Joint Interim Follow-through inspection of services
to protect children and young people in the
Moray Council area
1 October 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
3
4.
Conclusion
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5.
What happens next?
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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 Moray Council area in February
2009. Working together, services within the Moray Council area prepared an action
plan indicating how they would address the main points for action identified in the
original HMIE inspection report.
At the request of Scottish Government Ministers inspectors revisited the Moray
Council area earlier than planned in June 2009 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.
2. Continuous improvement
Elected members in Moray Council are committed to strengthening their scrutiny role
and had established a child protection sub-group of the Children and Young
People’s Committee. The Moray Chief Officer’s Group (MCOG) had participated
fully in a review of the effectiveness of the North East of Scotland Child Protection
Committee (NESCPC). The MCOG was taking a more outward-looking approach to
learning from best practice in other parts of Scotland. The Chief Social Work Officer
had established a team to lead on improving child protection practice on children
and families social work. Social workers were having more regular contact with
children on the child protection register (CPR) which helped trusting relationships to
be built.
Grampian Police had formed a Public Protection Unit combining services for child
protection, the management of sex offenders, domestic abuse and vulnerable adults.
This had provided new opportunities for responding more efficiently and effectively
to these areas of risk. Developments to the force’s information technology were
improving information-gathering and performance management. The co-located
police and social work child protection unit was now fully staffed and operational.
Joint working was starting to have positive benefits for service users.
The NHS Grampian Protecting Children Group had been re-designed and planned
improvements were being introduced. A consultant paediatrician from another
Health Board was assisting with a review of child protection practice in Dr Gray’s
Hospital. The paediatric services at the Royal Aberdeen Children’s Hospital and Dr
Gray’s Hospital were being combined into one service delivered from the two sites.
This was with a view to providing improved access to specialist advice and greater
consistency in practice standards. Actions to improve child protection arrangements
in health centres had been identified following a second audit by General
Practitioners (GPs) in the Community Health and Social Care Partnership (CHSCP).
The CHSCP was setting up a Health and Wellbeing School Project as part of a
national programme to re-design the school nursing service, and develop a
dedicated transition team and a healthy minds service. It was anticipated that these
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initiatives would make a significant contribution to improving outcomes for vulnerable
children.
3. Progress towards meeting the main points for action
The initial inspection report published in February 2009 identified six main points for
action.
3.1 Ensure that assessments of risk are rigorous and appropriate legal
measures are used, when necessary, for children in need of protection
Noticeable progress had been made in improving assessments of risk and the
appropriate use of legal measures to protect children.
Inter-agency, as well as social work, procedures for doing risk assessments of child
protection concerns had been strengthened. As staff were becoming more familiar
with these improved procedures, their confidence in making initial risk assessments
was increasing. Joint-training was being provided to staff working with vulnerable
children. Some important groups of staff working with parents of vulnerable children
had yet to complete this training.
Improvements in the initial gathering and sharing of information amongst staff across
services were helping social workers to improve the quality of risk assessments.
Practice was still variable. Health and education staff were encouraged to share
concerns about children at an earlier stage. When children were considered to be at
risk of harm staff were starting to take more immediate steps to manage or reduce
the risks before the initial child protection case conference. Social work staff were
carrying out checks more consistently before placing children with relatives and
friends.
The roles and responsibilities of staff when considering the use of legal measures to
protect children assessed as being at significant risk of harm had been clarified.
Social work procedures now made it clear that the final decision on making
application for child protection orders and other legal measures was the
responsibility of social work managers. The use of legal measures was being
considered at an earlier stage and staff were becoming more confident in using
these to keep children safe. More appropriate use was being made of child
protection orders and referrals to the Children’s Reporter for compulsory measures
of supervision. Operational managers across all services had yet to ensure these
new procedures were implemented consistently and firmly established in practice.
3.2 Fully implement agreements and guidance to ensure the effective sharing
of information
Encouraging progress has been made both within and across agencies in
implementing agreements and guidance to ensure information was shared more
effectively.
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Inter-agency training was increasing staff confidence in information-sharing. There
were early signs that staff were seeking and sharing information in a more
systematic way. Police consistently shared child welfare concerns with health and
education staff to raise their awareness of children at risk. Restructuring in the
CHSCP had improved information-sharing. Health visitors and school nurses were
becoming more involved in the gathering and sharing of relevant information with
other services. New appointments of a specialist nurse for child protection and a
children and families social worker in Dr Gray’s Hospital were having a beneficial
impact on practice.
