munro the munro review of child protection interim report the child's journey

Upload: francisco-estrada

Post on 06-Apr-2018

218 views

Category:

Documents


0 download

TRANSCRIPT

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    1/116

    The Munro Reviewof Child Protection

    Interim Report:The Childs Journey

    Professor Eileen Munro

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    2/116

    2

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    3/116

    Itsallaboutrelationships.Wearetalkingaboutdealingwithpeoplewithproblems,

    withpainfulstuff.Youhavetoknowsomeone,trustthem.Theymustbereliableand

    bethereforyouifyouaregoingtobeabletotalkaboutthethingsyoudontwant

    to.Thethingsthatscareyou. Parent

    FamilyPerspectives

    on

    safeguarding

    and

    relationships

    with

    childrens

    service

    TheChildrensCommissionerforEngland,June2010

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    4/116

    Contents

    Acknowledgements

    Preface

    ExecutiveSummary

    ChapterOne: Introduction

    ChapterTwo:

    Getting

    help

    early

    Whatlevelofhelpisneeded?

    Thescaleoftheproblem

    Earlyhelp:understandingneed

    Earlyhelp:recentpolicyandpracticedevelopments

    Multiagencylocalityteamswithsocialworkexpertise

    Conclusion

    ChapterThree: Childandfamilysocialwork

    Introduction

    Reasoningandemotions

    Relationshipbasedpracticewithchildren

    Evidencebasedpractice

    Developingexpertise

    Conclusion

    ChapterFour: Managingfrontlinesocialwork

    Introduction

    Managingtime

    Supervision

    Professionaldevelopment

    Tools

    Procedures

    Journeyauthorities

    Themediaandthepublic

    Monitoringperformance

    Developmentsinsocialwork

    ChiefSocialWorker

    CollegeofSocialWork

    Conclusion

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    5/116

    5

    ChapterFive: Sharedlearningandaccountability

    Introduction

    Complexorganisations

    Signposting

    Leadership

    Accountability

    Managingperformance

    Inspection

    Sectorbasedapproachestoimprovement

    Multiagencytrainingandlearning

    Methodsoflearningfrompracticethroughcasereviews

    SeriousCaseReviews(SCRs)

    Developingotherkindsofreviewsandlearningactivity

    Childdeathreviewprocesses

    RevisingWorking

    Together

    to

    Safeguard

    Children

    (2010)

    FamilyJusticeReview

    Conclusion

    ChapterSix: Conclusion

    AnnexA: AssociationofChiefPoliceOfficersStatementofRisk

    Principles

    Annex

    B:

    Tower

    Hamlets

    Draft

    Record

    For

    Understanding

    Families

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    6/116

    6

    AcknowledgementsIamgratefultoalltheindividualsandorganisations,fromacrossthewholespectrumof

    childrensservices,

    who

    have

    assisted

    me

    in

    this

    review

    of

    the

    child

    protection

    system.

    I

    wouldliketoextendmythankstothoseprofessionalgroupswhoparticipatedintherecent

    roundofvirtualconversations,andtothereadersofCommunityCare.Theirideasand

    examplesofgoodpracticewillcontinuetoinformthethinkinginthenextphaseofthe

    review.

    Specifically,Iwouldliketothank:

    themembersofmyreferencegroup:

    o MelanieAdegbite;

    o DistrictJudgeNickCrichton;

    o MarionDavis;

    o AvrilHead;

    o ProfessorCorinneMayChahal;

    o LucySofocleous;

    o DrSheilaShribman;

    o ProfessorSueWhite;and

    o MartinNarey.

    DrDavidLane,anadvisortothereview

    themembersofmysubgroups:

    o EarlyHelp:

    DrSheilaShribman,AnnGoymer,StephenScott,VivHogg,AndrewCooper,

    JaneBarlow,RichendaBroad,PaulMcGee, DrCatherinePowell,Nick

    Hudson,JaniceMcAllister, JoWebber,ColinGreen,SaraGlen.

    o RulesandGuidance:

    RachelJones,TrishKearney,JaniceAllister,JanetFyle,FionaSmith,Deborah

    Hodes,TaraWeeramanthri, FfionDavies,VonniGordon,HelenLincoln.

    o ChildrenandYoungPeople:

    AvrilHead,LucySofocleous(andtheOfficeoftheChildrensCommissioner

    andtheOfficeoftheChildrensRightsDirectorwhohavecollectedand

    submittedevidencefromchildrenandyoungpeople).

    o Courts:

    DistrictJudgeNickCrichton,SimonPickthall,AudreyDamazer.

    o ICT:

    ProfessorSueWhite,JackieRafferty,ProfessorDavidWastell,Professor

    DarrelInce,KayFletcher,DrSuzanneSmith.

    o LearningfromPractice:

    ProfessorCharlesVincent,DrPeterSidebotham, DrSheilaFish,ColinGreen,

    StephenCobb,FrancesOrchover,MarthaCover,JasonGordon.

    o MediaandPublicConfidence:

    ProfessorCorinneMayChahal,ProfessorIvorGaber,ProfessorJon

    Silverman,AmandaCallaghan,KateTonge,AniaRainbird,RichardVize.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    7/116

    7

    o PerformanceandInspection:

    MarionDavis,EleanorSchooling,RobHutchinson,PaulCurran,Anne

    Plummer,JohnGoldup,MikePinnock,KarenMarcroft,ProfessorJune

    Thoburn.

    theleads

    of

    the

    other

    independent

    reviews

    commissioned

    by

    the

    Government

    with

    whomIhavebeenworkingclosely:

    o GrahamAllenMP;

    o RtHonFrankFieldMP;

    o DavidNorgrove;and

    o DameClareTickell.

    thechildrenandyoungpeoplewhohavemetmetotalkabouttheirexperiences

    organisationsthatmyteamvisitedtolookatexamplesofinnovation,

    transformationandgoodpracticeinactionaspartofthe programmeoffieldwork:

    o Bathand

    North

    East

    Somerset

    Council;

    o EastBerkshirePrimaryCareTrust;

    o EastSussexCountyCouncil;

    o LincolnshireCountyCouncil;

    o LondonBoroughofHaringey;

    o LondonBoroughofTowerHamlets;

    o StaffordshireCountyCouncil;

    o WarringtonBoroughCouncil;and

    o WarwickshireCountyCouncil.

    organisationsthathaveapproachedthereviewandaskedtotrialamoreflexible

    assessmentprocess:

    o CumbriaCountyCouncil;

    o GatesheadMetropolitanBoroughCouncil;

    o KnowsleyMetropolitanBoroughCouncil;

    o LondonBoroughofHackney;and

    o WestminsterCityCouncil.

    DeborahRamsdale,secondedfromStaffordshireCountyCounciltothereviewteam

    andtheteamofcivilservantssupportingmeattheDepartmentforEducation(DfE).

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    8/116

    8

    Preface

    Thisisthesecondreportofthereviewofchildprotection

    inEnglandcommissionedinJune2010bytheSecretaryof

    StateforEducation,theRightHonourableMichaelGove

    MP.Itsthemeisthechildsjourney. Tooofteninrecent

    history,thechildprotectionsystemhas,inthepursuitof

    imposedmanagerialtargetsandregulations,forgotten

    thatitsraisondtreisthewelfareandprotectionofthe

    child.Thisphaseofthereviewlookedathowthesystem

    couldbereformedtokeepafocusonthechildsjourney

    thejourneyfromneedinghelptoreceivingit. Thiscoversanumberofareas,

    includingworkwithchildrenandfamilieswhohavenotyetmetthethresholdforchildprotection.

    ThereviewisworkingcloselywithanumberoflocalauthoritiesincludingCumbria,

    Gateshead,Hackney,KnowsleyandWestminster.Thesefiveauthoritieshaveasked

    totrialflexibleassessmenttimescales,sothatsocialworkerscanexercisetheir

    professionaljudgmentmoreeffectivelytoimproveoutcomesforvulnerable

    children.Iamverygratefultotheseauthoritiesfortriallingthisnewwayofworking

    and,subjecttotheiragreementtotheconditionsofthetrialwithMinisters,Ilook

    forwardtoconsideringtheirearlyfindingsintimeforthefinalreport.

    InthisphaseofworkIhavecontinuedtobesupportedbyanexpertreferencegroup

    andkeyleadersinthesector,andhavebenefitedfromfieldvisitstoanumberof

    localauthorities. Ihavealsoconvenedamultiagencyworkinggroupconsisting,so

    far,ofrepresentativesfromsocialwork,healthandpoliceprofessionalstrategic

    bodiesinordertoconsiderthefutureofinteragencyrulesandguidance.Inaddition

    IhavebenefitedfromtheexcellentworkundertakenbyGrahamAllen,FrankField

    ClareTickellandDavidNorgroveintheirrespectivegovernmentreviews.

    AsIsaidinmyfirstreportinOctober,Iammindfulofthefactthatthisreviewis

    takingplace

    at

    atime

    of

    financial

    constraint,

    and

    it

    is

    within

    this

    context

    that

    my

    recommendationswillbemade. However,thisreviewofchildprotectionhasbeen

    fortunateinbeingthefirstnottohavebeeninitiatedinresponsetoaparticular

    tragedyandmyfinalreportinAprilwillnotseekaseriesofsuperficialquickfixesin

    asystemascomplexasthechildprotectionsystem,therearenoquickfixestobe

    had. Thereare,however,barrierstogoodpracticewhichcanberemovedand

    incentivestobetterpracticewhichcanbeputinplace.Ihopethattheresultwillbe

    arecalibrationofthewholesystemaroundtheimmediateneedsoftheindividual

    childrenandfamiliesthatitseekstoserve.

    ProfessorEileen

    Munro

    LondonSchoolofEconomicsandPoliticalScience February2011

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    9/116

    9

    Executivesummary

    1. TheMunroReviewofchildprotectionispartofanationaldrivetoimprovethe

    quality

    of

    child

    protection

    services.

    The

    aim

    of

    this

    report

    is

    to

    set

    out

    for

    discussion

    thecharacteristicsofaneffectivechildprotectionsystem,andthereformsthat

    mighthelptocreatesuchasystem. ThisreportiscalledTheChildsJourney,

    referringtothechildsjourneyfromneedingtoreceivingeffectiveprotectionfrom

    abuseandneglect.

    2. Thereviewsfirstreportprovidedananalysisoftheunintendedconsequencesof

    previousreformsthathadariseninthechildprotectionsystem.Itconcludedthat

    professionalsare,inparticular,constrainedfromkeepingafocusonthechildbythe

    demandsandrigiditycreatedbyinspectionandregulation. Manyoftheareas

    identifiedforreformatthisstageofthereviewrelate,therefore,tothesepartsof

    thesystem.

    3. Toencouragechange,thereviewhasbeenworkinginpartnershipwithfive

    authoritieswhohaverequestedgreaterflexibilitywhenassessingtheneedsof

    childrenandyoungpeople,withtheaimofdeliveringimprovedoutcomesandmore

    focusedinterventions.TheSecretaryofStateforEducationisconsideringusinghis

    powerstoenablethemtomodeltheresponsibleinnovationthisreviewwantsto

    encourage. Theselocalauthoritieswillbegrantedtemporarysuspensionfrom

    certainrequirementsinstatutoryguidanceforasixmonthperiod,subjecttotheir

    agreementwithMinisterstotheconditionsofthetrial.

