No good options?

Although it contains few surprises, there is a great deal that is important in the All Party Parliamentary Group for Children’s report of the Inquiry into Children’s Social Care in England, entitled No Good Options.

The report is nicely summarised in the Guardian.

Four main themes emerge from the report.

Firstly, the inquiry found that resources are not keeping pace with demand for services and that, as a consequence, early intervention services are being cut back. Children’s needs had often grown significantly before any support is put in place, resulting in more children being taken into care with the paradoxical consequence of higher costs being incurred as a result.

The report describes a very worrying national funding picture in England, a finding which is confirmed by the Local Government Association, which has warned that councils face a £1.9bn funding gap for children’s services by 2020.

Secondly wide variations in practice and spending between local authorities are noted. The inquiry found that rates of looked after children varied from a low of 22 per 10,000 of the population in one authority to a high of 164 per 10,000 in another. The local authority with the highest rate of looked after children had seven times the rate of the lowest. Likewise, it was found that local authority spending per child in need ranged from £340 in the lowest spending local authority to £4,970 in the highest. The inquiry was unable to establish the reasons for these variations and the report calls for research to discover the causes.

Thirdly, the inquiry found that high turnover of social workers and multiple care placements had a profoundly adverse impact on the stability of services and the quality of care. In some areas agency staff were found to account for more than 40 per cent of children’s social workers. Poor retention of children’s social workers was said to contribute to ‘churn’ in services.

Finally, the Inquiry found that children and young people’s participation in the services they receive was patchy. In many places children in care are not routinely involved in decisions made about them. In some cases, children do not know the reasons why they are looked after by the local authority.

While the report’s findings are sound and hard-hitting, its weakest section, in my view, is the one that considers what needs to happen next. The report’s recommendations to Government are peppered with anaemic phrases such as ‘conduct a review’, ‘incentivise investment in early intervention’, ‘strengthen duties’, ‘consult’, ‘commission an inquiry’, ‘develop a strategy’, ‘adopt a more flexible approach (to intervening in failing children’s services)’ and ‘establish a national program for developing senior leaders’. In stating the problems, the report pulls no punches, but the anodyne conclusions come as a considerable disappointment. It is almost as if the report’s authors had run out of steam.

I would have liked to see a real challenge to the Government on the issue of funding. It is simply not possible to continue to under-fund services while taking no steps to revise the offering or manage increasing demand. The inevitable result will be a thinner and thinner spread of provision with the eventual breakdown of services an ever-looming prospect. It doesn’t need a ‘review’ of funding to work that one out and the Government should not be pandered to on this issue. Rather ministers need to be confronted with the unsustainable situation they are creating and be challenged to change course urgently.

The issue of variations in practice and spending also requires urgent action to discover what is going on. Commissioning an independent inquiry into this issue, as the report recommends, sounds too much like kicking the issue into the long grass. And, although independent research may be useful, it is likely to take years to complete. The only route to a quick response to this issue is for the Department for Education and local authorities to take an urgent look at what is happening themselves and to put in hand actions to address the causes of the variation forthwith. If a motor manufacturer discovered huge variations in the quality of the brakes of its cars, it would not be satisfactory to suggest setting-up an independent inquiry and waiting a few years for it to report. The issue would need to be addressed immediately and with gusto. Children and young people in need of protection deserve no less.

Likewise, rather than the report’s ponderous recommendation of developing a ‘strategy’, there should be no delay in setting in-hand actions to reduce ‘churn’. It takes little reflection to list improvements which are likely to result in greater retention of children’s social workers, few of which are currently being pursued. Of great importance is ensuring that motivators, such as job satisfaction, recognition and opportunities for personal growth, are designed into social work jobs and nurtured in everyday practice. Absolutely crucial is attacking the blame culture, so that children’s social workers and others feel safe in talking openly about individual errors and service failures. That is a precondition of creating organisations which learn and improve rather than comply and atrophy.

And it takes more than a few nudges from central government to ‘incentivise’ local authorities to “… improve participation practices so that vulnerable children play a meaningful role in their care”. What is required is a fundamental change in culture which puts children and their experiences at the centre of service design, rather than prioritising management fads and government obsessions and clever wheezes thought up by clever people.

It is that little word ‘culture’ which is so starkly missing from the recommendations of this report. But thinking about how culture can be changed is the beginning of a journey to a place where there are some good options. Doing the right thing when resources are stretched painfully thinly is never easy. But inventive and responsive services, which place children’s needs and wants at the centre and adapt and learn, will cope much better with a harsh environment than heavy-footed, top-down-bureaucracies with their ethos of authority, compliance and blame.

