State abuse?

There is something deeply shocking about the proposals from the UKBA (UK Borders Agency) to take dental X-rays of asylum seeking young people in order to determine if they are children or adults. http://www.guardian.co.uk/uk/2012/mar/30/uk-border-agency-x-rays-asylum-seekers

I don't know enough about anatomy to know if the technique is reliable, but I do know that X-rays can have very harmful side effects and should be used on people only under medical supervision and if clinically strictly necessary.

I see that on this issue I am in good company. All Four UK Children's Commissioners, the medical and dental professions, the Immigration Law Practitioners' Association and the former chief medical officer, Sir Liam Donaldson, have all warned that such checks are potentially harmful and may, in fact, be an illegal violation of children and young people's rights.

The UKBA is under a statutory duty to safeguard children and promote their welfare. It is intolerable that the agency should arrogantly cast aside its responsibilities. Administering X-rays without medical supervision could be an assault, even if the person in question has 'consented' to the procedure. I would like to see any public official found to have irradiated a child or young person in this way made to face the full force of the law.

Gove on Edlington

I was quite impressed by the letter written by the Secretary of Sate for Education, Michael Gove, concerning the Serious Case Review of the Edlington tragedy. That is the case in which two boys attacked two other boys, causing serious injury.

Gove is not impressed by the overview report of the Serious Case Review, the publication of which he has ordered. I found that there was far too much redaction in the published report for me to make a sound judgement about its quality, but I do think that Gove has a point when he says: “It documents everything that happened but with insufficient analysis of why and what could have been done differently.”

That was not, however, what I found impressive. Rather the following extract from Gove’s letter seems to me to be spot on:

“I do not want these reports to be used to assign blame where terrible incidents have taken place. People working in these circumstances need to have confidence that they will be backed by their managers when they take difficult decisions with good intent and sound judgement, whatever the outcome. Publishing factual information about serious incidents helps ensure that all the lessons are learned, nationally and locally, to reduce the risk of repeating mistakes. This will not only help people working at the front line; it will also give the public greater confidence. We want an open, confident, self-regulating system where professionals are continually asking how they can improve rather than a system clouded by secrecy and fear.”

I would like to pin that up somewhere, and I only hope that when, or if, another tragedy occurs Michael Gove will stick to these ideals without flinching.

Sadly Doncaster council is reported to be taking disciplinary action against five members of staff over the Edlington affair and has referred one former employee to the General Social Care Council.  It also resisted the publication of the overview report.

Not much evidence of an end to the blame culture there!

A Procedural Bloodbath?

A ding-dong row appears to be brewing concerning the revision of the procedural document 'Working Together’. Camilla Pemberton, in Community Care reports that there are fears that a “slaughter” of procedures is about to take place, with the suggestion that the professional advisory group, charged with revising the document, and the Secretary of Sate, Michael Gove, are determined to cut the length of the present document (just less than 400 pages) to 60 or even to 10. http://www.communitycare.co.uk/Articles/28/03/2012/118112/fear-over-plans-to-slaughter-child-protection-guidance.htm

Liz Davies, of London Metropolitan University, and Nushra Mansuri, professional officer for the British Association of Social Workers (BASW), are mentioned as being opponents of such drastic pruning of 'Working Together'. Davies is quoted as saying that it would be “extremely dangerous” and Mansuri argues that “core child protection guidance” cannot be taken out.

On the other hand, I am on record as having condemned lengthy child protection procedures and I strongly believe that Working Together in its present form is little short of a disgrace. http://chrismillsblog.blogspot.co.uk/2010/12/matter-of-procedure.html

But I agree with Nushra Mansuri that using a small group of ‘experts’ and civil servants to prune the document has not been wise. And I have considerable sympathy with her view  that the practitioner voice appears to have been effectively excluded from the professional advisory group. Perhaps, with the benefit of hindsight it would have been better to have set-up an advisory group to advise the Secretary of Sate on how to reduce child protection procedures, rather than to undertake the task directly.