    4. Thereviewendorsesthecrucialrolethatinspectioncanplayinimprovingservices

    forchildren,andwillbeworkingwithOfstedtodevelopaninspectionprocessthat

    driveschildcentredpractice,focusesontheeffectivenessofhelpprovidedand

    assessesthequalityoflearningacrosslocalorganisations,ratherthancompliance

    withprocess. Theconsensusviewinfeedbacktothereviewhasbeenthat

    announcedinspectioncarriesaconsiderableamountofbureaucraticburden. The

    reviewisrecommendingthatannouncedinspectionsshouldendaspartof

    forthcomingrevisionstotheinspectionframework.Instead,unannounced

    inspectionsshouldbegivenabroaderremitacrossthecontributionofallchildrens

    servicesto

    the

    protection

    of

    children.

    5. SeriousCaseReviews(SCRs)havebeencriticisedforfailingtoidentifyorexplainthe

    factorsthathavecontributedtopoorpractice. Thereviewisthereforeconsidering

    adoptingthesystemsapproachusedinthehealthsector,whichexploresthese

    factorsandthereforeoffersthepotentialfordeeperlessonsandimprovedlearning.

    ThereviewhasalsoreceivedevidencethatthesystemofexternalevaluationofSCRs

    hasdistortedtheprioritiesinconductingthesereviews,addingtobureaucracy,and

    inhibitinglearning. AlongsidetheGovernmentspolicythatSCRoverviewreportsare

    published,thereviewisrecommendingthatOfstedevaluationsofSCRsshouldend

    indue

    course.

    Instead,

    the

    quality

    of

    learning

    more

    generally

    should

    be

    given

    greater

    coveragewithintheoverallinspectionprocess.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    10/116

    10

    6. WorkingTogethertoSafeguardChildrenisthecoreguidanceformultiagency

    working. Thedocumentisnow55timeslongerthanitwasin19741. Oneofthe

    reasonsforthisgrowthhasbeentheinclusionofprofessionaladvicealongside

    statutoryguidance. Thereviewisworkingwithagroupofrepresentativesfromthe

    relevantprofessions

    to

    consider

    how

    statutory

    guidance

    could

    be

    separated

    out

    fromprofessionaladvice,withtheprofessionstakingresponsibilityforthelatter. In

    thenextreportthereviewwillmakerecommendationsonhowthiswouldallowfor

    statutoryguidancetobecomeashortermanualinwhichthecoreprinciplesand

    rulesareclearertoallprofessionals.

    7. Seniorleadersfromlocalagenciesworktogether,throughtheLocalSafeguarding

    ChildrenBoard(LSCB),toprovidelocalleadershipandclarityaboutworkingtogether

    tohelpkeepchildrenandyoungpeoplesafe. LSCBsareuniquelyplacedtotakea

    holisticapproachtochildprotection.Thereviewismindedtostrengthentheroleof

    LSCBsin

    monitoring

    the

    impact

    of

    practice,

    training

    and

    learning

    on

    the

    childs

    journey,aswellasidentifyingandaddressingemergingproblemsinthesystem.

    8. Withtheextentofcurrentpublicservicereform,theroleofleadershipandlinesof

    accountabilityinchildprotectionservicesneedtobeclear. Thereviewagreeswith

    LordLamingsconclusionontheneedforastronglocalspineofaccountableleaders,

    withresponsibilitylocatedinthelocalauthority,asreflectedinthecurrentstatutory

    framework. Inparticularthereviewconsidersitimportantthatlocalauthorities

    ensurethattheroleoftheDirectorofChildrensServicescontinuesasthekeypoint

    ofprofessionalaccountabilityforchildprotectionserviceswithinthelocalauthority

    andthat

    this

    is

    not

    diluted

    or

    weakened.

    9. Localauthoritiesandtheirpartnersneedperformancedatatoknowhowthesystem

    isfunctioning. TheGovernmenthasannouncedthattheNationalIndicatorSetof

    performancemeasureswillbereplacedwithasinglecomprehensivelistofdata

    requiredcentrally. Thereviewisconsideringaminimumdatasetforchildprotection

    madeupofatwincoreofnationallycollecteddataandrecommendedstandardised

    localdata. Suchdatacanhelpinformthedevelopmentandevaluationofpolicyby

    centralGovernmentanddriveimprovementandlearningatalocallevel. Itis

    importantthatdataallowsthechildsjourneythroughthesystemtobemappedand

    thatsuch

    data

    informs

    discussions

    about

    local

    practice,

    rather

    than

    being

    used

    as

    absoluteindicatorsofgoodorbadperformance.

    10. Earlyidentificationandprovisionofhelpisinthechildsbestinterestsandmulti

    agencyserviceswhichdeliversupportforfamiliesarevitalinpromotingchildrens

    wellbeing. Thereviewendorseseffortstoimprovefamilysupportservicesinthe

    communitysuchasSureStartChildrensCentresandthehealthvisitorservice,and

    emphasisgiventothisissuebyFrankField(reportedDec2010),GrahamAllen

    (reportedJan2011)andClareTickell(Spring2011)intheirrespectivereviews.

    1Parton,N (2010) The Increasing Complexity of Working Together to Safeguard Children

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    11/116

    11

    11. Allwhocomeintocontactwithfamilieshaveaparttoplayinidentifyingthose

    childrenwhoseneedsarenotbeingadequatelymet. Someoftheseneedscanbe

    helpedbyuniversalandearlyinterventionservices,whileothersmayneedreferral

    tomorespecialistservices,includingchildrenssocialcare. Evidencesubmittedto

    thereviewshowsstrongsupportforthecurrentpolicywhere,withthefamilys

    consent,an

    assessment

    is

    made,

    using

    aformat

    common

    to

    all

    local

    agencies,

    that

    canbesharedasappropriatewithotherprofessionals. Itisimportanttominimise

    dependencyandempowerfamilies,givingthemownershipoftheirpersonal

    assessment.

    12. Maltreatmentisnotalwaysbeingsafelyidentifiedandrespondedtoappropriately

    becausesocialworkexpertisemaynotalwaysbereadilyavailabletoother

    professionals. Thiscontributestoahighlevelofreferralstochildrenssocialcare

    thataresubsequentlyassessedasinappropriate. Initsfinalphase,thereviewwill

    considersolutionsdevelopedinsomelocalareas,wheremultiagencyteams,that

    includesocial

    workers,

    are

    located

    in

    the

    community

    alongside

    universal

    services.

    Theseteamsenablechildrenandyoungpeoplewhoareinneedofprotectionfrom

    maltreatmenttobemoreaccuratelyidentified.

    13. Thereviewisconsideringwhether,whenachildisreferredtochildrenssocialcare,

    anyexistingassessmentiscontinuedbysocialworkers,ratherthanthecurrent

    systemwhichstartsanewbureaucraticprocessofinitialandcoreassessments.

    Currentpracticeisdominatedbyprescribedtimescales,butthereshouldbea

    strongerawarenessofbalancingthetimelinesswiththequalityofassessment,so

    thatthespecificneedsofanychildcanbewellassessed. Timelinessmattersbutso

    doesquality,

    and

    local

    arrangements

    should

    monitor

    both.

    The

    review

    is

    working

    withtheFamilyJusticeReviewtoexplorehowlocalauthoritiescancontributeto

    reducingunnecessarydelaysinthechildsjourneythroughthecourtsandcare

    proceedings.

    14. Managersinsocialworkplayacrucialpartincreatingtheworkconditionsthat

    facilitategoodpractice. Thecurrentmanagementstyleputstoomuchemphasison

    thebureaucraticaspectsofthework. Radicalreformisneededtogivedueweightto

    theimportanceofthecognitiveandemotionalrequirementsofthework,theneed

    forcontinuingprofessionaldevelopment,andforaccesstoresearchinordertohelp

    workersperform

    at

    ahigh

    level.

    The

    scale

    of

    rules

    and

    procedures

    may

    help

    achieve

    aminimumstandardofpractice,butinhibitsthedevelopmentofprofessional

    expertiseandalienatestheworkforce,thuscontributingtotheseriousproblemsof

    recruitmentandretention. Thereviewisconsideringhowusercentreddesignof

    assessmentanddecisionmakingtoolscanprovidebetteraidstoprofessional

    reasoning. Thereviewisworkinginparticularwithpractitionersonhowthedesign

    ofIntegratedChildrensSystem(ICS)softwarecanbemademoreuserfriendlyand

    efficient.

    15. Goodsocialworkpracticerequiresformingarelationshipwiththechildandfamily

    and

    using

    professional

    reasoning

    to

    judge

    how

    best

    to

    work

    with

    parents.

    The

    natureofthiscloseengagementmeansthatsupervision,whichprovidesthespace

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    12/116

    12

    forcriticalreflection,isessentialforreducingtheriskoferrorsinprofessionals

    reasoning. Thereisagrowingbodyofrelevantresearchtosupportprofessionals

    reasoning. Itisimportantthatsocialworkersmakegooduseofthistomakemore

    accurateassessmentsandtodifferentiatethoseaspectsofpoorparentingthattend

    tobecorrelatedwithadverseoutcomesforthechildfromthelessdamagingones.

    Socialworkers

    need

    to

    make

    best

    use

    of

    evidence

    on

    how

    to

    help

    families

    change.

    Thisshouldincludebothevidenceaboutthenatureofeffectiveworking

    relationships,andofmethodstousewithintheserelationshipstopromotechange.

    16. TheSocialWorkReformBoard(SWRB)hasdevelopedacapabilitiesframework

    whichoutlinesthegenericskillsandknowledgeneededbyasocialworkerat

    differentstagesintheircareer. Thereviewisbuildingonthisanddraftingthe

    specialistcapabilitiesneededinchildandfamilysocialwork. TheSWRBhas

    recommendedthatthecareerstructureshouldbealteredtogivesocialworkersa

    longtermprofessionalcareerwithoutbecomingamanager. Thereviewis

    consideringhow

    this

    could

    be

    developed

    in

    child

    and

    family

    social

    work,

    to

    enable

    thedevelopmentofexpertisethatshouldbeavailabletosupportthefrontline

    practitioner.

    17. Manyprofessionals,inthepast,havereflectedontheclimateoffear,blameand

    mistrustthatseemstobeendemicwithinthechildprotectionsystem2. Thereis

    considerableevidencethatthechildprotectionsystemandsocialworkersin

    particulararestillportrayedverynegativelyinthemedia. Thisunderminespublic

    confidenceintheprofessionandputschildrenatgreaterrisk. Suchreportingalso

    hasunintendedconsequencesforthewaythesystemfunctions,forexample,by

    alteringreferral

    patterns,

    creating

    spikes

    in

    demand,

    and

    increasing

    thresholds.

    The

    review,workingwiththeCollegeofSocialWork,newlyestablishedonthe

    recommendationoftheSocialWorkTaskForce,isconsideringhowtohelpthepublic

    gainabetterunderstandingofthecomplexity,uncertaintyandemotionalchallenge

    inherentinchildprotection. Thisincludesimprovingtheresponseofthesocialwork

    professiontopublicdebatesabouttheirwork,especiallyinacrisis,sothatthereisa

    cleareraccountofprofessionalpractice.

    18. Agoodchildprotectionsystemshouldbeconcernedwiththechildsjourneythrough

    thesystemfromneedingtoreceivinghelp,keepingaclearfocusonchildrensbest

    intereststhroughout.

