OUR CHILDREN AND YOUNG PEOPLE OUR SHARED RESPONSIBILITY

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OUR CHILDREN AND

YOUNG PEOPLE – OUR SHARED

RESPONSIBILITY

INSPECTION OF CHILD PROTECTION

SERVICES IN NORTHERN IRELAND

OVERVIEW REPORT

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OUR CHILDREN AND

YOUNG PEOPLE - OUR SHARED

RESPONSIBILITY

INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND

ACKNOWLEDGMENTS

A multi-disciplinary, interagency approach to child protection work is essential. It is a difficult and complex area of work which requires a shared commitment, effective communication and a focus on achieving the best outcomes for children. A multi-disciplinary, interagency inspection team was established with representation drawn from the various professional disciplines within the Department of Health, Social Services and Public Safety, the Police Service of Northern Ireland and the Education and Training Inspectorate of the Department of Education. A Lay Assessor was also appointed to the inspection team.

Representatives from the Office of the Northern Ireland

Commissioner for Children and Young People and the Regulation and Quality Improvement Authority were also involved in the latter part of the inspection.

The inclusion of the different disciplines, agencies, lay

representation and most importantly the views of children, young people and families ensured that the report reflects the sensitive and complex nature of child protection work and the relationship of each discipline and agency with children, their families and each other.

The Department wishes to acknowledge the contribution of all who participated in the inspection and to express its confidence that the lessons learned will lead to more effective approaches in the area of child protection.

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SOCIAL SERVICES INSPECTORATE

OVERVIEW REPORT

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PEOPLE – OUR SHARED

RESPONSIBILITY

Inspection Team:

Mrs Maire McMahon Inspection Manager Dr Teresa Donaldson Child Care Consultant Mr Ken Wilson Child Care Consultant Mrs Lynne Peyton Child Care Consultant

Miss Marion Reynolds Social Services Inspectorate

Ms Theresa Nixon Regulation & Quality Improvement Authority

Mrs Marian Robertson Nursing, representing Nursing and Midwifery Advisory Group

Dr Alison Livingstone Medical, representing Medical and Allied Group Dr Erin Knowles Medical, representing Medical and Allied Group Mrs Heather Crawford Allied Health Professional, representing Medical

and Allied Group

Mr Willie McAuley Police Service of Northern Ireland D.I. Anne Marks Police Service of Northern Ireland Dr Lynne McMullen Education and Training Inspectorate,

Department of Education

Mrs Betty Robinson Education and Training Inspectorate, Department of Education

Ms Teresa Devlin Northern Ireland Commissioner for Children and Young People

Dr Helen Beckett Northern Ireland Commissioner for Children and Young People

Mr Raymond Gordon Lay Assessor

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FOREWORD

All children and young people need to be cherished and cared for. They need to be looked after, to live in safety and to be protected from abuse. They need to be supported to achieve their full potential so that they may grow into confident, well adjusted adults. This is the vital role that families fulfil in our society.

Unfortunately, not all children and young people are properly looked after within their families. Some families need extra support to help them and for a small number of children and young people, additional steps have to be taken to ensure that they are safeguarded from harm. This is a responsibility we all share. The decision by statutory

authorities to intervene in family life is never taken lightly. To do so is to take on direct responsibility for the protection and wellbeing of the children and young people concerned. This is a responsibility which must be taken seriously and which requires the highest levels of skill, integrity and dedication. It is difficult, pressurised work that requires an understanding of the most complex needs and risks.

This inspection report considers how well agencies and professionals are meeting these challenges. The inspection found examples of good practice undertaken by highly motivated staff. These staff and their work are to be commended. However, the inspection has also found evidence of serious failings. In a number of areas there are fundamental flaws in child protection arrangements resulting, in some instances, in a failure on the part of organisations to adequately discharge their statutory responsibilities to protect vulnerable children and young people. This is not acceptable.

I was not prepared to wait for the publication of this report before taking steps to improve and strengthen child protection services in Northern Ireland. I have already initiated a fundamental reform of child protection services, including: the introduction of robust governance and

performance management arrangements; the development of a single assessment framework for children’s services; developing agreed regional thresholds for access to children’s services; the strengthening of community child protection teams; and the establishment of an

independently chaired Safeguarding Board for Northern Ireland, which will have an enhanced role in child protection matters. Furthermore, this report makes a number of detailed

recommendations which will be implemented by Departments, Boards, Trusts and other agencies in the coming months.

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These child protection reforms are being taken forward alongside an unprecedented

investment across the full range of children’s services. This investment taken together with the reforms already underway will, I believe, help deliver significant improvements in outcomes for all our children and young people. This is the goal that I and my colleagues in all Government Departments are determined to achieve.

I welcome this report. It is a full and candid appraisal of our child protection services and it clearly sets out what we must do to meet our shared responsibility to keep our children and young people safe from harm.

PAUL GOGGINS MP

Minister for Health, Social Services and Public Safety

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CONTENTS

PAGE

GLOSSARY OF ABBREVIATED TERMS iii

1. INTRODUCTION AND SUMMARY OF KEY FINDINGS 1

- Legislative and Policy Background 1 - Aim and Scope of the Inspection 4

- Inspection Standards 5

- Factors Impacting on the Inspection 5 - Summary of Key Findings 6

2. PLANNING, COMMISSIONING, MONITORING AND MANAGEMENT AND 11 PROVISION OF CHILD PROTECTION SERVICES

3. THE PURPOSE OF SERVICES 21

4. ACCESS TO SERVICES 27

5. ASSESSMENT, CASE PLANNING, CASE MANAGEMENT AND 33

RECORD KEEPING

6. PROTECTING VULNERABLE CHILDREN IN SPECIFIC CIRCUMSTANCES 45 7. QUALITY ASSURANCE AND MANAGING PERFORMANCE OF SERVICE 49 8. THE ESTABLISHMENT AND OPERATION OF THE AREA CHILD PROTECTION 55

COMMITTEE (ACPC) AND THE CHILD PROTECTION PANEL (CPP)

