OUR CHILDREN AND YOUNG PEOPLE OUR SHARED RESPONSIBILITY

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

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.

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

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

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.

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

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 12. EDUCATION: KEY FINDINGS AND RECOMMENDATIONS 89 i

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

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

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

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 1994 1 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 1995 2 (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 The Explanatory Note can be accessed at: http://www.opsi.gov.uk/si/si1995/uksi_19950755_en_55.htm#exnote PAGE 1

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 17. 5 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. PAGE 2

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 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. 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 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. 9 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: 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-climbieinquiry.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. 9 The 2003 Order can be accessed at: http://www.opsi.gov.uk/si/si2003/20030431.htm PAGE 3

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. 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) 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 and responsibilities of the CPP are set out in CtSC, Chapter 4. PAGE 4

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. 12 1.11 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. 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 12 The DHSSPS Website can be accessed at: http://www.dhsspsni.gov.uk/ PAGE 5

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. 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 13 The ACPC Regional Policy and Procedures can be accessed at: http://www.childrensservicesni.co.uk PAGE 6

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. 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. PAGE 7

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. 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. PAGE 8

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

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND PAGE 10

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 CC3/02. 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 protection of children in their areas. PAGE 11

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 16 Hardiker, P., Exton, K., & Barker, M. (1991) Policies and Practices in Preventive Child Care, Avebury, Gower. PAGE 12

2 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. 17 In 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 key roles and responsibilities of the post. PAGE 13

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND executive director. 18 This 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 Cooperating 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. 18 Circular METL 2/94 sets out the statutory requirement on Trusts providing a significant amount of personal social services to appoint an Executive Director of Social Work and provides guidance on the responsibilities of the post. PAGE 14

2 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. 19 The responsibilities of the Board s designated doctor and the Trust named paediatrician are outlined in paragraphs 3.17-3.19 of CtSC. PAGE 15

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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. 20 The roles of the Board Designated Nurse and the Trust Named Nurse are detailed in paragraphs 3.20-3.21 of CtSC. PAGE 16

2 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 22 set 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. 22 The NISCC Codes of Practice can be accessed at: http://www.niscc.info/registration/pdf/codes_of_practice.pdf PAGE 17

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 ; PAGE 18

2 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 Employers of Social Care Workers. PAGE 19

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3 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 guidance 23 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. PAGE 21

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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. 24 Turner, M. and Beresford, P. 2006, Contributing on Equal Terms: Service User Involvement in the Benefit System, SCIE. PAGE 22

3 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, userfriendly 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 PAGE 23

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Complaints 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. 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. 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). PAGE 24

3 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; 26 Hardiker et al (1995), A Framework for Analysing Services, the National Commission of Inquiry into the Prevention of Child Abuse. PAGE 25

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND - 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; 27 and 18. review and clarify their thresholds for entitlement to services and ensure that children, young people and families in need have access to timely and appropriate preventative and supportive services. Trusts must ensure that: 19. information about the complaints process is prominently displayed, that all parents, children and young people routinely receive a copy of the Trust s complaints leaflet at the point of entry to the service and the process is personally explained to them. 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 http://www.dhsspsni.gov.uk/index/hss/child_care/child_care_guidance.htm. PAGE 26

4 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. 28 The 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; 28 CtSc, Chapter 4, paragraph 4.2. PAGE 27

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 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 Centre 29 and Chinese Welfare Association. 30 This 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 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/ 31 The Safe Parenting Handbook can be accessed at: http://www.dhsspsni.gov.uk/show_publications?txtid=12653. PAGE 28

4 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 32 Johnston, I., Professional Social Work, BASW, August 2006 PAGE 29

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND GOOD PRACTICE EXAMPLE: Ormeau Road Family and Child Care Office, South and East Belfast Trust The Ormeau Road Family and Child Care office is user-friendly and characterised by the following features: - situated on a main arterial route serviced by local and regional transport; - onsite car parking with additional parking in adjacent streets; - an obvious and unambiguous sign indicating the service available within the building; - bright, fresh and welcoming reception/waiting room facilities with appropriate décor and furnishings; - wall display with a number of relevant leaflets; - pleasant and professional reception staff with evidence of appropriate respect for privacy and confidentiality; and - appropriate and accessible case conference room with a separate smaller meeting/interview room. 4.2.11 A number of the Trusts inspected had difficulty in providing a consistent and timely response to requests for services and this seriously impacted on the ability of children and families to access support. Levels of referrals were only one part of the problem. Difficulties with the transfer of cases between teams in some Trusts had created serious backlogs and pressures for duty and intake teams, children in need teams and for LAC services. Even when there were clear protocols for the transfer of cases these were often not implemented in practice. Trusts were experimenting with a range of models for restructuring services to streamline appropriate case allocation. 4.2.12 All but one of the Trusts inspected had a backlog of cases for allocation, raising serious issues about parents and children s ability to access services and about Trusts capacity to discharge their delegated statutory responsibilities. PAGE 30

4 4.3 Recommendations Boards and Trusts must ensure that: 20. adequate and appropriate information is available to potential service users and members of the public about the nature of child protection services and how and when to access them. This information should be presented, whenever necessary, in accessible formats, including translations for those for whom English is not a first or competent second language; 21. information is developed, disseminated and regularly audited in association with parents and young people and made available through the range of facilities commonly used by potential service users; and 22. a comprehensive review of the out-of-hours duty system is undertaken and that the relevant expertise and experience is available to provide an effective and responsive child protection service. Trusts must take action to improve: 23. arrangements for other agencies to receive information and feedback about the allocation of referrals made by them; 24. arrangements for parents, children and young people as well as staff in other agencies, to access relevant services and support within agreed timescales and in line with agency standards; 25. the reception, waiting and meeting room facilities within local children s services offices; and 26. systems for parents, children and young people to enable them to contact their social workers, as required, including: - provision of voicemail, email, and mobile telephone numbers; - monitoring arrangements to check that responses are within agreed timescales; and - customer care training for receptionists and duty officers. PAGE 31

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5 5. ASSESSMENT, CASE PLANNING, CASE MANAGEMENT AND RECORD KEEPING STANDARD 4 The Board/Trust has written policies and procedures, which provide direction and guidance to staff. These are underpinned by effective supervision and management arrangements, and policies and procedures which detail expectations regarding assessment, case planning, case management and record keeping of individual cases at all stages of the child protection process. 5.1 While legislation provides the policy framework in which services are delivered and social workers practise, particular attention to the implementation of policy is needed to effectively achieve policy aims. 33 5.2 Key Findings Regional Policies and Procedures 5.2.1 The substantive guidance for multi-disciplinary child protection practice is contained in CtSC and has been further developed by Boards/Trusts in the ACPCs Regional Policy and Procedures was launched in March 2005. There were agreed arrangements for the timely and systematic dissemination of these procedures. However, there were some issues regarding the rigour with which distribution and awareness-raising was effected in practice. Some staff, including mental health workers, allied health professionals and hospital nurses, reported difficulties in obtaining copies of the procedures. Management of Referrals 5.2.2 In all of the Trusts there were differing criteria for referrals between Social Services and other professional groups and agencies. This contributed to a lack of a common understanding of what constitutes a child in need/child protection referral which required a multi-agency assessment. This needs to be addressed as the literature suggests: 33 Collins, M., (2006) The Children Order: A Perspective from the United States, Child Care in Practice 12.2, Routledge. PAGE 33

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND concepts of risk and need are both central to child welfare systems. Risk primarily but not exclusively is related to child protection and need also primarily but not exclusively is related to family support. Adequate conceptualisation and measurement of both concepts are needed. 34 5.2.3 There is a fundamental issue about differing understanding of thresholds for referring children in need to Social Services. There were also difficulties about the failures to communicate effectively across disciplines and the need for agencies to negotiate an agreed and consistent threshold for referral. Thresholds have been discussed in Chapter 3. 5.2.4 Information gathering from other professionals at the point of referral was inconsistent across Trusts and not all social workers understood the importance of making preliminary enquires with the general practitioner, health visitor and school: It is a duty placed on social services to assemble and analyse information about children who may need to have their welfare safeguarded and promoted. This needs to be done in a rigorous way, viewed, as far as possible, through the eyes of the child. 35 5.2.5 The difficulty in some Trusts in allocating and responding to new referrals created additional pressures for referring agencies and disciplines including Education, PSNI, health visitors and mental health professionals who had to manage the identified risks within their own resources. Many workers expressed their anxieties about the risks for children and about their own sense of inadequacy in supporting families without Social Services involvement. 5.2.6 The difficulties in relation to referrals were not formally reported through line management to senior officers in each discipline and in each organisation. Furthermore, they were not formally notified to the interagency forums of CPP and ACPC by the respective agency representative. Trusts, PSNI and Education had no agreed formal mechanisms to bring concerns or failures by any party to conform to procedures, to the attention of their senior management and through them to senior officers in other agencies. 34 Collins, ibid. 35 Laming, ibid, 4.189. PAGE 34

5 5.2.7 The standard required by CtSC that referrals should be made in writing and acknowledged in writing was not consistently achieved. Assessment 5.2.8 During the period of the inspection the DHSSPS was working with Boards, Trusts and key agencies in developing the UNOCINI initiative, through which a single assessment framework was being developed and piloted. 5.2.9 An agreed model for assessment had not been introduced across the region and during the timescale for the inspection there was considerable variation in the approaches to assessment. The models available within Trusts were not consistently applied and often were not used appropriately in the identification of the needs of children and risks within family situations. 5.2.10 In many of the cases inspected there were gaps in the multi-agency assessment due to a failure to either seek, or appropriately utilise, the specialist expertise of other disciplines such as paediatricians, psychologists, allied health professionals and mental health workers. The importance of this is highlighted in UNOCINI. 5.2.11 The failure to recognise the importance of the particular contributions a range of professionals can bring to the assessment process was particularly evident in one CMR considered during the inspection. This highlighted the tensions that can occur when professional responsibilities for specific aspects of assessment, role boundaries and the limits of expertise are not clarified and when the child protection process does not remain focused on the child. It has been noted that: Understanding and meeting the needs of children in a comprehensive holistic and consistent way is one of the great challenges facing social care, health and education agencies today. Many enquiries have brought to the fore failings in staff being equipped to meet the fundamental requirements of good quality assessments. 36 36 Richards, J., Mason, D., & Kelly, J (2006) Understanding the Needs of Children in Northern Ireland. PAGE 35

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 5.2.12 Medical and paediatric assessments were not routinely carried out when there were concerns about neglect or developmental delay. Arrangements for the joint medical assessment of children by paediatricians and forensic medical practitioners were only evident in a small number of cases in one Trust area and this was due to the commitment of medical professionals in this Trust. GOOD PRACTICE EXAMPLE: Joint paediatric/forensic medical examinations, Foyle Trust Due to effective collaboration within the Foyle Trust, joint paediatric/forensic medical examinations were carried out on young people who alleged they had been sexually assaulted. This helped to ensure that in addition to collecting appropriate evidence, the impact of the trauma on the child was considered and appropriate counselling, advice and supports were provided. 5.2.13 Social work reports and assessments did not always take a child-centred or analytical approach but tended to focus on the adults perceptions of their family s needs or on the relationship between adults. Hence they often failed to consider the impact of the behaviour and level of functioning of adults on the child s shorter and longer term psychological development and emotional wellbeing. 5.2.14 Many of the case files examined did not demonstrate the use of a theoretical basis to conceptualise the risks for children. This was particularly evident in cases characterised by domestic violence, mental illness, learning disability and drug or alcohol dependency. 5.2.15 By the latter stages of the inspection many staff had already attended training on comprehensive assessment and on the Assessment Framework Model developed by the Department of Health in London. However, the application of this was not always evident in assessments available within case files and there were often long delays in completing them. In addition, concerns were raised about the time available on the professional social work course curriculum in relation to assessment and risk assessment and there was a view that course content needed to be improved in this regard. While assessment and risk assessment are contained within the Framework Specification for the new Honours Degree in Social Work, it is important that teaching and skill development are monitored to ensure they reflect current best practice. PAGE 36

5 5.2.16 The lack of a consistent approach to structured assessment made it difficult for staff to plan effectively, measure progress and achieve appropriate outcomes for individual children. It was often difficult to find evidence of positive change in cases known to Social Services for long periods. Case Conferences 5.2.17 CtSC and the ACPCs Regional Policy and Procedures provide the framework for the operation of case conferences. These outline the timeframes within which case conferences should be convened, provide guidance about who should be invited to attend, chairing and managing the process and how the conference should be minuted. The chair has responsibility to ensure the case conference process is able to elicit and consider the evidence available from those present in order to take the appropriate decisions. 5.2.18 Case conferences were not always held within the timescales stated in procedures. 5.2.19 Case conferences were chaired appropriately by experienced social workers at Assistant Principal Social Worker (APSW) level or above. Within Trusts this responsibility was shared by a number of APSWs and a review of minutes, feedback from both professionals and parents, as well as observation of the process, indicated that there was considerable variation in how case conferences were conducted within and between Trusts. As the chairing role is extremely challenging, senior managers need to audit, monitor and quality assure the implementation of procedures and the decision making process, to support case conference chairs and bring about greater consistency in practice. 5.2.20 Relevant professionals were not always in attendance at case conferences. Some professionals interviewed during the inspection felt that when they did attend their contribution was not valued and there was therefore a reticence to contribute. This sometimes stemmed from inexperience and a lack of clarity about their role at the case conference. Reasons for non-attendance from Education were varied. It was the view of teachers that case conferences, on occasions, were not being arranged at a suitable time or at short notice. There was a view that teachers find it difficult to contribute effectively to case conferences as they have built a relationship with parents and have to pick up the pieces following the case conference. PAGE 37

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 5.2.21 Most parents and young people were very apprehensive about attending case conferences and felt the process was daunting. This was due largely to the numbers of professionals present and the formal nature of proceedings. Many of them had neither received adequate information/preparation nor had the opportunity to read reports from professionals in advance. Parents had strongly held views as to how case conferences could be improved and their greater involvement facilitated. In particular parents wanted to have: reports provided in advance; better information and preparation both for themselves and young people for case conferences, including information on who will attend and why they need to be there; pre-meetings to set and agree objectives for the case conference; appropriate waiting room and conference facilities with less formal and less intimidating room layout; and timely minutes confirming the decisions and actions with better follow through of decisions taken. 5.2.22 Several young people reported that their social worker had spent time preparing them for attendance at case conferences and had fully explained the process to them. This made the experience more beneficial and these young people felt included in the process. This good practice is commended and must become the standard for all Trusts. 5.2.23 Case conferences were generally held in rooms within community-based Trust facilities, some of which posed challenges in terms of access and the adequacy of waiting areas. There is a need for greater understanding and sensitivity to the needs and feelings of parents and young people attending case conferences and their rights to privacy and respect should be upheld in the physical arrangements for meetings about their families. 5.2.24 The format and content of health visitors reports for case conferences varied between Trusts. The reports inspected did not always contain a full assessment of the health/developmental needs of each child and relevant information relating to PAGE 38

5 parents health and parenting skills. The role of the school nurse in child protection cases and the interface between the school nurse and health visitor was not always clear. 5.2.25 In some Trusts, a review of a number of case conference minutes indicated that the focus was placed on rehearsing the content of available reports rather than on the core issues, consideration of the needs of and risks for children, parenting capacity, what needed to change and the outcomes required. 5.2.26 There was extensive evidence of staff in social work, health visiting, community paediatrics and voluntary organisations working closely with families. What was less evident was the use of clear written contracts with parents about the standards and outcomes that they must achieve if their children are to remain safely in their care or are to be returned to their care. Evidence in case files, as well as feedback from Education and health visiting, indicated that unacceptable levels of neglect were tolerated in some family situations and that the adverse consequences for children were not fully appreciated. Improvements required by parents were not made specific in the records or the minutes, for example reduction in use and abuse of alcohol, the need to provide an adequate standard of living, improve school attendance, or provide appropriate supervision for children and set appropriate boundaries for young people. 5.2.27 There was considerable evidence that the right to family life and the principle of maintaining children within their families were reflected in the decision making process. However, the paramountcy principle in relation to protecting the welfare of the child must be upheld. The Children Order requirement on maintaining children with their parents is so far as is consistent with the Trust s duty to safeguard and promote the welfare of children. 37 This was not always adequately achieved. In a number of the cases files examined, children s life chances could have been promoted more effectively by greater challenges to the care offered by their families and by making explicit the consequences if standards of care were not achieved and if the risks to children did not significantly diminish. Many of these cases eventually came to the attention of the court and Care Orders were granted. 5.2.28 In some cases, practitioners were not aware of previous or current involvement by their own department or other services within the Trust. Several families were the subject of multiple referrals and these were not always appropriately crossreferenced. 37 Children (Northern Ireland) Order 1995, Article 18(1)(a) and (b). PAGE 39

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 5.2.29 There was considerable evidence of work on child protection plans, although the commitment to developing these through core groups was stronger in some Trusts than others. Some core group membership was limited to health visitors and social workers and did not involve other relevant professionals such as those from Education and the PSNI. Child protection plans frequently consisted of a list of actions to be taken by those working with the family rather than the improvements required from the parents to reduce the risks for their children. 5.2.30 Most Trusts had trained minute takers. This arrangement worked well and facilitated senior social workers to make a fuller contribution to the case conference process. However, vacancies and absences among minute takers were common and this gap was filled by senior social workers. 5.2.31 The format and content of minutes in some Trusts did not comply with the regional guidance. Minutes were rarely circulated within agreed timescales and there was a delay of several months in providing the minutes. There were examples of minutes only being provided at the subsequent case conference and this meant that professionals and parents had no formal record of the key actions required within the child protection plan. Record Keeping 5.2.32 Records should contain the range of significant information required for effective planning to meet the needs of the child or young person. Records should identify the relevance and source of the information recorded and a clear plan for each child. This should include the child s developmental needs, parental capacity to respond to the child s needs and the impact of family and environmental factors. It should also specify the particular service to be provided and why, the desired outcome and how progress towards this goal will be monitored. Records should contain summaries, case histories, chronologies and analysis of interventions to maintain a clear focus on the needs of the child or young person in individual cases. Case records are important measures of accountability and of the effectiveness of the practitioner and organisation. The quality of records has been a key issue in child protection inquiries. 5.2.33 All of the Trusts had an agreed format for children s services files and health visiting files, with sections for storing specific types of information. Each Trust had a range of appropriate recording forms and considerable efforts had been made to streamline these. PAGE 40

5 5.2.34 The volume of recording and information contained in the longer term cases presented challenges for file management and for the easy retrieval of relevant information. In many ongoing cases, there was no up-to-date basic family information sheet or summary of key developments at the front of the current file. In those cases where records were typed, it was easier to access salient information and review how the case had been managed. 5.2.35 There was a variety of children s social services referral forms in use across the region. The standard of completion of referral forms was variable and many omitted basic information about children and their circumstances. 5.2.36 Where Trusts had introduced specialist teams to process and investigate new referrals this was generally accompanied by new referral forms. These forms were more robust, and were generally more fully completed. However, there was still some evidence of gaps in basic information. There was variability in the direction provided by team managers in setting out the actions and outcomes required in the initial assessment or the reasons for actions taken. There was limited evidence of monitoring the quality of record keeping. 5.2.37 Records of contacts with young people, parents and professionals were often overly detailed, and the absence of summaries made it difficult to establish chronology and to get an overview of the situation within each case. When questioned about the extent of recording and the absence of professional opinion in case records, a number of social workers reflected a misunderstanding about the purpose, content and use of records. There was a disproportionate concern about client access and about the need to record factual detail and avoid recording professional opinions. CtSC states that records should contain an analysis of progress and should clearly differentiate between fact, opinions, judgement and hypothesis. 38 5.2.38 By contrast, court reports contained a comprehensive collation of pertinent information about a family s background, present circumstances and the professional justification for intervention. This is to be commended. 5.2.39 A number of managers demonstrated consistent good practice in recording decisions taken in the context of supervision on case files and signed case notes to demonstrate their ongoing monitoring role. However, this was evident only in a minority of the case records inspected. 38 CtSC, Chapter 8, paragraphs 8.1-8.4 deal with record keeping. PAGE 41

