ORGANISATION, OUTCOMES AND COSTS OF INTER-AGENCY TRAINING FOR SAFEGUARDING AND PROMOTING THE WELFARE OF CHILDREN

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1 Research Brief DCSF-RBX November 2009 ORGANISATION, OUTCOMES AND COSTS OF INTER-AGENCY TRAINING FOR SAFEGUARDING AND PROMOTING THE WELFARE OF CHILDREN Professor John Carpenter (Research Director), Dr Eszter Szilassy and Dr Demi Patsios School for Policy Studies, University of Bristol Professor Simon Hackett, School of Applied Social Sciences, Durham University Introduction Lord Laming s progress report on The Protection of Children in England (2009) i considered that: Multi-agency training is important in helping professionals understand the respective roles and responsibilities and the procedures of each agency involved in child protection, in developing a joint understanding of assessment and decision making practices, and in learning from Serious Case Reviews. However, the scale and quality of multi-agency training needs to be substantially improved (5.18). It is the responsibility of Local Safeguarding Children Boards (LSCBs) to ensure that single-agency and inter-agency (or multi-agency) training in safeguarding and promoting welfare is provided in order to meet local needs (paragraph 3.22, Working Together). This study investigated the training provided by eight LSCBs in England, asking how it was organised; what training was provided and by whom; whether it was effective and how much it cost. Key Findings Inter-agency training is mandated by central government but does not receive ring-fenced funding. It relies very significantly on the good will of LSCB partner agencies and professional and personal relationships. The system is vulnerable to cuts in partner agencies financial contributions and to changes in personnel. Training is organised by a training coordinator, generally employed by the LSCB, and support staff. The training co-ordinator works with a training subgroup (TSG) of partner agency representatives. In general, TSGs were good examples of effective partnership working. Substantial programmes of training were offered on: recognising and responding to child protection concerns; inter-agency and interprofessional collaboration; and on specialist topics such as safeguarding disabled children and safeguarding in the context of parental mental illness and drug and alcohol misuse. Courses were generally for participants lasting one to two days. They were taught by skilled and experienced staff from partner agencies and independent trainers. Enabling a mix of staff to engage in inter-agency training was a challenge and participation was varied: there were concerns about the low numbers of doctors and adult services staff, and the lack of more experienced staff taking specialist courses to update their knowledge and skills. The opportunity to learn together was very highly valued. Outcomes were remarkably consistent across types of course and LSCBs. There were substantial and significant gains in knowledge of the substantive topic and in self-confidence regarding safeguarding policies and procedures and promoting the welfare of children.

2 Some partner agencies were making substantial in-kind contributions to the provision of training in addition to their annual subscription to the Board. The only explanation for the considerable variations in proportional contributions between LSCBs was historical precedent. The cost of training compared favourably to the fees charged by commercial organisations. They were seen by LSCB partners as very good value for money. Background Statutory inquiries, policy guidance and research reviews have consistently advocated that if professionals concerned with safeguarding children are to work together more effectively they should learn together. Working Together to Safeguard Children 1 (2006) charged Local Safeguarding Children Boards (LSCBs) with a statutory responsibility to ensure that training is provided to safeguard and promote the welfare of children. It asserted that, Training delivered on an inter-agency basis is a highly effective way of promoting a common and shared understanding of the respective roles and responsibilities of different professionals, and contributes to effective working relationships. (para. 4.2). Lord Laming s Progress Report on The Protection of Children in England (2009) which followed the Baby Peter case, placed similar faith in the value of training, in particular inter-agency training. However, two recent reviews of the international research literature found that the evidence base concerning training for safeguarding children in general was decidedly thin, and especially so for inter-agency and interprofessional training. Aims The aim of the research was to develop an evidence base for inter-agency training to safeguard and promote the welfare of children. The key questions were: How is inter-agency training organised? Is the system robust? What kind of training is delivered and by whom? 1 HM Government (2006) available at Does it work? Do participants develop a shared understanding of their respective roles and responsibilities? Is it value for money? Methodology The project was carried out collaboratively with the training coordinators in eight LSCBs in four parts of England and with the support of an advisory group which included family carers and young people s representatives. The research team observed meetings of LSCB training subgroups and carried out sixty interviews with LSCB representatives to investigate the means by which inter-agency training is planned and delivered. Training courses are generally evaluated using happy sheets completed at the end of the programme. These are not satisfactory for research purposes. So, the research team developed specific questionnaire measures to assess the outcomes of both generic and specialist courses on such topics as Introduction to safeguarding and Safeguarding disabled children. These measures were designed to be completed at course registration (generally 6-8 weeks in advance); the start and end of the course; and three months later. The research design was based on the hypothesis that, in the absence of any training intervention, there would be no change in mean total scale ratings between registration and the start of the course; at the end of the course, there would be an improvement in mean scores compared to the start and that this could be attributed to the training; finally, ratings made three months later would indicate whether or not learning had been sustained. Finally, the costs to LSCB partners of providing training (in cash and in kind) and of participating in training were calculated based on staff time and use of resources. Findings The context of inter-agency training Inter-agency training for safeguarding children is an unusual example of partnership working in that it is mandated by central government but does not receive ring-fenced funding. Central government funding to each employing organisation is intended to include training for its own staff. Consequently, inter-agency training