9. CASE MANAGEMENT REVIEWS 61

10. EQUALITY AND HUMAN RIGHTS 65

11. THE INTERFACE BETWEEN RESIDENTIAL AND FIELDWORK CHILD 67 CARE SERVICES

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13. POLICE SERVICE OF NORTHERN IRELAND: KEY FINDINGS AND 93 RECOMMENDATIONS

14. REGULATION AND QUALITY IMPROVEMENT AUTHORITY: 97

KEY FINDINGS AND RECOMMENDATIONS

15. THE VIEWS OF CHILDREN AND YOUNG PEOPLE: OFFICE OF 99

COMMISSIONER FOR CHILDREN AND YOUNG PEOPLE

16. CONCLUSION AND RECOMMENDATIONS 107

APPENDICES

APPENDIX 1 INSPECTION BRIEF 125

APPENDIX 2 DRAFT STANDARDS FOR THE INSPECTION OF 137

CHILD PROTECTION SERVICES

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GLOSSARY OF ABBREVIATED REFERENCES

ACPC Area Child Protection Committee AHPs Allied Health Professionals

APSWs Assistant Principal Social Workers BASW British Association of Social Workers

CAMHS Child and Adolescent Mental Health Services CARE Child Abuse and Rape Enquiry

CMR Case Management Review

CPD Continuing Professional Development CPNAs Child Protection Nurse Advisors CPP Child Protection Panel

CSP Children’s Services Planning

CtSC Co-operating to Safeguard Children CYPC Children and Young People’s Committee DE Department of Education

DHSSPS Department of Health, Social Services and Public Safety DVO Domestic Violence Officer

EOTAS Education Other Than At School ETI Education and Training Inspectorate EWOs Education Welfare Officers

HRA Human Rights Act LAC Looked After Children

NICCY Northern Ireland Commissioner for Children and Young People NISCC Northern Ireland Social Care Council

NMAG Nursing and Midwifery Advisory Group PSNI Police Service of Northern Ireland

RQIA Regulation and Quality Improvement Authority SAM School Aged Mothers

SCIE Social Care Institute for Excellence SLA Service Level Agreement

SMT Senior Management Team SSI Social Services Inspectorate

UNOCINI Understanding the Needs of Children in Northern Ireland UNCRC United Nations Convention on the Rights of the Child VOYPIC Voice of Young People in Care

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1. INTRODUCTION AND SUMMARY OF KEY FINDINGS

1.1 This overview report presents the main findings of a multi-disciplinary, interagency inspection of child protection services in Northern Ireland. The inspection was led by the Social Services Inspectorate (SSI) of the Department of Health, Social Services and Public Safety (DHSSPS) and undertaken in 5 Health and Social Services Trusts (Trusts) and their commissioning Health and Social Services Boards (Boards). This report, its recommendations and the associated draft standards provide a clear and coherent framework for the future provision of robust, high quality child protection services. They also provide the basis for self-audit by providers of services. The findings of the inspection and the implementation of the recommendations will:

• improve arrangements for safeguarding children and young people,

• increase public awareness in this important area;

• enhance professional practice, multi-disciplinary and interagency working and service provision; and

• inform policy development with regard to safeguarding children and young people.

Legislative and Policy Background

1.2 The Health and Personal Social Services (Northern Ireland) Order 19941provides for specified functions of a Board, known as ‘relevant functions’ to be exercised by a Trust on behalf of a Board. The functions are prescribed in the Health and Social Services Trusts (Exercise of Functions) Regulations (Northern Ireland) 1994 (The Exercise of Functions Regulations). Prior to the commencement of the Children (Northern Ireland) Order 19952_{(the Children Order) in November 1996, the DHSSPS}

amended the Exercise of Functions Regulations to prescribe as ‘relevant functions’, all functions under the Children Order. Trusts are responsible in law for the discharge of all the Children Order functions (statutory functions) that have been delegated to them by Boards.

1 _{The Health and Personal Social Services (Northern Ireland) Order 1994 can be accessed at:}

http://www.opsi.gov.uk/si/si1991/Uksi_19910194_en_1.htm#tcon

2 _{The Children (Northern Ireland) Order 1995 can be accessed at: http://www.opsi.gov.uk/si/si1995/Uksi_19950755_en_1.htm#tcon}

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1.3 Boards are responsible for prescribing the professional and other quality standards governing the discharge of statutory functions, for approving Trusts’ policies and procedures in respect of these and for monitoring and evaluating services on a basis agreed with Trusts. In November 2005, the DHSSPS issued for consultation a draft Circular in order to reclarify the roles and responsibilities of Boards and Trusts in relation to the discharge of statutory functions and the duty to safeguard and promote the welfare of children. The Circular in its final form has now been issued.

1.4 Boards have a general strategic responsibility for commissioning services in line with the identified needs of their populations. In addition, under the Children Order as amended by the Children (1995 Order) (Amendment) Children’s Services Planning Order (Northern Ireland) 1998,3 _{each Board is specifically required to review the}

services provided in its area under Part IV of the Children Order and prepare and review plans in light of this.

1.5 The statutory functions that have been delegated to Trusts by Boards under the Children Order include all the provisions of Part VI of the Children Order relating to the protection of children. Article 664_{places a duty on a Trust, where it has reasonable}

cause to suspect that a child who lives or is found in the Trust’s area is suffering or is likely to suffer significant harm to “make or cause to be made such inquiries as it considers necessary to enable it to decide whether it should take any action to safeguard or promote the child’s welfare”. The Children Order also provides the legislative basis to underpin the provision of services to children “in need” and their families as defined by Article 17.5

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3 _{The 1998 Amendment Order can be accessed at: http://www.opsi.gov.uk/sr/sr1998/19980261.htm} 4 _{66. (1)} _{Where an authority –}

(a) is informed that a child lives, or is found, in the authority’s area— (i) is the subject of an emergency protection order; or

(ii) is in police protection; or

(b) has reasonable case to suspect that a child who lives, or is found, in the authority’s area is suffering, or is likely to suffer, significant harm,

the authority shall make, or cause to be made, such inquiries as it considers necessary to enable it to decide whether it should take any action to safeguard or promote the child’s welfare.

