range and level of Personal Social Services appropriate to those childrens' needs. Although Trusts and Boards have statutory responsibility for the provision of services, the philosophy underpinning the Children Order is that this duty is a shared responsibility for all those agencies which provide services to children. Article 46 deals with the requirement of agencies to co-operate with Trusts' responsibilities under this legislation. Article 46 is weak in that there are effective opt-outs for agencies which should be complying with these requirements. The Children Order introduced the concept of children in need as a central theme, underlining the importance of family support services aimed at safeguarding or promoting the child's welfare. Family support is therefore integral to the protection of children. RECOMMENDATION The Assembly Health, Social Services and Public Safety Committee should consider how Article 46 of the Children(Northern Ireland) Order could be amended to strengthen multi-agency co-operation in safeguarding the welfare of children. 6. FINANCIAL FRAMEWORK AND CHILD PROTECTION 6.1 The Children Order was the most radical piece of child care legislation in 20 years. At the time of implementation, the Department took a very conservative view of the cost of implementing this legislation and reduced considerably the Board' estimates. The following key areas were excluded; child protection, family placement, residential care and medical implications and these areas have subsequently proved to be resource intensive. Although there has been significant investment in children's services, the amount has fallen short of that deemed necessary by the Boards. This reduction has been compounded by subsequent policy initiatives, many of which have been very resource intensive. They include: n Children's Services Planning legislation and the processes n New juvenile justice responsibilities arising from the Juvenile Justice (Children) Order 1999 have increased emphasis on working with young people who offend in community settings; n Sex Offenders Act 1997 and new multi-agency procedures developed under the Northern Ireland Sex Offenders Strategic Management Committee; n Recommendations arising from the Social Services Inspectorate reports; n Planning for children in care and implementation of Looked After Children forms; n Northern Ireland Children's Strategy, "Children First"; n Framework for the assessment of children in need and their families. 6.2 Effective child protection services need to be appropriately resourced and supported if they are to be fully effective. Through its commitment to evidence-based commissioning, the Board is very aware of the impact of such issues as poverty, mental ill health, family breakdown, educational failure, increasing substance misuse on the safety and well-being of children and young people, and the consequences of 30 years of conflict. 6.3 The recent Needs and Effectiveness Review identifies that: n Over a quarter of children in Northern Ireland (26% in 1999) were dependents of claimants of Job Seekers Allowances or Income Support benefits, compared with 20% in Great Britain; n The proportion of children in lone parent households is higher in Northern Ireland (12.6%) compared to England (9.1%); n The Troubles have contributed to an increase in stress, isolation and mental ill health affecting parents and children, as well as other groups in society. There is also an unwillingness to access some Social Services facilities across community divides, resulting in the need for additional facilities or in unmet need. 6.4 It would be expected that expenditure in Personal Social Services for children and families in Northern Ireland, a relatively disadvantaged area of the UK, would at least match that of other areas. Although there may not be strict comparability of expenditure, the Needs and Effectiveness Review found that this is clearly not the case. In 1999/00 the spend per head of child population was 51% greater in England and 11% greater in Wales than in Northern Ireland. The Quality Protects initiative, which is putting an additional £885m into family and child care services in England over five years from 1999/00, has contributed to the increased spend there. On average, this is an extra £15 per child per year. No such additional funds have been made available in Northern Ireland. 6.5 The Review also found that the proportion of the Personal Social Services (PSS) budget devoted to the Family and Child Care Programme of Care is lower than in England (16.9% in Northern Ireland in 1999/00 compared to 27.6% in England), despite our younger population profile. Indeed, the level of PSS spending on children across all Programmes of Care (e.g. including children with a disability) is only half the level spent in England. Despite our higher levels of disadvantage, the extent to which children are in public care is broadly comparable across Northern Ireland, England and Wales. Northern Ireland has a slightly higher ratio of children on Child Protection Registers than England and Scotland, but lower than Wales. Given the levels of disadvantage which are prevalent in Northern Ireland, it may be that the thresholds for putting a child's name on a Child Protection Register or admitting a child into care are higher here than in England and Scotland, but no hard evidence is available to substantiate this. A substantial level of investment is therefore required in order to bring children service's in Northern Ireland up to the level of funding in England. Any child protection strategy that focuses on policies, procedures and structures to the exclusion of resourcing will necessarily fail and will further demoralise hard-pressed staff. 