3 relies very significantly on the willingness of partner agencies to pool resources and on professional and personal relationships developed parochially. There are obvious strengths to this approach, but also weaknesses. In particular, the system is vulnerable to cuts in partner agencies financial contributions to the budget and to changes in personnel; it is highly dependent on a few people, specifically the training coordinator and their support staff. Mechanisms for the delivery of training Inter-agency training is organised by a training coordinator, generally employed by the LSCB, and support staff. The training co-ordinator works with a training subgroup (TSG) of partner agency representatives. Health trusts, children and young people s social care, education and the police are usually all represented, but some members are much less active than others. In general, TSGs were seen to be good examples of effective partnership working, with members believing that their agency s and the partnership s goals with respect to inter-agency training are interdependent and mutually beneficial. Key concerns were: the perceived inadequacy of funding and the uncertainty about partner agencies financial contributions; a lack of capacity to deliver all the training requested (courses were usually oversubscribed); the challenge of reaching the right people so that there was a good interprofessional mix of course participants, and ensuring that these staff could be released for training. The content and delivery of training The programmes of training in the eight LSCBs studied were substantial. They offered training on important safeguarding issues in accordance with the guidance in Working Together. Introductory courses on identifying and responding to child protection concerns were offered to a wide range of people in regular contact with children, including nurses, teachers, librarians, fire officers and social workers. Some of these courses were offered as e-learning programmes. More advanced courses were provided for professionals working regularly with children and those who may be required to contribute to assessments. The focus here was on effective, collaborative inter-agency working and on understanding roles and responsibilities. These courses, typically over two days, included a focus on child protection conferences. Specialist courses addressed topics including safeguarding disabled children, safeguarding children and domestic abuse, and safeguarding in the context of parental mental illness and drug and alcohol misuse. Other specialist courses concerned working with young people with sexually harmful behaviours and female genital mutilation. The courses were short, the great majority being for one day only, and typically involved around 20 participants. These courses make a substantial contribution to learning the skills and knowledge of the Common Core and thus to the training of children s workforce in general. Courses are led by enthusiastic, skilled and experienced trainers using participative educational models. Most LSCBs used staff with specialist knowledge and skills from their own partner agencies as well as independent trainers. However, it was apparent that many trainers felt undervalued and that they needed more recognition and support. Participation in inter-agency training The introductory courses studied were attracting much of the target audience of people in contact with children, including support workers as well as nurses and social workers. However, some groups including housing workers, librarians and leisure staff were barely represented. These groups might be reached more effectively by e- learning. In the light of the findings of the Care Quality Commission review of health services involvement in Baby Peter s case ii, it was alarming that very few doctors and GPs were represented in the advanced courses on interprofessional working to safeguard children. The Care Quality Commission s subsequent review of safeguarding in the NHS (2009) iii considered the low proportions of NHS staff reported as being up to date with their training extremely concerning (p.16). In contrast, both experienced and less experienced social workers, teachers, nurses and probation were well represented in the programmes in this study. The great majority of attendees on specialist courses had been in service for between one and five years, which suggests that these courses were considered suitable for relatively new staff. It