5 _17. _{For the purposes of this Part a child shall be taken to be in need if—}

(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 under this Part;

(b) his health or development is likely to be significantly impaired, or further impaired, without the provision for him of such services; or

(c) he is disabled,

and “family” , in relation to such a child includes any person who has parental responsibility for the child and any other person with whom he has been living.

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1.6 Whilst Trusts hold the primary statutory responsibility for safeguarding children and conducting any necessary investigations in this regard, the Children Order places duties on other bodies and authorities to assist Trusts with their inquiries, provided this does not conflict with the discharge of their own statutory functions.

“Co-operating to Safeguard Children”6(CtSC) is the most recent child protection guidance and was issued by the DHSSPS in May 2003. This guidance sets out the role of Boards, Trusts and other agencies and how they should co-operate to promote children’s welfare and to protect them from abuse or neglect. CtSC has been informed by messages and lessons drawn from research, national and local Case Management Reviews (CMRs) and the experience of practitioners.

1.7 The Inquiry led by Lord Laming into the death of Victoria Climbié in 2003 produced a report containing 108 recommendations.7This included a requirement that agencies conduct an audit of their child protection services against key themes drawn from the Inquiry Report. An audit of child protection services against the Laming

recommendations was conducted by the DHSSPS in Northern Ireland during 2004. The audit revealed shortcomings in a number of areas. Boards and Trusts were advised to rectify these and that a further self-audit would be undertaken. Lessons continue to be collated from CMRs in Northern Ireland concerning multi-disciplinary and interagency practice in cases where a child has died or suffered a potentially life threatening injury and where abuse or neglect is known or suspected to be a factor.8 1.8 From 25 April 2003, a statutory duty of quality was imposed on Boards and Trusts by

the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003.9Quality assurance is being implemented through the establishment of care standards, clinical and social care governance standards and risk management systems that have implications for the monitoring and audit of all services within the HPSS, including children’s services and child protection services.

6 _{“Co-operating to Safeguard Children” DHSSPS (2003), can be accessed at:}

http://www.dhsspsni.gov.uk/show_publications?txtid=14022

7 _{Laming (2003) Victoria Climbié Inquiry Report. The Victoria Climbié Inquiry Report can be accessed at:}

http://www.victoria-climbie-inquiry.org.uk/finreport/report.pdf.

8 _{Chapter 10 of “Co-operating to Safeguard Children sets out when a CMR should be undertaken and its purpose. It also provides}

guidance on the action to be taken following the completion of a CMR Report.

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Aim and Scope of the Inspection

1.9 The purpose of the inspection was to obtain information about the nature, range and quality of child protection services in Northern Ireland, about interagency working arrangements, the operation of Area Child Protection Committees (ACPCs)10and Child Protection Panels (CPPs)11 _{and to make recommendations as appropriate.}

1.10 The inspection was undertaken in 5 Trusts. An inspection of the interface between residential and fieldwork child care services was conducted in 2 Trusts (South and East Belfast Trust and Sperrin Lakeland Trust) due to issues identified within their children’s residential care homes. The Foyle Trust residential/fieldwork interface was inspected as part of the Sperrin Lakeland inspection. The 5 Trusts inspected were:

• Craigavon and Banbridge Trust - Southern Health and Social Services Board (SHSSB), May/June 2004;

• Foyle Trust - Western Health and Social Services Board (WHSSB), June/July 2004 (fieldwork services) and January/February 2006 (residential and fieldwork

interface);

• Causeway Trust - Northern Health and Social Services Board (NHSSB), May/June 2005;

• South and East Belfast Trust - Eastern Health and Social Services Board (EHSSB) September/October 2005 (including residential and fieldwork interface); and

• Sperrin Lakeland Trust - Western Health & Social Service Board (WHSSB) January/February 2006 (including residential and fieldwork interface).

Individual inspection reports were provided and action plans sought from Trusts and Boards in response to the recommendations. Reports were issued to Trusts and Boards and the DHSSPS has continued to work with them to ensure that actions proposed were robust and addressed with appropriate urgency to secure

improvement. In addition, the Regulation and Quality Improvement Authority (RQIA)

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10 _{The role of the ACPC is to develop a strategic approach to child protection. The full role and responsibilities of ACPCs are set out in CtSC,}

Chapter 4.

11 _{The role of the CPP is to implement locally the ACPC’s policy and procedures ensuring a high standard of professional practice. The roles}

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has maintained close scrutiny of developments with regard to children’s residential care. The inspection reports and associated action plans can be accessed on the DHSSPS website.12

1.11 The inspection of child protection services, was led by the SSI, and comprised a multi-disciplinary, interagency inspection team with representation drawn from Medical, Nursing and Midwifery Advisory Group (NMAG), Allied Health Professionals (AHPs), Police Service of Northern Ireland (PSNI), Education and Training Inspectorate (ETI) and a Lay Assessor. The team was expanded for the inspection of the Sperrin Lakeland Trust to include representatives from the Office of the Northern Ireland Commissioner for Children and Young People (NICCY) and from the RQIA. The inclusion of these different disciplines ensured that the inspection methodology reflected the sensitive and complex nature of child protection and the relationship of each discipline/agency with children, members of the public and other professionals. The inputs from education and police representatives on the inspection team

concentrated on a review of issues arising for and within those sectors. The inspection brief and methodology is detailed in Appendix 1.

Inspection Standards

1.12 To progress the inspection of child protection services in Northern Ireland a set of draft standards was developed following extensive consultation with representatives from the DHSSPS, Boards and Trusts, the PSNI, the ETI of the Department of

Education (DE), and the Voluntary Child Care Sector. The draft standards are included in Appendix 2.

Factors Impacting on the Inspection

1.13 There were a number of significant developments during the course of the inspection which the inspection team was asked to address. Issues raised initially in the context of specific Trusts were subsequently found to have more general relevance and led to a significant number of regional recommendations.