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 5.2.40 Health visiting records were variable and could have been enhanced by the inclusion of a family needs assessment as a front sheet on each file and the completion of a chronology of significant events proforma as a means of summarising important information about the family. There were examples of clear assessment, planned interventions and appropriate review in some health visiting records. Other case files lacked assessment and demonstrated only limited evidence of supervision and monitoring by nurse managers. Supervision is dealt with in Chapter 7. 5.3 Recommendations The DHSSPS must: 27. continue to progress the implementation of a single model of assessment for Northern Ireland as a matter of urgency and ensure that: Trusts must: - there is consistent use of the model for assessment across the region and that the impact on improved outcomes for children and families is evaluated, in collaboration with the key disciplines and agencies; - Boards and Trusts, through ACPC and CPP, provide practitioners and managers from all disciplines and agencies with appropriate training in the application of the assessment model; and - the NISCC actively regulates social work training and monitors professional course content, particularly in relation to assessment and risk assessment to ensure that it reflects current best practice. 28. monitor and audit the implementation of case conference procedures and ensure that: - case conference chairs fulfil their role in leading the case conference as set out in CtSC and are supported through appropriate line management supervision, effective monitoring arrangements, adequate on-going training and the provision of suitable accommodation; - training is provided to professionals in relation to their roles and contributions to the case conference process; - the case conference process remains focused on the needs of children; - information from the range of agencies working with families is summarised; PAGE 42

5 - the roles of school nurse and health visitor are clearly defined and that their reports provide full assessment of the health/developmental needs of the child and relevant information in relation to the parents health and parenting skills; - the needs and risks in respect of individual children are analysed and whether the requirements for child protection registration are met; - the parents and family s strengths and qualities and their existing network of supports are assessed; - the deficits in parenting skills and the kinds of supports required to address these are clarified; - any changes needed and standards to be achieved in order for children s names to be removed from the register are clearly set out; - advice is provided to parents of the importance of co-operating with the child protection plan and the potential consequences in terms of Care Order applications when the threshold of significant harm has been reached; - an appropriately trained minute taker records all child protection case conferences, that minutes are consistent with CtSC and are circulated within 14 days as required by the regional ACPC Policy and Procedures; and - the views of children and young people and parents about the conduct of case conferences, are considered and, if necessary, appropriate action taken; 29. evaluate/audit case recording in their family and child care services to ensure that information from all relevant disciplines is appropriately collated, analysed and recorded and that this forms the basis for the assessment, including risk assessment and therapeutic intervention required in each case; and 30. retain in the file one completed comprehensive set of essential information record forms, a front chronology sheet that is regularly updated with information on the child/family, case summaries and transfer reports and records typed, crossreferenced and filed in date order. PAGE 43

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6 6. PROTECTING VULNERABLE CHILDREN IN SPECIFIC CIRCUMSTANCES STANDARD 5 The Board/Trust, in co-operation with other providers and services, has effective arrangements in place for the protection of children in groups known to be vulnerable and in specific circumstances. 6.1 There are children who are more vulnerable because of their specific personal or family circumstances. These include children with disabilities, children living away from home, those who have been abused or neglected, as well as children whose parents behaviour leave them vulnerable and exposed to risk. For example, children living in households characterised by domestic violence, misuse of alcohol or drugs, mental illness or learning disability. Particular regard also has to be paid to the needs of children within minority and ethnic groups. Professionals should always consider children s rights to be protected from harm, and the balance that needs to be achieved with the right to a private and family life for both children and parents. 6.2 Key Findings 6.2.1 The ACPCs Regional Policy and Procedures takes account of the range of specific conditions and circumstances in which children might be vulnerable. From the evidence contained in the case files inspected, the application of these procedures was not always consistent. This was particularly the case for children living in residential children s homes and in families characterised by domestic violence, misuse of alcohol or drugs and mental illness. Residential children s homes are dealt with in Chapter 11. 6.2.2 Most staff in the range of other disciplines and agencies working with children and families with special needs had knowledge of the Regional Policy and Procedures and had access to information/awareness sessions about its content. 6.2.3 Staff working with adults in a range of circumstances did not always understand the potential consequences of adult behaviour for children. There was little evidence of any joint training for staff in child care and staff in mental health and addiction services on the impact of mental illness or drug and alcohol misuse on children. Staff in mental health services were not always included in child protection awareness training. PAGE 45

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 6.2.4 The examination of case records revealed a number of situations in which child protection procedures had not been activated although thresholds had been reached. This typically involved situations where attempts were being made to work in partnership with parents without fully assessing the risks to and needs of their children. There was often insufficient challenge by Social Services and the PSNI in families characterised by repeated domestic violence and excessive misuse of alcohol by parents whilst having the care of young children. Humphries and Stanley highlight the importance of responding to the separate needs of women and children in violent situations. 39 6.2.5 Some children remained in families where due attention was not always afforded to their basic health, developmental and educational needs. Extensive family support failed to bring about needed improvements in their situation. The needs of parents with learning disability or mental illness were addressed sometimes at the expense of appropriate levels of physical and emotional care being provided to children. 6.2.6 Decision making was not always informed by appropriate clinical and psychological assessment of parental capability/level of functioning or of the impact of mental health disorders or addictions on parental behaviour. The particular needs of children within families characterised by learning difficulties and/or mental health problems were often not fully understood. 6.2.7 Children with disabilities are particularly vulnerable and there was evidence that those working with them, including Allied Health Professionals (AHPs), are becoming increasingly aware of their child protection responsibilities. However, the expertise of AHPs was not always sought when assessing risks to children with special needs and in child protection planning for this group of young people. 6.2.8 Undue responsibility was placed on young people to make a complaint. The joint responsibility of Trusts and PSNI to take action to protect children is not dependent on a complaint or on whether a prosecution is instigated. In one example, separate incidents of physical injury to 2 children in the same family were not progressed because the children did not want to make a complaint against a parent. 6.2.9 Children for whom English is not their first language were under-represented in the sample of case files inspected. The needs of the increasing numbers of minority and ethnic families as well as children of migrant workers and refugee and asylum seeking children, will need to be further understood and considered. See Chapter 4. 39 Humphreys, C., and Stanley, N. (Ed) (2006) Domestic Violence and Child Protection, Kingsley PAGE 46

6 6.3 Recommendations Trusts must ensure that: 31. child protection procedures are initiated in all situations where the criteria are met and that there is an appropriate multi-agency assessment of risk and adequate child protection planning; 32. the expertise of AHPs is more fully utilised in the assessment and management of child protection cases, where appropriate; 33. the management of cases reflects an appropriate balance between working in partnership with parents to avoid family breakdown and using its authority to effectively intervene to challenge harmful situations and safeguard children, and - written contracts with parents specify the work plan and clearly state the standards and improvements expected of them; 34. decision making is appropriately informed by clinical and psychological assessment of parental capability and level of functioning; and 35. staff in mental health, learning disability and addiction services receive appropriate child protection training and staff in child care receive appropriate training in mental health, learning disability, alcohol and drug abuse and the impact of these on children. PAGE 47

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7 7. QUALITY ASSURANCE AND MANAGING PERFORMANCE OF SERVICE STANDARD 6 Child protection services respond to the needs of children and their families, operate to high standards, conform to regulations, guidance, policies and procedures and are monitored and audited by the Board/Trust, ACPC and CPP. 7.1 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. This has major implications for the monitoring and audit of child protection services and strengthens existing governance requirements set out in Circular HPSS/PPRD5/5/94, Circular METL 2/94 and Circular CC3/02. All Boards and Trusts are required to complete corporate parenting reports which are in turn submitted to the DHSSPS. 7.2 Increasing accountability for professional decision making and actions requires strong, confident, competent leadership and management in child protection. Managers at each level create the ethos and culture of the organisation. They are responsible for ensuring that the required professional standards are met and must therefore provide the processes to assist staff to deliver services which conform to expectations. Best practice needs to be embedded and standards implemented, audited and reviewed on a uni and multi-disciplinary basis. 7.3 Key Findings Governance 7.3.1 There were variations between Boards about the arrangements in place to discharge governance responsibilities and how they responded to identified/reported difficulties and individual Trust s ability to meet their statutory responsibilities. The inspection process exposed serious weaknesses in the arrangements for monitoring, auditing and quality assuring statutory child protection activity at all levels across the region. Examples of this included: Boards contract monitoring arrangements did not identify the extent and severity of Trusts failure to discharge statutory duties; PAGE 49

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND some Trust boards had not been made aware of the significant deficits in services through CC3/02 reports. Others had received this information but appeared not to fully understand or take appropriate urgent remedial action to address shortfalls; some Directors did not always appropriately share significant issues affecting the performance of their service with the Trust s Senior Management Team (SMT) for discussion and resolution. Consequently the performance of other directorates and the Trust itself, as a corporate parent, was compromised; PSNI did not formally challenge, through appropriate channels, Trusts inability to identify social workers to carry out joint protocol interviews; and the Education sector did not formally communicate their concern about Social Services failure to allocate cases. 7.3.2 The absence of statements of purpose for children s services, including child protection, along with a lack of implementation of standards and guidance for staff resulted in variations in how cases were managed. There was little evidence of senior management staff auditing case records to monitor the quality of intervention. This was a particular issue in those longer term cases which were being managed, sometimes inappropriately, outside the child protection system and within a family support context. 7.3.3 During the course of the inspection management letters 40 were issued by the DHSSPS to 4 of the 5 Trusts inspected due to serious concerns about practice and management in specific child protection cases. The DHSSPS is continuing to review the implementation of the action plans developed by the Boards and Trusts to address the serious concerns identified. 7.3.4 In many Trusts there was some evidence that senior social workers, as first line managers, checked on the quality of the practitioner s work and on progress against plans. There was less evidence of processes to ensure that quality assurance occurred at every level in children s services. The need for senior managers and directors to sample and review individual cases to satisfy themselves about decision making was an explicit recommendation in the inquiry report into the death of Victoria Climbié and needs to be addressed. 41 40 Management letters are issued by the Chief Inspector, SSI in the course of an inspection where there are matters of serious concern which require immediate action on the part of Boards and/or Trusts. 41 Laming, ibid, Recommendation 30. PAGE 50

7 7.3.5 There was no evidence of arrangements for joint monitoring by PSNI and Social Services of the application of the Joint Protocol, including joint investigations and joint protocol interviews. Decisions not to proceed with child protection investigations following joint interviews were often made by first line managers and there was no quality assurance process for endorsing or challenging these decisions. Supervision 7.3.6 Supervision is one of the fundamental processes through which Trusts can quality assure their child protection practice. It is a means to develop and control the quality of a service, taking account of the needs and rights of users and the quality of staff performance. 42 7.3.7 All of the Trusts inspected had a supervision policy for social workers. Many social work staff across the region commented favourably on the value of supervision received from senior social workers. 7.3.8 There were inconsistencies in the frequency and quality of social work supervision and this was often related to staffing pressures, of which senior managers were aware. However, there were often no formal processes in place whereby more senior managers agreed achievable targets for supervision. In some instances, where first line managers were on long term sick leave, supervision did not occur in a consistent manner. Furthermore, there was little evidence that more senior managers made appropriate alternative arrangements for supervision. 7.3.9 It was evident from a review of case files that there were weaknesses in the support provided for social workers in applying theoretical concepts and models for intervention within their practice. Many case files lacked structure and analysis within recording and there was an absence of direction by managers in regard to the outcomes required to reduce the risks for children. There was little evidence of formal audit or monitoring across teams and Trusts to identify the quality of support for staff involved in the decision making process. 7.3.10 Managers did not consistently record the decisions made in supervision on the relevant case files. Similarly, there was inconsistent evidence that senior social workers or second line managers regularly read and signed files, as recommended by 42 Payne, M., (1995) Modern Social Work Theory, Palgrove MacMillan) PAGE 51

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND the Victoria Climbié Inquiry and the subsequent audit by the DHSSPS in 2004. This raised issues about how Directors can satisfy Circular METL 2/94 and Circular CC3/02 requirements. 7.3.11 There was little evidence that Boards and Trusts review how they are adhering to regulatory and professional codes of practice, particularly in relation to the supervision, support and management of staff. 7.3.12 Arrangements for the supervision of health visitors were variable across the region. Increasingly, direct supervision of child protection cases was provided by child protection nurse advisors (CPNAs). The need for this supervision to be more frequent and to be on an individual rather than group basis was identified in a number of Trusts, as was the need for clarification about the interface of responsibilities between nurse managers and CPNAs. 7.3.13 Quality assurance arrangements within nursing in several Trusts failed to respond appropriately to the significant concerns and resultant pressures on health visitors when social workers did not respond to their referrals about children. 7.3.14 Arrangements for appraisal and continuing professional development for staff were at various stages of implementation across the region. 7.4 Recommendations Boards must ensure that: 36. Trusts have in place robust arrangements for monitoring and auditing: - the management of the child protection process; - the implementation of policies and procedures for referral, assessment, case planning, case management and record keeping of individual cases; and - the effectiveness of interventions in achieving specified outcomes for children and families. Trusts must ensure: 37. compliance with NISCC, NMC, GMC, HPC and other regulatory bodies guidance on supervision, continuous professional development and appraisal as part of their governance arrangements and this should be monitored by the RQIA. PAGE 52

7 Boards and Trusts must: 38. audit the standards and procedures for supervision for all staff and ensure that staff are appropriately supported and managed in their work with children and families; and 39. in collaboration with PSNI, review and monitor the implementation of the joint protocol. The DHSSPS must continue to ensure that: 40. Boards and Trusts have reviewed and taken action on the serious issues identified in the management letters issued during the inspection and that safeguards for children are in place and practice improved. PAGE 53

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8 8. THE ESTABLISHMENT AND OPERATION OF THE AREA CHILD PROTECTION COMMITTEE (ACPC) AND THE CHILD PROTECTION PANEL (CPP) STANDARD 7 The Boards/Trusts exercise their respective lead responsibilities for the establishment and effective working of ACPCs and CPPs as detailed in Cooperating to Safeguard Children. 8.1 ACPCs which are sub-committees of the Boards have responsibility and collective authority to support, oversee and promote the multi-disciplinary, interagency child protection process. Although social services staff in Boards and Trusts have responsibility for child protection services, a multi-disciplinary approach to this work is essential. As a result there should be an ACPC in each Board area to determine the strategy for safeguarding children and to develop and disseminate policies and procedures. 43 The ACPC and its Chair are accountable to the HSS Board which constituted the committee....each representative is responsible for ensuring that the issues applicable to their agency for the safeguarding of children are given proper consideration. Contributing agencies are expected to have a mechanism for considering the policy, planning and resource implications of issues brought to the attention of the agency by its ACPC representative. 44 Similar responsibilities and accountability arrangements for the CPP and its Chair at Trust level are set out in CtSC. 45 8.2 Key Findings 8.2.1 All Boards have established an ACPC and the Committees include representatives from an appropriate range of disciplines and agencies. Similar arrangements apply to 43 CtSC, Paragraph 4.1 44 CtSC, Paragraph 4.3 45 CtSC, Paragraphs 4.18 and 4.19 PAGE 55

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Trusts and the establishment of CPPs. All ACPCs meet on a regular basis, work to an agenda, produce records of meetings and have established sub-groups to assist in the conduct of business. 8.2.2 There was a strongly held view from the interviews undertaken during the inspection that representation on ACPCs should be at a more senior level. Interviewees also believed that agency representatives should have a mandate to take decisions to enable strategic and resource issues to be addressed and negotiated. Several ACPC members commented that they did not have sufficient seniority or authority within their agency to properly fulfil the responsibilities required by ACPC membership. Education and PSNI representatives advised of the difficulties inherent in trying to inform and represent the broad constituency of interests within their organisations. 8.2.3 Inconsistent attendance by some members of ACPCs and CPPs was common and this made it difficult to build an effective working forum. There was evidence of considerable drift with items remaining on the agenda for some time without ever reaching resolution. When serious issues of interagency significance arose, the relevant representatives were not always in attendance. Neither ACPCs nor CPPs were used as forums in which significant interagency difficulties such as the impact on families of staff shortages in PSNI and Social Services or the difficulties experienced in residential care could be resolved. 8.2.4 All ACPCs produced annual reports which, more recently, have incorporated business plans for the forthcoming year. While these contained broad statements about the strategy envisaged, some reports contained little comment on how outcomes achieved would be measured; who had lead responsibility for actions; and how the overall process would be audited and monitored. Some plans were overly ambitious and contained limited or no explanation as to why particular activities were not followed through. The annual reports made available to the inspectors varied across ACPCs and did not fully reflect the pressures on the system and the multi-agency network. The dissemination of an abbreviated plan would have assisted staff and the public to gain greater knowledge of the ACPC strategy and work. 8.2.5 Staff in all disciplines and agencies who participated in focus groups reflected a lack of awareness of ACPCs and CPPs generally and were unclear as to the membership, responsibilities and relevance of ACPC/CPP work for front line child protection practitioners. There was little evidence of minutes being circulated or of attempts to regularly apprise staff of the activities and business of ACPCs and CPPs. Many staff had not seen an annual report of either ACPC or CPP. PAGE 56

8 8.2.6 Participants in focus groups commented on the lack of opportunity for the ACPC or CPP to receive direct feedback from staff and service users on the application of policy and procedures. 8.2.7 ACPC and CPP activities had a strong emphasis on Board and Trust business, and particularly on the children s social services agenda, with less focus on the interdisciplinary and interagency responsibilities or the corporate nature of child protection envisaged in CtSC. In some Committees and Panels, action plans did not always appear to be owned and driven by all disciplines and agencies. Very often there was a reliance on the chair, policy officer, where one existed, and the training officer to drive forward the business. 8.2.8 The ACPC s accountability to the Board was often discharged through the production of the annual report and an associated presentation. There was little evidence of ongoing structured reporting arrangements from the ACPC chair to the Area Board or of mechanisms for monitoring implementation improvement plans. The inspection revealed significant deficits regarding ACPCs and CPPs in keeping their Area Boards or Trust boards informed about the demands and complexity involved in safeguarding children. This was particularly evident where staff shortages compromised the capacity to meet statutory responsibilities. In one instance, where the appropriate channel was used and the CPP chair provided updates on the crisis in unallocated cases, the response and remedial action taken were inadequate. 8.2.9 Agency representatives to ACPCs and CPPs did not always report serious concerns to senior officers within their own agency. Such reporting would have ensured that each agency had the opportunity to respond to these concerns appropriately thereby promoting an interagency multi-disciplinary approach to problem solving. There was evidence that some ACPCs were auditing responses to the management of referrals/waiting lists for allocation. However, auditing and monitoring activity was not consistent. Not all ACPCs had an auditing or monitoring sub-group and there was little evidence of a programme for monitoring, particularly in regard to how agencies and disciplines were working together. 8.2.10 All those involved in ACPCs recognised the importance of multi-disciplinary training, particularly for those in day to day contact with children and families. In each area, arrangements were in place for the provision of training. These were comprehensive in 2 Board areas but less so in the others. In one Board, there was no dedicated, funded training post. There was a significant reliance on Social Services training budgets and no evidence of a pooling of resources or funding to provide interagency and multi-disciplinary training. PAGE 57

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 8.2.11 All ACPCs faced challenges in relation to training. These included the identification of training needs across disciplines and agencies; funding the necessary training; and securing attendance at relevant courses. The uptake of places on courses was variable and there was little evidence of monitoring attendance at training courses. There was also limited evaluation of the impact of training or how learning is incorporated into practice. GOOD PRACTICE EXAMPLES: Training - Northern and Southern Boards The Northern ACPC s Recognising and Responding to Child Protection courses, which provide multi-disciplinary training in the fundamentals of child protection practice and procedures, are offered on a regular basis to meet the needs of newly qualified staff. The Southern ACPC s voluntary and community sector training initiative created awareness and empowered staff and volunteers in a wide cross section of groups and clubs working with young people to recognise and respond to child protection concerns. 8.2.12 The DHSSPS has recognised that the current ACPC and CPP structures require reform. It is currently progressing the establishment of a Safeguarding Board for Northern Ireland to replace current ACPC/CPP arrangements. In the interim, a number of recommendations which will facilitate ACPCs and CPPs to more effectively discharge their responsibilities are made. 8.3 Recommendations Boards and Trusts, in conjunction with key agencies, represented on ACPCs and CPPs must ensure that: 41. representatives are of sufficient seniority in their own organisations and disciplines to fully discharge the responsibilities of membership. Representatives must have the necessary mandated authority to make strategic decisions and allocate and pool resources on behalf of their organisation and discipline, and PAGE 58

