Education and Culture Committee

Meeting date: Tuesday, May 14, 2013

Official Report 727KB pdf

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Taking Children into Care Inquiry

Good morning. I welcome everybody to the 15th meeting in 2013 of the Education and Culture Committee. I remind everyone present that electronic devices, particularly mobile phones, should be switched off at all times.

Apologies have been received from Neil Bibby; Mark Griffin is his substitute. Welcome to the committee, Mark.

Item 1 is oral evidence in our inquiry into decision making on whether to take children into care. I welcome to the committee Professor Eileen Munro, who is professor of social policy at the London School of Economics and Political Science, and Professor Brigid Daniel, who is professor of social work at the University of Stirling.

The theme of today’s session is decision making in relation to neglect and permanence. Professor Munro recently conducted a review of child protection in England, and Professor Daniel recently co-authored a review of child neglect in Scotland. I expect that we will draw a number of lessons from today’s evidence session that will inform the report that we will publish later in the year.

Members should indicate if they have questions that they wish to ask the witnesses.

Good morning.

I want to ask Professor Munro a question that is probably very difficult to answer. The committee is wrestling with a problem. A number of stakeholders have said to us that there is a considerable need for consistency in decision making, but that does not always fit with the best interests of the child. I noticed that you said in your report that there was a bit of an imbalance between those things. Is having complete consistency across the board almost too much of an idealistic expectation, or can both things go together?

I can see the value of consistency in terms of justice and equity, but if a person is making decisions about taking action with a family, they have to be influenced by their local resources. If they are thinking about whether they should remove a child, the question is not, “Should I remove the child or not?” but, “Should I remove the child, or can I work with his family and give them extra services to make them safe enough?” There will be great variation in resources around Scotland; even with the best will in the world, that will happen. People will be off sick and there will be a shortage, or there will be no foster care placements. I do not think that consistency should be given such a high status relative to thinking about a certain child in a certain situation; otherwise we will end up with rather mechanical and impersonal decision making.

What can we do better to ensure that the child’s best interests are looked after across the board and that people who are working to try to help them understand that consistency is not necessarily the most important thing?

I did a review of the English system and know from the feedback that I got from Scottish social workers that life is not totally different here. I think that it is not quite as bad—that will make me popular here.

I will talk about social workers in particular, as they are the group that I know best. If we want social workers to focus on the best interests of the child, we must ensure that we do not tell them to focus on something else instead. In England, the reality had become that the priority was to please the inspection service rather than the child. The priority for a person’s use of their time was always to keep their records up to date and meet timescales, and the quality of their work was not very visible or appreciated. Over time, we have therefore deskilled and disempowered workers a great deal. Obviously, you are in a better position than I am to know how true that is in Scotland, but some simple and well-known ways of working with families that are more effective than others tend to be overlooked, and people end up with somewhat hostile, adversarial and bitter relationships with families that alienate those families over time, and they will not like to come forward for help.

The more we can help workers to become skilled in showing compassion and respect for people as well as authority about what parenting is acceptable or unacceptable, the more we can provide a service that is genuinely supportive, rather than a service that is a rather phoney cover for policing.

It has been put to the committee very strongly that the delay in taking some decisions is a significant problem. You mentioned that in your report. Do you have any evidence about what can make a difference to reduce such delays, and therefore ensure that things progress much more quickly for the child?

One of the things that happened in England is that we created timescales for little chunks of the process. There was an obsession with the assessment stage, but no one checked how people got on after that stage. That meant that—in an underresourced service—most of the energy went into the start of a child’s journey to receiving help, with less attention paid to the later stages.

I am very opposed to fixed timescales for all children. Children are varied, and people should look at the child rather than at a timescale. It would be a good idea for all those involved with a child to have easy access—for example, on their computer screen—to the length of time since that child first caused concern, so that everyone can be aware that people have been worrying about that child for six months, two years or whatever. To have feedback about how long a child has been living in undesirable circumstances would be a much better motivator for caring professionals than some artificial timescale thought up by a committee.

Would you say that the most important reason for delay just now is administrative difficulties?

There is also a problem with the expertise of the workforce. If people are not confident in their skills, they dither and delay, and avoid making decisions.

Professor Daniel, given your work in Scotland, do you have any comments on those questions about consistency?

I endorse everything that Professor Munro has said. It would be very difficult to say that we will have consistency. One of the things that people ask for is an agreed threshold for action, but I think that wanting a threshold is to chase a rainbow—it is just not possible.

