Joint follow-through inspection of services
to protect children and young people in the
Angus Council area
February 2009
Contents
Page
Introduction
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1.
The inspection
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2.
Continuous improvement
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3.
Progress towards meeting the main points for action
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4.
Conclusion
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How can you contact us?
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Introduction
The Joint Inspection of Children’s Services and Inspection of Social Work Services
(Scotland) Act 2006, together with the associated regulations and Code of Practice,
provide the legislative framework for the conduct of joint inspections of the provision
of services to children. Inspections are conducted within a published framework of
quality indicators, ‘How well are children and young people protected and their
needs met?.’ 1
Inspection teams include Associate Assessors who are members of staff from
services and agencies providing services to children and young people in other
Scottish local authority areas.
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How well are children and young people protected and their needs met? Self-evaluation using quality
indicators, HM Inspectorate of Education 2005.
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1. The inspection
HM Inspectorate of Education (HMIE) published a report on the joint inspection of
services to protect children and young people in the Angus Council area in February
2007. Working together, services within the Angus Council area prepared an action
plan indicating how they would address the main points for action identified in the
original HMIE inspection report.
Inspectors revisited the Angus Council area in October 2008 to assess the extent to
which services were continuing to improve the quality of their work to protect
children and young people, and to evaluate progress made in responding to the
main points for action in the initial report.
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2. Continuous improvement
The Angus Executive Group for Child Protection and the Child Protection Committee
(CPC) took good account of relevant local developments and national strategy. The
CPC had continued to gather and make use of a range of management information
to inform its work and this provided a very effective basis for planning improvements.
Across services, managers had taken action to ensure better outcomes for children.
The structures for planning services for children had been reviewed and redesigned
to ensure better links with community planning. The links between the Children’s
Services Quality Improvement and Performance Management Group and the CPC
had also been strengthened.
Responsibility for child protection in NHS Tayside was clearer and the Child
Protection Action Group now reported to the Child Health Strategy Group. A
number of subgroups had also been developed to ensure consistency of practice by
health staff and to support continuous improvement across Tayside. A Nurse
Consultant for Child Protection had been appointed and this post was making a
positive impact. However, improvements in health services to protect children in
Angus were sometimes slow to fully implement as they relied too heavily upon a
limited number of staff.
Services worked well together and the CPC had assisted in the production of a
range of helpful policy and guidance. The CPC had strengthened its approaches
to self-evaluation and quality assurance. It had focused on the experiences and
outcomes for children and families. As a result, the CPC had established a good
understanding of the effectiveness of services to protect children across Angus.
The learning points from case reviews and audits had been turned into action
plans and communicated effectively to managers and staff through planned
training events.
A high priority was placed on consulting with stakeholders and in particular with
children and families who had first hand experience of services to protect children.
Notable improvements included the introduction of Viewpoint to gather the views of
children and young people to inform child protection meetings and to evaluate the
effectiveness of services.
The very effective measures to publish and disseminate high quality information to
the public had been sustained. A continued emphasis on raising public awareness
had ensured that members of the public and staff across a wide range of services
knew when to report a concern and who to contact. The CPC had recently
developed and launched an informative website about the protection of children.
A training coordinator appointed by the CPC had introduced a three year strategy for
child protection training. A very effective training programme had contributed
significantly to the improved competence and increased confidence of staff across a
wide range of services. The skills of staff to support and protect vulnerable children
had been enhanced.
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3. Progress towards meeting the main points for action
The initial inspection report published in February 2007 identified four main points for
action.
3.1 Develop clear and shared thresholds of risk to ensure that staff
consistently apply procedures for reporting and responding to concerns.
Good progress had been made towards meeting this main point for action.
There was an improved understanding among staff across a wide range of services
of their responsibilities to keep children safe. They were clearer about when and
how to report concerns. Guidance for staff on reporting concerns had been revised
and shared widely. Staff working with children had access to helpful advice to assist
them in taking action to protect children.
Staff held a better understanding of roles and responsibilities and took part in early
discussions when there were concerns about children. Increasingly, staff carried out
joint initial assessments, for example, through joint visits to see children and families
in their own homes. A number of inter-agency agreements had supported the
sharing of information. Joining up the dots allowed staff in different health
departments to share information about some children. Front line police officers
routinely used child concern forms to report incidents which placed children’s safety
and welfare at risk to the Family Protection Unit (FPU). This had achieved greater
consistency in assessment and ensured that the most vulnerable children were
identified quickly. Child concern forms were circulated promptly to other services,
ensuring all relevant staff had the information they needed. A range of multi-agency
meetings, including core groups, network meetings and the Pre-birth Allocation
Meetings (PRAMs) were used effectively to share concerns, agree risks and make
plans to meet children’s needs.