1.14 In September 2004, NICCY raised the issue of unallocated child care cases with the DHSSPS. The DHSSPS sought written information from each Board and Trust as to whether this was a problem in its area, the number of cases awaiting allocation, if any, and an action plan, if required, to remedy the situation. Inspectors were asked to

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take account of this issue in the Trusts still to be inspected and sampled a number of unallocated/waiting list cases as well as cases which had been recently allocated. Inspectors also explored the extent of the problem and examined the Boards’/Trusts’ attempts to resolve it in the context of their joint responsibilities in relation to

statutory functions and their duty to safeguard and promote the welfare of children and young people, referred to as “corporate parenting”.

1.15 The initial inspection brief and process was itself complex and became more diverse due to the specific set of circumstances which each Board and Trust was facing. These included:

• the outcome of a public inquiry in one Trust;

• a number of CMRs in each Board area;

• the scale of “acting-up” arrangements at senior management level in a number of Trusts;

• changes in service delivery arrangements; and

• replacement of a board in one Trust.

Summary of Key Findings

1.16 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 are still needed. Some of the good practice, identified in the report, includes the development of the Young People’s Project, joint forensic and paediatric medical examinations, ACPC Regional Policy and Procedures,13 ACPC information and communication strategy and training courses on responding to child protection.

1.17 Severe pressures and difficulties were, however, identified across a number of the Boards and Trusts with systemic failures in a number of Trusts in the discharge of statutory functions and lack of appropriate safeguards for children within fieldwork

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and residential settings. There was clear evidence of repeated failures to undertake timely and appropriate assessments and to provide child protection intervention, resulting in children being left at risk both at home and in residential care.

1.18 Major deficiencies relating to governance have been identified in the report for Boards, Trusts and key agencies to address at a number of levels. At the organisational level, these include:

• the need for a review of structures, leadership and accountability in child protection;

• implementation of a clear workforce development strategy, and associated recruitment, retention and training programme; and

• provision of consistent high quality staff support, supervision and appraisal.

A number of inter-related operational issues also need to be addressed, including:

• clear regional thresholds for access to services;

• consistent interpretation and implementation of policy and procedures and associated protocols; and

• a uniform approach to assessment of need and risk analysis.

At the practice level, there must be:

• more effective risk management in fieldwork and residential care;

• better planning and preparation for admissions to care, including placements in and transfers between care settings;

• an appropriate range of preventative and therapeutic interventions to ensure timely and effective responses; and

• sustained implementation of monitoring and auditing programmes of statutory functions and children’s services.

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1.19 There is a need, at all levels, for more effective interagency strategies for responding to alcohol and drug misuse, mental health problems and domestic violence and their impact on children and young people. The importance of multi-disciplinary and interagency training for all staff with a role in child protection has been

underestimated and under-resourced. Similarly, ownership of ACPCs and Trust CPPs and their effectiveness in discharging their corporate role was limited. Consequently, arrangements for interagency communication and effective engagement at both Board and Trust level between PSNI, Education and Social Services and other significant stakeholders need to be significantly strengthened.

1.20 Consultation and engagement with children, young people and families was variable and generally not sustained. There was an absence of any ongoing campaign by Boards and Trusts to encourage referrals about child protection concerns by parents and children, the general public or staff in other organisations.

1.21 In addition to the actions already taken by Boards, Trusts, PSNI, Education and the RQIA, the DHSSPS, in collaboration with the key agencies, needs to progress, as a matter of urgency, a number of areas that will enhance and strengthen current arrangements. These include:

• the development and implementation of the Single Assessment Framework for Northern Ireland, namely “Understanding the Needs of Children in Northern Ireland” (UNOCINI);

• the establishment of a regional Safeguarding Board to replace current ACPC/CPP structures;

• the establishment of specialist teams and the creation of principal practitioner posts for child protection services; and

• the development of arrangements for the dissemination of learning from CMRs and subsequent review of policy and practice areas.

1.22 There now needs to be a comprehensive and sustained programme of change involving 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.

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Key recommendations for Boards, Trusts, agencies and Government Departments are made throughout this report and brought together for ease of reference in Chapter 16.

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2. PLANNING, COMMISSIONING, MONITORING AND MANAGEMENT AND PROVISION OF CHILD PROTECTION SERVICES

STANDARD 1

The Board/Trust has arrangements in place for the planning, commissioning, monitoring and management and provision of child protection services across relevant agencies and disciplines required to meet the assessed needs of children and families involved in the child protection process. These take account of

Board/Trust resources and those available from other sources, including education, service options, client choice and value for money.

2.1 Commissioning has been described as the process of “specifying, securing and monitoring services to meet people’s needs at a strategic level”.14Commissioning must seek to enhance the quality of life of children, young people, their families or their carers through a commitment to the improvement of services. It must make the best use of all available resources to meet the needs and aspirations of service users, linking financial and service planning with effective working partnerships.

2.2 Children’s services are particularly complex and challenging. Boards as

commissioners of services and Trusts as providers of services require close working relationships in which their specific responsibilities are clearly defined. It is imperative that those who serve on Area Boards and Trust boards are clear about their

responsibilities for children’s services and the contribution required by them as Executive and Non-Executive Directors as outlined in the DHSSPS Circular CC3/02.15

Their key governance responsibilities are to ensure that:

• the discharge of child protection statutory duties remains a priority on the corporate agenda;

• performance against core standards is effectively monitored; and

• appropriate inquiries/investigations are commissioned when there are concerns about shortcomings.

14 _{Richardson, F., (2006) Institute of Public Care, Oxford Brookes University, in Care Services Improvement Partnership, Health and Social}

Services Change Agent Team. http://www.cat.csip.org.uk/_library/eBook/Chap1FRichardson.pdf

15 _{Circular CC3/02 sets out the role and responsibilities of Directors of HSS Trusts, Executive and Non-Executive, in relation to the care and}

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The Area board must hold the Trust board to account for its discharge of statutory functions and for the delivery of the specified outcomes required for children’s services.

