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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: 16 August 2002 Further to your letter
of the 20th June 2002 please find attached a submission on behalf of the Southern
Area Child Protection Committee, Armagh and Dungannon, Craigavon and Banbridge,
and Newry and Mourne Child Protection Panels. There is no objection to this
submission being made public by the Committee. If you require any
further information please do not hesitate to contact me.
T RODGERS
Contents
Summary 1. Introductions 2. Ethos 3. Casework 3.1 Case Recording 3.2 Professional Judgement 3.3 Assessment and
Analysis of Information 4. Communication 5. Linkages 6. Workforce Issues 7. Training 8. Resources 9. Lessons Learned 10. General Comments 11. Conclusion Appendix
1 Appendix
2 SUMMARY Northern Ireland
Assembly Inquiry into Child Protection Services in Northern Ireland - Submission
on behalf of the Southern Area Child Protection Committee, Armagh and Dungannon,
Craigavon and Banbridge, and Newry and Mourne Child Protection Panels. (i) Introduction The Southern Health and Social
Services Board commissions services and Trusts within its area deliver services
to support and protect the children. The Southern Area Child Protection Committee
operates at a strategic level to ensure effective inter-agency, multi-disciplinary
working in respect of protecting children. The three Child Protection
Panels within the Southern Board area take the lead in inter-agency, multi-disciplinary
working at operational level. (ii) Ethos A holistic perspective is
essential to assessing and meeting the needs of children. This must maintain
a focus on the needs of the child. Child protection services must be viewed
as part of wider support services required for families in need. (iii) Casework Recording of child protection
cases, for all disciplines, is a complex and detailed task given the nature
of intervention and decision making and the level of contact between professionals
and others. The implementation of the Children (NI) Order 1995 has led to
significant increase in the detail of information required. The importance of ongoing
monitoring of case files is acknowledged. Case files are routinely accessed
within ongoing audit processes. Following a recent SACPC
External Review of Thresholds for Decision Making across the SHSSB (at referral,
case planning and child protection stages). management decisions and details
of case discussions within the professional supervision arena will be contained
on case files. The proposed implementation of a framework for assessment will
enable decision making to be made explicit on files. (iv) Professional Judgement A number of external factors influence the use
of professional judgement, including, the Human Rights Act 1998, Data
Protection Act 1998, issues of client confidentiality and consent, policy and
procedures and professional codes of practice. Professional judgement within
a multi-disciplinary arena enhances child protection systems and decision making.
Supervision provides a sound professional framework within which professional
judgement can be guided To address the issue of differing interpretations
of thresholds for referral to services SACPC and local Child Protection
Panels have compiled "Multi-Agency Guidance for Services to Children in the
SHSSB Area". This
places services within four levels, ranging from universal services for those
to safeguard children. It is hoped this guidance will lead to appropriate and effective
identification and referral of all needing support. (v) Assessment and Analysis of Information Assessment is the fundamental
basis to intervention and action. A complete assessment at either child protection
or case planning level must maintain a focus on the child, the capacity of
the parent/carer to meet the child's needs and the wider environment. The SHSSB and Trusts
in its area, are currently adapting the Framework for the Assessment
of Children in Need and their Families into a multi-disciplinary inter-agency
approach for use in the Board area. Such an approach will require to be adequately
resourced. The Southern Area Child Protection
Committee has recently endorsed the use of a Risk Analysis Model to detail
risk in the context of strengths and weaknesses within the family and the likely
impact on the child and potential for change. (vi) Communication Multi-disciplinary inter-agency
communication is crucial to effective protection of children. The concept of
children in need emphases the need for liaison between agencies and disciplines
across the entire continuum of family support and child protection. Channels
of communication tend to become clear when cases enter the formal child protection
arena. Prior to this stage communication, needs to take account of confidentiality,
consent from families and children, and Human Rights legislation. Communication
is enhanced by the understanding and awareness of different professionals and
agencies on appropriate thresholds and differing roles and responsibilities.
(vii) Linkages Involvement with families
and local communities is crucial in prevention and early intervention relating
to children in need. The Childrens' Services Planning process provides an integrated
approach to strategic planning. This is informed by reference and user groups
within local communities. The resultant plans require to be funded on an inter-departmental
level to ensure appropriate intervention and protection services can be developed
across agencies. Surestart adopts an integrated
approach to family support, and the Wraparound initiative in the Southern Board
area, represents a multi-disciplinary approach to meeting the needs of disabled
children. Such projects should be expanded and funded on a recurrent basis. The importance of involvement
with individual families and children is fully recognised by professionals
working in child protection. Considerable effort is invested in working with
families, many of whom are experiencing extreme distress or are hostile to
child protection interventions. (viii) Workforce Issues The Children (NI) Order 1995
has significantly increased demands on staff. The complexity and level of responsibility
attached to working in child protection has resulted in a high turnover of
staff, significant difficulties in recruitment and retention of experienced
staff and increasing levels of sickness for staff in all disciplines and agencies. (ix) Training Multi-disciplinary, inter-agency
training is fundamental to enhancing existing knowledge and skills within
the workforce. It is a key vehicle for keeping staff up to date with practice,
research, and developments in legislation, policy and procedures. (x) Resources The SHSSB and Trusts in its area are committed
to prevention and early intervention to support vulnerable families.
Resource issues within child care services are detailed in appendix 1 to the
main report. Increasing resource needs
must be seen in the context of developments in practice, procedural and administrative
demands, and the broader perspective taken towards support services and protection
needs within the Children (NI) Order 1995. It is essential that all aspects
of this service are adequately funded across all disciplines and agencies. (xi) Lessons Learned The need to learn from case
management reviews and inquiry reports is fully recognised. Efforts to learn
lessons should be placed within the context that risk cannot be entirely eliminated.
Responses are therefore in relation to identification and management of risk.
Work is ongoing to draft a regional risk framework within which work with families
and children can be placed. (xii) General comments The negative impact of domestic
violence on children must be recognised. It is essential that an effective
approach to addressing domestic violence at prevention and protection level
is fully resourced. (xiii) Conclusion The publication of the Revised
Children (NI) Order Volume 6 'Co-operating to Safeguard Children' will mark
the opportunity for further change and development in child protection work.
Such developments, however, will require to be accompanied by the necessary
resources. SUMMARY OF RECOMMENDATIONS Casework
n
Regional standards and formats should be developed for recording practices
in child care cases.
n
Recording in child care cases should become an integral part of professional
training.
n
All agencies involved in child protection work should routinely audit their
recording systems. Such audits should be both uni and multi disciplinary/agency
in nature.
n
Child Protection Panels should inform ACPCs on monitoring arrangements and
audits carried out on child protection files.
n
Formal professional supervision should be put in place for all professions
working with children.
n
It is recommended consideration be given to adapting 'Guidance Notes on Management
of Cases involving Children', for use by other disciplines.
n
A standardised tool for assessing the needs of children should be implemented
on a regional basis.
n
Additional resources must be made available to support the multi-disciplinary,
inter-agency implementation of such an approach. These should be allocated
across all disciplines.
n
Consideration should be given to developing and resourcing an appropriate mechanism
for managing risk posed by those who have perpetrated non-sexual offences against
children. Communication
n
Agencies and individual disciplines need to take ownership of their roles and
responsibility within the child protection process.
n
There is a need to explore the roles of the Primary Health Care team within
Child Protection, in particular the changing role of family GP's which now
needs to be revisited and updated. This should be carried out at both regional
and local level.
n
Agencies involved in investigation of child abuse must be appropriately staffed
and resourced for this complex task.
n
Given the complexity and increased workloads in family support and child protection
services the role of the Child Protection Nurse Specialist needs to be appropriately
resourced and accompanied by specialist uni-disciplinary training.
n
Training initiatives should provide Child Protection courses for all professionals
including in particular core group members that is, Doctors, Health Visitors
and Social Workers. This should include an outline of the role of any specialised
posts within the Child Protection process. Linkages
n
Community based projects of a preventative nature require stable mainstream
funding.
n
Existing Surestart Projects should be funded on a longterm basis with additional
Surestart Projects developed in disadvantaged areas.
n
The Wraparound approach to multi-disciplinary services to disabled children
needs to be developed with funding secured on a recurrent basis.
n
Further consideration should be given to how to provide effective support to
enhance the participation of families and children, particularly those who
are disabled or from ethnic minorities. Workforce Issues
n
Workload measurement systems should be developed on a regional basis to determine
appropriate level caseloads for all staff working in Child Protection.
n
An urgent review of terms and conditions should be undertaken for those employed
in Child Protection.
n
On a regional basis, career structures should be established to enhance the
overall service through providing experienced staff with the opportunity to
remain in practice. Training
n
The Department should mandate the establishment of ACPC Training Subgroups
within each ACPC with training representation from each of the key ACPC agencies.
This would ensure that each agency would have ownership and commitment to child
protection training and so reduce the downgrading of child protection training
as an optional extra for agencies outside of the Social Services.
n
The creation of a Regional Child Protection Training Taskforce, the key function
of which would be the dissemination of child protection training issues from,
research, audits and lesson to be learnt from past experience of serious case
reviews. If this were established regionally key child protection training
issues could be standardised across the province.
n
With the development of a Regional Taskforce would be the recommendation to
establish closer working relationships, and cross fertilisation of best practice,
between Board training units, the Departments Child Care unit, and the Colleges
and Universities of Further and Higher Education. Joined up structures would
facilitate greater standardisation of child protection training. This could
be achieved through regular secondments, and placements between Departments.
n
Adequate funding be set aside for workload easement with suggestions as to
how Boards and Trusts may innovatively facilitate the use of such funding.
n
It is recommended that child protection training should be built on the delivery
of core courses that would provide staff with key tools for practice. These
should include:
-
Skills in assessment
-
The analysis of risk
-
Threshold models for case allocations
-
Effective recording, and the sharing of information
-
Therapeutic intervention
n
The SHSSB would recommend the establishment of a Regional Project aimed at
researching the effectiveness of multi-agency child protection training and
its outcomes for children. Resources
n
All disciplines and services working within child protection services need
to be appropriately resourced to carry out this work.
n
A regional response needs to be provided to identify unmet need.
n
Long term funding needs to be put in place to support a range of family support
services.
n
The Children Service's Planning process, which takes a strategic approach to
planning services on an inter-agency, multi-disciplinary basis, needs to have
corresponding funding across Government Departments made available to progress
these plans.
n
Increasing needs identified within Child Protection, e.g. those contained within
forthcoming "Co-operating Safeguard Children" should be fully resourced. Lessons Learned
n
The SACPC, in conjunction with local Child Protection Panels, should devise
and implement a multi-disciplinary, inter-agency protocol in relation
to Sudden Unexplained Death in children. This should be formally evaluated.
It may also inform the development of a Regional initiative.
n
A Regional approach should be taken to dissemination of key lessons learnt
from Case Management Reviews and Inquiries into child abuse. This would enable
a shift to be made from the traditional culture of blame to one of a more open,
constructive learning environment.
n
Consideration should be given to establishing regional structures within
which lessons from Case Management Reviews and Child Abuse Inquiries
could be considered. This might include a Regional Child Protection Task Force,
mandated ACPC Training Groups and a Regional Research Team.
n
Any resource implications related to recommendations within Case Management
Reviews, Child Abuse Inquiries, Inspection reports must be assessed
and the necessary funding made available to facilitate meaningful improvements
in child protection services. General Comments
n
The SACPC and Child Protection Panels recommend that risk assessment tools
specific to domestic violence are developed.
n
Domestic Violence Forums should be adequately funded to progress inter-agency
initiatives to address domestic violence 1 INTRODUCTION 1.1 This submission has been jointly prepared
by representatives of the Southern Area Child Protection Committee, Armagh
and Dungannon, Craigavon and Banbridge, and Newry and Mourne Child Protection
Panels. Those involved welcome the opportunity to provide a contribution to
this Inquiry. 1.2 The Southern Health and Social Services
Board (SHSSB) has a population of approximately 94,400 children and young people
under the age of 19 years. The SHSSB role is to commission services for children
and families within its area (inclusive of family support and child protection
services) based on assessed need. Statutory functions relating to child protection
are in turn delegated to Trusts who deliver services to support and protect
children in their area. 1.3 The Southern Area Child Protection Committee (SACPC) is an inter-agency,
multi-disciplinary forum operating at strategic level. Its overall aim
is to develop and ensure an effective inter-agency, multi-disciplinary approach
is taken to protecting children. The SACPC is collectively accountable to the
SHSSB, which constituted it. Individual members remain responsible to their
own agencies, which in turn are responsible for taking any action falling within
their respective remits. The full duties and responsibilities of the SACPC
are detailed in the Children (NI) Order 1995, Regulations and Guidance, Volume
6, 'Co-operating To Protect Children'. This document has been reviewed by the
Department of Health, Social Services and Public Safety, and an updated version,
'Co-operating to Safeguard Children' is awaited. A Private Members Bill in
relation to placing the functions of ACPCs on a statutory basis is presently
subject to consultation. This proposes strengthening the role and functions
of ACPC. 1.4 There are 3 Child Protection Panels (CPPs)
in the SHSSB area. These are based in Armagh and Dungannon Health and Social
Services Trust, Newry and Mourne Health and Social Services Trust and, Craigavon
and Banbridge Community Health and Social Services Trust. The latter includes
representation from Craigavon Area Hospital Trust. The role of Trust Child Protection
Panels is to ensure effective inter-agency, multi-disciplinary working
at an operational level taking account of local issues. The overall responsibilities
of Trust Child Protection Panels are contained within the Children (NI) Order
1995, Regulations and Guidance, Volume 6, 'Co-operating To Protect Children'.
1.5 Trust Child Protection Panels are constituted
by their respective Trust Boards and are accountable to those Boards, with members accountable
on an individual basis to the agencies they represent. Trust Child Protection
Panels are not therefore accountable to SACPC, however are required to work
closely with SACPC. 2 ETHOS 2.1 A holistic perspective is essential to
assessing and meeting the needs of children, that is, one, which takes account
of the child itself, the family or care situation and the wider environment.
A focus must be kept on the child with each viewed as individuals in their
own right. It should be recognised that services to protect children cannot
be viewed in isolation from wider support services required for families in
need. Protection of
children is everyone's responsibility, at an individual level, as communities,
and agencies and organisations within the statutory, voluntary, community,
and private sector. Inter-agency, multi-disciplinary working is therefore a
fundamental component of provision of an effective child protection system.
3 CASEWORK 3.1 Case Recording 3.1(1) Case recording is specific to each individual profession, each of which
must adhere to agency and professional codes on recording practice while
taking account of the SACPC Child Protection Policy Procedures. 3.1(2) Recording of child protection cases is a complex
and detailed task given the nature of intervention and decision making, and
the level of contact between professionals and others. Recording needs to be
given importance within the day to day workload and must be viewed in the context
of the complete range of administrative tasks required of staff. The implementation
of the Children (NI) Order 1995 has led to a significant increase in the detail
of information required and accompanying proformas and reports. 3.1(3) Trusts within the SHSSB recognise the importance
of ongoing monitoring of case files to ensure they meet the necessary requirements.
Case files are routinely accessed within ongoing audit processes. In 2001 a
comprehensive audit of health visiting records was carried out in the SHSSB.
Five per cent of all current files were examined. The audit included an examination
of records regarding health visitor child protection practice. A user survey
was also conducted. Whilst results were positive an action plan has been developed
and records will be re-audited as part of an amended supervision policy. 3.1(4) A recent SACPC External Review of Threshold
for Decision Making across the SHSSB (at referral, case planning and child
protection stages) noted that although it was apparent the necessary process
had been followed, the basis of decision making was not explicit on some files.
This has been recognised and is being addressed via the proposed implementation
of a framework for assessment of children and their families. As a further
result of this Review, management decisions and details of case discussions
within the professional supervision arena will be contained on case files. 3.1(5) The SACPC have had in place a suite of forms
to support the child protection process. These ensure that essential information
to protect children is conveyed in a standardised format. During 2000 these
forms were reviewed and updated to take account of changes in practice. The
revised child protection forms were implemented in June 2000. 3.1(6) Records are subject to an open access policy
to ensure the rights of service users within a spirit of working together and
transparency. (There are exceptions in situations where there may be a conflict
of interest, in such circumstances the needs of the child will be paramount.) 3.1(7) An audit of usage of proformas in relation to the Protocol for the Joint
Investigation of Child Abuse, requested by SACPC, was completed and
submitted by the three community Trusts in the SHSSB in January 2001. This
audit highlighted the administrative complexities related to administrative
processes across more than one agency (in this instance the police and social
services). This audit related to proformas held on social services files. As
a result of the audit, monitoring of Joint Protocol recording has been recommended
to senior managers. 3.2 Professional Judgement 3.2(1) A number of external factors influence the use
of professional judgement. These include, the Human Rights Act 1998, the Data
Protection Act 1998, issues of client confidentiality and consent, policy and
procedures and professional codes of practice. Professionals are accountable
for their own individual professional judgement and decision making. 3.2(2) While the Children (NI) Order 1995 and its corresponding
Regulations and Guidance represents the primary legislation in relation to
protecting children, this is accompanied by SACPC Child Protection Policies
and Procedures. These do not replace the necessity for professional judgement
which dictates how and when policies and procedures are applied. Such judgement
is based on values, knowledge, experience, and consultation with others.
Professional judgement within a multi-disciplinary arena enhances child protection
systems and decision making. Scope for professional judgement is an integral
part of the Framework for the Assessment of Children in Need and Their Families
recently implemented in England and Wales. 3.2(3) Good quality professional supervision aids and
supports professional judgement. Each of the community Trusts within the SHSSB
area has recently, or is currently updating supervision policies for social
services staff. SACPC, working in conjunction with representatives from the
Trusts, has recently implemented a document entitled 'Guidance Notes on Management
of Cases involving Children', to assist social services staff across all programmes
of care in the identification of potential child care issues. Nursing staff
are also finalising a supervision policy to meet their professional needs.
3.2(4) At the outset SACPC has recognised that there
are often differing views between a range of disciplines and agencies about
when children should receive formal services, what those services should be,
and provided by whom. This relates to the whole spectrum of services required
by children and families. The SACPC and local Child Protection Panels have
just completed drafting 'Multi-Agency Guidance for Services to Children in
the SHSSB area'. This model sits well within the confines of the Children's
Services Planning process. It was drafted on an inter-agency basis and is applicable
to those within the statutory, voluntary, community and private sectors who
come into contact with children. It places services within four levels, ranging
from universal services to those to safeguard children. Its aim is to assist
in determining the level of service appropriate for the child. It is hoped
that this will lead to appropriate and effective identification and referral
of those needing support. 3.2(5) The recent External Review of Thresholds for
Decision Making across the SHSSB took account of the views of a number of professionals
involved in identified cases. Following this Review Child Protection Panels
and SACPC are completing two further audits. One relates to the formal use
of discretion (as defined within the SACPC Child Protection Policies and Procedures)
about the need to convene a case conference. The second audit will examine
a sample of cases at case planning level to establish clear, standardised criteria
to determine when the child's needs should be met within the case planning
or child protection arena. It is intended that this will lead to clearer criteria
for routing cases via case planning or child protection. It is essential that
multi-disciplinary perspectives inform this decision. 3.3 Assessment and Analysis of Information 3.3(1) Assessment is an ongoing process, which must
be supported by professional judgement in order to ensure information is appropriately
analysed. 3.3(2) The assessment process in relation to children
in need is detailed in the Children (NI) Order 1995 Policy and Procedures.
Assessment of risk is fundamental to cases in the child protection process. 3.3(3) It should be noted that there have been significant
developments in professionals working together to assess the needs of children
and families. Co-working between disciplines (involving nursing, social work,
etc) is a common feature in completion of assessments and risk analysis. 3.3(4) A complete assessment at either child protection
or case planning level must maintain a focus on the child, the capacity of
the parent/carer to meet the child's needs and the wider environment. In recognition
of this, extensive work has been undertaken within the SHSSB to adapt and move
towards the implementation of a framework for assessing the needs of children
and their families. This would move practice beyond the DHSS Comprehensive
Assessment implemented in 1988, (known as 'The Orange Book'). 3.3(5) The formal Framework for the Assessment of Children
in Need and Their Families has been adopted within England and Wales. This
has been mandated by the DOH. The same assessment has not, as such, been mandated
by the DHSS&PS but has been referred to within the draft revised Vol 6,
'Co-operating to Safeguard Children'. 3.3(6) The model has been piloted on a multi-disciplinary
basis within each of the three community Trusts in the SHSSB area. It has also
been evaluated. Professionally the overall ethos of this Framework was positively
received and certain stages of the approach were commended, although the resultant
resource implications of compiling a more detailed, multi-disciplinary,
inter-agency assessment were highlighted by all disciplines and agencies
(nursing, medical, social work, education, etc). 3.3(7) Following the evaluation and a subsequent consultation
day, detailed comment about the actual structure of the assessment has been
taken into account. The model is now being adapted into stages which allows
decision making to be explicit at referral stage, initial assessment stage
and core assessment. This includes summarised analysis of the information and
consideration of risk. This will also provide clarity on the process of assessment
and decision making for recording purposes. 3.3(8) In considering the complexity of risk analysis
the SACPC and Child Protection Panels in the SHSSB area have piloted a risk
assessment model in collaboration with Greg Kelly of the School of Social Work
at Queens University, Belfast. An evaluation taking account of the views of
social work, health visiting and medical staff was completed during 2000. The
model was useful in helping structure decision making and promoting the discussion
of risk in an organised way. An amended 'SACPC Risk Analysis Model' has been
fully implemented with effect from May 2001. The SACPC requires that risk analysis
will be completed at child protection case conferences to detail risk in the
context of strengths and weaknesses within the family, likely impact on the
child and potential for change. 3.3(9) The Multi-Agency Procedures for the Assessment
and Management of Risk posed by Sex Offenders have recently been implemented.
It is recognised that these only focus on those who have been convicted of
sexual offences. The procedures do not address the management of those who
have been convicted of non-sexual offences against children. The difficulty
also remains of how to effectively protect children from those where offences
have been alleged, there is insufficient evidence to bring criminal charges,
yet concerns remain about potential risk to children. 3.a
Regional standards and formats should be developed for recording practices
in child care cases. 3.b
Recording in child care cases should become an integral part of professional
training. 3.c
All agencies involved in child protection work should routinely audit
their recording systems. Such audits should be both uni and multi disciplinary/agency
in nature. 3.d
Child Protection Panels should inform ACPCs on monitoring arrangements
and audits carried out on child protection files. 3.e
Formal professional supervision should be put in place for all professions
working with children. 3.f
It is recommended consideration be given to adapting 'Guidance Notes
on Management of Cases involving Children', for use by other disciplines. 3.g
A standardised tool for assessing the needs of children should be implemented
on a regional basis. 3.h
Additional resources must be made available to support the multi-disciplinary,
inter-agency implementation of such an approach. These should be allocated
across all disciplines. 3.i
Consideration should be given to developing and resourcing an appropriate
mechanism for managing risk posed by those who have perpetrated non-sexual
offences against children. 4 COMMUNICATION 4.1 The nature and level of multi-disciplinary,
inter-agency liaison is clearly specified within the Children (NI) Order 1995
and its accompanying Regulations and Guidance and Policy and Procedures, and
is fully reflected within the SACPC Child Protection Procedures. These procedures
will be updated in line with the forthcoming revised Vol 6, 'Co-operating to
Safeguard Children'. 4.2 Communication between parties and agencies
can be affected by demands and increasing workloads on individual professions.
The sheer extent of workloads can cause delay in accessing appropriate individuals
to provide specific information. 4.3 Liaison between parties and agencies is
clear when cases enter the child protection arena. It should be noted that
prior to this stage, communication, in the spirit of working with carers and
children, needs to take account of confidentiality, the need to obtain consent of families and
children, and Human Rights legislation. 4.4 Communication is also enhanced by the understanding
and awareness of different professionals and agencies on appropriate thresholds.
The work already completed on Multi-Agency Guidance for Childrens' Services
and the multi-disciplinary, inter-agency assessment framework enhances this
understanding as does ongoing multi-disciplinary inter-agency training. 4.5 The lead in the strategic multi-disciplinary
and inter-agency working in child protection is taken by SACPC and Trust Child
Protection Panels. The SHSSB has created three designated Professional Support
posts, one for each Trust Child Protection Panel. These key posts work at trust
level across all disciplines involved in child protection. They ensure an additional
resource is available to work within Trusts, alongside SACPC and to action
child protection developments. These posts link closely with the Policy Adviser
to SACPC. Representatives from each Trust Child Protection Panel also sit as
members of SACPC. 4.6 The Children (NI) Order 1995 introduced
the concept of Children in Need which places family support on a continuum
with child protection. Therefore liaison between agencies and disciplines must
take place along the entire continuum. 4.7 The Multi-agency Guidance for Services
to Children within the SHSSB Area and the framework approach to assessment, presently
being adapted are initiatives to promote positive early and effective communication
between professionals. They also enhance understanding of individual professional
roles and agencies roles and responsibilities. 4.8 Liaison between Social Services and the
Police Service of Northern Ireland is most frequently in relation to the operation
of the Protocol for the Joint Investigation of Child Abuse, that is, at investigation
stage. Recent changes within the PSNI have led to a reduction in the number
of officers presently available within the Child Abuse and Rape Enquiry (CARE)
Units. 4.9 The Joint Protocol has also been recently
reviewed leading to a more intensive, specialised, competency based approach
to training small numbers of selected staff within both agencies. 4.10 The SACPC Annual Report 2001/2002 comments
on the ongoing issue of low attendance of GP's of Child Protection Case Conferences.
Individual Child Protection Panels have medical representatives and have in
place proformas
to assist GP's to provide written contributions when they are unable to attend.
The changing nature of the GP role prompts the need to consider how
they can effectively contribute to child protection processes and strengthen
GP communication with all those involved in child protection especially at
the early stages of investigation and assessment. 4.11 The establishment of Child Protection Nurse
Specialist posts within Trusts has been a particularly positive development
in enhancing communication with the Child Protection process. Child Protection
Nurse Specialists are core members of case conference. They advise, support
and supervise nurses, midwives and health visitors in relation to child protection
practice. Their role includes the development and monitoring of nursing policies, and the
provision of a nursing perspective to multi-disciplinary and inter-agency initiatives.
Additional resources are required to meet the increasing demands of these posts.
4.12 Given the time constraints, it was not possible
to obtain a composite view from medical personnel, however a separate contribution
provided by the Consultant Community Paediatrician who represents one of the
Trust Child Protection Panels on SACPC has been attached. (Please see Appendix
2) 4.a
Agencies and individual disciplines need to take ownership of their
roles and responsibility within the child protection process. 4.b
There is a need to explore the roles of the Primary Health Care team
within Child Protection, in particular the changing role of family GP's which
now needs to be revisited and updated. This should be carried out at both regional
and local level. 4.c
Agencies involved in investigation of child abuse must be appropriately
staffed and resourced for this complex task. 4.d
Given the complexity and increased workloads in family support and child
protection services the role of the Child Protection Nurse Specialist needs
to be appropriately resourced and accompanied by specialist uni-disciplinary
training. 4.e
Training initiatives should provide Child Protection courses for all
professionals including in particular core group members that is, Doctors,
Health Visitors and Social Workers. This should include an outline of the role
of any specialised posts within the Child Protection process. 5 LINKAGES 5.1 The value and importance of working with children, parents/carers
and local communities is fully recognised. Given that child protection
is on a continuum with family support services, involvement with family and
local communities is crucial at all stages. They play a fundamental role in
prevention and early intervention. The Children Services Planning Process aims
to provide an integrated approach to strategic planning of services to children
and families. This includes input from reference and user groups from within
local communities. The Southern Area Childcare Partnership plays a lead role
in supporting families through strategic development of services based on assessed
need. A Community approach 5.2 The role of community based parental education
and family support, taken forward in co-operation with the parent or carer,
is crucial in a preventative approach to child protection. Community and voluntary
providers are often the first point of contact for families and have a role
in the prevention of, and detection of, child abuse. Adequate training and
support for staff is important. Stable, mainstream funding for community and
voluntary sector projects would ensure that non-judgemental and accessible
resources are available to families and communities. 5.3 The SHSSB has a comprehensive Community
Sector Training Programme in place which uses a cascade training model to work
with local community and voluntary groups on child protection issues. 5.4 Surestart is pioneering an integrated approach
to family support. The impact of the initiative will be to facilitate "a joined-up"
approach to professional working practices and better links between professionals,
parents and communities. Surestart funding needs to be secured on a long term
basis and additional Surestart projects should be developed in disadvantaged
areas. 5.5 The Wraparound initiative recently developed within the Southern
Board Area represents a multi-disciplinary approach to meeting the needs
of disabled children. An integral part of the Wraparound project (based in
each Trust area) is the open and transparent working with children, parents
and carers themselves. The Wraparound Project has only attracted funding for
a three year period. This approach to working with children and families should
be expanded and fully funded on a recurrent basis. 5.6 The above examples of engagement with children
and young people, families and communities are built on by initiatives through
Child Protection Panels and the SACPC. These are based on awareness raising
through local media and information leaflets for the general public. Press
articles have included awareness raising regarding domestic violence, punishment
of children, supervision of children, child protection and the internet. Working with Parents/Carers
and Children/Young People 5.7 An Open Access Policy is in place to enable
users of services to access information on case files. 5.8 Children (NI) Order 1995 Representations
Complaints Policy Procedure is also in place within each of the Trusts. This
has recently been updated and is accompanied by a range of public information
leaflets for parents, carers and young people. 5.9 Requirements to involve parents, carers and children throughout
the process of family support/case planning and child protection are
detailed within the relevant Policy and Procedures. Good practice requires
that parents/carers and children (as appropriate) are encouraged to actively
participate in the process, are supported to do so, and have reports shared
with them in advance of meetings and can complete proformas. It should be noted
that as rule there is a high level of participation by families. 5.10 SACPC working with Child Protection Panels
have implemented a proformae with children and young people inputting to case
conference. The leaflet for parents/carers on the case conference process has
recently been updated. One of the Trusts within the SHSSB area has the facility
for parents to have a support person from the Parents Advice Centre accompany
them to child protection case conference. 5.11 Families requiring formal interventions of
this nature are already under great stress making participation at this stage,
and within procedural time frames, particularly difficult. Enabling the involvement
of families and children is a complex task for staff concerned. 5.a
Community based projects of a preventative nature require stable mainstream
funding. 5.b
Existing Surestart Projects should be funded on a longterm basis with
additional Surestart Projects developed in disadvantaged areas. 5.c
The Wraparound approach to multi-disciplinary services to disabled children
needs to be developed with funding secured on a recurrent basis. 5.d
Further consideration should be given to how to provide effective support
to enhance the participation of families and children, particularly those who
are disabled or from ethnic minorities. 6 WORKFORCE ISSUES 6.1 Recruitment and retention of qualified
staff is the main stay of an effective service to children and families. 6.2 The introduction of the Children (NI) Order has had a
significant impact on increasing workloads for staff. This has presented
particular difficulties for social services staff working in Child and Family
Care programmes. 6.3 The demands of court work have dramatically
increased in respect of Care Orders, Article 8, and Freeing applications. This
now ordinarily requires provision of additional reports and court attendances
in addition to the necessary preparation work. The statutory Looked After Children
process has also added increased administrative burdens and professional demands
on staff. These, in conjunction with the complexity of and level of responsibility
attached to the Child Protection process has led to a high turnover of staff
and significant difficulties in recruitment and retention of experienced staff
and increasing levels of sickness. 6.4 SACPC, Child Protection Panels and Senior
Managers across disciplines are acutely aware of pressures on staff and the
agencies' duty of care towards those staff. Family friendly policies have been
implemented to assist staff balance home and work demands. These in themselves
present 6.5 Staff are dealing with increased procedural requirements, administrative
demands, increased time required to work in a meaningful multi-disciplinary,
inter-agency way, and increasing expectations from the general public. 6.6 Working within Child Protection, staff
are committed to working with the most vulnerable and often disadvantaged members
of society. However, this is often at a time of distress and anger for families.
Hostile reactions are not uncommon, with staff frequently subjected to verbal
and physical threat and assault. 6.7 Such pressures are not specific to Social
Services staff and in fact are evident across all disciplines and agencies
working with children and families. This is leading to staff electing to work
in other programmes of care, other specialist agencies, or indeed in Southern Ireland where
attractive financial incentives are in place. 6.8 Quality supervision is central to the support
and professional development of staff. Trusts within the SHSSB area have recently
revised (or are in the process of) revising their supervision policies. Supervision
policies are also being developed for nursing staff. Nonetheless these must
be supported by a full compliment of staff, appropriate remuneration, and a
safe working environment where staff feel valued. 6.a Workload measurement systems should be
developed on a regional basis to determine appropriate level caseloads for
all staff working in Child Protection. 6.b An urgent review of terms and conditions should be undertaken
for those employed in Child Protection. 6.c On a regional basis, career structures
should be established to enhance the overall service through providing experienced
staff with the opportunity to remain in practice. 7 TRAINING 7.1 Since 1990 multi-agency child protection
training has been an integral part of SACPC structure. 7.2 Child protection training is supported
through a dedicated training post funded jointly by the SHSSB and the Southern
Education and Library Board. This unique post and partnership arrangement is
the only one of its kind in the Province. 7.3 In order to identify the multi-disciplinary
child protection training requirements of staff for the SHSSB annual training
needs analysis is carried out in conjunction with the three Trusts Child Protection
Panels, the Children and Young Peoples Committee and the objectives, policies
and procedures set by ACPC. During this process cognisance is taken of many
other factors such as national and regional issues, as well as current research,
messages from inquiries and, lessons from Case Management Reviews. 7.4 The delivery of training is provided both
in house by the multi-disciplinary child protection trainers and also commissioned
through external trainers. 7.5 The provision of such a dedicated ACPC
child protection training post is currently in keeping with the proposals outlined
in the Private Members Bill on the role and functions of ACPCsi.
The organisation of our training programme, content and target audiences are
in keeping with the framework for training outlined in the Departments draft
document "Co-Operating to Safeguard Children"ii. 7.6 The SHSSB would support this draft framework
outline for the delivery of training, which ensures that multi-disciplinary
child protection training is seen as a process of building on existing knowledge
and skills and not simply a one of training event. 7.7 In the Southern Board area the child protection
trainers are provided with the opportunity to be part of key working groups
tasked with devising new practice guidelines or amending existing policies
and procedures. The training requirements are then directly translated into
training courses ensuring that training bridges the gap between policy, procedures
and practice. 7.8 Over the past two consecutive years approximately
700 to 800 staff have received child protection training from awareness through
to skills training. 7.9 One of the major recurring difficulties
in child protection training is the release of staff to attend training sessions.
Increasing pressures of work, and the lack of workload easement often denies
staff the opportunity to attend training. This does not reflect the commitment
of either staff or management to child protection training but highlights the
reality of child protection work. 7.10 It must also be recognised that multi-disciplinary
training endeavours to offer training to a wide grouping of staff. Inevitably
given the numbers of staff involved this has to be targeted. Mechanisms need
to be in place to address the uni-disciplinary requirements of staff in all
disciplines who come into contact with children and families, such as nursing,
medical personnel, PAMS, education sector staff, housing staff etc. 7.11 SHSSB welcomes new arrangements set by the
NI Social Care Council for the post registration of diploma students to consolidate
learning. This will allow Trusts the necessary mandate to quality assure practice. 7.a
The Department should mandate the establishment of ACPC Training Subgroups
within each ACPC with
training representation from each of the key ACPC agencies. This would ensure
that each agency would have ownership and commitment to child protection
training and so reduce the downgrading of child protection training as an optional
extra for agencies outside of the Social Services. 7.b
The creation of a Regional Child Protection Training Taskforce, the
key function of which would be the dissemination of child protection training
issues from, research, audits and lesson to be learnt from past experience
of serious case reviews. If this were established regionally key child protection
training issues could be standardised across the province. 7.c
With the development of a Regional Taskforce would be the recommendation
to establish closer working relationships, and cross fertilisation of best
practice, between Board training units, the Departments Child Care unit, and
the Colleges and Universities of Further and Higher Education. Joined up structures
would facilitate greater standardisation of child protection training. This
could be achieved through regular secondments, and placements between Departments. 7.d
Adequate funding be set aside for workload easement with suggestions
as to how Boards and Trusts may innovatively facilitate the use of such funding. 7.e
It is recommended that child protection training should be built on
the delivery of core courses that would provide staff with key tools for practice.
These should include:
n
Skills in assessment
n
The analysis of risk
n
Threshold models for case allocations
n
Effective recording, and the sharing of information
n
Therapeutic intervention 7.f
The SHSSB would recommend the establishment of a Regional Project aimed
at researching the effectiveness of multi-agency child protection training
and its outcomes for children. 8 RESOURCES 8.1 As already noted the Children (NI) Order introduced the concept
of placing family support and child protection on a continuum. However,
while both the SHSSB and Trusts are committed to prevention and early intervention
to support vulnerable families this approach must be adequately funded
across all disciplines and sectors (social work, nursing, medical etc). It
is recognised that resources channelled into prevention services would reduce
the number of children and families requiring statutory child care interventions.
A paper drafted by the 4 Boards 'Family and Child Care Services in Northern
Ireland in 2000' details issues related to funding and resources which require
serious consideration within this Inquiry. (Please see Appendix 1) 8.2 It is worthy of note that Priorities for
Action has not included consideration of initiatives to improve child care
services in the community. 8.3 Reference has already been made to the
increased demands on staff. This is reflected in the statistical data which indicates a corresponding
increasing demand on Child Protection services across the three community
Trusts in the SHSSB area. 8.4 The data which is most readily available
relates to child protection activity, however a large amount of work is carried
out by a range of professionals who work with cases at case planning levels.
This work is equally complex and resource intensive and often goes unrecognised
when considering this formal child protection system. 8.5 Information contained in the SACPC Annual
Report 2001/2002 indicates a steady increase in child protection referrals. CHILD PROTECTION REFERRALS TO SHSSB
- 1 APRIL 2001 - 31 MARCH 2002
Referrals are indicating increasing levels of complexity
with families presenting with multiple difficulties, including for example
alcohol dependency, mental health difficulties, domestic violence etc. Data
on the child protection process, numbers and categegories of child protection
registration in the SHSSB are detailed below. Initial Case Conferences/Registrations THE CHILD PROTECTION PROCESS BY
TRUST - 1 APRIL 2001 - 31 MARCH 2002
A case conference may have
considered more than one child 8.6 The number of children on the Child Protection
Register in the SHSSB area over the last five years is outlined below. NUMBER OF CHILDREN IN THE SHSSB
AREA ON THE CHILD PROTECTION REGISTER AS AT 31 MARCH 1998 - 2002
CATEGORIES OF REGISTRATION FOR
CHILDREN ADDED TO THE REGISTER IN SHSSB AREA AS AT
This represents a major resource
demand for all those involved in protecting children experiencing or likely
to experience significant harm. 8.7 While the demand remains high in formal
Child Protection services, there has been significant difficulty in shifting
the already limited resources into family support and prevention initiatives.
8.8 The Statutory Childcare Sector works in
partnership with the voluntary, community, and private sectors to meet the
assessed needs of families and children. Such services are increasingly financed
through short term or one-off funding. 8.9 The increased pressures at all points in
the service can cause delays in responding to the needs of families, thereby
compounding the difficulties for all involved. 8.10 The SHSSB is working with community Trusts
in its area to improve existing information systems. A database is being developed,
the Childcare Recording Information System (CRIS) to add to data obtained via
SOSCARE and manual systems. Trusts routinely record and report on unmet need
as required within the Children (NI) Order 1995. 8.11 As practice increasingly takes account of
relevant research and evidence there are resultant resource implications. One
example of this is the SACPC initiative developing a Child Protection policy
in respect of the "The Impact of Domestic Violence on Children". This policy
recognises the detrimental impact on children and potential for significant
harm for children within families where domestic violence is a feature. This
policy based on an increasing body of knowledge strengthens the requirement
for a multi-disciplinary, inter-agency consideration of the needs of children
experiencing domestic violence increasing the numbers likely to require support
as children in need. 8.12 The increasing complexity of needs of those
children and young people in the Looked After system also requires consideration.
Those with challenging behaviours can often pose a risk to themselves and others.
Difficulties arise in the availability of and difficulty in accessing secure
accommodation placements for these young people at a time when they are in
greatest need. 8.13 The revised draft volume 6, "Co-operating
to Safeguard Children" broadens the range of issues which should be considered
within child protection. This now includes bullying, child prostitution, domestic
violence, abuse of children on the internet. Such developments require corresponding
resources to enable child protection systems to effectively intervene and protect
the needs of children in these situations. 8.a
All disciplines and services working within child protection services
need to be appropriately resourced to carry out this work. 8.b
A regional response needs to be provided to identify unmet need. 8.c
Long term funding needs to be put in place to support a range of family
support services. 8.d
The Children Service's Planning process, which takes a strategic approach
to planning services on an inter-agency, multi-disciplinary basis, needs to
have corresponding funding across Government Departments made available to
progress these plans. 8.e
Increasing needs identified within Child Protection, e.g. those contained
within forthcoming "Co-operating Safeguard Children" should be fully resourced. 9 LESSONS LEARNED 9.1 The NSPCC Out of Sight Report makes distressing and dismaying
reading, particularly for all those involved in the difficult and demanding
work of protecting children. Tragically, key themes are repeated in the recommendations
of these reports. Most commonly these relate to poor communication and failures
in multi-disciplinary working. Efforts to learn lessons from these tragic events
should be placed within the context that risk cannot be entirely eliminated.
Responses are therefore in relation to identification and management of risk.
The SACPC is currently involved in regional endeavours to establish a risk
framework within which work with families and children can be placed. 9.2 It is acknowledged that poor multi-disciplinary
inter-agency communication is a recurring theme in the numerous enquiries into
child deaths at the hands of their carers. Where the resultant response had
been to endeavour to direct communication via stronger more defined procedures
it is apparent that this in itself has limitations. Communication must essentially
be based on a professional recognition and commitment of the need to do so.