8 - ACPC and CPP chairs regularly apprise them of safeguarding developments, immediately reporting issues which have the potential to compromise governance and corporate parenting responsibilities. Proposed quality improvement plans to deal with these should also be included; and - the ACPC is adequately informed about local and agency child protection concerns, including referral and workforce issues, so that these can be addressed and resolved; and 42. ACPC and CPP business plans and action plans conform to CtSC and that they: - reflect the interagency nature of child protection work; - have specific targets and outcomes which are measurable and time bounded; - include the development and implementation of a robust and ongoing programme of auditing and monitoring which ensures that the safeguarding strategy for the area is working; - identify the multi-agency training requirements and funding arrangements; and - are available in an abbreviated format and made widely available to staff, children, young people and families. The DHSSPS must continue to: 43. progress the introduction of the new Safeguarding Board for Northern Ireland to replace the existing ACPC/CPP structure. PAGE 59

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9 9. CASE MANAGEMENT REVIEWS STANDARD 8 The ACPC conducts Case Management Reviews under Co-operating to Safeguard Children Chapter 10 and ensures that outcomes effectively inform practice at all levels. Lessons are communicated clearly to all those who need to know and changes are implemented, audited and reviewed to maximise the safeguards provided to children. 9.1 In May 2003, CtSC increased the range of circumstances in which a CMR should be considered and responsibility for determining the need for a CMR and for managing the process moved from the Trust to the ACPC. Prior to this, only a small number of CMRs had been carried out as required by the previous guidance contained in Cooperating to Protect Children. 9.2 At the time of this inspection only a few CMRs had been completed under the new procedures although a significant number of CMRs were in progress. Despite the small number of CMRs completed some common themes and issues were emerging. 9.3 Key Findings 9.3.1 The ACPCs Regional Policy and Procedures have incorporated the guidance on CMRs contained in CtSC. 9.3.2 ACPCs generally reported that responsibility for the conduct of CMRs was more clearly defined, that the process was helpful and was conducive to learning the lessons from experience. 9.3.3 ACPCs were establishing CMR Panels as required by CtSC but encountered problems in securing and resourcing independence and impartiality in the chairmanship and composition of Panels and in securing appropriate expertise among Panel members. 9.3.4 The complexity, time commitment and administrative burdens associated with the CMR process has resulted in CMRs not always being completed within recommended time frames. PAGE 61

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 9.3.5 Securing timely reports from individual agencies presented challenges for some Panels. 9.3.6 There is a lack of clarity amongst some agencies and officials regarding the status, integrity and confidentiality of CMRs and the interface of these with the wider processes of the law. 9.3.7 The arrangements for implementing and monitoring the outcomes of CMR recommendations within the relevant Board/Trust were not always adequate. Some recommendations remained unaddressed for an unacceptable period of time. 9.3.8 While the learning had usually been shared with staff in children s social services teams, there was a lack of clarity about how lessons from CMRs were disseminated among other disciplines, including mental health professionals. Many staff were unaware of the professional implications arising from CMRs for their practice. 9.3.9 The CMR reports produced to date have varied significantly and do not always conform to the standard set out in CtSC that recommendations should be few in number, focused and specific and capable of being implemented. 46 9.3.10 ACPCs were struggling with the volume of recommendations generated by CMRs and with their potential application across the region. CtSC provides for these to be considered centrally through Regional Case Management Overview Reports 47 and feedback from interviews indicates that a review is needed. 46 CtSc, Chapter 10, paragraph 10.31 47 CtSc, Chapter 10, paragraph 10.38 PAGE 62

9 9.4 Recommendations Boards must ensure that: 44. CMRs are undertaken in accordance with CtSC and that the lessons learned are communicated, understood and actioned within their Board/Trust and across all disciplines/agencies, and - there is a process in place to inform practice and measure improvement; and - problems identified in undertaking CMRs are brought to the attention of the DHSSPS so that these can be considered in any amendments to regional guidance. The DHSSPS must ensure that: 45. the CtSC Working Group completes its review of the lessons emerging from CMRs and, in collaboration with the Boards and Trusts, consider the issues for policy and practice developments, and - the status of CMRs is clarified and that issues about interfaces with the wider processes of the law are addressed within the new Safeguarding Board arrangements. PAGE 63

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10 10. EQUALITY AND HUMAN RIGHTS STANDARD 9 The Board/Trust fulfils its statutory duties in respect of human rights and equality legislative requirements. Human rights and equality principles are integrated into practice within all aspects of child protection services. 10.1 The Equality and Human Rights Standard underpins all other standards and all aspects of the inspection were conducted with due regard to the requirements of the United Nations Convention on the Rights of the Child 48 (UNCRC) and the 1998 Human Rights Act. 49 10.2 Key Findings 10.2.1 Most staff had received training in and demonstrated awareness of the provisions of the UNCRC and placed value on the core principles of children s rights. They sought to incorporate these into their practice. This is to be commended. 10.2.2 All Trusts had equality schemes in place and reported that all existing and new policies were screened for compliance with the requirements of section 75 of the Northern Ireland Act 1998. 10.2.3 The CSP process in all of the Boards took account of the diversity of children s needs in terms of disability, religion, gender, sexual orientation, political opinion and race. LAC placements took account of religious and cultural background and interpreting services could be accessed when appropriate. 10.2.4 The UNCRC establishes a child s right to be protected from harm. The inspection identified concerns that some children did not have access to timely and appropriate assessment and consequent access to services. 48 The United Nations Convention on the Rights of the Child can be accessed at: http://www.ohchr.org/english/law/crc.htm 49 The Human Rights Act 1998 - On 23 October 1997 the Lord Chancellor introduced the Human Rights Bill 1997-98 into Parliament. It incorporates into domestic law the rights and liberties enshrined in the European Convention on Human Rights, a treaty to which the United Kingdom is signatory but which until 2000 had no application in domestic law. The Act received Royal Assent on 9 November 1998 and came into force in October 2000. The Act can be accessed at: http://www.opsi.gov.uk/acts/acts1998/19980042.htm PAGE 65

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 10.2.5 In addition, the thresholds for access to services, which excluded some vulnerable groups, also created a potential to undermine the rights of children and families. 10.2.6 At the time of the inspection there was a significant number of unallocated cases across the region. Additionally, the focus on maintaining family life led to a tolerance of unacceptable levels of alcohol and drug misuse and domestic violence. 10.2.7 Similarly, access to Child and Adolescent Mental Health Services (CAMHS) was limited for many young people with emotional and behavioural problems or alcohol and drug dependency or relationship difficulties. Trusts need to fully consider the implication of these issues in fully upholding the right of these young people to be protected from harm. 10.2.8 In 4 out of 5 Trusts there were issues about geographical inequality in the provision of services, which related to challenges in servicing rural and sparsely populated areas, difficulties in providing local points of access to services and in ensuring that service level agreements took account of the need to service outlying communities and respond to demographic changes. GOOD PRACTICE EXAMPLE: Facilitating access to services, Sperrin Lakeland Trust The Trust is to be commended for the extent to which transport is provided to enable children, young people and their families to access services. The use of family support workers in supporting young people s attendance at facilities and programmes is also noteworthy. 10.3 Recommendation Boards and Trusts in planning, commissioning and providing child protection services must ensure that: 46. the rights of children and young people are appropriately safeguarded in the context of these services and that services are provided equitably having due regard to the assessed needs, changing profile and diverse needs of young people and families. PAGE 66

11 11. THE INTERFACE BETWEEN RESIDENTIAL AND FIELDWORK CHILD CARE SERVICES 11.1 In 3 of the 5 Trusts inspected (South and East Belfast HSS Trust, Sperrin Lakeland HSS Trust and Foyle HSS Trust) the interface between residential and fieldwork services was examined. The decision to extend the remit of the inspection in this way followed concerns noted by the SSI with regard to the safeguarding of children placed in children s homes by the Trusts. There were also concerns relating to the Boards and Trusts roles in monitoring adherence to the standards and the quality of care provided. The purpose, objectives and methodology, which were agreed for this part of the inspection, are included in Appendix 1. Resources 11.2 Residential care is a service provided for some of the most vulnerable children and young people in the looked after population. Many have previously experienced abuse and/or neglectful parenting. Meeting their needs is a complex process which places demands and pressures on residential staff. Residential staff therefore require particular skills, training, support and supervision. Good teamwork between fieldwork and residential care staff and their managers is also essential. Effective assessment and care planning processes are required to enable residential staff to properly discharge their responsibilities to children and young people placed in residential care. Matching the needs of children and young people with appropriate placements is crucial and a priority. Currently, however, there is an inadequate supply of sufficiently varied placements for children and young people. 11.3 Key Findings 11.3.1 Trusts reported that they are not always in a position to meet the assessed needs of each child or young person requiring a residential placement and that there are limited choices, except in some specialist residential care placements. 11.3.2 There is an insufficient range of placements, including specialist fostering, respite and placements for the 11+ age range of children. Consequently, children and young people were, on occasion, found to be inappropriately placed. PAGE 67

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 11.4 Recommendation Boards and Trusts must: 47. give effect to their child care responsibilities. In order to achieve this they need to: - strengthen the commissioning, quality assurance and monitoring processes to ensure a high standard of planning and effectiveness in their Looked After Children (LAC) services; - review the provision of the full range of LAC services to ensure they are adequate in terms of numbers and choices; - develop a range of additional remand/specialist/therapeutic placements to provide a greater range of choice; and - review training and support for foster carers as part of their action plans to further develop foster care services. Inspection Reports on Children s Residential Services 11.5 In order to acquire a regional overview of the operation of children s homes, inspectors reviewed inspection reports on children s homes over the last 3 years. Inspectors also convened a focus group meeting with RQIA inspectors of children s residential services. Many concerns emerged in relation to the operation of children s residential services regionally, which included failure to discharge statutory functions and meet legislative requirements. Many of the recommendations had been made in previous inspections by the Registration and Inspection Units (R&I Units) which preceded the RQIA. There was little evidence, however, of Boards or Trusts putting in place quality improvement plans to make the necessary changes required. The following findings have been reported on by the RQIA in its inspection and annual reports to the Boards and Trusts. 11.6 Key Findings 11.6.1 Pre-admission planning of placements occurs in a minority of cases. Children are generally admitted in an emergency, without appropriate attention being paid to preadmission assessment planning, despite the majority of young people being well known to fieldwork staff prior to their admission. PAGE 68

11 11.6.2 Children s homes are not regularly operating to their Statements of Purpose and Function. Consequently an inappropriate mix of residents creates problems in relation to achieving good outcomes for children and a satisfactory work environment for staff. Where homes operate to their Statement of Purpose and Function the standard of care and outcomes are demonstrably enhanced. 11.6.3 A range of Children s Resource/Placement Panels operate across Northern Ireland. There is no shared remit or common understanding of how these should operate; who should be represented on them; or how information on assessment is requested and used to inform the decisions taken. 11.6.4 There is a tolerance by staff of inappropriate and unacceptable behaviours on the part of looked after children, which means that, at times, child protection procedures are not being properly invoked. However, on other occasions, the staff response to the behaviour of children and young people is described as inflexible and sometimes served to exacerbate already difficult situations. This has resulted in the inappropriate involvement, at times, of the PSNI in seeking to resolve difficulties being experienced in managing the behaviour of children and young people. 11.6.5 As a consequence, there are major concerns regarding the criminalisation of young people s behaviour through the involvement of the PSNI which, on occasions, results in young people being remanded to the Juvenile Justice Centre. 11.6.6 PSNI are not investigating allegations of abuse of children where the children or young people concerned refuse to make a formal complaint and Trusts, generally, are not pursuing complaints on behalf of children and young people in their care. 11.6.7 Assessment, care planning, risk assessment and management, are not always evident in children s case records. 11.6.8 The aim of Trusts to be self-sufficient in relation to their children s residential services has resulted in general purpose children s homes. This lack of clear differentiation of purpose contributes to the creation of a residential group which is difficult to manage as young people often have complex and diverse needs. 11.6.9 Monitoring arrangements external to children s homes are not operating as effectively as they could be. Senior Managers in Trusts are not promptly addressing failures to meet legal requirements as identified in inspection reports. PAGE 69

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 11.6.10 Learning from inspection reports was not used to inform practice or to develop a strategic approach to managing children s homes. 11.6.11 There was a lack of choice in respect of children s residential and foster care services. There was little evidence of Trusts dealing in a strategic way with problems caused by the breakdown of placements or demonstrating creative efforts to explore alternative or more appropriate provision. 11.6.12 The excessive use of casual staff is of concern as they do not have the stability of relationship with the children and at times are unfamiliar with the routines in homes. Difficulties in relation to staffing levels are reported to impact on the time available for engaging meaningfully with children and young people. 11.6.13 Significant Event Reports indicated that a number of homes were not being adequately and safely managed. There was insufficient analysis and overview by senior management, PSNI and the RQIA of practice/trend data from untoward incidents to help inform a strategic approach to manage high level of risks highlighted. These risks included inappropriate sexual activity among young people, misuse of alcohol and drugs and frequent running away from children s homes. 11.6.14 Good quality professional supervision was not consistently being offered to staff to inform their work with children. 11.6.15 Statutory monthly social work visits to children and young people were not always undertaken. In addition, there was insufficient evidence of therapeutic intervention taking place with children or that group work skills and theories are routinely used to inform intervention with children and young people. 11.7 Recommendation Trusts should urgently review: 48. the recommendations made in recent RQIA inspection reports and develop and implement quality improvement plans. Senior Managers should ensure that legislative requirements are met in order to provide appropriate safeguards for children and young people in residential care. PAGE 70

11 Pre-admission Planning and Admission to Care 11.8 Admissions to children s homes should occur on a planned basis following an assessment of need. This assessment should inform the choice of placement and set out a clear programme of work with the child or young person from the commencement of the placement. Evidence from the inspection shows that a significant number of placements are made in response to an emergency. For many, the decision could have been taken at an earlier stage. 11.9 In 1982, the Barclay Report pointed out that: there is often a big organisational divide between residential and fieldwork in Social Work Departments. Perhaps even more telling, many social workers in the field regard it as one of their primary objectives to keep people out of residential care wherever possible....a strongly held child care view stresses the importance of family life (the child s own or substitute) to the extent that efforts have been extended to avoid using residential care in any circumstances but as a last resort. It is important that such a view does not deprive children/young people of services which they need and from which they can benefit. 50 The same issues were identified by Jean Packman and colleagues when they found that: there is a sense in which a defensive last resort stance - much the most common reaction, in our experience actually contrives to reinforce the failings, ensuring that public care is something to be avoided. Some of this precipitates entrances into care, with their distressing lack of preparation, hastily arranged placements and all the attendant risks for breakdown and future disruptions to follow seemed to be directly attributable to such negative attitudes. A rule of pessimism operated about the care system, which meant that admission, was sometimes almost unthinkable, until it became too late to think at all. Last resorts are after all, seldom desirable or constructive places to be. 51 Inspectors were concerned that over 2 decades later these views still persist. Much work needs to be done to ensure that children receive services that meet their assessed need and from which they can grow and develop. 50 Barclay Report Social Workers: Their roles and tasks, 1982, Chapter 4: Social work in residential and day services. 51 Who Needs Care Social work decisions about children, Jean Packman, John Randall, Nicola Jacques (1986). PAGE 71

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 11.10 Key Findings 11.10.1 Where admissions are planned, they are made through the Trust s Children s Resource/Placement Panels. 11.10.2 The terms of reference and membership of Children s Resource/Placement Panels varied considerably and Heads of children s homes were not represented on them. 11.10.3 There was limited evidence of quality assurance or monitoring of the implementation of the protocols and decision making of the Panels in relation to admission and care planning. 11.10.4 On occasions, the reluctance of social workers to accept that residential care is the most appropriate placement for the child or young person has resulted in delays in the decision making process. As a result, adequate planning with the child or young person, family and residential staff has not always been possible. Placement choice also was not always consistent with assessed need. 11.10.5 There was limited evidence of pre-admission discussions within the home in relation to the admission of children. Consideration of the impact of new admissions on other children in the home, who also had complex needs and sometimes presented high levels of risk, was not evidenced in file records of children who had been placed by Panels. The ability of the home to meet the assessed needs of the child and the potential disruption that could be caused by placements was not always discussed with the Head of the children s home where the child or young person was being placed. 11.10.6 Few children or young people had introductory visits to children s homes. However, children and young people admitted to the regional care centres did have introductory visits. 11.10.7 There were insufficient levels of direct engagement by the social worker with some children and their extended families following admission. The file records did not indicate if arrangements had been made for the child to be seen by the social worker, that a planned programme of work by the residential and fieldwork social worker was agreed or that statutory visits were being made. Furthermore, there was a lack of clarity about the role and function of the field social worker and the purpose of the statutory visit. A monthly summary of work undertaken was completed in some cases by the residential worker but there was no evidence that this had been discussed or agreed with the field social worker. PAGE 72

11 11.10.8 When children transferred from one children s home to another, and particularly where the previous placement had ended badly, there was no evidence of consideration being given to the impact of endings and the need for further work with the child in relation to loss and transitions. 11.10.9 Staff should seek to resolve difficulties or challenging behaviours before moving children to new placements, otherwise there is a danger that these difficulties and behaviours will re-emerge. Staff also need to be aware of the consequences of broken attachment and loss and to consider this in their work with children and young people. Staff in new placements need to be briefed about the likes and dislikes of each child or young person and about what works best in terms of meaningful engagement with them. There is an urgent need for skilled and experienced practitioners to provide the intensive therapeutic work required with children and young people in residential care and their families. 11.11 Recommendations Boards and Trusts must: 49. review the terms of reference for their Children s Resource/Placement Panels, and - ensure representation from Heads of children s homes in order to utilise their expertise in the decision making process; - ensure social workers provide an up-to-date comprehensive assessment on every child and young person to enable the Panel to consider the most effective placement option and to provide appropriate assessment information to the home prior to the admission decision; - consider the impact of new admissions and any associated high risk behaviours on the other children and young people in the home; - ensure that discussions are held about the actions required to resolve behaviours evident in a placement before agreeing to transfer the child to another environment; - share the learning from previous movement between placements in terms of, for example, challenging behaviour and what works best for the child or young person. Consideration should be given to the impact of endings, loss and attachment theory so that the needs of children and young people are appropriately met; and PAGE 73

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND - regularly review the quality of the Panel s decision making process as part of their governance arrangements. Trusts must ensure that: 50. pre-admission discussions are held regarding each admission and that: - a programme of planned visits is arranged to introduce the child to other children in the home, their key worker and staff; - formal admission contracts are introduced which provide clarity for the child and family on the rationale, purpose and expected outcome of the admission to care; and - the contact arrangements and respective roles and tasks of residential workers and the fieldworker are clarified in relation to the work plan and the follow up arrangements regarding statutory visits, family contact and reviews. The DHSSPS, in collaboration with key stakeholders, must: 51. review and research best practice in providing therapeutic intervention and support to children and young people in residential care and their families, from admission to discharge, and - review the current structure and management arrangements for providing therapeutic services to children and young people at high risk. Consideration should also be given to establishing a pilot team of highly skilled social work practitioners and other professionals to deliver this service. Placement Protocols 11.12 As part of the inspection process a placement protocol which had been drawn up by one Trust, in relation to a specific children s home, was examined. The protocol was designed to address commissioning of placements in the home by other Trusts in Northern Ireland and Authorities in the Republic of Ireland. 11.13 Key Findings 11.13.1 The inspection team found a number of fundamental flaws in the protocol. These included factual inaccuracies, a lack of appropriate reference to legislative PAGE 74

11 requirements and a lack of clarity about the roles and responsibilities of both host and placing Trusts/Authorities. These matters were brought to the attention of the Board and Trusts and, as a consequence, the protocol was reviewed and remedial action taken to address its deficits. 11.13.2 In addition to reviewing the placement protocol, the inspection team also examined the assessment and care plans of the young people in the home concerned. This raised serious concerns related to the management of high risk behaviours including inappropriate sexual activity between young people in the home and outside the home, alcohol and drug misuse and frequent running away. The risk assessments did not provide appropriate preventive interventions through, for example, the initiation of child protection procedures. 11.14 Recommendation Boards and Trusts must: 52. immediately implement the revised protocol and ensure that: - arrangements for the placement of children outside a Trust area are appropriately monitored, that assessments, including risk assessments, inform the care plans for children and young people and that child protection procedures are appropriately initiated. Assessment 11.15 The Children Order, its accompanying regulations and guidance introduced a systematic approach to the individual assessment of children s needs. This approach requires that written care plans are produced, which are subject to regular review, thereby creating the opportunity to improve the quality of care provided to children and young people and promoting and safeguarding their wellbeing. 11.16 However, research and findings from a number of Inquiry Reports and inspections have previously highlighted weaknesses in the area of assessment. Structured individual assessment of a child s needs is the foundation for effective planning and delivery of appropriate care services. Assessment requires the collection and collation of information from a range of sources and an objective analysis which informs decisions about how best to intervene to achieve desired outcomes. PAGE 75