2.3 Key Findings

Planning and Commissioning Arrangements

2.3.1 All Boards have arrangements in place for the planning, commissioning and

monitoring of child protection services. While there are some variations, all Boards use a programme of care approach to commission services and have established multi-disciplinary strategic commissioning teams to focus on children’s social and health care needs and requirements. These encompass relevant professional disciplines, and representatives from planning and finance departments.

2.3.2 Boards’ planning and commissioning arrangements provide the foundation for the provision of integrated services, facilitate the analysis of need which in turn directly influences the Boards’ priorities and resource allocation. These arrangements, used appropriately, are capable of identifying and addressing the needs of each Board’s child population and of maximising the effectiveness of the available resources. Given the failures identified within this inspection to assess and respond to the needs of children within the child protection and Looked After Children (LAC) systems, the effectiveness of planning and commissioning needs to be evaluated.

2.3.3 The Children’s Services Planning (CSP) arrangements in each Board contribute to the overall assessment of need and commissioning of services on an interagency basis and include the voluntary and community sectors. Although there are variations across the region in how CSP is progressed, all 4 Children and Young Peoples Committees (CYPCs) have collaborated and agreed the Northern Ireland Family Support Model as a basis for understanding and planning services to meet young people’s needs. The model, which uses a 4-level approach to demonstrate how needs can be addressed and highlights the inter-dependency between each level, is based on the work of Hardiker and colleagues.16

2.3.4 The efforts made by all CYPCs to develop a more regional and multi-dimensional approach to planning children’s services is commendable. There was considerable activity and commitment evident among all the CYPCs. There were good examples of

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joint planning, commissioning and provision of services in all Board areas, such as “Education Other Than At School” (EOTAS) and “School Aged Mothers” (SAM) projects. These supported young people who, due to individual circumstances and needs, could not be educated within the mainstream school system.

Contract and Performance Monitoring

2.3.5 Monitoring was carried out through regular reports to Board Senior Officers in individual disciplines and regular formal service performance/contract monitoring meetings between senior officers in Boards and Trusts. These parallel processes should have effectively contributed to the continuous overview of pressures and priorities so that emerging difficulties could be quickly identified and addressed. All Boards also had systems and processes in place for monitoring compliance with statutory responsibilities and these were reported on through CC3/02 reports.

2.3.6 However, it was clear during the inspection that some Trusts were experiencing significant challenges in discharging their child care statutory functions. These

difficulties were not being adequately identified by either Boards or Trusts within their contract monitoring arrangements. The main issues related to staffing levels, staff absences and temporary staffing arrangements, waiting lists for services, giving rise to inter-disciplinary and interagency tensions and significant management and safeguarding issues for young people in residential care. There was a clear need for quality improvement plans to be agreed with Boards and for their implementation be monitored and audited.

2.3.7 There was consistency across all 4 Boards in that the lead responsibility for child protection services was discharged by the Director of Social Services/Social Care (DSS). It is a key responsibility of the DSS to provide professional advice to the Board and the Chief Executive.17In one Board, the DSS was also “acting up” as Chief Executive. The Board was asked to review the arrangement and ensure that the responsibilities of the DSS were discharged effectively.

2.3.8 Arrangements in some Trusts were not sufficiently robust for reporting and monitoring compliance with statutory functions. Guidance issued by the then Department of Health and Social Services (DHSS) sets out the requirement for “any HSS trust which provides a significant amount of personal social services to include, on its

management board, a person holding a recognised qualification in social work as an

17 _{Circular HPSS/PPRD/5/94 requires Boards to appoint a DSS who shall be a qualified social worker and sets out broad guidance on the}

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executive director”.18This is to ensure that the Trust meets its legal responsibilities and achieves the highest professional standards for social services. In 3 of the Trusts inspected, the Executive Director of Social Work also had the lead role for child protection. In 2 Trusts, the Executive Director of Social Work was not directly responsible for children’s services and, as a result, problems were identified in relation to accountability, communication and responsibility for reporting concerns to the Trust board.

2.3.9 The inspection findings emphasise the importance of Trusts reviewing and evaluating how the Executive Director of Social Work fulfils his/her responsibilities and the adequacy of the accountability and reporting arrangements, through the Chief

Executive, to the Trust board. This is particularly important in relation to reporting key areas of need and risk to ensure there is an overview at Trust board level and

ultimately to the Area Board. This issue will need to be taken account of in the post Review of Public Administration arrangements for the HPSS.

Assessing Needs

2.3.10 While each Board had undertaken a variety of relevant needs assessments, focusing on the needs of children and young people in residential and community settings, many of the issues raised, with regard to staffing, work practices and management had not been fully identified or resolved.

2.3.11 There were increasing pressures arising from the growing number of referrals to Social Services and increasing difficulties in meeting the needs of young people in residential care. Systems in place were not sufficiently robust to identify and address these pressures at an early stage. These issues should also have been brought to the attention of the DHSSPS Children Matter Taskforce and the inter-departmental Co-operating to Safeguard Children Group. The extent of difficulties varied across Trusts and the inspection has highlighted how important it is for Boards and Trusts to commission services based on accurate and validated information relating to need and risk. These difficulties also highlighted the need for more effective monitoring and auditing arrangements to ensure that resources are directed to areas of identified need, utilised effectively and bring about desired outcomes for children and families.

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18 _{Circular METL 2/94 sets out the statutory requirement on Trusts providing a significant amount of personal social services to appoint an}

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2.3.12 There was limited evidence at either operational or strategic level of the review and evaluation of the effectiveness of services, some of which were not impacting positively on individual children’s situations. However, in a number of Boards there were waiting lists for services which had been positively evaluated by both families and practitioners. Some of these services were under threat of closure because of financial constraints or the termination of short-term funding. In one Trust, for

example, funding for a much needed family centre was coming to an end. In another, support services for staff, which were an important feature of the Trust’s staff

retention strategy, had been suspended because of financial constraints.