The CPC had arranged training which focused on risks to help staff develop their
skills in initial assessment and decision-making. These training events had been
very well attended by a wide range of staff and were evaluated very positively by
staff. Joint training had increased staff confidence and competence in identifying
children in need of protection and supported more effective joint working.
The social work service had established a new intake service to respond and assess
all new referrals. This had made a positive impact on clarifying roles and
responsibilities for responding to concerns about children. The intake service
provided a clearer and more direct route for staff and the public to report their
concerns about children. There was insufficient capacity within the intake service to
meet all of the demands placed on it. There had been delays in following up some
concerns, particularly when they were not clearly identified as needing immediate
action to protect children. Staff who had reported concerns to the intake service had
not always been kept informed about the action taken. Feedback to staff who
reported concerns about children from the out-of-hours social work service had
improved.
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3.2 Ensure the full involvement of health and medical staff in child protection
processes.
Good progress had been made towards meeting this point for action.
NHS Tayside was proactive in its work to increase the awareness and competence
of health staff in the protection of children. A planned approach to developing the
performance and practice of public health nurses had made a significant impact over
the last year. Public health nurses now worked across the 0-16 age range and had
an increased confidence in participating fully in child protection processes. School
nurses were very skilled and now targeted their service towards more vulnerable
school aged children. They operated all year round and supported the family
carrying out home visits when this was appropriate. Dentists had received child
protection awareness training and they were now making referrals about children for
whom they had concerns. Progress in providing training to General Practitioners
had been slow.
The Social Paediatrics Clinics provided a very effective and prompt referral route for
staff to obtain a health assessment of children by community paediatricians. These
health assessments included children for whom there were concerns about neglect.
A Looked After Children’s Nurse had been appointed to support the health of all
looked after children.
A very recent start had been made to introduce three-way Initial Referral Discussion
(IRDs) involving police, social work and health staff when a child protection concern
was received. Staff were unclear about the purpose of IRDs and how these
discussions would be carried out. Health staff were not consistently involved and
paediatricians were not routinely asked at an early stage to assist in the decision
about whether a medical examination was necessary, or, to form a view whether
medical treatment was required.
The arrangements for carrying out medical examinations had been improved. A
multi-agency procedure for medical examinations and a clear process for the
medical assessment of children who may have been abused had been implemented.
There was a sufficient number of paediatricians experienced, trained and able to
respond to enquiries and requests for medical examinations at all times. These
developments were not included in the revised inter-agency child protection
guidelines. The forensic medical examination service was unable to ensure that
joint paediatric forensic medical examinations were always carried out by suitably
trained and experienced doctors.
3.3 Improve the processes for assessment of need and ensure that children
who require compulsory measures of care are identified and receive this
when they need it.
Services had made very good progress towards meeting this point for action.
Policies, procedures and guidance on assessment of risks and needs had been
updated. Staff now had a high level of awareness of the importance of carrying out
detailed assessments. A variety of materials had been developed to assist staff to
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carry out high quality assessments of risks and needs. Increasingly, staff came
together in multi-agency meetings to jointly assess the risks and needs of children.
Dated lists of significant events were now completed routinely and used very
effectively to assist in identifying concerns, the accumulation of risks and to inform
assessments. Staff now based their assessments on the My World format.
Angus Council’s Social Work and Health Department had provided significant
funding to improve the skills of social work staff in the assessment of risks and
needs. A three year child protection training strategy for social workers had been
implemented. Social workers carried out comprehensive assessments of risks and
needs which were of a consistently high quality. Assessments were well written.
Staff sought and gathered all of the necessary information on which to base sound
analyses of the risks to children. All children on the child protection register now had
a comprehensive assessment carried out. This had improved the quality of planning
and decision-making about what they needed to help keep them safe. However, the
action plans for children in family groups did not always focus sufficiently on the
specific needs of individual children. There were examples of assessments which
took full account of the implications of historic sexual abuse. The social work service
had increased the number of reviewing officers to chair initial child protection case
conferences. These were now held promptly and within agreed timescales. A
systematic approach had been introduced at all multi-agency child protection
meetings to consider whether children required compulsory measures of care to
meet their needs. A framework for assessing kinship carers had been introduced
and this was beginning to improve the quality of the assessments of how children’s
needs could be best supported within their extended family. A joint approach to
assessment had yet to be developed.