9.3 Structures established via SACPC and Trust
Child Protection Panels include increasing levels of audit and monitoring systems for local
practice to ensure adherence to procedures. Through analysis of child protection
information attempts are made to monitor and identify local trends in child
protection and respond to these. The recent external review of thresholds for
decision making across the SHSSB (2001) evidences a pro-active response across
the three community Trusts to explore varying trends in child protection within
the Board area. A detailed action plan has been set in place to address the
recommendations. This is now being taken forward. 9.4 There is a recognition and commitment to
take account of research and evidence. This has become an integral part of
child care training initiatives and, in fact, has been included in recent policy
developments led
by SACPC e.g. the SACPC Impact of Domestic Violence on Children includes a
separate research section. 9.5 The SHSSB, in conjunction with local Trusts, considers Departmental
and SSI reports and develops accompanying action plans to progress recommendations
contained within these. 9.6 Child Protection Panels within the SHSSB are alert to
individual cases where formal criteria for case management reviews
are not met, however, the circumstances of the case warrant consideration at
Panel level. This is an attempt by Panels to scrutinise practice at local level. 9.7 The Policy Advisor post to the SACPC and
the establishment of the Professional Support posts developed in the SHSSB
has assisted bringing up-to-date research and pertinent information from enquiries
to local fora and effectively integrating this into local practice. 9.8 It is acknowledged that a case management review has recently
been completed within the SHSSB following the death of a child and serious
injury to his twin brother, both of whom were subjects of an ongoing inter-country
adoption. Following the internal Case Management Review an Independent Enquiry
was initiated by the DHSS & PS. The Case Management Review focussed both
on the inter-country adoption arrangement and the child protection issues.
With regard to the former, the recommendations referred to the need for adherence
to procedures, recording issues and communication across the various disciplines.
In terms of child protection the review highlighted the need for all professionals
to be aware of child protection responsibilities, the importance of communicating
post-mortem findings and the need to review the current process. The more formal
child protection process was actioned when the second child was injured and,
following this, there was evidence of good practice across the various disciplines.
In tandem with recommendations relating to the need for improved communication
there was also a need to look at notification arrangements within the Trust
and from the Trust to the Board and Department. Whilst awaiting the Independent Enquiry report, action has already been
taken on a significant number of the recommendations within the Case
Management Review, specifically the application of adoption policy and procedures,
recording and communication issues. This has been facilitated by training to
address particular areas. In addition, work is also progressing on the development
of a protocol for instances of Sudden Unexplained Deaths in Children. It is
critical that all of the agencies and professionals accept the need for this
protocol and play an active part in its formulation. The SACPC and Child Protection
Panels in the SHSSB area are committed to improving practice and learn key
lessons identified within this Case Management Review. Further action necessary
will be taken when the Independent Enquiry is completed. 9.a
The SACPC, in conjunction with local Child Protection Panels, should
devise and implement a multi-disciplinary, inter-agency protocol in relation
to Sudden Unexplained Death in children. This should be formally evaluated.
It may also inform the development of a Regional initiative. 9.b
A Regional approach should be taken to dissemination of key lessons
learnt from Case Management Reviews and Inquiries into child abuse. This would
enable a shift to be made from the traditional culture of blame to one of a
more open, constructive learning
environment. 9.c
Consideration should be given to establishing regional structures within
which lessons from Case Management
Reviews and Child Abuse Inquiries could be considered. This might include a
Regional Child Protection Task Force, mandated ACPC Training Groups
and a Regional Research Team. 9.d
Any resource implications related to recommendations within Case Management
Reviews, Child Abuse Inquiries, Inspection reports must be assessed and the
necessary funding made available to facilitate meaningful improvements in child
protection services. 10 GENERAL COMMENTS 10.1 The SACPC and Trust Child Protection Panels
believe that within the present integrated health and social services structure
there is already a positive foundation on which to build further improvements
necessary to meet the growing demand on the child protection system. 10.2 The SACPC and Child Protection Panels in
the SHSSB area have introduced a number of initiatives to improve practice.
These include: the Multi-Agency Guidance on Childrens Services; a protocol
on the relationship between Adult Mental Health Services, Child and Adolescent
Mental Health and Child Protection Services: a Policy on the Intimate Care
of Children; Child Protection Policy and Procedures for Disabled Children:
and Policy and Procedures on the Impact of Domestic Violence on Children. 10.3 Domestic violence and its negative impact
on families is worthy of specific comment. While its impact on children is
now being recognised, it is important that this is addressed and resourced
in both child protection and family support arenas. It is essential that the
necessary risk assessment tools are developed to assist staff consider risk in families suffering domestic violence.
The Regional Domestic Violence Forum and the inter-agency domestic violence
forums already established in trusts play a crucial role in setting in place
structures to address domestic violence. However to effectively progress initiatives,
adequate funding is required. 10.a
The SACPC and Child Protection Panels recommend that risk assessment
tools specific to domestic violence are developed. 10.b
Domestic Violence Forums should be adequately funded to progress inter-agency
initiatives to address domestic violence 11 CONCLUSION 11.1 The SACPC awaits the publication of the forthcoming
Revised Children (NI) Order Vol 6 Co-operating to Safeguard Children. This
will mark the opportunity for further change and development of child protection
work. 11.2 It is hoped that this submission on behalf
of the SACPC and Child Protection Panels within its area will assist in informing
the Assembly's Inquiry into Child Protection Services in Northern Ireland and
contribute to the enhancement of those services.
Appendix 1 Contents Introduction 1 Family and Child Care Services in Northern
Ireland - Overview 1.1 Context 1.2 Funding - Comparisons with England 1.3 Funding the Children Order in Northern
Ireland - Shortfalls 2 Supporting Children and their Families 2.1 Background Briefing 2.2 Requirements Anticipated in 1995 2.3 Emerging Demands 1996-2000 2.3.1 Increased Referrals by Children 'In Need' 2.3.2 Waiting Lists - Identified Unmet Need 2.3.3 Article 8 - Private Law Cases 2.3.4 Children's Services Planning
n
Youth Justice
n
School Exclusion
n
Child/Adolescent Mental Health Service 2.3.5 Children with a Disability 2.3.6 The NI Child Care Strategy 2.3.7 Additional Policy Impacts 3 Keeping Children Safe 3.1 Background Briefing 3.2 Requirements Anticipated in 1995 3.3 Emerging Demands 1996-2000 3.3.1 Operational complexity 3.3.2 Refocusing 3.3.3 Court Work 3.3.4 Impact on Direct Work with Clients 3.3.5 Additional Pressures 4 Children Who are Looked After by Boards
and Trusts 4.1 Background Briefing 4.2 Requirements Anticipated in 1995 4.3 Emerging Demands in 1996-2000 4.3.1 General Residential Provision 4.3.2 Specialist Residential Provision 4.3.3 Family Placements - Foster Care 4.3.4 Permanency and Adoption 4.3.5 Leaving and After Care 5 Summary and Recommendations 5.1 Summary 5.2 Recommendations References Introduction This paper will present
a review of Family and Child Care Services in Northern Ireland. It is submitted
as an agreed position, by the four Health and Social Services Boards. Social Services in
Northern Ireland are organised at two levels:
n
Commissioning is undertaken by the four
Health and Social Services Boards, who carry statutory responsibilities for
the planning, resourcing, monitoring and quality assurance of services.
n
Service provision and operational management
are undertaken by the eleven Community Trusts, which have delegated statutory
responsibilities and are accountable to Boards for the management of staff/resources
and delivery of services. Boards and Trusts have developed
organisational arrangements to plan and deliver a wide range of Social Services,
of which Family and Child Care teams constitute a significant part. The Children
(NI) Order 1995 is the legislation which mandates the bulk of Family
and Child Care activity. It is important to
establish that Social Services Departments draw their clients from society's
most vulnerable groups. Such clients are typically located at the margins of
systems such as health, education, training etc, or in the intersections and
overlaps between systems. Whilst the Children Order gives Family and Child
Care teams a number
of core legal responsibilities in respect of vulnerable children and young
people, the needs of such children and young people are often too complex
to be met by a single agency. All agencies have responsibilities in this area.
This has been recognised in government policy, with increasing emphasis on
the importance of multi-agency collaboration in both delivery and planning
of service. The paper will examine
the areas where Boards/Trusts have core responsibilities, as well as demonstrating
the multi-agency dimension. It will be argued that the needs of the most vulnerable
families and children in Northern Ireland have created a level of demand for
Family and Child Care Services which has significantly outstripped supply.
Services are not sufficiently well developed to provide the responses which
are required and are under increasing, severe pressure. Parts of the service
have been described as in crisis. The paper will concentrate on the three main
themes of the Children Order (family support, protecting children, and services
for children in care), and will summarise:
n
factors contributing to increased need;
n
the history of service funding since the introduction of the Order;
n
the operational consequences of implementing the Children Order;
n
key strategic developments which impact on service provision and planning. It will draw attention
to under-funding, and to funding deficits in comparison with other parts of
the United Kingdom. Referring to a range of research sources and policy directives,
it will identify areas of need where investment is necessary in order to implement
statutory responsibilities, to address social exclusion and to promote the
best interests of children and young people as active citizens in the Northern
Ireland of the future. CHAPTER 1 1. Family and Child Care Services in Northern Ireland 1.1 Context Northern Ireland has 463,226 children and young
people, who comprise 27% of the total population (compared to 22% in
England). Many children and young people in Northern Ireland experience economic
and social disadvantages which are likely to bring them within the legal definition
of 'In Need', creating entitlement to access to a range of personal social
services(1).
n
There is ample evidence of
the negative effects of poverty
and deprivation on life outcomes for significant
numbers of
children. Evidence, for example, of differentials in infant mortality(2),
health risks to children(3), poor educational attainment(4) and school suspension
and expulsion(5) point to just some of the disadvantages. At least
one child in every four in Northern Ireland (26.5%) was a dependant of claimants
of Job Seekers Allowance and Income Support Benefits in 1998/99(6).
23.9% of school children received Free School Meals in 1999/2000(7),
higher than in every other part of the United Kingdom. This is the socio-economic
context in which Family and Child Care Services are delivered(8).
n
It is estimated that 22% of males and 8% of females in Northern Ireland in
1998 consume alcohol above sensible levels(9). This is a growing,
culturally accepted, area of concern, with numerous consequences for children.
Alcohol abuse has been strongly linked
to violent crime and to domestic violence(9). The percentage of
those aged 16-24 years drinking above sensible limits is higher and is growing
faster than that for those aged 25 years+(10).
n
There is a growing level of concern about drug
abuse. The WHO study in 1997/98, from a sample of 6574 young people between
11-15 years, estimated that 23% had been offered drugs(10). Police
report that the number of drug seizure incidents rose by 29.6% in 1999/00(11).
n
Figures from the Northern Ireland Court Service provide evidence of concern
about the extent of Family Breakdown.
In the year 1997/98, the Courts, under Article 8 of the Children Order, dealt
with applications for 2539 Contact
Orders (permission), 2179 Residence Orders, 121 Prohibited Steps Orders,
45 Specific Issue Orders(12). It is reported by Relate NI that there
are approximately 5000 divorces or legal separations in Northern Ireland each
year, which is a 44% increase on 10 years ago. 27% of marriages now end in divorce(13). There
is research evidence that children from separated families are
more susceptible to a number of disadvantages in emotional wellbeing, health,
educational performance, etc.(14).
n
In 1997/98, 1408 children in Northern Ireland had to be accommodated in a Refuge
because of the experience of domestic
violence(15). In 1999, 14456 incidents of domestic violence
were reported to the RUC. In 93% of cases, children were present. There is
research evidence of strong links between the experience of children of domestic
violence and child abuse(16).
n
26% of all families with dependant children in Northern Ireland in 1997/98
were lone parent families(17). This has increased from the
1990/91 figure of 19% of all families. Lone parents are much more
likely to experience disadvantages arising from poverty than two parent families(18),
and their children are more likely to be 'in need'.
n
Northern Ireland has a teenage birth rate approaching 30 per 1000 women. This
trend is consistent with the UK trend, which is the highest in Western Europe(19).
Research shows that young people with a history of disadvantage are at significantly
greater risk of becoming parents in their teens. Teenage pregnancy has been targeted
by the Government Social Exclusion Unit as an area of particular concern.
n
Northern Ireland is a society emerging from a conflict which continues to have
adverse consequences for
significant members of its children and young people. It was estimated in 1997
that 26% of those who had lost their lives in the troubles were aged
21 years or less(20). The Bloomfield Report refers to 'secondary'
effects(21), to the traumatic and continuing experiences of the
children and families of people who have been killed or injured. Two major
studies carried out by Sperrin Lakeland Trust following the Omagh Bomb has
mapped the consequences for one community of a major atrocity(22).
The experience of the Trust in addressing the consequences of the bombing reveals
the wider poisoning effects of the tragedy, with, for example, increased family
discord, alcohol use and referrals of children to enuretic clinics. The Children
Study suggests that 15.8% of adolescents in the Omagh area were traumatised 15
months after the bombing. The study into the impact on younger children found
even higher levels of distress. Such findings can be multiplied many times
over. The significance of the Omagh studies and experience is that, for the
first time in the history of the Troubles of the past 30 years, the impact
of violence has been assessed through community studies and quantified. In
2000, very many children and young
people have spent formative years in environments where confrontation
and violence have been endemic. Electoral Wards with high deprivation scores
predominate amongst those with the largest numbers of deaths because of the
'Troubles'(23). The impact of the conflict on the lives of children
and young people has not yet been fully examined or understood, but clear examples
of outcomes, such as youth-led violence, are emerging. Whilst the transformation
to a non-violent society is at an early stage, it is expected that rather than
a move from political violence to 'no violence at all, a new pattern of violence
will emerge, reflected in increased crime related violence, inter-gang conflicts,
territorial 'wars', drugs 'wars' and at a community level, increases in domestic
violence, child abuse and other forms of personal violence. The Government social policy
agenda has been based on the objective of promoting social inclusion, with
emphasis on early intervention. The Equality Legislation and the Human Rights
Act have provided a statutory basis for promoting the rights and needs of children
and young people particularly those who are vulnerable(24). Both
of these major policy developments will have significant consequences for the
effect and nature of family and child care planning and provision. 1.2 Funding - Comparisons with England The DHSS document 'Key Indicators of Personal Social
Services in Northern Ireland' reports that: "A total of £61.4m was spent
on Family and Child Care Services in Northern Ireland in 1997/98. The figure
for 1995/96 was £56m. Although this represents an increase of 9.7% of money
spent in Family and Child Care over the past 3 years, the proportion of
PSS expenditure spent on Family and Child Care has fallen, from 17.6% in
1995/96 to 16.7% in 1997/98. England has spent a higher percentage of PSS
expenditure on Family and Child Care than in Northern Ireland in each of the
last 3 years". (25) Figure 1 - Per-Capita Expenditure on
Provision for Children and Their Families (£)
(Source: SSI 1999)(25)
Figure 2 - Percentage of Expenditure
on Provision for Children and Their Families
(Source: SSI 1999)(25)
1.3 Funding the Children Order in Northern
Ireland - Shortfalls In 1994, prior to the implementation
of the Children (NI) Order 1995, the 4 Boards were invited by the Departmental
Children Order Implementation Group to submit estimated costs of enabling Boards
and Trusts to discharge the additional statutory responsibilities which the
Order would place on them. A common framework for presenting the costs was
developed. Each Board then built up from Trust level a detailed analysis of
the services which would be required on the ground. There was considerable discussion
regarding these submissions between Boards and the DHSS. The Department took
a conservative view of the cost implications of the Order, and considerably
reduced the Board estimates in their submission to the 1995 Public Expenditure
survey. Figure 3 - Board and Departmental Estimates
re Children Order Funding
(Source: HSS Boards) In the Departmental bid to
the Public Expenditure Survey, the following areas containing itemised costs
identified by the Four Boards were excluded:
n
Child Protection
n
Family Placements
n
Residential Care
n
Medical Implications It should also be noted that
monies identified in the Departmental bid for legal processes took account
only of the cost of the Guardian ad Litem Agency, and not of additional costs
to Boards/Trusts. Since 1995, the Boards have
received recurring cumulative allocations amounting to approximately £17m (current
prices). Whilst this represents a significant investment in Children's Services,
it falls some £9m (current
prices) short of the Department's Public Expenditure Survey Bid in 1995, and
some £17m (current prices)
short of the amount initially identified by the Boards as necessary. It is important to establish that allocations to
Family and Child Care Programmes in Boards have also been subject to financial pressures
from other Programmes, and in particular from the Acute Health Services sector.
The Eastern Health and Social Services Board has been severely effected
in this respect. As Figure 4 (below) demonstrates, not all of the funding allocated to the
EHSSB was subsequently transferred into Trust baselines:
n
In 1996/97 £16,000 was held
by the Board to cover commissioner costs. The difference between the two
figures other than this was made up of funding which the Board used to contract
with voluntary organisations to provide children's services.
n
In 1997/98 and 1998/99 the bulk of the difference between the figures can be
accounted for by the difference in monies transferred to the Board to fund
the Regional Child Care Centres (Glenmona, Rathgael and St Joseph's) and the
cost of actual usage. The recurrent deficit to the EHSSB
in this regard was £815,000. The remaining differences
can again be accounted for by the Board contracting directly with voluntary
organisations to provide children's services.
n
In 1999/2000 the EHSSB applied
£1.449 million recurrently and a further £1.269 million non-recurrently
from the programme to cover its deficit. In this year the Board applied this
approach pro rata to all of the development money which it received for all
Programmes. In this respect Family and Child Care Services were affected, in
the same way as other service areas, by the needs of the Board to regain and
maintain financial balance.
n
To put this matter further into context it is important to appreciate that
in 1998/1999 alone the Eastern Board invested £3.6m more than the amount which
the regional needs based 2nd Capitation Report would have suggested it invest. Figure 4 - Allocations (£000) to Boards
and Trusts for Investment in Children Order Services,
(*) This variation has been made up in year 2000/01 and allocated accordingly. (Source:
HSS Boards) This paper will demonstrate that
funding calculations need to be urgently revisited, from three perspectives: 1. The 1995 Public Expenditure Bid excluded
key areas which have subsequently proved to be extremely resource intensive
i.e.:
n
Residential Child Care (note that a portion of the allocation made by the Department
has been targeted at Residential Child Care despite its exclusion from the
1995 PES bid)
n
Family Placement provision
n
Child Protection services
n
Medical, paramedical and nursing implications
n
Legal costs 2. The original submission by Boards under-estimated
the true costs of implementation. 3. This under-estimation has been compounded by a number
of subsequent policy developments and initiatives - including
n
Changes in Juvenile Justice
n
Children's Services Planning
n
The NI Child Care Strategy,
Children First (including the Pre-School Education Expansion Programme)
n
Revision of 'Co-operating to Protect Children'
n
SSI Reports (especially Planning to Care 1999 and Fostering in Northern Ireland
1998)
n
National Foster Care Standards and Code of Practice
n
Sex Offenders Act
n
Waterhouse Report - 'Lost in Care'
n
Introduction of the Framework of the Assessment of Children in Need and their
families. CHAPTER 2 2. Supporting Children in Their Families 2.1 Background Briefing The legislative context for Family and Child Care
services prior to the Children Order promoted concentration on services
to protect children who were assessed as at risk of abuse. The Children Order
introduced, for the first time in Northern Ireland, and heavily emphasised,
the provision of support for Children
In Need. In essence, this placed a statutory responsibility on Boards
and Trust to develop personal social services for children who require such
support in order to achieve adequate levels of physical, social and educational
development. This is a much larger constituency of children and young people
than that for which Personal Social Services Departments were previously responsible. The development of services
in this area is crucial for the following reasons:
n
To prevent long term consequences for children of adverse experiences such
as poor health awareness/ uptake of health services, parental instability,
missed education etc
n
To reduce the number of children who are potentially exposed to abuse, and/or
who require child protection services
n
To meet the needs of children
successfully at home and thereby to prevent the need for admission to care.
2.2 Requirements Anticipated in 1995 In 1995 Boards requested
an allocation of £19.34m (current prices) to implement this part (Part 4) of
the Children (NI) Order. This was reduced in the Public Expenditure Survey
bid, and was subsequently over-run by pressures arising from other priorities
which were excluded from the PES bid - for example, residential care, foster
care. 2.3 Emerging Demands 1996-2000 2.3.1 Increased Referrals by Children 'In Need'
Trusts are required to complete
an assessment of all children referred as potentially 'In Need'. In the year
1997/98, 13048 children were referred in this category. Figures from Boards
suggest that the referral rate is increasing significantly over time - in the
period from the fourth quarter of 1996/97, for example, to the corresponding quarter in
1999/00, there was a 69% increase in referrals to the NHSSB, as parents, communities
and a range of professionals have become more familiar with the concept and
the legislation. Children, once assessed 'In
Need', are entitled to individualised Care Plans (care packages), negotiated
in consultation with parents and other professionals, and regularly reviewed.
The increasing level of demand for assessment has the consequence of reducing
time available for direct delivery of services to meet those assessed needs. 2.3.2 Waiting Lists - Unmet Need Information received from
trusts indicates that there are significant numbers of children awaiting individual
service responses in respect of Family Support Services e.g.
(Source: Trust Directors - Unmet Need Return for the Province at 12/5/00) 2.3.4 Article 8 - Private Law Cases In Chapter 1 of this paper,
reference was made to evidence of family breakdown as measured by Court related
activity. Whilst the majority of cases involving marital breakdown are dealt
with in private law, Courts have expected that Social Services will become
involved in the assessment of children's welfare and in the resolution of difficult
contact issues. This has been a significant pressure which is explicitly acknowledged
in the Children Order Report 1999(28) which states that "It is clear
that private law proceedings constitute a considerable workload for HSS Trusts,
and that the potential exists for those demands to increase. Delay in providing
Courts with Welfare Reports will have implications for Court disposal times".
A range of new services to resolve the contentious issues in these cases, such
as Contact Centres, have been requested by the Courts. The above information relates
to the provision of direct Personal Social Services, which forms just one aspect
of the emerging social policy agenda. The other significant developments are
those of: 2.3.5 Children's Services Planning The agenda for the development
of Family Support has been further shaped by the introduction of multi-agency
Children's Services Planning for vulnerable children and children in need.
The Children's Services Planning Order 1998, which is an amendment to the Children
Order, has expanded awareness of the range of children and young people who
are in need. Children's Services Planning
has drawn attention to, for example:
n
Children/Young people in conflict with the law (Youth Justice) The Children Order makes
explicit reference to a new duty on Board/Trusts to take steps to "encourage
children - not to commit
criminal offences". (Schedule 2, 8(b)).
Children in conflict with the law are therefore regarded as children
in need. This is a significant departure from previous practice which gives
Trust what is in effect a new area of responsibility for diversion.
The demand on Personal Social Services in the field
of Youth Justice has been further emphasised through: (a)
the implementation of the Juvenile Justice (Children) Order, in 1999
which has significantly reduced the numbers of serious offenders given custodial
sentences in favour of community based disposals which require intensive care
planning.
(b)
The Criminal Justice Review Consultation Paper which has proposed that
full responsibility for the management of young offenders under 13 years should
rest explicitly with Trusts, under their 'Children in Need' responsibilities. It is anticipated that the
provisions of the Human Rights Act will further underline the need for individualised,
negotiated, community based programmes for young offenders. Other demands in
this area are emerging from the Police led development of inter-agency Juvenile Justice Bureaux and Children's
Panels, and from the piloting of restorative justice projects. Youth Justice provision will
also be addressed in Chapter 4 of the paper on residential care. This is one
prominent area where Personal Social Services Departments have been mandated
by the Children Order to undertake, and are faced with, because of legal and
policy developments, significant responsibilities in an area in respect of
which no provision has been made for resourcing.
n
Children who are Excluded/Suspended from School It is a central contention
of the Government's Social Exclusion agenda that, with appropriate inter-agency
support, schools
can make a difference to outcomes for pupils with a range of difficulties.
There is evidence of
significant overlaps between children excluded or suspended from the school
system, and children known to Social Services Department, Probation Departments, Police and Health
Professionals. National Research has estimated, for example, that truants are more than
three times more likely to offend than non-truants(31). A study commissioned by DENI,
published in 1999, estimated that, in the year 96/97, 2631 pupils were reported
as having been suspended from school in Northern Ireland(32).
n
Child and Adolescent Mental Health Services The accessibility of high
quality assessment and treatment programmes for children who have significant
emotional, behavioural, psychological
or psychiatric needs is an issue which effects all of the children/young
people described in this paper. Epidemiological studies have shown repeatedly
how common mental health problems are in children, and that severe disorders
can give rise to devastating handicap in later life(33). Research has
suggested that, in the UK, 50% of young offenders on remand, and 30% of those
sentenced, suffer from diagnosable mental disorders(34). On 31/1/00, Directors in 10 of the Trusts estimated
that 603 children were on Child and Adolescent psychiatric waiting lists, and 14 were
in adult mental health and learning disability hospitals(35). Waiting
lists have often developed as the result of the lack of services
offering earlier intervention when needs were less pressing. The current under-provision
(there are only 6 inpatient adolescent beds) in Northern Ireland has led to
highly inappropriate placements of children and young people in adult psychiatric
environments. In addition, Children's Services
Plans have addressed the needs of children and young people who are Homeless, and the needs of Young Carers.
2.3.5 Children With a Disability (including Sensory
Impairment, Physical Disability and Learning Disability) A highly significant area is that of Children with
a Disability, who are explicitly defined as Children In Need in the Children Order. It
has been estimated that 35 children per 1000 of the under 16 population in
Northern Ireland have a disability (compared to 32/1000 in GB)(36). Children/young people with
a disability are entitled to a multi-disciplinary assessment and, if necessary,
a co-ordinated care package of specialist services tailored to meet their individual
needs. The Children Order emphasis that Children with
a Disability are Children First requires that a child's needs be met within families and communities,
for example, children with learning disabilities and other complex needs
are no longer admitted to continuing care hospitals, but are supported at home
by their carers through a repertoire of services. The development of services
acceptable to families is currently the subject of work undertaken in each
of the Children's
Services Plans, and represents a significant challenge for statutory agencies
and a significant commitment of resources. The regional prevalence rate
suggests that in the region of 15,000 children potentially may be entitled
to a child in need assessment. At present, only a fraction are known to Personal
Social Services Department. The task of agreeing a regional model for establishing
and maintaining Registers of Children with a Disability is under way. When
completed, this will further emphasise the profile of this group. Children with disabilities
and other complex needs, as children in need, with the associated services
pressures, have not been
universally included in the funding of Child and Family Services. Children
and young people with disabilities and mental health problems continue
to be integrated within adult programmes of care. The aspirations contained
in the Children Order set out clear ambitions for services for children with
disabilities and other complex needs, which have not been strategically factored
into the development and resourcing of services. 2.3.6 Children First - the Northern Ireland Child
Care Strategy As part of the wider social
policy framework, the Northern Ireland Child Care Strategy emphasises the availability
of high quality affordable child care for children aged 0-14 years, in every
neighbourhood. This development, managed through inter-agency Childcare Partnerships,
is placing emerging demands on Personal Social Services: (a)
Boards and Trusts have a statutory responsibility to register, inspect
and support child care provision. The Departmental Circular HSS (cc) 2/99 has
identified good practice standards which Trusts are attempting to implement.
The rapid expansion of services is placing unexpected considerable demand on
Registration and Inspection Units.
(Approximate) Child Care Provision - Child
Care Partnership figures 1999-2000 In the case of
childminding alone, one Trust in the WHSSB estimates that assessment and registration
requires 17 hours of staff time, with a further 5 hours of staff time required
for annual review(37). (b)
A considerable amount of funding in this area has historically been
of a short-term nature. In the Childhood Fund for example, approximately £30m
was made available to develop Early Years Services. These are services with
long-term funding implications. Finance for development has also been made
available from other sources such as NIVT and District Partnerships. Boards
and Trusts will be under considerable pressure to maintain these services once
existing funding has ceased. It is noted that
Northern Ireland continues to fall seriously behind in respect of investment
in programmes introduced in England and
Wales to combat the effects of poverty and social exclusion on children e.g.
n
The Sure Start programme
is substantially better financed, and was introduced considerably earlier,
in England and Wales. 2.3.7 Additional Policy Impacts There are increasing expectations
in the voluntary and community sector of core funding from Boards and Trusts
in relation to other services. The European Union Special Support Programme
for Peace and Reconciliation has enabled a wide range of voluntary and community
groups to develop high quality services for children in need and their families.
These projects to a large degree have embraced Targeting Social Need and community
development approaches. They are well integrated and accepted within local
communities experiencing high levels of social disadvantage. As these time-limited funding arrangements come
to an end, organisations are increasingly turning to Boards and Trusts to provide mainstream
financial support. While additional monies may be made available by the
European Union, an increasing number of projects will need core funding. This
issue does not only apply at local level, but also at regional level - examples
of major voluntary organisations which could be affected include: Parents
Advice Centre, NICMA, NIFCA, NIPPA, Children's Law Centre, NSPCC, Homestart,
Barnardos, Relate, Women's Aid. Policy developments in the
areas of Community Development, Health (Health Action Zones, Healthy Living
Centres) and Targeting Social Need also require inputs from Boards and Trusts.
Investment in partnerships, needs assessment projects and in new service developments
undoubtedly have the potential to strengthen services which support and are
acceptable to families.
CHAPTER 3 3. Keeping Children Safe 3.1 Background Briefing A key statutory responsibility
of Boards and Trusts is related to the protection of children and young people.
Each Board has established an Area Child Protection Committee to monitor and
develop its child protection services. These are inter-agency committees, emphasising
the need for maximum collaboration in this area of work. The core professionals
mandated by the legislation to implement the extensive regulations are Social
Workers in Family and Child Care Programmes. Researchers have openly acknowledged
the difficulty of accurately measuring the incidence of child abuse (38). Studies
are much more specific, however in identifying long-term consequences for children
who suffer serious abuse.
In Northern Ireland, 3264
child abuse investigations were undertaken in 1998, of which 65.4% were carried
out by Social Workers and 32.4% jointly by Social Workers and Police. There
were, on 31/3/98, 1386 children on child protection registers, representing
30.1 children per 10,000 under 18 years. This compares with a figure of 28
per 10,000 in England(45). 3.2 Anticipated Requirements in 1995 Collectively Boards anticipated
requiring £3.27m (at current price levels)
to enable them to effectively discharge their responsibilities for child protection
under the new legislation. In the event, the DHSS did not release any monies
specifically for this purpose. 3.3 Emerging Demands 1996 - 2000 In the period since initial
implementation, the Children Order has generated the following increases in
demand in respect of child protection work; 3.3.1 Operational Complexity The Child Protection process is complex and resource
intensive. Procedures, which are based on legislation and Departmental
policy, and which are mandated by each Area Child Protection Committee, set
out detailed guidance on how to manage:
n
Investigations (including joint Social Work-Police protocol)
n
Initial Child Protection Case Conferences
n
Parental consultation and involvement/participation of children
n
Decisions about registration
n
Comprehensive family assessments (recently revised and updated)
n
Child Protection plans
n
Review Case Conferences
n
Decisions about de-registration Children on Child Protection
Registers attract high levels of co-ordinated service. Research indicates that
the majority remain in their families and communities(46).
Child Care Managers estimate
that the time needed to carry out Child Protection procedures has, at least,
doubled since 1995
because of additional procedural guidance, and emphasis on parental and child
participation. 3.3.2 Refocusing The number of children on
Child Protection Registers, whilst significant, should not be read as the only
measure of activity in this area of work. The 'refocusing' agenda signalled
by the DHSS study 'Child Protection
- Messages from Research'(48) has led to greater emphasis, where possible,
on managing family and child care cases, without resort to the
formal Child Protection procedures. Area Child Protection Committees, following
departmental guidance, have taken strategic decisions to try to raise the threshold
for Child Protection Registration, and to promote family support services which
are preventative rather than reactive. Trusts report that services are increasingly
demanded for children and families with high levels of need, but who have
not crossed the threshold for Child Protection registration. Professional judgements
are no less complex in this area. Whilst such cases do not warrant the
same level of procedure as cases on the Child Protection Register, the time
needed for direct input with clients and for case planning, can be considerable
. It is important to note that
the retraction in residential care places (see Chapter 4) has also impacted on risk management in the community,
in that numbers of children who require residential care have to be supported
at home pending identification of an appropriate placement. 3.3.3 Court Work Where it has been necessary
to instigate legal action in order to protect children, it has become evident
that the time needed by social workers for the Court process has increased
significantly. In the period 01.04.97 to 31.03.98, Courts made 60 Emergency Protection Orders and 324
Care and Supervision Orders. The legal process can be protracted - during
the above period, the average disposal time in Family Proceedings Courts was
9.7 weeks(49). The attached Case Summary is not regarded as untypical.
There have also been significant cost pressures for legal support, including
the use of expert witnesses.
3.3.4 Impact on Direct Work with Clients The increased demands on
social work time arising from processing child protection cases and cases in
the court system, reducing time available for direct work with children who
have experienced abuse. 3.3.5 Additional Pressures The demands outlined above
are directly related to the operation of the Children Order. Resource implications
have arisen for a number of other developments which would not have been anticipated
at the time when Boards were making their preliminary calculations. These include: Management of Sex Offenders There have been a number
of developments in respect of therapeutic programmes for young abusers, and
each Board has developed projects. In the SHSSB for example, the Juvenile Perpetrators
Project has worked with almost 100 young abusers in the past 3 years. This work is
intense, with the programme taking a minimum of 6 months, and a proportion
still being engaged after 2 years. The issue of the management of adult sex
offenders in the community has attracted a high public profile recently, drawing
attention to the complexity and sensitivity of the issues. Domestic Violence As already indicated, awareness
of the links between child protection and domestic violence has been heightened,
increasing the risk profile of families where such patterns exist. Trusts have
developed Inter-Agency Domestic Violence Forums, in order to ensure that collaboration
is well developed. Area Child Protection Committees have also drawn attention
to the links between domestic violence and child abuse. CHAPTER 4 4. Children Who Are Looked After by Boards and Trusts 4.1 Background Briefing 2354 children were Looked
After in 1997/98, 10% fewer than in 1995/96 (51). The rate of Looked After
Children per 10,000 in Northern Ireland (at 51.1) remains higher than in England
(at 47.2). The provision of services
to children who are in care is another key statutory responsibility of Boards
and Trusts. For
the majority of children, 'care' refers to placement with a foster family (64%)
or in a residential unit (11%). The Children Order also provides for
children to be placed with relatives or friends who will be subject to formal
assessment and approved as foster carers. A number of children (21%) are placed
at home but subject to Care Orders
and continued monitoring by Trusts. Children Order Regulations and Guidance
have greatly expanded the range of procedures associated with the management
of the Care System. Trusts have estimated an increase in staff time by a factor
of three, compared to pre-Children Order requirements. Children enter the Care System
whenever it is no longer possible to maintain family life. The majority of
such children bring with them complex and traumatic experiences associated
with abuse, separation, loss etc. Most are able to go home within 12 months, but in 1997/98 for example,
one child in every five (21.8%) had been in care for more than three
years(52). Regional and national research studies have recorded
the vulnerability of young people who have had to grow through adolescence
in the care system, to:
n
Substance and drug abuse(53)
n
Mental health problems(54)
n
Involvement in crime(55)
n
Teenage pregnancy(56)
n
Poor emotional health(57) The Quality Protects Policy, whose introduction
in Northern Ireland is expected, is based on the realisation that services
for children and young people in care need to be greatly improved and resourced.
Attention is drawn to the extent to which Northern Ireland has fallen behind
in England and Wales, where this policy has been operational from several years.
'Quality Protects' is part of a concentrated drive to address the deficits
described above, by providing additional investment in services which are linked
to specific targets and outcomes. The effectiveness of this approach has been
demonstrated in England. This section of the paper
will look at five key themes relating to the operation of the care system:
n
General residential provision
n
Specialist residential provision
n
Family placements
n
Leaving and After Care services
n
Adoption - permanency planning 4.2. Anticipated Requirements in 1999 Board submissions in respect of residential care
and family placements were excluded from the Departmental submission
for funds to the Public Expenditure Survey 1995. Very soon after the advent of the Children Order
1999, it became clear, as had been anticipated by Boards, that there
were to be significant implications and pressures arising from the requirement
to satisfactorily respond to the needs of Looked After Children. 4.3. Emerging Demands 1996-2000 4.3.1 General Residential Provision The introduction of the Children Order coincided
with major downsizing of the voluntary residential child care sector.
This culminated in the Department undertaking a regional review of residential
child care leading to the publication of 'Children Matter' (SSI 1998). This
report has been approved by the Minister of Health, Social Services and Public
Safety as providing the definitive agenda for future development and provision
of residential child care. It concluded:
n
there was insufficient number of places to meet demand;
n
urgent action was required to expand provision;
n
the lack of differentiation within homes led to resident population in each
home with conflicting needs. At best this resulted in unsatisfactory living
conditions for children and at worst situations where their protection and
well being was compromised;
n
the lack of specialist provision resulted in a range of inappropriate placements
for children with psychiatric needs, those with a disability and those at risk
of offending;
n
children and young people should be looked after as close to their home as
is possible;
n
provision should not be located on campus sites. In response to Children Matter, the four Boards
in collaboration with Trusts prepared a detailed plan which outlined
an integrated approach to implementation across the four Health and Social
Services Boards. There was a very clear acknowledgement of the pressures being
faced by Trusts which can be listed as:
n
Inability to admit children to care when required.
n
Lack of choice of placements to meet children's needs.
n
Inappropriate placements.
n
Overcrowding.
n
Children having to share rooms inappropriately.
n
Rise in number of serious untoward incidents in children's homes.
n
Inability to access secure accommodation.
n
Inability to protect adequately children who are absconding.
n
Inability to control violent and aggressive children. The four Board report concluded on the need to
increase the level of child care places by approximately 30% from 352 places to 453. This
paper detailed the way forward over the next five years and provided costings
which showed a minimum
capital requirement of £25million and revenue
requirement of £10.5million. The Trust Directors have
provided details on unmet need as at the end of May 2000 which reinforces the
urgency for action and resources.
(*) Accommodation in Regional Child
Care Centres (Source: Trust Directors)(58) It is noted that the Department
of Health, Social Services and Public Safety has now established a Task Force
to take forward the implementation of 'Children Matter'. 4.3.2 Specialist Residential Provision A further area of particular
concern has been the lack of specialist provision for young people with mental
health difficulties and those with a learning
disability and challenging behaviour. The "Caring for Young Minds"
(QUB) (59) report indicated that increasingly young people were being admitted
to adult wards as a result of lack of age appropriate provision. There is evidence of an increasing
number of young people with a history of offending who are beyond parental control and whose needs cannot
be met by community based alternatives.
The needs of these children are placing additional
strains on mainstream residential childcare services which are already
under considerable stress in the discharge of statutory responsibilities. In
the longer term these needs should be appropriately met through the implementation
of the proposals for the development of residential childcare services
based on locally differentiated and specialist models and through other community
based alternatives. However until these models are fully implemented there
is an urgent need to secure interim arrangements which will provide a response
to the needs of such young people and will ensure as far as possible their
safety and well-being. With regard to children with a disability it is recognised that
they are extremely vulnerable and the current configuration of provision falls far short of meeting
their needs. As stated in Children Matter, there remains a need to carry out a detailed
study on demand and requirements, particularly in order to avoid inappropriate
hospital placements. Children with a disability
availing of respite are deemed to be Looked After within the legislation. They
are therefore subject to LAC Review procedures etc., similar to children in
residential or foster care. This brings particular safeguards but also consequent
resource implications which have not been adequately recognised within Children
Order allocations to date. 4.3.3 Family Placement - Foster Care As with residential child
care this service area was not accepted for inclusion in the Departmental submission
for PES funding. The original submission from
the four Health and Social Services Boards included a substantial bid for Family
Placement amounting to circa £1.8million. The order has resulted in a significant
impact on the workload of foster care teams.
n
Requirement to undertake annual reviews of foster carers.
n
The impact of quality living standards. The pressures and demands
on the service is reflected in the numbers of children waiting on family placement. September
1999 - 143 January 2000
- 290 May 2000 - 303 (61) Trust staff report that the
needs of children seeking admission to Care are becoming more complex. The
level of demand should not be underestimated and is reflected in the recruitment
and retention of foster carers. Research indicates that effective recruitment
and retention requires dedicated support workers for foster parents, and better
training to assist in the management of children with complex needs. Issues
are also emerging which merit the development of remuneration systems linked
to payment for skills. There is a strengthening lobby which argues that the
fostering services need to move from a voluntary to a professional basis. The demand for services,
as well as pressures for retention and recruitment have necessitated that foster
care payment rates have been increased at the rate of 4% per annum over the
past three years. The only source of funds has been finance diverted from the
implementation of the Children Order. There remains a shortfall in rates payable
to foster carers in Northern Ireland in contrast with the United Kingdom.
There is a recognition that
foster care and residential care are inextricably linked. Recent allocation
letters from DHSSPS have emphasised the need for the further development of
both services in tandem. Finally, UK National Foster
Care Standards and Code of Practice for Foster Care Recruitment, Selection,
Training and Support were launched in 1999. The implementation of these documents
is proving to have significant financial implications for Boards and Trusts. 4.3.4 Permanency and Adoption There is consensus about the need to plan intensively for children who
come into the care system, so that those children who will not be able to return
to the care of their parents can be identified quickly, and so that permanent,
long term, family placements can be identified. Research demonstrates that
adopted children enjoy better long-term outcomes than children in Care (63). Emerging evidence from the
current SSI inspection of adoption services suggest that there are children
for whom permanency planning
has been less than adequate. There remain many children within the Looked
After system where permanency needs could have been met through adoption. Reports
have highlighted:
n
children with multiple placements
n
'drift' in care
n
problems with obtaining freeing
orders, which places significant demands on social work time and associated
legal costs. Adoption work is resource intensive. There is a
need to radically revise methods of recruitment, assessment and preparation
for prospective adoptive parents. This is reflected in recent government pronouncements,
particularly from the Prime Minister. There is a need to enhance support services
for adoptive parents post adoption. Better counselling services to address
the needs of birth parents are required. As the characteristics of adopted
children change, and children with more complex needs are adopted, family support,
therapeutic and recovery services will be needed. The adoption allowance scheme
needs to be extended. Finally inter-country adoptions are increasing considerably
in numbers. While charging for assessments may address some of the funding
issues associated with this, a considerable amount of scarce expert social
work time is required to carry out assessments. Furthermore the implications
of any subsequent breakdown in placement or need for services will be felt
by the host Trust. It should also be noted that
the Children Order enables permanency to be established through the granting
of Residence Orders
to, for example, long-term foster carers. The loss of financial support, under
the current system, however, is a deterrent. The development of a pro-active
quality adoption service requires investment, and the service is currently
under review by the Social Services Inspectorate. Proposals for the development
of a regional service should be examined. 4.3.5 Leaving and After Care It is only within the past
few years that greater recognition has been afforded to the rights and needs
of young care leavers. As the research studies referred to in the opening paragraph
of this chapter indicate, Boards and Trusts have to be concerned about improving
outcomes for Looked After children. As Corporate Parents they have clear
responsibilities for preparing the young people for independent living and
supporting them in the transition to adulthood, and it is anticipated that
this will be emphasised in terms of specific monitoring and outcome targets
on the introduction of 'Quality Protects' in Northern Ireland. A survey of HSS Trusts in
1999, revealed that between 1996 and 1999 a total of 665 young people aged
16 - 18 became care leavers. 164 of these young people were aged 16 (25%)(64). The Children Order places
a responsibility on Trusts to provide support to care leavers up to age 21,
and beyond in exceptional circumstances. The development of these services
has been uneven across the four Boards. In some areas responsibility for Leaving
Care and Aftercare is not designated whilst in others there are specific teams
to provide this services. The expertise in these teams has resulted in the
ability to identify a series of complex needs of these young people in areas
such as:
n
Financial support
n
Training and employment
n
Social and emotional support. Voluntary organisations representing
young people and foster carers in Northern Ireland - for example, First Key,
VOYPIC, NIFCA - have emphasised the need for investment in high quality support
services, and the issues have been given government recognition and endorsement
in the Children (Leaving Care) Bill which is being progressed through Parliament.
Whilst the Bill may not be immediately enacted in Northern Ireland, Care Leavers
are entitled to expect the same standards and level of provision which apply
elsewhere. The implications will include the following measures:
n
Regulations to be made placing a duty on local authorities to provide general
assistance to those 18-21 year olds, either in kind or in cash.
n
The appointment of a Personal Adviser for each young person.
n
Authorities must keep in touch with these young people until they reach the
age of 21 (or 24 if the authority are helping them with education and training).
n
Authorities will be required to make available a wide variety of places including
accommodation with associated support and training opportunities, supported
lodgings, house shares as well as independent and semi-independent flats. CHAPTER 5 5. Summary and Recommendations 5.1 Summary This paper has demonstrated
the key characteristics of Family and Child Care provision in Northern Ireland.
It has been argued that:
n
The proportion of the 0-18
year old population in Northern Ireland is significantly higher than in England.
n
There is evidence that more children and young people live in circumstances
characterised by poverty and deprivation than in other parts of the UK.
n
Factors such as trends in
alcohol misuse, changing patterns in family organisation, and greater awareness
of the extent and
impact of domestic violence have impacted significantly upon levels of need
and demand.
n
Levels of disability are higher than the UK average.
n
The transition from conflict is a unique feature, and the consequences for
children and young people are not yet fully understood or documented. The Children Order 1995 greatly
expanded the responsibilities placed on Social Services Agencies. The paper
has drawn attention to a number of areas where demand for Family and Child
Care Services has outstripped supply, and when the quality of service is unable
to meet need - in particular attention is drawn to:
n
Serious under-provision in residential care
n
Serious pressure on fostering services
n
Serious pressure on statutory fieldwork services
n
Deficits in family support provision. The situation has been compounded
by policy developments which have occurred since the Children Order was introduced,
including:
n
The need for youth justice provision
n
The need for core funding of voluntary and community organisations in order
to sustain early years/ family support provision.
n
The paper has argued that funding for Family and Child Care Services in Northern
Ireland has been inadequate, on the basis that:
n
Board estimates in 1995 of the cost of funding the Children Order were not
accepted, and were subject to revised, downward estimation in the 1995 PES
bid. Key services only were excluded.
n
Subsequent allocations have fallen short of the 1995 PES bid.
n
Per-capita expenditure of Family and Child Care Services in Northern Ireland
has fallen below the rate in England, as has the percentage of total expenditure
over a number of years.
n
Key areas of service development have not been funded.
n
Important national policy initiatives have either not been introduced in Northern
Ireland, or have been introduced late and with diminished funding. 5.2 Recommendations 5.2.1 Urgent Review of Children Order Funding There should be an urgent
review of the funding requirements for implementation of the Children Order
over the next five years. This should be undertaken by an appropriately convened
Task Group. 5.2.2 UK Policy Initiatives There should be a review
of social policy initiatives which have been introduced in England and Wales,
but which have either been delayed, or which have not been made available,
in Northern Ireland. 5.2.3 Quality Services for Looked After Children A commitment is required from the Department of
Health and Social Services and Public Safety, to produce urgent proposals
to drive up quality, governance and accountability for children in Care. The
need for a Northern Ireland version of 'Quality Protects', with additional
resources tied to targets and outcomes, is being emphasised. 5.2.4 Children Matter A major drive to secure the capital and revenue
resources to ensure that 'Children Matter' is implemented, and to achieve
real additionality, is required. 5.2.5 Youth Justice A commitment is required from Government to review
the impact of recent legislation and policy developments in Youth Justice,
with particular emphasis on the reduction in NIO provision, and the consequent
demands on Board/Trust Family and Child Care Services to provide additional
services. An appraisal of organisational arrangements to promote integrated
service delivery is strongly indicated. 5.2.6 Foster Care There needs to be a comprehensive review of foster
care provision, in order to develop a strategic approach geared to the
assessment needs of children and young people over the next 10 years. 5.2.7 Early Years A commitment is required
to promote and sustain Early Years Services as a means of breaking into the
cycle of deprivation on families, by means of: (a)
An urgent review of the potential effect of withdrawal of European Funding
on services. (b)
A review of Sure Start funding arrangements in comparison to England,
and a commitment to develop this initiative. References (1) The Children Order states that a child
shall be taken to be 'in need' if (Art. 17): (a) "he is unlikely to achieve or maintain, or to have the
opportunity of achieving or maintaining, a reasonable standard of health
or development without the provision for him of services by an authority .. (b) his health or development is likely to
be significantly impaired, or further impaired, without the provision for him
of such services (c) he is disabled." (2) Article by Dr Henrietta
Campbell, Chief Medical Officer, NI in 'Promoting Health', Nov '99 (3) The Health Behaviour of
School Children in Northern Ireland, WHO 1997/98 (4) Rutter & Madge 1976,
Pilling 1990 (5) Kilpatrick et al, DENI,
1999 (6) SSI Paper 'Children in
Northern Ireland - An Overview' 2000 (7) DENI Statistics (28.07.00) (8) Child Protection - Messages
from Research, HMSO 1995 (9) Reducing Alcohol Related
Harm in Northern Ireland, DHSS Project Team, June 1999 (10) The Health Behaviour of School
Children in Northern Ireland, WHO 1997/98 (11) Chief Constable's Report
1999/2000 (12) Children Order Report, DHSS,
1999 (13) Relate Northern Ireland -
Annual Report 1998-99 (14) Divorce & Separation
- The Outcomes for Children, Joseph Rowntree Foundation 1998 (15) NI Woman's Aid Federation
Statistics (16) Briefing Paper - Domestic
Violence and Child Protection, Western ACPC, June 2000 - (unpublished) (17) SSI Paper - Children in Northern
Ireland - An Overview 2000 (unpublished) (18) The Institute of Fiscal Studies
1995 found that 75% of children growing up in lone-parent families were living
in poverty, compared to 18% from 2 parent families. (19) Population and Trends No.95
Spring 1999 ONS (20) Fay, Morrisey, Smith, 1997
'Mapping the Troubles' (21) Bloomfield Report 'We Will
Remember Them' 1998 (22) [1] Omagh Community Study
1999 & [2] The Omagh Children's Study 1999 - Sperrin Lakeland Trust (23) Fay, Morrisey, Smith, 1997
(page 46) (24) See Getting It Right - the
State of Children's Rights at the end of the 20th Century, SCF 1999 (25) Key Indicators of Personal
Social Services in NI, SSI 1999, p14. (26) Report of the National Commission
of Inquiry into the Prevention of Child Abuse - NSPCC publication 1997 (27) The Report of the National
Commission of Inquiry into the Prevention of Child Abuse 1997 notes that "there
are substantial funds that, at least in principle, could in part be transferred
to support the prevention of abuse. On the other hand, it is also evident that
until preventative work can be better established, it would be unacceptably
risky to diminish formal child protection work. Inevitably this means that
some extra resources will be required in the short term to enable the necessary
preventative work to develop" (page 13). (28) Children Order Report 1999,
DHSS (29) RUC - Chief Constable's Report
1999/2000 (30) SSI Paper - Children in Northern
Ireland, An Overview 2000 (31) Kilpatrick, Barn, Wylie,
The 1996/97 Northern Ireland Suspension and Expulsion Study, DENI (32) Home Office Research Study
145, (1995) (33) Graham PJ (1996) in Childhood
Epidemiology, British Medical Bulletin (34) Youth Crime Update, Fact
Sheet No.6, British Youth Council 1999 (35) SSI Paper - Children in Northern
Ireland - An Overview 2000 (pages 33-36) (36) Policy, Planning and Research
Unit, 1992,DHSS (37) Figures from Sperrin Lakeland
HSC Trust (38) Child Protection - Messages
from Research HMSO 1995 (39)
Palmer et al (1990) (40) BLISS (1984) (41) Harrington, Fudge, Rutter,
Pickles, Hill (1990) (42) One Way Street, Children's
Society 1999 (43) 'The Fundamental Facts --
All the latest facts and figures on Mental Illness' The Mental Health Foundation
1999 (44) Childhood Matters - The Report
of the National Commission of Inquiry into the Prevention of Child Abuse, NSPCC
1997 (45) Key Indicators of Personal
Social Services for Northern Ireland - SSI 1999 p35-36 (46) HMSO Studies in Child Protection
1995 - 'Child Protection - Messages from Research' (47) Sperrin Lakeland HSC Trust
figures Augus 2000 (48) HMSO Studies in Child Protection
1995 - 'Child Protection - Messages from Research' (49) Children Order Report 1999 (50) Case Study - supplied by
Foyle HSS Trust (51) Key Indicators of Personal
Social Services, SSI 1999 (52) Key Indicators of Personal
Social Services SSI 1999 (53) Saunders & Broad 1997 (54) Audit Commission 1999 (55) Graham & Bowling 1995 (56) Garnett 1992, Pinkerton &
McCrea 1996 (57) West 1995, Canham 1997, McCann
et al 1996 (58) Trust Directors, Summary
of Unmet Need 2000 (59) QUB ' Caring for Young Minds' (60) SSI Paper - Children in Northern
Ireland - An Overview 2000 (61) Trust Directors Summary of
Unmet Need 2000 (62) SSI - Fostering in Northern
Ireland - Children and Their Carers 1998 (63) Permanency Planning for Children;
Adoption - Achieving the Right Balance HSS Circular May 1999 (64) Children in Northern Ireland
- An Overview 2000 Appendix 2 The Medical/Child Protection Interface I would wish to make the
following comments from the perspective of my role as Consultant Community
Paediatrician with a specialist interest in Child Protection. The investigation
of alleged child abuse should be multi-professional and co-ordinated to minimise
distress to the child and family. The principle aims
of a full medical assessment in suspected child abuse are to:
n
Establish the need for treatment
n
Provide information which might support the allegation, as well as, in
due course, sustain care plans and criminal proceedings
n
Offer reassurance to the child and family
n
Plan ongoing health care Roles and Responsibilities of Medical Staff General Practitioners: The first point
of contact is often the General Practitioner. They may be involved in the detection
and notification of suspected abuse, or they may be asked to make a judgement
on the accidental versus non-accidental nature of presenting injuries. Depending
on the level of their expertise they may either give a clinical opinion, or
refer onward to the Consultant Paediatrician for a further opinion, if the
child is in urgent need of medical attention Accident and Emergency may be
used. They often have a
great deal of information on the family, but may find it difficult to divulge
this, as it will have subsequent
difficulties for relationships with the family, and there are concerns about
disclosing family information because of confidentiality. Forensic Medical Officers (FMO): are employed by the Police
Service of Northern Ireland particularly in relation to gathering forensic
evidence in child sexual abuse. Physical Abuse or
Emotional Abuse/Neglect requires specialist assessment. Forensic Medical Officers
should conduct examinations jointly with an appropriately trained Consultant
Paediatrician - acute or community, using up-to-date equipment etc. Accident and Emergency Staff: may be presented with a
range of children from physical abuse to burns, fractures Non Accidental
Injury, unexplained child deaths etc. They usually work closely with the local
Consultant Paediatrician in child protection but they must have a high index
of suspicion to child protection issues and junior staff need training as they
often work single-handed at night. Junior Medical Staff: also first point
of contact and need training and supervision. Staff Grades/Associate Specialists in Community
Child Health: currently they often act as Core Members at Case Conference.
They need to be up-to-date with procedures, the interpretation of medical issues
etc and have an importance liaison role with Social Services and the Child
Protection Nurse Specialist. The roles of the
various Doctors are often not clear. Trusts should have
a named Paediatrician for child protection with this role well understood and
accepted by all relevant professionals. It would seem that there has been resistance
to the implementation of this in Northern Ireland and this Doctor must be considered
as a key stakeholder within a truly multi-disciplinary service. The role must, of course,
be resourced and I believe that this person would be key to liaising and communicating
with General Practitioners within the process but especially inputing
to the case planning stage and case conferences. Routes of referral
for children suspected of having been abused Children suspected
of having been abused can be referred for medical assessment in a number of
ways often depending on the initial professional involved. Social Services usually refer
children directly either to their General Practitioner or a named Consultant
Paediatrician (when a decision would be taken on timing of assessment
- either immediate or within a few days, depending on the particular concerns) General Practitioners
may refer children to a variety of professionals
n
Accident and Emergency Departments immediately
n
Consultant Paediatrician following direct discussion
n
Acute Hospital Paediatric Unit following discussion with SHO/Registrar on-call. PSNI will usually
ask for assessment by a FMO and examination is usually carried out in CARE
Unit suite or by a GP in their own practice premises. Occasionally PSNI may
request input from a Consultant Paediatrician. Consultant Paediatricians
may ask for a second opinion from a colleague in certain circumstances. They
may ask, or have arrangements with PSNI, for joint medical assessments with
FMO if they think forensic samples may need to be taken. This request may be
facilitated by the FMO or refused depending on the geographical area or the
particular FMO involved. There is therefore
a lack of clarity about appropriate referral pathways for various professional
staff which needs to
be addressed to avoid assessments being carried out by inappropriate professions,
needing repeated or being conducted at inappropriate times for children
and their families when they could be delayed. The referral process should
not depend on who sees the child first but on the nature of the concerns and
needs to be applied consistently. Setting for examination
of Children Children suspected
of being abused are examined in a number of venues:
n
GP surgery
n
Hospital Accident and Emergency Department
n
Acute Paediatric Unit
n
Community Child Health Facility
n
PSNI CARE Unit Regardless of the
location of the facility it is important that it be child-friendly and non-intimidating.
In particular cases of CSA an Accident and Emergency Department is not appropriate.
Specific units do exist for assessment of children throughout Northern Ireland
but as there is currently no standard requirements for professions can be reluctant
to utilise them for a variety of reasons. Facilities/Equipment
for Assessment of Children who are suspected of abuse A child-friendly
facility is vital with opportunities for the child to play and feel as relaxed
as possible and privacy issues for the child and family provided for. In cases of physical
injury it will be important to have access to a haematology laboratory for
coagulation studies, radiology facilities and medical photography for documenting
injuries. (Although problems exist if the case is subsequently subject to legal
proceedings as only police photography is admissible in Court - the Consultant
Paediatrician has therefore to predict this at an early stage and involve PSNI
before any decision about likelihood of deliberate physical injury has been
made). In cases of possible
Child Sexual Abuse additional facilities should be available. It is considered
good practice for a
permanent record (still photographs or video) of the genital/anal findings
to be obtained. These images are usually obtained via a colposcope.
This is desirable for the following reasons:
n
It allows a permanent record which can later be viewed by other colleagues/experts
for the purpose of second opinion in clinical circumstances or legal proceedings
thus preventing any need for repeated examination of the child.
n
It can be accessed for peer review of cases.
n
It can be used for teaching purposes for medical staff. Obviously all of
the above is dependent on informed consent of the person with parental responsibility
and the child if appropriate. Assessment of Children
with possible Sexually Transmitted Diseases This is an area of
practice with considerable difficulty. The prevalence of Sexually Transmitted
Infections (STI) in sexually abused children depends on the prevalence in the
"abusing" population but studies in the UK estimate 2-13% sexually abused children
developed STI. The detection of
STI in children is of vital importance as failure to treat can lead to long-term
complications for the child and presence of infection may be used as corroborative
evidence in legal proceedings. Currently FMO's do
not take bacteriological/virological swabs or samples for STI. A pre-pubertal
child may be referred
to adult GUM Clinic to obtain samples. This is entirely unsatisfactory, as
it requires a further examination in facilities which are not child-friendly. Consultant Paediatricians
also have difficulties investigating for STI. Most hospital microbiology laboratories
do not procedures for fulfilling chain-of-evidence requirements so if an STI
is discovered there are difficulties presenting this as evidence in legal proceedings
and some of the microbiological techniques used to not fulfil evidential requirements.
These issues need addressed on a Regional basis. Emotional Abuse/Neglect Standards for follow-up
of non-organic failure to thrive need to be agreed as these children constitute
the largest category in the child protection registers in Southern Health and
Social Services Board. Clear pathways for paediatric monitoring and follow
up of these vulnerable children need to be developed. This is the clear remit
of a Consultant Paediatrician with expertise in child protection. Fabricated or Induced
Illness Royal College of
Paediatricians and Child Health publication in February 2002 outlines clear
procedures for medical assessment and evaluation where such problems are suspected. There are significant
training issues for all staff. The level of their training should be appropriate
to the relevant professional i.e. Social Worker will need a different level
of training to the Consultant Paediatrician. In summary I believe that
there are significant issues for doctors that need to be considered. These
include resources and training. The training should involve health visitors
and social workers who need to know and accept the role of the designated doctor
concept, as I believe it would lead to better multi-disciplinary communication
which seems still to be the basis of many case management reviews and inquiries
in child protection.
DR MINA HOLLINGER WRITTEN SUBMISSION BY: 9 August 2002 Thank you for your
letter of 20 June 2002 inviting the Board to submit evidence to the Committee
in relation to its Inquiry into the above matter. I enclose for the Committee's
attention a response prepared by Board Officers. Unfortunately, because of
the timescale specified, it has not been possible to submit this response
to our Board for approval. We would wish to reserve the right therefore to
submit any additional views as a result of discussions at the relevant Board
Committee which meets in early September. IRENE M KNOX 1. Introduction This submission has been
prepared by the Chief Education Welfare Officer who acts as the Board's Designated
Officer for Child Protection and by the Adviser - Services for Children and
Young People who is the Deputy Designated Officer and has a responsibility
for Board policy and training in the area of child protection. These 2 officers
deal with the majority of concerns relating to child protection which are received
by the Board. The SELB welcomes the opportunity to contribute to the Northern
Ireland Assembly's Inquiry into Child Protection Services in Northern Ireland
as it is conscious of the important role the education sector plays in protecting
children. This response is structured in line with the requirements outlined
in the letter of 20 June 2002. 2. Case-Work The Board endorses the introduction
of a number of clauses in the draft Education and Libraries Bill, aimed at
strengthening the current child protection arrangements within education. However,
it has concerns about the proposed introduction of the Needs Led Assessment
framework across the 4 Health & Social Service Boards without additional
funding attached to it. We feel that it may create additional pressures for
fieldwork staff in terms of the amount of information which has to be collected
and then analysed and acted upon within a specified time-frame. In addition,
Designated Teachers and other Education staff will require further training
in order to implement the new framework effectively. 3. Communication Evidence from 2 pieces of
research by the SELB into Designated Teachers' Experiences of making a Referral
conducted in 2000 and 2001 highlighted the fact that whilst communication and
partnership working between education and social care has improved, there is
still room for improvement in terms of who needs to know specific information.
Time is a critical factor for all professionals working in this area. A small scale pilot
carried out in the Craigavon and Banbridge Trust area in 2001 (the School Liaison
Project) where each school had an designated social worker and there was regular
liaison between school, education welfare officer, social worker and health professional
identified the clear benefits of multi-agency working. However, it proved
too costly of time and resources to be able to sustain the project. 4. Linkages Since the introduction of DENI 1999/10, teachers
have become more open and 'upfront' with parents when they have concerns despite
the evidence that, in a small minority of cases, this has provoked parental
anger and verbal abuse. Schools have positively welcomed
the opportunity for consultation with Social Services prior to making a referral
which the Trusts working within the SELB area have afforded them. The fact
that the SELB's area is not co-terminus with that of the SHSSB is an additional
area of complexity in making links with appropriate health and social service
professionals. In addition, links with the Interlink Project have been made
and have proved invaluable in seeking to ensure the safety and welfare of pupils
in school when a young person known to pose a risk remains in mainstream education.
(The Interlink project is an NSPCC - managed project within the SHSSB area
which deals with young people aged 10-18 who have a sexual behaviour problem.) 5. Workforce Issues At the present time, the
trusts operating within the SELB area (Armagh and Dungannon, Craigavon and
Banbridge, Homefirst and
Newry and Mourne) appear to be under-resourced and short-staffed. They seem
to have difficulty
in recruiting and maintaining staff in Family and Childcare teams as the work
is perceived to be very stressful. Because of staffing issues, they
are often able to respond in the short-term only to the cases which are most
critical. This situation is both frustrating and demoralising for education
staff, in some cases, who feel they have made a genuine referral and yet no
action appears to be have been taken. In terms of issues for Designated
Teachers, one respondent in our research last year pointed out that the role
of Designated Teacher was one of 20 she held within the school! This represents
an extreme case but Designated Teachers generally have a number of roles to
fulfil apart from their teaching duties. There is a fairly constant turnover
of staff due to early retirement/promotion opportunities and therefore there
is an ongoing need for staff training as new appointments are made. There is limited understanding of the pressures
on teaching and social care staff faced by the other profession. The board tries to address
this in its uni-disciplinary training by inviting senior social workers to
participate in the training sessions and for them to explain the social
work process to education staff. Similarly, we provide training for residential
social workers, childcare social workers and indeed foster carers on educational issues such as
the curriculum framework, the proposed changes and Suspension and Expulsion
Policies. This helps to create a better understanding of the pressures faced
by other professionals. 6. Resources Core funding for childcare
and child protection work and services appears to have decreased in real terms
as funding for specific short-term projects becomes increasingly available
at regional level. This process of erosion is extremely detrimental to the
welfare of children and families as the shortfall in the basic human and financial
resources used to provide services to meet the needs of families means that
those needs are not able to be met. Preventative work can not always be a priority
and yet the thrust of the Children Order legislation was to place a strong
emphasis on early intervention. 7. Lessons Learnt The sharing of appropriate
information with the appropriate personnel as the need arises remains the critical
link in promoting children's welfare. 8. General Comments
n
The links between the DHSS&PS and DE need to be made more explicit and
apparent if children's welfare
is to be promoted. The evidence of 'joined up thinking' between the 2 departments
in the interest of children is not evident. If partnerships have not
developed at the top, it is unrealistic that they should develop elsewhere
in the system.
n
The SELB would like to express its concern about the disparity between the
number of children on the Child Protection register in the 4 Health and Social
Services Boards.
n
There appears to be some variation in what constitutes "significant harm" and
'thresholds' between the 4 Trusts which operate within the SELB area.
There is also a discrepancy between how Social Services and education staff
view 'risk'.
n
In terms of good practice,
we feel it is appropriate to draw your attention to the model operating within
the SELB area in developing child protection policy and training pathways
for education staff. Designated Teachers (and Deputy Designated Teachers) and
other education staff receive uni-disciplinary training in child protection
from the SELB's specialist staff at Foundation and Intermediate levels (a 2
x day followed by a 1 x day course). Those members of staff are also available
to provide training at whole school/whole service level for all board staff.
In addition, in each Teachers' Centre area, a Forum for Designated Teachers
meets once a term to update practice and to discuss issues of common concern.
The senior social
worker or an invited speaker from a related discipline may attend. In addition,
the SELB has its own Child Protection Committee, a sub-committee of
its Education Committee, which meets once a term and consists of representatives of the key
agencies involved in child protection which includes schools. The committee discusses
issues of immediate concern, receives reports from different agencies
and services and advises the Education Committee on all matters pertaining
to child protection. As the SELB contributes 50% of the salary costs
of the multi-disciplinary trainer in child protection employed by the SHSSB, education staff
then proceed to a variety of courses offered by the trainer in a multi-disciplinary
setting. All of those who have an interest and involvement with child protection
work (uni-disciplinary trainers, multi-disciplinary trainer, youth service
personnel with responsibility for child protection, the Designated
Officer, Cass staff with a responsibility for Pastoral Care) meet approximately
6 times per year to ensure consistency of approach, to promote joined
up thinking and to share information and new developments. These initiatives
are primarily funded from the SELB's Children Order budget as is day 1 of the
Designated Teacher training and the substitute cover (half a day) which is
allocated to schools to facilitate attendance at case conferences, case reviews and from September
onwards Looked After Children reviews. For the third year running a
research project into how the referral process is working is being undertaken.
This year, at the request of the SACPC, we are undertaking research with teachers
and social workers on the introduction of a new form, the CPR4, used by education
staff when making a child protection referral. All of these initiatives
assist in taking forward the work of Child Protection within education. As
the SACPC in its Annual Report breaks down the referral statistics into various
headings, we are able to monitor the number of referrals made each year by
the education sector. They are rising year on year. RECOMMENDATIONS 1. There is a need for an increase in direct
funding for core child protection services. In addition there needs to be a
strategic plan in place to determine what direction childcare and child protection
services will take over the next 3-5 years. 2. Structures need to be in place in each
board which facilitate and promote ongoing communication and liaison between
all the professionals and agencies (including education). 3. Stand alone training on a one-off basis
is not sufficient training for Designated Teachers. An integrated programme
of uni-disciplinary and multi-disciplinary training is essential to promote
effective practice in child protection. If the Committee for Health,
Social Services and Public Safety of the Northern Ireland Assembly wishes to
hear directly from practitioners and officers of the SELB in relation to this
area, the board would be prepared to nominate representatives to present evidence
in person. WRITTEN SUBMISSION BY: 14 August 2002 1. Introduction 1.1 The Soldiers, Sailors and Airmen Families
Association - Forces Help, known as SSAFA Forces Help is a registered charity,
incorporated by Royal Charter to relieve need, suffering and distress amongst
serving and ex-service men, women and their families. 1.2. The Soldiers and Sailors, Families Association
as it was first called was founded in 1885 by Major James Gildea, of the Royal
Warwickshire Regiment for the purpose of looking after the wives and families
of soldiers going overseas to form the Second Egyptian Expeditionary Force.
As the organisation grew, volunteers were recruited to establish a visiting
service to the home of servicemen's families to assess their need and ensure
appropriate help was given quickly. 1.3 After the formation of the Royal Air Force
the association title was amended to include them, and the term 'SSAFA' emerged.
The final change in title occurred when the organisation amalgamated with the
Forces Help Society in 1997 to become SSAFA Forces Help. 1.4 Since its inception as a voluntary organisation
in 1885 SSAFA evolved to incorporate a uniformed District Nursing Service in
1892. Interestingly the first nurse was employed in the Curragh Camp, Dublin
in 1892 before sending "SSAFA Nursing Sisters" to all major Garrisons both
home and abroad. Later a Health Visiting Service was formed to provide families
serving abroad with support which they would normally receive from the United
Kingdom authorities. In 1963 the Ministry of Defence recognised the need for
qualified Social Workers to help with complex social and family problems facing
service families. There are now professional Social Workers in Units, Garrisons
and Air Force Bases in Northern Ireland, Great Britain and overseas. 2. SSAFA Forces Help in Northern Ireland 2.1 In Northern Ireland the military environment
becomes a way of life not only for soldiers and airmen but also for their spouses
and families. A service person's job affects theirs and their families' social
and personal life, meaning that they must live within the constraints of the
security situation. The cumulative effects of a variety of stressors are thus
enhanced by the military scene and under some drawbacks in using outside agencies. 2.2 SSAFA Forces Help initially provided on
Social Work advisor to Military Headquarters, Northern Ireland until 1993 a
decision was taken to pilot a scheme whereby professional Social Workers from
the field of family and child care would work alongside and supervise unqualified
Welfare Workers. This agency is known in Northern Ireland as the Personal Welfare
Service. 2.3 The Personal Welfare Service, Northern
Ireland consists of a Co-ordinator, equivalent to an Assistant Principal Social
Workers, five Social Workers at Senior Practitioner level, and one Social Worker,
all of whom are supplied by SSAFA Forces Help and adhere to the legally defined
code of ethics for Social Workers. They offer a professional service direct
to the military chain of command and to any soldier, sailor, airmen and service
family in Province. Professional staff also bear responsibility for supervision
and development of three Occupational Welfare Officers. 2.4 Personal Welfare Teams are located in Lisburn,
Ballykinler, Omagh, Londonderry and RAF Aldergrove and are co-ordinated from
Headquarters Northern Ireland. 2.5 This service is provided in line with some
key points of principle from the Armed Forces Overarching Personnel Strategy:
n
To recognise that the provision
of welfare support to dependant families is a key factor in the well being
of the serving person.
n
To provide appropriate, timely and confidential specialist welfare support
(including proactive and preventative services), directed by professionally
qualified full-time staff, for service personnel and their dependant families.
n
To ensure that families of service personnel's needs are taken into account
.. so that they are not disadvantaged in comparison with their civilian counterparts
... 2.6 Given that most service families are removed
from normal support resources coupled with fears of seeking local community
support they are undoubtedly in danger of being disadvantaged. SSAFA Forces
Help, therefore, in line with the personnel strategy endeavours to respond
sensitively to their needs whilst bridge building between them and local agencies. 3. Casework 3.1 Whilst SSAFA Forces Help offers a generic
social work service, our client community consists of a young married population
with a large proportion of pre-school and pre-teen children. Many incoming
referrals, therefore, impact directly or indirectly on the well being of those
children. A copy of our Statistic Returns Forms is attached at Annex A. 3.2 In the two year period 1 January 2000 to
31 December 2001, a total of 2771 referrals required response from the service.
In the categories of health, relationships and child care there were 1102 referrals
with 272 of those specifically dealing with child care issues and 58 being
child protection investigations. 3.3 All potential child protection investigations
are referred to Social Services. The names of those placed on the Child Protection
Register are transferred to the Military Child Protection Register which is
compiled and maintained by SSAFA Forces Help Co-ordinator on behalf of Headquarters
Northern Ireland. 3.4 The current Northern Ireland Military Register
was opened in May 1994. One hundred and twenty-five children have been registered
to date. Twenty-five names having been added since 1 December 2000. 3.5 SSAFA Forces Help conducts the service
under the Northern Ireland Children Order (1995) where specific reference is
made to the organisation's role under "Arrangements for Armed Forces". 3.6 Casework is governed by the organisation's
Procedures Manual in two volumes. Volume One - Professional Issues and Volume
Two - Administrative Issues. 3.7 Volume one of the Procedures Manual outlines
our Principals and Practice including Child Protection Procedures for both
Army and RAF, Domestic Violence Policy, Record Keeping and Access to File,
Confidentiality Policy, Complaints Police and Supervision and Appraisal Policy. 3.8 Individual Case Files are maintained by
use of the following: Set of Case Records; Referral Form; Initial Assessment;
Agreed Client Work Plan; Contact Record; District Contact Record; Review Form
and Closing Transfer Summary. 3.9 All policies relating to referral intake,
assessment of need, case recording and professional practice closely follow
those upheld by the Northern Ireland Social Services Trust with whom each SSAFA
Force Help Social Worker liases with closely. 3.10 Social Workers with SSAFA Forces Help in
Northern Ireland tend to be recruited locally thus ensuring that professional
practice is replicated in line with local legislation. 4. Communication 4.1 Regarding Child Protection issues for Armed
Forces the instruction for liaison with SSAFA Forces Help is detailed in the
Northern Ireland Children Order (1995). 4.2 With SSAFA Forces Help's tendency to employ
locally recruited Social Workers with three years post qualification experience
in family and child care, many natural networks with statutory and voluntary
agencies are already in place. 4.3 These networks are extended in the first
three months of employment in accordance with SSAFA Forces Help orientation
policy. Through this, new staff must undertake self introductions to all of
the following in their area of responsibility, Schools, Health Visitors, Social
Services Departments as well as become members of Local Domestic Violence Forums,
and Child Protection Committees. 4.4 In January 2002, the Northern Ireland SSAFA
Forces Help Social Work Co-ordinator and a military representative met with
Child Care Services in each Trust to raise awareness of our organisation and
discuss how we could work together more effectively. The aspirations for formal
co-working was expressed by each Trust. 4.5 Potential communication difficulties exist
when Social Workers do not have full appreciation of the system in which a
military family lives. There continues to be mistrust of the military by some
local Social Workers who wrongly think that information is being withheld and
that military personnel will protect their families from outside agencies if
challenged. 4.6 It is important to continue to extend communication
between SSAFA Forces Help Social Workers and local Social Services offices
as some Social Services mistakenly believe that SSAFA Forces Help carry statutory
responsibility for the military community. Consequently local Trust can be
slower to respond when a referral is received or are reluctant to allocate
resources and services to military families, especially when it is thought
that these families will move on within a short time frame. 4.7 It is hoped that some more formal mechanisms
for working together could be put in place, otherwise there is a potential
for a gap in protection of children in military families, especially as SSAFA
Forces Help is very limited in resources. 5. Linkages 5.1 SSAFA Forces Help/Personal Welfare Service
undertakes the following links:
n
Between statutory agencies and military personnel
n
Between military chain of command and families
n
Between families and statutory or voluntary agencies
n
Between military personnel serving in Northern Ireland and their extended families
in Great Britain or other parts of the world
n
To produce services for military families being posted from Northern Ireland
to other places through the wider branch of SSAFA Forces Help 5.2 With SSAFA Forces Help emphasis placed
upon the preventative element of social work such linkages are vital as is
advertising the service. 5.3 SSAFA Forces Help/Personal Welfare Service
advertise the service through a Forces monthly families newspaper and on British
Forces Radio as well as daily networking with military welfare personnel. 5.4 Staff are invited to speak about their
work at a variety of military events including a Northern Ireland Welfare Seminary
hosted once year by Personal Welfare Service. 5.5 Last year SSAFA Forces Help Special Needs
Advisor from Central Office, London visited the province to chair a two day
special needs event for carers and welfare staff. 5.6 Whilst SSAFA Forces Help has a generally
high profile within military circles, it is never certain that those who really
need the service are aware of what support we can offer or if they come forward
for help. 5.7 With only five Social Workers and three
Welfare Workers serving all of the Northern Ireland military population, the
service is fully stretched. Any increase in linkage therefore creates further
demands on an already under staffed resource. 6. Workforce Issues 6.1 Given that each Personal Welfare Service
team is located in isolation from others, SSAFA Forces Help places much emphasis
on maximising team support and supervision. 6.2 Supervision contracts are made between
Line Managers and each field worker, with formal supervision sessions being
held once a month. Supervisions is minuted by the Line Manager and signed by
both parties. 6.3 Supervision for the Northern Ireland SSAFA
Forces Help Co-ordinator is provided by Director of Social Work, SSAFA Central
Office, London on a quarterly basis, is minuted by Director Social Work and
signed by both parties. 6.4 Support is offered through staff team meetings
held every two months to include both field workers and administrative staff. 6.5 From Personal Welfare Service conception
in 1994 to 2001 referrals had risen by 500%. This rise continued to be managed
by the original number of fieldwork staff until March 2002 when an additional
Social Worker was appointed to Lisanelly Barracks, Omagh. 6.6 This extra workers has alleviated some
pressure, however since taking up post in Omagh, seventy referrals have been
made in four months in that location alone. 6.7 Pressures on SSAFA Forces Help and Personal
Welfare Service stem from the following sources: a)
Continual growth in referral rate, leading to workers being fully stretched
at all times. b)
Time and distance spent travelling between office base and area covered
reduces hours available to clients. c)
Volume of incoming referrals reduces time available to develop community
support and prevention projects. 6.8 Unavailability of Military Welfare Workers
for 25% of any year increases the presses on the Social Worker in each area.
Similarly any gap whilst awaiting replacement causes an unacceptable reduction
in the service provided. 6.9 SSAFA Forces Help is a member of the Voluntary
Organisation Forum who provide access and support for our workers to undertake
the Post Qualification Award in Social Work. Four SSAFA Forces Help Social
Workers in Northern Ireland have already completed Post Qualification Modules. 6.10 Other training is accessed through local
Trusts and independent training opportunities. 6.11 North Down and Ards Community Trust have
recently initiated a training partnership with SSAFA Forces Help, which promises
to be of great benefit. 7. Resources 7.1 SSAFA Forces Help in Northern Ireland is
financially resourced from Central Office, London, which also takes responsibility
for professional and legislative support. 7.2 Paragraph 6 outlines our access to training
resources through local trusts. The downside to this is that except for North
Down and Ards Community Trust, no formal mechanisms exists. Individual Social
Workers rely on using personal contact for invitations to local training events. 7.3 The most obvious scarcity in resources
lies in staffing, which, given the demands posed by the geographical extent
of each individual's patch, is inadequate. 7.4 To overcome these demands additional staff
are required to cover Palace Barracks, Holywood and Mahon Barracks, Portadown.
Currently there is no agreement to funding for this. 8. Lessons Learnt 8.1 With military families frequent movement
from one area to another, some fall through the safety net. SSAFA Forces Help
could be used in formalising a tracking system for families where there is
potential for child abuse or neglect so that maximum support and protection
can be provided. 8.2 We also experience inconsistencies between
Trusts as to their response time (eg 7 day assessment time scales), their order
of priorities and working relationships with CARE units. 8.3 Often, Looked After Children enlist into
the Forces or marry Forces personnel from the age of 17 years onwards. These
young people have additional problems in coping with military life. In tandem
with social Services SSAFA Forces Help could alleviate many difficulties both
by the Leaving Care Planning Meeting and in After Care support. There is potential
to develop partnership in this area. 8.4 Recently SSAFA Forces Help in Northern
Ireland have been involved alongside Military Police with investigations into
soldiers accessing child pornography from computers. Whilst these crimes may
be manageable for the duration of the soldiers posting to Northern Ireland
there is a potential to loose track of him/her with successive postings to
other countries. This points to a gap in child protection which could be formalised
via SSAFA Forces Help. 8.5 Civilian Courts in Northern Ireland liase
with Social Services when dealing with cases of child abuse. It appears that
the same links do not exist when alleged abusers are tried by Court Martial.
Improvement in communication is required here as service personnel who are
likely to have abused children may be found not guilty and move on to abuse
again. 8.6 There is also a need for co-ordination
of tracking potential abusers or needy families who are part of this mobile
community. SSAFA Forces Help could contribute to this. 9. General Comments 9.1 SSAFA Forces Help is a registered Adoption
Agency in Great Britain. Currently negotiations are underway to extend this
service to Northern Ireland. When in place military families will have the
opportunity for swifter assessment as well as not being disadvantaged by their
frequent change of address. 9.2 SSAFA Forces Help Social Work Service in
Northern Ireland is continually evolving and developing. During the past nine
years of its existence alongside military welfare workers, we have continued
to strengthen our service in preventing abuse and neglect to children living
in the military community. In addition to the liaison role and attendance at
child protection conferences, there is, however, much potential for SSAFA Forces
Help to adopt a more formal role on behalf of Social Services eg undertake
initial child care assessments, children in need assessments, parenting assessments,
fostering and adoption assessments and in planning for Looked After Children
who enlist or marry into the Navy, Army or RAF. 9.3 There are 8789 Forces wives and children
living in Northern Ireland all of whom potentially require social work support.
The task of supporting, identifying need and prevention of abuse or neglect
is being managed province wide at present by five Social Workers and three
Occupational Welfare Workers. Further resources are required to enable us to
reach those who need support most and to initiate preventative projects such
as positive parenting; self esteem groups; domestic violence management; child
protection awareness. 9.4 Although it is accepted that Community
Resources are under extreme pressure, under Anti-Discriminatory Practice families
should have equal opportunities for provision and support. The military system
should not been seen as an option to provide resources as an alternative to
Statutory Provision. 9.5 A SSAFA Forces Help Social Worker assigned
to each military base would enable our service to liase more proactively with
local Trusts to the extent that "working together" could be practical in a
literal sense to take some pressure from other family and child care social
work teams. 9.6 Not only would such working together ensure
that Professional Child Care Standards are maintained. It would also service
to uphold the Forces Personnel Strategy that families of service personnel
are not disadvantaged in comparison with their civilian counterparts.
M SMITH WRITTEN
SUBMISSION BY: August 6, 2002 Thank you for your invitation to submit evidence to the Committee for Health, Social Services and Public Safety concerning the above. Because Strabane District Council does not have a strategic role in child protection we are unable to provide evidence relating to the categories outlined in your letter. Strabane District Council has produced good practice guidelines for those involved in delivering summer scheme projects. It is also currently developing a child protection policy, which is currently in draft form. I have enclosed both for your information. They will hopefully provide the inquiry with an indication of how child protection applies to our work..
GRACE TURPIN INTRODUCTION The Community Relations Department of Strabane District Council provides a Summer Scheme for a number of registered community groups from throughout the Strabane District. The Summer Scheme involves providing a range of sports, leisure, arts and crafts activities for children for two hours a day five days a week during the month of July. Children between the ages of 7 and 18 years participate. This Code of Practice is designed to ensure that children participating in the summer scheme are provided with proper care in accordance with legislation and best practice. It is also recommended that the community groups should ask the Department of Health and Social Services (DHSS) Pre - Employment Consultancy Service to carry out a check on any of its volunteers who have substantial access to children. Further information can be obtained from Child Care Unit THE
LEGAL CONTEXT The ratification of the UN Convention on the Rights of the Child by the British Government, along with the influence of legal opinion and pressure groups, ensured that a number of key principles informed the new Children (NI) Order 1995. There are five key principles (5 Ps): PARAMOUNTCY - The fundamental principle in child care law and practice that the welfare of the child must always be the paramount consideration in decisions taken about him or her. PARENTAL RESPONSIBILITY - This principle is that parents have responsibility to children rather than rights over them. There may be situations where a number of adults share this responsibility with one or both parents. PREVENTION - This principle is about preventing situations arising where children are separated from their families and providing services to keep the children within their families and to promote health and welfare. PARTNERSHIP - The basis of this principle is that the most effective way of ensuring that a child's needs are met is by working in partnership. This means that the provision of services must take account of the parents' views PROTECTION - The principle is that children should be safe and should be protected by intervention if they are in danger. In practical terms this means that there is a legal duty to provide a safe environment for children and young people, where their welfare is of paramount importance. There should be good lines of communication with parents or carers who should be informed and consulted about any decision affecting their child. Parents equally have a responsibility to ensure that their children grow and develop in an environment safe from harm. The Northern Ireland Human Rights Commission suggests that there is an opportunity for a Bill of Rights in Northern Ireland to draw upon provisions in the UN Convention which have not yet been properly implemented here under the terms of the Children Act 1989 or the Children (NI) Order 1995. These potential developments must also be taken into account at the appropriate time. GENERAL
PRINCIPLES The children's welfare and development will be paramount in formulating programmes. Children will be treated and respected as individuals whose rights will be recognised and respected, and whose needs, including special educational needs, will be catered for. Parent's responsibility for their children will be recognised and respected. The values derived from different backgrounds - religious, racial, cultural and linguistic - will be recognised and respected. The role of parents as the first educators of their children will be respected. Parents will be made aware of, and given easy access to, information about services, policies and procedures. RESPONSIBILITY Children may be placed in the care of Summer Scheme Providers (note 1), during the course of some activities. Summer Scheme Providers will assume responsibility for children from when they are placed in their care until their parents or other responsible person collects them. Summer Scheme Providers act in loco parentis while children are in their care. Therefore, they must show a degree of care which is commensurate with their role which, in some cases, because of specialist knowledge, may be a higher duty of care than that expected of a parent. PERSONNEL Supervision and Support of Staff / Volunteers Good management of any organisation requires making sure that everyone in the organisation is clear about what they are trying to achieve and about what their roles are. You must consider whether everyone in your organisation knows what the responsibilities of management and the responsibilities of the employees and volunteers are. Regardless of whether workers in your organisation are paid employees or voluntary workers, it is important that there are clearly defined procedures for reporting incidents or accidents, making complaints or referring matters of concern, which everyone is fully aware of. Summer Scheme Providers need to ensure that: 1. That volunteers and staff are familiar with all policies and procedures 2. That they are aware of what is expected of them in terms of behaviour 3. That there are opportunities for managers to observe volunteers / staff interacting with children 4. That there are formal and informal opportunities for volunteers / staff to express concerns or anxieties 5. That there are formal structures for supervision and support of volunteers / staff 6. That there are support structures in place for those leaders who do report concerns, and for colleagues in the case of an allegation against a leader. 7. Only staff / volunteers over the age of 18 will be considered in assessing whether adequate provision is being made. No one under the age of 16 will be employed in the formal supervision of children. Leaders Leaders should: 1. Be competent and qualified 2. Be positive, enthusiastic and cheerful 3. Reinforce the principles of play 4. Give feedback in a constructive and encouraging manner 5. Involve parents as much as possible 6. Recognise that they themselves are human and will not get it right all the time! Above all, leaders should recognise the importance of fun in children's activities. Children should not be treated as mini-adults and their needs should be recognised at all stages. In addition the leader is in a unique position of trust and this position must be maintained with integrity at all times. Behaviour of Leaders
(see also Code of Behaviour) The leader should: 1. Maintain the highest standard of personal conduct and support the principles of fair play 2. Respect the rights, dignity, and worth of every human being. Specifically the leader should treat everyone equally regardless of sex, age, ability, ethnic origin, religion or political persuasion. In this regard, the leader should ensure that all are given sufficient opportunity to participate in the activity. 3. Be responsible for setting and monitoring the boundaries between a working relationship and friendship with participants. This is particularly important when the leader and participant are of opposite sex and / or when the participant is a young person 4. Realise that certain situations or friendly actions could be misinterpreted by the participant or by outsiders and could lead to allegations of misconduct or impropriety. 5. Encourage the participants to adhere to the spirit of the rules. Furthermore, the leader must not encourage or allow participants to violate the rules and should actively seek to discourage such action 6. Never exert influence over a participant in order to obtain personal benefit or reward 7. Be watchful of all situations, particularly bullying, which may occur (i) child to child (ii) group to child; and (iii) adult to child 8. Have enjoyment of the activity as a priority 9. Encourage two - way communication with participants 10. Prohibit swearing or other inappropriate language, signing or behaviour Supervision
of Children 1. Leaders in charge must be satisfied that those workers and adults who accompany group parties are fully competent to do so. 2. Children must be supervised at all times. 3. Children must not be left unsupervised at any venue whether it is indoors or out of doors. 4. Leaders should know at all times where children are and what they are doing. 5. Any activity using potentially dangerous equipment should have constant adult supervision. 6. Children will be safer if supervised by two or more adults 7. Dangerous behaviour by children should not be allowed. Adult
/ Child Ratios Levels of supervision must be adequate whether at the organisation's venue or on a journey / visit. Therefore, when deciding how many adults are required to supervise, leaders must take into account a range of practical matters. 1. The number of participants in the group 2. The nature of site / venue 3. The activities to be undertaken 4. It is important that each individual supervisor knows the responsibilities he / she is expected to bear 5. It is recommended that no journey / visit should be undertaken without a minimum of two adults in attendance, one of which must be a worker. Bus drivers should not be considered as supervisors. 6. Where a party consists of children of both sexes, both male and female supervision should be provided unless otherwise agreed 7. The standard recommended ratios are: 0 - 2 years
1 member of staff to 3 children
There should be one additional staff member 8. It is for the leader in charge to exercise his / her professional judgement in deciding the level of supervision taking into account the guidance as stated above. 9. The ratio of staff and volunteers to children with disabilities is dependent on the needs of the individual child. PLANNING It is important that activities are planned in such a way that no leaders are working in isolation, for their own protection as well as for the protection of children. In terms of safety it is also important to ensure that: 1. There is a suitable ratio of staff to children depending on the particular activity 2. Activities are suitable to the age and ability of the children participating. This is particularly important where there may be a wide range of ability and disability. 3. That activities take place in suitable venues 4. That there is first aid expertise available and a proper first aid kit available 5. That everybody participating in the activity understands the rules 6. That all equipment has been checked for safety and suitability for the maturity of participants 7. That there is a book / form available for recording accidents or injuries 8. That parents are informed of their responsibilities with providing suitable equipment and collecting children after activities 9. That all activities have a register of participants It is equally important that everyone appreciates that your organisation does not have the sole responsibility for the protection of children in your care. Other people, primarily their parents or carers, also have responsibility in relation to the children with whom you come in contact. There are a number of reasons why you should establish and maintain contact with the parents of children involved with your organisation. Parents have the primary responsibility for the care and upbringing of their children and have a wealth of knowledge about their lives and their emotional, physical and cultural needs. Generally, the most effective way of ensuring that children's needs are met is by working in partnership with their parents or carers. This means that you should take steps to encourage the participation of parents as much as possible in your organisation. The different degrees and levels to which this can be developed may range from the representation of parents on management committees to actual participation in day-to-day activities. Some basic things that you should at least consider would include: 1. Knowing who the parents, carers or others with "parental responsibility" of all the children are. 2. Obtaining parental consent for all activities. 3. Having a record of the name, address and contact number of all parents / carers. 4. Making sure all parents and carers have an awareness of your child protection policy and reporting procedures, devising a complaints procedure for parents and carers and making sure everyone knows about it. INSURANCE 1. Bearing in mind the potential for accident, organisers / providers of all activities have a duty to ensure there is adequate insurance cover in place and to give advice on what personal accident cover might be appropriate. 2. All organisations should ensure that adequate insurance cover is in place to cover the activities of the group, leaders and participants. Away trips should be included in such cover. 3. Adults transporting children in their cars should be familiar with the provisions made in their motor insurance policy in relation to acceptable numbers and liability. SAFETY 1. All organisations involved in providing summer scheme activities should have first aid expertise available for all sessions. They should have a proper first aid kit, including gloves for each open wound injury and sponges to be used on a once-off basis only 2. Injuries, including minor ones, should be recorded, with a note of the action taken 3. Parents / guardians should be notified of all injuries which their children incur within an activity 4. All activities should be governed by a clear and widely known emergency action plan 5. Leaders must ensure that the conduct of the games and the implements used are in accordance with the rules 6. Children should be taught the rules of the game. Many rules are there for safety 7. Parents / guardians have the responsibility for ensuring that their children get to and from sessions safely. Code
of Behaviour for Coaches, Volunteers, Helpers and Officials These guidelines have been produced to help protect anyone working with young people during summer scheme activities and should be followed at all times. Adult - Child relationships should be: n Entered into by choice n Open, positive and encouraging n Defined by a mutually agreed set of goals and commitments n Respectful of the creativity and autonomy of children n Defined by an ethical code of conduct relating to interaction and bullying n Carried out in a context where children are protected and where their rights are promoted n Free from verbal, physical, emotional or sexual abuse n Respectful of the needs and developmental stage of the child n Aimed at the promotion of enjoyment and individual progress n Respectful of the roles and responsibilities of leaders n Governed by a code of ethics and good practice (Code of Ethics & Good Practice for Children's Sport in Ireland) Leaders are responsible for setting and monitoring the boundaries between a working relationship and friendship with participants. The leader must realise that certain situations or friendly words and actions could be misinterpreted not only by the participant, but also by outsiders motivated by jealousy, dislike or mistrust, and could lead to allegations of misconduct or impropriety. 1. Always be publicly open when working with children. Avoid situations where you and individual children are completely unobserved. 2. If physical contact is necessary, it should be done openly. Care is needed, as it is difficult to maintain hand positions when providing manual support if the child is constantly moving. Some parents are becoming increasingly sensitive about touching children and their views should always be carefully considered. 3. Where possible, allow parents to take responsibility for their children in changing rooms. If groups are to be supervised in changing rooms, always ensure that adults work in pairs and that gender is appropriate. If travelling to an event is necessary, make sure that the parents give verbal (preferably written) permission. Parents should be asked to ensure that children are collected on time. 4. Where mixed groups participate in activities away from home, at least one male and one female adult should always accompany them. 5. All should respect the rights and dignity and worth of all participants. Specifically leaders must treat everyone equitably and sensitively within the context of their activity and ability, regardless of gender, ethnic origin, cultural background, sexual orientation, religion or political affiliation. 6. Members working with children should hold appropriate qualifications in coaching, leadership, officiating etc. Leaders should also ensure that they are working at a level commensurate with their qualifications. 7. Adults should ensure that the activities which they direct or advocate are appropriate to the age, maturity and ability of the participant e.g. they should not break rules on suitable competition for age groups. Sessions should include clear progressions and coaches should keep a clear record of all sessions undertaken, clearly planning for future sessions. It is advisable to keep a training / coaching diary. Make sure all participants know to inform the coach of any injury or illness before, during or after the activity. 8. Adults should always promote the positive aspects of the activities and never condone rules violations; bad sportsmanship or use of prohibited substances. 9. Adults should consistently display high standards of personal behaviour and appearance as well as appropriate dress, language and respect for equipment and facilities. It is not acceptable for adults responsible for children to consume alcohol. Adults should never encourage children to drink alcohol. 10. Adults should never overtly criticise participants' or officials' judgements or use language or actions, which may cause the child to lose self-esteem or confidence. All members must also be aware that as a general rule, it does not make sense to: n Spend amounts of time alone with children away from others n Take children alone on car journey, however short n Take children to your home If it should arise that such situations are unavoidable they should only take place with the full knowledge of someone in charge in the Club and / or a person with parental responsibility for the child. Leaders and helpers should be aware that normal car insurance does not cover them for transporting participants to and from events. All leaders and helpers should try to be on time; and inform an appropriate person if ill or unable to attend an activity session. Leaders should NEVER! n Engage in rough physical or sexually provocative games including horseplay n Share a room with a child n Permit or engage in any form of inappropriate touching n Permit children to use inappropriate language unchallenged n Make sexually suggestive comments to children, even in fun n Allow allegations made by a child to go unchallenged, unrecorded or not acted upon n Do things of a personal nature that a child can do for themselves n Agree to meet a child on your own If you accidentally hurt a child or cause distress in any manner, report the incident. If the child appears to respond in a sexual manner to your actions, misunderstands, misinterprets something you have done; report the incident to a colleague supported by a brief written report of the incident as soon as possible. Parents / carers should be informed of the incident. These guidelines apply to all persons who are engaged in work either as a paid employee or as a volunteer with a group or organisation registered with Strabane District Council's Summer Scheme. The terms "LEADER" and "SUMMER SCHEME PROVIDERS" are used for convenience. In these guidelines the term "CHILD" is as defined in The Children (NI) Order 1995, i.e. any young person under the age of 18 years. PRINCIPLES
OF GOOD PRACTICE All Voluntary Organisations Working With Children Should. 1. Promote the general welfare, health and full development of children and protect them from harm of all kinds 2. Recognise that children have rights as individuals and treat them with dignity and respect 3. Raise awareness of what children are entitled to be protected from 4. Adopt and consistently apply a thorough and clearly defined method of recruiting and selecting staff and volunteers 5. Plan the work of the organisation so as to minimise opportunities for children to suffer harm 6. Develop effective procedures in responding to accidents and complaints 7. Establish links with parents and other relevant organisations Children's
Right to Self - Protection Do children in your organisation know that they have the right.
Figure 1 - Responsible Leadership
Figure 2 - Reporting Procedures
STRABANE
DISTRICT COUNCIL CHILD PROTECTION POLICY INTRODUCTION Strabane District Council is responsible for ensuring that a safe environment is provided at all times for children who take part in Strabane District Council activities or use Council facilities. This means employing people, either directly or indirectly, who are suitable for working with children and making sure that users of Council facilities do the same. The policy sets out suitable child protection arrangements for employees and others who come into substantial contact with children. It outlines appropriate action and reporting procedures for child protection. The policy also includes monitoring and evaluation arrangements. BACKGROUND Under the Recreation and Youth Service Order (Northern Ireland) 1986, Strabane District Council provides a range of indoor and outdoor community and leisure provision. It also engages a range of external service providers and community and voluntary groups through its Community Services grant aid programmes and other initiatives to help fulfil its statutory remit of enhancing the quality of life and wellbeing of local residents. Council amenities are also open to the public for hire. These facilities and activities bring its employees into direct daily contact with members of the public, including children. Strabane District Council already has a Code of Practice of Summer Scheme Providers and this policy will expand on this to include all Council provision where substantial contact with children is involved, as well as the activities of groups that use Council facilities. POLICY
STATEMENT Strabane District Council will work in partnership with parents, statutory and other stakeholder organisations to ensure that the welfare and protection of children in its care is paramount. It will do this through effective prevention and appropriate and timely intervention. In doing so, Strabane District Council embraces the UN Convention on the Rights of the Child. STATUTORY
DUTIES Strabane District Council has a duty to care to the users of its premises under the Health and Safety at Work (Northern Ireland) Order 1978, the Occupiers' Liability Act Northern Ireland 1957 and under the law of tort. Under the children Northern Ireland) Order, 1995, the Western Health and Social Services Board (Trust) has a statutory duty to ensure the welfare of a child. POLICY
OBJECTIVES The objectives of the policy are: 1. To put in place clearly defined procedures for referring, reporting and dealing with incidents relating to child protection. 2. To ensure that child protection responsibilities are fully understood and complied with. 3. To ensure effective selection, supervision and training of employees and those employed by other organisations on child protection issues. 4. To put in place appropriate and timely referral and reporting arrangements with statutory and other agencies dealing directly with child protection. DEFINITIONS Child In this policy, the term "child" is any person under the age of 18 years. Child Protection Child protection means protecting children against abuse and non-accidental injury. Child Abuse Child abuse means physical injury, emotional abuse, bullying, sexual abuse and severe neglect. WHO
DOES THE POLICY APPLY TO? The Child Protection Policy applies to all Strabane District Council employees, especially those who work directly with children. The term employee of Strabane District Council includes anyone who works full-time, part-time, seasonally, on-call, on a student placement or as a volunteer. The policy also applies to external service providers. This includes organisations running programmes on behalf of Strabane District Council. It applies to community and voluntary groups taking part in Council programmes or receive grant aid support from Strabane District Council's funding programme. Those who hire Strabane District Council facilities and premises should also read this policy. EQUALITY All those working with children should respect the rights and dignity and worth of all participants. Every child must be treated equitably and sensitively within the context of their activity and ability, regardless of gender, ethnic origin, cultural background, religion or political affiliation, and, in the case of older children/young adults, sexual orientation. PREVENTION The following rules should be followed at all times by any person working with children, be it employees, volunteers, club member, instructor or external service provider. They are to ensure that incidents involving child protection are prevented from occurring. They are also designed to protect employees with children in their care. Employees must: 1. Maintain a strict working relationship with children. It must be realised that certain situations or friendly words and actions could be misinterpreted not only by the child, but also by observers motivated by jealousy, dislike or mistrust, and could lead to allegations of misconduct or impropriety. 2. Be watchful of bullying, which may occur n child to child n group to child; and n adult to child 3. Be vigilant for signs of child abuse. Employees must not: 1. Engage in or permit any form of touching, unless appropriate to the sport. [i] In exceptional circumstances, such as where the child needs first aid, physical contact should be done openly, with another colleague present. 2. Be alone with a child on any occasion. This includes taking a child alone on a car journey, however short, or to an employee's home. 3. Engage in rough physical or sexually provocative games, including horseplay. 4. Share a room with a child. 5. Permit children to use inappropriate language unchallenged. 6. Make sexually suggestive comments to children, even in fun. 7. Allow allegations made by a child to go unchallenged, unrecorded or not acted upon. 8. Do things of a personal nature that a child can do for themselves. In an emergency situation, or where these tasks have to be done to, say, very young children or children with disabilities, parents should be fully informed. 9. Agree to meet a child on their own. Adult/Child
Ratios It is recommended that no journey / visit should be undertaken without a minimum of two adults in attendance, one of which must be a worker. Bus drivers should not be considered as supervisors. Where a party consists of children of both sexes, both male and female supervision should be provided unless otherwise agreed. The recommended ratios are: 0 - 2 years
1 member of staff to 3 children 2 - 3 years
1 member of staff to 4 children 3 - 7 years
1 member of staff to 8 children 8 years and over
2 members of staff (preferably one of each gender) for up to 20 children Always ensure that adults work in pairs and that gender is appropriate in changing rooms. If travelling to an event is necessary, make sure that the parents give verbal (preferably written) permission. INTERVENTION Strabane District Council will share any significant information about employees' or others' behaviour deemed to be putting children at risk of harm with police and social services. Every case will be decided on its own merits and a decision as to whether there is cause for concern will be based on the balance of probabilities, rather than conclusive proof. Decisions will be based on opinions formed reasonably and in good faith. Employees must fill in an Incident Report Form (appendix 1) and report incidences or concerns to the designated Child Protection Officer where: 1. They accidentally hurt a child or cause distress in any manner. 2. A child appears to respond in a sexual manner to employees' actions, misunderstands or misinterprets something they have done. 3. They suspect that a child is being bullied. 4. They have concerns over the propriety of other activities or suspect that a child is being abused. 5. A child itself tells them that there is abuse occurring. In this case they should: n React to the child with belief n Inform them that someone else will have to be informed. They must not: n Inform parents: this is the job of the police/social services. n Promise to keep the matter secret. n Interrogate the child or ask leading questions. n Speak to anyone against whom allegations are made, even if this is a colleague. RESPONSIBILITIES Head of Culture, Arts and Leisure The Head of Culture, Arts and Leisure will be responsible for: n Managing the overall Child Protection Policy. Community Support Officer and Leisure Services Officer The Community Support Officer and Leisure Services Officer will be responsible for: n Co-ordinating and monitoring the Child Protection Policy n Ensuring that all relevant employees are fully trained in and understand the Child Protection Policy. n Making sure that employees follow the prevention and intervention rules of this policy. n Monitoring and controlling situations were over-friendliness of employees could lead to misconceived allegations. n Providing the Head of Culture, Arts and Leisure with a regular monitoring report on the Child Protection Policy, including outcomes of investigations and bringing to her immediate attention those of a disciplinary or referral nature. n Conducting a further investigation on any incident for disciplinary purposes. n Sharing any significant information about employees' or others' behaviour deemed to be putting children at risk of harm with police and social services. n Ensuring that external service providers, organisations that hire Council premises and grant aid recipients comply fully with the Child Protection Policy. n Gathering information on reports of Child Protection incidents and referring these to the Head of Department of Culture, Arts and Leisure . n Advising employees and others of the Child Protection Policy and its intervention procedures. Human Resources Officer The Human Resources Officer will be responsible for: n Advising on the disciplinary procedure that may result from an investigation by either the Child Protection Officers or management. n Ensuring that all employees of Strabane District Council have successfully passed a PECS check. External Service Providers External service providers must show that they comply with the Child Protection Policy by signing a compliance declaration form (appendix 2). This includes a declaration that a DHSS Pre-Employment Consultancy Service (PECS) check has been carried out on those who will have substantial access to children (appendix 3). Grant Aid Recipients Grant aid recipients must show that they comply with the Child Protection Policy by signing a compliance declaration form. This includes a declaration that adequate child protection checks (PECS) have been carried out on those who will have unavoidable substantial access to children. Organisations that Hire Council Facilities All those who hire or use premises or facilities of Strabane District Council must complete and sign a declaration that they comply with this policy and that adequate child protection (PECS) checks have been carried out on those who will have unavoidable, substantial access with children. Spot checks will be carried out on organisation to ensure that they have carried out child protection checks on employees. Those that are deemed not to have done this will be suspended from using the premises. CONFIDENTIALITY Strabane District Council will balance the right to confidentiality with the legal principle that the welfare of the child is paramount. It aims to protect both the rights of the child and of the alleged perpetrator by ensuring that only those who need to know are given the relevant information. ADDITIONAL
READING Strabane District Council Code of Practice for Summer Scheme Providers Western Education and Library Board Child Protection Guidelines Child Care Northern Ireland Our Duty to Care HELP
LINES NSPCC Child Protection Helpline Northern Ireland Childline Appendix 1 Child Protection Incident Report Form Appendix 2 Compliance Declaration Form Appendix 3 Pre-Employment Consultancy Service Pre-Employment Consultancy Service (PECS) is a service which aims to help organisations working with children or with adults with a learning disability to check prospective employees and volunteers. it does this by giving them a means of access to any information held by the police or the DHSSPS which might have a bearing on their suitability.
WRITTEN SUBMISSION BY: Submission Prepared
by: Mr R H Williamson,
Executive Director. Mr Williamson has 30+ years' experience in the area of
child and family care including 6 years as professional advisor to an Area
Child Protection Committee. Mr Stephen Knox,
Training & Development Manager. Mr Knox has over 20 years experience of
working in the child welfare field, much of it in the area of developing therapeutic
responses to child protection concerns. Contents Introduction PART I The Role of NIGALA in Child Protection Statutory Duties Para 1.1 Staff Development Para 1.2 Current Trends &
Implications for Resources Para
1.3 Agency Links Para 1.4 PART 2 Proposals for Change in Child Protection
Arrangements Overview Para 2.1 A Proposal for Structural
Change Para 2.2 Area Child Protection
Committees Para 2.3 Regional Role Para 2.4 Voice of the Child Para 2.5 Care Planning Para 2.6 Consistency in Child
Protection Arrangements and Practice
Para 2.7 Summary of Recommendations Introduction The Northern Ireland
Guardian ad Litem Agency (NIGALA) welcomes the opportunity to provide a written
submission to this inquiry, the terms of reference of which are as follows:- "To inquire into the arrangements in place in Northern
Ireland to protect infants, children and young people under the age
of 18 from physical, emotional and sexual abuse and neglect; and to determine
if child protection services are meeting the welfare needs of children and
protecting them from significant harm. Regard will be paid to the:-
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role and responsibilities of the Department of Health, Social Services and
Public Safety, other relevant Departments, and statutory and voluntary agencies,
including area child protection committees and child protection panels;
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role of the Commissioner for Children;
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role and use of the child protection register;
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legislative context within which child protection services operate;
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resources available for those services; and
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current guidelines." This paper will begin
by setting out the role and remit of NIGALA in respect of child protection
arrangements and then go on to address a number of the more salient issues relating to
the future of child protection in Northern Ireland. PART I - The Role of NIGALA in Child Protection 1.1 Statutory Duties The role of NIGALA is encapsulated
in the Agency's Mission Statement as follows:- "To
advise the courts of children's wishes and feelings and to independently represent
and safeguard the interests of children in specified public law and adoption
proceedings in Northern Ireland" Specified Public Law proceedings
refer to proceedings specified under Article 60 (6) of the Children (NI) Order
1995, and under Rule 4.3 (2) of the Family Proceedings Rules (NI) 1996/Rule
2 (2) of the Magistrates Courts (Children (NI) Order 1995) Rules (NI)
1996. Almost all these proceedings are initially brought to court because a
Trust believes that a child is suffering, or is likely to suffer significant
harm. Thus the need for court sanctioned protection of a child has been recognised
by the applicant Trust. The Guardian ad Litem's job is to safeguard the child's
interests throughout the duration of the court proceedings, ensuring that the
child's voice is heard, and an appropriate plan (if one is required) which
meets the needs of the individual child is in place. Similarly under Article 66
(2) of the Adoption (NI) Order 1987, the Guardian is charged with safeguarding
the interests of the child in:-
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all adoption applications
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applications to free a child for adoption.
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applications to revoke an order freeing a child for adoption.
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applications for a child to be adopted abroad. The Guardian ad Litem is
therefore involved with children or young people at a time in their lives when
their future is being determined and when their vulnerability is most evident.
Most of these children will have experienced significant trauma in their lives,
where action to protect them has been necessary. In safeguarding the interests
of children in specified proceedings, the Guardian plays a central role in
the management of the case through the court proceedings. Key tasks of the
Guardian in Children Order cases include:-
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appointing a Solicitor for the child.
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ensuring the child's views are made clear to the court.
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inspecting Trust records.
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avoiding delay.
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making a recommendation to the court on the appropriate order (if any) required,
based on thorough investigation of the circumstances, and assessment and analysis
of the information available. In performing his role as
the independent representative of the child, the Guardian will ensure that
there is ongoing liaison with the Trust Social Work staff and will interview
all other professionals relevant to the application as well as the child, his
parents and any other relevant persons. If, during the course of his involvement
with the child, the Guardian becomes aware of any previously unknown child
protection concerns, he should follow the guidance detailed in the Agency's
Child Protection Policy, as ratified by the NIGALA Board. 1.2 Staff Development All Guardians have access
to a detailed in-house training programme and opportunities to engage in further
study are encouraged and supported. Guardians receive regular supervision and
annual appraisal. 1.3 Current Trends and Implications for Resources The period from 1st April
2001 to 30th June 2002 has seen a rise in cases allocated to Guardians of 18%
compared with the previous 15 months. Much more significantly, allocations
to Guardians of Care Order applications have risen by a dramatic 60%, involving
over 50% more children. This is indicative of considerable child protection
activity on the part of the Trusts seeking to bring these cases to court. It
is the view of NIGALA, that while not all of these applications result in the
granting of Care Orders, the actions of Trusts at the time of application were,
in the main, appropriate. Such a rise in activity has stretched the resources
of NIGALA beyond its limits, as is undoubtedly the case for the Trusts. In order to manage this situation, NIGALA
has reluctantly had to introduce a waiting list while continuing to bid for
increased funding to ensure the service to children is not undermined.
1.4 Agency Links The Agency has sought to
take a proactive role in relation to issues affecting the welfare of children
before the courts. Formal liaison arrangements with all the Trusts have been
established, providing a forum for discussion of matters of mutual concern
and interest between NIGALA Senior Managers and Trust Senior Managers. The
Agency has also promoted debate and discussion on key topics relating to child
protection. In May 2001, NIGALA co-hosted a major conference entitled "Exploring
Significant Harm", to which key personnel from the judiciary, social care and
medical fields contributed. In addition, the Agency is represented on the Children
Order Advisory Committee. PART 2 - Proposals for Change in Child Protection Arrangements 2.1 Overview The Northern Ireland Guardian ad Litem Agency is
a regional service and consequently is in the privileged position of
having an overview of social work practice and trends, as far as these pertain
to public law and adoption proceedings. The Agency recognises the significant
pressures Trusts find themselves under in seeking to deliver the highest possible
standards of service and indeed is currently experiencing similar pressures with regard to
fulfilling its mandate. Nevertheless, the need to ensure that as individuals,
groups, organisations and as a society, we have proper arrangements
in place to protect children from abuse is imperative. While the abuse of children is an age old phenomenon,
awareness of the problem at all levels of our society has increased
dramatically over the last forty years. Successive child abuse inquiries have
highlighted failings in the child protection system and the residential care
of children, and questioned the state's capacity to intervene sufficiently
in family life, while at other times, heavily criticising the authorities for
intervening too intrusively. Inquiries have focused on child deaths, eg. (Maria
Calwell 1973, Jasmine Beckford 1984, Tyra Henry 1984, Kimberley Carlisle 1986,
and currently Victoria Climbié); the residential care of children, eg. (Hughes
1986, Waterhouse 2000); and on the actions of the authorities regarding
suspected sexual abuse (Cleveland 1987, Orkneys 1992). While the inquiry into the
death of Victoria Climbié has yet to report, previous inquiries have consistently
highlighted:-
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poor inter-agency communication
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lack of proper assessments being carried out
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inadequate multi-disciplinary responses
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a failure to focus on the child The Climbié inquiry has sparked a debate on whether
and to what degree the current child protection arrangements need to be overhauled.
On the one hand, Dale et al (2002)¹ assert that it is not the structure of
current systems that is at fault, but the failure to implement systems
and the lack of systematic evidence-based assessment. On the other hand, questions
are being asked as to the need to reinvent the child protection system and
perhaps whether a single national agency to deal with child protection matters
needs to be established. In the light of this debate, it is clearly timely
that all organisations have the opportunity to consider what changes might
be appropriate in Northern Ireland. 2.2 A Proposal for Structural Change Over the last twenty five years there has been
a massive investment in policies and procedures in child protection
designed to ensure co-operation
between disciplines and the sharing of all relevant information. Departmental
guidance, (currently "Co-operating to Protect Children") has been gradually
developed over the years: the four Area Child Protection Committees, in turn,
produce their localised policies and procedures to ensure optimum protection
for children from abuse. Much has been achieved since the mid 1970's, especially
in the area of inter-disciplinary co-operation. It is an unfortunate fact that
there is no public recognition of all of those instances when things go right,
but when the small minority go wrong, there often follows public opprobrium
accompanied by media vilification. Nevertheless, the continuing weaknesses
in the current child protection system which include, inter-disciplinary barriers
to shared information, lack of clarity of roles and responsibilities of other
professionals, resourcing problems and inability to recruit and retain the
appropriate calibre of staff, suggest that it is no longer adequate to attempt
to fine tune or modify the present system. Proposal. The Minister for Health,
Social Services and Public Safety has published proposals² for modernising
hospital services and reforming the organisational structures of the Health
and Personal Social Services. These proposals at the time of writing, are issued
for consultation. There is therefore an opportunity to restructure services in a way which would help
to break down the barriers to inter-disciplinary co-operation and offer
clarity as to the extent of responsibility carried by each discipline. A reduction
in the number of HSS Trusts would facilitate effective networking between organisations
in the delivery of services. The establishment of a Children's Division in
each of these HSS Trusts with fully integrated social work, nursing and medical services
including psychiatry, child psychology and speech and language therapy services
is now proposed. Recently in England and Wales,
the spending review white paper Opportunity
and Security for All indicated that the government planned to "pilot children's trusts which
will unify at a local level the various agencies involved in providing
services to children". Planned to become operational by the end of 2003 it
is envisaged that the trusts could include partnerships in any area "where
social care, health and education services need to work together" and that
their services would include child protection. In Northern Ireland there are
excellent protocols in place with the education authorities and the police
with regards to inter-disciplinary co-operation in dealing with child abuse.
Article 46, Children (NI) Order 1995 provides for "co-operation between authorities
and other bodies in the exercise of functions relating to Part IV of the Order
ie Support for Children and Their Families.
A similar provision incorporated in Part VI of the Children (NI) Order 1995, ie The Protection of Children would reinforce
the status of the current protocols. This would provide a sound basis
for partnership between the proposed Children's Divisions and organisations
such as the Police Service (NI), the NI Housing Executive and the Education
and Library Boards. 2.3 Area Child Protection Committees There are currently four
Area Child Protection Committees ie one per Health and Social Services Board.
In a future structure which may have a reduced number of HSS Trusts and the
potential for the four HSS Boards to be abolished (perhaps to be replaced by
a single Regional Authority), it could be argued that each HSS Trust's area
should have an Area Child Protection Committee. This would make the strategic
work of the ACPC more responsive
to local need. It would also ensure that the work of the ACPC was more
open and accessible (currently different professionals often comment that they
are not aware of who is representing them or even what work is being undertaken
by an ACPC). The various organisations constituting the ACPC would thereby
be made more accountable for their actions not only to the Regional Authority
but to the public
for whom they provide a service. It is recommended that the Area Child Protection
Committees should be placed on a statutory footing with clear lines
of accountability and a greater clarity of purpose. 2.4 Regional Role A key element of governmental
response to child deaths (as a result of child abuse) over the last 25 years
has been to develop
ever more detailed procedures in order to maximise multi-disciplinary co-operation
and, at the same time, to increase the regulatory framework within which
professionals work. The effort to close down all conceivable loop-holes has
given rise to ever more complex procedures and paradoxically increased the
chances of professionals falling foul of procedures. This has given rise to
"defensive" child protection work and, for many social workers in particular,
there is a propensity either to leave child and family care or not come into
it in the first place. Government has a responsibility to create a more
positive climate within society within which our children may be better
protected from child abuse and within which professional staff may be better
supported. This role of government in educating the public regarding child
protection matters should be part of the wider Children's Strategy which is
currently being drafted by the Office of the First Minister and Deputy First
Minister. Child protection is everybody's
business. A Northern Ireland strategy in child protection would offer a vision
of the future which could be embraced by the public and professionals alike.
Goals could be set which encourage imaginative thinking and encourage collaborative
working. The DOH Quality Protects Programme in England and Wales is an excellent
example of objectives being established by government to improve the life chances
of vulnerable children with on-going funding of projects at a local level being
linked to positive results. A similar programme should be established in Northern
Ireland. Finally, it is imperative
that 'best practice' guidance is widely disseminated among all of the disciplines
involved in child protection work. Individual Case Management Reviews carried
out consequent to the death or serious injury to a child where child abuse
may have been the causative or contributory factor, will produce recommendations
which may be of benefit beyond the area of the HSS Trust. A Review Group at
Departmental level should distill the key messages from Case Management Reviews,
Public Inquiries and Caselaw in order that this vital information could be
disseminated throughout Northern Ireland on a regular basis. 2.5 The Voice of the Child One area that requires close
examination is that of the rights of the child in child protection arrangements.
Article 12 of the United Nations Convention on the Rights of the Child states
that:- 1. "States parties
shall assure to the child who is capable of forming his or her own views the
right to express those views freely in all matters affecting the child, the
views of the child being given due weight in accordance with the age and maturity
of the child. 2. For this purpose,
the child shall, in particular, be provided with the opportunity to be heard
in any judicial and administrative proceedings affecting the child, either
directly or through a representative or an appropriate body in a manner consistent
with the procedural rules of national law".³ There is now general agreement
amongst many academics and child protection professionals that there should
be much greater involvement of children and young people in shaping the child
protection system. It is argued that the views, interests and experiences of
children and young people need to be clearly and explicitly represented in
child protection policies and procedures. Corby (2000)4 makes the
point that "many
child protectionists are convinced that the assertion of children's rights
is a key mechanism for reducing child abuse generally". NIGALA agrees with these views and recommends that:-
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children and young people should be involved in the development of child protection
policies and procedures.
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child protection policies and procedures should reflect a clear child focus,
and should be supported by guidance
on assessment similar to the Department of Health's Framework for the Assessment
of Children in Need and their Families', which places the child at the
centre of the process; and
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policies and procedures should establish clear mechanisms for communicating
the views of the child at all stages of the child protection process from the
initial case conference to deregistration, where appropriate. 2.6 Care Planning One of the most important functions of the Guardian
is to scrutinise a Trust's proposals as to how the welfare of a child
is to be promoted following the granting of a Care Order. The care plan, presented
to the court, should include detail of how the full range of a child's needs
are to be met, what living arrangements are most appropriate and what support
the child requires. The Guardian's role ends on the completion of the proceedings
and therefore he has no further remit in ensuring that the plan agreed at court
will be implemented by the Trust. This issue of the implementation
of care plans received considerable attention recently in the Court of Appeal
in England and Wales as a result of its deliberations in Re W&B where a
local authority failed to carry out key elements of its plan to rehabilitate
two children with their mother. Essentially the Court of Appeal ruled that
in all cases before a final Care Order is made, thought must be given as to
which elements in the care plan are so fundamental that they require starring.
If these elements are not fulfilled, the Guardian and the court should have
a power to review the case. While the House of Lords overturned the Court of
Appeal's decision, Lord Nicholls, in his judgement, did recognise the need
for "urgent consideration" as to "whether some degree of court supervision
of local authorities' discharge of their parental responsibilities would bring
about an overall improvement in the quality of child care provided by local
authorities". In its consideration of child
protection arrangements, NIGALA urges the committee to address this issue to
ensure that children's welfare is promoted before, during and after court proceedings.
2.7 Consistency in Child Protection Arrangements
and Practice The creation of a consistently
effective child protection system has been complicated by 3 fundamental elements.
These 3 elements - the definition of child abuse; the increasing complexity
of child protection work; and the threshold for intervention, are like shifting
sands and make the operation of a consistent service across the province a
most difficult task. Each of these elements require examination:- (a)
Definitions - the 1995 publication by the Department of Health, "Child
Protection, Messages from Research"5 notes how society continually
reconstructs definitions of child maltreatment. Jane Gibbons' summarised the
situation saying that "as a phenomenon, child maltreatment is more like pornography
than whooping cough. It is a socially constructed phenomenon which reflects
values and opinions of a particular culture at a particular time". One has
only to look at the changing definitions over time in government guidance and
social work literature to realise the elusive quality of the concept. (b)
Complexity in child protection work - child protection work today is
almost unrecognisable from that of 40 years ago. The "discovery" of child abuse
focused on the physical abuse of children, known more specifically at the time
as "baby battering". Over the subsequent years, the existence of neglect and
particularly the sexual abuse of children in our society, have focused the
minds of professionals and become firmly embedded in the psyche of the public.
More recently the association of domestic violence with child abuse has significantly
influenced practice and the threat to children's safety as a result of technological
advances such as the internet is yet another factor to be considered. Recent
years have also seen major changes in both domestic and international legislation,
which have dramatically increased (for the better) the range of factors a professional
must take into account when dealing with child protection issues. The context in
which child protection practitioners now find themselves, then, is one where
society's perception as to what constitutes
child abuse continuously evolves and the knowledge and skill required to do
the job is becoming increasingly complex. A stable, mature workforce is required.
In responding to this situation, it is essential
that the Department plans a workforce strategy specifically in relation
to child protection. This strategy must include the following key elements:
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recruitment
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training
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retention
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ongoing support
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attractive conditions of service (c)
Thresholds - There are a number of points at which the application of
consistent thresholds in the child protection process are particularly problematic.
Two of these are: (i)
The threshold which sparks a child protection inquiry and (ii)
The threshold which determines the placing of a child's name on the
child protection register Spratt (2000)6
found that there was considerable disagreement between senior social workers
as to what constitutes a child protection referral. When it comes to placing
children's names on the register there are significant variations in rates
of registration between Trusts. Mostyn (1996)7 found that: "the
chance that a child will be placed on the register depends on definitions and
interpretations which vary in different parts of the UK and on thresholds determined
by local circumstances, practice and resources". While Gordon and Gibbons
(1998)8 did not find evidence to support fears that decision making
in child protection is so unreliable that local aspects of the system rather
than children's needs determine their placement on protection registers, the
Northern Ireland figures show that rates of registration vary considerably
across Trusts from 61.7 children per 10,000 aged under 18 in North & West
Belfast to 6.00 children per 10,000 aged under 18 in Craigavon & Banbridge,
(Key indicators of Personal Social Services for Northern Ireland 2001).9 Given the variations in both
initiating child protection inquiries and the rates of registration, and while
allowing for the influence of demographic factors, this issue of the application
of more consistent thresholds must be addressed. These initiatives may include
:- (i)
commissioning of relevant research which will assist in (ii)
development of evidence based practice and in the production of (iii)
improved guidance on decision-making which, in turn, would provide a
baseline for (iv)
system of monitoring at a local and regional level Summary of recommendations
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Establishment of a Children's Division in each new HSS Trust with fully
integrated social work, nursing and medical services including psychiatry,
child psychology and speech and language therapy services.
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Amendment of the Children (NI) Order 1995 to include an Article in Part
VI. Protection of Children mandating co-operation between organisations
involved in combating child abuse ie an Article similar to Article 46 which
relates to Part IV, Support for Children
and their Families.
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An Area Child Protection Committee is established in each of the new HSS Trusts.
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Area Child Protection Committees should be placed on a statutory footing with
clear lines of accountability and a greater clarity of purpose.
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A Proactive role for government which includes:- (i) A vision of child protection which may
be embraced by all and contained within the proposed Children's Strategy. (ii) A public education remit. (iii) Establishment of a comprehensive programme aimed at encouraging
imaginative thinking and collaborative working: objectives set to improve the life chances of vulnerable
children with on-going funding of projects at a local level being linked to
positive results. (iv) A Review Group charged with distilling the
key messages from Case Management Reviews, Public Inquiries and Caselaw and
responsible for dissemination of this information.
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Urgent steps to be taken to ensure compliance with the UN Convention on the
Rights of the Child and Human Rights legislation by providing mechanisms for
children to be more included in decision making: (i) children and young people should be involved
in the development of child protection policies and procedures; (ii) child protection policies and procedures
should reflect a clear child focus, and should be supported by guidance on
assessment similar to the Department of Health's Framework for the Assessment
of Children in Need and their Families, which places the child at the centre
of the process; and (iii) policies and procedures should establish clear mechanisms for
communicating the views of the child at all
stages of the child protection
process from the initial case conference to deregistration, where appropriate.
n
Review of boundaries of responsibilities between the Health and Social Services
Trusts and the courts in relation to the discharge of corporate parental responsibility
n
The development of a multi-disciplinary workforce
strategy which must include the following key elements:
-
Recruitment
-
Training
-
Retention
-
Ongoing support
-
Attractive conditions of services
n
Initiatives should be taken to address the variations in practice regarding
the interpretation of the appropriate criteria for (a) undertaking child protection
inquiries and (b) placing children's names on the Child Protection Registers.
Initiatives may include: (i) commissioning
of relevant research which will assist in (ii) development
of evidence based practice and in the production of (iii) improved guidance on decision-making which,
in turn, would provide a baseline for a system of monitoring at a local and regional level REFERENCES
[i] Sports where touching is not appropriate include swimming. Sports where touching is appropriate is gymnastics
9 October (vol 3b) / Menu / 9 October 2002 (vol 3d) |
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