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 11.17 Key Findings 11.17.1 There was evidence in some residential workers files of assessments being completed using a Risk Assessment model piloted by the Southern Health and Social Services Board. The outcome of this was shared with the child and informed the agreed work plan on a monthly basis and was regularly reviewed. This practice is to be commended. However, there was no evidence that parents were fully engaged in this process, for example, through the completion and signing of mutually agreed contacts setting out actions necessary on their part to secure desired outcomes. 11.17.2 Delays were evident in social workers providing residential homes with a comprehensive assessment of the child and family. There was also evidence of a lack of engagement of residential staff in the admission process. This resulted in residential staff having to rely on their own assessment in the absence of a full case history. As a result, the potential for risks not to be detected, particularly safeguarding risks posed by the admission, to other children in the home was created. 11.17.3 A number of children were admitted with mental health needs requiring urgent assessment. A number also had a history of abusing aerosols/drugs and threats of self-harm. In several case files examined, children had lost a close relative. It was unclear from the file records what level of social work support and psychological therapy was provided. In others, the comprehensive assessment was delayed due to information not being available e.g. CAMHS reports. These factors presented significant challenges for staff to work with. 11.17.4 The inspection of records revealed that a number of the problems experienced by families of children in care were of a detailed, historic and entrenched nature. Decisions for key changes to care plans were not always evidenced. In one case, a change of care plan to allow contact with the parent was agreed with no indication of how the judgement was arrived at when there was evidence that the parent could not establish boundaries for the child. In others, children were sent home on trial to situations where areas of risk continued to exist without evidence of how the risk was to be managed. 11.17.5 Most assessments reviewed by inspectors considered the educational needs of children. However, these did not always receive the attention they required. In one case file examined one young person was described as nocturnal as she slept all day and ran away each night. This persisted without any proactive review of the planned programme of work to address the problem on a multi-disciplinary, interagency basis. PAGE 76

11 11.17.6 In a number of cases there was evidence of close working relationships with schools in sharing information to inform assessments but this is described as variable. 11.17.7 In the files examined there was significant evidence of comprehensive gathering of information; this was not always subject to robust analysis. There was a failure to explore the nature of strengths and weaknesses present, the relationship between these and their implications for the child and other family members in order to inform the care plan for the child. There was a tendency to focus on the number rather than the consequences of identified strengths and weaknesses. Some of the weaknesses were critical in terms of parents ability to protect a child, particularly where there was evidence of long standing alcohol or drug misuse. GOOD PRACTICE EXAMPLE: Learning and Training, Foyle Trust Foyle Trust provided learning and training opportunities for staff and members of the CPP focusing on both the impact on and issues for children whose parents misuse alcohol and/or drugs. 52 11.18 Recommendations Trusts must: 53. ensure that each assessment of need and risk is robust and informs work with the child or young person in seeking to achieve the stated goals in the care plan and that it is shared with parents. It should include: - an assessment of the respective strengths and weaknesses of the family in meeting the needs of the child and their implications for the child; and - the care plan which clearly sets out decisions regarding contact, home on trial arrangements and their expected benefits; and 52 At the Foyle Trust CPP meeting held in January 2006 a presentation was provided by OiWillo, Training and Practice Development, on Child Protection A Sobering Reality. This focused on the impact and issues for children whose parents abuse drugs/alcohol. Information about OiWillo can be accessed at: http://www.oiwillo.com/ PAGE 77

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 54. review their access to CAMHS for looked after children, and - take action to ensure children in residential homes have prompt access to these services; and - take account of the residential home s staffing complement to ensure that they have the necessary skills and expertise required in order to meet the children s mental health needs. Risk Assessment and Management 11.19 Risk assessment and management processes must be able to: identify key risks in a timely manner; evaluate the likelihood and impact of occurrence; prioritise these; and enable action to be taken to reduce the likelihood of occurrence and any negative impact. In residential homes, particular attention needs to be given to the impact of different behaviours on the total resident group and to the actions needed to safeguard the individual and the wider group. Children are not young adults and each one requires a response that reflects his or her level of need, understanding, cultural background and stage of development. They have to be encouraged to take responsibility appropriate to their age and circumstances. The preparation of young people for independent living, which includes helping them to identify and avoid potentially dangerous or harmful situations such as sexual exploitation, inappropriate sexual behaviour and alcohol or drug misuse is also vital. Effective risk assessment and an agreed and shared risk management strategy are critical to ensuring the safety of the individual child or young person and the wider residential peer group. 11.20 Key Findings 11.20.1 In a number of files, issues identified in the risk assessment had neither been reflected in the comprehensive needs assessment nor resulted in appropriate change to the care plan. 11.20.2 There was a high tolerance of unacceptable behaviours in children s homes with some homes reacting to events without adequate reflection on the causes of these events or the consequences of staff responses to them. For example, residential workers regularly called upon the police to return children to care. There was no evidence that the young person s reasons for running away or the risks they were PAGE 78

11 exposed to during their absence were examined by social services staff and police on an individual basis. Similarly, there was no evidence of information sharing and analysis of reasons for absences from homes between PSNI and Social Services, on a general basis. This work is necessary to inform responses to and management of absences from homes in the future. The ACPCs/CPPs were not informed of the difficulties or used as a vehicle to address the problems, or to share information with Boards, placing Trust and Authorities, the PSNI and the RQIA. 11.20.3 Most children, on admission, had serious problems within the family and at school and a number had significant emotional, psychological and mental health needs, which had implications for their care within a group setting. 11.20.4 Trust senior managers indicated that the procedure for reporting significant events in children s homes was being properly followed. The volume and content of Significant Event Reports for looked after children evidence the scale of risks which are presented and therefore requiring closer scrutiny and appropriate action by senior managers in Trusts. 11.20.5 Major risks and child protection concerns were evident in respect of the frequency of children and young people running away from a number of homes, their engagement in inappropriate sexual activity and the management of absconding behaviours by residential/fieldwork staff and the PSNI. 11.20.6 The arrangements for monitoring, reviewing and gaining assurances about the management of risk were poorly developed across Board and Trust areas. Specific concerns were raised in relation to one residential care home where children had been placed by a number of Trusts and Authorities from the Republic of Ireland. With regard to this home, there was insufficient overview by senior management, PSNI and the RQIA of practice/trend data from untoward incidents to help inform a strategic approach to better manage the risks highlighted. 11.20.7 There was insufficient understanding of the need to initiate child protection procedures by residential workers, fieldwork staff, Trust senior managers and the RQIA. In a number of cases examined, appropriate child protection actions, both strategically and operationally, were not taken to adequately safeguard children and young people or to monitor the development of robust plans for their care and support. PAGE 79

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 11.20.8 Staff members were clearly assigned responsibilities and accountability for assessing, reporting and managing identified risks in the children s homes. However, it was of major concern to the inspection team that the assessments and risk assessments, which clearly identified child protection issues, failed to immediately alert staff to the need for the initiation of child protection procedures. 11.20.9 In one children s home, there was evidence of young people entering each others rooms, engaging in inappropriate sexual activity, closing off access to residential staff and the PSNI being called to break down the door. There was no evidence recorded that staffing levels were reviewed and appropriate adjustments made to provide adequate safeguards for the young people. There was also no evidence that the Board and Trusts, who had placed young people in the home, were advised by the host Trust of the extent of problems in order to collectively discuss and agree a more strategic approach to resolving them. 11.20.10 There was no effective communication between staff and local communities in relation to children and young people who frequently run away. Furthermore there was a lack of evidence of meetings being held with PSNI and out-of-hours staff to agree a coherent strategy on how best to respond to children and young people running away and the associated risks and safeguarding problems. 11.21 Recommendations Boards and Trusts, in collaboration with PSNI and the RQIA, must: 55. develop management information systems which facilitate the collation and analysis of information about looked after children; identify key areas of risk requiring action; assist in service planning; and quality assure decisions, and - provide guidance and training on the full range of powers available to their staff to assist with the use of these under Articles 67 and 68 of the Children Order. Trusts must ensure that: 56. issues identified in risk assessments, including any child protection concerns, are taken into account in the comprehensive assessment and reflected in the care plan. Child protection arrangements for children must be explicit and followed through; PAGE 80

11 57. a risk assessment for each child or young person is completed where there is potential for abuse, either as victim or perpetrator, and - a risk management strategy is developed to support both the individual child and the residential group; and - risk criteria are reviewed, including whether urgent consideration by their Audit/Risk Committee, the Boards and placement/host Trusts is required; 58. where children or young people are returning to children s homes following a period of running away they are interviewed to establish their reasons for this behaviour and to establish what risks they have been exposed to during their absence. Particular consideration should be given to whether or not they have been involved in high risk behaviours such as sexual exploitation, inappropriate sexual activity and/or the misuse of alcohol or drugs. Trusts should also ensure that these children and young people have access to appropriate therapeutic and other support services, as needed; 59. a review is conducted on policies, protocols, practice issues and reporting arrangements in residential care, including: - all Significant Events Reports and address any risks identified therein; - their policy on children and young people entering each others rooms including the actions to be taken when staff cannot gain access; - the locking arrangements for all internal doors throughout the home to ensure staff can gain access at all times; - the implementation of their Anti-Bullying Policy and ensure this is taken forward as part of the child protection process and that the children receive follow-up counselling, where appropriate; - staffing levels to ensure that they are adequate where there are known risks to children and young people and where closer monitoring is required; - the safety and security features on windows in children s homes to prevent children and young people from running away; - existing protocols with PSNI with a view to responding appropriately and effectively to children and young people who run away; and - the protocols for informing other Boards, Trusts and relevant agencies of serious events and agreeing a strategic approach to the resolution of these. PAGE 81

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Recording and File Management 11.22 The case file is a vital tool enabling social workers and their managers to make decisions as to how best to safeguard the welfare of children in their care. The inclusion in a case file of a clear comprehensive and up-to-date chronology of key facts, events, interventions, reviews and decisions made is essential. This was not always evident in files examined by the inspectors in relation to the fieldwork/residential interface. Managers should ensure that appropriate steps have been taken to address this deficit in recording practice. 11.23 Key Findings 11.23.1 The quality of case recording in Trusts was variable. From the records examined, the process 53 style of recording used, made it difficult to assess the quality of the analysis of information collected or how this was used to inform the interventions and therapeutic work required. Although in some individual cases contacts were described in detail, it was difficult to gain a sense of the child s story. Risks were often identified, however, an agreed management strategy to reduce these was not evident. 11.23.2 There was information on a number of files regarding ongoing contact with PSNI. However, outcomes from these contacts were not recorded. 11.23.3 The duplication of LAC documentation in files created unnecessary bulk in case records. Many records were not filed in date order and at times were illegible. Case summaries or case transfer reports were rarely evident in files. These can be useful in identifying care work in progress and the key issues requiring to be addressed. 11.23.4 In a number of files, records of contacts and therapeutic interventions were not kept up-to-date. There was no evidence of this practice being monitored or challenged by senior social workers. Furthermore, the case records examined did not provide evidence that statutory social work visits had taken place and had been verified by senior social workers. 11.23.5 Recommendations related to recording have already been made in Chapter 5. 53 Process recording is a specialised, highly detailed form of recording everything that takes place in an interview. PAGE 82

11 Individual Work with Children 11.24 In order to grow and develop as caring, confident and capable adults, all children need to experience love, care and attention and appropriate and consistent boundaries and security. Children who have been disadvantaged by trauma, rejection or loss, need to experience additional care to help compensate for the loss of attention of normal childhood experiences and the absence of the security of parents. Many children come into care with a distrust of adults based on their personal experiences and this presents particular challenges in children s homes. Almost inevitably, some will be angry and aggressive on occasion. It is essential, therefore, that opportunities to vent anger are provided to children in residential care and staff are trained in positive anger-management methods. Finding a balance between promoting the independence of children and a sense of safety and security for their normal development can be difficult. 11.25 Key Findings 11.25.1 There was evidence in records of young people misusing alcohol or drugs or engaging in other risk-taking behaviours. However, these behaviours were not always addressed in individual or group sessions with the young people. For example, in one case where a young person was involved in the use of cannabis, contacts by the social worker were not always adequate to address the situations that arose. It was also of concern that telephone contacts and text messages were used in a number of high risk situations that would have warranted direct therapeutic intervention. 11.25.2 Contacts between social workers and children and young people in care should contribute to the achievement of positive outcomes for them in line with their care plan. This should include providing opportunities for children and young people to discuss their fears, anxieties, hopes and ambitions. While there were examples of children and young people being taken out for a treat by their social worker, there was no record to demonstrate the purpose of the contact or the outcome desired. 11.25.3 By contrast, in a number of Trust files examined by the inspectors there was evidence of a clear programme of planned and purposeful work being undertaken with children over a period of time by the residential worker. For example, in one case file there was evidence of the residential worker drawing up clear guidance for other staff on the most appropriate response for dealing with a child should they become angry or aggressive in the home. In other files, there was evidence that some social workers PAGE 83

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND and residential staff encouraged and made arrangements for sibling contact to help the children develop attachments and sense of identity. This is to be commended. Such practice needs to be endorsed and supported by the team leader as an example of good practice and noted in the case record. GOOD PRACTICE EXAMPLES: Evidence-based and focused practice There was evidence in a number of cases that social workers were knowledgeable about the literature regarding the effects and outcome of emotional abuse and neglect and were using this knowledge to inform their assessment and interventions with children and young people. There was evidence of focused individual work by residential staff with a child on anger management, lost identity and citizenship and good support provided to enable the child s re-entry to school. Residential staff demonstrated their commitment to providing continuity of care and practical and emotional support to facilitate young people s return to the children s home which necessitated substantial travelling to and from Belfast on their part over a period of time. 11.26 Recommendation Trusts must ensure that: 60. the good practice applied in a number of cases within residential care is widely disseminated and replicated, and - social workers contacts with children are therapeutically focused and consistent with care plans; - telephone calls or text messages by social workers do not become a substitute for the direct contact needed, particularly, when a child is distressed or has suffered a traumatic experience; and - team leaders in residential care regularly review and sign records of individual work sessions with children and young people. PAGE 84

11 Care Planning 11.27 Care planning must be at the heart of social work practice with children and families to ensure good quality decisions and positive outcomes for children in care. Good practice requires that the care planning process is child-centred, undertaken in a timely manner and sets out clearly defined objectives. 11.27.1 The Arrangements for Placement of Children (General) Regulations 54 places a statutory duty on responsible authorities (Trusts) to draw up a plan for a child whom they are proposing to look after or accommodate in consultation with the child, his or her parents and other important individuals in the child s life (Regulation 3). Planning for the child should begin prior to the placement. During the placement, the plan should be reviewed and adjusted as necessary. Regulation 4 and the Schedules identified therein set out the general matters to be included, where practicable, or be considered, so far as is reasonably practicable, in arrangements to accommodate children. These matters include general information about the child, information about contact arrangements with his or her family, details of services to be provided and consideration of the child s health and educational needs. 11.27.2 When making decisions about looked after children there is a requirement that Trusts consult, where reasonably practicable, with all relevant parties as set out in Articles 26(2), 76(2) and 92(2) of the Children Order. The LAC Placement Plan Part 1 and Part 2, has been designed to enable and evidence compliance with statutory requirements in relation to planning for children in care. 11.28 Key Findings 11.28.1 The standard of LAC Placement Plans in the Trusts varied considerably. Some of the findings relating to the standard of completion of these forms have implications for the discharge of Trusts duties under the Children Order. 11.28.2 In the residential files examined, care plans did not always set out clearly the objectives of the placement and how the child s needs would be specifically met. Many lacked specific targets in terms of short, medium or long term goals. There was a lack of evidence of a comprehensive assessment of the child s needs. Furthermore, 54 The Arrangements for Placement of Children (General) Regulations can be accessed at: http://www.opsi.gov.uk/sr/sr1996/nisr_19960453_en_1.htm PAGE 85

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND there was no evidence of a contract setting out the roles and responsibilities of the child, his or her family, staff and others in terms of how they would contribute to the achievement of objectives set out in the care plan. 11.28.3 In the majority of files examined, the Review of Arrangements Form was not signed by the LAC chair, social worker or reviewing officer, where one existed, nor was it appropriately countersigned. The LAC Placement Plan Part 1 was not always signed by parents or relevant others to indicate their involvement in drawing up and agreeing the Plan. There was little evidence of either professional or managerial challenge to address any of these deficits. 11.28.4 LAC Reviews identified work to be undertaken. However, the rationale for this was not always documented. For example, in one case recommendations were made that work should be undertaken with a parent but no indication was given as to the type of work needed, its duration, purpose or the date for review. GOOD PRACTICE EXAMPLE Care Planning There was evidence in one file of a LAC psychologist s analysis of information on a child and her home background, which was used to inform the work programme. This is commended and should be encouraged as standard practice. Understanding the cause of behaviours or problems will facilitate the development of a tailored approach to meeting the needs of the child. 11.29 Recommendation Trusts must ensure: 61. the full involvement of the child, his or her parents and relevant disciplines/agencies is considered before completing care plans. Care plans should be clearly documented and comply with regulatory requirements. PAGE 86

11 Management/Monitoring and Governance Arrangements 11.30 Circular CC3/02 sets out the roles and responsibilities of Directors of HSS Trusts, Executive and Non-Executive, in relation to the care and protection of children in their areas. Boards are required to enter into an Annual SLA with their provider Trusts; to commission a range of services for children; to establish quality standards and monitoring arrangements; and to ensure that statutory functions are satisfactorily discharged and reported on annually. For children who are looked after, Boards and Trusts have a legal and ethical duty to provide them with the kind of support that caring and responsible parents would give to their children. Through their commissioning arrangements, Boards are required to ensure that Trusts are appropriately discharging their duties to children. The standard set by Boards in their commissioning guidance is that services should be delivered within the policies and procedures established by their Trusts as agreed with Boards and set out in Schemes for the Delegation of Statutory Functions. 11.31 Key Findings 11.31.1 There was no evidence of case files being jointly audited by Trusts and Boards. Furthermore there was no evidence of regular meetings being held between residential staff, fieldwork staff and staff from other agencies. This was of particular concern in relation to one home where the Trusts failed to respond appropriately to problems raised by and in the home. In the course of the inspection, this was raised by SSI with the Board and Trusts concerned and immediate remedial action was taken. The inspection team was concerned that the PSNI did not make use of their powers to intervene to safeguard children in response to known risks. Additionally, the Board and Trusts as caring and responsible corporate parents failed to challenge the PSNI in this regard. Chapter 13 sets out key findings and recommendations in relation to the PSNI. 11.31.2 There was evidence in the CC3/02 Reports and Board minutes of failure to discharge statutory responsibilities in respect of issues raised by the RQIA. These related to children s homes regulatory requirements and statutory visits to children s homes. PAGE 87

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 11.32 Recommendation Boards and Trusts must: 62. address the key risk areas arising out of inspection findings, and - agree and implement a quality improvement plan and a formal programme of audit to ensure that actions agreed have been implemented and lessons learned disseminated to key staff in order to improve practice and outcomes for children. PAGE 88

12 12. EDUCATION: KEY FINDINGS AND RECOMMENDATIONS 12.1 Staff across the Education sector recognise the importance of the pastoral dimension in the education of children and young people, and generally make good provision for it by ensuring their physical and emotional welfare as well as helping to progress their academic development. The findings of the inspection indicate that, from the education perspective, the present child protection system does not always work as effectively, or as quickly, as it needs to in the interests of children. The main issues identified within the Education sector concern gaps in the present system and the consequent dangers to children and young people. The weaknesses in the support structures for children in need, particularly those in residential care, identified during the inspection, are having an adverse affect on their ability to take full advantage of educational opportunities. 12.2 Key Findings 12.2.1 The care and wellbeing of pupils is given a high priority across the Education sector. However, teachers and Education Welfare Officers (EWOs) report fundamental weaknesses in the out-working of the current arrangements for child protection. 12.2.2 Schools are dealing with increasing numbers of pupils who present with complex needs. Often, the resources available are not adequate to effectively manage the needs of these pupils. The role of the designated teacher is time-consuming and carries a high level of responsibility. Schools require additional resources to help manage the care and wellbeing of the pupils. They also require up-dated guidance on child protection from the Department of Education (DE) which should take cognisance of the DHSSPS guidance Co-operating to Safeguard Children. 12.2.3 The Education sector is not well served by the established structures of the ACPC and CPP and the educational representatives report that they do not fully understand their roles on the Committees and Panels. Consequently, they are not adequately using these forums to take forward effectively strategic or operational issues arising and other problems identified within their areas. 12.2.4 Schools recognise that multi-agency, collaborative working and good communication are essential components in helping to safeguard and promote the welfare of children and young people. Present structures and protocols across Education and Social Services do not facilitate a multi-disciplinary approach and have not been audited for their effectiveness. The response from Social Services to education referrals is PAGE 89