What we can have is consistency of approach and consistency of the principles that underpin practice. For example, there could be consistency of attention to the developmental stage of the child and to the extent to which its development was progressing as one would expect. You might expect academics to say that we need more research, but I do not think that we do. We need a more concerted effort to put into practice the research that we already have, because we know a lot about the principles that are needed to underpin effective practice—particularly with the area of neglect, which feels intractable and difficult for practitioners. We know enough now to understand what is associated with authoritative practice and that has to be the key.

We need to combine support, warmth and empathy with clear boundaries about what has to change, by what time, and what will happen if there is no change, while keeping a real focus on the child’s development. In some ways that is quite simple, but in other ways it is quite complex, so it requires straightforward attention to the simple fact that the child’s life is pretty miserable and needs to be improved, with a willingness to tolerate the complexity of all the different factors that might be affecting that. We need all the different professionals to pull together in understanding that.

I would like your opinion of something that has come up in committee a few times, in particular when we spoke to young people who had been through the care system. It goes back to the issue of consistency in decision making. There are situations where a decision is taken to remove an elder sibling after a number of years in which they have been brought to the attention of professionals, yet younger siblings living in exactly the same parental home are left there. I know that a tension arises when we try to take each child in a family as an individual case, even though the difference between the responsibility and behaviour of the parents to each of those children does not seem to be great. What is your view about the tension between those two aspects?

The academic community has given that a name: the start-again syndrome. Marian Brandon has talked about that quite a bit. It is the tendency with each new child to think, “Now, here’s an opportunity.” When someone is expecting their next child, they often feel optimistic and think, “This time we’ll be able to make it work.” There is a tendency in the system to err too much on the side of not looking back at the history and the previous children who have been removed, and to be optimistic. Practitioners have to remain optimistic that people can change; otherwise, they would just give up and we would not have a social work profession.

I am not talking so much about situations where a child is removed and another child is born subsequently. I am talking about cases in which there are two children in the home.

And one is taken and one is left.

Yes.

A whole range of decisions will go into that. I can see how it might often be, and it might often seem, inconsistent. Partly, it depends on the extent to which people take children and young people’s own views into account. One of the difficulties of neglect is that children do not always know what they are not getting until they have a different experience, at which time they realise what they have been missing out on.

You have articulated the tension between treating each child as an individual and being sensible and consistent in decisions—and also looking at the potential fit, because if a child is being removed, there has to be a good place for them to go. That requires a very good alternative care system.

There are certainly times when it can be a sensible decision to leave one child and remove another, but there are also a lot of times when it is a sign of rather poor reasoning, either because not much attention has been paid to the other child and not much effort has been made to talk to him and find out the quality of his life, or because people think, “The older child has become extremely disturbed in his behaviour and he’s showing all the adverse effects of poor parenting. We’ll wait until the next one is equally damaged before we remove him.” Also, people can do it without considering what harm they will cause by separating the siblings. We need to consider the cost of that as well. There are times when it is a sensible decision, but there are a lot of times when it is a dubious decision.

Thank you.

A number of the young people to whom we spoke who have been through care talked about being removed from the home, allowed back, removed again, and then allowed back again under what people refer to as the rule of optimism, which Professor Daniel mentioned. They told us that they wished that a decision had been made once and for all at an earlier stage because they felt that they and their relationships were more damaged by that continual movement back and forth. How do we deal with that issue? How can we prevent that from happening?

Again, it is a question of the quality of the professional work. It depends whether they are returned home in the hope that things will go better or whether there is a plan to work with the family and monitor what is going on. Justice requires us to give parents a chance if we think that they have some potential to provide a home, because the child has a right to be with their birth family if possible. It is not just about the parents’ rights; it is also about the child’s rights.

Sometimes, we get that in-and-out pattern for good reasons. If there is a parent with a relapsing illness, the child might come into care every time the parent is chronically ill and has an acute phase, and then they will go back home again. However, it is often an example of poor quality assessment and a failure to make a firm decision and say, “That’s it.”

We want authoritative social practice, as Brigid Daniel said, but we also want that authority to be based on competence, not on ignorance. I think that we need to improve the workforce and allow it to operate at a skilled level rather than focusing on process and administrative details.