    This

    includes

    developing

    the

    expertise

    and

    the

    organisational

    environmentthathelpsprofessionalsworkingwithchildren,youngpeopleand

    familiestoprovidemoreeffectivehelp. Thereviewisconsideringwhether,inlight

    ofwiderreformofpublicservices,thereisaneedforapanelcomposedofthe

    relevantprofessionswithinthechildprotectionsystem,toadviseGovernmentand

    theprofessionsonhowthedifferentpartsofthechildprotectionsystemare

    interactingandwhetherproblemsareemerging.

    19. Thisreviewistakingplaceatatimeofmajorreforminalloftherelevantpublic

    services,whereseriousfinancialconstraintsarebeingappliedandwithmajor

    2Ayre, P. (2001), Child Protection and the Media: lessons from the last three decades, BJSW 31(6), 887-901

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    13/116

    13

    workforceissuesparticularlyinthefieldofsocialwork. Itremainsessentialthatthe

    protectionofchildrenisaprioritywithinthesereforms. Itisinthiscontextthatthe

    reviewwillbeseekingthehelpofeachprofessionwithinthesectortodevelopthe

    reformsproposedinthisreportandworkwitharangeofgroupstodevelopits

    thinkingbeforeproducingafinalreportandrecommendationstoGovernmentin

    April.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    14/116

    14

    ChapterOne: Introduction

    1.1 TheMunroReviewofChildProtection,PartOne:ASystemsAnalysis3setoutthe

    currentproblems

    in

    the

    child

    protection

    system

    and

    offered

    an

    analysis

    of

    why

    these

    problemshadarisen. Itconcludedthatanimbalancehasdevelopedbetweenthe

    demandsofthemanagementandinspectionprocessesandprofessionalsneedfora

    workenvironmentandtherightcapabilitiestohelpthemexerciseprofessional

    judgment,provideeffectivehelp,andkeepaclearfocusonthebestinterestsofthe

    child. Theaimofthisinterimreportistosetthecharacteristicsofaneffectivechild

    protectionsystemandtooutlinethereformsthatmighthelpthecurrentsystemget

    closertotheideal,seekingfeedbackonthisbeforemakingdetailed

    recommendationstoGovernmentinthefinalreportattheendofApril.

    1.2

    Providingeffective

    help

    to

    children

    who

    are

    at

    risk

    of

    abuse

    or

    neglect

    has

    both

    immediateandlongtermbenefits. Childmaltreatmenthasbeenassociatedwiththe

    followinglongtermimpacts:

    Figure1.1PreVail,ResearchBrief: InterventionstoPreventChildMaltreatment

    (March2010)4

    1.3 TheUnitedNationsConventionontheRightsoftheChild(UNCRC)providesachild

    centredframework

    that

    spells

    out

    the

    basic

    human

    rights

    that

    children

    everywhere

    have:therighttosurvival;todeveloptothefullest;toprotectionfromharmful

    influences,abuseandexploitation;andtoparticipatefullyinfamily,culturaland

    sociallife. ThefourcoreprinciplesoftheConventionarenondiscrimination;

    devotiontothebestinterestsofthechild;therighttolife,survivaland

    development;andrespectfortheviewsofthechild5. Thevisionofchildrenimplicit

    intheUNCRCandintheChildrenAct1989isthatchildrenareneithertheproperty

    3Munro,E.(2010).TheMunroReviewofChildProtectionPartOne:ASystemsAnalysis,retrieved

    fromhttp://www.education.gov.uk/munroreview/downloads/TheMunroReviewofChildProtection

    Part%20one.pdf4http://prevail.fims.uwo.ca/docs/CM%20Research%20Brief%20Mar10.pdf

    5http://www2.ohchr.org/english/law/crc.htm

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    15/116

    15

    oftheirparentsnorhelplessobjectsofcharity. Theyareindividuals,membersofa

    familyandacommunity,withrightsandresponsibilitiesappropriatetotheirstageof

    development.

    1.4 Thechildprotectionsystemcouldbetakentoreferspecificallytothereactive

    serviceof

    identifying

    incidences

    of

    maltreatment

    and

    preventing

    their

    recurrence.

    However,astheUNCRCmakesclear,thechildsrighttoprotectionfrom

    maltreatmentplacesadutyontheStatenotjusttoreacttoincidentsof

    maltreatmentbuttoprovidesupporttofamiliestoreducetheincidence. Article19

    oftheUNCRC:

    1.StatesPartiesshalltakeallappropriatelegislative,administrative,socialand

    educationalmeasurestoprotectthechildfromallformsofphysicalormental

    violence,injuryorabuse,neglectornegligenttreatment,maltreatmentor

    exploitation,includingsexualabuse,whileinthecareofparent(s),legal

    guardian(s)or

    any

    other

    person

    who

    has

    the

    care

    of

    the

    child.

    2.Suchprotectivemeasuresshould,asappropriate,includeeffective

    proceduresfortheestablishmentofsocialprogrammestoprovidenecessary

    supportforthechildandforthosewhohavethecareofthechild,aswellasfor

    otherformsofpreventionandforidentification,reporting,referral,

    investigation,treatmentandfollowupofinstancesofchildmaltreatment

    describedheretofore,and,asappropriate,forjudicialinvolvement.

    1.5 Childcentred: ThisreportisentitledTheChildsJourney,meaningthechilds

    journeyfrom

    needing

    to

    receiving

    effective

    help

    for

    problems

    arising

    from

    family

    andsocialcircumstances. Evidencepresentedtothereviewshowsthatthesystem

    doesnotcurrentlystaychildcentred. Whilemanyprofessionalsmakestrenuous

    effortstokeepafocusonthechildandmanychildrenpraisethehelptheyhave

    receivedthereareaspectsofthecurrentsystemthatpushpractitionersinto

    prioritisingotheraspectsoftheirwork. Assetoutinthisreviewsfirstreport6:

    Itmayseemselfevidentthatchildrenandyoungpeoplearethefocusofchild

    protectionservicesbutmanyofthecriticismsofcurrentpracticesuggest

    otherwise. Inasystemthathasbecomeoverbureaucratisedandfocusedon

    meetingtargetswhichreducethecapacityofsocialworkerstospendtimewith

    childrenand

    young

    people

    and

    develop

    meaningful

    relationships

    with

    them,

    thereisariskthattheywillbedeprivedofthecareandrespectthatthey

    deserve. Thechildrenandyoungpeoplewhohavecontributedsofartothe

    reviewconfirmthattheydonotfeelasthoughtheyarecentrallyimportantand

    heldinmindbytheirsocialworker:

    IwasneveraskedabouthowIfeltorwhatIwantedtohappen.Askingme10

    minutesbeforethemeetingisnotthesame

    Youngpersonspeakingtothereview

    6

    Munro,

    E.

    (2010).

    The

    Munro

    Review

    of

    Child

    Protection

    Part

    One:

    A

    Systems

    Analysis,

    retrieved

    fromhttp://www.education.gov.uk/munroreview/downloads/TheMunroReviewofChildProtection

    Part%20one.pdf

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    16/116

    16

    1.6 AnchoringthereviewintheconceptofthechildsjourneyandtheUNCRChelpsto

    keepaclearfocusonwhetherthereviewsreformsarelikelytohaveabeneficial

    impactonthesafetyandwellbeingofchildren. Itprovidesastructurewhen

    thinkingaboutthedesignofaneffectivechildprotectionsystem. Whatdochildren

    needfrom

    achild

    protection

    system?

    What

    do

    they

    need

    frontline

    practitioners

    to

    beabletodo? Howshouldpractitionersbemanagedinordertoprovidethis? How

    shouldservicesbeinspectedtocheckthatthisisbeingachieved? Anysuggested

    reformshouldhaveaclearlinktotheimpactonthewellbeingandsafetyof

    children.

    1.7 Thereisalsoanimportantgroupofchildrenwhoarethesubjectofachildprotection

    enquiryandwheremaltreatmentisnotfound. Forthesefamilies,theexperience

    rangesfromunpleasanttohighlytraumatic,sometimesleavingthemwithafearof

    askingforhelpinthefuture. Inthefirstreport,itwasnotedthatthemoreany

    systemtries

    to

    avoid

    missing

    acase

    of

    maltreatment

    then

    the

    more

    non

    abusive

    familieswillbedrawnintothenetofchildprotectioninquiries. Itisimportantto

    rememberthatthesearchforaccuracycomeswithahumancostthatisbornebya

    childandparentsandsothesystemneedstopayattentiontotheimpactoftheir

    serviceinvolvementonchildrenwho,itislaterconcluded,arenotatriskof

    significantharm.

    1.8 Earlyhelp: Thesequenceofthechaptersinthisreportfollowsthechildsjourney.

    Fromachildspointofview,theidealiswherefamily,friends,community,and

    universalservicesprovideallthatisrequired,andthisistheexperienceformost

    childrenin

    England.

    The

    second

    best

    is

    that

    any

    emerging

    problems

    are

    identified

    quicklyandaddressed. Chaptertwodiscussestheimportanceofprimaryand

    secondarylevelsofpreventiveservices,servicesthatsupportfamiliessothat

    problemsdonotariseoraredealtwithspeedilywhilestillatalowlevel. Supporting

    familiesisamultiagency,multiprofessionalresponsibility. Allhaveaparttoplayin

    identifyingchildrenwhoseneedsarenotbeingadequatelymet,sometimesbecause

    ofparentalabuseorneglect.

    1.9 Therearethreeotherreviews,commissionedtoconsideraspectsofearlyprovision

    ofhelpforchildren,whicharerelevanthere. Theirrecommendationswillbetaken

    intoaccount

    in

    this

    review:

    theIndependentReviewonPovertyandLifeChancesledbyFrankFieldMP

    reportedinDecember20107recommendingactionsrequiredbygovernment

    andotherinstitutionstoreducepovertyandenhancelifechancesforthe

    mostdisadvantaged. Thefinalreportsetoutanewapproachtomeetingthe

    Governmentstargetforabolishingchildpoverty,inparticularforthe

    inclusionofnonfinancialelements;

    7Field,F.(2010),FoundationYears:preventingpoorchildrenbecomingpooradults(availableonlineat

    http://povertyreview.independent.gov.uk/)

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    17/116

    17

    theindependentcommissionintoearlyinterventionledbyGrahamAllenMP

    presentedtheirfirstreportinJanuary2011. Thereportidentified19

    programmesthathaveaproveneffectivenessinhelpingchildrenandyoung

    peopletofulfilltheirpotentialandhelpbreakintergenerationaltransfersof

    disadvantageandunderachievement8;and

    areview

    of

    the

    Early

    Years

    Foundation

    Stage

    (EYFS)

    is

    being

    undertaken

    by

    DameClareTickellwhoiscarryingoutareviewoftheEYFSsothatitisless

    bureaucraticandmorefocusedonyoungchildrenslearningand

    development9.

    Forthisreview,akeyconcernistheproblemofidentifyingthosechildren,receiving

    earlyinterventionservices,whoaresuffering,orarelikelytosuffer,significantharm

    andneedadifferentlevelofresponse.

    1.10 Childandfamilysocialwork: Chapterthreebeginsbyconsideringwhatexpertise

    childrenneed

    social

    workers

    to

    have.

    It

    builds

    on

    the

    work

    of

    the

    Social

    Work

    Task

    ForceandtheSocialWorkReformBoardtooutlinetheskills,knowledgeandvalues

    needed.

