Tuesday, 19 October 2010

Lean thinking in Solihull

On Monday 18th October 2010 the BBC Radio 4 Today programme had an interesting report by Andrew Hosken that detailed initiatives by Solihull Council’s to apply lean thinking to their systems for vetting foster parents.

The Chief Executive of the council said that a large part of the problem of slow and inefficient vetting of foster parents was found to be caused by custom and practice. Over the years steps had been introduced into the processes which were not strictly required, but which various people at various times in the past had thought to be helpful. As a result there was repetition and waste. Instead of getting it right first time it was more a matter of getting it right in the end.

The council has been working with consultants who come from an engineering background and who are introducing council employees to key lessons from Japanese motor industry practice.  The lean approach is applied to analyse business and professional processes: look for the value-adding parts of the process and avoid activities that consume time and resources that don’t add value. The emphasis is on avoiding duplication and waste and on ensuring that things happen at the right time, so preventing downstream delays. For example it was reported that by doing CRB checks early in the process, rather than late, unnecessary work could be avoided if they come back negative.

Back in September of last year - following a conference paper which I felt had fallen mostly on deaf ears - I wrote about the lean approach in this blog. I said that 

"....Lean is the deceptively simple idea that we need to devote our energies to those business and professional processes which "add-value" rather than to those which don't. Put at its simplest this means that resources should be directed so far as possible only to those activities which are strictly necessary to satisfy the needs we are trying to meet. In child protection terms this means activities which either prevent child maltreatment or which rescue children from it and meet their resulting needs; not administration, paper-work, recording or meetings.
"In the mid 20th century Japanese manufacturing companies realised that they were wasting time and resources on non-value-adding activities such as administration, in-process inventory and re-work. They developed an abhorrence of waste and gradually moved towards a situation in which all changes to the production system were vetted for their contribution to establishing a truly lean environment. In child protection work in Britain we appear to have moved in the opposite direction by developing ever more complex procedures and time consuming recording and IT systems. The amount of time that front-line staff are engaged in administration appears to have increased dramatically. Indeed it is hard to find any evidence that the impact of changes such as new procedures, recording and assessment systems on the ability of front-line staff to practice effectively have ever been evaluated.
"Becoming lean would involve child protection services rigorously re-assessing where value is added and where it is not. Procedures, recording systems and administration need to be re-designed to maximise the time available for direct value-adding work with families and children."
I'm glad to hear that the folks in Solihull have come to similar conclusions. They are likely to end up with a better service as a result.

There are strong moral and ethical reasons why we should embrace lean methodology in children's social work. The whole business of safeguarding children and promoting their welfare, and of acting in their best interests, involves us not only in doing the right things, and not doing the wrong things, but also ensuring that all the available resources go towards doing the right things, not other things which have no value for children and young people. Ethical child protection requires us not only to do no harm, but also to ensure that we do not squander scarce and valuable resources by doing things which make no difference.

If you are interested in reading more about Lean there is a very good account of how it can be applied in the public sector - and some of the pitfalls - which has been produced by colleagues at the Warwick Business School:

The Lesson of the Khyra Ishaq Tragedy

Welcome opportunities for travel in September and October have kept me away from the blog. But I have done some reading, in particular looking at the Khyra Ishaq Serious Case Review Report.

A crucial and very worrying part of the report focuses on the events of 19th and 20th December 2007. What follows is my prĂ©cis of pages 49 – 51 of the report.

On 19th December a child protection referral was made by the Deputy Head Teacher of the child’s school to Birmingham Children’s Social Care. The concerns expressed were that the child and a sibling had been taking food from other children’s bags and cramming food into their mouths. Both children were reported to be thin but generally clean and tidy. It was also reported that the child had been out of school following a meeting between school staff and the mother, after which the mother had been very hostile towards school staff.

The response by Children's Social Care to this referral was as follows:
  • It was stated that the Children’s Social Care team manager had recommended that the school education social worker and the school nurse should deal with the matter
  • It was also suggested a CAF (Common Assessment) was required, with the education social worker as the lead practitioner, even though the mother was uncooperative and hostile.
Later the same day, the Deputy Head spoke again to Children’s Social Care. Again s/he emphasised that this was a child protection referral and raised further concerns about the sibling cramming food into her/his pockets, loitering in the dining room and reporting feeling cold. S/he also stated that there had been a sudden change in the mother’s behaviour and described her as “concerned and agitated”. Again s/he was told that the recommended approach was for the education social worker to prepare a Common Assessment.

The following day, 20th December 2007, the Deputy Head again contacted Children’s Social Care, asking for an update on the referral. S/he was told that it was not being progressed and that an initial assessment would not be undertaken. Again the Deputy Head requested a home visit and was told that Children’s Social Care had decided not to proceed. The Deputy Head was not satisfied with this response and requested that the concerns be taken to the line manager. But s/he was told that the manager would not accept the referral and had suggested a CAF. The Deputy Head was told if the school remained concerned then the police could be contacted for a “Safe and Well” check. This was subsequently undertaken by West Midlands Police, who visited the home but were not admitted. Officers did however see the children on the doorstep and were reassured.

There is no doubt that crucial errors occurred at this point:
  1. The failure to accept what was clearly a child protection referral
  2. The ill-judged advice that a CAF should be completed, instead of a child protection assessment
  3. The ill-judged recommendation that the police should be requested to perform a Safe and Well check (these are checks generally performed by the police when children who have been reported by their parents as missing subsequently return home).
The report gives some context to these failures:
  • There was a history of high levels of vacancy in Birmingham Children's Social Care, with a vacancy  for qualified social workers of 14% when the report was written (June 2009).
  • Social care staffing per capita was 22% lower than the national inner city average. 
  • The Social Worker involved in the case had an excessive workload of 50 allocated cases.
We know generally that decision-making can be adversely affected by over-work and difficult working conditions. One can imagine - although the report provides no detail - that staff in a hard-pressed child protection team where trying to keep too many balls in the air. Any referral that could be marked "NFA" would be a welcome outcome. And we can imagine that a decision-maker in this case may have erred because s/he wanted this not to be a child protection case, looking perhaps for any details which would mean that it did not need to be allocated. The alternatives of the Common Assessment and the Safe and Well Check may have predisposed to turning down the referral.

There are two morals. The first is that over-worked teams cannot function safely. The pressure to increase referral thresholds is too great. The second is, perhaps, less obvious. While the Common Assessment Framework has been welcomed in many quarters as part of an early intervention approach, there has been too little attention given to how it operates alongside child protection inquiries. An inherent danger will always be that a CAF will be undertaken or recommended where a child protection assessment is required. Thought need to be given to how this danger can be reduced or eliminated.