It seems to me that the Government may go some way to salvaging the situation by ensuring that the consultation on the revised draft is conducted in a most through-going manner, and not, as is so often the case with Government consultations, seen as an opportunity for those opposed to the proposals to blow off steam before being ignored. The Department for Education must listen and be prepared to revise the draft document extensively if it is to maintain credibility.

Whatever way forward is adopted I remain firmly of the belief that 'Working Together' can be drastically pruned. I defy anyone to read (say) Chapter Five of the document (‘Managing individual cases where there are concerns about a child’s safety and welfare”) without being immediately struck by the sheer amount of verbiage in a document that should be strictly to the point.

Take section 5.5 for instance. This takes more than two pages to say little more than that work to safeguard and promote the welfare of children should be child-centred and informed by evidence and knowledge of child development. And the section is littered with high sounding but uninformative gobbledegook, such as the paragraph on page 134 titled ‘Holistic in Approach’, which contributes very little while using up a lot of space.

There is also a lot of unnecessary stuff about the Common Assessment Framework on page 138, which could be reduced to one line: if there is any doubt concerning a child’s safety make a referral to Children’s Social Care and discontinue the Common Assessment.

Then there are the pages (141-3) on the subject of underage sexual activity, which seem to sit oddly here and which go into unnecessary detail. So that it is not until Section 32 of the Chapter (12 pages in) that any discussion of the local authority’s response to a referral begins!

This stuff is not so much ‘procedures’ as an essay! And the sad thing is that for all their wordiness these procedures do not tell you some simple and important things, for which some sort of procedure would be a good idea.

For example despite the rant on underage sex, the Section on “Responding to welfare concerns where there is or maybe an alleged crime” (pp 140-3) gives no clear steer on how to distinguish matters in which the police only need to be involved (e.g. where a child has suffered a crime at the hands of a third party). And there is nothing to say what happens if a local authority refuses to act on a referral.

My approach to rewriting Chapter 5 would be to: (1) get rid of the verbiage, (2) simplify expression and eliminate ambiguity, (3) stick to the point and not get side-tracked, (4) make sure there were no significant omissions and (5) get in someone who knows how to draw process flow diagrams and eliminate the confusing five flow charts with which the Chapter concludes.

Even if the Government has gone about the process of re-writing 'Working Together' in a ham-fisted way, I would urge everyone to stick with the vision. Munro’s ideas are absolutely right. Procedural manuals that have been amassed as a result of risk-averse responses to various enquiries are not the way to go forward. Detailed procedural manuals are appropriate in some circumstances (for example where a piece of equipment or closed system has been carefully designed) but we are deluding ourselves if we believe that they make child protection any safer. On the contrary child protection is a very uncertain sphere. It does not operate like a well-oiled machine. That makes writing the rules in advance a pointless, and sometimes a dangerous, exercise.

How to rebuild trust

I was struck by an article in the Guardian by Dr Graham Dietz of Durham University about how to rebuild trust in businesses following a variety of corporate failures.

In particular Dietz makes reference to the impact of the Baby P tragedy, observing that following a major failure of trust, it is common to overreact by introducing new strict controls. He argues that revised child protection procedures can be “… so onerous that they may make detection of vulnerable children harder, and hit recruitment into the profession”.

Dietz’s and (co-author) Gillespie’s report (Building and Restoring Organisational Trust) ought to be compulsory reading for all policy makers and senior managers in child protection.

Poor support for family and friends carers

Research by the Family Rights Group and Oxford University’s Centre for Family Law and Policy, has found significant shortfalls in support for children who are being cared for by family and friends. http://www.frg.org.uk/

Nearly 500 carers, caring for more than 750 children, were surveyed. Ninety-five in-depth interviews were also conducted. In addition local and central government data was analysed.

Some of the main findings were:

• 44% of carers surveyed said they had received no practical help from their local authority
• 95% identified at least one form of support they had needed, but had not received
• 70% rated the support they received from their local authority as ‘poor’ or ‘very poor’

In addition it was found that:

• 76% of carers surveyed felt they did not have enough understanding of the legal options to make informed decisions
• 38% of the children living with family and friends carers suffered emotional and behavioural problems
• Two thirds of the carers had raised stress levels - twice the national average 
• 38% of carers exhibited high levels of stress

Care by family and friends is often seen often as preferable to foster care because it helps retain children’s links with their families. In some circumstances it can also be an attractive alternative to formal care proceedings, especially where a court has made a Residence Order or Special Guardianship Order.

Under-resourcing care by family and friends is clearly counter-productive. Breakdowns in family and friends placements result in more expensive foster care, so creating a vicious spiral. Local authorities and central government need to take steps to ensure that financial and professional support for this important resource is properly planned for and provided at an appropriate level.

Young people still having to leave care too early

I was sorry to read that Dr. Roger Morgan (the Children’s Rights Director) has recently found that nearly 50% of looked after children and young people say they have to leave care too early. A similar proportion was found to believe that they had been badly or very badly prepared for leaving care.

http://www.ofsted.gov.uk/news/50-say-they-have-leave-care-too-early

The survey found that some young people were leaving care as young as 16 years old. Shockingly one said: 'As a 16 year old I have gone from a children’s home to a women’s refuge. I have gone from having lots of support to having none.'

There is no clearer example of a resource shortfall. Young people are not being forced to leave care too early, or being badly prepared, because someone thinks that’s the right thing to do. Nobody believes that abandoning sixteen years olds is justified. The only reason this is happening is because there are not the funds to care for these young people properly. That is shocking in a so-called ‘advanced economy’.

The Impact of Munro

The Guardian takes a look at how the Munro recommendations are being implemented. 

There is a lot in this article about new management structures and new posts but not too much about changed practices. I know it is still early days but I think the implications of the Munro Review run very deep. It is not just about designating someone ‘principal social worker’ or even reorganising your services to resemble what they do in Hackney.

My view is that the real message of Munro is that effective child protection services can only be delivered by organisations that are willing and able to learn. Learning is inhibited by centralised policies, rules and regulations and, of course, by the dead hand of bureaucracy. But it is also inhibited by ‘expertise’.

Let me explain….

There is no shortage of reports, books and articles that set out new ways in which we can protect children. They are usually written by impressively qualified experts and are very good at saying what is wrong with the child protection system. However, when it comes to saying what must change, a hint of arbitrariness usually creeps in. We are counselled that such and such a reform is necessary, but the argument is invariably tenuous and the evidence is often obscure.

Meanwhile the people who actually do the work, and recognise and understand what is happening at the front line, are effectively sidelined and marginalised by the emphasis on the contribution of experts. A small, select group knows best and the majority of practitioners are there solely to implement the reforms, not to influence them.

However, the truth of the matter is that effective child protection is too complicated - and too important - to be invented by individuals or small ‘expert’ groups – whether they be groups of senior managers, inspectors or academics. Munro’s emphasis on organisational learning and professionalism implies that it is those doing the work who need to be the learners and the changers. Why? Because they are best placed to gather the evidence and to develop improvements.

What is not so clear in Munro’s approach, but which is very clear in my own mind, is that the learning and improvement needs to be small scale and continuous, not large scale and sporadic.

The history of quality management is littered with examples of organisations that have implemented huge one-off improvements, only to find that as time goes by the impact rapidly dissipates as the organisation reverts to traditional ways of working. On the other hand, where organisations empower their members to take charge of quality issues, and embed the expectation that each and every employee will strive to make small-scale improvements on a daily basis, the cumulative effect can be breathtaking.

So my hope is that the impact of Munro will be to encourage child protection organisations to devise ways of engaging each and every member of staff in discovering how they can learn more about mistakes and successes; and in coming up with ways of empowering those members of staff to translate their learning into concrete suggestions for achieving a perpetual stream of small-scale, achievable improvements.