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND inconsistent and often poor. Education staff report that they do not always receive confirmation of action, or comment about the progress of individual cases, and that they are not well informed about the way in which child protection referrals are managed, following referral. They express concern that some children do not qualify for a service because they do not meet the thresholds for intervention which have been set by some Trusts. 12.2.5 Education staff report that they have not been appropriately consulted on new arrangements and in particular on thresholds for access to services. The lack of a shared understanding of thresholds for intervention, and of agreed mechanisms for effective communication, constrains the effectiveness of the professionals joint working to safeguard children. 12.2.6 Teachers and EWOs are concerned that they do not have the expertise or resources to provide support for some of the children who do not enter the child protection system. They also share concerns about the way in which some case conferences are managed. It was reported by both teachers and EWOs that specific cases, referred by education, had reached crisis point before substantive action was taken to provide support for the children at risk. 12.2.7 The inspection identified weaknesses in the support structures for looked after children, which adversely affect their ability to take advantage of educational opportunities. There is a need for all the relevant agencies to work together to ensure that vulnerable children can be supported within a co-ordinated framework of services, in order to improve their educational outcomes and life chances. GOOD PRACTICE EXAMPLES: Partnership Projects There was evidence of innovative partnership projects across a number of the Trusts inspected. These projects demonstrated the importance of the resources of Education and Social Services being pooled effectively to provide choice and appropriate support for children and families. The inspectors commend Boards, Trusts and their partners in Education for developing and continuing to sustain these resources. PAGE 90

12 Staff in schools reported that they had very good support from the Designated Officers for Child Protection in the Education and Library Boards (ELB) and that they relied heavily on them for advice about child protection concerns. There was some evidence of effective working, between child care staff and education, in respect of looked after children and children requiring additional behaviour support. In some of the examples quoted by teachers, a number of children in residential care were making very good progress at school as a result of the interest and dedication of care staff in fulfilling their role as a corporate parent. In a number of situations, education staff were most appreciative of the support received from individual social workers. The joint protocol document on the education of young people, who are looked after in the Western HSS Board and educated by the Western ELB, provides comprehensive and helpful guidance for staff in Social Services and in education. The full implementation of this guidance would strengthen the support arrangements for looked after children. 12.3 Recommendations The DE must: 63. provide up-dated guidance on child protection, which takes account of the DHSSPS guidance Co-operating to Safeguard Children and ensure that there are adequate resources, including staffing and training, to support the effective management of the child protection system across the Education sector. The Education sector, in collaboration with Boards and Trusts, must: 64. monitor the outcomes of child protection referrals and outcomes of case conferences and agree a system whereby relevant information, about the needs of individual children, can be shared between Education and Social Services. PAGE 91

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Boards and Trusts, in collaboration with the Education sector, must: 65. review and clarify the roles and responsibilities of the educational representatives on ACPC and CPP and the arrangements for multi-disciplinary/interagency working, in order to achieve greater effectiveness in joint working arrangements and improve outcomes for children; and 66. ensure that they consult appropriately with the Education sector and other key agencies on new children services arrangements including thresholds for access to services, and - provide information, training and support. PAGE 92

13 13. POLICE SERVICE OF NORTHERN IRELAND: KEY FINDINGS AND RECOMMENDATIONS 13.1 The Police Service of Northern Ireland (PSNI) carry statutory responsibility for the investigation of crime and have a statutory duty under Article 45 of the Children Order to assist Social Services Boards and Trusts in carrying out their child protection and welfare responsibilities. Officers interviewed throughout the inspection process recognised that child protection work is critical, both at a strategic and operational level. However, it was evident that, with the exception of those officers who specialise in this field, not all officers recognised the full extent of what constituted a child in need. 13.2 Key Findings 13.2.1 Children s homes provide a service for some of the most vulnerable children and young people in our community, many of whom have previously experienced abuse and/or neglect. Meeting the needs of these children places considerable demands and pressures on police and residential staff. With some exceptions, there was little evidence that interaction with children s homes is being dealt with by police in a strategic manner. Accountability issues and how existing police resources are utilised were not being fully considered. This has resulted in residential staff calling on police regularly and children being criminalised unnecessarily. There was also little evidence of residential staff and District Command Unit personnel learning from one another. 13.2.2 Police, on the whole, were neither investigating abuse of children within residential care who refused to complain nor using any form of deterrent as a protective measure in the case of risky individuals associating with them. There was also an example of a situation which largely met the criteria for organised abuse but which was not responded to as such. 55 The Northern Ireland Office (NIO) has commissioned an independent body to review the PSNI responses to issues arising and how PSNI can more effectively engage with child protection matters and interagency processes. 13.2.3 There was little or no evidence of intelligence gathering or collating and analysing statistical data in relation to critical incidents of children in homes. In the case of those children who frequently absconded there was rarely evidence of any standard form of communication or strategic overview between PSNI and HPSS. 55 CtSC defines organised abuse as abuse that may involve a number of abusers, a number of children and often encompasses different forms of abuse. It involves an element of organisation. CtSC identifies a range of abusing activity covered by the term and sets out the approach to be followed (CtSC, paragraphs 6.18-6.24). PAGE 93

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 13.2.4 Evidence from across the region would suggest that the investigation of emotional abuse/neglect cases needs improvement. These forms of abuse are tolerated not only by police but by all agencies for long periods of time. Incidents of sexual assault or one-off serious physical assaults are subject to investigation much more quickly. Examination of case conference minutes also evidenced a lack of willingness by police officers to challenge decisions around these types of cases, often opting instead for ongoing family support type interventions. This matter has not only been highlighted in SSI inspections but also in subsequent CMRs, into the death or serious injury of a child. 13.2.5 Police are identified as one of the core agencies that make up an ACPC located within each HSS Board area. An ACPC is accountable to the HSS Board and its role is to develop a strategic approach to child protection within the overall children s services planning process. All members of the ACPC are also accountable to the agencies they represent. Police officers in general had little knowledge, in the case of many Domestic Violence Officers (DVOs) and Youth Division Officers (YDOs) no knowledge, of the ACPC and CPP purpose or work. There was also a lack of awareness by officers that difficulties, which at times might arise in Joint Protocol working, may be addressed at ACPC by the police representative on the Committee. 13.2.6 Although ACPC policies and procedures were prominently displayed in Child Abuse and Rape Enquiry (CARE) offices there was no evidence that CARE officers, YDOs and DVOs had sight of the ACPC business and action plan and how this might impact on police work. 13.2.7 CARE officers, in general, received notification of training courses but they were only able to attend on occasions given their high volume of work and staff shortages. YDOs and DVOs rarely received notification of training events or recognised it was attributable to ACPC. 13.2.8 There was also concern expressed by police representatives on the various ACPCs that they were not of an appropriate senior rank and this issue needs to be addressed within PSNI. PAGE 94

13 GOOD PRACTICE EXAMPLE: Interagency working There were many examples of good working practice. In particular, evidence highlighted excellent levels of co-operation between PSNI and DHSSPS, good working knowledge of the Protocol for Joint Investigation and all police officers were fully acquainted with arrangements for making referrals to the Trusts and demonstrated same. 13.2.9 However in a number of situations difficulties were not always followed through to ensure appropriate action was taken by the Trusts or use made of CPPs and ACPCs to resolve problems. This raised issues about the role of the Joint Protocol Core Group and governance arrangements within PSNI. During the inspection it became apparent that the regional leadership for child protection within PSNI had been inconsistent, with several changes in the overall management of CARE Units in 2 years. 13.3 Recommendations The PSNI, in collaboration with Boards and Trusts, must: 67. produce strategic guidance on the management of the range of problems referred to the police including young people who run away from children s homes in order to improve safeguarding arrangements and reduce the number of inappropriate referrals made. The Training Education and Development Branch should provide: - training to staff, in particular District Command Unit personnel, on such guidance and on the various deterrent methods and powers available to them to assist in the safeguarding of children, e.g. Risk of Sexual Harm Orders; and - training in respect of police contribution at case conferences for all newly appointed CARE officers, YDOs and DVOs and review attendance and content of CID Foundation training and CARE Awareness courses. PAGE 95

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND The PSNI must ensure that: 68. appropriate models of intelligence are used in the gathering and collation of information and consult with the Boards, Trusts and the RQIA to ensure a full overview of the situation is available and appropriate action is taken; and 69. police representatives on ACPCs and CPPs: - are of sufficient seniority in rank to deal effectively with the strategic and local issues arising; - are clear about the importance of their role and function and that they table child protection issues at ACPC/CPP meetings as a matter of course and at the CARE Detective Inspectors monthly meeting; and - structure into their key performance targets enhanced joint evaluation/assessment in order to quality assure the standard of joint investigations. The DHSSPS must ensure that: 70. dissemination of lessons to be learned from individual CMRs are forwarded expeditiously to C2, Head of Branch for CARE, Criminal Justice Department, and Head of Training, Education and Development Department in order to ensure improvement to practice. The NIO must ensure that: 71. the outcome of the review currently commissioned provides enhanced opportunities for PSNI to more effectively engage in child protection matters and interagency processes. PAGE 96

14 14. REGULATION AND QUALITY IMPROVEMENT AUTHORITY: KEY FINDINGS AND RECOMMENDATIONS 14.1 The Regulation and Quality Improvement Authority (RQIA), was established in April 2005 with overall responsibility for regulating, inspecting, monitoring and reporting on the standard and quality of health and social care services, including residential and day care services, and encouraging improvement in these services. Prior to this the HSS Boards were responsible for ensuring compliance with the recommendations made by the Boards R&I Units. 14.2 The inspection examined evidence from a wide range of sources including: inspection reports on children s homes over the past 3 years; R&I Units annual reports presented to the Boards; CC3/02 reports; and Board minutes. 14.3 Key Findings 14.3.1 Key issues and concerns regarding the safeguarding of children in children s homes and the failure to meet the regulatory and legislative requirements were continually reported to the Boards and Trusts over the last 3 years, through the inspection reports, CC3/02 reports and from the annual discharge of statutory functions reports to the Boards. However no quality improvement plans or robust monitoring arrangements were put in place to address the serious child protection issues raised. 14.3.2 There has been a lack of appropriate collation and analysis of trend data following significant numbers of serious untoward incidents in children s homes. As a result no strategic overview was provided to Boards, Trusts and PSNI to enable a more strategic and planned approach to managing the risks to children. 14.3.3 Inspection reports were not always issued to the Board and Trust Chief Executives and many of the recommendations were not appropriately targeted to the key personnel. Trusts often failed to deliver their statutory monthly monitoring reports to the RQIA resulting in serious issues arising from the inspections not being followed up in a timely manner with the appropriate Boards and Trusts Senior Management Teams. Chief Executives were not routinely notified of their failure to comply with the duty of quality and other statutory requirements. PAGE 97

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 14.3.4 Problems in relation to workforce, recruitment, retention, staff supervision, training and development opportunities and support were raised throughout the inspection. There was little evidence of Board and Trusts compliance with and monitoring of their adherence to the NISCC Codes of Practice for Employers of Social Care Workers. 14.4 Recommendations The RQIA must: 72. ensure that its inspection reports are issued to Board and Trust Chief Executives and recommendations appropriately targeted to the key personnel; 73. agree quality assure and monitor the implementation of improvement plans put in place by the Boards and Trusts in respect of their children s residential services and consider enforcement action where required; 74. develop a trend data analysis system in collaboration with the key agencies, to provide early alerts about key areas requiring improvement and review; and 75. monitor and report on Boards and Trusts compliance with their responsibilities under the NISCC Code of Practice for Employers of Social Care Workers. PAGE 98

15 15. THE VIEWS OF CHILDREN AND YOUNG PEOPLE: OFFICE OF COMMISSIONER FOR CHILDREN AND YOUNG PEOPLE 15.1 The Office of Commissioner for Children and Young People (NICCY) has the principal aim of safeguarding and promoting the rights and best interests of children and young persons. The Commissioner is further tasked to keep under review the adequacy and effectiveness of law, services and practice relating to the rights and welfare of children and young persons. 56 All this is done with explicit reference to the United Nations Convention on the Rights of the Child (UNCRC), as ratified by the UK government in 1991. 15.2 In keeping with its duties under Article 7 of the NICCY Order 57, NICCY was invited to participate in one strand of the inspection into child protection and residential care services within Sperrin Lakeland and Foyle Trusts. The particular role attributed to NICCY was to elicit the views of children and young people who have personal experience of the child protection system and/or residential care. This was undertaken through a series of 4 focus groups across the two Trusts. 15.3 The findings from NICCY s work, as set out below, stem from the views of the young people in these 2 Trusts. However, they have significant resonance with views expressed to NICCY by young people across Northern Ireland, in casework undertaken through NICCY s complaints processes and in other review work undertaken by NICCY. 58 15.4 Key Findings Child Protection System 15.4.1 Most young people who spoke of their involvement in the child protection system did so in a generally positive manner, expressing overall satisfaction with the degree to which they were involved, the manner in which they were kept informed and the extent of their understanding. Most also knew why they had become involved in the child protection system, though this was not always the case, as illustrated by one young person who thought he was involved in the system because of his lack of attendance at school. 56 Article 7 of the Commissioner for Children and Young People (Northern Ireland ) Order 2003 57 The Commissioner for Children and Young People (Northern Ireland) Order 2003 can be accessed at: http://www.opsi.gov.uk/si/si2003/20030439.htm. 58 A Northern Ireland Based Review of Children and Young People s Participation in the Care Planning Process, June 2006, www.niccy.org PAGE 99

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 15.4.2 A few young people spoke of the benefits their involvement in the child protection system had brought, highlighting the relief they felt when problems were brought out into the open and subsequently addressed. Others expressed resentment with child protection services forced intervention in their lives and the subsequent damage to familial relationships (and in one case exposure to further abuse). However, one young person expressed resentment with the failure of services to adequately intervene, despite his repeated requests for assistance. LAC Reviews 15.4.3 Young people s feedback on their experience of LAC reviews varied greatly across and within the 4 focus groups. Whilst some young people found reviews to be a positive worthwhile experience, approximately two-thirds of those who spoke to NICCY did not. Some of these young people chose to opt out rather than face the review. 15.4.4 Those young people who spoke positively of their LAC reviews cited the following in their explanation of what was good about reviews: adequate preparation for the review (meeting with social worker, seeing reports, writing own report etc.); having a say in who attends; having the personal confidence to speak up at the review; receiving feedback if you cannot, or have chosen not to, attend; and a good relationship with their social worker and/or the Chair of the review. 15.4.5 Those young people who found their LAC reviews to be a negative experience and/or chose not to attend cited the following reasons: inappropriate timing of reviews: several young people said that they didn t attend their reviews because they were held at awkward times, during school ; too many (inappropriate) people present at the review: most young people told us that they felt too many adults were present at their reviews and that, in their opinion, many were superfluous to the purpose of the review. Particular reference was made to teachers and other school staff in this regard; PAGE 100

15 feeling studied : several young people made reference to being stared at and talked about, rather than talked to and engaged with; reviews are boring and last too long: some young people spoke of reviews lasting as long as two hours without a break; reviews are too personal: young people said they felt embarrassed and uncomfortable when personal issues were being discussed: they felt that people pry into things and go into your past you don t feel comfortable ; professionals argue with one another about what should happen to you; reviews are not pitched at an appropriate level: several young people said that they didn t understand what was discussed at their reviews. As one young person commented, I come out and think what happened there I don t understand three-quarters of it ; reviews concentrate on the negatives: young people spoke of leaving reviews feeling depressed, pissed off or put down as the focus was primarily on the difficulties in their life or what they had done wrong, with little attention paid to anything positive; and loss of faith in the system: several young people expressed a loss of faith in the review system, based on past experiences of disappointment and frustration. Some young people felt that nothing they said would make a difference as they don t listen anyway and expressed frustration with repeated experiences of thwarted requests: you never get what you want out of them. This was particularly pertinent in terms of contact with family members. 15.4.6 In spite of the negatives, virtually all young people who engaged with NICCY recognised the need for LAC reviews or at least some kind of forum where issues in their life could be discussed and resolved. The young people s preference was not, however, that these should continue in the current format, but that reviews should be reconfigured in a way that enabled young people to participate more freely and engage more fully. 15.4.7 The specific suggestion forwarded by several young people was that of a two-stage process. At the first stage, young people would participate in a smaller, shorter initial meeting with their social worker and other people they chose to invite. Subsequently, PAGE 101

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Social Workers the views of the young person would be presented to a larger secondary meeting, if required, by a representative nominated by the young person. An alternative suggestion forwarded by other, perhaps more confident young people, was that of cochairing their reviews. 15.4.8 Young people s experiences of social workers were similarly varied. Some spoke very positively about their social worker, stating that they made every effort to keep them informed, explain things to them and take on board their views and wishes. The majority of young people were, however, less positive overall, with several stating that although their social worker did try to engage with them, they didn t see them as often as they should. Several also stated that, at times, they had difficulty contacting their social worker when they needed them. 15.4.9 Frequent turnover of social workers (often with very little advance notice) was a problem identified by the majority of young people, several of whom spoke of the difficulties this caused in terms of bonding, sharing and trusting: I ve had ten social workers and I ve only been in care two years you get to know them then they go ; you spend your time building relationships with them then losing them means you have to go over the same things again and again. The practice of social workers meeting the young people in the presence of other people, such as foster carers or grandparents, was also criticised by several young people who indicated that they felt inhibited in what they could say in such situations. 15.4.10 Most young people were aware that Social Services kept records on them, but these were not routinely shared with the individual in question. Many young people assumed they were not allowed to see them. Most young people were also aware of how to make a complaint regarding their social worker or the care they received, but several felt there was little point, having followed this course of action before with no result. One young person informed NICCY of the difficulty accessing complaints cards within his home; he stated that staff would not give out complaints cards unless you told them why you wanted to complain. From this point of view, he felt the whole process was pointless. He suggested instead, the provision of an easily accessible stand where complaints cards could be displayed. PAGE 102

15 Other Forms of Support 15.4.11 Encouragingly, all the young people who met with NICCY stated that they felt they had someone they could turn to or talk to: for a few young people this was their social worker; for the others it was a family support worker, a counsellor, residential care staff, leaving and after care worker or a teacher in their school. 15.4.12 The feedback received on family support services was very positive overall. All young people who had been engaged with such services stated it had been a beneficial experience in terms of the friendship, support or counselling/therapy they had received. Whilst this is clearly positive, some concern was noted by NICCY staff as regards the extent of some young people s trust and reliance on their family support worker, suggested by statements such as I d do anything for and I did because they asked me. 15.4.13 There were a number of young people still traumatised by their abusive experiences and separation from their birth families. Whilst some of these young people were pleased to be in care, others, naturally, were less so. Despite the obvious emotional implications of this, therapeutic support was reported not to have been widely available to these young people. Living in Residential Care 15.4.14 Two thirds of the young people who spoke to NICCY were either currently living in residential care or had recent experience of the same. These young people s experiences of residential care varied significantly according to the particular home in which they resided, most notably in terms of relationships with staff and residents and the degree of freedom and independence allowed. 15.4.15 Considering first the positives; most young people could identify at least one member of staff within their residential unit whom they respected and/or felt they could approach for advice or assistance; some could name several. A few felt that staff in their home regularly looked out for residents ; tried to work with them, gave them freedom and would negotiate before consequences. These same young people also had access to residents meetings, which were seen as an effective forum for raising concerns and complaints and enabling communication between staff and residents. PAGE 103