6.6 A range of short-term funding measures has enabled voluntary and community groups to develop high quality services for children in need and their families. These projects, to a large degree, have targeted social need and they are well integrated and accepted within local communities where there are high levels of social disadvantage. As these time-limited funding arrangements come to an end, organisations are increasingly turning to Boards to secure mainstream financial support. Meanwhile, the statutory sector is becoming increasingly reliant on short-term funding to develop core services to meet the requirements of new legislation and policy initiatives. If statutory child protection services are to effectively address the risk of significant harm, it must be understood this is a long-term initiative and needs to be funded accordingly. 6.7 Failure to support families and prevent child abuse effectively has major implications, including financial ones. For instance, the 4 Board paper "Family and Child Care Services in Northern Ireland in 2000" (submitted to the DHSS&PS in 2001) stated that: n Studies have demonstrated that 47.6% of females referred to mental health services have reported sexual abuse as children; n The Children's Society estimate that 42% of child prostitutes in Great Britain say that their first sexual experience was of abuse; n Recent research has revealed that more than 90% of all 10-17 year old violent offenders had been victims of severe childhood trauma and deprivation. It is good sense to invest in effective and accessible services which seek to reduce the levels of abuse and neglect and provide children and families with a range of therapeutic supports. These supports will help to heal the hurt of child abuse and neglect and reduce the levels of abuse and neglect and re-abuse experienced by children. The alternative is to continue to invest heavily in responding to the mental health problems, offending and educational failure that are all too often the symptoms of child abuse and neglect and which can extend well into adult life. RECOMMENDATIONS The DHSS&PS should take action to increase the proportion of the Personal Social Services budget devoted to the Family and Child Care Programme of Care in line with funding levels elsewhere on these islands. The DHSS&PS should assess the impact on statutory Social Services arising from short-term funding arrangements. 7. CHILDREN'S SERVICES PLANNING 7.1 Supporting families and improving the life chances of children are an integral part of the child protection process. The Children's Services Planning Order 1998 required Boards to co-ordinate the production of Children's Services Plans on an inter-agency basis. A core assumption underpinning Children's Services Planning is that the needs of children and young people who are most at risk of being marginalised in society, should be addressed holistically by bringing together organisations, communities and individuals who have an important part to play in achieving better outcomes for vulnerable children and their families. Supporting these families and preventing child abuse is, therefore, a primary objective for all agencies involved in Children's Services Planning in the Board area. 7.2 The process of developing a Children's Services Plan for the Board area required unprecedented and widespread strategic collaboration and consultation involving statutory and voluntary agencies and communities. The Northern Area Children & Young People's Committee, chaired by the Director of Social Services, is responsible for setting out a coherent strategic direction in relation to services for children in need and vulnerable children based on shared objectives agreed by all participating agencies. Significant progress has been achieved in relation to: n Joint commissioning with the North Eastern Education & Library Board of educational support service for looked after children. n 4 Board service specification for the family placement service which will inform a regional strategy. n Extension and reconfiguration of residential child care services to meet the requirements of the Children Matter Task Force Action Plan. n Establishment of an Independent Visitor Service for looked after children. n Development of aftercare services for looked after children. n Establishment of Family Group Conferences. n Development of Permanency Planning. n Establishment of community based pilots in areas of highest need. Locality steering groups representing local voluntary, statutory and community organisations co-ordinate the development of local service networks. Funding has been secured from the Children Fund to establish a Parenting Pilot Scheme in Larne which is managed by NCH (NI) and the North Eastern Education & Library Board has secured resources to develop services for young people in Bushmills. 