OUR CHILDREN AND YOUNG PEOPLE OUR SHARED RESPONSIBILITY

Transcription

1 OUR CHILDREN AND YOUNG PEOPLE OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND OVERVIEW REPORT December 2006

2 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED 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 multidisciplinary, 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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4 SOCIAL SERVICES INSPECTORATE OVERVIEW REPORT OUR CHILDREN AND YOUNG PEOPLE OUR SHARED Inspection Team: Mrs Maire McMahon Dr Teresa Donaldson Mr Ken Wilson Mrs Lynne Peyton Miss Marion Reynolds Ms Theresa Nixon Mrs Marian Robertson Dr Alison Livingstone Dr Erin Knowles Mrs Heather Crawford Mr Willie McAuley D.I. Anne Marks Dr Lynne McMullen Mrs Betty Robinson Ms Teresa Devlin Dr Helen Beckett Mr Raymond Gordon Mr Kieran Taggart Inspection Manager Child Care Consultant Child Care Consultant Child Care Consultant Social Services Inspectorate Regulation & Quality Improvement Authority Nursing, representing Nursing and Midwifery Advisory Group Medical, representing Medical and Allied Group Medical, representing Medical and Allied Group Allied Health Professional, representing Medical and Allied Group Police Service of Northern Ireland Police Service of Northern Ireland Education and Training Inspectorate, Department of Education Education and Training Inspectorate, Department of Education Northern Ireland Commissioner for Children and Young People Northern Ireland Commissioner for Children and Young People Lay Assessor Community Information Branch

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6 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.

7 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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

8 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 ACCESS TO SERVICES ASSESSMENT, CASE PLANNING, CASE MANAGEMENT AND 33 RECORD KEEPING 6. PROTECTING VULNERABLE CHILDREN IN SPECIFIC CIRCUMSTANCES QUALITY ASSURANCE AND MANAGING PERFORMANCE OF SERVICE THE ESTABLISHMENT AND OPERATION OF THE AREA CHILD PROTECTION 55 COMMITTEE (ACPC) AND THE CHILD PROTECTION PANEL (CPP) 9. CASE MANAGEMENT REVIEWS EQUALITY AND HUMAN RIGHTS THE INTERFACE BETWEEN RESIDENTIAL AND FIELDWORK CHILD 67 CARE SERVICES 12. EDUCATION: KEY FINDINGS AND RECOMMENDATIONS 89 i

9 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 ii

10 GLOSSARY OF ABBREVIATED REFERENCES ACPC AHPs APSWs BASW CAMHS CARE CMR CPD CPNAs CPP CSP CtSC CYPC DE DHSSPS DVO EOTAS ETI EWOs HRA LAC NICCY NISCC NMAG PSNI RQIA SAM SCIE SLA SMT SSI UNOCINI UNCRC VOYPIC YDO Area Child Protection Committee Allied Health Professionals Assistant Principal Social Workers British Association of Social Workers Child and Adolescent Mental Health Services Child Abuse and Rape Enquiry Case Management Review Continuing Professional Development Child Protection Nurse Advisors Child Protection Panel Children s Services Planning Co-operating to Safeguard Children Children and Young People s Committee Department of Education Department of Health, Social Services and Public Safety Domestic Violence Officer Education Other Than At School Education and Training Inspectorate Education Welfare Officers Human Rights Act Looked After Children Northern Ireland Commissioner for Children and Young People Northern Ireland Social Care Council Nursing and Midwifery Advisory Group Police Service of Northern Ireland Regulation and Quality Improvement Authority School Aged Mothers Social Care Institute for Excellence Service Level Agreement Senior Management Team Social Services Inspectorate Understanding the Needs of Children in Northern Ireland United Nations Convention on the Rights of the Child Voice of Young People in Care Youth Division Officer iii

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12 1 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 provides 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 (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: 2 The Children (Northern Ireland) Order 1995 can be accessed at: The Explanatory Note can be accessed at: PAGE 1

13 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 66 4 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 The 1998 Amendment Order can be accessed at: (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 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. PAGE 2

14 1 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. Cooperating to Safeguard Children 6 (CtSC) is the most recent child protection guidance and was issued by the DHSSPS in May 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. 7 This 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 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 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 Quality 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: 7 Laming (2003) Victoria Climbié Inquiry Report. The Victoria Climbié Inquiry Report can be accessed at: 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. 9 The 2003 Order can be accessed at: PAGE 3

15 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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) 10 and Child Protection Panels (CPPs) 11 and to make recommendations as appropriate 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) 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 The role of the CPP is to implement locally the ACPC s policy and procedures ensuring a high standard of professional practice. The roles and responsibilities of the CPP are set out in CtSC, Chapter 4. PAGE 4

16 1 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 The inspection of child protection services, was led by the SSI, and comprised a multidisciplinary, 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 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 12 The DHSSPS Website can be accessed at: PAGE 5

17 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 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 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 13 The ACPC Regional Policy and Procedures can be accessed at: PAGE 6

18 1 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 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. PAGE 7

19 OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 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 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 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. PAGE 8

20 1 Key recommendations for Boards, Trusts, agencies and Government Departments are made throughout this report and brought together for ease of reference in Chapter 16. PAGE 9

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22 2 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. 14 Commissioning 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/ 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 Circular CC3/02 sets out the role and responsibilities of Directors of HSS Trusts, Executive and Non-Executive, in relation to the care and protection of children in their areas. PAGE 11