There are a couple of big research studies that back up what those young people are talking about. Elaine Farmer has done some research on reunification with children who have been removed from neglect, as have Jim Wade and his colleagues. Both those studies found a similar pattern: there is a tendency—not in all cases, but in some—for children to be removed from home and then returned to situations in which no one has done anything to fix the problem that led to the child’s removal in the first place.

10:15

Objectively, anyone would say that that is a silly system. If you are going to remove a child from a situation, you need to do something to fix the situation before they go back. Both studies identify good examples of factors that are associated with the system working better. They include making proper plans for returning home; not returning the child too quickly, and taking the time to do it properly; and paying close attention to the features that have led to the children going into care in the first place. Those features often include parental substance misuse and mental health issues, which need to be dealt with through skilled, focused and concerted efforts.

The other approach that shows some promise involves the family drug and alcohol courts that are being trialled. They deal with issues authoritatively, and say that they need to see something change before the child goes back. That approach is associated with things turning out a bit better more often, on the whole.

If we can focus on dealing with the features that have led to the problems in the first place, it is perfectly reasonable to remove the child for a while, work on those things and then return them home. However, things might have just drifted, so the children just vote with their feet and go or make it very difficult for their carers to continue to look after them. Elaine Farmer describes the difference between passive practice and authoritative proactive practice, which is much more to do with local authorities and their culture of practice than the characteristics of children and families. Everything depends on the quality of the systems and the people who are working in those systems in different authorities. It would be useful for the committee to have a look at some of the work in that area.

The cases to which I referred are not specifically to do with illness, although that depends on how we assess illness. A number of cases involved substance misuse and episodic events, in addition to continual mental health problems.

That links in with your comments about the deskilling of social workers. We have heard a number of times throughout our inquiry that social workers are not particularly engaged in the one-to-one preventative work and rehabilitative work that they may have undertaken historically. They are seen more as being the big baddie who comes along and does something bad to a family, and there are all sorts of issues around resources and the rest of it. Perhaps you can comment on that. Is that how social workers are now being seen? Do they still have that other role?

If social workers are given the chance, they have a lot of those skills, or at least the appetite to gain them. I have seen—not only in the United Kingdom but in other countries—that, if you turn the system upside down and say that the primary aim is not just to comply with the administrative process but to get to know the family well and help them to parent better, you will find a radical improvement in the number of children who can stay safely at home.

Work has been done on that as part of the Hackney model—I do not know whether you have heard of it. The London Borough of Hackney developed a radically new way of working with families by placing an emphasis on skilled engagement with them along with high-quality clinical supervision. The local authority has found that providing a much more intensive service to problematic families has meant that its overall costs have dropped because children can stay at home and there are no costs for removal, and the re-referral rate is also dropping.

Some other places are working with the signs of safety approach, which has a great deal of similarity with the Hackney model. Again, the emphasis is on getting to know the family and the extended family, and making it clear to them what is wrong with their parenting, not just by saying vaguely that they have mental health issues, but by telling them what that means for a two-year-old child and engaging their motivation. If the social workers can see that parents are not engaging, they will have to remove the child, but the signs of safety approach tends to lead to children being able to stay at home rather than being rereferred into the system.

The City of Edinburgh Council is using the signs of safety as well.

The picture is extremely mixed. A lot of social workers are doing a lot of brilliant work. The problem with preventive work is that we do not know that it has happened, because we do not hear about it as much. We are not very good at looking at where things are working well. I know from running a lot of post-qualifying provision that there are many social workers who are doing a great deal of creative work. I read a lot about the work that they are doing.

Part of the issue depends on the setting in which social workers work, so we need to think about the service and the profession. There are a lot of qualified social workers working in many different settings. Many social workers work in voluntary organisations delivering specialist support, which they do extremely well when they have the structure to do it. Part of the difficulty for social workers arises if they work in a setting that restricts their time to do that direct work, in which case the skills to do it become eroded, but there are many social workers who are doing it and, given the right opportunities—as Eileen Munro said—they can and want to do it.

In Scotland, there is a big push for early intervention and prevention to be delivered by the universal services. Whether we have enough health visitors is another issue, on which I am sure the committee has been lobbied separately. That is a strong and sensible approach, which involves reserving social workers for the heavy end. However, at the early stage we often need expertise in gauging the extent of the parents’ capacity and willingness to change, with the support that they are offered. Health visitors and teachers can offer a lot of extremely helpful preventive support, but they sometimes need the skills of social work to assess whether the parents will be able to change quickly enough for the child’s development.