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 15.4.16 Around two-thirds of those young people in residential care interviewed expressed dissatisfaction with the rules of their home, restrictions on their freedom and methods of behavioural control. Issues cited as causing particular resentment were: bedtimes and house closing times (which varied noticeably across different homes); when you were allowed out and where to; loss of pocket money for unacceptable behaviour such as swearing; insufficient facilities for studying, refreshments etc; staff controlling external relationships and, perhaps most contentious of all, staff interpreting, even brief, absences from the home as absconding and calling in the police. 15.4.17 Some young people also expressed concerns about the age and gender mix of the resident population, drawing particular attention to the issue of bullying within residential care. GOOD PRACTICE EXAMPLES: The rights of children and young people The key examples of good practice, from a children s rights perspective, observed within this inspection are: - the use of family support services and the provision of therapeutic support in the early stages of a child or young person entering the care process. Feedback from the young people engaged in the inspection clearly indicated benefit from, and satisfaction with, these services; - the inclusion of young people in decisions regarding the day-to-day running of children s homes and the facilitation of their views and concerns via the medium of regular resident meetings; and - the consultation process mediated by Voices of Young People in Care (VOYPIC) 59 as regards current issues and effective models of consultation. 59 Information about the work of VOYPIC can be accessed at: http://www.voypic.org/ PAGE 104

15 15.4.18 Reflecting on the experiences shared by the young people who participated in this inspection, NICCY observe an urgent need for further investment in the promotion, and fulfilment, of children and young people s rights. There is a particular need to address the areas of: children and young people s participation in decision making; and the best interests of the child or young person. 15.5 Recommendations Trusts must ensure that: 76. their practice is focused on the right of the child to meaningfully engage in decisions about their life, in an age-appropriate manner. A fundamental review of both child protection case conferences and LAC reviews is needed to ensure they are child-centred and child-friendly. This should focus on: - timing and location of meetings; - the language/terminology used (both during the meeting and in preparation and feedback); - style and content of contribution forms; - the duration of meetings and who attends these; and - more effective ways to involve children, for example, part attendance of either themselves or their representatives at reviews, co-chairing reviews or splitting reviews into a two-stage process; and 77. after care services are of the highest quality and individually tailored to secure the best interests of the child or young person. Further actions that would help realise this goal for all children and young people in the care of Trusts include: - provision of staff training on children s rights and effective participation strategies; - greater continuity of social work personnel; - increased availability of therapeutic assessment and support when required; and - unfettered access to complaints procedures. PAGE 105

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Parallel actions that would help children and young people currently in residential care are: - reviewing the age and gender mix; - developing responses to bullying and other inappropriate behaviour; - mainstreaming use of participative mechanisms such as residents meetings; and - developing greater consistency in practice across homes, in terms of house rules and use of sanctions. PAGE 106

16 16. CONCLUSION AND RECOMMENDATIONS 16.1 This inspection has identified many areas of good practice and good quality work undertaken by highly motivated staff who are working in extremely pressurised and high risk situations, in both fieldwork and residential children s services. The inspection has sought to identify both what is working well and where improvements still need to be made. 16.2 There now needs to be a comprehensive and sustained programme of change established with all the key stakeholders. Significant co-ordinated regional action is required to deliver the necessary high quality services needed to safeguard children and young people in Northern Ireland. The findings of the inspection and the implementation of its recommendations will assist in improving arrangements for safeguarding children and young people and in increasing public awareness in this critically important area. 16.3 This report, its recommendations and the draft standards provide a clear and coherent framework for the future provision of robust, high quality child protection services. 16.4 The key recommendations made to the Boards, Trusts, key agencies and Government Departments are set out below: Planning, Commissioning, Monitoring and Management and Provision of Child Protection Services - Chapter 2 Boards must ensure that: 1. the Director of Social Services/Care is clearly identified as having lead responsibility for child protection services and the postholder effectively discharges the responsibilities associated with this post; 2. there is a Designated Doctor and Designated Nurse to provide clear leadership within these disciplines for the development, implementation, monitoring and review of child protection services; 3. information obtained directly from Trusts, such as contract compliance and CC3/02 reports, is validated, analysed and used to inform planning and commissioning; and PAGE 107

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 4. quality improvement plans and effective monitoring arrangements are put in place to address the deficits identified in CC03/02 reports and to ensure that Trusts have the capability at all levels within children s services to discharge statutory child care functions. Trusts must ensure that: 5. the Director of Children s Services is clearly identified as having lead responsibility for child protection services and effectively discharges the responsibilities associated with this post and with the post of Executive Director of Social Work; 6. the lines of professional responsibility and accountability from the front line of practice to the Chief Executive and to the Trust board are clear and unambiguous thus enabling the Trust board to discharge its responsibilities in regard to children s services effectively; 7. there is a Named Doctor and Named Nurse with clearly defined job plans and responsibilities to provide a lead role for child protection within these disciplines; 8. difficulties or risks in regard to its ability to discharge statutory child care functions are included in CC03/02 reports and brought to the attention of the Trust board. Trusts should also seek to agree, implement and review quality improvement plans, as appropriate; and 9. their workforce strategy enables them to meet their requirements as an employer as set out in the NISCC Code of Practice and complies with social care governance arrangements. Boards and Trusts must ensure that: 10. Executive and Non-Executive Directors are clear about their individual and corporate responsibilities and receive mandatory training in understanding their role as a corporate parent ; 11. information provided to the Boards to secure resources for children s services is appropriately collated, validated and analysed, and - resources made available to children s services are directed to identified areas of need, and progress is regularly and appropriately reported on; and PAGE 108

16 - investment in children s services is continuously reviewed and the findings included in the annual reports to the Area Board on the discharge of statutory functions. 12. the DHSSPS is advised of difficulties in discharging statutory functions for child protection and children s residential services, the action plan and timescale proposed to address these, and any specific shortfall in resources; and 13. staffing difficulties within the professional groups are brought to the attention of the DHSSPS Workforce Planning Group and Children Matter Taskforce and addressed. The DHSSPS must ensure that: 14. the structures and arrangements for children s services planning and commissioning are evaluated on a regional basis every 3 years; 15. experienced practitioners are encouraged to remain in the front line of child care and child protection practice, for example, through the review of the senior practitioner grades and the introduction of principal practitioners in this area of social work; and 16. in relation to the NISCC Codes of Practice: - the NISCC makes sure that practitioners comply with the Code of Practice for Social Care Workers working, where necessary, in collaboration with the RQIA; and - the RQIA monitors employers compliance with the Code of Practice for Employers of Social Care Workers. The Purpose of Services - Chapter 3 Boards and Trusts must collaborate on a regional basis, and 17. involve service users, including parents, children and young people, and relevant disciplines and agencies, to produce a clear statement of purpose, which: - outlines their statutory duties and responsibilities to children in need and those at risk of significant harm; PAGE 109

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND - includes information about the nature of services, how and when they can be accessed, the standards to which they operate, how parents, children and young people will be involved in service design, development, review and feedback and how to make a complaint; - is widely available to all stakeholders, including potential service users and referral sources, through an appropriate range of paper-based and electronic means and is accessible to those with special needs and those for whom English is not a first or competent second language; and - is referenced in all relevant documentation produced by them; and 18. review and clarify their thresholds for entitlement to services and ensure that children, young people and families in need have access to timely and appropriate preventative and supportive services. Trusts must ensure that: 19. information about the complaints process is prominently displayed, that all parents, children and young people routinely receive a copy of the Trust s complaints leaflet at the point of entry to the service and the process is personally explained to them. Access to Services - Chapter 4 Boards and Trusts must ensure that: 20. adequate and appropriate information is available to potential service users and members of the public about the nature of child protection services and how and when to access them. This information should be presented, whenever necessary, in accessible formats, including translations for those for whom English is not a first or competent second language; 21. information is developed, disseminated and regularly audited in association with parents and young people and made available through the range of facilities commonly used by potential service users; and 22. a comprehensive review of the out-of-hours duty system is undertaken and that the relevant expertise and experience is available to provide an effective and responsive child protection service. PAGE 110

16 Trusts must take action to improve: 23. arrangements for other agencies to receive information and feedback about the allocation of referrals made by them; 24. arrangements for parents, children and young people as well as staff in other agencies, to access relevant services and support within agreed timescales and in line with agency standards; 25. the reception, waiting and meeting room facilities within local children s services offices; and 26. systems for parents, children and young people to enable them to contact their social workers, as required, including: - provision of voicemail, email, and mobile telephone numbers; - monitoring arrangements to check that responses are within agreed timescales; and - customer care training for receptionists and duty officers. Assessment, Case Planning, Case Management and Record Keeping - Chapter 5 The DHSSPS must: 27. continue to progress the implementation of a single model of assessment for Northern Ireland as a matter of urgency and ensure that: - there is consistent use of the model for assessment across the region and that the impact on improved outcomes for children and families is evaluated, in collaboration with the key disciplines and agencies; - Boards and Trusts, through ACPC and CPP, provide practitioners and managers from all disciplines and agencies with appropriate training in the application of the assessment model; and - the NISCC actively regulates social work training and monitors professional course content, particularly in relation to assessment and risk assessment to ensure that it reflects current best practice. PAGE 111

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Trusts must: 28. monitor and audit the implementation of case conference procedures and ensure that: - case conference chairs fulfil their role in leading the case conference as set out in CtSC and are supported through appropriate line management supervision, effective monitoring arrangements, adequate on-going training and the provision of suitable accommodation; - training is provided to professionals in relation to their roles and contributions to the case conference process; - the case conference process remains focused on the needs of children; - information from the range of agencies working with families is summarised; - the roles of school nurse and health visitor are clearly defined and that their reports provide full assessment of the health/developmental needs of the child and relevant information in relation to the parents health and parenting skills; - the needs and risks in respect of individual children are analysed and whether the requirements for child protection registration are met; - the parents and family s strengths and qualities and their existing network of supports are assessed; - the deficits in parenting skills and the kinds of supports required to address these are clarified; - any changes needed and standards to be achieved in order for children s names to be removed from the register are clearly set out; - advice is provided to parents of the importance of co-operating with the child protection plan and the potential consequences in terms of Care Order applications when the threshold of significant harm has been reached; - an appropriately trained minute taker records all child protection case conferences, that minutes are consistent with CtSC and are circulated within 14 days as required by the regional ACPC Policy and Procedures; and - the views of children and young people and parents about the conduct of case conferences, are considered and, if necessary, appropriate action taken; 29. evaluate/audit case recording in their family and child care services to ensure that information from all relevant disciplines is appropriately collated, analysed and recorded and that this forms the basis for the assessment, including risk assessment and therapeutic intervention required in each case; and 30. retain in the file one completed comprehensive set of essential information record forms, a front chronology sheet that is regularly updated with information on the PAGE 112

16 child/family, case summaries and transfer reports and records typed, crossreferenced and filed in date order. Protecting Vulnerable Children in Specific Circumstances - Chapter 6 Trusts must ensure that: 31. child protection procedures are initiated in all situations where the criteria are met and that there is an appropriate multi-agency assessment of risk and adequate child protection planning; 32. the expertise of AHPs is more fully utilised in the assessment and management of child protection cases, where appropriate; 33. the management of cases reflects an appropriate balance between working in partnership with parents to avoid family breakdown and using its authority to effectively intervene to challenge harmful situations and safeguard children, and - written contracts with parents specify the work plan and clearly state the standards and improvements expected of them; 34. decision making is appropriately informed by clinical and psychological assessment of parental capability and level of functioning; and 35. staff in mental health, learning disability and addiction services receive appropriate child protection training and staff in child care receive appropriate training in mental health, learning disability, alcohol and drug abuse and the impact of these on children. Quality Assurance and Managing Performance of Service - Chapter 7 Boards must ensure that: 36. Trusts have in place robust arrangements for monitoring and auditing: - the management of the child protection process; - the implementation of policies and procedures for referral, assessment, case planning, case management and record keeping of individual cases; and PAGE 113

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND - the effectiveness of interventions in achieving specified outcomes for children and families. Trusts must ensure: 37. compliance with NISCC, NMC, GMC, HPC and other regulatory bodies guidance on supervision, continuous professional development and appraisal as part of their governance arrangements and this should be monitored by the RQIA. Boards and Trusts must: 38. audit the standards and procedures for supervision for all staff and ensure that staff are appropriately supported and managed in their work with children and families; and 39. in collaboration with PSNI, review and monitor the implementation of the joint protocol. The DHSSPS must continue to ensure that: 40. Boards and Trusts have reviewed and taken action on the serious issues identified in the management letters issued during the inspection and that safeguards for children are in place and practice improved. The Establishment and Operation of the Area Child Protection Committee (ACPC) and the Child Protection Panel (CPP) - Chapter 8 Boards and Trusts, in conjunction with key agencies, represented on ACPCs and CPPs must ensure that: 41. representatives are of sufficient seniority in their own organisations and disciplines to fully discharge the responsibilities of membership. Representatives must have the necessary mandated authority to make strategic decisions and allocate and pool resources on behalf of their organisation and discipline, and - ACPC and CPP chairs regularly apprise them of safeguarding developments, immediately reporting issues which have the potential to compromise governance PAGE 114

16 and corporate parenting responsibilities. Proposed quality improvement plans to deal with these should also be included; and - the ACPC is adequately informed about local and agency child protection concerns, including referral and workforce issues, so that these can be addressed and resolved; and 42. ACPC and CPP business plans and action plans conform to CtSC and that they: - reflect the interagency nature of child protection work; - have specific targets and outcomes which are measurable and time bounded; - include the development and implementation of a robust and ongoing programme of auditing and monitoring which ensures that the safeguarding strategy for the area is working; - identify the multi-agency training requirements and funding arrangements; and - are available in an abbreviated format and made widely available to staff, children, young people and families. The DHSSPS must continue to: 43. progress the introduction of the new Safeguarding Board for Northern Ireland to replace the existing ACPC/CPP structure. Case Management Reviews - Chapter 9 Boards must ensure that: 44. CMRs are undertaken in accordance with CtSC and that the lessons learned are communicated, understood and actioned within their Board/Trust and across all disciplines/agencies, and - there is a process in place to inform practice and measure improvement; and - problems identified in undertaking CMRs are brought to the attention of the DHSSPS so that these can be considered in any amendments to regional guidance. PAGE 115

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND The DHSSPS must ensure that: 45. the CtSC Working Group completes its review of the lessons emerging from CMRs and, in collaboration with the Boards and Trusts, consider the issues for policy and practice developments, and - the status of CMRs is clarified and that issues about interfaces with the wider processes of the law are addressed within the new Safeguarding Board arrangements. Equality and Human Rights - Chapter 10 Boards and Trusts in planning, commissioning and providing child protection services must ensure that: 46. the rights of children and young people are appropriately safeguarded in the context of these services and that services are provided equitably having due regard to the assessed needs, changing profile and diverse needs of young people and families. The Interface between Residential and Fieldwork Child Care Services - Chapter 11 Boards and Trusts should: 47. give effect to their child care responsibilities. In order to achieve this they need to: - strengthen the commissioning, quality assurance and monitoring processes to ensure a high standard of planning and effectiveness in their Looked After Children (LAC) services; - review the provision of the full range of LAC services to ensure they are adequate in terms of numbers and choices; - develop a range of additional remand/specialist/therapeutic placements to provide a greater range of choice; and - review training and support for foster carers as part of their action plans to further develop foster care services. PAGE 116

16 Trusts should urgently review: 48. the recommendations made in recent RQIA inspection reports and develop and implement quality improvement plans. Senior Managers should ensure that legislative requirements are met in order to provide appropriate safeguards for children and young people in residential care. Boards and Trusts must: 49. review the terms of reference for their Children s Resource/Placement Panels, and - ensure representation from Heads of children s homes in order to utilise their expertise in the decision making process; - ensure social workers provide an up-to-date comprehensive assessment on every child and young person to enable the Panel to consider the most effective placement option and to provide appropriate assessment information to the home prior to the admission decision; - consider the impact of new admissions and any associated high risk behaviours on the other children and young people in the home; - ensure that discussions are held about the actions required to resolve behaviours evident in a placement before agreeing to transfer the child to another environment; - share the learning from previous movement between placements in terms of, for example, challenging behaviour and what works best for the child or young person. Consideration should be given to the impact of endings, loss and attachment theory so that the needs of children and young people are appropriately met; and - regularly review the quality of the Panel s decision making process as part of their governance arrangements. Trusts must ensure that: 50. pre-admission discussions are held regarding each admission and that: - a programme of planned visits is arranged to introduce the child to other children in the home, their key worker and staff; - formal admission contracts are introduced which provide clarity for the child and family on the rationale, purpose and expected outcome of the admission to care; and PAGE 117

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND - the contact arrangements and respective roles and tasks of residential workers and the fieldworker are clarified in relation to the work plan and the follow up arrangements regarding statutory visits, family contact and reviews. The DHSSPS, in collaboration with key stakeholders, must: 51. review and research best practice in providing therapeutic intervention and support to children and young people in residential care and their families, from admission to discharge, and - review the current structure and management arrangements for providing therapeutic services to children and young people at high risk. Consideration should also be given to establishing a pilot team of highly skilled social work practitioners and other professionals to deliver this service. Boards and Trusts must: 52. immediately implement the revised protocol and ensure that: Trusts must: - arrangements for the placement of children outside a Trust area are appropriately monitored to make sure that assessment, including risk assessment, inform the care plan for children and young people, and that child protection procedures are appropriately initiated. 53. ensure that each assessment of need and risk is robust and informs work with the child or young person in seeking to achieve the stated goals in the care plan and that it is shared with parents. It should include: - an assessment of the respective strengths and weaknesses of the family in meeting the needs of the child and their implications for the child; and - the care plan which clearly sets out decisions regarding contact, home on trial arrangements and their expected benefits; and 54. review their access to CAMHS for looked after children, and - take action to ensure children in residential homes have prompt access to these services; and PAGE 118

16 - take account of the residential home s staffing complement to ensure that they have the necessary skills and expertise required in order to meet the children s mental health needs. Boards and Trusts, in collaboration with PSNI and the RQIA, must: 55. develop management information systems which facilitate the collation and analysis of information about looked after children; identify key areas of risk requiring action; assist in service planning; and quality assure decisions, and - provide guidance and training on the full range of powers available to their staff to assist with the use of these under Articles 67 and 68 of the Children Order. Trusts must ensure that: 56. issues identified in risk assessments, including any child protection concerns, are taken into account in the comprehensive assessment and reflected in the care plan. Child protection arrangements for children must be explicit and followed through; 57. a risk assessment for each child or young person is completed where there is potential for abuse, either as victim or perpetrator, and - develop a risk management strategy to support both the individual child and the residential group; and - review the risk criteria, including whether urgent consideration by their Audit/Risk Committee, the Boards and placement/host Trusts is required; 58. where children or young people are returning to children s homes following a period of running away they are interviewed to establish their reasons for this behaviour and to establish what risks they have been exposed to during their absence. Particular consideration should be given to whether or not they have been involved in high risk behaviours such as sexual exploitation, inappropriate sexual activity and/or the misuse of alcohol or drugs. Trusts should also ensure that these children and young people have access to appropriate therapeutic and other support services, as needed; and PAGE 119

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 59. a review is conducted on policies, protocols, practice issues and reporting arrangements in residential care, including: - all Significant Events Reports and address any risks identified therein; - their policy on children and young people entering each others rooms including the actions to be taken when staff cannot gain access; - the locking arrangements for all internal doors throughout the home to ensure staff can gain access at all times; - the implementation of their Anti-Bullying Policy and ensure this is taken forward as part of the child protection process and that the children receive follow-up counselling, where appropriate; - staffing levels to ensure that they are adequate where there are known risks to children and young people and where closer monitoring is required; - the safety and security features on windows in children s homes to prevent children and young people from running away; - existing protocols with PSNI with a view to responding appropriately and effectively to children and young people who run away; and - the protocols for informing other Boards, Trusts and relevant agencies of serious events and agreeing a strategic approach to the resolution of these. Trusts must ensure that: 60. the good practice applied in a number of cases within residential care is widely disseminated and replicated, and - social workers contacts with children are therapeutically focused and consistent with care plans; - telephone calls or text messages by social workers do not become a substitute for the direct contact needed, particularly, when a child is distressed or has suffered a traumatic experience; and - team leaders in residential care regularly review and sign records of individual work sessions with children and young people. Trusts must ensure: 61. the full involvement of the child, his or her parents and relevant disciplines/agencies is considered before completing care plans. Care plans should be clearly documented and comply with regulatory requirements. PAGE 120