Administrative Support for Child Protection Social Work

In the 1970s and 1980s social workers had more administrative support. I remember that in one job just one colleague and I shared a full-time secretary. I can still remember her bashing out my court reports on an elderly Imperial manual typewriter. We dictated our records into tape machines and she typed them up too. She also answered all incoming phone calls, booked appointments and dealt with callers if we were out of the building. I can’t say I ever found administration easy, but this arrangement made it very tolerable.

  

In recent times, it has become the norm in Britain for children’s social workers to provide much of their own administrative support. Records and reports are typed by social workers directly into computers. Correspondence, appointments, statistical returns and routine administration are often also the responsibility of practitioners. In 2009 researchers from Loughborough University [1] noted an increase in administrative and indirect activities undertaken by social workers and a shortage of administrative support. Other surveys have produced similar findings [2].

Most people who go into children’s social work do so because they want to work with people, not to do paperwork, computer work and other administration. Conceiving the social worker’s task primarily in administrative terms, as the architects of the Integrated Children’s System did [3], is a tragic mistake, which has untold negative ramifications for employee-motivation, organisational morale and the safety and quality of services.

So, it is music to my ears that the lessons of the past appear to be being learned, at least in Hampshire and the Isle of Wight. There an experiment has been undertaken with highly skilled administrators or PAs being assigned to social workers in a ratio of three social workers to one PA. [4]

This is said to have resulted in a decrease in the time social workers spend on administrative tasks (from 36% to 14%) and an increase in the time they spend with children and families (from 34% to 58%). It is also reported that there has been more than an 80% reduction in short-term staff sickness and decreases in stress levels experienced by social workers. The overall team environment is said to have improved. Not only that but the researchers conclude that providing social workers with PAs is very cost effective. They calculate that there are notional savings of about £9,000 per social worker because of reductions in unproductive time spent in undertaking inappropriate administrative tasks. It is argued that these savings are likely to increase over time because of lower rates of staff sickness absence and improved retention of social workers.

It is always gratifying when it turns out that doing things in the best way is also the most cost effective way. Children’s services managers should be learning from this research, not only taking on board its specific findings, but also embracing an overall approach which focuses on exploring how jobs like children’s social worker can be designed to make it easier for those who do them to do them well.

Notes

[1] Lisa Holmes, Samantha McDermid, Anna Jones and Harriet Ward. “How Social Workers Spend Their Time: An Analysis of the Key Issues that Impact on Practice pre- and post Implementation of the Integrated Children’s System” Department for Children, Schools and Families. Research Report DCSF-RR087 2009.

https://www.lboro.ac.uk/media/wwwlboroacuk/content/ccfr/publications/how-social-workers-spend-their-time-dcsf.pdf

[2] See for example reports of the survey conducted by the Northern Ireland Association of Social Workers in 2012: http://www.newsletter.co.uk/news/social-work-is-two-thirds-paperwork-1-4534431

[3] Sue White, David Wastell, Karen Broadhurst and Chris Hall, “When policy o’erleaps itself: The ‘tragic tale’ of the Integrated Children’s System”, Critical Social Policy, July 29, 2010, http://journals.sagepub.com/doi/abs/10.1177/0261018310367675

[4] Katy Burch, Colin Green, Steve Merrell, Viv Taylor and Sue Wise, “Social Care

Innovations in Hampshire and the Isle of Wight. Evaluation Report” March 2017

Department for Education, Children’s Social Care Innovation Programme Evaluation Report no. 23

https://www.gov.uk/government/publications/social-care-innovations-in-hampshire-and-the-isle-of-wight

Corbyn on Mandatory Reporting of Child Abuse

I was sorry to hear what Britain’s Leader of the Opposition, Jeremy Corbyn, recently said about the need for mandatory reporting of child abuse, albeit focused on child protection in sport.

http://www.itv.com/news/granada/update/2017-03-16/watch-jeremy-corbyn-supports-calls-for-mandatory-reporting-of-suspected-child-sexual-abuse-in-sport/

I agree that anyone who suspects child abuse and neglect should always report it. And I agree that this should be reflected in policy and guidance. But that is very different from the arguments of those who support mandatory reporting, who want to see a criminal offence of failing to report, backed by criminal sanctions, probably substantial sentences of imprisonment.

