Hampshire County Council

Policy and Resources Scrutiny and Select Committee Item 7

11 April 2005

SELECT COMMITTEE INQUIRY 1: The Prevention & Management of Risk with Children and Young People

Report of the Inquiry Panel Chairman: Cllr Ludlow

Officer Contact: Share D'All, Chief Executive's Department.

e-mail: [email protected] Tel: 01962 846634

1. Executive Summary:

This report covers the final recommendations of the Inquiry Panel looking into the Prevention & Management of Risk to Children and Young People as well as a brief review of our experience operating in the style of a Select Committee.

The Inquiry Panel chose to investigate: "How we can respond effectively to early indicators that a child is at risk of detrimental outcomes (emotionally, socially, educationally and/or mentally) and through early intervention reduce the likelihood of their having difficulties later on".

The Panel were aware throughout the process that the subject was a huge one and that we could not possibly cover every aspect. We focused on prevention of risk because it was urgent and was timely, given the current changes being implemented as a result of the Children Act. The Panel hoped to provide useful input to the planning of that implementation as well as recommendations to Cabinet and other Councillors for minimizing risk to children and young people.

The Inquiry Panel have enjoyed taking evidence from both external and internal witnesses and have benefited greatly from the expertise of both groups. The recommendations in this report are therefore made while recognising the very good work already being done. We hope to add value to that work and provide a focus for future planning and action as well as monitoring by Members, and our ultimate aim is to ensure the best outcomes for the children and young people of Hampshire.

This report supports Aims 1, 4, 5 and 6 of the Corporate Strategy.

1.1 The Recommendations:

The `headline' strategic recommendations are summarised below but further recommendations, for different groups, and detail is contained in the body of the report.

On a strategic level the Inquiry Panel recommends that Hampshire County Council, in its lead role under the Children Act:

1.1.1. Plans to ensure that the whole of the workforce delivering universal services to children and young people in Hampshire is trained to:

· Spot early indicators and warning signs of risk

· Know how to respond and access other universal or specialist service where necessary

· Understand and effectively undertake their part in supporting families and developing resilience in children

1.1.2. Collects and collates data from across organisations which is then visibly used to:

· Plan and prioritise actions to prevent risk

· Provide ongoing trend information to enable us to evaluate the impact and plan future prevention activity.

1.1.3. Uses strategic and local data effectively in its planning with partners to:

· Agree and prioritise a few realistic outcomes across the County

· Identify and prioritise local needs and interventions

· Map existing services against local needs to identify gaps and make best use of existing resources.

2. Introduction:

The Inquiry Panel was set up by the Policy and Resources Scrutiny & Select Committee as their first experiment of operating in the style of a Select Committee. This report covers the work of the panel and comments on the style of working (Appendix 1).

The Panel chose to investigate: "How we can respond effectively to early indicators that a child is at risk of detrimental outcomes (emotionally, socially, educationally and/or mentally) and through early intervention reduce the likelihood of their having difficulties later on".

Our report is written with three groups of reader in mind:

1. It is written primarily for County Councillors who need to know what must be done to avoid tragedies which have occurred too often in the past. They need to understand the risks to children and the corporate responsibility they have in reducing risk. They need to understand the work already being done by HAMPSHIRE COUNTY COUNCIL and partners; future developments which need to be supported and improvements which need to be monitored and measured. This will be even more important with new members after the elections.

2. Members of the public who have a general interest in the Council's approach.

3. Professionals and partner organisations who will be involved in implementing improvements and in studying further aspects of the study.

3. The Process

We began by studying written evidence from publications and written submissions.

The Panel then took evidence from several external witnesses (detailed in Appendix 2) who are experts in the field; some external practitioners and also officers from both key departments within the Council. Although aware that this was not an exhaustive list it provided very useful information about the key success factors and areas for concern in working around prevention with children and young people.

Given the pressures on Officers, who need to maintain services while they face major reorganisation as the Children Act is implemented, it was agreed with Senior Officers that we should interview a very small number of internal witnesses. As a result of this decision, the current work by the Council may be under-represented and the Panel would recommend a commitment by the Council to a more thorough review and action in the next few months.