16 Boards and Trusts must: 62. address the key risk areas arising out of inspection findings, and - agree and implement a quality improvement plan and a formal programme of audit to ensure that actions agreed have been implemented and lessons learned disseminated to key staff in order to improve practice and outcomes for children. Education: Key Findings and Recommendations - Chapter 12 The DE must: 63. provide up-dated guidance on Child Protection, which takes account of the DHSSPS guidance Co-operating to Safeguard Children and ensure that there are adequate resources, including staffing and training, to support the effective management of the Child Protection system across the Education sector. The Education sector, in collaboration with Boards and Trusts, must: 64. monitor the outcomes of Child Protection referrals and outcomes of case conferences and agree a system whereby relevant information, about the needs of individual children, can be shared between Education and Social Services. Boards and Trusts, in collaboration with the Education sector, must: 65. review and clarify the roles and responsibilities of the educational representatives on ACPC and CPP and the arrangements for multi-disciplinary/interagency working, in order to achieve greater effectiveness in joint working arrangements and improve outcomes for children; and 66. ensure that they consult appropriately with the Education sector and other key agencies on new children services arrangements including thresholds for access to services, and - provide information, training and support. PAGE 121

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Police Service of Northern Ireland: Key Findings and Recommendations - Chapter 13 The PSNI, in collaboration with Boards and Trusts, must: 67. produce strategic guidance on the management of the range of problems referred to the police including young people who run away from children s homes in order to improve safeguarding arrangements and reduce the number of inappropriate referrals made to police. The Training Education and Development Branch should provide: - training to staff, in particular District Command Unit personnel, on such guidance and on the various deterrent methods and powers available to them to assist in the safeguarding of children, e.g. Risk of Sexual Harm Orders; and - training in respect of police contribution at case conferences for all newly appointed CARE officers, YDOs and DVOs and review attendance and content of CID Foundation training and CARE Awareness courses. The PSNI must ensure that: 68. appropriate models of intelligence are used in the gathering and collation of information and consult with the Boards, Trusts and the RQIA to ensure a full overview of the situation is available and appropriate action is taken; and 69. police representatives on ACPCs and CPPs: - are of sufficient seniority in rank to deal effectively with the strategic and local issues arising; - are clear about the importance of their role and function and that they table child protection issues at ACPC/CPP meetings as a matter of course and at the CARE Detective Inspectors monthly meeting; and - structure into their key performance targets enhanced joint evaluation/assessment in order to quality assure the standard of joint investigations. The DHSSPS must ensure that: 70. dissemination of lessons to be learned from individual CMRs are forwarded expeditiously to C2, Head of Branch for CARE, Criminal Justice Department, and Head of Training, Education and Development Department in order to ensure improvement to practice. PAGE 122

16 The NIO must ensure that: 71. the outcome of the review currently commissioned provides enhanced opportunities for PSNI to more effectively engage in child protection matters and interagency processes. Regulation and Quality Improvement Authority: Key Findings and Recommendations - Chapter 14 The RQIA must: 72. ensure that its inspection reports are issued to Board and Trust Chief Executives and recommendations appropriately targeted to the key personnel; 73. agree, quality assure and monitor the implementation of improvement plans put in place by the Boards and Trusts in respect of their children s residential services and consider enforcement action where required; 74. develop a trend data analysis system, in collaboration with the key agencies, to provide early alerts about key areas requiring improvement and review; and 75. monitor and report on Boards and Trusts compliance with their responsibilities under the NISCC Code of Practice for Employers of Social Care Workers. The Views of Children and Young People: Office of Commissioner for Children and Young People - Chapter 15 Trusts must ensure that: 76. their practice is focused on the right of the child to meaningfully engage in decisions about their life, in an age-appropriate manner. A fundamental review of both child protection case conferences and LAC reviews is needed to ensure they are childcentred and child-friendly. This should focus on: - timing and location of meetings; - the language/terminology used (both during the meeting and in preparation and feedback); PAGE 123

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND - style and content of contribution forms; - the duration of meetings and who attends these; and - more effective ways to involve children, for example, part attendance of either themselves or their representatives at reviews, co-chairing reviews or splitting reviews into a two-stage process; and 77. after care services are of the highest quality and individually tailored to secure the best interests of the child or young person. Further actions that would help realise this goal for all children and young people in the care of Trusts include: - provision of staff training on children s rights and effective participation strategies; - greater continuity of social work personnel; - increased availability of therapeutic assessment and support when required; and - unfettered access to complaints procedures. Parallel actions that would help children and young people currently in residential care are: - reviewing the age and gender mix; - developing responses to bullying and other inappropriate behaviour; - mainstreaming use of participative mechanisms such as residents meetings; and - developing greater consistency in practice across homes, in terms of house rules and use of sanctions. PAGE 124

APPENDIX 1 INSPECTION BRIEF Child Protection Services Inspection PAGE 125

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1. INTRODUCTION Background 1.1 The Children (Northern Ireland) Order 1995 (the Children Order) places a duty on HSS Boards/Trusts to promote and safeguard the welfare of children in need in their areas. Article 66 of the Children Order requires a Trust to investigate, if it has reason to suspect that a child in its area is suffering or likely to suffer significant harm, so it can decide what action is required to safeguard and promote the child s welfare. The help of other agencies is essential if this is to be carried out effectively and the Children Order places a duty on key agencies to assist (Article 46), where this is consistent with the discharge of their own statutory duties. 1.2 Co-operating to Safeguard Children (May 2003) is Departmental guidance relating to the management of child protection. The guidance sets out how all agencies and professionals have a role to play in the safeguarding of children and sets out how they should co-operate to promote children s welfare and protect them from abuse and/or neglect. 1.3 The Department of Health, London published Child Protection: Messages from Research in 1995, which summarised the key findings from 20 research studies. The University of East Anglia s 1999 report Learning How to Make Children Safer suggested that child protection services should: focus on outcomes for the child; place child protection in context, by enabling access to a range of services for children in need and their families; encourage working in partnership with children and families; recognise and facilitate work across professional and organisational boundaries; and provide skilled assessment for children and families. 1.4 More recently, Lord Laming in The Victoria Climbié Inquiry (February 2003) highlighted a series of professional and managerial weaknesses, which culminated in the death of Victoria. Laming made a series of highly focused recommendations to PAGE 127

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND ensure children are protected more effectively by child protection systems. Following on the Green Paper Every Child Matters also begins to challenge established systems and the role professionals play within these. 1.5 In Northern Ireland, the increase in the number of Case Management Reviews and the learning emerging from these influenced the development of Co-operating to Safeguard Children. Learning from local practice and experience creates the potential to ensure more appropriate solutions are developed to inform practice in Northern Ireland. 2. PURPOSE OF THE INSPECTION OF CHILD PROTECTION SERVICES 2.1 The purpose of this inspection is to examine: a. the nature, range and quality of, child protection arrangements, services commissioned and/or provided by Boards/Trusts on a direct and/or partnership basis; b. the strategic and operational functioning of the Area Child Protection Committee (ACPC) and the Child Protection Panel (CPP); and c. the Child Protection interface between residential and fieldwork child care services in 3 of the Trusts inspected. 3. OBJECTIVES OF THE INSPECTION Fieldwork 3.1 To examine how Boards/Trusts discharge their responsibilities in regard to: children and families who are dealt with through the child protection process; working with other agencies to promote and safeguard the welfare of these children in their areas; and the child protection interface between residential and fieldwork child care services in 3 of the Trusts inspected. PAGE 128

3.2 To examine how the Board/Trust in conjunction with the ACPC/CPP develop a strategic approach and deliver child protection services in their area. 3.3 To examine and evaluate the ACPC and Trust policies/procedures, and the practice and decision making processes in respect of child protection with specific reference to: the management of individual cases at all stages of the child protection process; the protection of vulnerable children in specific circumstances; the involvement of children and families; information provided to staff, professions, the public and users of services; the provision, uptake and relevance of training for those involved in child protection work; and the quality of professional practice and management of services. 3.4 To examine how Case Management Reviews are conducted and how lessons learned from these are disseminated and used to inform policies and practice within and across Trusts. 3.5 To examine the effectiveness of multi-agency/disciplinary working at both strategic and operational levels. Residential and Fieldwork Interface 3.6 This aspect was examined during the inspections in the last 2 Trusts, that is, South and East Belfast Trust and Sperrin Lakeland Trust. The Foyle Trust residential/fieldwork interface was examined as part of the Sperrin Lakeland inspection. 3.7 To consider the practice in relation to care planning and the safeguarding of children and how this informs decision making in respect of placement choice. 3.8 To review assessments of children s needs prior to their placement in a children s home to determine what consideration has been given to their vulnerability to abuse. PAGE 129

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 3.9 To consider the governance arrangements established within the Trusts to monitor safeguarding arrangements within their residential children s homes and to quality assure the interface between residential and field social workers. 3.10 To review recent inspection reports and interview Regulation and Quality Improvement Authority (RQIA) Child Care Inspectors in order to: consider whether the care and management arrangements within children s homes meet the identified needs of children in need of safeguarding; and examine the responses of the Trusts and residential staff to incidents of abuse occurring to children who are resident within the children s homes. 3.11 To make recommendations designed to improve professional practice, reporting and management arrangements at various levels with the Board and Trust. 4. SCOPE OF INSPECTION AND LOCATIONS TO BE INSPECTED 4.1 The inspection will focus on those arrangements established to safeguard and promote the welfare of children who are in need of protection both in community settings and in residential children s homes. The inspection will consider the work undertaken by ACPCs and CPPs to enhance the protection of children. 4.2 Inspectors will examine cases relating to children who require protection and will consider the work undertaken at each stage of their involvement with social services from initial referral though to closure. 4.3 The Trusts inspection timetable: Craigavon and Banbridge Health and Social Services Trust (May/June 2004) Foyle Health and Social Services Trust (June/July 2004) Residential/fieldwork interface (January/February 2006); Causeway Health and Social Services Trust (May/June 2005); South and East Belfast Health and Social Services Trust, including residential/fieldwork interface (September/October 2005); and PAGE 130

Sperrin Lakeland, including residential/fieldwork interface (January/February 2006). 5. TIMESCALE FOR OVERALL INSPECTION 5.1 The following timescales were established: formal consultation on draft standards with all Boards/Trusts and other organisations, June - July 2003; development of the methodology and initial planning for the inspection, June 2003 - March 2004; fieldwork/analysis of findings in each Trust selected for inspection, April 2004 - February 2006; collation of overview inspection report on the 5 sites and launch of the report, January 2007; and dissemination of findings, February - March 2007. 6. INSPECTION TEAM 6.1 In keeping with the inter disciplinary/agency nature of child protection work a multi disciplinary team has been established to take forward the inspection comprising representatives from Social Services Inspectorate, Medical and Nursing Branches within DHSSPS, the Education and Training Inspectorate, and Police Service Northern Ireland and a lay assessor. For the inspection of the fifth Trust, the inspection team was extended to include representation from the Office of the Northern Ireland Commissioner for Children and Young People (NICCY) and the RQIA Inspection Manager Child Care Consultants Maire McMahon (ACI) Dr Theresa Donaldson Lynne Peyton/ Ken Wilson PAGE 131

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND SSI RQIA (Residential Services) Nursing Allied Health Profession Education & Training Inspectorate (ETI) Medical Police Service Northern Ireland (PSNI) Police Service Northern Ireland) (PSNI) Lay Assessor NICCY Statistician Marion Reynolds (S&E Belfast) Theresa Nixon Marian Robertson Heather Crawford Lynne McMullan/ Betty Robinson Dr Erin Knowles (S&E, Causeway, C&B)/ Dr Alison Livingstone (Foyle, SL) Willie McAuley Anne Marks Raymond Gordon Teresa Devlin/ Dr Helen Beckett Kieran Taggart 7. OFFICE FOR INSPECTION TEAM 7.1 To facilitate the inspection, an office will be required in each Board/Trust area to be the base for the inspection. Inspectors will also require access to a desk, lockable filing cabinet, telephone and a meeting room. 8. CO-ORDINATOR IN EACH BOARD/TRUST 8.1 The Board/Trust are asked to identify a person for the inspection to co-ordinate and facilitate the collation of statistical data and completion of pre-inspection PAGE 132

questionnaires, inspection programme plan, organise visits to other locations within the Board/Trust area, the temporary transfer of case files and to enable access to relevant staff, service users and partner agencies. 8.2 The Lead Inspector will work with the co-ordinator to, draw up a programme for the inspection, outline the methodology for the fieldwork and to ensure that sampling is representative of patterns of work throughout the Trust. 9. DRAFT CHILD PROTECTION STANDARDS 9.1 The inspection will consider practice against the agreed draft standards in relation to the following: planning, commissioning, management and monitoring and provision of services; the purpose of services; access to services; assessment, case planning, case management and record keeping; protecting vulnerable children in specific circumstances; quality assurance and managing performance of service; the establishment and operation of the Area Child Protection Committee (ACPC) and the Child Protection Panel (CPP); case management reviews; and equality and human rights. PAGE 133

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 10. METHODOLOGY 10.1 Inspection methods will include: Data the collation of pre-inspection data relevant to child protection from all Health and Social Services Boards and Trusts; and the collation of specific data from each of the 5 Trusts selected for inspection. Documentation an examination of relevant Board/Trust/ACPC/CPP documentation in respect of fieldwork and residential services (samples to be requested prior to the inspection fieldwork). Records an examination of a sample of Field and Residential Children s Services records to specifically include referral, assessment, case planning information and case files in respect of a census period (June 2003 - April 2005); and an examination of a sample of residential records (12) in respect of children resident in the homes. Questionnaires a written questionnaire survey of service users, service providers and staff from across disciplines and agencies selected from the sample of cases referred for child protection reasons. Interviews/Focus Groups interviews and focus groups with service users, service providers from statutory and voluntary sectors, Education, PSNI and staff involved in child protection work from acute/community Trusts and other agencies in respect of specific cases; PAGE 134

a written survey of and interviews with chairpersons and members of ACPC and CPP; and where possible, observation of child protection case conferences, Child Protection Panels and Area Child Protection Committees. Children s Homes/Inspection Reports In addition, the Inspection Team will: examine the children s homes inspection reports pertaining to the children s residential records examined; interview the inspectors responsible for the children s home reports examined to highlight key issues/concerns arising; and conduct a focus group with RQIA Child Care Inspectors to determine current concerns/issues within children s homes and Trusts. 10.2 Fieldwork will include: an examination of a random sample of 40-60 child care referrals, in addition a number of unallocated referrals will be sampled; an examination of 15-20 child protection case files deemed child protection at referral and referred to child protection case conference (stratified and random sample within this); an examination of 12 children s residential case records; an examination of 15-20 cases not deemed child protection but who received a service; and a detailed study of 10-12 case files in each Trust examining the process from referral through to closure/current situation. PAGE 135

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 10.3 This examination of cases will also include interviews with: the staff involved, children/families/carers; the Board/Trust senior managerial staff; and key personnel from other involved disciplines/agencies. Samples chosen will seek to take account of: a. how cases were managed in respect of children in the following age bands: 0 1 Yrs; 1-5 Yrs; 5-11 Yrs; 11-17 Yrs; and b. Trust size and population. 10.4 At the completion of the fieldwork, verbal and written headline feedback will be presented to Senior Managers within the Board and Trust. A draft report will be issued to the Board and Trust for a factual accuracy check at the completion of the inspection in keeping with Circular No HSS (EC) 1/94. At the completion of the fieldwork in all 5 sites an Overview Report will be prepared and its findings widely disseminated. 11. FINDINGS OF THE INSPECTION 11.1 The findings of the inspection will be used to; improve protection for children and young people and assist the public to have a greater understanding of the issues; contribute to enhancing professional practice, management and monitoring arrangements; and inform policy development. PAGE 136

APPENDIX 2 DRAFT STANDARDS FOR THE INSPECTION OF CHILD PROTECTION SERVICES PAGE 137

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DRAFT STANDARDS FOR THE INSPECTION OF CHILD PROTECTION SERVICES Page Introduction 141 Legislation Underpinning the Standards 142 Values and Principles 142 1. Planning, Commissioning, Monitoring and Management and Provision of Services 144 2. The Purpose of Services 148 3. Access to Services 149 4. Assessment, Case Planning, Case Management and Record Keeping 150 5. Protecting Vulnerable Children in Specific Circumstances 155 6. Quality Assurance and Managing Performance of Service 157 7. The Establishment and Operation of the Area Child Protection Committee (ACPC) and the Child Protection Panel (CPP) 159 8. Case Management Reviews 162 9. Equality and Human Rights 164 PAGE 139

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INTRODUCTION The draft standards for the inspection of child protection services have been developed to assist the process of inspection and will enable the members of the multi-disciplinary, interagency inspection team to consider child protection services for children and young people in a consistent and systematic way. It is anticipated that they will provide the foundation for informing best practice and assist in developing the planning, delivery and ongoing monitoring of services. There are 9 key standards; each supported by a number of criteria statements. These criteria statements are the components that the inspection team will consider when determining the extent to which services comply with the expectations contained in the standards. To assist in the development of the standards, a reference group was established by Social Services Inspectorate, with representation from the wide range of disciplines and agencies from across Northern Ireland who have a role in and responsibilities for the safeguarding of children, with the following terms of reference; to provide advice and guidance regarding standards development ensuring that the focus remains on the protective needs of children and young people; to act as the conduits for dissemination and consultation on standards development and provide feedback from Area Child Protection Committees (ACPCs); Child Protection Panels (CPP); Boards and Trusts; Professional groups and Agencies involved in child protection work; to act as a point of reference for the inspection team taking forward the inspection of child protection services; to contribute to the development of the methodology for conducting the inspection; and to consider the draft findings and recommendations from the inspection. The standards and criteria have been developed in consultation with the reference group, Board and Trusts, voluntary organisations and the views of young people who have experienced child protection services. In addition, the standards have been influenced by: a review of existing standards in the area of child protection; PAGE 141

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND a review of a wide body of literature and research on child protection; the recommendations contained in The Victoria Climbié Inquiry (2003); this report made many far-reaching and challenging recommendations for all engaged in the governance, planning, management and delivery of child protection services; Co-operating to Safeguard Children (DHSSPS), May 2003. The standards work has had a direct influence on the final shape of the policy guidance; the learning from Case Management Reviews within Northern Ireland; and a series of workshops which were held to facilitate wide consultation with the full range of stakeholders in child protection work and included Health and Social Services Boards/Trusts, ACPCs, CPPs, the voluntary sector and young people. Individual agencies have also made a contribution. Legislation Underpinning the Standards The basis for the draft standards and criteria is derived from the following main areas of legislation, which impose certain statutory duties on Boards and Trusts: Children (Northern Ireland) Order 1995 (the Children Order); Education (Northern Ireland) Order 2003; Human Rights Act 1998; Protection of Children and Vulnerable Adults (Northern Ireland) Order 2003; Chronically Sick and Disabled Persons Act (Northern Ireland) 1978; Mental Health (Northern Ireland) Order 1986; Disability Discrimination Act 1995; Northern Ireland Act 1998, specifically section 75 requirements; and Criminal Evidence (Northern Ireland) Order 1999 Values and Principles A number of important themes have emerged from legislation, relevant literature and the consultation process which are reflected in the following values and principles statements. 1. Safeguarding and promoting the welfare of children at risk of abuse or neglect is a priority when decisions are made about access to and eligibility for services. PAGE 142

2. Listening to and engaging children and their families is crucial to ensure their full participation when decisions are being made that affect them. 3. Children and their families receive responses and services which engage them as partners in problem solving, avoiding where possible family breakdown, preventing harm and promoting children s development and life chances. 4. Some children are particularly vulnerable due to their circumstances and the design and delivery of services promotes and safeguards their wellbeing. 5. Child Protection Services promote the inclusion and citizenship of children, are provided within an ethos that maximises, protection, access to appropriate education, life chances, opportunities and independence and accommodates religious, linguistic, ethnic, social and cultural backgrounds, individual circumstances and children and families rights to privacy. 6. Services are planned and delivered in a way which empowers children requiring to be safeguarded, respects their dignity and assists them to lead as full a life as possible. 7. Children and their families are involved in the assessments of their needs and in the co-ordinated approaches designed to meeting these. 8. Children have a right to equality of access to services, which are developed/tailored to best meet their assessed need. PAGE 143

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 1. PLANNING, COMMISSIONING, MONITORING AND MANAGEMENT AND PROVISION OF 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. Criteria 1.1 The Board/Trust has established arrangements across the range of appropriate disciplines and agencies for resourcing and planning its child protection services that meet: statutory planning requirements within the context of its Children s Services Plan (CSP); Departmental guidance in respect of child protection services; and ensure their lead role for child protection is fulfilled and statutory obligations are met. 1.2 The Trust, with their partner agencies, have : agreed joint protocols, guidance and procedures for delivering and monitoring child protection services in its area; policies, procedures and guidance which address all aspects and stages of the child protection process; systems which make explicit the role, responsibility, functions and accountability of those involved in case management and decision making; and arrangements which ensure the regular review of interagency working 1.3 The (ACPC) business plan is available to staff and agencies who contribute to the delivery of the plan and to those who may need to use services. PAGE 144

