GOOD PRACTICE EXAMPLE
16. CONCLUSION AND RECOMMENDATIONS
16. CONCLUSION AND RECOMMENDATIONS
16.1 This inspection has identified many areas of good practice and good quality work undertaken by highly motivated staff who are working in extremely pressurised and high risk situations, in both fieldwork and residential children’s services. The
inspection has sought to identify both what is working well and where improvements still need to be made.
16.2 There now needs to be a comprehensive and sustained programme of change established with all the key stakeholders. Significant co-ordinated regional action is required to deliver the necessary high quality services needed to safeguard children and young people in Northern Ireland. The findings of the inspection and the
implementation of its recommendations will assist in improving arrangements for safeguarding children and young people and in increasing public awareness in this critically important area.
16.3 This report, its recommendations and the draft standards provide a clear and coherent framework for the future provision of robust, high quality child protection services.
16.4 The key recommendations made to the Boards, Trusts, key agencies and Government Departments are set out below:
Planning, Commissioning, Monitoring and Management and Provision of Child Protection Services - Chapter 2
Boards must ensure that:
1. the Director of Social Services/Care is clearly identified as having lead responsibility for child protection services and the postholder effectively discharges the
responsibilities associated with this post;
2. there is a Designated Doctor and Designated Nurse to provide clear leadership within these disciplines for the development, implementation, monitoring and review of child protection services;
3. information obtained directly from Trusts, such as contract compliance and CC3/02 reports, is validated, analysed and used to inform planning and commissioning; and
4. quality improvement plans and effective monitoring arrangements are put in place to address the deficits identified in CC03/02 reports and to ensure that Trusts have the capability at all levels within children’s services to discharge statutory child care functions.
Trusts must ensure that:
5. the Director of Children’s Services is clearly identified as having lead responsibility for child protection services and effectively discharges the responsibilities associated with this post and with the post of Executive Director of Social Work;
6. the lines of professional responsibility and accountability from the front line of practice to the Chief Executive and to the Trust board are clear and unambiguous thus enabling the Trust board to discharge its responsibilities in regard to children’s services effectively;
7. there is a Named Doctor and Named Nurse with clearly defined job plans and responsibilities to provide a lead role for child protection within these disciplines;
8. difficulties or risks in regard to its ability to discharge statutory child care functions are included in CC03/02 reports and brought to the attention of the Trust board.
Trusts should also seek to agree, implement and review quality improvement plans, as appropriate; and
9. their workforce strategy enables them to meet their requirements as an employer as set out in the NISCC Code of Practice and complies with social care governance arrangements.
Boards and Trusts must ensure that:
10. Executive and Non-Executive Directors are clear about their individual and corporate responsibilities and receive mandatory training in understanding their role as a
“corporate parent”;
11. information provided to the Boards to secure resources for children’s services is appropriately collated, validated and analysed, and
- resources made available to children’s services are directed to identified areas of need, and progress is regularly and appropriately reported on; and
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- investment in children’s services is continuously reviewed and the findings included in the annual reports to the Area Board on the discharge of statutory functions.
12. the DHSSPS is advised of difficulties in discharging statutory functions for child protection and children’s residential services, the action plan and timescale proposed to address these, and any specific shortfall in resources; and
13. staffing difficulties within the professional groups are brought to the attention of the DHSSPS Workforce Planning Group and Children Matter Taskforce and addressed.
The DHSSPS must ensure that:
14. the structures and arrangements for children’s services planning and commissioning are evaluated on a regional basis every 3 years;
15. experienced practitioners are encouraged to remain in the front line of child care and child protection practice, for example, through the review of the senior practitioner grades and the introduction of principal practitioners in this area of social work; and 16. in relation to the NISCC Codes of Practice:
- the NISCC makes sure that practitioners comply with the “Code of Practice for Social Care Workers” working, where necessary, in collaboration with the RQIA;
and
- the RQIA monitors employers’ compliance with the “Code of Practice for Employers of Social Care Workers”.
The Purpose of Services - Chapter 3
Boards and Trusts must collaborate on a regional basis, and
17. involve service users, including parents, children and young people, and relevant disciplines and agencies, to produce a clear statement of purpose, which:
- outlines their statutory duties and responsibilities to children in need and those at risk of significant harm;
- includes information about the nature of services, how and when they can be accessed, the standards to which they operate, how parents, children and young people will be involved in service design, development, review and feedback and how to make a complaint;
- is widely available to all stakeholders, including potential service users and referral sources, through an appropriate range of paper-based and electronic means and is accessible to those with special needs and those for whom English is not a first or competent second language; and
- is referenced in all relevant documentation produced by them; and 18. review and clarify their thresholds for entitlement to services and ensure that
children, young people and families in need have access to timely and appropriate preventative and supportive services.
Trusts must ensure that:
19. information about the complaints process is prominently displayed, that all parents, children and young people routinely receive a copy of the Trust’s complaints leaflet at the point of entry to the service and the process is personally explained to them.
