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"It's everyone's job to make sure I'm alright"
Report of the Child Protection Audit and Review

Chapter 4: The case audit: Meeting children's needs

Immediate action
Longer-term action
Home support
Extended family
Foster care
Support for children
Key staff
How were families treated?
How were children treated?
Outcomes for children
Key Messages

4.1 The audit of practice showed that there was considerable work by professionals in respect of the children. The weight of concern was great and in many cases extensive energy and resources were deployed. In this chapter we discuss the kind of services offered and how effective they were in meeting children's needs. We also consider the extent to which children's lives were improved by agency intervention.

Immediate action

4.2 Some children needed immediate protection by removal from home. In the majority of such cases social workers and the police worked with parents to persuade them to agree to their children being moved elsewhere. There were occasions when parents would not co-operate with social work or other agencies, however, and risk remained. In these instances there was a need to consider taking out either a child protection order (CPO) to remove the child to a place of safety, or an exclusion order to remove the person who presented the risk, from the family home.

4.3 CPOs were rarely applied for. Social workers were reluctant to seek them unless they could demonstrate to a court that there was an immediate risk to the child. Some social workers were not confident about seeking one. A number of social workers expressed concern about appearing in court and being cross examined about their work. Other agencies often saw a CPO as a precaution to be taken in relation to something that might happen, for example, a parent deciding to remove a child from hospital against the advice of the doctors. Even where other agencies felt strongly that a CPO was necessary they did not use their own powers to seek one.

4.4 Social workers generally held the view that there was little point in seeking exclusion orders as they placed the responsibility on the other adult in the household (usually a woman who had previously been unsuccessful in excluding the man) to keep the abuser out. We saw only one example of an exclusion order being used.

4.5 In a small number of cases children were at risk from males who were not living in the family home, but were living close by or were frequent visitors. The risks to children were sometimes very serious in such cases but the grounds for compulsory measures of supervision - that a child 'is likely to become a member of the same household' as an offender - could not be met. Reporters had difficulty in framing grounds in such cases and the Hearing system could not offer an effective way of protecting the child. Similarly when a child was showing sexualised behaviour, but no conclusive evidence was found that the child was being sexually abused, Reporters often struggled to frame grounds.

Longer-term action

4.6 Much of the abuse and neglect was the result of poor parenting skills. Once recognised, agencies normally responded with a range of compensatory measures to improve the day-to-day conditions for the children:

• increasing support in the home through home carers helping the children to rise and wash, getting them ready for school or nursery and preparing and providing meals;
• providing early or full-time nursery placements;
• schools, through breakfast clubs and school dinners, provided food and on occasions, supplementied clothing; and
• providing respite care.

4.7 The work by social workers and social work assistants, home care workers, teachers and classroom assistants often sustained children. Where there were problems of parental substance abuse, we found some evidence of high levels of home support stabilising situations. Home care workers also often provided a key liaison channel for health and education staff. Respite care allowed children to experience nurturing and develop new skills whilst retaining the family bond.

4.8 We saw a range of educative programmes for parents. Where support to improve parenting skills was offered, the contributions of family centres or nurseries were particularly impressive. In a few cases health visitors also played a significant part. Most services were either directed at women or both parents together. We came across only one example of special provision for men where a black Muslim health visitor voluntarily offered his services to fathers in the local mosque in his own time. The provision of such a service in this way suggests that provision for fathers is much needed but is not being developed by statutory agencies.

Home support

4.9 In some cases parents were greatly assisted in developing the ability to care effectively for their children.

4.10 Where intensive remedial work was provided solely in the home, we found little evidence of long-term success. In some cases it was not possible for home carers to engage in the educative role without first clearing and cleaning a space in which this might occur, for example, in food preparation or washing clothes. This resulted in many home carers 'doing' rather than educating and training as intended. Although home care support was often aimed at improving the cleanliness of both the home and that of the children, many children remained dirty, poorly clad and smelly. This left them open to bullying at school and within the community.

4.11 In several cases, children were living at home, but virtually all the day-to-day and occasional night care was provided by a range of support services rather than the parents. In reality the local authority was parenting the child.

4.12 In some instances children continued to suffer physical harm, in spite of considerable family support. Where additional support was provided through schools, there were examples of children's situations deteriorating over the school holidays. Most fundamentally, however, these arrangements did not address the lack of parental interest and care without which children's positive self-esteem cannot develop.

4.13 Although professionals recognised the weaknesses of an approach which allowed children to remain with their parents in these circumstances, they had clear reasons for not removing children from their homes.

• Children had strong attachments to their family.
• Research showed that outcomes for looked after children were poor.
• There was a lack of good quality foster homes and residential provision.
• Residential provision would not meet the needs of the child.

Extended family

4.14 For many children, a key aspect of their needs being successfully met was the part played by the extended family, most commonly aunts or grandparents. Where they lived in the neighbourhood, they often provided practical and emotional support for the children and their family, enabling the family unit to be preserved. Where parental ill-health, or the presence of a dangerous partner, made the maintenance of the family unit untenable, in many instances it was a relative who took over care of the children. The ability of these relatives to operate effectively was often seriously constrained, however. In unstable home situations, it sometimes seemed that relatives' availability to pick up the pieces 'at the drop of a hat', and then relinquish care of the child equally quickly, was taken for granted.

4.15 Where relatives took on the long-term care of children they often felt unsupported and their requests for help were not always met. Often there were difficulties in obtaining financial support when children were being looked after by relatives. On occasions, in an emergency agencies moved children to relatives without checking the suitability of the family.

Foster care

4.16 When, to secure their safety, children were placed successfully in foster care, their circumstances, particularly material and health circumstances, often improved. Schools often noted improvements in the attitude and performance of older children following fostering. If children were accommodated, their health needs were properly attended to and any remedial work, such as treating dental caries, was undertaken. When looked after away from home, children also had opportunities for developmental activities such as joining clubs or having new experiences.

4.17 We also saw cases, however, where foster carers could not cope with the behaviour of children.

4.18 Occasionally, children were sent back home from care, against their will, in one case to a household with a father who had convictions of sexual abuse against children.

Support for children

4.19 For some children, good outcomes were the result of effective anticipation and/or early intervention. Practice was generally better for new babies whose parents had a learning disability, mental health problem or drug problem. Health services arranged for pre-birth or pre-discharge meetings with the other key agencies. These worked well when all the key agencies attended, a multi-agency plan was made and the individual workers each played a part in implementing it. Good work also prevented risks escalating.

4.20 The type of services children and young people needed in order to develop and mature into healthy, well-adjusted adults ranged from immediate practical and emotional support to long-term therapeutic help. In too many instances the case audit found that children were not receiving the services they needed.

4.21 Overall there was a shortage of skilled workers with time to offer children practical and emotional support. We were told that:

• social workers were unable to offer services directly to children or their parents because of a lack of time for regular meetings or because they felt they lacked the appropriate skills; and
• psychology, psychiatry and specialist counselling waiting lists were so long that children could not gain access in a reasonable timescale. Psychological and psychiatric support services would not deal with cases where they recognised a range of other contributory family problems.

4.22 A few authorities provided or directly commissioned therapeutic support from voluntary agencies. Where support was offered, it was valued and made a good contribution to the welfare of children. In some instances individual social workers took the initiative in seeking funding and setting up support groups when they could not access appropriate help for the child. Examples included:

• a group for boys with low self-esteem;
• a group for the children of substance abusers; and
• a service for children with sexualised behaviour.

4.23 Overall there was a tendency to overlook the needs of child perpetrators. Nationally there are one or two programmes for young people who exhibit sexually abusive behaviour. Nor were programmes available for children who were showing signs of other damaging compulsive behaviours such as self-harming.

4.24 Generally, referrals to the educational psychology service did not result in children receiving specialist support. Schools told us that the use of educational psychologists as advisers to schools rather than as caseworkers limited the availability of such support for children with emotional and behavioural needs.

Key staff

4.25 Good workers made a real difference to the outcomes for children. In a number of instances, particularly in relation to drugs or alcohol abuse, where strong, supportive relationships had been established between the social worker and the misusing parent, he or she was able to address the problems and was very positive about the support received. In some cases, children suffering from emotional abuse began to respond positively when they developed good relationships with the classroom assistants assigned to them by their schools.

4.26 Often, successful practice in meeting children's needs was due to the approaches, determination and effective work of particular individuals, either from the agencies or in some instances from the extended family. Notable examples of determined and effective work were:

• the social worker who persistently and intensively worked with a drug using mother about the impact of the drugs on her new baby;
• the care workers who, on a daily basis, worked with unskilled parents to gain their confidence, raise their expectations and performance and served as a key line of communication with other agencies;
• the primary headteacher who specifically deployed a classroom assistant to provide 'a haven' for a much neglected pupil;
• the nursery manager who employed a home visitor to support parents who were struggling and to prevent child abuse developing;
• the police officers who supplemented other evidence by searching through supermarket video-camera surveillance footage;
• the relative who spent a whole day, largely unsupported by statutory agencies, with a suicidal mother in order to physically prevent her taking her own life;
• the Reporter who made wide-ranging enquiries to ensure that all the needs of one child were attended to; and
• the health visitor who was persistent in ensuring a child protection plan was made and implemented.

4.27 Good practice in relation to support for children included:

• Support from a named worker to reassure children that their concerns had been addressed.
• Therapeutic services where children had an opportunity to work through what had happened to them, come to terms with it and move towards a different future.
• Remedial health care to address neglected problems such as poor eyesight, dental decay and hearing difficulties.
• Information and guidance about inappropriate behaviour, particularly in cases of sexual abuse or bullying.
• Change programmes that targeted entrenched problem behaviours.
• Foster carers with the level of expertise and skill to care for children whose behaviour was so disturbed that they needed more specialist help.
• Remedial help that provided opportunities to make up for gaps in children's development, in particular those that improved confidence, sense of purpose and self-esteem.
• A sustained relationship with an individual who would 'be there for' a child consistently, spending time with them, listening to them in their distress and helping and supporting them as they developed.

How were families treated?

4.28 The review team had access to very few parents. We interviewed parents in respect of 17 children. The majority of the parents were happy with agency responses and a number spoke highly of the professionals involved with them. In most cases, agencies established good relationships with families in what were often difficult circumstances, but families often felt that they were not kept fully enough informed about what was happening.

4.29 The views of parents were generally well recorded in social work files if they were critical of social work or if parents had sought a change in supervision patterns. Where parents valued social work, or other help, this was rarely recorded.

4.30 The children and families in the sample who were of minority ethnic descent came into contact with primarily white British practitioners. The practitioners were all committed to understanding their needs but were frequently concerned about their lack of knowledge about ethnicity and different religions and cultures and were worried about 'getting it wrong'. Interpreters were usually available but there were cases where older children were used to interpret for their parents. In one case an external interpreter adapted the evidence to provide a culturally acceptable translation. Professionals from the statutory sector often used staff from voluntary organisations who worked with minority ethnic groups for providing advice on matters relating to race and ethnicity, especially in relation to domestic abuse.

4.31 Families and children had their own views about successful outcomes which often focused on public punishment of the abuser. Where court cases were not pursued through lack of evidence, or were dismissed, victims felt that they had not been believed. The arrest and imprisonment of offenders was not always a reliable protective measure particularly when the cases of bailed offenders might take a year to come to court. Sometimes, through lack of evidence, cases were not proven. In one case a previously convicted offender was released on bail, pending appeal, without any warning to the victim or her family and he continued to be a threat to them. We were concerned that, in these circumstances, advice was not sought from social work or the police about the appropriateness of bail addresses or the need for any conditions of bail.

4.32 As evidenced from social work files, families sometimes said that agencies' arrangements for monitoring the care of their child(ren) felt intrusive. In these cases social workers helped parents to accept the level of oversight whilst recognising that it was difficult for them.

4.33 There was some variation in agencies approaches to working with families. This was identifiable in:

• practice in making announced or unannounced visits to homes;
• preparing families for, and supporting them through investigations and the child protection case conferenceor court process;
• providing them with records of meetings and decisions; and
• involving them in the on-going core group discussions.

4.34 Some parents were dissatisfied because their preferred outcome from an investigation, for example removal of a child from the care of an ex-partner, was not considered warranted or to be in the best interests of the child. Agencies experienced difficulties in working with parents where an acrimonious break up left both parties with major suspicions of their ex-partners. The case audit found that investigations were approached differently and in some cases the complaints about a partner's behaviour were treated with extreme caution because the complainant had not acted when the couple were together.

4.35 Occasionally parents complained to social work about the allocation of particular workers - a single mother, with good reason to be nervous of male contacts, found herself assigned a male social worker, in another case, a parent was assigned a social worker who had been her social worker when she was a child. Complaints were properly responded to.

4.36 We found examples where parents had valued highly the support given. We interviewed parents who found the support helpful even if they wished it had not been necessary. Many had social workers who listened to them about their concerns, directly helped them in parenting tasks and provided much needed material resources.

4.37 In many cases parents were co-operative and able to make use of the support that was on offer. There were a number of cases, however, where parents were either resentful of intrusion, or reluctant to accept support. Nonetheless, in many of these cases effective practitioners had put considerable effort into maintaining a relationship with the parent.

4.38 The key features of effective work with parents were:

• persistence in maintaining a working relationship;
• provision of practical social and emotional support for both parent/s and children;
• provision of feedback;
• clarity about risks and what needed to change;
• flexibility about time and place of meetings; and
• taking decisive action to protect children when necessary.

How were children treated?

4.39 Children who had come to the attention of agencies because of abuse and neglect, particularly if there were a number of cases, experienced contact with a large number of adults from different agencies. In respect of one child, the case audit team had contact with 18 people from different agencies. Contact with a dozen professionals was not uncommon.

4.40 The team met with young people who were very positive about the support which they and their family had received. In these cases a recurring feature was the sustained relationship developed with key staff from one or more agency. This contrasted with other cases where young people referred to the ever-changing set of workers to whom they were supposed to relate. Circumstantial evidence from schools, of major changes in attitude and performance of some children, particularly where they had been moved into foster care, suggest that social work intervention had also been beneficial in these cases.

4.41 The team also met and heard about young people who felt let down by the system. These young people felt they had not been listened to or believed and that their problems had not been addressed. Some children were bitter at being required to return to homes where they did not feel safe. Children who became part of a yo-yo cycle between home and foster care were left with little security or sense of worth.

4.42 Children's perspectives were recorded in some cases. In social work files, if a parent or a child had expressed a view about their treatment by professionals, or the various systems, this was well recorded. There was little evidence, however, of children being asked about their experiences of abuse and neglect. For example, where children spoke to teachers or where professionals themselves identified concerns, agencies referred the case to social workers or the police as a matter of course, according to guidance. We did not find records of either children's views about what should happen with their concerns or of their views about whether the information should be passed onto another agency. In cases of physical or sexual abuse the views of the children were generally recorded as part of the investigation interview process - what happened and how they felt about it. Children, who expressly stated a view about a particular course of action (for example not to prosecute a parent), had their views recorded, but children were not routinely asked what they thought should happen with their concerns.

4.43 In cases of neglect sometimes there were discussions with children about where they wanted to live and when children expressed a view this was recorded. However, their experience of neglect or their views about their day to day life experiences were not recorded. There was no real indication from the files of what children felt about their experiences or the emotional relationships they had with their carers.