7.3 A high proportion of the limited resources that are available are invested in the investigation of child abuse and the care and protection of looked after children. As a consequence, investment is diverted from those services geared to preventing abuse and neglect in the first instance or to keeping children safe from further abuse and neglect. Such under-investment has significant consequences. For example, substantial investment in foster care services is indicated if the regional issue of demand outstripping supply is to be addressed effectively. Around a quarter of all requests for emergency foster care placements in Causeway Health & Social Services Trust cannot be met. As Corporate Parent the Board is committed to ensuring that children in the public care are protected from abuse. This requires the implementation of initiatives such as the Waterhouse Overview Report and a ready availability of an appropriate range of well supported and trained foster carers consistent with the National Foster Care Standards. Specialist community based child and adolescent mental health services have seen a marked and sustained increase in referrals in recent years and a corresponding increase in waiting lists. There are currently only 4 statutory family centres in the Northern Board area, despite the proven effectiveness of such services in protecting children. The Board has been active in addressing deficits in all of the above areas, but gaps still remain. 7.4 Children's voices need to be heard. Planning services in partnership with children and families is integral to Children's Services Planning and they need to be able to participate at all stages of the planning process. Those who work in direct contact with children need to be open to listening to both what they say and what their behaviour conveys. Staff in regular contact with children are well placed to identify developmental delay and physical or behavioural concerns that may indicate poor parenting. Staff need to be aware of their responsibilities to identify children in need and to be clear about their part in the wider system for meeting children's needs. 7.5 The Northern Childcare Partnership acts as the Children's Services Planning sub-group which deals with early years and family support. It is a partnership of voluntary and statutory agencies tasked with augmenting and improving universal provision of child care. It was formally established in March 2000 as a requirement of "Children First", the Northern Ireland Child Care Strategy. Although the child care focus is on universal day care services such as childminding, playgroups and after school groups, it has a growing role in respect of the development of family support for vulnerable children, particularly through the targeting of European Union Peace II funding. Research shows that investment in early years support for vulnerable children and their families is more likely to prevent delinquency, educational failure and child abuse than large scale investment when children are older. The Childcare Partnership has secured investment to establish the Sure Start initiative and five schemes are currently operational providing a range of services to approximately 1,900 children and their families. The Childcare Partnership and the Area Child Protection Committee work in close collaboration to deliver a child protection training programme to early years service providers. Sponsored childminding schemes have been established across the Board area to provide a non-stigmatising support service for vulnerable parents who require assistance to provide safe care for their children. 7.6 The Board has lead responsibility for the establishment and effective functioning of the Northern Area Child Protection Committee, (ACPC) a multi-agency body constituted in accordance with Children Order guidance, "Co-operating to Protect Children". The function of ACPC is to develop a strategic approach to child protection within the overall Children's Services Planning framework which provides the context for joint planning and co-ordinated action to safeguard and promote the welfare of children in need. Although Social Services has statutory responsibility for child protection, ACPC is intended to ensure that the exercise of this responsibility is carried out on a multi-disciplinary/inter-agency basis. The ACPC is essentially an advisory and co-ordinating committee rather than an executive body. Collectively, the ACPC is accountable to the Board, however members remain individually accountable to their own agencies which, in turn, are responsible for taking any action properly falling within their respective remits. 7.7 The ACPC is chaired by the Assistant Director Social Services, Family and Child Care, Northern Health & Social Services Board. Membership includes senior representatives from a range of organisations with an interest in child protection and reflects the various disciplines involved in this work; 7.8 Working together needs to be supported by a strong lead from senior managers. Member responsibilities are set out in a role specification which was recently endorsed by the ACPC. This is intended to inform senior managers of the responsibilities to be discharged by their agency representatives, to raise their awareness of the ACPC's requirements and provide an indication of the time/work commitment required of members (Appendix 1). 7.9 In order to ensure the protection of children in the most effective way, the ACPC has established a small number of standing sub-groups and time-limited task groups to take forward the day-to-day work. n The Strategic Planning Group co-ordinates and plans the business of ACPC, ensuring that work priorities are progressed in accordance with agreed timescales and targets. n A Publicity Sub-Group has been established to develop a media strategy which will promote awareness of issues relating to children's safety. This includes the preparation and publication of guidance and information leaflets and articles for the local press. Leaflets produced to date include; - Information about the Northern Area Child Protection Committee - What to do if you are concerned about a child where there is resistance to allowing the child to be seen - Child Protection Information for Children - Child Protection Information for Adults - Internet Safety for Parents - Internet Safety for Young People (Appendix 2) n The Training Sub-Group promotes inter-agency training and provides a comprehensive training programme. n Time-limited task groups are established to take forward specific pieces of work identified in the ACPC action plan. Membership of these task groups is augmented by co-opting individuals with specific expertise. 