We do not want too much of a split. We need the expertise of social work to be available across the board, rather than for things to be split by service and profession. Have I articulated that okay? Do you know what I mean?

Yes.

If we rely on health visitors and teachers to do all the supportive work, although a lot of the work that they do is very good, they might flounder a bit when it comes to a more in-depth assessment of capacity to change.

One of my recommendations in relation to the English system was that, rather than having to go through a 10-page referral form, people in the other services should be able to have a conversation about a concern with a social worker to help them to formulate their thoughts on whether the situation is worrying enough to ask for a deeper assessment. Instead of always thinking of moving families across into child protection, we should recognise that families want consistency of relationships and bring in the child protection component when it is needed.

I want to pick up on a point that Professor Munro made. She said that it is the right of the child to be with the birth parents. Does that not involve making an assumption that that is the best thing for the child? How much weight is given to that, as opposed to—

I said “if possible”. That is in the United Nations Convention on the Rights of the Child, and it is probably in the Scottish legislation, too. Of course there are times when that is possible and times when it is not but, to a degree, the state has a responsibility to try to make it possible. The United Nations guidance says that there should be support services for families as well as a reactive child protection service.

I was coming on to the issue of how much weight is given to that. In the past, we have taken evidence that has indicated that many social workers are relatively inexperienced in making such decisions, which often leads to what has been referred to as the rule of optimism. How much weight is given to the right of the child to be with the birth parents? How much is that influencing inexperienced social workers to follow the rule of optimism?

There is certainly a lot of evidence about the rule of optimism, although I am not sure whether it is limited to new social workers.

Society varies in the message that it sends. There are times when it says that a child should never be left in any danger, but it gets into a paddy when a lot of children are taken away. It is always a pendulum that we are trying not to let swing too far in either direction. The reality is that, if children are removed, a lot of mistakes will be made in removing children who could have stayed at home, but if the aim is to keep children at home, there is a higher probability that some of them will be harmed.

I am not keen on maligning social workers—

You have got the wrong people for that. [Laughter.]

I do not think that newly qualified social workers should be making decisions of that nature. They are the most fundamental, important decisions that can be made, and they should be made by very experienced people.

In previous evidence that we have taken, questions have been raised about the level and quality of training of social workers and the support that they get in making these decisions. Will you comment on that?

The places where I have seen fantastic improvements in the service that is given to families all have the feature of decision making being a group process and not the result of an individual talking to a supervisor in a rushed 10 minutes. The reclaiming social work model involves having a social work unit of five people including somebody with a clinical background in child and adolescent mental health services, so a good clinical component is included. If a group of people talk things through, between them, they can think of all the options, challenge all the evidence and do the kind of critical appraisal that we might get in a court of law. That is what is needed for such important decisions. Bringing in other voices and challenges is part of checking the quality of reasoning, and it makes it more likely that a good decision will be made.

I help to educate social workers and I think that we do not too bad a job. A combination of things is needed. Only so much can be fitted into a social work degree. What is really scary, and what we have to avoid, is what they are attempting to do in England, which is to slim it right back and have a much reduced, social work-lite kind of training. However, even with the best will in the world, we can only fit so much in.

A lot of the difference depends on the facilitating conditions. It depends on where people end up working and what support there is for continuing professional development. In places where on-going learning and development is supported, we see really skilled social work practice. Where that is restricted and where people are made to follow lots of guidelines, we see things closing in. As with all professions, the initial qualification is the start, and it is what happens next that makes a lot of difference to the quality of the practice that people develop.

In any case, it is not individual social workers who are making the decisions. They make recommendations but, as you know, there is a child protection investigatory system, which is a multidisciplinary system, and we also have the children’s hearings system. We often have children going through both of those. A range of different decision-making bodies comes into play in the area, and social workers have to work with children to navigate through the system. Sometimes, they are thwarted in the things that they would like to happen by some of the structures and systems.

We have touched on the importance of assessments again today. The panel that we took evidence from last week was consistent on that theme. Notwithstanding the risks that are associated with attaching too rigid timescales to how and when assessments ought to take place, they are clearly fundamental to the decisions that are subsequently taken. Last week, we heard evidence of cases in which complex assessments are made by people who do not necessarily have the experience to make them. Previously, we visited Glasgow to witness the New Orleans model, under which there is a far more joined-up approach to the way in which assessments are made.