The most likely impact of introducing criminal sanctions for failing to report, targeted at people who work with children, will be to heighten the already prevalent culture of fear and blame surrounding working with child abuse and neglect.

I want people who have concerns about a child to feel free to discuss those concerns with colleagues and managers to determine what should be done in the best interests of the child. I don’t want professionals to be faced with a situation in which they feel that their first priority is to ensure that they themselves are protected from prosecution.

The reality of child abuse and neglect is that usually those who first notice it in a particular family or situation are never quite sure about what they are seeing. Can it really be that this child is being abused? Our natural first reaction is often “surely not”. At that point what is required is not the threat of prison if you happen to make the wrong decision. What is required is the right kind of support from people with more experience and insight to reflect on, and tease out, what is really happening. If then abuse seems to be likely, a referral can be made with confidence.

Imagine a teacher who discovers that a child in her class, about whom she has had no previous concerns, is being assessed for abuse and neglect. Will she feel free to speak openly about her past dealings with the child and family if there is a realistic prospect of her being prosecuted, especially if, as is often the case with the benefit of hindsight, things that appeared to have had an innocent explanation now turn out to be sinister? More likely she will resort to taking legal advice and where possible exercise her right to silence and, of course, that will do nothing to help the child.

And, if there is an inquiry into what went wrong in that case, will that teacher feel confident in cooperating fully with that inquiry and openly talking about what may be seen as her own mistakes and failings? If she risks punishment, I think not. The outcome will be that she will remain stumm and, as a result, important learning will not take place, the inevitable consequence of a culture of blame and fear.

Mandatory reporting, backed by the threat of criminal sanction, does not make children safer. It just gives those who want someone to punish when things go wrong some easy targets. 

Pay - how to dissatisfy child protection workers

Pay is what Herzberg called a ‘hygiene’ factor – a possible source of dissatisfaction but not a motivator.

https://en.wikipedia.org/wiki/Two-factor_theory

Whatever investment bankers tell you, you don’t get high performance simply by paying people lots of money. More important are factors such as job satisfaction, recognition and opportunities for personal growth.

But paying people badly can make them very dissatisfied. It can piss them off. It can convey a message that they are not valued. At worst, it can make it financially difficult for them to do the job, when their pay is less than they need to keep a roof over their heads or feed their families.

So a report from the Resolution Foundation makes for worrying reading.

It summarises the situation on public sector pay in Britain as follows:

“… the picture is similar in education, health and social work, and public administration (which covers most other roles). Indeed, on these projections average real pay in these sectors in 2019-20 would be lower than in 2004-05, meaning over 15 years of lost pay growth. In public sector education, real pay in 2016 was already lower than in 2003 and is now set to fall further, while health and social work could face a further 6 per cent real fall by 2019-20.” (page 4)

You can’t go on paying children’s social workers and other public sector workers involved in child protection less and less and expect it to have no impact. You can have all the recruitment campaigns you want, but you will not retain staff if you keep cutting their pay in real terms.

It’s a simple fact of life – it's not rocket science.

Stop blaming, start learning

You don’t need to go much further than a very interesting report in Community Care to see how the blame culture results in services which are less safe.

http://www.communitycare.co.uk/2017/03/16/social-worker-falsely-logged-visits-due-fear-managers-criticism/

A stressed and struggling social worker is reported to have falsified records in order to avoid being publicly named and shamed by her manager. Apparently, the manager circulated a group email to colleagues each week, listing all instances of work which had not been completed within the required time scales.

That blame and fear of blame are the primary enemies of safety is now a well-established fact. Civil aviation has taken this lesson to heart and has devised systems and practices to make it easy for people to talk about their mistakes and failings, so that things can be put right before disasters happen.

Any manager who creates conditions in which members of staff fear to report things going wrong is acting contrary to the interests of her or his organisation and, most importantly, to the interests of those to whom services are delivered. It isn’t just bad practice, it is dangerous practice.

A good introduction to how civil aviation thinking can inform safety debates in health and other fields is provided in a recent ITV programme. Trevor Dale, a former airline pilot, explains how the blame culture works against safety in the NHS. It is well worth half-an hour of your time watching it, if you haven’t done so already.

http://www.itv.com/hub/tonight/1a2803a1060

The overall message is clear: stop blaming, start learning. 

Mandatory Reporting in New South Wales

I am currently in Australia. Reading the Sydney Morning Herald this week I noticed an interesting article about mandatory reporting of child abuse and neglect.