2.3.13 Service Level Agreements (SLAs) with voluntary organisations were of variable standard and some did not specify the quantity or quality of service to be provided. This undermined the opportunity for monitoring the impact of these specific services in addressing identified needs. An important omission in some SLAs was the

requirement to have a child protection policy and procedure, capable of being monitored on an ongoing basis.

2.3.14 A common theme and difficulty for commissioners of service was dealing with the competing demands for time and resources between the acute and community sectors. The dominance of the acute sector was also an issue for integrated acute hospital and community Trusts.

Workforce Planning

2.3.15 The adequacy of workforce planning varied considerably across the region with good arrangements in place in some Trusts while others faced considerable challenges in developing and implementing an appropriate workforce strategy. This resulted in the stability of children’s services teams being undermined through high levels of

sickness, short and long term vacancies, temporary appointments and other

temporary arrangements. This was reported by staff to be associated with the lack of effective leadership. In some Trusts, it was also reported that there was a lack of urgency in filling vacant posts. The clear need for effective collaboration between Boards and Trusts in developing, implementing and monitoring the impact of workforce strategies was evident.

2.3.16 Boards and Trusts had made efforts to appoint Designated and Named Doctors.19

However, not all positions were filled because of a regional shortage of paediatricians and difficulties in accommodating these responsibilities within consultant contracts.

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Paediatric input to child protection, detection and management is crucial and needs to be appropriately resourced through commissioning arrangements and workforce planning.

2.3.17 All Boards had appointed a Designated Nurse by the end of the inspection process but there was a lack of clarity in some Trusts about who was undertaking the Named Nurse responsibilities.20

2.3.18 All Trusts were experiencing challenges in recruiting and retaining an appropriately qualified social work workforce. While staff shortages were most apparent at social work level, vacancies were also evident for first line and middle management posts. Key leadership positions for children’s services in some Boards and Trusts were vacant or filled through “acting up” arrangements. Vacancies created additional pressures for colleagues within children’s services teams as well as problems in making referrals for those in schools and the police service and for other disciplines, particularly health visiting. This had a negative impact on morale and relationships.

2.3.19 In 4 of the 5 Trusts inspected, inexperienced social workers reported they were carrying complex and high risk cases and there was evidence that social workers were often handling work beyond their level of expertise and experience. In one Trust, 50% of the staff in children’s services had been qualified for less than 2 years.

Concerns were identified in one Trust with regard to the extent of responsibilities undertaken by unqualified family support workers in complex and high risk cases.

2.3.20 There was evidence of increasing demands on children’s social services as a direct result of rising referral rates, in part, due to higher reported levels of domestic violence, the prevalence of alcohol and drug misuse, the additional demands of the family court system as well as the levels of complexity in cases now being presented to social services teams.

2.3.21 In the Trusts inspected, there was evidence of an increasing and creative use of Senior Practitioner posts although some of these posts were at an early stage of development. There is a need to ensure consistency across the region in the responsibilities assigned to senior practitioners and their impact on the quality of services will need to be monitored. Trusts were aware of the DHSSPS “Principal Practitioner Pilot Project” and the opportunities this presented for enhancing expertise and providing specialised support for staff in dealing with complex cases.

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2.3.22 All Trusts inspected had generic staff induction arrangements in which most new staff participated. In addition, most children’s services had specific written induction

programmes. However, due to pressures of work and the requirements of

probationary periods, the need for higher levels of supervision and support was not always met. In a number of Trusts, there were specific concerns about newly qualified workers starting their career in adolescent teams, with high risk young people

presenting complex needs. In 2 of the Trusts inspected the arrangements for induction, supervision and support fell seriously below the standard required.

2.3.23 There was often an over-reliance on the commitment and dedication of first line managers who frequently carried cases themselves in order to meet statutory requirements. Inquiries have repeatedly highlighted the dangers of this practice.21

2.3.24 The Northern Ireland Social Care Council (NISCC) “Codes of Practice for Social Care Workers and Employers of Social Care Workers”22set out the responsibilities and standards for employers and employees in respect of providing safe, reliable and competent social care practice. These include ensuring the registration of the social care workforce, providing well-managed human resources and processes for vetting and appointing staff, induction and training, professional supervision and continuing professional development. Boards and Trusts will be required to ensure that they are complying fully with the Codes, and their implementation will be reviewed as part of the RQIA governance monitoring programme. The NISCC in its workforce regulatory role will monitor practitioners’ compliance with the Code of Practice for Social Care Workers.

2.4 Recommendations

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;

21 _{Reder, P., Duncan, S., and Grey, M., (1993) “Beyond Blame: Child Abuse Tragedies Revisited”.}

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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”;

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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

- 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 regulates compliance 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

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3. THE PURPOSE OF SERVICES

STANDARD 2

The Board/Trust has a written statement of purpose about its child protection services, including its statutory basis, availability, user entitlement and expected standards informed by the DHSSPS guidance “Co-operating to Safeguard

Children” (May 2003).

3.1 The statutory functions in relation to child protection are outlined in the Children Order, its accompanying regulations and guidance23_{and in the ACPCs’ Regional Policy}

and Procedures. It is imperative that Boards and Trusts produce their own explicit statements of purpose which explain their child protection responsibilities to their key stakeholders, including:

• Board/Trust board members;

• staff in all disciplines;

• service users including parents and children; and

• referrers including other statutory agencies, the voluntary and community sector and the general public.

3.2 Key Findings Statements of Purpose

3.2.1 Boards, through their lead role with ACPCs, have collaborated effectively with all Trusts and key agencies to produce the Regional Policy and Procedures which

replaced the former individual ACPC’s guidelines. This provides a good foundation for

23 _{The Children Order series of regulations and guidance consists of the following:}

Volume 1: Court Orders and other legal issues. Volume 2: Family Support, Child Minding and Day Care. Volume 3: Family Placements and Private Fostering. Volume 4: Residential Care.

Volume 5: Children with a Disability.