4 was noticeable however that more experienced professionals were not using these courses to update their skills and knowledge; this is a matter of concern. Outcomes of the inter-agency training courses The findings concerning outcomes were remarkably consistent across types of course and LSCBs. There were substantial gains in knowledge of the substantive topic (e.g. domestic violence and child abuse; sexually abusing adolescents) and in self-confidence regarding safeguarding policies and procedures. These positive outcomes were found irrespective of the participants gender, age, ethnicity, service experience and even when they had been required rather than volunteered to attend the course. The opportunity to learn together to work together was very highly valued, even more so at the end of the course than at the beginning. There were very substantial improvements in their self-reported understanding of the roles of different professionals who engage in work to safeguard and promote the welfare of children and in their confidence and comfort in working with these colleagues. This finding is important for the self-confidence of social workers and for other professionals understanding of their roles and responsibilities. At follow-up 3 months later, these gains had been maintained, but the response rates at this stage were disappointing and the evidence is correspondingly weaker. Costs Training is a major investment for the delivering and participating agency and incurs indirect as well as direct costs. Through supplying their own professional staff to act as trainers, by sharing the use of their training facilities and by the time spent as members of training support groups, some partner agencies were making substantial in-kind contributions in addition to their annual subscription to the Board. Taking all these contributions into account, there was wide variation in the proportion of costs to the partner agencies. Children and young people s social care services and education met between 23% and 86% of the costs; Health met between 13% and 34%. The only explanation for these differences was historical precedent. The health service, through the use as trainers of doctors and nurses with specialist knowledge, made the largest in-kind contribution to the costs of courses (43%). The mean comprehensive costs of a day s training per participant was around 100 (range ). This compares favourably to the fees charged by commercial organisations. Local courses have considerable advantages in creating opportunities for networking. They were seen by partners as very good value for money. The mean cost to agencies of staff participating in training was 183 per person per day (range 134 to 260). The cost per day for an individual participant ranged from 1,100 for a GP in London to less than a tenth of that ( 90) for a support worker on the same course. Implications for practice and policy Policy makers Better and more transparent funding arrangements are needed for LSCBs to be able to invest strategically in training to extend its reach and scope to more complex safeguarding issues. Lord Laming s progress review recommended that there should be protected funding for training. (Recommendation 54) There should be a more robust system nationally for prioritising and disseminating key training issues for individual LSCBs to supplement locally determined priorities. Training materials, produced by the NSPCC with support from DCSF, based on best research evidence iv are valued and should continue to be developed and updated. Professional bodies, especially in medicine, should review the reasons for the low participation of staff in inter-agency training. Consideration should be given to building LSCB inter-agency courses into the postqualifying professional development frameworks for different groups of professional staff. This would both raise the status of courses and might also help to draw in professional groups who are currently underrepresented, such as more experienced workers (over 5 years in service), doctors and staff working in adult services. An expanded programme of training for trainers is needed, including standards and accreditation.

5 LSCBs and training subgroups LSCB partners, especially those responsible for doctors and adult services should review the attendance of their staff on courses and ensure that sufficient inter-agency training is being undertaken by both new and experienced professionals. Support for training co-ordinators is essential; they and their support staff are critical in ensuring the effective operation of the training programme. LSCBs must ensure that arrangements for providing their inter-agency training programmes are robust; it is advisable to compile a potential risks register. The pool of generic and specialist trainers needs to be expanded. An internal audit of training skills and capacities in both the LSCB and partner agencies would help identify areas in which recruitment is needed and where staff secondment could alleviate undue pressures on a few dedicated trainers. Review the feedback, training and support given to trainers, especially those from partner agencies. Enable them to review the learning objectives and course content in the light of up to date research evidence. The outcomes of training should be evaluated more rigorously. LSCBs, training coordinators and trainers could consider using the measures developed in this study to evaluate the outcomes of their courses. Additional Information Further information about this research can be obtained from Isabella Craig, Analysis and Research Division, 4FL-ARD, DCSF, Sanctuary Buildings, Great Smith Street, London SW1P 3BT Isabella.craig@dcsf.gsi.gov.uk The views expressed in this report are the authors and do not necessarily reflect those of the Department for Children, Schools and Families. Information about other studies which are part of the Safeguarding Children Research Initiative can be found at i Lord Laming (2009)The Protection of Children in England: A Progress Report oad/hc-330.pdf ii Care Quality Commission (May 2009) Review of the involvement and action taken by health bodies in relation to the case of Baby P. iii Care Quality Commission (2009) A review of arrangements in the NHS for safeguarding children. n_review.pdf iv NSPCC Child Protection Learning Resources ningresources/learningresources_wda47881.html