Training and on-going professional development are clearly key to assessments, but do you have any recommendations about how we can improve the assessment process?

10:30

I made a point earlier about group supervision, which is a very good way to help fill in the gaps. Someone might say that mental health issues are involved—this really irritates me—and somebody in the group will ask, “What exactly do you mean? What illness? What behaviour does it produce? How does it affect the parenting?”

I do not know what kind of assessment forms you have in Scotland, but in England we have a Government-produced integrated children’s system, which has been very dysfunctional. It encourages people to put little blocks of data into different boxes on different screens, and people are surprised when they cannot pull the information together and get a full picture of the family. There is a lot of development work to be done around how technology can support, rather than hinder, good assessment. I am convinced that it could do a lot more to help people—to alert them when they have forgotten something and to ask them questions. Technology could be very useful, but so far we have used it more to gather data for management than to help practitioners think.

We have a very good assessment model in Scotland in getting it right for every child, which provides the basis for doing good, comprehensive assessments. We have the knowledge base, with the combined professional expertise, to undertake good assessments. We know that people often struggle with analysis, however. People are quite good at gathering lots of information, but the key is to take the time to work out what it actually means and to make sense of it. People need headspace time so that they can think it through and work out what it actually means.

Another difficulty is the tendency to reassess and reassess. An assessment can be a very good way for people to feel as if they are doing something, but it is a bit like writing lists. We have to tick things off the list and actually do them, and we sometimes get a bit stuck. There is an expression for that: assessment paralysis, where people get stuck in the assessment phase.

One of the challenges in the multidisciplinary field, which we will have to tackle when the Children and Young People (Scotland) Bill is implemented, is how to get different professions to trust one another’s assessments, so that each one does not feel that it has to reassess. For instance, a health visitor might do an initial assessment, and the people at social work might decide that they then need to do their own assessment. In the Highland pathfinder project, lots of work was done to overcome that problem. That was pretty successful: a single plan and a single assessment were developed and everyone agreed to work together on producing one assessment, rather than everyone doing separate, bitty ones.

There is a very good, evidence-based, structured assessment model and we have the components in place, but attention needs to be given to some of the nitty-gritty stuff about how to put things into practice and how to work collectively to do that.

As regards that collective work, are there issues that we should be concerned about in relation to the different approaches that the professionals involved take, either to the assessment or to the analysis that flows from that assessment? Do you need that creative tension in order to come to the right decision?

Yes—they would not be different professions if they had the same knowledge and skill, would they?

Obviously, Liam.

Indeed.

I have seen lots of effective multidisciplinary practices. Things have changed dramatically over the past few years. Although it has been a little bit forgotten about, the child protection reform programme in Scotland was hugely influential in bringing universal services much more to the fore in terms of their responsibility for children’s wellbeing. People in universal services no longer need to be convinced that they have a role in child protection—they know that they do. They worry about it and are not sure quite how best to do it, but that is a better place to be than people thinking, “That’s not my job.” Phrases such as, “It’s my responsibility”, “It’s everybody’s job”, and, “We’re all in this together” now trip off everybody’s tongue. People are now looking for support for the next stage of working out the intricacies of how things work on the ground and who takes responsibility for what. That will involve moving away from people covering their backs and the fear of being hung out to dry and so on.

Those things need to be worked through on the ground to enable people to do what they want to do, which is to work together for the benefit of children. I see a huge urge to do that. It is not as if we have to persuade people.

You have clearly described a degree of collective responsibility for what flows out of that.

Yes.

I certainly appreciate that people will come at this from different perspectives, but in giving effect to that collective responsibility, is there anything in how systems operate that suggests that responsibility for taking forward any actions falls between stools, or is who is responsible for which aspect clearly understood?

It is patchy and variable, and it depends on the quality of planning. Some areas have plans that make it clear who is responsible for what and when something has to be done by. In other places, that is much more open. There is a lack of consistency about being clear about who is taking what forward and what will happen.

I do not know whether this applies in Scotland but it certainly applies in children’s services in many other countries: a layer of the problem tends to get neglected. The very problematic families get into the child protection system and the mildly to moderately dysfunctional families get services. However, the families that are not bad enough to get a child protection reaction but which are too challenging for the universal services end up with nothing.