Volume 6: Co-operating to Safeguard Children (Published in May 2003 replaces previous Volume 6: Co-operating to Protect Children) Volume 7: Schools Accommodating Children.

Volume 8: Leaving and After Care Guidance and Regulations.

The Guidance and Regulations produced by the Department in the context of the Children (Northern Ireland) Order 1995 can be accessed through: http://www.dhsspsni.gov.uk/hss/child_care/child_care_guidance.htm.

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ensuring common and equitable child protection standards across the region. The Regional Policy and Procedures also provide other agencies such as PSNI and the Education sector with a common framework for interfacing with Social Services.

3.2.2 The absence of a clear statement of purpose within the overall complex agenda for Boards and Trusts resulted in statutory child protection activity and issues receiving inconsistent attention within annual reports and business planning documents. There was limited information about statutory child protection services on websites and within general paper-based and electronic search facilities used by the general public. Parents and young people, some professional groups and other agencies described difficulties in obtaining information about the nature of family support and child protection services. There was confusion about entitlement and the processes involved in referral and allocation of services. Information about standards for services was limited.

Engaging Service Users

3.2.3 People who receive services have a very different perspective from those who commission or provide services. High quality service development and improvement demands that the perspectives of all parties are brought together thereby ensuring a common understanding of what can be delivered and how.24

3.2.4 Boards’ and Trusts’ efforts to engage with young people and parents as service users were variable. Most Boards had made some attempts to engage service users

through CSP arrangements and while there was evidence of good initiatives in

specific Boards/Trusts this was often sporadic and not sustained. The feedback from children and young people on their experiences is included in detail in Chapter 15.

3.2.5 Effective participation by young people requires the sustained support of adults and this cost must be built into commissioning arrangements. Within several Trusts there were good examples of meaningful engagement of young people, particularly older adolescents, in the development of specific projects. However, there were neither clear policy commitments nor standards for their ongoing and meaningful

involvement in all aspects of service design, development and review.

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GOOD PRACTICE EXAMPLE:

“Young People’s Project”, Craigavon and Banbridge Trust

The Project had a clear statement of purpose to support young people at risk of becoming disaffected. Information about the Project was readily available, user-friendly and easily understood. Young people, as service users, were involved in the Project’s ongoing development and in the various programmes offered. Participation by family members was encouraged and parallel initiatives were developed to assist their understanding of young people’s needs. The interagency network was also fully engaged in the overall process.

Parents’ Feedback

3.2.6 As part of the inspection process, parents in each Trust participated in focus groups or individual interviews. The majority of parents reported that intervention by Social Services in their families had been necessary and appropriate. Most parents were positive about the support they received from social workers.

3.2.7 In all of the Trusts there was a strong ethos of cooperating with parents in individual cases and engaging them at an early stage in the process. However, feedback demonstrated some inconsistencies in practice and parents expressed

disappointment and powerlessness when meetings were cancelled at short notice or when they considered their views were not taken into account. They felt social

workers were overstretched and often did not have time to fully implement the agreed child protection plan.

3.2.8 Parents were frustrated by frequent changes of social worker and the damaging effect the lack of continuity had on their family situation. They recognised the importance of the relationship with the social worker for them and their children and felt let down when their social worker changed. Inevitably this impacted on progress as it took time to build trust between the family and the new worker.

3.2.9 The most common concern expressed by parents across the region was their anxiety and discomfort about attending case conferences. They described initial case

conferences as intimidating because of the formal setting and the number of people in attendance. While they recognised the need for sharing information and the

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difficulties in setting up and managing case conferences, parents felt that they should be more involved in working with Social Services. Parents thought that this would help ensure a more user-friendly environment and a process in which they could be

supported to make a fuller contribution, which ultimately would improve the decision making process. In particular, they wanted to be listened to and treated with respect. Case conferences are examined further in Chapter 5.

Complaints

3.2.10 Complaints in relation to children and families were generally managed appropriately and in line with the Children Order Complaints Procedure. However, there was

inconsistent evidence across and within Trusts that children and their parents were routinely provided with information about how to make representations and

complaints. Some parents were unaware of the complaints process and had limited understanding of their rights. The number of complaints recorded in most Trusts was low. Given the issues with regard to unallocated cases, response times and changes of social workers, a higher volume of complaints would have been expected.

Thresholds

3.2.11 In one Board, the Thresholds for Intervention Model in use clearly sets out the nature and purpose of services provided by children’s social services.25_{It represented an}

attempt to utilise the available children’s social services resources in targeting those families whose needs were assessed as being at levels 3 and 4 based on the

Hardiker model. However, it created a threshold for entitlement to services which was artificially high and hence excluded some children in need and their families, who without early intervention, were likely to progress to a higher level of risk and need. Groups that had the potential to be excluded included children with behavioural problems, pregnant teenagers and parents who required assistance to develop

appropriate parenting skills. The impact of this approach had not been fully evaluated in one Trust before the approach was extended to the other. Other community

services, including health visiting, PSNI and Education, reported that they had not been fully engaged in the development and review of the model and were concerned about the impact of failure to resource families below the thresholds and the

consequent burden this would place on schools and other support services.

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25 _{The 4 levels identified in the Thresholds for Intervention Model are: Level 1 - Universal services and community development (available to}

all children and families); Level 2 - Support services for children and families in need (children from households where there are identified stresses which may affect their health and development); Level 3 - Services for children and families with severe difficulties (children whose health or development is being impaired or there is a high risk of impairment); Level 4 - Intensive and long term support for children and families in chronic difficulty (children experiencing significant harm or where there is a likelihood of significant harm. Children at risk of removal from home).

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3.2.12 CSPs were focused on family support. However, a number lacked clarity about Trusts’ obligations to use their statutory powers to secure the wellbeing of children when family support interventions do not achieve positive outcomes for them. There was often a failure to state that there are likely to be a small percentage of families who cannot, even with high levels of support, safely take care of their children and for these children permanency arrangements outside the family will be appropriate to secure their safety and meet their needs.