Access to Services - Chapter 4 Boards and Trusts must ensure that:
20. adequate and appropriate information is available to potential service users and members of the public about the nature of child protection services and how and when to access them. This information should be presented, whenever necessary, in accessible formats, including translations for those for whom English is not a first or competent second language;
21. information is developed, disseminated and regularly audited in association with parents and young people and made available through the range of facilities commonly used by potential service users; and
22. a comprehensive review of the out-of-hours duty system is undertaken and that the relevant expertise and experience is available to provide an effective and responsive child protection service.
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Trusts must take action to improve:
23. arrangements for other agencies to receive information and feedback about the allocation of referrals made by them;
24. arrangements for parents, children and young people as well as staff in other agencies, to access relevant services and support within agreed timescales and in line with agency standards;
25. the reception, waiting and meeting room facilities within local children’s services offices; and
26. systems for parents, children and young people to enable them to contact their social workers, as required, including:
- provision of voicemail, email, and mobile telephone numbers;
- monitoring arrangements to check that responses are within agreed timescales;
and
- customer care training for receptionists and duty officers.
Assessment, Case Planning, Case Management and Record Keeping - Chapter 5 The DHSSPS must:
27. continue to progress the implementation of a single model of assessment for Northern Ireland as a matter of urgency and ensure that:
- there is consistent use of the model for assessment across the region and that the impact on improved outcomes for children and families is evaluated, in collaboration with the key disciplines and agencies;
- Boards and Trusts, through ACPC and CPP, provide practitioners and managers from all disciplines and agencies with appropriate training in the application of the assessment model; and
- the NISCC actively regulates social work training and monitors professional course content, particularly in relation to assessment and risk assessment to ensure that it reflects current best practice.
Trusts must:
28. monitor and audit the implementation of case conference procedures and ensure that:
- case conference chairs fulfil their role in leading the case conference as set out in CtSC and are supported through appropriate line management supervision,
effective monitoring arrangements, adequate on-going training and the provision of suitable accommodation;
- training is provided to professionals in relation to their roles and contributions to the case conference process;
- the case conference process remains focused on the needs of children;
- information from the range of agencies working with families is summarised;
- the roles of school nurse and health visitor are clearly defined and that their reports provide full assessment of the health/developmental needs of the child and relevant information in relation to the parents’ health and parenting skills;
- the needs and risks in respect of individual children are analysed and whether the requirements for child protection registration are met;
- the parents’ and family’s strengths and qualities and their existing network of supports are assessed;
- the deficits in parenting skills and the kinds of supports required to address these are clarified;
- any changes needed and standards to be achieved in order for children’s names to be removed from the register are clearly set out;
- advice is provided to parents of the importance of co-operating with the child protection plan and the potential consequences in terms of Care Order applications when the threshold of significant harm has been reached;
- an appropriately trained minute taker records all child protection case
conferences, that minutes are consistent with CtSC and are circulated within 14 days as required by the regional ACPC Policy and Procedures; and
- the views of children and young people and parents about the conduct of case conferences, are considered and, if necessary, appropriate action taken;
29. evaluate/audit case recording in their family and child care services to ensure that information from all relevant disciplines is appropriately collated, analysed and
recorded and that this forms the basis for the assessment, including risk assessment and therapeutic intervention required in each case; and
30. retain in the file one completed comprehensive set of essential information record forms, a front chronology sheet that is regularly updated with information on the
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child/family, case summaries and transfer reports and records typed, cross-referenced and filed in date order.
Protecting Vulnerable Children in Specific Circumstances - Chapter 6 Trusts must ensure that:
31. child protection procedures are initiated in all situations where the criteria are met and that there is an appropriate multi-agency assessment of risk and adequate child protection planning;
32. the expertise of AHPs is more fully utilised in the assessment and management of child protection cases, where appropriate;
33. the management of cases reflects an appropriate balance between working in partnership with parents to avoid family breakdown and using its authority to effectively intervene to challenge harmful situations and safeguard children, and - written contracts with parents specify the work plan and clearly state the
standards and improvements expected of them;
34. decision making is appropriately informed by clinical and psychological assessment of parental capability and level of functioning; and
35. staff in mental health, learning disability and addiction services receive appropriate child protection training and staff in child care receive appropriate training in mental health, learning disability, alcohol and drug abuse and the impact of these on
children.
Quality Assurance and Managing Performance of Service - Chapter 7 Boards must ensure that:
36. Trusts have in place robust arrangements for monitoring and auditing:
- the management of the child protection process;
- the implementation of policies and procedures for referral, assessment, case planning, case management and record keeping of individual cases; and
- the effectiveness of interventions in achieving specified outcomes for children and families.
Trusts must ensure:
37. compliance with NISCC, NMC, GMC, HPC and other regulatory bodies’ guidance on supervision, continuous professional development and appraisal as part of their governance arrangements and this should be monitored by the RQIA.
Boards and Trusts must:
38. audit the standards and procedures for supervision for all staff and ensure that staff are appropriately supported and managed in their work with children and families;
and
39. in collaboration with PSNI, review and monitor the implementation of the joint protocol.
The DHSSPS must continue to ensure that:
40. Boards and Trusts have reviewed and taken action on the serious issues identified in the management letters issued during the inspection and that safeguards for children are in place and practice improved.
The Establishment and Operation of the Area Child Protection Committee (ACPC) and the Child Protection Panel (CPP) - Chapter 8
Boards and Trusts, in conjunction with key agencies, represented on ACPCs and CPPs must ensure that:
41. representatives are of sufficient seniority in their own organisations and disciplines to fully discharge the responsibilities of membership. Representatives must have the necessary mandated authority to make strategic decisions and allocate and pool resources on behalf of their organisation and discipline, and
- ACPC and CPP chairs regularly apprise them of safeguarding developments, immediately reporting issues which have the potential to compromise governance
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and “corporate parenting” responsibilities. Proposed quality improvement plans to deal with these should also be included; and
- the ACPC is adequately informed about local and agency child protection
concerns, including referral and workforce issues, so that these can be addressed and resolved; and
42. ACPC and CPP business plans and action plans conform to CtSC and that they:
- reflect the interagency nature of child protection work;
- have specific targets and outcomes which are measurable and time bounded;
- include the development and implementation of a robust and ongoing programme of auditing and monitoring which ensures that the safeguarding strategy for the area is working;
- identify the multi-agency training requirements and funding arrangements; and - are available in an abbreviated format and made widely available to staff, children,
young people and families.
The DHSSPS must continue to:
43. progress the introduction of the new Safeguarding Board for Northern Ireland to replace the existing ACPC/CPP structure.
Case Management Reviews - Chapter 9 Boards must ensure that:
44. CMRs are undertaken in accordance with CtSC and that the lessons learned are communicated, understood and actioned within their Board/Trust and across all disciplines/agencies, and
- there is a process in place to inform practice and measure improvement; and - problems identified in undertaking CMRs are brought to the attention of the
DHSSPS so that these can be considered in any amendments to regional guidance.
The DHSSPS must ensure that:
45. the CtSC Working Group completes its review of the lessons emerging from CMRs and, in collaboration with the Boards and Trusts, consider the issues for policy and practice developments, and
- the status of CMRs is clarified and that issues about interfaces with the wider processes of the law are addressed within the new Safeguarding Board
arrangements.
Equality and Human Rights - Chapter 10
Boards and Trusts in planning, commissioning and providing child protection services must ensure that:
46. the rights of children and young people are appropriately safeguarded in the context of these services and that services are provided equitably having due regard to the assessed needs, changing profile and diverse needs of young people and families.
The Interface between Residential and Fieldwork Child Care Services - Chapter 11 Boards and Trusts should:
47. give effect to their child care responsibilities. In order to achieve this they need to:
- strengthen the commissioning, quality assurance and monitoring processes to ensure a high standard of planning and effectiveness in their Looked After Children (LAC) services;
- review the provision of the full range of LAC services to ensure they are adequate in terms of numbers and choices;
- develop a range of additional remand/specialist/therapeutic placements to provide a greater range of choice; and
- review training and support for foster carers as part of their action plans to further develop foster care services.
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Trusts should urgently review:
48. the recommendations made in recent RQIA inspection reports and develop and
implement quality improvement plans. Senior Managers should ensure that legislative requirements are met in order to provide appropriate safeguards for children and young people in residential care.
Boards and Trusts must:
49. review the terms of reference for their Children’s Resource/Placement Panels, and - ensure representation from Heads of children’s homes in order to utilise their
expertise in the decision making process;
- ensure social workers provide an up-to-date comprehensive assessment on every child and young person to enable the Panel to consider the most effective
placement option and to provide appropriate assessment information to the home prior to the admission decision;
- consider the impact of new admissions and any associated high risk behaviours on the other children and young people in the home;
- ensure that discussions are held about the actions required to resolve behaviours evident in a placement before agreeing to transfer the child to another
environment;
- share the learning from previous movement between placements in terms of, for example, challenging behaviour and what works best for the child or young person. Consideration should be given to the impact of endings, loss and attachment theory so that the needs of children and young people are appropriately met; and
- regularly review the quality of the Panel’s decision making process as part of their governance arrangements.
Trusts must ensure that:
50. pre-admission discussions are held regarding each admission and that:
- a programme of planned visits is arranged to introduce the child to other children in the home, their key worker and staff;
- formal admission contracts are introduced which provide clarity for the child and family on the rationale, purpose and expected outcome of the admission to care;
and
- the contact arrangements and respective roles and tasks of residential workers and the fieldworker are clarified in relation to the work plan and the follow up arrangements regarding statutory visits, family contact and reviews.
The DHSSPS, in collaboration with key stakeholders, must:
51. review and research best practice in providing therapeutic intervention and support to
51. review and research best practice in providing therapeutic intervention and support to