1.4 The Board/Trust, in conjunction with the ACPC, have: assessed and quantified the level of need for children and their families involved in the child protection process; agreed the range of services to be provided; based these services on an adherence to statutory duties and responsibilities; stated how the range of needs and demands will be met within available resources; established a system for identifying and quantifying unmet needs; and established a process for Board and Trust members to monitor and scrutinise audits of the performance of the child protection service in its area. 1.5 The Board/Trust has an explicit process for commissioning services, which takes into consideration: assessed local need; best practice; equity; service options and client choice; budgetary constraints; and value for money. 1.6 The Board/Trust ensures that, where services are provided on a partnership or commissioned basis, the service level agreements clearly state the required and agreed expectations in regard to the level and quality of the service provided. 1.7 The Board/Trust has a clear workforce strategy in place, which demonstrates that it has signed up to and conforms to codes of conduct and practice for employers and employees and defines: recruitment processes; skills, knowledge and experience required by staff working with children who need to be safeguarded; induction requirements for staff; agreed organisational structure and clarity of role and function of staff; level of responsibilities and accountability delegated to each level within the organisation; supervision requirements, including its quality, regularity and the recording of same; PAGE 145

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND arrangements for staff development and post qualifying training; how the effectiveness of training is evaluated; staff appraisal and performance systems; caseload management and monitoring systems; quality, timescales and standard of responses expected in regard to child protection services; quality and standard of recording practices; and the requirements of the Protection of Children and Vulnerable Adults (NI) Order 2003 when selecting, recruiting, managing and retaining staff and volunteers who have access to children. 1.8 All managers and staff within Boards and Trusts and relevant professionals in partner organisations have knowledge of child protection policy and procedures and of services available for the protection and support of children and families and can demonstrate that they have received training in child protection. 1.9 Child protection provision is located within a continuum of services to children in need and their families and include a range of interventions for the prevention and treatment of significant harm. 1.10 The Board/Trust has effective mechanisms in place for: reviewing how it complies with social care governance, including codes of practice for employers as part of their corporate responsibility; the ACPC and CPP to inform respectively the Board/Trust about child protection issues and developments or deficits in the area; managers to assess practice and acknowledge good performance and to evidence that they value staff; staff to be helped to build into their work ways of measuring outcomes for children and families; and gaining feedback from staff, children and families to inform service planning, resource allocation and service delivery. 1.11 The Board/Trust regularly monitor and review complaints, representations, Case Management Reviews and audits of practice to: ensure satisfactory outcomes; learn from both positive and negative experiences; PAGE 146

PAGE 147 share and disseminate knowledge gained across disciplines and agencies and as appropriate throughout the region; identify and take account of unmet need; inform the planning of services and allocation of resources, workforce planning, improve joint working arrangements and provide better focus on work with children and families; consider the input of different professionals to Child Protection Case Conferences (CPCC) and review processes; consider the attendance of children and parents at CPCC and reviews; and consider the qualities of communication across staff/teams/offices/professionals.

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 2. 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). Criteria 2.1 The Board/Trust has written statements about the range of child protection services in its area. These set out the nature and purpose of the services provided based on statutory functions and responsibilities and informed by the guidance contained in Co-operating to Safeguard Children. 2.2 The Board/Trust has established clear priorities for its child protection services and the standards of service expected of staff. (ref 3.2). 2.3 The Board/Trust staff are clear about their roles and responsibilities and are aware of statutory functions, DHSSPS guidance Co-operating to Safeguard Children and related policies and procedures. 2.4 The Board/Trust can demonstrate that they have been proactive in making children and parents aware of how they can express their views about services. 2.5 Children and parents are aware of how they can express satisfaction with, or complain about, the response made to their needs and the reliability and quality of the services they receive. 2.6 Children and parents are aware of how they can make constructive suggestions and recommendations for the improvement of and development of child protection services. 2.7 The Board/Trust monitors the outcomes of services provided to ensure that their purpose is fulfilled and that adjustments are made where necessary. PAGE 148

3. 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. Criteria 3.1 The Board/Trust provides written information to actual and potential users of its services about the range of family support services available, including child protection services. 3.2 The Board/Trust establishes criteria for entitlement to these services and identifies the priorities and service standards (ref 2.2). 3.3 The Board/Trust in conjunction with ACPC and CPP work effectively to encourage appropriate referrals from children and families, members of the public and others who work with children where there are child protection concerns. 3.4 The Trust responds quickly and avoids undue delay in finding alternative placements where necessary for children in need of protection and provides choice to ensure individual needs can be met. 3.5 The Board/Trust has communication strategies in place to ensure that marginalised groups are provided with information on how they can access services. 3.6 Those who make referrals and enquiries about safeguarding children are responded to in a way which ensures: an appropriate response to the concerns raised; and written acknowledgement of the referral within 24 hours of it being received. 3.7 Children and their families receive responses and services which engage them as partners in problem solving and avoid family breakdown wherever possible, prevent harm and promote children s life chances. 3.8 Public access, reception and duty arrangements, including out-of-hours or emergency arrangements, enable appropriate access to services and support. PAGE 149

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 4. ASSESSMENT, CASE PLANNING, CASE MANAGEMENT AND RECORD KEEPING STANDARD 4 The Board/Trust has written policies and procedures, which provide direction and guidance to staff. These are underpinned by effective supervision and management arrangements, and policies and procedures which detail expectations regarding assessment, case planning, case management and record keeping of individual cases at all stages of the child protection process. Criteria 4.1 The Trust gives clear guidance to its staff in the form of written policies and procedures and has established agreed multi-agency guidelines which take account of: statutory responsibilities, DHSSPS guidance, ACPC s policies and procedures, and evidence available from research and best practice; the need for timescales and systems for: - the response to an initial referral/known case expressing concern about significant harm/welfare of a child which is prompt, thorough and proportionate; - responding to referrals on the basis of the urgency and complexity of the case; - the matching/allocation of referrals and work to the competence of staff and their current workload; - the tracking and reviewing of actions taken in response to the referral; and - the screening of referrals, written response to referrals and subsequent actions by the line manager; all aspects and stages of the child protection process and the obligation to provide a professional service; the role, responsibility, function and accountability for those involved in individual case management and decision making; and planning and managing investigations under Article 66 of the Children Order, according to the ACPC written policies and procedures. 4.2 Staff have available to them referral, assessment and case planning guidance and criteria to assist them reach professional judgements about recourse to the child protection process which is demonstrable in their practice. PAGE 150

4.3 The Board/Trust, through the ACPC, ensure that procedures and guidance are reviewed and revised in the light of new developments and research in child protection, changes in legislation, regulation, policy and/or guidance and learning emerging from case management reviews and audit. Record Keeping 4.4 There is Trust guidance in place which details: how records are to be formatted and maintained from referral through to closure of the case; how individual case files are to be structured; what individual children s case files must contain including the need for: - accurate and comprehensive records which are maintained by staff at all levels; - referral information, initial and multi-disciplinary assessments, initial and review case conference minutes, case plan; and - evidence of professional opinions, action and decisions which are carefully detailed and properly endorsed at each stage of the child protection process. 4.5 There is evidence within the child s case file that records: are regularly agreed and signed by the line manager; are reviewed, signed and dated by senior management; and demonstrate that information is exchanged both verbally and in writing between disciplines and relevant agencies as appropriate and in a timely manner. 4.6 Child protection procedures are applied consistently and effectively so that practice conforms to regulations, guidance, policy and procedures. Strategy Discussion 4.7 Strategy discussions are held in accordance with guidance in Co-operating to Safeguard Children (Paragraphs 5.16-5.19) and decisions and actions taken and the outcome of these inform the progression of the case and are reflected in writing in the case record. PAGE 151

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND Initial/Second Stage and Multi-Disciplinary Assessment 4.8 Assessments are carried out on a single agency and multi disciplinary basis and are consistent with the principles of the Children Order and Co-operating to Safeguard Children and the Draft Child Protection Standards. These contain an analysis of the needs of the child, parenting capacity and family and environmental circumstances and indicate a clear direction for current and future work. 4.9 Assessments bring together all aspects of the case at each stage of the process and are based on: established and relevant research; current professional practice; clear information from the child and family; a partnership with children and parents; identified needs and risks for the child; identified strengths and capacity of the parents; and professional knowledge and expertise of other relevant disciplines and other agencies communication and sharing of information. 4.10 Initial/second stage and multi-disciplinary assessments are carried out within the time frame established in Co-operating to Safeguard Children and the written document shows: how identified issues in the case are being dealt with; how a work programme is being developed and who is responsible for carrying out each element of it; what are the intended outcomes and by whom; remaining risk/and actions taken to manage it; what services are being provided alongside the assessment process; and next steps and actions required. Initial and Review Child Protection Case Conferences 4.11 Initial and review Child Protection Case Conferences are held in respect of children who have suffered significant harm or where there is a likelihood that this has or is likely to occur: PAGE 152

Child Protection Case Conferences should: - be chaired by a senior manager who should fulfill the responsibilities detailed in Co-operating to Safeguard Children (Paragraphs 5.47 and 5.56); - be held within 15 working days of the first strategy discussion; - have relevant professionals/agencies invited in attendance; - involve the child and family; - have written reports invited and have the range of information available to enable appropriate decisions to be taken; - complete the tasks identified in Paragraph 5.59 Co-operating to Safeguard Children ; and - be conducted according to Co-operating to Safeguard Children and ACPC procedures. Child Protection Case Conferences have in attendance a person trained to take minutes of the meeting and these should include: - a record of invitees, those who attended, or sent apologies, or those who did not attend; - a list of all reports considered by the case conference; - a summary of the essential facts of the case; - a summary of views expressed and analysis of information; - a record of all decisions reached including any dissenting views; - actions to be taken, by whom and timescales for each action; and - minutes and or summary of decisions taken should be circulated within 14 days of the conference being held. Child Protection Plans 4.12 Child Protection Plans are drawn up as defined by Co-operating to Safeguard Children and the ACPC written procedures, agreed with those involved, and copies are provided to the workers involved, to parents/carers and children as appropriate. 4.13 Children and families are advised of, and helped to understand, the purpose and outcome of assessment, care planning, case conferences, review processes and receive a copy of the completed assessments and Child Protection Plan. They are actively encouraged to participate in the process and experience it as increasing their understanding of the child s/family s needs. PAGE 153

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 4.14 The Trust ensures that: each child whose name is on the child protection register has a named social worker allocated; the allocated social worker duties include co-ordinating the contributions of other disciplines and agencies to achieve the completion of tasks identified in the child protection plan; and there are mechanisms for resolving difficulties when tasks are not carried out as defined by the agreed Child Protection Plan. PAGE 154

5. PROTECTING VULNERABLE CHILDREN IN SPECIFIC CIRCUMSTANCES STANDARD 5 The Board/Trust, in co-operation with other providers and services, has effective arrangements in place for the protection of children in groups known to be vulnerable and in specific circumstances. Criteria 5.1 The ACPC policies state that child protection procedures apply to all settings where children live or meet. 5.2 There is operational guidance for all staff in respect of children who have been subject to: sexual abuse; physical abuse; emotional abuse; and neglect, including failure to thrive. the guidance takes account of specific conditions or circumstance, such as: children living away from home 60 ; disabled children; risks to the unborn child; children where a parent/carer is misusing drugs/alcohol; child prostitution; induced or feigned illness; children who abuse others; bullying; ethnic minorities; domestic violence; parents with a mental illness; parents with a disability; and under age parenthood. 60 Children looked after in care, either foster care or children s home for respite, short term or long term; children staying with host families on exchanges/holidays; children in residential or boarding schools; and children in youth justice custody settings. PAGE 155

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 5.3 Staff from all disciplines/programmes of care within the Trust and related agencies demonstrate an understanding and awareness of child protection guidance in their practice. 5.4 Where there is a concern about child abuse: actions required are clearly defined; processes are applied consistently, irrespective of setting; and there are mechanisms in place for providing feedback to the relevant disciplines involved. 5.5 The Trust treats seriously any complaints or allegations of abuse to a child by a professional, staff member, carer or volunteer/or child and adheres to DHSSPS guidance and the ACPC child protection procedures in dealing with such allegations. 5.6 All investigations of child abuse are conducted according to the ACPC child protection procedures. 5.7 There are systems in place for centralising information and collating concerns about children and families arising at different times and in different places. PAGE 156

6. QUALITY ASSURANCE AND MANAGING PERFORMANCE OF SERVICE STANDARD 6 Child protection services respond to the needs of children and their families, operate to high standards, conform to regulations, guidance, policies and procedures and are monitored and audited by the Board/Trust, ACPC and CPP. Criteria 6.1 The Board/Trust ensures there is leadership and responsibility for the management and co-ordination of child protection services within its overall children s services strategy. 6.2 The Board/Trust ensures that, where services are provided on a partnership or commissioned basis, there is a mechanism in place so that: children and families eligible for child protection services receive a skilled multidisciplinary assessment, which looks holistically at the child s circumstances and includes health and development, education and social needs and the wider family and environmental context; and services are managed, audited and monitored to ensure that they are of good quality and responsive to need. 6.3 The Board/Trust ensures that those receiving and those seeking a service at all times are treated sensitively and with respect and employers and employees adhere to professional codes of conduct and practice. 6.4 There are effective systems in place so that service users know whom they can contact about queries, comments or complaints, advice and advocacy services and these are audited and monitored. 6.5 Management information is collated and monitored and responded to in ways which improve services to children and families. PAGE 157

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 6.6 The Board/Trust in conjunction with the ACPC and CPP ensures that they have in place: a means for staff to provide feedback on the usefulness of guidance and procedures; and a means for those who use services to provide feedback on the standard of service received. 6.7 The Board/Trust ensures that staff and carers working to safeguard children are supported appropriately through proper induction training and ongoing supervision, and have available to them adequate support services and resources. PAGE 158

7. THE ESTABLISHMENT AND OPERATION OF THE AREA CHILD PROTECTION COMMITTEE (ACPC) AND THE CHILD PROTECTION PANEL (CPP) STANDARD 7 The Boards/Trusts exercise their respective lead responsibilities for the establishment and effective working of ACPCs and CPPs as detailed in Cooperating to Safeguard Children. Criteria 7.1 The ACPC is constituted as required by Co-operating to Safeguard Children and has appropriate representation from relevant agencies, at an appropriate level of authority. 7.2 The ACPC has a strategy for child protection in its area, a business and action plan and terms of reference, which are agreed and fully owned by all disciplines and agencies involved in the safeguarding of children. 7.3 The ACPC has developed and implemented policies, procedures and information, agreed by agencies for interagency/disciplinary work, within the framework provided by Co-operating to Safeguard Children. 7.4 The ACPC sets objectives and performance indicators for safeguarding children and has established guidance which takes account of the multi disciplinary/interagency contribution. 7.5 The ACPC continually monitors and reviews child protection activity in its area, identifies how professional services and agencies work together and bring learning points and needs to the attention of CPP and agencies involved. 7.6 The ACPC, in conjunction with the CPP, actively engages and informs the community of the need to safeguard children, and has in place a strategy to ascertain views and explain how the community can contribute. 7.7 The ACPC actively addresses issues of diversity and equality and actions are taken where necessary to ensure these are addressed. PAGE 159

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 7.8 The ACPC undertakes Case Management Reviews and a regular programme of auditing in accordance with guidance in Co-operating to Safeguard Children (ref 8.2). 7.9 The ACPC has in place and implemented a strategy for multi-disciplinary/agency training based on the child protection process, and the identified needs of all levels of staff involved in child protection work. 7.10 The ACPC has policy and procedures for access to and use of information entered on the child protection register and can demonstrate the effectiveness of the stated arrangements. 7.11 There are effective mechanisms in place for the ACPC to ensure that: the Board/Trust complies with their governance and corporate responsibilities for safeguarding children; the CPP informs the Board/Trust about child protection issues and developments in its area; staff are assisted to build into their work, ways of measuring outcomes for children and families; and the ACPC gains feedback from staff at all levels within agencies, including comments from children and families. Trust Child Protection Panel (CPP) 7.12 The Trust CPP membership reflects the range of professionals and agencies involved in safeguarding children in its area. 7.13 The Trust CPP has developed terms of reference and carries out its activities within the framework provided by the ACPC business plan. 7.14 The Trust CPP in partnership with the ACPC actively monitor and address: how services in its area work together to safeguard children; how objectives set to improve outcomes for children are progressed; the implementation of child protection policies and procedures; the resources needed in its area; the use of, and access to the child protection register; and PAGE 160

training and development needs of those working to safeguard children, and design and deliver training which meets identified need. 7.15 The Trust CPP in partnership with the ACPC actively informs the public of the need to safeguard children and provides information about the range of services which are available. PAGE 161

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 8. CASE MANAGEMENT REVIEWS STANDARD 8 The ACPC conducts Case Management Reviews under Co-operating to Safeguard Children Chapter 10 and ensures that outcomes effectively inform practice at all levels. Lessons are communicated clearly to all those who need to know and changes are implemented, audited and reviewed to maximise the safeguards provided to children. Criteria 8.1 The ACPC has a policy and procedures for undertaking Case Management Reviews. 8.2 The ACPC ensures that the preparation and process for Case Management Reviews is carried out in accordance with Co-operating to Safeguard Children and any policies and procedures developed are in line with the policy guidance (ref 7.8). 8.3 The ACPC ensures that the Case Management Review Panel is made up of individuals who are independent of HSS Trusts and other agencies concerned with the case under examination and includes the range of relevant disciplines and agencies required to carry out the review to achieve impartiality, openness and independence. 8.4 The ACPC ensures that the Case Management Review Panel has terms of reference and that a plan for progressing the work is drawn together, which meets the guidance in Co-operating to Safeguard Children and addresses the specific issues in the case. 8.5 The ACPC ensures that the Case Management Review is completed within the timescales established by Co-operating to Safeguard Children. 8.6 The ACPC ensures that: the Case Management Review Report addresses relevant issues and is presented in the format prescribed by Co-operating to Safeguard Children ; there is a plan constructed for the dissemination of lessons emerging from the Case Management Review Report which includes all relevant agencies and professionals at all levels within relevant organisations; PAGE 162

the plan includes a process for reviewing and auditing how changes implemented have improved outcomes for children and how this will be disseminated; and the Case Management Review Report and plan is shared with DHSSPS within the timescale established by Co-operating to Safeguard Children. 8.7 The ACPC has a system in place to follow up recommendations contained in the Case Management Review Report to ensure that its recommendations have been acted upon and progress has been achieved. PAGE 163

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND 9. EQUALITY AND HUMAN RIGHTS STANDARD 9 The Board/Trust fulfills its statutory duties in respect of human rights and equality legislative requirements. Human rights and equality principles are integrated into practice within all aspects of child protection services Criteria 9.1 The rights of children under the UN Convention on the Rights of the Child and the Human Rights Act are respected, valued and promoted. 9.2 All relevant policies have been subject to appropriate screening and consultation in accordance with Section 75 of the Northern Ireland Act 1998. 9.3 The age and stage of development of children, their disability, religious belief, gender, sexual orientation, political opinion and racial group are recognised and respected when consulting with children and in the planning and delivery of service. 9.4 There is consideration and respect for the diversities arising from differing cultural and community identities and there is consideration of these in the provision of services to children. 9.5 Appropriate assistance is provided during interviews, assessments and meetings which include access to interpreting services to enable the views of children, parents, family members and other carers to be communicated fully, where English is not their first or competent second language. 9.6 Child protection services demonstrate that the wishes and feelings of children are ascertained and considered in actions taken on their behalf. 9.7 Services are delivered equitably across Board and Trust areas. PAGE 164

NOTES PAGE 165

OUR CHILDREN AND YOUNG PEOPLE - OUR SHARED INSPECTION OF CHILD PROTECTION SERVICES IN NORTHERN IRELAND NOTES PAGE 166

Produced by: Department of Health, Social Services and Public Safety, Castle Buildings, Belfast BT4 3SQ Telephone: (028) 9052 0517 Textphone: (028) 9052 7668 www.dhsspsni.gov.uk December 2006 Ref: 154/2006