3.2.13 All of the Boards have been influenced by Hardiker’s work. However, child protection activity is complex and the framework model can only be effective within the context of good quality assessment and decision making at case level as well as appropriate organisational management of services which includes effective quality assurance. We would endorse Hardiker’s view:

“If issues in child protection were clear cut, there would be little need for Social Workers and Welfare Agencies; cases could be processed through legal and administrative systems. If child abuse was a clearly identified syndrome children could be neatly allocated to the appropriate levels of intervention. If social policies and welfare arrangements were static and conflict-free, it might be relatively easy to develop a continuum of family support services in line with the enabling philosophy underlying the Children Act 1998. None of these conditions prevails”.26

3.3 Recommendations

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;

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- 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;27and

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.

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27 _{‘A Guide for Parents’ which was issued by the DHSS to coincide with the Children (Northern Ireland) Order 1995 provides a useful model.}

Other leaflets, produced by the DHSS, to explain aspects of the Children Order include ‘The Children Order and You - A Guide for Young People’; ‘Getting Help from Social Services - A Guide for Children and Young People’; ‘Living Away from Home - Your Rights - A Guide for Children and Young People’. In all, 8 explanatory leaflets were produced, which can be accessed through

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4. ACCESS TO SERVICES

STANDARD 3

The Board/Trust promotes access to services by children and families and concerned members of the public where there are child protection concerns.

4.1 Promoting access to services requires Boards and Trusts to provide information about the nature and availability of services, in a wide range of formats, to families and children. Requests for services need to be responded to in a timely, sensitive and professional manner. It is also important that those seeking support for themselves or others are assured that referrals are responded to speedily and appropriately.

4.2 Key Findings Information

4.2.1 Boards, through their ACPCs, have at various times produced information for children and families and the general public about how to recognise child abuse and neglect and how to report concerns to the relevant agencies. These initiatives have been undertaken collaboratively with the other key statutory organisations represented on ACPCs and with the relevant children’s voluntary organisations.

4.2.2 ACPCs and CPPs, working collaboratively have recently developed a regional ACPC information and communication strategy to address their public communication responsibilities as outlined in CtSC.28The regional approach was developed to provide a common and informed response to the range of current and complex child protection issues in the public domain. This is to be commended and has the

potential to maximise opportunities to harness the powerful influences of the media in a positive and educational way.

4.2.3 Campaigns to encourage child protection referrals to Trusts’ children’s social services have been sporadic and were not supported on an ongoing basis by the availability of easy to access information in a range of formats and settings, including yellow pages and telephone directories; community information services; Board and Trust websites; sponsored links on all relevant websites; libraries and other public services settings;

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health centres and hospitals; buses, shopping centre trolleys and similar advertising initiatives.

4.2.4 Most community-based children’s social services offices had leaflet displays about early years services, community nursing and paediatrics, specialist facilities and resources as well as projects provided by community groups and voluntary organisations. However, there were few Trust-produced leaflets promoting and explaining the core statutory services for children in need or at risk and how to access them. There was an absence of information on child protection services in reception areas within Board and Trust headquarters and in their publications. Directories of services, where they existed, were often out of date.

4.2.5 ACPCs have produced a range of reports and information leaflets which give a broad overview of multi-agency child protection activity in their area. In some Boards and Trusts there were good examples of collaborative work to produce information leaflets in different languages, with agencies such as the Multi-Cultural Resource Centre29_and

Chinese Welfare Association.30This is to be commended and should be expanded to include the needs of the increasing number of immigrant families living here. Where high quality information leaflets had been produced, they were not always available and there was no consistent process for updating and reprinting leaflets.

GOOD PRACTICE EXAMPLE:

“Safe Parenting Handbook”, DHSSPS with ACPCs

The “Safe Parenting Handbook”, which was produced by the DHSSPS in partnership with the 4 ACPCs, is a comprehensive, user-friendly document which identifies the range of issues and challenges faced by parents in raising their children. It

acknowledges the circumstances in which parents may need support, and sets child protection within this broader context. It provides information on how to access a range of services and describes the processes involved. Contact information for all the Trusts, for ACPCs and for children’s voluntary organisations is included. The handbook is available in Cantonese, Lithuanian, Portuguese, Polish and Russian, French and Tetum and is on the DHSSPS website. 31

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29 _{Information about the Multi-Cultural Resource Centre can be accessed at: http://www.mcrc-ni.org/} 30 _{Information about the Chinese Welfare Association can be accessed at: http://www.cwa-ni.org/}

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Duty Systems

4.2.6 All of the Trusts offered both an office duty system and an out-of-hours emergency response service. The arrangements varied considerably both between and within Trusts, in respect of geographical accessibility, operating hours and in whether duty/intake services were provided by a specialist team or as part of the generic responsibilities of the local children’s services team.

4.2.7 Problems were identified in relation to the out-of-hours service and the limited skills and knowledge base of some staff in dealing with highly complex child protection cases and problems with children in residential children’s homes.

4.2.8 While the office duty system in most areas facilitated the taking and recording of referrals, significant problems were reported by professionals in other disciplines and agencies in relation to feedback regarding these referrals and allocation of cases for assessment.

4.2.9 Reception and waiting areas were variable in terms of their accessibility, décor and privacy. Parents and young people reported that it was difficult to contact their social workers or, in their absence, to speak with a senior social worker. The frequent changes in social workers and the lack of information about who to contact if their social worker was on sick leave or annual leave, was a frequently expressed frustration by parents and children.

4.2.10 Arrangements for the provision of accessible local community-based children’s social services were variable and individual Trusts have experimented with different models within the main centres of population. There is a demand for local offices which are user-friendly and can accommodate functions such as office duty, face to face interviews with children, young people and families, one to one work with young people, case conferences and LAC reviews. Recent advice from the British

Association of Social Workers (BASW), endorsed by the inspection team, stresses that “social workers need to become as integral to community life as family doctors if the relationship between the profession and service users is to be improved”. BASW advocates "social workers should be deployed in the places where a need for their services is likely to be first identified".32