7.10 In 2001 the ACPC worked with an external facilitator to undertake a review of the strategic direction and the effectiveness of its approach. Although members were positive about achievements in relation to multi-agency focus, inter-agency training, development and implementation of sound inter-agency policies and procedures, it was agreed that the ACPC required a sharper focus on the strategic priorities which shape action plans. The outcome of this work is an action plan based on 4 strategic themes: n Improving Practice n Policy Regulation and Guidance n Influencing n Public Awareness and Education (Appendix 3). This has enabled the ACPC to continue to develop a wider approach to children's safety, particularly in relation to the impact of substance misuse, domestic violence and adult mental health on children's well-being. The action plan has also facilitated collaboration with other ACPCs in relation to: n Reviewing policies and procedures A 4 ACPC task group has been set up to produce a revised
set of policies and procedures common to the 4 ACPC areas. n Developing training The establishment of a regional
ACPC Trainers Group has improved the quality of child protection training and
it also provides an opportunity to develop training expertise. n Sharing of information The 4 ACPC chairs meet on a regular basis. In addition the 4 ACPCs collaborate to organise a regional conference on an annual basis. The outcome of the most recent conference, Management of Risk in Child Protection, has resulted in a 4 ACPC group tasked to produce a regional Management of Risk in Child Protection Policy. The 4 ACPCs have recently collaborated to produce and launch internet safety leaflets for parents and children. 7.11 Although the ACPC is pivotal to child protection, it does not carry a statutory remit. Its authority flows from the accountability of members to their individual agencies and the agencies' responsibility to translate into action that which falls within their respective remits. Agency priorities are determined largely by core business. Social Services carries statutory responsibility for child protection and this reinforces the view that child protection is its core business. Other organisations, while accepting that child protection is important, may feel that their role on ACPC is secondary. This impacts on patterns of attendance and availability to contribute to task groups. Although there is a strong ethos of working together on the ACPC, the reality is that some members are unable to fulfill their commitments due to conflicting demands placed on them by their own agencies. A small number of members who represent statutory agencies therefore play a pivotal role in contributing to the work of the ACPC. 7.12 The ACPC is not directly funded by the DHSS&PS on a recurring basis, although funding was secured from the Board to establish the post of Training and Development Officer and to set up the inter-agency training programme. No additional recurrent funding has been secured to enable this programme to be extended. As a consequence, it is not possible to meet all of the demands for inter-agency training arising from new policy initiatives and legislation. The only resources secured by the ACPC are provided by the Board's Social Services training budget. This further contributes to the view that child protection is solidly a Social Services responsibility rather than every agency's business. The ACPC does not have a professional advisor to take responsibility for advising on child protection matters, developing policies/procedures, co-ordinating and supporting the work of task groups or contributing to audits. This work is currently taken forward by the Chair and the Training Officer, who do so in addition to their other responsibilities. There is no recurring budget to cover the cost of producting, publishing and disseminating procedural handbooks, reports and information leaflets, all of which are distributed to member agencies at no cost. Member agencies do not contribute financially to the work of the ACPC, although some agencies make a small contribution towards training course fees. RECOMMENDATIONS The DHSS&PS should increase the level of investment in prevention and family support and this should be reflected as a priority in the Programme of Government. The infrastructure around child protection should be strengthened by placing Area Child Protection Committees on a statutory footing. The DHSS&PS should ensure that the Area Child Protection Committee is properly resourced to discharge its functions. 8. TRAINING AND CHILD PROTECTION 8.1 The ACPC has a well established multi-disciplinary training programme drawn up annually, based on a training needs analysis,policies and procedures of ACPC, new legislation and policy initiatives and messages from current research and Case Management Reviews. Training is provided by local and external trainers, with additional inputs from staff who have particular expertise in the topic area. Courses are provided at 3 different levels; foundation, core and specialist. This is intended to assist staff to access a level of training most appropriate to their role and responsibilities. Regular monitoring is undertaken in relation to attendance by discipline and effectiveness of training. 