3.4 Improve the recording monitoring and assessment by health practitioners.
Very good progress had been made towards this main point for action.
Separate recording systems for information about child health and family health had
been introduced for public health nurses. Health visitor’s records were now stored
systematically and were readily available to all staff who needed access. Children
and families who needed intensive intervention could now be easily indentified.
Staff were thorough in recording their contacts with children and families and the
quality of recording had improved significantly. There was no standard approach to
the structure of the records and there was still some variability in the quality of
recording.
Staff made more home visits to vulnerable children and families. The frequency
of visits was linked to assessments of risks and clearer plans to provide
appropriate levels of support. The monitoring of families who moved around the
local authority had been improved. These families no longer experienced
frequent changes of health staff associated with changes of address.
A stronger emphasis has been placed on staff supervision. All public health nurse
team leaders had been trained in the supervision of child protection work. Staff
now received regular supervision and found this to be helpful and challenging.
NHS Tayside had produced a draft policy with ambitious targets for supervision.
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Health visitors had begun to complete lists of significant events for all very young
children assessed as requiring additional and intensive monitoring. These were
also completed for all vulnerable children on transition to primary school. These
provided very useful information when responsibility transferred from health
visitors to school nurses. An assessment of health needs was carried out for all
families with new babies, children moving into the area and when a concern was
raised about school aged children. Health visitors and school nurses carried out
assessments based on the My World format and were generally well recorded.
Some action plans arising from assessments were limited and expected outcomes
were not always clearly recorded. Staff had received training on the new
assessment model but needed continued support and advice.
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4. Conclusion
The Angus Executive Group for Child Protection and the Angus CPC had taken very
effective action to implement the main points for action arising from the full
inspection.
Through the strong leadership of the CPC, services had continued to work well
together and were active and productive in improving the provision for children in
need of protection.
There were notable planned improvements. Examples included working with
families affected by substance misuse through the Montrose Demonstration Project
and central coordination of information and concerns about children by NHS
Tayside’s Joining up the dots project. A clear strategy for developing a shared
approach to providing support and assistance to all children who need it in line with
the Getting it Right for Every Child approach had yet to be developed.
Services were well placed to work together to continue to improve services to protect
children. As a result of effective performance shown by services in taking forward
improvements HMIE will make no further visits in relation to the inspection report
published in February 2007.
Jacquie Pepper
Inspector
February 2009
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How can you contact us?
If you would like an additional copy of this report
Copies of this report have been sent to the Chief Executives of the local authority
and Health Board, Chief Constable, Authority and Principal Reporter, Members of
the Scottish Parliament, and other relevant individuals and agencies. Subject to
availability, further copies may be obtained free of charge from HM Inspectorate of
Education, First Floor, Denholm House, Almondvale Business Park, Almondvale
Way, Livingston EH54 6GA or by telephoning 01506 600262. Copies are also
available on our website www.hmie.gov.uk.
If you wish to comment about this inspection
Should you wish to comment on any aspect of this inspection you should write in the
first instance to Neil McKechnie, HM Chief Inspector at HM Inspectorate of
Education, Denholm House, Almondvale Business Park, Almondvale Way,
Livingston EH54 6GA.
Our complaints procedure
If you have a concern about this report, you should write in the first instance to our
Complaints Manager, HMIE Business Management Unit, Second Floor,
Denholm House, Almondvale Business Park, Almondvale Way, Livingston
EH54 6GA. You can also e-mail HMIEcomplaints@hmie.gsi.gov.uk. A copy of our
complaints procedure is available from this office, by telephoning 01506 600200 or
from our website at www.hmie.gov.uk.
If you are not satisfied with the action we have taken at the end of our complaints
procedure, you can raise your complaint with the Scottish Public Service
Ombudsman. The SPSO is fully independent and has powers to investigate
complaints about Government departments and agencies. You should write to the
SPSO, Freepost EH641, Edinburgh EH3 0BR. You can also telephone
0800 377 7330 (fax 0800 377 7331) or e-mail enquiries to ask@spso.org.uk. More
information about the Ombudsman’s office can be obtained from the website:
www.spso.org.uk.
Crown Copyright 2009
HM Inspectorate of Education
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