A comprehensive action plan had been drawn up to improve information-sharing
amongst health staff. Standards for the assessment and transfer of children to the
Royal Aberdeen Children’s Hospital had been reviewed. A case note review was
being developed to evaluate information-sharing between Aberdeen Maternity
Hospital, community midwives and health visitors. The Pan Grampian Information
Sharing Protocol had been issued to NHS Grampian staff.
A helpful information-sharing guide had been issued to education staff, but was not
widely available to staff in other services. Housing staff were becoming more aware
of their roles and responsibilities to share information about vulnerable children and
families. New procedures to support the Getting It Right For Every Child (GIRFEC)
approach included clear arrangements for staff to seek consent to share information
from parents and young people. These had yet to be fully implemented.
3.3 Introduce inter-agency discussions to manage effectively the investigation
of suspected child abuse
Limited progress has been made in implementing inter-agency Initial Referral
Discussions (IRDs).
Inter-agency procedures had been developed to support IRDs. These were in draft
form and had yet to be approved by the MCOG. The work of the co-located police
and social work child protection unit was strengthening the response to child
protection referrals and the planning of joint investigative interviews. Social workers
were routinely carrying out checks with GPs, health visitors and school nurses.
However, there was no single point of contact in health from whom to obtain relevant
information on a child and the significant adults in their life. Health visitors, school
nurses, midwives and education staff were starting to participate in some IRDs. The
involvement in IRDs of a suitably trained and experienced paediatrician had yet to
take place. Practice in the completion of recently introduced IRD documentation
was variable.
3.4 Improve assessment, planning and decision-making for children whose
names are on the Child Protection Register (CPR)
Some positive steps had been taken to improve assessment, planning and
decision-making for children whose names were on the Child Protection Register.
Priority had been given to improving the quality of assessments of risks and needs in
child protection. A Risk Assessment and Management Manual for social workers
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provided a framework for assessing and managing child protection risks. The
Manual was clearly linked to inter-agency and single agency child protection
procedures. The advice had been supported by a series of training events for social
workers and staff from other agencies. There was improved risk assessment and
analysis in some reports presented to child protection case conferences and the
Children’s Reporter. Staff were beginning to have greater confidence in their
assessments.
Midwives, health visitors and school nurses had received support in producing reports
on children for child protection case conferences. There was now an expectation that
health assessment reports would be submitted to case conferences and a helpful format
had been devised for this purpose. The ante-natal care pathway had now been built
into child protection procedures and arrangements were underway to strengthen this
planning process.
Local Integrated Assessment Planning (LIAP) had raised awareness of the benefits to
vulnerable children of multi-agency approaches to assessment. However, in child
protection cases too much reliance was still placed on social work staff to gather and
analyse the information from individual agencies and draw conclusions. A joint
inter-agency approach to assessment of risk and needs was still at a very early stage of
development. The post of GIRFEC Inspector had been created by Grampian Police to
support the implementation of this approach. Not all staff were aware of the
significance of the information they held and how this could inform assessments of risks
and needs. As a result, assessments were not always based on all of the relevant
information.
Attendance at case conferences by staff from all agencies was much improved. School
nurses and drugs and alcohol staff now attended regularly and made a valuable
contribution to decision-making. Nurseries and schools were ensuring that they had
representatives available to contribute to planning and decision-making meetings during
holiday periods. Chairs of child protection case conferences were monitoring and
reporting on attendance. They now acted with the authority of the MCOG and this was
leading to improved challenge on the progress made with child protection plans.
Regular core group meetings were held, but attendance by staff from each of the key
agencies remained inconsistent. The extent to which core groups evaluated the
effectiveness of the child’s plan was variable. Planning was beginning to focus more on
reducing identified risks within specified times.
3.5 Increase the involvement of children in decision-making about their
lives and consult them on the development of services to protect children
There had been some very positive improvements to the involvement of children in
decision-making about their lives. More limited progress had been made in
consulting them on the development of services to protect children.
Information leaflets for children and parents about key child protection processes
had been revised and improved by the NESCPC. Children and parents involved in
joint child protection investigations now received informative leaflets about what was
going to happen. Following joint investigations, staff in the co-located child
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protection unit issued questionnaires to children and parents to learn from their
experiences. There was a high response rate and feedback was generally very
positive. Children felt listened to and understood why police and social workers
wanted to speak with them.
New procedures for assessment of risks and needs strongly emphasise the
importance of taking account of the views of children and parents. Staff across
services had found training on approaches to seeking children’s views helpful.