    1.11 Whenlookingatwaystoreducebureaucraticdemandsonsocialworkers

    considerationneedstobegiventowhythesedemandswereintroducedand

    whetherthosereasonsstillholdtrue. Thereseemtohavebeentwomaindriving

    forcesbehindtheproliferationofprescriptionanddocumentation: improvingsocial

    workpracticeandincreasingtransparencyandaccountability. Bothissuescontinue

    tomatter,soanyreformsneedtotrytoachievethesamegoalsbutbydifferent

    means.The

    former

    issue

    is

    covered

    in

    chapters

    three

    and

    four

    while

    the

    latter

    topic

    oftransparencyandaccountabilityisdealtwithinchaptersfourandfivewhen

    discussingmanagerialoversightandinspection.

    1.12 Managingfrontlinesocialwork: Thefirstreportconcludedthatthemanagementof

    childrenssocialcarehadevolvedtoofarintoatopdown,compliancedriven

    organisation. Thisstifledcreativityanddistortedpriorities,withmoreattention

    giventothecompletionofbureaucratictaskstospecifiedtimescalesasthemeasure

    ofsuccess,thantheappraisalofthequalityofhelpreceivedbychildrenandtheir

    families. Chapterfourconsidershowchildrenssocialcareorganisationsneedto

    movetowards

    being

    adaptive,

    learning

    organisations

    that

    keep

    aclear

    focus

    on

    creatingtheworkenvironmentthathelpsfrontlinesocialworkershavetheskills,

    timeandresourcestovisitfamilies,engagewiththem,developagood

    understandingoftheirproblemsandprovideeffectivehelp.

    1.13 Accountabilities: Chapterfivesmultiagency,multiprofessionalfocusstartsby

    8Allen,G.(2011),EarlyIntervention:thenextsteps(availableonlineat

    http://media.education.gov.uk/assets/files/pdf/g/graham%20allens%20review%20of%20early%20int

    ervention.pdf)9

    Launch

    notice

    available

    online

    at

    http://www.education.gov.uk/inthenews/inthenews/a0061485/reviewofearlyyearsfoundation

    stage

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    18/116

    18

    discussingtheroleofLocalSafeguardingChildrenBoards(LSCBs)inmonitoringhow

    welllocalservicesaresafeguardingchildren. Italsoreemphasisestheimportanceof

    localleadersintheregularenquiryoftheimpactoftheirhelplocallyonchildrenand

    youngpeopleandbeginstoconsiderhowinspectioncandrivealearningculture.

    LSCBsarerequiredtoconductaSeriousCaseReviewwhenachilddiesorisseriously

    injuredand

    abuse

    or

    neglect

    is

    thought

    to

    be

    acontributory

    factor.

    The

    chapter

    exploreswhetherthesystemsapproachusedinthehealthsectoroffersabetter

    modelforlearning.

    1.14 Assessmentandtimescales: Inthespiritoffosteringalearningandadaptiveculture

    withinlocalchildprotectionsystems,thereviewhasengagedwithanumberoflocal

    authorities,inordertounderstandthechallengestheyface. Thereviewteamhas

    beenworkinginpartnershipwithfiveauthoritieswhohaverequestedgreater

    flexibilitywhenassessingtheneedsofchildrenandyoungpeople,withtheaimof

    deliveringimprovedoutcomesandmorefocusedinterventions. Theselocal

    authoritieswill

    be

    granted

    temporary

    suspension

    from

    certain

    requirements

    in

    statutoryguidanceforasixmonthperiod,subjecttotheiragreementwithMinisters

    totheconditionsofthetrial. Thetrialswillbeginshortlyandrununtiltheendof

    July. Theearlyresultswillinformthinkingforthefinalreportofthereview(see

    chapterfourfordetails).

    1.15 Thehypothesisisthat,whilsttimescalesandfixedstagesofassessmentprovide

    somecontrolofthechildprotectionsystem(forexamplebypreventingdriftand

    controllingdemand),theycandosoattheexpenseofthoughtfulsocialwork

    practice. Itispossiblethatadifferentapproachtolocalmanagementandleadership

    couldmitigate

    these

    negative

    tendencies.

    It

    should

    be

    possible

    to

    provide

    thoughtfulassessmentandtimelydecisionmakingwithouttheneedforfalse

    assessmentdistinctionsandtimescaleswhichseektooverstandardisethemany

    variedandcomplexneedsofvulnerablechildren.

    1.16 Theissueoftimescalesisoneelementofabroaderthemethatpermeatesthe

    review:theproblemoffindingabalancebetweenprescriptiverulesandprofessional

    judgmentbasedonexpertise. Targetsandperformanceindicatorsarecriticisedas

    implicitlycreatingarule,i.e.meetingthatindicatorisautomaticallyanindicationof

    goodpractice,regardlessofwhetheritisinthebestinterestsofthechild. In

    reality,because

    of

    the

    diversity

    of

    childrens

    needs

    and

    circumstances,

    the

    data

    needstobeinterrogatedtoseewhatpracticehasproducedthisresultandwhether

    itwasbeneficialforthechildornot. Inasimilarway,theexpansionofprocedures

    andprescriptiveguidanceisfaultedforoverstandardisingpracticeandundervaluing

    theskillsrequiredtoapplyprinciplesindiversecircumstances.

    1.17 Rulesandjudgment: Whilstsomerulesandprescriptionwillalwaysbenecessary

    notleasttoenablepeoplefromdifferentagenciestocoordinatetheirworkthey

    havecometobeseenasawayofmakingquickimprovementsinapoorservice,

    withoutneedinglengthytrainingtoexplaintothemultiagencyworkforcewhythey

    matter.

    In

    the

    long

    term,

    improvement

    in

    the

    quality

    of

    the

    service

    provided

    to

    children,youngpeopleandfamilies(thequalityofthejourney)restsonhavinga

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    19/116

    19

    welltrained,wellsupportedworkforcethatunderstandstheunderlyingprinciplesof

    childprotectionandhasthespacetoassesshowbesttoapplythem.

    Theprinciplesofchildprotection

    1.18 Initsfinalphase,thereviewwillconsiderhowbesttoframetheseprincipleswhich

    underpinastrongchildprotectionsystem. Thefollowinglistisaninitialdraftfor

    consideration:

    thefamilyisthebestplaceforbringingupchildrenandyoungpeople,butthe

    childprotectionsystemfacesdifficultjudgmentsinbalancingtherightofa

    childtobewiththeirbirthfamilywiththeirrightforprotectionfromabuse

    andneglect;

    thechildprotectionsystemisamultiprofessional,multiagencyoperation

    requiringallwhoworkwithchildren,youngpeopleandfamiliestoconsider

    theeffectivenessoftheirwork;

    thechildprotectionsystemshouldbechildcentred,recognisingchildrenand

    youngpeopleasindividualswithrights,includingtheirrighttoparticipation

    inmajordecisionsaboutthem,inlinewiththeirevolvingcapacities;

    thechildprotectionsystemunderstandsitsdualmandatetosupportfamilies

    andhelpthemprovideadequatecareandtointerveneauthoritativelywhen

    childrenandyoungpeopleneedprotection;

    thegeneralpublicandallwhoworkwithchildren,youngpeople,familiesand

    carershavearesponsibilityforprotectingchildrenandyoungpeople;

    helpingfamiliesinvolvesworkingwiththemandthereforethequalityofthe

    relationshipbetweenthefamilyandprofessionalsdirectlyimpactsonthe

    effectivenessofhelpgiven;

    childrensneedsandcircumstancesarevariedandsothechildprotection

    systemrequiressufficientflexibility,with spaceforprofessionaljudgmentto

    meetthatvarietyofneed;

    thecomplexityoftheworldmeansthatuncertaintyandriskarefeaturesof

    childprotectionworkandthatriskmanagementcannoteliminateharm,only

    reduceitsoccurrence;

    alearningandadaptivesystemischaracterisedbyregularquestioningofhow

    thesystem(locallyandnationally)isfunctioningandwhetherchildrenare

    receivingeffectivehelp;and

    goodprofessionalpracticeisdrivenbyknowledgeofthelatesttheoryand

    research.

    Itisvitaltoo,thatanyprinciplesthatseektosupportchildprotectionaremindfulof

    theinherentriskanduncertaintyinprotectingchildrenandyoungpeoplefrom

    harm. Inthisarea,thereviewhasbeenparticularlyimpressedbytheriskprinciples

    developedbytheAssociationofChiefPoliceOfficers(ACPO),andisconsideringways

    inwhichtheycouldbeincorporatedintochildprotectionwork(seeAnnexA).

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    20/116

    20

    Nextsteps

    1.19 Thefinalphaseofthereviewwillproposehowthecurrentsystemcanbeadjusted

    sothat,overtime,itbetterreflectstheneedsofchildrenandyoungpeople. Asthe

    review

    develops

    detailed

    recommendations

    to

    Government

    in

    each

    of

    these

    areas

    it

    willworkverycloselywithstakeholdersandchildprotectionprofessionalsinorder

    tothinkclearlyabouttheimplicationsofimplementation,beforemaking

    recommendationstoMinistersbytheendofApril.

    1.20 Thisisanopportunitynottosettherightsysteminstone,buttobuildanadaptive,

    learningsystemwhichcanevolveasneedsandconditionschange. Itisonlyby

    seekingwellbalancedflexibilitythatthesystemcanhopetoretainitsfocuson

    helpingchildrenandfamilies,ratherthansimplycomingtoserveitsown

    bureaucraticends.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    21/116

    21

    ChapterTwo: Gettinghelpearly

    Nochildsfutureshouldbepredeterminedbythedecisionsormistakesofhis

    or

    her

    parents,

    and

    I

    firmly

    believe

    every

    child

    should

    have

    the

    chance

    to

    succeed,regardlessoftheirbackground.Interveningearlierwithtroubled

    familiescannotonlypreventchildrenandtheirparentsfallingintoacycleof

    deprivation,antisocialbehaviourandpovertybutcansavethousandsifnot

    millionsofpoundsinthelongerterm10.

    2.1 Theearlier,thebetter: Fromachildoryoungpersonspointofview,theearlier

    helpisreceived,thebetter. Researchonchildrensdevelopmentalsoemphasises

    theimportanceoftheearlyyearsontheirlongtermoutcomes. Thischapter,

    therefore,discussesthecurrentpoliciesofpreventionandearlyintervention,but

    hasaspecificfocusonidentifyingthosechildrenwhoaresuffering,orarelikelyto

    suffer,significant

    harm

    as

    aresult

    of

    maltreatment.

    It

    begins

    by

    describing

    the

    levels

    ofpreventionthatcanbeofferedtochildrenandfamiliesbeforediscussingthescale

    oftheproblem,adiscussionthatrevealshowmuchunmetneedforprotectionthere

    is. Themeritsofprimaryandsecondarypreventiveservicesarealsocovered,asis

    theproblemofhowtoidentifythechildrenwithinthoseserviceswhoaresuffering

    orarelikelytosuffersignificantharm. Evidencesubmittedtothereviewsuggests

    thatoneconstructivewayofdealingwiththisproblemiscreatingmultiagency

    teamsinthecommunitythathaveanexperiencedsocialworkeramongother

    professionalssothatmoreinformedappraisalsofsignsofconcerncanbemade.

    2.2 Engagingfamilies:

    There

    is

    atension

    in

    providing

    support

    to

    parents.