8.2 An average of 550 staff attend ACPC training annually. However, the pattern of uptake has varied across agencies and professional disciplines. During the past year 3 General Practitioners attended training. The uptake by Education, Social Workers and Police Officers has fallen mainly due to work pressures, staff shortages, lack of staff cover/workload easement and in relation to Education and PSNI, lack of funding to cover training costs. Course fees have, however, been kept to an absolute minimum and free places are provided from time to time to ensure an appropriate balance of multi-disciplinary representation. There has been a significant increase in training uptake by community and hospital nursing staff, voluntary and community sector organisations and district councils and hospital based medical staff, including those who work in Paediatrics. 8.3 A recent survey of General Practitioners in the Board area was undertaken to ascertain the level and range of child protection training received by GPs, and to collate GP views and experiences in relation to reporting child abuse and neglect. There was a 70% response to this survey. The findings from the survey showed that over 20% of GPs surveyed admitted to not reporting suspected child abuse. This was linked to a lack of confidence in ability to make diagnosis, concerns about relationship with the extended family and a lack of confidence in child protection services. 70% of GPs surveyed identified a need for child protection training, particularly in relation to the recognition, diagnosis and referral of abuse. The ACPC will use the findings from this survey to plan a series of workshops for General Practitioners to provide a multi-disciplinary perspective on the roles and responsibilies of General Practitioners in relation to child protection. RECOMMENDATIONS The DHSS&PS should collaborate with Area Child Protection Committees to develop a regional child protection training strategy. Child protection training should be deemed mandatory for all professionals who work with children. 9. NORTHERN IRELAND PROTOCOL FOR JOINT INVESTIGATION
BY SOCIAL WORKERS AND POLICE OFFICERS OF ALLEGED AND SUSPECTED CASES OF CHILD
ABUSE 9.1 Social Services, Police and NSPCC are the agencies which carry statutory responsibility for investigating alleged or suspected cases of child abuse. By working in partnership and adhering to a joint protocol, they aim to ensure that children are protected and offenders brought to justice. There are significant benefits for children of a single process of capturing information at an early stage by using video recorded interviews. There are also significant benefits in terms of inter-agency collaboration and achieving a common understanding and commitment to ensure the needs and rights of children are upheld in a way that achieves an appropriate balance and in no way compromises the rights of defendants. 9.2 A significant decline in the number and quality of video evidence interviews and recent research into professional practice has shown that there is a need to improve the quality of practice in video interviewing for evidential purposes. The Core Group [iii] , in consultation with PSNI and Health & Social Services Trusts, has developed an operational model which targets a small number of experienced staff. They are provided with specialist training in joint investigative interviewing linked to the standards of the Memorandum of Good Practice. A model for the assessment and evaluation of all video evidence interviews has also been developed. A standardised regional approach to training has been agreed and a training plan has been developed with a view to implementation by October 2002. 9.3 The medical component in the investigation of child abuse is extremely important. Medical advice should always be sought as part of the investigative process of alleged or suspected child abuse. Children suspected of having been abused are currently assessed by a number of different medical professionals, each with different training, expertise and focusing on different aspects of abuse. There is considerable variation and practice in relation to the conduct of medical examinations of children. In some instances, Forensic Medical Officers with no ongoing paediatric training or experience may provide the only medical input. ACPC would welcome the establishment of a regional working group to prepare guidance and to specifically address: n Roles and responsibilities of medical staff ; n Routes of referral; n Standards which should apply to joint medical examinations; n Availability of appropriately trained and experienced staff. The working group should include representation from General Practice, Paediatrics, Forensic Medical Officers, Accident and Emergency, Child and Adolescent Mental Health Services, Social Services and PSNI. RECOMMENDATION The DHSS&PS should establish a regional working group to develop regional policy and guidance on medical examination of children. 10. CASE MANAGEMENT REVIEWS 10.1 Case Management Reviews which are normally conducted when a child has died, or in the case of serious injury where it is believed that abuse is a contributory factor, are an important way of learning lessons in order to improve practice in all agencies. 