There were a few examples where children’s views were clearly recorded in
assessment reports. The number of children attending child protection case
conferences was increasing and their contribution was becoming routine. As a
result, meetings were becoming more child-centred. The minutes of meetings still
needed to clearly record the contribution of children and parents. The participation
of children in core group meetings had yet to be developed.
The post of a Who Cares? worker had recently been filled and a new independent
Child Protection Advocacy Worker for children in need of protection appointed.
Arrangements to provide children and young people with independent advocacy
services and to support them in using these were starting to improve.
There were some examples where services had involved children and families in
service development, however progress to ensure a systematic approach across
services was limited. The NESCPC had consulted children on the revision of
information leaflets. The NESCPC website had been improved following
consultation with school-aged children across Grampian. However, participation by
children and young people in the Moray Council area in these consultations was not
widespread. Health services were consulting with young people about the future
delivery of drop-in sexual health advice services. Children and young people had
yet to be consulted on the re-design of the school nursing service.
3.6 Improve the effectiveness of the NHS Protecting Children Group, the
NESCPC and the MCOG in protecting children and meeting their needs
Some early progress had been made in improving the effectiveness of the key
groups providing leadership and direction in protecting children and meeting their
needs.
Immediate steps had been taken to ensure that the NHS Protecting Children Group,
the NESCPC and the MCOG operated more effectively to deliver service
improvements. Helpful action plans were developed and agreed as a result of
improved partnership working. However, these were at too early a stage of
implementation to be able to show impact in protecting children and meeting their
needs. Revised child protection procedures were being monitored and new systems
and processes were under development. These provided a foundation for achieving
greater consistency and reducing risks. Senior managers recognised that sustained
effort was needed to drive forward cultural and practice change both within and
across services.
The NHS Protecting Children Group had set up various sub-groups with a wide
membership of staff from across health services, including practitioners, to plan and
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monitor provision. Management monitoring of responses to concerns about child
abuse in Dr Gray’s Hospital had been strengthened significantly. An audit of health
visitor and school nurse records across Grampian was about to take place. Case
supervision for health visitors and school nurses with responsibility for child
protection was being reviewed. A child protection training co-ordinator had been
appointed to deliver a child protection training strategy for health staff. Members of
the Health Board had helpfully discussed the NHS Grampian child protection
strategy, but this had yet to be formally agreed.
Following the findings of reports from inspections of services to protect children
across the three Council areas in Grampian, a review of the effectiveness of the
NESCPC had taken place. Options for building on current strengths and increasing
local accountability were being considered by the Chief Officer’s Group. The
process for conducting Significant Case Reviews was being strengthened. Methods
of seeking assurance that the learning from Significant Case Reviews was improving
practice had yet to be developed.
Management information was being developed by the MCOG and shared with the
NESCPC to monitor improvement. The MCOG had a shared vision of a co-located
child protection unit. They had started to take this forward with the aim of delivering
more consistent and effective help to children in need of protection. Plans for
purpose built accommodation to support this were being pursued actively. Positive
steps had been taken to improve the out-of-hours Emergency Social Work Service
by strengthening the role of duty managers and making information from the social
work electronic system more accessible. It was too early to show any impact of this.
Management information about the demand for services to protect children
out-of-hours was still unavailable.
4. Conclusion
Overall, encouraging progress has been made in a short time in tackling concerns
raised in the initial inspection report. There was an increased acceptance by senior
managers across services of the need to take collective responsibility for ensuring
necessary change and improvement. There were early signs of an increasing focus
on the quality of children’s involvement with child protection services and on
improving outcomes for vulnerable families. The NESCPC and MCOG recognised
that priority had now to be given to developing joint self-evaluation to improve
outcomes for children in need of protection.
There was a high level of commitment amongst staff to improving the life chances of
the most vulnerable children in Moray. They were adopting new ways of working
with staff from other services. Managers at all levels were becoming aware of the
longer-term challenge of sustaining improvement and building on this. They were
increasingly supporting and developing staff to improve practice further.
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5. What happens next ?
Within one year of publication of this report, inspectors will revisit the authority area
to assess further progress made in meeting the main points for action.
Emma McWilliam
Inspector
October 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 wish to comment about any of our inspections, contact us at
HMIEenquiries@hmie.gsi.gov.uk or alternatively you should write to BMCT,
HM Inspectorate of Education, Denholm House, Almondvale Business Park,
Almondvale Way, Livingston, EH54 6GA.
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 Services
Ombudsman (SPSO). 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: 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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