    For

    most,

    the

    rightapproachistoofferserviceswithfamiliesmakingavoluntarychoicetoreceive

    them. Therearefamilieswhoselevelofparentingraisessomeconcernandthe

    relevantservicesmakemorestrenuouseffortstomakethemawareofthehelp

    availableandtogaintheircooperation. Therearealsofamilieswhoseparenting

    raisesseriousconcern,anditmaybenecessarytotakeamorecoerciveapproach.It

    istheproblemofdecidingwhentoescalatethelevelofprofessionalinvolvement

    thatisoneofthemainconcernsofthisreview:identifyingthosechildren,receiving

    earlyinterventionservices,whoaresuffering,orarelikelytosuffer,significantharm

    andneedadifferentlevelofresponseisthedilemmaprofessionalsface. A

    complicatingfactor

    is

    that

    parents

    who

    voluntarily

    engage

    with

    support

    services

    tendtomakemoreprogresswhileamorecoerciveapproachcandeteriorateintoan

    adversarialrelationshipwhichblocksprogress. Therefore,movingupthescaleof

    intrusivenesscarriesbothgainsandlossesandsocreatesacomplexdecision.

    2.3 Helping: Thereviewusesthetermhelpratherthanthemorecommonlyusedterm

    interventionindescribingprofessionalservicesbecausehelpcarriesastronger

    connotationofworkingwithfamiliesandsupportingtheiraimsandeffortsto

    change. Inthefirstreport,itwasstressedthatsuccessinhumanservicesisthe

    resultofthejointeffortsoftheprofessionalandtheserviceuser:allpublicservices

    10MinsterofState,SarahTeatherMP, onlaunchingtheGrahamAllenreviewonEarlyIntervention,

    http://www.dwp.gov.uk/newsroom/pressreleases/2010/july 2010/dwp09710280710.shtml

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    22/116

    22

    requirethecustomertobeanactiveagentintheproductionofthedesired

    outcomes11

    . Itisimportant,however,tostressthatusingthetermhelp,doesnot

    takeawayfromthefactthatchildprotectionworkrequiresauthoritativeand,at

    times,coerciveactiontoprotectchildrenandyoungpeople.

    2.4 Currentpolicy:

    Evidence

    submitted

    to

    the

    review

    shows

    that

    there

    is

    strong

    support

    forthecurrentpolicyofbuildingupearlysupportserviceswhichfocusinvestment

    ontacklingemergingproblems. Thereisalsoaconsiderablebodyofevidencethat

    interveningearlycansavemoneybyavoidingmorecostlyinterventions(see,for

    example,theworkofGrahamAllen,mentionedbelow). Manysuchapproaches

    alreadyexist,suchashealthvisitingservices(forwhichthereisaplannedexpansion

    programme)andSureStartChildrensCentreswhicharecurrentlybeingreformed

    withanincreasedfocusonearlyinterventionsupportforthefamiliesingreatest

    needandgreaterinvolvementofvoluntaryandcommunityorganisationswitha

    trackrecordofsupportingfamilies.

    2.5 Supervisedvolunteershavearoletoplayasanaidtotheearlysupportworkforcefor

    children,youngpeople,theirfamiliesandcarers,offeringflexiblehelp. Forexample,

    throughanetworkofover16,000trainedparentvolunteers,HomeStartsupports

    parentswhoarestrugglingtocope. Trainedvolunteerstrytohelpbuildthe

    resilienceandemotionalstrengthoffamilies. Almost25%offamiliestheyhelp

    referredthemselvestotheservice12

    . Inaddition,thereisalongtraditionofchildren

    andtheirfamiliesdrawingonsupportfromarangeofsourcesoutsideofthestate,

    fromcorefrontlineservicesprovidedbysomeofEnglandslargestcharitiesto

    groupsoflocalvolunteersassistingsocialcaretoenhancetheserviceitprovides.

    2.6 Thesignificanceofpreventionandearlyprovisionofhelpisreinforcedbythefactthatweknowfarmoreabouthowtopreventtheprimaryoccurrenceof

    maltreatmentthanhowtorespondeffectivelyoncemaltreatmenthasoccurred13

    .

    AstheAllenReviewargues,thisstrengthensthecaseforhavingselectiveprimary

    preventionprogrammesofferedtofamiliesinhighriskgroups14

    .

    2.7 Itisalsoimportantnottoseeallfamiliesasproblematic. Themajorityoffamilies

    usesupportfromwithinthefamily,friends,communitiesanduniversalservicesin

    raisingchildren. Thebasicsofabigsocietyarealreadyinplace.

    2.8 Inusing

    research

    evidence

    about

    correlations

    between

    childhood

    factors

    and

    later

    outcomes,itisimportantnottoassumeasimpledeterminismattheindividuallevel.

    Researchcanidentifygroupswithinwhichtherewillbeahigherthanaverage

    numberofindividualswhohaveproblemslaterbutsomeinthegroupwillnot.

    Studiesofsiblingswhohavesufferedmaltreatmentrevealhowvariedtheirlife

    11Chapman,J.(2004)SystemFailure;whyGovernmentsMustLearntoThinkDifferently,Demos

    12www.homestart.org.uk

    13Macmillan,H.etal(2009),Interventionstopreventchildmaltreatmentandassociated

    impairment,TheLancet,Volume373,pp25026614

    Allen,

    G.

    (2011),

    Early

    Intervention:

    the

    next

    steps,

    chapter

    3

    (available

    online

    at

    http://media.education.gov.uk/assets/files/pdf/g/graham%20allens%20review%20of%20early%20int

    ervention.pdf)

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    23/116

    23

    coursemaybe15

    . Thisbodyofresearchisimportantnotonlybecauseitunderscores

    theneedtoavoidfatalism,assumingthataspecificchildisgoingtobeproblematic,

    butalsobecauseitdrawsattentiontotheimportanceofresiliencefactorsthathelp

    childrencounteradverseexperiences.

    Whatlevel

    of

    help

    is

    needed?

    2.9 Whenaneedforhelpisidentified,childrenneedprofessionalstomakeagood

    assessmentthatleadstotherightlevelofresponsetotheirneeds. Itiseasytooffer

    adefinitionofwhichfamiliesorproblemscanbehelpedthrougharangeof

    preventiveservicesbut,inpractice,therearemanydifficultiesinassigningfamilies

    toappropriateservicesthatmeettheirneeds.

    2.10 Thestandardcategoriesofpreventionare:

    universal

    primary

    prevention

    addressing

    the

    entire

    population

    and

    aiming

    toreducethelaterincidenceofproblems,e.g.theuniversalservicesof

    health,education,

    selectiveprimarypreventionfocusingongroupswhichresearchhas

    indicatedareathigherthanaverageriskofdevelopingproblems. Manyof

    theinterventionsrecommendedinGrahamAllensreviewfallintothis

    category,e.g.offeringadditionalsupportservicestosingle,teenagemothers;

    secondarypreventionaimingtorespondquicklywhenlowlevelproblems

    ariseinordertopreventthemgettingworse. Thisareaofmultiagencywork

    hasbeenthesubjectofpolicydevelopmentsincetherefocusingdebatein

    199516

    andEveryChildMattersin2003;

    tertiaryhelp/preventioninvolvingaresponsewhentheproblemhas

    becomeserious,e.g.childprotection,hospitalcare,criminaljustice;and

    quarternaryhelp/preventionprovidingtherapytovictimssothattheydo

    notsufferlongtermharm,e.g.therapyforvictimsofsexualabuseor

    therapeutichelpforlookedafterchildren.

    2.11 Thisreviewisremittedtoreformthechildprotectionsystemwhichfallsintothe

    tertiaryandquaternarylevels:theserviceofferedtofamilieswhenthereare

    significantproblemsinthecareofchildrenandyoungpeopleandtheyarethought

    tobesuffering,orarelikelytosuffer,significantharm. Whenweconsiderthisfrom

    theperspectiveofthejourneyofthechildfromneedingtoreceivinghelpweare

    inevitablyinterestedintheearlystagesofchildmaltreatmentandtheservices

    providedatbothprimaryandsecondarylevelsofpreventiontoreducethenumber

    ofchildrenwhosufferseriousmaltreatment.

    2.12 However,thelinkbetweenthelevelsofservicesisnotclearcut. Assessingchildren

    andfamiliesandassigningthemtotherightleveloftherighttypeofserviceisa

    difficulttask. Thereareparticularchallengesinvolvedinassessingwhetherchildren

    15

    Bifulco,

    A.

    (2008),

    Risk

    and

    resilience

    in

    young

    Londoners

    in

    Treating

    traumatised

    children:

    Risk,

    resilienceandrecovery,ed.Brom,D.,PatHorenczyk,R.,&Ford,J.16

    ChildProtection.MessagesfromResearch(1995)HMSOISBN01103217811

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    24/116

    24

    aresuffering,orarelikelytosuffer,significantharm. Statutoryguidancetellsthose

    workingwithfamiliestorefersuchchildrentosocialcare,butmakingthisdecisionis

    notstraightforward. Maltreatmentrarelypresentswithaclear,unequivocalpicture.

    Ingeneral,itisthetotalityofinformation,theoverallpatternofthechildsstory,

    thatraisessuspicionsofpossibleabuseorneglect.

    2.13 Secondarypreventiveservicesseektoidentifyfamilieswithfirstsignsofproblems,

    buttheymayfitseveralcategoriesanditisnoteasyforworkerstoknowwhichis

    which. Thepresentingsignsmaybefirstsignsthatarelowlevelandare

    appropriatelydealtwithbyearlyinterventionservices. Theymay,however,befirst

    signsthatsuggestseriousmaltreatmentthefirstsignmaybeafracturedskullina

    baby.

    2.14 However,themostproblematicgrouparethosewherethefirstsignslooklowlevel

    buttheyarereallythetipofanicebergandthechildisactuallybeingseriously

    harmed.So,

    to

    give

    areal

    example,

    asupport

    worker

    may

    visit

    ahome

    and

    be

    told

    thatonechildisvisitinghisgrandmother. Shecanseethathisbrotherandsisterare

    wellcaredfor. Beingtoldthatachildisvisitingagrandparentdoesnot,onitsown,

    ringalarmbells. Ifthatchildcontinuestobeoutofsightonfuturevisitsaswell,then

    therecomesapointwhenthesupportworkershouldbecomesuspicious,though

    thisrequiresjudgment. Thereisnosimplerule. Inoneformofmaltreatment,

    parentsscapegoataparticularchildandtakegoodcareoftheothers. Inthiscase,

    theabsentchildwas,infact,lockedinabedroomstarving.

    2.15 Thislastpossibility,thatthepresentingproblemthoughlowlevelinitself,maybe

    thesurfaceevidenceofadeeperproblemreceivesmoreattentionwhentherehas

    beenamajorchilddeathstoryinthemedia. Workersoftenthenmakemorereferralstochildrenssocialcareincase,onfurtherinvestigation,thechildisfound

    tobesufferingsignificantharm. AfterthedeathofPeterConnellyandthe

    associatedpublicityinwhichprofessionalswerecastigatedforfailingtoseehewas

    beingmaltreated,therewasanaverage11%riseinreferralsintheyearthat

    followedandthishassustainedsincewithfiguresfor200910showinga10.4%

    increaseonthepreviousyear17

    . Forsomelocalauthorities,therisehasbeenhigher

    thantheaverage.