It was reported that the Royal Commission into Institutional Responses to Child Sexual Abuse had heard evidence that the New South Wales child abuse hotline is “clogged” with almost half of reports made in 2016 not meeting the criteria for statutory action. One hundred child protection caseworkers were said to be necessary to handle reports of cases which did not meet the criteria for statutory action. Mandatory reporting was said to be part of the problem. The Royal Commission was told that mandatory reporters and staff of Child Wellbeing Units were reporting matters that didn’t meet the criteria for statutory action nearly 50 per cent of the time.

http://www.smh.com.au/nsw/child-abuse-helpline-clogged-with-less-serious-cases-royal-commission-20170307-gut2z1.html

Like most Australian states and territories, New South Wales has an established system of mandatory reporting in which professionals such as teachers, doctors and police officers have a legal obligation to report child abuse.

The experience here is highly relevant to the discussions which have gone on in Britain, since the death of Daniel Pelka, with many arguing that Britain should copy Australia in introducing a similar mandatory reporting approach.

The experience in New South Wales must give pause for thought. Britain’s child protection system is already under very great stress. To introduce a system that resulted in a significant increase in what appear to be unnecessary referrals would be a reckless step.

Ending the blame game

I liked the post on the Association of Directors of Children’s Services website by Ian Thomas, Strategic Director of Children and Young People’s Services at Rotherham Council.

http://adcs.org.uk/blog/article/tackling-blame-culture

Ian argues against the prevalent culture of blame in society and its ramifications for children’s services and concludes that blaming staff for service failures should only happen in a very small number of cases of clear ‘professional negligence’. He concludes: “No one comes to work to deliberately do a bad job.”

One aspect that Ian doesn’t mention is that a blame culture results in unsafe working. Where people are afraid to talk about service failures, and their parts in them, opportunities to learn from things going wrong are significantly reduced. And that means that members of staff and managers have fewer opportunities to create safer and more reliable services.

The only safe services are ones in which everybody involved in service delivery and support are not only willing to explore errors, especially their own, but are actively congratulated and rewarded for doing so.

OK, so more needs saying …

I was so relieved that the Government has dropped the so-called ‘exemption clauses’ that perhaps I got carried away. There is more to be said as LouiseTickle demonstrates so well in the Guardian. The most important thing to say over and over again is that improvement and innovation are possible without the clauses.

  

One approach, which Louise does not mention and in which neither Government nor the Association of Directors of Children’s Services has shown much interest hitherto, is Lean.

Lean was originally developed in manufacturing industry, but is equally applicable to services. Its fundamental idea is that it is all too easy to do things which do not contribute to adding value to a product or service. But doing things which don't add value must be avoided at all costs. 

Lean abhors unnecessary bureaucracy, waste, unnecessary overhead and re-work. Organisations become lean by thinking about how to get rid of those evils, usually through making small but frequent changes to business processes to eliminate them. Forms can be simplified, procedures streamlined and management processes simplified. Unproductive and poorly focused ways of working can be eliminated. All kinds of waste can be identified and reduced. Perhaps most importantly focusing on how value is added and thinking about how to reduce re-work are likely to result in higher quality services.

Rather than focusing on removing legislation to create space for improvement, as the Government had proposed, Lean children’s services would concentrate on getting rid of barriers to high quality services such as unnecessary forms and procedures, poorly designed IT, unfocused working practices (such as unnecessary meetings and unnecessarily complex procedures) and unproductive tiers of management. Every new working practice, and every proposed change to an existing working practice, would be scrutinised to determine exactly how it added-value and whether it could be done better in some other way.

Instances of re-work and other service failures (e.g. repeated investigations following re-abuse, re-assessments following a poor quality initial attempt) would need to be closely examined and scrutinised to determine what had gone wrong and how it can be avoided in future.

All staff would need to be steeped in a culture of abhorring waste and trying to focus all resources on providing value to children and young people and not squandering resources on unproductive overhead or inefficient or unnecessary practices.

Say no more ….

There’s no need for extended comment on the Government’s reported decision to drop the controversial exemption clauses. 

It’s simply very good news.

The Government’s proposals for children’s social worker accreditation – a good idea, but horribly flawed in the making

The Government is consulting on the proposed introduction of an accreditation system for children’s social workers.

https://consult.education.gov.uk/social-work-reform-unit/naas-consultation/

The plan is to introduce a national post qualification specialism in child and family social work comprising three levels of seniority: the child and family practitioner, the practice supervisor and the practice leader. The specialist knowledge and skills needed to undertake each area of social work successfully are set out in three documents, one for each ‘level’.

https://www.gov.uk/government/publications/knowledge-and-skills-statements-for-child-and-family-social-work

The Government expects all child and family social workers to become accredited over time and promises to work progressively with employers to achieve this.