10.2 During 1999 the Committee produced and endorsed guidance for the conduct of Case Management Reviews. At that time the Committee considered that the guidance contained in Co-operating to Protect Children was weak and did not make sufficient provision for independent analysis. Subsequently, the Committee conducted a Case Management Review using the revised guidelines. They provided a sound framework for the process of investigation and reporting. However, there is still a perception that Case Management Reviews are only undertaken when mistakes have been made and that their purpose is to find people to blame. This perception is further underlined because ACPC does not have the capacity to continuously review cases which would increase the likelihood of identifying examples of good practice. Recommendations from a Case Management Review conducted by the Committee are being implemented through an action plan which was drawn up and endorsed by all member agencies. This included: n A review of ACPC training programme; n Provision of further training to facilitate inter-agency working; n Preparation of a staff information leaflet to highlight awareness of responsibility to report concerns; n Guidance on the content of a child protection induction pack for member agencies; n Development of a system to monitor and evaluate training; n Review of ACPC guidance ; n Production of good practice guidance - "What to do if you are concerned about a child where there is resistance to allowing the child to be seen" n Preparation for implementation for needs led Assessment Framework; n Review of resourcing of Trust Child Care Teams. 10.3 The Committee welcomes the DHSS&PS intention to establish a Child Protection Review Group which will ensure a consistent approach to the dissemination of key messages arising from the conduct of Case Management Reviews, as well as putting in place arrangements for handling media interest in child protection cases. There is a need to strengthen and improve the functioning of ACPCs if they are to make an effective contribution to the conduct of Case Management Reviews. The proposed Private Members' Bill on the regulation of ACPCs will build upon the functions and remit of ACPCs as set out in the draft "Co-operating to Safeguard Children". The placing of ACPCs on a statutory footing is therefore an important step in strengthening the infrastructure around protecting children. RECOMMENDATIONS There should be a statutory duty placed upon DHSS&PS to disseminate key findings from Case Management Reviews. DHSS&PS should ensure that funding is available to Area Child Protection Committees to cover the cost of conducting each Case Management Review. 11. CASE WORK, PROFESSIONAL JUDGEMENT ASSESSMENT
AND ANALYSIS OF INFORMATION 11.1 Case work should be conducted within the framework of ACPC Policy and Procedural Guidance by professionals who have a sound knowledge and skill base consistent with the complexities involved in assessing levels of need and the need for protection. The core knowledge and skills that social workers require in order to identify and assess levels of need in children, as well as the need for protection include: n knowledge of human growth and development; n attachment and bonding; n personality disorder; n individual and group pathology; n the impact of poverty and social exclusion; n the influence of race, language, religion and culture; n family breakdown; n information gathering, sharing and analysis; n communicating with children; n knowledge of mental health; n awareness of the impact of drug and alcohol misuse and domestic violence; and n recording, risk assessment and management. These core skills also need to be part of all training courses for professionals who work with children, for example nurses, doctors, teachers and police officers. Every professional needs to be aware of their individual responsibility to gather information, hear what children are saying, contribute their own expertise to the analysis of evidence and make sound professional judgements based on good assessment. Competent, trained, supported and supervised staff working within an agreed policy and procedural framework are essential requisites for the development of sound professional judgement. 11.2 Professionals who are concerned about a child need to be able to contribute to a multi-disciplinary assessment and, as appropriate, refer to an agency where this can be placed in the context of other information. The Assessment Framework introduces a systematic approach for gathering and analysing information about all children. It is a useful tool to help professionals understand the strengths and weaknesses in families and communities. If all organisations are to accord a high priority to the development of a co-ordinated approach to assessment there needs to be an acknowledgement that the Assessment Framework is resource intensive. Although the 4 Boards are committed to developing a co-ordinated approach to the development of the Assessment Framework, this needs to be underpinned by regional guidance. A pilot study to ascertain the time and skills necessary to implement the Assessment Framework could provide useful information on the additional resources required. RECOMMENDATIONS DHSS&PS should develop regional guidance to ensure a co-ordinated approach to the implementation of the Assessment Framework. A pilot study should be undertaken to determine the time and human resources required to produce assessments to the requirements of the Assessment Framework. 