The committee would be better placed than I am to know whether that applies in Scotland, but there tends to be a bit of a gap. Universal services have upped their game and are dealing with more but they have not reached the point where the child protection service takes over.

I recognise that here when it comes to that bit in the middle—that nebulous grey area in the middle where everyone is a bit unsure about who is responsible for what.

I have a supplementary question on the technology that Professor Munro mentioned. From what you say, I envisage a move away from a basic case management system towards an expert system that would prompt certain responses in certain areas. Have you come across examples of that in practice elsewhere?

There are some nice examples from medicine—you can type in “appendicitis” and immediately go to a website that tells you about it in detail. I am aware of a lot of experimental work being done in many countries. There seems to be a common pattern, with a Government investing billions in an extremely dysfunctional system and finally conceding that that system has to be scrapped. There is some progress. Even things such as putting a genogram into the software—not a genogram, but something that shows all the professionals involved—

An ecogram?

Yes, an ecogram. Visually, that can help people’s thinking so that they do not forget things—so that they do not forget the other child in the family, for instance. As regards the role of narrative relative to data boxes, it is fairly well evidenced that that is a much better way of getting the human thought process going.

The other thing to remember is that the deep thinking that is required to do a good analysis and make decisions is very effortful and human beings are lazy, so you find that people have to be encouraged to do it. There is so much drift in child welfare partly because it is so tough to make the decision that people delay—not because of their peculiarities but because human beings tend to behave that way. There again, I think that group supervision is really great in providing the encouragement and the challenge to get on and make the decision.

Some of the evidence that we have already taken suggested that the structure itself is very complex, which can cause delay and other problems. Is there a better structure that would put the child—or the benefit of the child—at the centre?

When I was asked to do the review of the English system, one of my early resolutions was that I would not recommend structural reorganisation because I am old enough to have seen many reorganisations, none of which led to a substantial difference. People are happy to get rid of the structure when a new idea comes along. I would not put my energy into structure. It is much more about the people and helping them to do the job.

We have what has been described as an interesting hybrid system in Scotland. We have the children’s hearings system, which uses a welfare-driven approach that is very different from the system in England. We also have the investigative bit, which is quite similar in many ways. Although they have a sort of alliance, there are some complexities around how those two systems align. For example, the child protection system might consider that a child had been neglected, whereas the children’s hearings system might characterise that more as lack of parental care. Some children go through both and some go through one or the other.

That complex, hybrid system can work okay—or not. One of the difficulties with the hearings system is that people have been misusing it as a way of compelling local authorities to provide services rather than compelling the child and family to use them. Sometimes universal services will make a referral to a children’s hearing because it feels that it is way of upping the ante when the family might not necessarily need some sort of compulsion. That is not a sensible way to use the system, which should not be about trying to unlock services. That is what we found years ago when we were doing the audit and review of child protection in Scotland.

It is useful to collect management information but because of the way in which our data are collected, the two systems do not link up. The child protection statistics are not linked with the children’s hearings statistics, so we cannot say how many children are in both systems. We could do things to make it easier to know what is happening without necessarily dismantling the whole system. It seems a bit odd to me that those statistical systems are not tied together.

Is there scope to merge the two systems and share information?

There is a lot of information sharing already. In some areas, the children’s reporter attends case conferences, for example. In some places, there is a lot of information sharing and people work closely together. However, that depends on how the children’s reporter and the local authorities work together.

Scotland is very passionate about its children’s hearings system. Whenever people try to mess with it, there are a hell of a lot of squeals.

I am just asking a question. [Laughter.]

There are those who argue that we have a child protection system in the children’s hearings system, so why do we need something else? If we could move to the system as envisaged in the GIRFEC approach, in which both compulsory elements are reserved for when they are really needed, it would become less of an issue because we do not necessarily need to be shovelling children through either system if we provide the right support early enough. We could reserve the compulsory element for when we genuinely need to use compulsion. There is an issue with misuse of the system, as I said earlier. We could unpick the whole system, and it might be quite fun to start afresh, but it could deflect a lot of time and energy too.

Thank you.

My original question has been answered in the answer to Neil Findlay’s question.

On support for parents when children are returning to families, you mentioned how the decision to return children is sometimes incorrect. However, it might be the right decision in a lot of cases, but because of lack of support for the family, those children return to care. Professor Daniel outlined some of the support for families. Could the witnesses elaborate on that?