4.44 Whilst all the professionals involved with children were concerned for their 'best interests', they often did not consult with children about what their 'best interests' might be. Many children in the sample were too young to express a view, but many were not. A number expressed strong views, usually in a negative fashion, by not co-operating with supervision orders, fighting against them or showing distress with the plans made for them.

4.45 In spite of social workers' efforts to work constructively with children there were difficulties over which they had no influence or control. In one case, a mother persistently threatened her children that 'if they were bad, social work would come and put them into care!' When it was eventually decided that the children should be taken into care and they were removed from their grandparents' home by social workers, they were very disturbed and believed they must have been 'very bad' for this to have occurred.

Outcomes for children

4.46 There had been concerns about the children in our sample in September 2001, and in most cases, the concerns remained at the time of the case audit in the spring of 2002. It was possible to arrive at an evaluation of how the children's needs had been met and to form a view about whether the longer-term plans were likely to lead to reduced risk or improvement in the children's circumstances. However, for most of these children, the long term outcomes remained unknown. Currently, agencies tend not to have mechanisms in place to evaluate the longer-term outcomes for children, nor was it possible for the case audit to do so and this was a weakness.

4.47 In coming to conclusions about cases we focused primarily on whether children were protected and whether their needs were met. We also considered if procedures had been followed and whether the general quality of the work was of a good standard. Of the188 cases examined by the team we were unable to draw conclusions in 9 cases because of insufficient information. Of the remaining 179 cases we found a number of children (40) were either not protected or their needs were not met following the intervention of agencies. A further 62 children were only partially protected or their needs only partially met. In 77 cases children were protected and their needs were met and in 24 of these cases the needs of the children were well met. Figure 5 on page 90 outlines two case examples in detail. In one case practice was considered to be good and the outcomes for the child were positive in that he was well protected and his needs and those of his family were met. In the other case practice was not good, the child and her siblings were not protected from abuse and neglect and their needs were not assessed or met.

Meeting need and protecting children: Good practice

4.48 Although we could not look at long-term outcomes for children we found that good practice occurred in those cases where:

• the direct provision of help to parents and children was given as and when it was needed;
• there was a helpful and timely response and early thought and preparation; and
• the source of the risk was properly addressed.

Where practice conformed to the above principles children and young people were more likely to be protected and more likely to have their needs met.

4.49 In cases of domestic abuse best practice was seen in those cases where the father's abusive behaviour was tackled and both the mother and children were protected.

Children who were not protected or whose needs were not met

4.50 Where children were unprotected or their needs were not met, the failures of the system were either multiple or related to one significant aspect of the case. In most cases a significant weakness was a lack of assessment of a child's needs and many cases also suffered from poor investigations or lack of thoroughness in enquiries.

4.51 Some professionals appeared to have become inured to the circumstances in which some children were living and did not recognise, or did not know how to act on their responsibility to effect change.

4.52 There were cases where children were not fully protected and their needs were not fully met, but where practice was on a day-to-day level of a good and consistent quality. A feature of these cases was the level of effort employed by agencies, particularly social work services, without an appreciable improvement in children's lives. In these cases a lack of assessment of the parent's ability to adequately care for their children was often a feature.

4.53 In some cases the action taken to meet need and protect a child was appropriate but only taken after a long history of abuse and neglect by which time children were already damaged by their experiences. In other cases all the correct procedures were followed when abuse was identified but the experience of the family and the child was a poor one. Occasionally, in spite of all practitioners' best efforts, a child remained unprotected because of decisions made elsewhere in the system.

Key messages

• Children are often unprotected due to poor assessment of risk and of parental capacity to meet their responsibilities. Some parents receive considerable family support and their parenting abilities are greatly improved but others are unable or unwilling to change despite high levels of intervention.
• Some children's circumstances significantly improve in foster care.
• In too many instances children do not receive the services they need.
• A consistent feature of good practice is the direct provision of help to parents and children as and when they need it.
• Good workers make a crucial difference to the outcomes for children.

Figure 5: Practice Examples

Figure 6: Summary of effective practice

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