    2.16 Puttingmorefamiliesintothesocialcarecategoryisproblematicintwomainways.

    Oneof

    the

    problems

    is

    ahigh

    level

    of

    referrals

    that,

    on

    closer

    examination,

    are

    not

    deemedtoneedaservice. Thismeansthatchildrenandfamiliesgothrougha

    stressfulprocessfornobenefitandsocialcareservicesareoverwhelmedin

    searchingthroughthereferralsforthosecaseswherechildrenaresuffering,orare

    likelytosuffer,significantharm. Theirabilitytoprovideeffectivehelptothemost

    seriouscasesisreducedbecausesomuchresourceisdevotedtodealingwiththe

    influxandprioritisingcases. Whilesomeofthesefamiliesneedthatcloser

    examinationtomakeaninformedjudgmentaboutachildssafetyandwelfare,itis

    17

    DfE:

    Children

    In

    Need

    in

    England,

    including

    their

    characteristics

    and

    further

    information

    on

    childrenwhowerethesubjectofachildprotectionplan(200910ChildreninNeedcensus,Final):

    http://www.education.gov.uk/rsgateway/DB/STR/d000970/index.shtml.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    25/116

    25

    clearfromthebigvariationsinreferralratesaroundthecountrythatthereis

    considerablescopeforhelpingpeopleworkinginprimaryandsecondarylevel

    servicestomakefewer,moreappropriatereferrals. Ifthiscanbeachieved,then

    familieswillexperiencefewerunproductivereferralstochildrenssocialcareandthe

    caseloadsinchildrenssocialcarewillbecomemoremanageable,andsohelpto

    createthe

    conditions

    in

    which

    help

    can

    be

    provided

    and

    amore

    effective

    service

    to

    childrenandfamiliescanbeconstructed.

    Thescaleoftheproblem

    2.17 For200910,DepartmentforEducationfiguresreportthat18:

    603,700referralsweremadetochildrenssocialcareservices,anincreaseof

    56,700(10%)fromthe200809figuresandan11%increasefrom200607;

    395,300initialassessmentswerecompletedwithintheyear(65.5%ofthe

    totalreferrals

    in

    the

    year),

    an

    increase

    of

    46,300

    (13%)

    from

    the

    2008

    09

    figuresanda30%increasefrom200607;

    137,600coreassessmentswerecompletedwithintheyear(22.8%ofthe

    totalreferred),anincreaseof17,000(14%)fromthe200809figuresand47%

    iftakenoverthethreeyearperiod,200710;

    39,100childrenweresubjecttoachildprotectionplanat31March2010,an

    increaseof5,000(15%)fromthe200809figures.Themostcommonreason

    forachildtobeplacedonachildprotectionplanwasneglect(43.5%);

    theChildreninNeedCensusreportedthat377,600childreninEngland

    startedanepisodeofneed19

    in200910and694,000wereinneedatsome

    pointin

    the

    year;

    on31March2010therewere375,900childreninneedinEnglandwhich

    equatesto341.3childreninneedper10,000childrenunder18years;and

    themostcommonreasonforachildtobeassessedasinneed,for39.4% of

    allcases,wasabuseorneglect.

    2.18 Thefiguresaboveindicatethatintheyear200910about3.14%ofthepopulation

    ofchildrenandyoungpeople,wereregardedaschildreninneed,butonly0.32%

    werethesubjectofchildprotectionplans(i.e.substantiatedcasesofabuse).

    2.19 Withthis

    level

    of

    unmet

    need,

    the

    contribution

    of

    universal

    services

    and

    services

    targetedonhighriskgroupsisevenmoreimportant,sincetheymayreachchildren

    whosemaltreatmenthasnotyetbeenbroughttotheattentionofchildrenssocial

    care,orwhosesituationdoesnotmeetthethresholdforstatutoryintervention. By

    18DfE:ChildrenInNeedinEngland,includingtheircharacteristicsandfurtherinformationon

    childrenwhowerethesubjectofachildprotectionplan(200910ChildreninNeedcensus,Final):

    http://www.education.gov.uk/rsgateway/DB/STR/d000970/index.shtml.19

    ChildrenAct1989,S17achildinneedisdefinedasachildrequiringadditionalsupportfromalocal

    authority,

    if

    he

    or

    she

    is

    unlikely

    to

    achieve

    or

    maintain,

    or

    have

    the

    opportunity

    of

    achieving

    or

    maintainingareasonablestandardofhealthanddevelopmentwithoutsupport,ifhisorher

    developmentislikelytobesignificantlyimpaired,withoutsupportand/orifheorsheisdisabled.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    26/116

    26

    reachingthesefamiliesearly,primaryandsecondarylevelservicescanreducethe

    numberofchildrenwhomightotherwiselatersuffersignificantharm.

    2.20 Therearenationalstatisticsavailableabouttheprevalenceofactualorpotentially

    harmfulcircumstancesinwhichchildrenarelivingandlocalareashavethetask(and

    statutoryduty

    in

    the

    case

    of

    the

    Joint

    Strategic

    Needs

    Assessment)

    of

    building

    up

    a

    profileoftheirownlocalneed,thathelpsprofessionalsunderstandthepotential

    varietyofresponsesthatmayberequiredintheirareaandtocommission

    appropriateandrelevantservices. Domesticviolenceisasignificantissuelinkedto

    childprotection,anditsprevalencemaybevariedindifferentlocalities. Services

    needtobedevelopedtoreflectthis:

    thereare120,000victimsinanyyearwhoareathighriskofbeingkilledor

    seriouslyinjuredasaresultofdomesticabuse20

    ;

    69%ofhighriskvictimshavechildren21;

    in75%

    to

    90%

    of

    incidents

    of

    domestic

    violence,

    children

    are

    in

    the

    same

    or

    thenextroom22

    ;

    childrenwholivewithdomesticviolenceareatincreasedriskofbehavioural

    problemsandemotionaltrauma,andmentalhealthdifficultiesinadultlife23

    ;

    thelinkbetweenchildphysicalabuseanddomesticviolenceishigh,with

    estimatesrangingbetween30%to66%dependinguponthestudy24

    . The

    RoyalCollegeofPsychiatristsstates:Abouthalfthechildreninsuchfamilies

    havethemselvesbeenbadlyhitorbeaten. Sexualandemotionalabuseare

    alsomorelikelytohappeninthesefamilies25

    ;

    thereareanestimated50,000to200,000youngpeopleintheUKcaringfora

    parentwith

    mental

    health

    problems26;

    20CAADA(2010),SavingLives,SavingMoney(availableonlineat

    http://www.caada.org.uk/Research/Saving_lives_saving_money_FINAL_REFERENCED_VERSION.pdf )

    21Howarth,E.,Stimpson,L.,Barran,D.,&Robinson,A.(2009),SafetyinNumbers:AMultisite

    EvaluationofIndependentDomesticViolenceAdvisorServices

    22Hughes,H.(1992)Impactofspouseabuseonchildrenofbatteredwomen,ViolenceUpdate,1

    August,pp911.;Abrahams,C.(1994),Hiddenvictims:Childrenanddomesticviolence,NCHAction

    forchildren)

    23Kolbo,J.R.,Blakeley,E.H.,&Engelman,D.(1996),Childrenwhowitnessdomesticviolence:A

    reviewoftheempiricalliterature,JournalofInterpersonalViolence,vol.11,no.2;Morley,R.,&

    Mullender,A.

    (1994)

    Domestic

    violence

    and

    children:

    what

    we

    know

    from

    research

    in

    Mullender,

    A.,

    &Morley,R.Childrenlivingwithdomesticviolence:puttingmensabuseofwomenonthechildcare

    agenda;Hester,M.,Pearson,C.,&Harwin,N.(2000;newed.2007)Makinganimpact:Childrenand

    domesticviolence:Areader

    24Hester,M.,Pearson,C.,&Harwin,N.(2000;newed.2007)Makinganimpact:Childrenand

    domesticviolence:Areader;Edleson,J.(1999),Theoverlapbetweenchildmaltreatmentandwoman

    abuse,NationalElectronicNetworkonViolenceagainstwomen(availableonlineat:

    http://www.vawnet.org/DomesticViolence/Research/VAWnetDocs/AR_overlap.php );Humphreys,C.,

    andThiara,R.(2002),RoutestoSafety:Protectionissuesfacingabusedwomenandchildrenandthe

    roleofoutreachservices,WomensAidFederationofEngland;Morley,R.,&Mullender,A.(1994)

    Domesticviolenceandchildren:whatweknowfromresearchinMullender,A.,&Morley,R.

    Childrenlivingwithdomesticviolence:puttingmensabuseofwomenonthechildcareagenda;

    Radford,

    L.,

    &

    Hester,

    M.

    (2006),

    Mothering

    through

    domestic

    violence

    25http://www.rcpsych.ac.uk/mentalhealthinfo/mentalhealthandgrowingup/domesticviolence.aspx

    26MyCare,TheChallengesFacingYoungCarersofParentswithaSevereMentalIllness,TheMental

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    27/116

    27

    morethan2.6millionchildrenintheUKlivewithhazardousdrinkers,

    705,000livewithadependentdrinkerandmorethan8millionpeopleare

    affectedbyafamilymembersalcoholuse27

    .A2010NSPCCChildLinesurvey

    revealedmorethan4,000children,someasyoungasfiveyearsold,had

    contactedtheserviceduringthepreviousyearworriedabouttheirparents

    excessivedrinking.

    Many

    of

    these

    callers

    also

    reported

    instances

    of

    abuse

    andneglect28

    ;and

    210,000adultsareintreatmentfordrugdependencyeachyear,overathird

    ofwhomatanyonetimeareparents29

    .

    Earlyhelp: understandingneed

    2.21 Problemsmayariseatanytimeinchildrenslivesandsoservicesneedtobe

    responsivetoemergingneedatallages. Theearlyyears,however,areaperiod

    whenconstructivehelpcanhavethemostimpact:

    Anexplosionofresearchintheneurobiological,behavioural,andsocial

    scienceshasledtomajoradvancesinunderstandingtheconditionsthat

    influencewhetherchildrengetofftoapromisingoraworrisomestartinlife.

    Thesescientificgainshavegeneratedamuchdeeperappreciationof:(1)the

    importanceofearlylifeexperiences,aswellastheinseparableandhighly

    interactiveinfluencesofgeneticsandenvironmentonthedevelopmentofthe

    brainandtheunfoldingofhumanbehaviour;(2)thecentralroleofearly

    relationshipsasasourceofeithersupportandadaptationorriskand

    dysfunction;(3)thepowerfulcapabilities,complexemotions,andessential

    socialskills

    that

    develop

    during

    the

    earliest

    months

    and

    years

    of

    life;

    and

    (4)

    thecapacitytoincreasetheoddsoffavourabledevelopmentaloutcomes

    throughplannedinterventions. Earlypathways,thoughfarfromindelible,

    establisheitherasturdyorfragilestageonwhichsubsequentdevelopmentis

    constructed30

    .

    2.22 Governmentpolicyinrecentyearshasbeendesignedinrecognitionthattheservices

    childrenandfamiliesreceivehavetoooftenbeenlimited,becauseofthefailureof

    professionalstounderstandoneanother'srolesortoworktogethereffectively.

    Policieshaveemphasisedthebenefitstochildrenandyoungpeopleofprofessionals

    workingtogether

    with

    families

    to

    try

    to

    understand

    their

    needs

    early

    on,

    identify

    the

    HealthFoundation(availableonlineat

    http://www.mentalhealth.org.uk/publications/?entryid=38571&entryid5=83759&cord=DESC&char=

    M)

    27Manning,V.et.al.(2009)Newestimatesonthenumberofchildrenlivingwithsubstancemisusing

    parents:ResultsfromUKnationalhouseholdsurveys,JournalofPublicHealth,9(1),pp377389

    28NSPCCmediarelease:http://www.nspcc.org.uk/newsandviews/mediacentre/press

    releases/2010/100816childrencarryshameofparentsdrinkanddrugsabuse/100816children

    carryshamefulsecretofparentsdrinkanddrugsabuse_wdn78148.html.

    29NationalTreatmentAgencyfigures:http://www.nta.nhs.uk/aboutbenefits.aspx

    30National

    Research

    Council

    (2000)

    From

    Neurons

    to

    Neighbourhoods:

    The

    Science

    of

    Early

    ChildhoodDevelopment,WashingtonD.C.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    28/116

    28

    supportandservicesneeded,andworktogethertomeetthem. Evidencesubmitted

    tothereviewshowsstrongsupportforsharedthinkingandassessmentamong

    professionals,where,withthefamilysconsent,afullerunderstandingofthefamilys

    needsisestablished,usingaformatcommontoalllocalagenciesthatcanbeshared

    amongthemasthefamilypermits. Cruciallysuchanassessmentshouldseekthe

    viewsand

    feedback

    of

    the

    children

    involved

    so

    that

    their

    voice

    can

    inform

    the

    assessmentandthenatureoftheserviceprovided.

    2.23 However,evidenceprovidedtothisreviewalsoshowsthemixedexperiencesand

    absenceofconsensusabouthowwellprofessionalsareunderstandingoneanothers

    rolesandworkingtogether. Thisemphasisestheimportanceofthoughtfully

    designedlocalagreementsbetweenprofessionalsabouthowbesttocommunicate

    witheachotherabouttheirworkwithafamily,andsupportingthoseconversations

    withalocallyagreedformatforrecordingtheneedsofafamilyandtheactionand

    helpthatwillbeprovided.

    Earlyhelp: recentpolicyandpracticedevelopments

    2.24 Undertakinganearlyassessmentisthestartofthehelpingprocess,enablingthe

    developmentoftherelationshipbetweentheprofessionalandthechildandfamily,

    butitwillnotitselfbesufficienttomeettheneedsoffamilies. TheCoalition

    Governmenthassetintrainstructuralreformstoservicessuchaseducation,

    policing,welfareandhealth. Takentogetherthesechangeshavethepotentialto

    changedramaticallythewayservicesinteractandsupportchildren,youngpeople

    andfamilies,buttheyhaveacontinuingcrucialroleinpreventingorrespondingto

    abuseand

    neglect.

    Universal

    services

    play

    an

    important

    role

    in

    the

    provision

    of

    informationtoparentsandchildren. Childrenhavecitedtheimportanceofaccessto

    goodinformationaboutabuseandaboutservicessotheycanunderstandwhether

    theyarebeingharmed. Theyhavealsostressedtheimportanceoftellinginasafe

    environment;usuallyuniversalservicesareseenbychildrenasasafehaven.

    2.25 Rolessuchasnamedanddesignatedhealthprofessionalorschoolleadfor

    safeguarding,forexample,haveanimportantparttoplayinthechildprotection

    system. Designatedleadswhoareexperiencedinchildprotectioncanhelp

    colleaguesthinkthroughworryingsignsanddecidewhetherornotreferralto

    childrenssocial

    care

    is

    needed.

    To

    prevent

    neglect

    and

    abuse,

    the

    provision

    and

    supportprovidedthrougharangeofuniversalservices,suchaseducationandhealth

    careiscritical.

    2.26 Therearealreadyanumberofpolicycommitmentsforuniversalandmoretargeted

    servicestomakeearlyhelpmoreeffective,includingsupportfortheprovisionof

    freenurserycareforpreschoolchildren. SureStartChildrensCentreswillbe

    reformedwithanincreasedfocusonearlyinterventionsupportforthefamiliesin

    greatestneedandgreaterinvolvementofvoluntaryandcommunityorganisations

    withatrackrecordofsupportingfamilies.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    29/116

    29

    2.27 Similarlythenumberofhealthvisitorsisduetobesubstantiallyincreased. Health

    visitorsaretrainednursesormidwiveswithspecialisttraininginfamilyand

    communityhealth. Theyareskilledatspottingearlyissues,whichmaydevelopinto

    problemsorriskstothefamilyifnotaddressed,forexampleaparentstrugglingto

    copeorachildhealthissuewhichneedsspecialattention. Thenationalhealth

    visitingprogramme

    aims

    to

    increase

    overall

    numbers

    of

    health

    visitors

    by

    4200

    by

    April2015to:

    develop,supportandpromotetheservicessetupbyfamiliesand

    communitiesthemselvesaspartoftheYourCommunityservice;

    delivertheHealthyChildProgrammeensuringallchildrengettheessential

    immunisations,healthanddevelopmentchecksaspartofaUniversal

    Service;

    providearapidresponsewithexperthelpforproblemslikepostnatal

    depressionorasleeplessbaby,aspartoftheUniversalPlusService;and

    provideongoing

    support

    as

    part

    of

    arange

    of

    local

    services,

    working

    together

    andwithdisadvantagedfamiliestodealwithmorecomplexissuesovera

    periodoftime,undertheUniversalPartnershipPlusService31

    .

    ThisisbeingtakenforwardinpartnershipwithSureStartChildrenCentres,local

    authoritiesandthenewHealthandWellbeingBoardsthatlocalauthoritieswilllead.

    2.28 ThePublicHealthWhitePaper,HealthyLives,HealthyPeople:Ourstrategyfor

    publichealthinEngland32

    ,respondstoProfessorSirMichaelMarmotsFairSociety,

    HealthyLives

    report33

    ,andaimstotacklethewidersocialdeterminantsofhealth.

    Thisnew

    approach

    will

    aim

    to

    build

    peoples

    self

    esteem,

    confidence

    and

    resilience

    rightfrominfancy,withstrongersupportforearlyyears.

    2.29 Alongsidethisreviewintochildprotection,thereareotherreviewsestablishedby

    theGovernmentthatareveryrelevanthere. ClareTickellsreview34

    oftheEarly

    YearsFoundationStageextendsacrosstheuniversalserviceofeducationandcare

    andisconsideringhowtoidentifyandprovidesupportforchildrenwhoarealready

    showingdevelopmentaldelaysorbehaviouralproblemsandwhoareinneedof

    additionalhelp. FrankFieldsreview35

    lookedathowtoprovideabettereconomic

    environmentforfamilies,povertybeingamajorcauseofadditionaldifficultiesin

    providinggood

    care

    and

    made

    recommendations

    on

    reducing

    child

    poverty.

    Graham

    31DepartmentforHealth(2011),HealthVisitorImplementationPlan20112015:ACalltoAction

    32Availableonlineat

    http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH

    _121941

    33Marmot,M.(2010),FairSociety,HealthyLives(availableonlineat

    http://www.marmotreview.org/ )

    34Launchnoticeavailableonlineat

    http://www.education.gov.uk/inthenews/inthenews/a0061485/reviewofearlyyearsfoundation

    stage

    35Field,F.(2010),FoundationYears:preventingpoorchildrenbecomingpooradults(availableonline

    athttp://povertyreview.independent.gov.uk/)

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    30/116

    30

    Allensreview36

    intoearlyinterventionhasalreadymadeastrongargumentforthe

    economicvalueinprovidinghelpintheearlyyearsandhasidentifiedanumberof

    programmesofhelpthathaveevidenceofsomeeffectivenessinimproving

    childrenslifechances.

    2.30 TheCoalition

    Programme

    for

    Government

    made

    acommitment

    to

    investigate

    anew

    approachtosupportingfamilieswithmultipleproblems. Thereareanestimated

    120,000familieswithmultipleproblemswith46,000havingoneormorechild,aged

    1015withbehaviourproblems. Overathirdofthesefamilieshavechildrensubject

    tochildprotectionprocedures37

    . Thesefamiliesexperiencearangeofhealthissues,

    includingpoormentalhealth,alcoholandsubstancemisuse. Evidenceshowsthat

    thesefamiliesarealsoatriskofexperiencingviolenceinthehousehold.

    2.31 Therearethreestrandstothestrategy:

    investto

    test

    and

    share:

    asmall

    number

    of

    exemplar

    areas

    are

    testing

    out

    newapproaches;

    learnfromsuccess: mentorareaswithatrackrecordofsuccessfully

    supportingfamiliesareactingasdisseminationhubs,sharingtheirknow

    howtohelpothersintheirareas;and

    breakdownbarriers: currentlyupto20localagenciescansupportthesame

    family,eachwiththeirownfundingrulesandregulations. Thishasbeen

    showntostandinthewayofcreatingasingleservicededicatedtotacklingall

    theproblemsaffectingasinglefamily. From1April2011localagenciesinthe

    first16areas(or28localauthorities)willbeabletocreateaCommunity

    Budgetfreeing

    up

    money

    to

    be

    spent

    on

    innovative

    types

    of

    family

    service.

    2.32 ThenewstrategywillbuilduponFamilyInterventions(FIs)thatareonewayof

    supportingvulnerableanddisadvantagedfamilies. Theyuseamultiagency

    approachwithanintensiveandpersistentstyleofworkingtochallengeand

    supportfamilies. TheFImodelfocusesonhavingakeyworkerwholinksinwith

    otheragenciesincludinghealthtoaddresstheneedsofeachfamilymember.

    2.33 TheFamilyNursePartnership(FNP)programmeisapreventiveprogrammefor

    vulnerableyoungfirsttimemothers. Speciallytrainednursesofferintensiveand

    structuredhome

    visiting

    from

    early

    pregnancy

    until

    the

    children

    are

    two,

    using

    practicalactivitiesandstrengthbasedmethodsthatchangebehaviourandtacklethe

    emotionalproblemsthatpreventsomemothersandfatherscaringwellfortheir

    child. FNPhasbeentestedinEnglandsince2007andtheSecretaryofStatefor

    HealthannouncedinOctober2010thathewoulddoublethenumberofplaceson

    FNPby2015. Theprogrammeisbasedonmorethan30yearsofUSresearchwhich

    36Allen,G.(2011),EarlyIntervention:thenextsteps(availableonlineat

    http://media.education.gov.uk/assets/files/pdf/g/graham%20allens%20review%20of%20early%20int

    ervention.pdf)37

    Patterns

    of

    Specialist

    Mental

    Health

    Usage

    in

    England,

    ONS.

    http://www.neighbourhood.statistics.gov.uk/dissemination/Info.do?page=analysisandguidance/analy

    sisarticles/patternsofspecialistmentalhealthserviceusageinengland.htm.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    31/116

    31

    hasshownsignificantbenefitsfordisadvantagedyoungfamilies,togetherwith

    substantialcostsavings.

    2.34 EarlyevaluationinEnglandsuggeststhatFNPcanbedeliveredsuccessfullyandthat

    takeupisgoodwithpromisingpotentialimpacts. Mothersarereducingsmokingin

    pregnancyand

    ahigh

    proportion

    are

    initiating

    breastfeeding;

    they

    have

    significantly

    improvedmastery,aformofselfesteemlinkedtopositivebehaviourchange,atthe

    endoftheprogrammecomparedtothestart;andtheyareverypositiveabouttheir

    parentingcapacity,reportinghighlevelsofwarmparenting,lowlevelsofharsh

    disciplineandlevelsofparentingstresssimilartothatinthenormalpopulation. FNP

    childrenappeartobedevelopinginlinewiththepopulationingeneral,whichisvery

    promisingasthisgroupusuallyfaresmuchworse.

    2.35 AreviewofinterventionstopreventchildmaltreatmentintheLancetrateditasthe

    programmewith'bestevidence'describeditashavingundergonethemostrigorous

    andextensive

    evaluation

    of

    child

    maltreatment

    outcomes38.

    Multiagencylocalityteamswithsocialworkexpertise

    2.36 Childrensproblemsmaybenoticedbytheimmediateorextendedfamilywhoseek

    helporbyprofessionalsincontactwithfamilymembers,forexampleprimaryhealth

    carecentres,healthvisitorservices,midwifery,antenatalservicesandGPpractices,

    schools,earlyyearsservicessuchasnurseriesandchildrenscentres,thepolice,

    adultmentalhealthservices,substancemisuseservices,andhousingservices. There

    are,therefore,alargenumberofprofessionalsandthepublicwhomayseesignsfor

    concernthat

    achild

    is

    being

    abused

    or

    neglected.

    Deciding

    how

    serious

    these

    signs

    areisnotalwayseasy.

    2.37 Asmentionedearlier,abuseandneglectrarelypresentinanunequivocalway,but

    peopleseeevidencethatisambiguous;itcouldindicatemaltreatmentorhavea

    morebenignexplanation. Manyinuniversalserviceswillhavehadsometrainingin

    recognisingmaltreatmentandthoseineducationandhealthhaveaccesstomore

    experiencedcolleagueswhoarethedesignatedleadsforchildprotectionandwho

    canhelpthemjudgewhethertheirevidencewarrantsfurtheractionornot.

    However,theevidencegiventothisreviewsuggeststhatthedecisiontoreferonto

    childrenssocial

    care

    is

    experienced

    as

    problematic

    by

    many.

    The

    variation

    in

    referralratesaroundthecountryandthefluctuationsinreferralratesinresponseto

    highprofilechilddeathsbothsuggestthatcomplexity,uncertainty,andanxietyplay

    asignificantpartinmakingthedecisiontorefer.

    Decidingwhatlevelofsupport/safeguardingresponseisrequiredremainsa

    vexingprobleminchildwelfare,anddecisionsareoftentakeninchallenging

    circumstancesandwithlimitedinformation39.

    38

    MacMillan,

    H.L.,

    Wathen,

    C.N.,

    Barlow,

    J.,

    Fergusson,

    D.,

    Leventhal,

    J.M.

    and

    Taussig,

    N.

    (2009),

    Interventionstopreventchildmaltreatment andassociatedimpairment, Lancet373:25026639

    Broadhurst,K.,White,S.,Fish,S.,Munro,E.,Fletcher,K.,&Lincoln,H.(2010),Tenpitfallsandhow

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    32/116

    32

    2.38 Thereviewhasbeenimpressedbythesolutionsdevelopedinsomelocalareas

    wheremultiagencyteamsthatincludesocialworkersarebasedinthecommunity

    withuniversalservices. Thisallowsthoseintheuniversalservices,whobecome

    concernedaboutachildssafetyorwelfare,toreadilydiscussthiswithan

    experiencedteamwhocancheckwhatelseisknownaboutthechildandfamilyand

    provideevaluation

    and

    assistance.

    This

    team

    enables

    adeeper

    professional

    considerationofthepresentingcontextandisresultinginbetterdecisionsabout

    howtoallocateearlyhelpand/ormoreintensesocialcaresupport. Thisapproach

    allowsprofessionalsandpractitionerstohaveaccesstosocialworkexpertise,

    helpingthemtomakebetteruseoftheircloserknowledgeandengagementswith

    thechildandfamily. Morespecifically,theprofessionalanxietythatexistsintrying

    tounderstandtheseverityoftheirconcernsaboutachildislessened. Thisseemsto

    comefromtheprovisionofsocialworkexpertisetotalkthroughconcernbeforea

    formalassessmentorreferralismade. Moresenseismadeofthepresenting

    concernandinformation,andaconsensusreachedaboutbestnextsteps.

    2.39 Theevidencefurthershowsthatthenumberofinappropriatereferralstochildrens

    socialcareisreduced. Theteamsarereportedtobehelpingtodirectthosefamilies

    inneedofadifferenttypeofhelptoanappropriatealternative.

    2.40 Theselocalinnovationshavebeenofdifferentforms. Some,forexample,havebeen

    socialworkledandsomeheadedbythepolice. Thereviewwillexplorehowlocal

    areascanbesupportedindevelopingtheirownarrangementsforteamstomeetthe

    localneedsofthecommunity. Becausesuchteamsprovidebenefittomany

    agencies,itisperhapsappropriatethattheirfundingshouldalsobesharedamongst

    theseagencies.

    Conclusion

    2.41 Thereisastrongcaseforprovidingprimaryandsecondarypreventiveservicesto

    preventmaltreatmentoritsfurtherescalation. Forchildren,providinghelpearly

    reducestheamountofdistressorharmtheymaysufferandweknowmoreabout

    preventingmaltreatmentthanstoppingitsrecurrence. Offeringhelpearlycanalso

    bedoneinarespectfulwaythatdoesnotunderminetheresponsibilityofthe

    parentstobringuptheirchildren. However,theproblemofidentifyingthose

    childrenreceiving

    early

    intervention

    services

    on

    aconsensual

    basis

    in

    partnership

    withparents,butwhoaresuffering,orlikelytosuffer,significantharmisnoteasy.

    Thereviewhasbeenimpressedbythoselocalinnovationsthathavetackledthis

    problembycreatingmultiagencyteamswhereconcernscanbeexaminedandmore

    accuratejudgmentsmadeaboutwhatlevelandtypeofhelpisneeded.

    2.42 Commontothesesuccesseshasbeenthecreationofchannelsthroughwhich

    practitionersfromdifferentagenciescandiscusstheirconcerns,eitherinameeting

    roomorsimplyoverthetelephone. Thevalueoftheseinformalbutstrategic

    conversationsisthattheyenableprofessionalstoexchangeideaswithoutneedingto

    toavoidthem:whatresearchtellsus,p.3

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    33/116

    33

    enterformalproceedings. Itistheseinformalrelationshipsbetweendifferenttypes

    ofexpertwhichthereviewholdstobecrucialtoimprovingearlyhelp. Whendone

    properly,thisshouldhelptoreducethenumberofunnecessaryreferralsto

    childrenssocialcare,freeingtimeandresourcesinbusydepartments. Butitshould

    alsogiveuniversalservicesandfamilysupportworkersbetteropportunitiestotalk

    throughconcerns,

    even

    when

    they

    are

    not

    immediate

    child

    protection

    issues,

    and

    so

    offerabetterchanceofthesechildrenreceivingappropriateattentionmorequickly.

    Initsnextphasethereviewwillconsiderhowthismutuallybeneficialrelationship

    betweenservicescanbefosteredandencouraged.

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    34/116

    34

    ChapterThree: Childandfamily

    socialwork

    Introduction

    3.1 Acentralpartofthisreviewsremitistomakerecommendationsonimprovingsocial

    workpractice. Thischapterconsiderstheexpertisesocialworkersneedtobeableto

    exerciseandthenextchapterfocusesonhowthesocialcareorganisationcanhelp

    (orhinder)theminacquiringandusingthatexpertise.

    3.2 Whenchildrenandyoungpeoplecomeintocontactwithchildrenssocialcare,their

    fundamentalneedisforunderstandingoftheproblemstheyandtheirfamilieshave,

    andfor

    the

    provision

    of

    help

    to

    resolve

    them

    in

    order

    to

    improve

    their

    safety

    and

    wellbeing. Howcansocialworkersbehelpedtoprovidetheunderstandingand

    helpthatchildrenandyoungpeopleneed? Howcantheyhelpparentschangeso

    thattheyprovidesafeandgoodqualitycare? TheSocialWorkTaskForceandthe

    SocialWorkReformBoardhavesummarisedtheirambitionsforreform40

    :

    bettertrainingwithemployers,educatorsandtheprofessionalltakingtheir

    fullshareofresponsibilityforinvestinginthenextgenerationandinenabling

    socialworkersalreadyinpracticetodeveloptheirskillscontinuously;

    improvedworkingconditionswithemployerssigninguptonewstandards

    forthe

    support

    and

    supervision

    of

    their

    frontline

    workforce

    that

    make

    good

    practicepossible;

    strongerleadershipandindependencewiththeprofessiontakingmore

    controloveritsownstandards,howitisunderstoodandvaluedbythe

    public,andthecontributionitmakestochangesinpolicyandpractice;

    areliablesupplyofconfident,highquality,adaptableprofessionalsintothe

    workforce,wheretheycanbuildlongtermcareersonthefrontline;

    greaterunderstandingamongthegeneralpublic,serviceusers,other

    professionalsandthemediaoftheroleandpurposeofsocialwork,the

    demandsofthejobandthecontributionsocialworkersmake;and

    moreuse

    of

    research

    and

    continuing

    professional

    development

    to

    inform

    frontlinepractice.

    3.3 Thisreviewendorsestheiranalysisoftheproblemsandtheirrecommendationsfor

    improvingthequalityofsocialworkpractice. However,italsoseekstobuildon

    thesefoundationstospecifythespecialistskillsandknowledgeneededinchildand

    familysocialwork. Thereisnowasubstantialbodyofresearchevidencethatcan

    helpsocialworkersmakebetterassessmentsofchildrensneeds,andoffermore

    effectivehelptofamiliestocreatesaferandmorenurturingparenting. Skilledsocial

    40SocialWorkTaskForce(2009),BuildingaSafeandConfidentFuture,p6

  • 8/3/2019 MUNRO the Munro Review of Child Protection Interim Report the Child's Journey

    35/116

    35

    workerscanmakeasignificantdifferencetothequalityofchildrenslives. Farmer41

    illustratesthispointwell,reportingthatthehighestsuccessrateforreunifying

    childrenwiththeirbirthfamilieswas64%whilethelowestwas10%,withthekey

    determinantbeingtheskillandinvestmentofthesocialworkteam.

    3.4 However,as

    the

    first

    report

    of

    this

    review

    concluded,

    we

    need

    to

    focus

    not

    only

    on

    whatexpertisewewantanindividualsocialworkertohave,butalsoonwhatwork

    environmenthelpsthemdevelopandusetheirexpertise.

    Indesign,weeitherhobbleorsupportpeoplesnaturalabilitytoexpressforms

    ofexpertise42

    .

    3.5 Itisimportanttoseethequalityofanyonesocialworkersperformanceasnotjust

    beingduetotheirexpertisebutarisingfromtheinteractionbetweenwhatthey

    bringtothejobandtheaspectsoftheworkenvironmentthatmakeiteasieror

    harderfor

    them

    to

    exercise

    that

    expertise.

    A

    dysfunctional

    workplace

    makes

    it

    difficultforeventhemostskilledandmotivatedsocialworkerstoachievethelevel

    ofeffectivenessthattheywouldlike. Thisappliesnotonlytothemajorobstaclesto

    goodpracticesuchasheavycaseloadsorlackofsupervision,buttothemoresubtle

    influencesofthedesignofassessmenttools,ororganisationalmessagesabout

    priorities. Thelessonslearnedinothersafetycriticalareasofworksuchashealth

    andaviationclearlyshowthatstudyingtheinterplaybetweenworkersandthework

    environmentisthemostproductivewayofimprovingstandardsandreducing

    errors43

    .

    3.6 This

    chapter

    begins

    by

    looking

    at

    how

    people

    exercise

    expertise,

    how

    they

    use

    their

    differentreasoningcapacitiesandemotionsbecausethishasimplicationsforhow

    theyaresupportedtoreachahighlevelofperformance. Thisaccountbringsout

    howengagingwith,andunderstandingachildandtheirfamily,involvesfarmore

    thanlogicalreason. Whensocialworkersaretalkingtoachildandfamilyintheir

    home,theyaredrawingonseveralsourcesofi