10:45

Neglect has a thousand different causes, and no single way of responding would be relevant to them all. However, quite a lot can be achieved by workers showing warmth and authority and being clear about what they are bothered about. One of the realities is that parents often do not know why people are concerned about their parenting. With many parents, if we can explain why their parenting is having an adverse effect on the child, we can harness some motivation in them to try to change. We can then look at the wider family and their friends to see what other support the parents could have and how they could solve problems.

You could spend millions of dollars on buying expensive American manualised services, but a large component of why they work is that they ensure that the worker has time to create a therapeutic relationship with the family in order to motivate them, and can stay around consistently to keep on helping them and be clear about what needs to change.

I warn the committee that when people say that something works, they mean that in a controlled trial the service was found to be superior to services “as normal” in an American state. However, services “as normal” in Scotland are probably very different from that, so I think that it would be better to put your money into helping the existing workforce to do the basic things well.

There are quite a few principles of intervention on neglect that we know are more likely to be effective so—again—we are talking about consistency of principles. Recent research that Action for Children commissioned into the work in its family centres showed some promising signs of its effectiveness in improving situations, even with cases of fairly chronic neglect. We know that a good therapeutic relationship with one practitioner is needed and that the intervention needs to be sustained and long term, and not episodic, so that we get away from the revolving-door situation. The intervention has to be really sustained, focused, structured, clear, authoritative and warm.

Perhaps particular techniques can be used, but a lot of it is about just sticking with it and being really determined. That approach gives good evidence of whether someone can, in fact, change because, if we try our best and someone still has not responded quickly enough, we know that we should take quick action to remove the child. We have good evidence that, whatever we throw at such situations, it will not make a difference.

In places where people put more effort into working creatively and warmly with families, when a decision is reached that the family cannot parent a child well enough, their behaviour at that point is a lot less adversarial, because the parents often understand the reasons. They might be sad about it, but they appreciate that the decision is sensible.

Professor Daniel referred to the problem of the revolving door and episodic interventions and talked earlier about targeting interventions that avoid the need to go down the route of the children’s hearings system or child protection. Last week, we heard evidence about a difference between the approach of children and families social workers and adult services social workers. The latter are perceived to take a longer-term approach because that sort of intervention is perhaps more characteristic of the work that they are involved in. Children and families social workers, perhaps because the timeframes for a child are obviously different, are more used to taking a short-term perspective and to trying to respond to difficult circumstances. Do you agree with that characterisation? Is there anything that we could and should do to rebalance that to ensure more of a long-term approach, or is that just the nature of the work?

That is an interesting observation, although a little more exploration might be needed into how prevalent the difference is, if there is a difference. Those who work in adult services certainly have a good understanding of the cycle of change, lapse and relapse and all that kind of thing. In particular, those who work with substance abuse have an understanding of those issues.

That adds to the point that multidisciplinary work means working not just across professions, but across different bits of the same system. As we join up some bits in our move towards more integrated services, we might pull apart other bits. Although we need health and social services that focus on greater integration within adult and children’s services, the danger is that we will pull apart the children and adult bits rather than bringing them together to combine the expertise of those who work with adults and that of those who work with children.

In terms of throughput and what is considered to be a good outcome, one slight shift that is required in the children and families sector is that keeping a case open should sometimes be seen as being a better outcome than shutting a case and moving things on. We are driven by the aim, “Shut. Move on. Close. Go on to the next one”. That is seen as success, but keeping cases open and working on them also needs to be seen as a successful outcome. That is a process, system and resource issue.

The process of getting adult and children’s services to work closely together has dramatically moved on. There are still problems, but since the “Getting Our Priorities Right” agenda—there is another such publication coming out fairly soon—there has been a lot more attention paid by adult services to their responsibilities to working with those who work with children. More can be done, and there is readiness for that.

How can we move away from a system that is based on crisis towards one that is based on prevention and early intervention, and what barriers to that exist? Professor Daniel used the phrase “unlock the services”, which I thought was quite telling; it suggests that there are gatekeepers, in dealing with the problems. You commented on the GIRFEC approach. Are we where we want to be with that? Are we moving in the right direction to make that a reality in terms of changing the service?

The rhetoric, the will and the evidence are all there; Harry Burns has never stopped talking about the need for early intervention. Of course, we will need some parallel funding for a while. Even if we have aspirations that early intervention will take away some of the crisis issues, we have in the meantime still to deal with crises. In speaking to people in local authorities, we find that the real tussle comes when we ask how they can justify moving their resources across while they still have a lot of crises to deal with. Local authorities will need support and clever financial thinking, or resource management, if they are to do both things at the same time. It is not possible just to switch from one system to another.

The Highland pathfinder offered hope; it showed that there has been a promising move upstream. However, a lot of resources and time were put into it in order to get to that place. That is why the other local authorities get grumpy, saying, “It was all right for the Highlands, because they got all that extra support”. As I said, we cannot just switch from one system to another, which is why people, especially those who are in charge of planning resources, get frustrated when everyone suggests a move to early intervention and prevention. Although the argument is well made, we are dealing with a bigger group of people—obviously, since the net is bigger—and so resources are spread more thinly. The question is: what do we do with the ongoing crises? Yes, the aspiration is good, but the aims need more working through.

I am unable to comment on the Scottish situation in particular. However, it is worth looking at how much time is spent in the current system on making referrals and doing assessments while not providing a service. When I was doing my review, a couple of local authorities in England did a monitoring exercise of the life of a case and realised that—from the child’s point of view—that child was referred, assessed and batted back and forth several times before receiving a service. If the first person in the process had been able to provide a service, a lot of professional time would have been saved. The current system of having very tight gate-keeping is extremely wasteful.

Do services use partners and other outside organisations as well as they might? A simple example is the reading and library initiatives: are they sufficiently used as services that could tackle some of the problems?

Again, such use is patchy. Eileen Munro’s observation about the two ends of the spectrum and the middle bit is helpful. A lot of support is being provided in the community for low-level problems, and we are piling a lot in for the children whom we are really worried about, but it is hard to keep track of what is on offer for the ones in the middle. We still have a tendency to set up schemes and to give them just short-term funding, which means only that they have to shut down; by the time the local social work team has found out that a particular scheme is running, it is just about to be run down again. There is reluctance to refer people to schemes for which there is no secure funding.

A lot is going on out there, but provision can be a little piecemeal and it is difficult to keep track of schemes that keep starting and stopping. We need a much more sustained approach to services.

Have training and qualifications for social workers changed to reflect the new direction with regard to early intervention and GIRFEC?

Yes—we certainly teach GIRFEC on our programmes. The heads of social work courses meet regularly, and we also meet regularly with the regulatory body and get input from Social Care and Social Work Improvement Scotland. We have a lot of discussions with employers, too. There is a great deal of interaction and interchange on how things are changing and developing.

We need to look at the personalisation and self-directed care agendas that are coming in. There is probably always a bit of a lag, but most of us are out and about doing that type of thing, so we know what is going on and we must try to incorporate it.

However, some of that work needs to be done post qualification, because we cannot do everything on an initial course. Organisations need to learn and to provide opportunities for their staff to continue to learn; some are better than others at doing that.

Does Liam McArthur want to go next?

My question has already been answered—I asked whether further research is required.

I said no, did I not? I am going to do myself out of a job, here.

I will ask the question. You did say no earlier, but it will be helpful if you explain and expand on that a little.

The answer is yes and no.

I have to say that your earlier answer was rather a surprise for me—I am not used to hearing a researcher say that no more research is needed.

We need a bit of research on how we can better put into practice research that we have already done. That sounds a bit convoluted, but it is probably the case. Quite a lot of the research that we are doing involves comparing different care outcomes for children, but we have not done much research into service as usual.

We do a lot of research on special manualised programmes and specific approaches, but we do not have enough information to know what is going on and how the collective activity of all those people with all that goodwill is supporting children at home. We need to support people to use more effectively the knowledge that we already have.

I do not want any more research that tells us that neglect is bad for children, for example. We have plenty of that and it is easy to do such research because we will find plenty of evidence. We need to think more about how we support people to work more authoritatively, and we could do some interesting developmental action research on that.

Professor Munro, do you agree?

Yes—I have been doing some such research in England and Australia. It is fascinating to work with the reform process, to see how it operates intellectually and emotionally and to see its impact on families.

We cannot make human life perfect, but—as Brigid Daniel said—we have at present some wisdom of which we are not making full use. We have ended up with a system that in many ways insults, alienates and demoralises parents, and probably makes them worse parents as a result. There is a lot that we could do with what we know already.

I thank you both for coming along this morning; your evidence has been very helpful to our inquiry.

10:59 Meeting suspended.

11:03 On resuming—