12. WORKFORCE ISSUES 12.1 All staff working with children must have the necessary skills, knowledge, support and experience to discharge their responsibilities in a professional manner. Staff must be able to communicate with children of different ages, abilities, social and cultural backgrounds. They need to be equipped to assess children's development and identify the reasons for concerns. Training needs to prepare them to work effectively in partnership with parents/carers and other key professionals. The complexities of working with children who are at risk of significant harm are reflected in the length of training courses undertaken by some professional disciplines, for example Child and Family Psychiatrists, Clinical and Educational Psychologists. We welcome the proposal that social work training will now take 4 years. The first 3 years will provide a balance of practice and academic input and the fourth year will be based in practice and will be a pre-registration year. This will enable social work students based in child care sites to develop specialist knowledge in child protection. Newly qualified social workers will therefore be more adequately trained to take on this complex and demanding work at the point of qualification. The Child Care Award now enables child care social workers to progress beyond qualifying or consolidation level to a more complex level of practice. This training is fully funded by DHSS&PS and the programme will continue beyond the introduction of the new qualification for social workers, for staff at post-qualifying level. A range of courses are also provided for Advanced Level Social Workers as follows: n Advanced Level Counselling n Diploma in Applied Social Learning n MSc in Systemic Psychotherapy 12.2 A skilled and experienced workforce is essential to the establishment of an effective and safe child protection system. Finely balanced decisions in child care often have to be made in difficult circumstances. Training for managers who have responsibility for providing professional supervision of staff involved in child protection work should be built in to all agency in-service training programmes. This is particularly relevant for first line managers because of their key role in co-ordinating the process and ensuring that sound professional judgements are made based on good assessments. Promoting the safety and well-being of children who may be at risk of significant harm is among the most challenging responsibilities discharged by social workers. The social work profession requires continuous training and people of the highest calibre with a high level of personal commitment. In recent years, the supply of professionally qualified social workers has not kept pace with demand. Although the Board has provided some funding to enable Trusts to establish additional social work posts, caseloads remain high due to the number of vacancies and high levels of sick leave often linked to work related stress. This is further compounded by a steady increase in referral rates over the past 3 years. The Northern Ireland Social Care Council report "Workforce Planning for Social Work", predicts that there will be continuing difficulties recruiting qualified social workers to meet service needs in coming years. Although strategies are being put in place to increase the supply of newly qualified social workers, retaining experienced practitioners in professional practice is equally important. Levels of remuneration should properly reflect the demanding and complex nature of this work. RECOMMENDATIONS All agency in-service training programmes should provide training for managers who have responsibility for providing professional supervision of staff involved in child protection work. Resources should be provided by DHSS&PS to establish Senior Social Worker Practitioner posts in Health & Social Services Trusts to promote the development of good professional social work practice in child protection. Appendix 1 NORTHERN AREA CHILD PROTECTION
COMMITTEE MEMBER
ROLE SPECIFICATION The role of the Northern Area Child Protection Committee is to develop a strategic approach to child protection within the overall Children's Services Planning process. Article 46 of the Children (Northern Ireland) Order 1995 requires co-operation between authorities and other bodies in the exercise of any of the authorities functions in the interests of children and their families. Children Order Regulations and Guidance (Co-operating to Safeguard Children), state that there should be an Area Child Protection Committee in each Health & Social Services Board area to co-ordinate policies and procedures. The Northern Area Child Protection Committee covers the administrative area of the Northern Health & Social Services Board which includes 10 District Council areas. There is a Child Protection Panel in each Health & Social Services Trust, Homefirst Community Trust, United Hospitals Trust and Causeway Health & Social Services Trust. The role of a Trust Child Protection Panel is to implement locally the ACPC Policy and Procedures ensuring a high standard of professional practice. ACPC
MEMBER RESPONSIBILITIES Each ACPC member has a responsibility to contribute to: n development and review of policies and procedures for inter-agency work to protect children; n monitoring and evaluation of how well services work together to protect children bringing any concerns to the attention of Child Protection Panels; n improved outcomes for children by setting objectives and performance indicators for child protection; n encouraging and helping to develop effective working relationships between different services and professional groups based on trust and mutual understanding; n ensuring that there is a level of agreement and understanding about operational definitions and thresholds for intervention; n improvement of local ways of working by taking account of knowledge gained through National and local experience and research, ensuring the any lessons learned are shared, understood and acted upon; n case Management Reviews as set out in Part 10 of Co-operating to Safeguard Children; n communicating clearly to individual services and professional groups their shared responsibility for protecting children and by explaining how each can contribute; n helping to improve the quality of child protection work and of inter-agency working through specifying needs for inter-agency training and development and ensuring that training is delivered, where appropriate in partnership with Child Protection Panels; n raising awareness within the wider community of the need to safeguard children and encouraging everyone to contribute to these objectives; n ensuring that information is available to enable children and families to understand child protection processes, particularly for those involved in them; n co-operating with relevant agencies under the "Multi-Agency Procedures for the Assessment and Management of Sex Offenders"; and n encouraging agencies to work together to safeguard and promote the welfare of children who are at continuing risk of significant harm. In addition to the above responsibilities each ACPC member is: n accountable to the agency which he/she represents which, in turn, is responsible for taking any action properly falling within their respective remits; n expected to ensure that the ACPC in it's decisions and processes seeks to meet the requirements of the Human Rights Act 1998 and Equality Schemes drawn up by its constituent bodies; n committed to anti-discriminatory practice; n expected to observe the principle of confidentiality; n expected to carry out all responsibilities in a co-operative, sensitive and positive manner. NOMINATING
OFFICERS OF MEMBER AGENCIES The above are expected to ensure that each agency representative is supported/facilitated to discharge his/her responsibilities in accordance with this role specification. The inter-agency/multi-disciplinary nature of the responsibilities of the ACPC require a balanced representation of member organisations and professional perspectives. In order to ensure that the strategic objectives of ACPC are met members will be expected to make an annual commitment of 6 days to contribute to the work agenda and attend meetings. Those members who sit on ACPC Strategic Planning Group will be expected to make an annual commitment equivalent to 10 days. This role specification will be subject to revision in accordance with policy, regulations and guidance. ACPC
ACTION PLAN IMPROVING
PRACTICE n Review and deliver inter-agency training programme. n Monitor attendance at training events by agency. n Draw up a long-term strategy to deliver Keeping Safe Child Protection Training for local community and voluntary groups. n Identify number of joint investigative interviews, including interviews where:
-
Memorandum of Good Practice is applied.
-
Joint Medical Examinations are conducted. n Identify member agency supervision/professional support arrangements and how they are monitored.
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Produce child protection staff information leaflet.
-
Produce guidance for ACPC member agencies on child
protection induction for new staff.
-
Disseminate practice guidance. n Contribute to the development of a co-ordinated multi-agency strategy to implement the needs led Assessment Framework. POLICY
REGULATION AND GUIDANCE n Contribute to PECS Awareness Regional group. n Revise ACPC handbook to meet revised Regulation and Guidance.
-
Co-ordinate regional policy and procedures group
(established to identify issues common to ACPC's arising from Co-operating
to Safeguard).
-
Implement 4 ACPC process for producing revised policy
and procedural guidance. n Review and recommend policy and practice issues in relation to children and domestic violence. n Contribute to the development of a Regional Management of Risk in Child Protection Policy. INFLUENCING n Influence practice by monitoring and evaluation. n Produce role specification for ACPC members. n Respond expeditiously to all consultation documents. n Seek to influence child care issues in collaboration with other ACPCs, organisations and through contact with political representatives. n Prepare action plan to implement the recommendations of the child protection/mental health report. PUBLIC
AWARENESS AND EDUCATION n Develop a local strategy through the publicity sub-group. n Identify the action required to raise professional awareness of the impact of domestic violence upon children. n Publish public information on Internet safety. n Evaluate the Ballycastle Health & Education Initiative. Raise awareness of child sexual abuse and how communities and families can protect children.
[i] Framework for systematic gathering and analysis of information which can be used as an assessment tool by all agencies for assessing children in need, (Department of Health).
[ii] Framework for systematic gathering and analysis of information which can be used as an assessment tool by all agencies for assessing children in need, (Department of Health).
[iii] Regional group representing PSNI, HSS Boards and NSPCC with strategic responsibility for policies and procedures in respect of a joint investigation by social workers and police officers of alleged and suspected cases of child abuse.
9 October (vol 2c) / Menu / 9 October 2002 (vol 3a) |
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