4. Understanding Risk and the definition of terms

Risk is the likelihood of harm to a child or young person and all children face a varying degree of risk throughout their lives. The level of risk at any time is the result of many risk factors: genetic, family circumstances, school, peers and so on. These risk factors may be mitigated by protective factors such as high self-esteem and protective factors confer a degree of resilience.

In managing risk, we have to reduce risk factors and increase protective factors to maximise positive outcomes. For the vast majority of children, this can be done through universal services such as education which are available to all children (Tier 1). But some children will be vulnerable and will need early intervention (Tier 2). Children at greater risk, or children in need will need targeted support (Tier 3). And children in acute need will need specialist support (Tier 4). Fortunately, the number of children concerned diminishes from Tier 1 to Tier 4.

Our objective must be to recognise problems early and offer support that protects vulnerable children. Only a small proportion of vulnerable children will progress from vulnerable to being at need or acute need and the problem is to identify which are the most at risk. These tend to be children with multiple risk factors: for example, deprived families whose parents also have a drug habit and mental health problems..

Often different risk factors are recorded by different organisations: education, social services, health and voluntary organisations. The presence of multiple risk factors then goes undetected unless information is shared between organisations.

Another way of identifying problems is by comparing performance of the child with expected performance. For academic progress or physical development, there are numerous tests which are well calibrated and delayed development may be picked up fairly easily. For emotional behaviour it is less easy to know what is expected at a given age and service providers vary in their experience of "what is normal" and consequently their ability to assess deviation from it.

5. Overview of Prevention:

Preventing detrimental outcomes for children and young people is equivalent to ensuring positive outcomes in all the following areas:

· Social / Behavioural (being good citizens; contributing positively to their relationships and communities)

· Intellectual / Educational (able to achieve results, in education and work, that reflect their potential)

· Mental / Emotional (sufficiently balanced and resilient to deal positively with the emotional and relational aspects and challenges of life)

· Physical (getting and staying physically unharmed, fit and healthy)

Prevention will often be achieved by developing universal services and applying them early; to targeted groups as well as the whole population.

Members found it useful to think of this as being a `Healthy Circle', with prevention being seen as activities which attempt to ensure that all individuals have the internal and external resources and support necessary to keep these four factors `in the Healthy Zone'.

The reality, for more children and young people than we would wish, is that they find themselves in what turn out to be `vicious circles' rather than healthy ones. The role of the Council and its partners is to:

· Spot those living or heading out of the `healthy circle' and intervene to bring them into it

· Ensure that once people are in the Healthy Circle they stay there

The Panel read articles and heard from several witnesses that whilst all people are different there are some fairly clear indicators of people `slipping out of the circle' which it would do well for us to spot early and act on, as it is easier to bring someone into the `Healthy Circle' if intervention is early and if they have not strayed too far out of the circle.

6. Key Themes in the Evidence:

The key challenge themes which came out of the oral evidence stage are available on the website (see the reference at the end of this report) but in summary they fell broadly into the following headings and bullet points:

6.1. Prioritise a realistic number of clear outcomes:

· A smaller number of realistic goals over a realistic time span - recognise that prevention work is not a quick impact area and needs long term strategies

· Do not try to target everything

· Ensure that all partners are really on board with the priorities

· Outcome-priorities should dictate organisational design

· Priorities should be clearly linked from strategic to local operational levels

6.2. Balance universal and specialist services

· Universal services are well placed to identify early indicators

· They can clarify what level of resource is needed at what tier of service. We need sufficient `critical mass' of resources at an early stage (prevention) to turn things around (analogy of pot boiling - takes a lot of energy to get it boiling but then less to keep it boiling)

· Importance of easy referral from universal to the appropriate tier of specialist service where needed - common language / assessment / access criteria etc

6.3. Identify Early Indicators

· Whole workforce (not just Education / SSD / Health) needs to understand what early indicators are etc