You can respond to the consultation yourself by 14^th March.

I am in favour of having post qualification specialisation and accreditation in social work,

but – and it is a very big BUT – an accreditation scheme has to be well-thought-out. It has to be well-designed and well-executed. It must result in practitioners who are more knowledgeable and more competent. It must clearly contribute to improving quality and safety of services. I don’t think that the Government’s proposals describe a scheme like that. Let me explain why.

A good post qualification accreditation scheme begins with analysis of the gap between the knowledge and skills conferred by basic training and the knowledge and skills required to deliver high quality and safe services in the most challenging of circumstances. What more does a highly experienced practitioner need to know to practice at an advanced or specialist level? This gap analysis needs to be detailed and thorough, setting out clearly and meticulously the required competencies for advanced or specialist practice and the results of a rigorous training needs analysis. The resulting accreditation scheme should set clear performance expectations for children’s social workers and provide a clear direction for learning new skills by setting out the major tasks which are required of children’s social workers immediately following qualification and subsequently at the two higher levels.

Unfortunately, the Government does not do this. What it gives us are the ‘knowledge and skills statements’ which are only loosely connected to tasks and which are general, sometimes vague and sometimes obscure. They come with no real explanation about how they were agreed and appear to have been conjured out of nowhere, a rather amateurish and essentially arbitrary listing of stuff which seems relevant to somebody. It’s the kind of thing you might get from a brainstorming session with a few bright but not necessarily knowledgeable people. Not bad for half-an-hour’s effort, but not definitive and not authoritative.

Not only does the Government provide no real detail about where these lists came from, it provides no proposals for how these knowledge and skills lists can be reviewed, improved and kept up to date in future. This is a serious failing since there is a real danger of these poor-quality lists becoming fixed in stone and becoming of decreasing relevance as time goes by.

Connected with these problems is the issue of ownership. The Government’s whole approach to accreditation is one of imposition rather than enabling. What will be tested, and how, have been decided by a small groups of government insiders, doubtless clever people but hardly representative of the profession. In contrast, post qualification training in medicine is a matter for the relevant Royal Colleges, whose members are themselves practitioners: paediatricians or anaesthetists or surgeons or psychiatrists etc. Inevitably the imposed system which the Government proposes for children’s social work, with control being vested in Government ministers and civil servants, will be at risk of being open to bureaucratic and political pressures rather than professional ones. And it risks alienating children’s social workers, by not involving them in choices about how their careers can be developed.

Although there is some information about the form of the proposed accreditation tests, I was unable to gain a clear impression from the consultation document and associated materials what the content of the tests will look like or how it is to be determined. What seems to be missing from the consultation document, in addition to the absence of a training needs analysis, is any account of curriculum. It is almost as if the Government has started from the premise that children’s social workers should be tested, rather than from the premise that they should be properly trained.

It is all too easy to make up tests for people to take, but the crucial question is whether the test is necessary to determine whether they have the requisite knowledge and skills to do the job. Nowhere in the consultation documents could I find any discussion of that issue.

Finally, the Government seems to have little to say about how post-qualification training can be evaluated and improved over time.

So, to summarise, a good approach to accreditation will have the following features:

• A clear understanding of the major tasks undertaken by advanced or specialist practitioners
• A clear understanding of the competencies required to deliver those tasks
• A clear understanding of the gap between those advanced or specialists competencies and those conferred by basic training
• Clear ownership of the scheme by the profession
• A well-structured curriculum, designed to equip practitioners with the knowledge and skills they require for advanced or specialist practice
• A mechanism for reviewing the relevance of the curriculum to the changing task environment, and updating as appropriate
• A mechanism for reviewing the effectiveness post qualification training and the accreditation system

Most, if not all, of these features are absent from the Government’s proposals.

A final thought. I was disappointed to see no mention in the consultation document of non-technical skills and knowledge. How well and how safely children’s social workers practice depends on their knowledge or child development, child abuse, the law relating to children, social work methods etc. etc., but it also depends on people’s skills and knowledge of how to work safely, how to understand error in the workplace, how to analyse and improve one’s own safety skills and how to analyse and develop practice to improve continuously the quality of service. Those are non-technical skills but sadly they are ones the Government seems to be currently ignoring.