6.4. Workforce development of the whole universal workforce (including School staff and all partners)

· Key need to develop common language and culture

· Need understanding of `attachment' and' resilience' theory

6.5. Culture change

· There are very different cultures between organisations and within them (departments) which need to be brought together for common understanding

6.6. The Importance of Common Language

· Language is an important part of culture. We need a common understanding of what we mean by `prevention', `outcomes', `intervention', `assessment', `resilience' etc

· The lack of common understanding acts as a barrier to information sharing and co-operation

6.7. Multi-agency working

· There is some good practice already around to learn from and we need to make sure we do learn from it (i.e. SureStart)

· Information sharing is vital (protocols and culture) and much work is being done in this area already

· We need clear lines of accountability for individual cases and overall working together (in other words, any officer suspecting a problem has a duty to act on their suspicions but there must be clearly defined responsibility of particular lead agencies)

6.8. Single & local points of access and accountability

· This could mean co-location of services

· People often prefer to access local and familiar services which may be local schemes or voluntary organisations. The County Council needs to work with these schemes or groups

· Are schools the natural access point? (Extended schools agenda)

6.9. The Need for Innovative Approaches;

· We should not always assume that Social Workers need to be involved

· Re-think who provides which service (de-commissioning)

· Go out to people rather than expecting them to come to us - especially for hard-to-reach groups

6.10. Understand & interpret local needs

· Similarity in local issues does not mean the same cause and therefore may not need the same solution / intervention

· Look at whole family not just individuals

6.11. Data collection and use

· Identify what data you need (both at local and whole county levels)

· Collate data collected across organisations

· Collect ongoing data and identify trends

· Map services against local-needs data

6.12. Fund preventative work

· There will be a challenge with the reduction of Children Fund

· Demand for specialist services inevitably puts pressure on funding for prevention although investment in this area can pay huge dividends for the future and is critical in a different way

6.13. Manage the image of Children's services

· Especially where the image of Social Services has been the service that `takes your children away'

6.14. Suggested areas of focus for Preventative Strategies

· Respite care for families (parents & siblings) and young carers

· Neglect is an important problem and must not to be overlooked

· We need to develop resilience in children (and parents)

· Involve parents

· Develop support during the middle years of education (transition years)

7. Current Work under Implementation of Children Act:

Many of the topics mentioned above were identified by both internal and external witnesses as key to success in the area of prevention, which was very heartening.

Recognising that we are in the very early stages of implementation of the Children Act, the Panel looked for areas where external witnesses had highlighted issues that were not strongly reflected by internal witnesses as these seemed to be areas for potential development.

8. Recommendations for the Future:

These fall into several categories:

8.1. For Cabinet and Senior Officers in Designing Strategy Now

There were three main strategic areas that were emphasised more strongly by external witnesses than in the evidence of County Council officers. These are areas where we need to reassess our progress and this, in turn, leads to the main recommendations of the Panel.

8.1.1. Hampshire County Council, in its lead role under the Children Act should plan to ensure that the whole of the workforce delivering universal services to children and young people in Hampshire is trained to:

· Know how to spot the early warning signs of risk to children & young people - they should know what development to expect of children at certain ages and be able to identify deviations and lack of progress

· Understand the theory and importance of attachment and bonding between parents and children and be able to observe indicators of its absence

· Have and use a common language, which enables common understanding and information sharing

· Know how they in their role can support families and develop resilience in children

· Understand their accountabilities and responsibilities for individual children

· Know how to share information between partner organisations

· Know how to assess when specialist services may be appropriate and how to access them

8.1.2 Hampshire County Council should take a proactive lead in collecting and collating data of risk indicators across the county in order to:

· Prioritise needs (both locally and strategically)

· Establish trends

· Collect ongoing data for measuring impact

8.1.3 Use data effectively by:

· Mapping needs for each locality against local services already in existence. It is especially important to take account of local schemes, such as "Surestart" and voluntary organisations. We were advised to "build on what is there".

· Using the data to work with partners to agree strategic priorities in preventative work

· Agreeing what ongoing data is required to measure impact of strategies - and how it will be collected, collated and learned from

8.2 For Future Planning:

The Panel also want to make the following recommendations about the focus of future planning and investigation:

8.2.1. Further attention should be given to resolving the potential conflict between the autonomy of schools and their role in fulfilling Hampshire County Councils leadership of children's services. (The Children Act imposes duties on schools and their staff that will conflict with their autonomy).

8.2.2. It is important to consider the whole family rather than just children when assessing need for preventative intervention

· For example, respite support for parents can have important benefits to siblings as well as parents and children with disabilities.

8.2.3. It is important to make use of resources that already exist - which is why mapping services is so important

8.2.4. The feedback from the public is that they prefer to access familiar local services (even if they are less plush) than have to travel to more expensive ones - this needs to be reflected in our planning

8.2.5. We must enable and support innovative solutions - which means good problem analysis and creativity and also opportunities for sharing good practice

8.2.6.

8.3. For Cabinet:

An important role for Cabinet will be to ensure that the strategic direction agreed is monitored for:

· Effective implementation

· Desired impact over time

8.4. For All Councillors:

The Panel feels it important to recommend that all Councillors need to be made aware of their responsibilities in this area both jointly (as Corporate Parent) and individually, especially with regard to the Council's aims and strategy in developing Children's Services and preventative work in particular.

The Panel recommends that all Councillors should :

a) Be aware of the strategic and local priorities for children & young people

b) Have a good understanding of the specific needs in their area and the services that are working with them. i.e.

· They should visit schools and other Children's Services establishments

· They should be able to discuss an input to the prevention priorities in their areas with recognition that causes vary and strategies need to be tailored and effective

c) They should monitor the effectiveness of partnership working in their area in this field

8 Acknowledgements

The Panel would like to thank all the witnesses and those who submitted written evidence for the time, insight and effort they gave unsparingly.

The Panel would also like to thank Share D'All, Colin Hinxman and Andrew Saint for outstanding officer support

Background Papers: (Section 100 D - Local Government Act 1972)

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

Title: File:

Written Evidence & Oral Evidence Summaries are available on Hantsweb and can be accessed from the following link:

http://www3.hants.gov.uk/scrutiny/cx-scrutiny-overview/cx-scrutiny-overview-inquiries/cx-scrutiny-overview-inquiries-children.htm

9 Appendices:

9.1 Appendix 1: Piloting the Select Committee Approach

The Panel made the following comments on their experience of operating as a Select Committee:

BENEFITS:

· It has been very useful, enjoyable and interesting to work as a group brought together around a subject - a new mix of people rather than a long term group.

o The Panel would welcome future opportunities to work in this way.

· The small group worked well and was able to make use of different people's interests, skills and insights.

· Having specific officer support was important and useful

CONCERNS:

· Will the Recommendations have any impact ? This is the acid test of the usefulness of any activity or approach

· The Panel feel that Full Council is the appropriate forum for the report to be presented and we need clear guidelines as to what the expected response timescales should be.

· Full Council should have the role of planning to monitor progress against those recommendations that are agreed.

LEARNING:

· We need to start with a more focussed subject - the broad `Children & Young People' heading was too broad and even when narrowed down to Prevention and Management of Risk was a huge subject.

· The timescale ended up being much too tight (especially with Christmas and Easter in the middle) - in the future the timescale needs to be arranged at the outset with dates set in advance. The need for a longer run in for booking oral evidence witnesses is particularly crucial.

· Each Inquiry needs to be carefully project planned

RECOMMENDATIONS FOR THE FUTURE:

· Create `select committees' around the specific subjects that warrant the intensive attention. Do not have `select committees' for the sake of them or as standing committees - they are not the only method but are good if used wisely

· Use more small groups working around specific subjects

· Getting the right subjects for scrutiny at the right time is crucial - we need to have a better process for identifying subjects and whatever the process is needs to enable all Members to contribute

· You need to project plan for each subject / group and have good officer support

9.2 Appendix 2: Witnesses

Oral Evidence was taken from the following witnesses: