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10. CAPACITY FOR IMPROVEMENT
10.1 At the time of transfer to Glasgow City Council in April 1996, Kerelaw had been without a substantive Principal for several months. The Deputy (Secure Unit) had been acting Principal since the Autumn of 1995, and he remained in charge until late 1997, after 2 unsuccessful attempts by the Council through open competition to make a substantive appointment. At the end of 1996, the SMT at Kerelaw was reduced to 4 with the retirement of an Assistant Head in the Open School. He was not replaced as a result of a review of Kerelaw and 3 other residential centres by Strathclyde Regional Council in 1994 (see paragraph 13.7).
10.2 The SMT was destined to experience significant churn over subsequent years. This was not helpful to the construction of a shared vision of what Kerelaw's direction should be in a new era of child care and protection, and change in the local government landscape. It would be untrue to suggest that no one considered that improvements at Kerelaw were required or tried to take up the challenge of change. There was recognition by certain individuals that the quality of care needed to improve, that the world was changing and that cultural issues needed to be addressed.
Tensions over change
10.3 The Deputy (Open School) at the time of the transition from Strathclyde Region to Glasgow City Council was aware of this and she sought among other things to improve staff access to training, to integrating the night staff with the daytime operations of the school, and to introducing new approaches to meeting the needs of young people. She also established a throughcare project to support young people leaving Kerelaw. In all of this she had some supporters. But she also faced opposition, as we noted at paragraphs 9.17, and a number of former staff gave evidence to the Inquiry about this. One stated that:
[the Open School Deputy] was a breath of fresh air and had a particular influence over the women working at Kerelaw……[she] gave power to the young people and that shell shocked some of the staff who had maintained a control regime for the last 20 years……but she wanted change to happen too quickly and didn't manage it well, so there was great resistance in some quarters
10.4 Another noted that:
[Her] nurturing and progressive approach did not suit everyone……
while one who supported her summed up the challenges she appears both to have posed and faced:
[She] was both the best and worst manager he had ever had, sometimes in the same day. She was committed to the school, to young people and the task. She made Kerelaw an interesting place to work but there were lots of tensions between her and the other managers.
10.5 We heard from a number of sources about tensions during this period between the Deputy (Secure Unit) and the Deputy Head (Open School) around aspects of practice, and that staff allegiances formed round one or the other. A report by North Ayrshire Council on its September 1996 inspection of the Open School, although positive about its Deputy, referred to relations between senior managers as strained. It may be an oversimplification to describe the opposing views as being between a disciplinarian and a child-centred, libertarian approach, but they appear to have been very polarised. One former member of staff encapsulated what several others also told the Inquiry, that there were:
…… tensions between [the two Deputy Heads] …their relationship was awful and generated schisms within the staff group. [one] represented a more liberal, progressive way of thinking but……would go off and do things without consulting anyone…….
10.6 The files and oral evidence to the Inquiry give an indication of the obstacles to progress and of who were not supportive. While more progress might have been made had the Deputy (Open School) gone about things differently, it appears to the Inquiry that her counter-cultural values would have been difficult for some managers and staff, regardless of her personal style.
10.7 The post of Principal was advertised again in September 1997, but no appointment was made. The acting Principal then asked for, and returned to, his former post as Deputy (Secure Unit), the role to which he had been recruited in the early 1980s. To fill the vacancy, the Council appointed another acting Principal who, as an Assistant District Manager, had been undertaking the role of external manager of Kerelaw, on behalf of the District Manager. We discuss external management arrangements in Chapter 13.
"Less than child friendly"
10.8 The Inquiry learned that the Deputy (Open School) had voiced concerns about the culture at Kerelaw to managers in the Social Work Department, although we were told that these were not sufficiently specific to enable action to be taken in respect of particular individuals. Nevertheless, following complaints by certain placing authorities and the subsequent investigations to which we referred at paragraphs 7.7-7.9, the Head of Service wrote in February 1998 about her concerns over Kerelaw to her line manager, the Depute Director of Social Work. In her memo she described a culture that was "less than child friendly".
10.9 In early March 1998 the Social Work Department re-issued its Care and Control Policy for residential care, partly in response to the concerns described above. It referred among other things to the aim of a "safe and caring" environment, and made clear that workers should not participate in horseplay with young people on the grounds that those who had experienced abuse might interpret physical contact as "threatening or oppressive". The document also set out rules on searching, and required each residential unit to have a development plan. Correspondence from the Social Work Department to the acting Principal referred to "worrying signals" about TCI and to potential use of a range of behavioural management techniques.
10.10 The acting Principal reported on a number of actions taken in response to the concerns raised, including circulating the re-issued Care and Control Policy to all staff, tightening complaints procedures, and ensuring proper recording of violent incidents. He also asserted that supervision took place more regularly than had been suggested by staff interviewed during fact-findings. Nevertheless, as we have described in Chapter 9, insufficient supervision continued to be a theme in inspection reports and reviews.
10.11 In June 1998 the acting Principal circulated the Council's Residential Child Care Staff Code of Practice with a requirement that managers discuss it with staff, who were to sign to confirm that discussion had taken place. The Code of Practice set out what was and was not acceptable conduct and covered professional and personal boundaries, professional conduct, role modelling, and children's rights. It made clear among other things that staff should show respect for young people and their families, and in dealings with colleagues. It covered the use of language, relationships, and contact with young people, and action to take if negligence or abuse was suspected. It referred to lessons from reports and Inquiries.
An outside appointment
10.12 In early 1998 the Deputy Head (Secure Unit) had taken extended sick absence and in April 1998, the post of Principal had been advertised again. This time an external candidate, with Secure Unit experience in England, was selected in competition with internal applicants. When he took up post in September 1998, he appears to have encountered some resentment over the appointment of "an outsider", but he managed to establish a working relationship with most of his senior managers, and believed at the time that he had reasonable support.
10.13 We were told in evidence that the new Principal had been impressed by how the selection process had been conducted but that, before accepting the appointment, he had visited the Secure Unit. He had considered the conditions there appalling and an important consideration in his acceptance of the post as Principal was an assurance given to him by Glasgow City Council that the Secure Unit was going to be rebuilt. In July 1996 the Government had published A Secure Remedy: a review of Secure Care in Scotland18 which had criticised Kerelaw's Secure Unit, and the Council had agreed in principle to redevelopment, subject to negotiations with the Government over funding (see also paragraphs 13.42 to 13.44).
10.14 Taking forward the planning for redevelopment and improving the running of the existing Secure Unit were high priorities for new Principal throughout his tenure. However, his arrival also brought a fresh external perspective on Kerelaw as a whole and an opportunity for general change. Although he was unaware prior to his arrival of the concerns previously expressed by the Deputy Head (Open School), he began to harbour his own concerns about practices in Kerelaw, including poor staff recruitment and staff cliques. A number of issues raised in the 1997 fact-finding investigations (see paragraphs 7.7 and 7.8) about restraints and sanctions remained to be addressed. An audit covering logs and files, controls, supervision, absence management, care programmes, recording, and follow-up, and other matters was put in hand. The Inquiry saw records which indicate management action on a number of fronts from telephone usage to health and safety, all of which suggest that a new broom had arrived. As with many new brooms, the actions he took were not always or universally welcomed.
10.15 In response to concerns related to the "riot" in 1998 (see paragraph 7.10), a Review of Night Care was undertaken in conjunction with the Social Work Department to address what management considered to be a large divide between day and night care staff. The findings were submitted in March 1999 and as we have noted, resulted in the consolidation of additional posts on night-shift which had been created on a temporary basis after the "riot".
10.16 The Review found that night staff felt isolated and that there was confusion over roles, boundaries, expectations and responsibilities. It proposed the attachment of night staff to particular units and greater integration with day staff under single unit management, which was to be strengthened. The aim of uniting day and night work was not fully achieved. The review identified deficiencies in staff supervision, which we discussed in Chapter 9. It also expressed concern about recruitment and the lack of regular assessment of temporary workers, and recommended improvements.
"A New Organisation"
10.17 We were told that senior managers in Glasgow saw the new Principal as an important appointment which would put Kerelaw on the road to improvement. That he understood that improvement was needed at Kerelaw is clear from a paper entitled "A New Organisation" which he sent to the Head of Service in February 1999. This sent a signal that, if Kerelaw had previously seen itself as standing off from the Social Work Department, this would need to change:
We are all part of Glasgow City Council Social Work Department and it is important that we strengthen and develop existing links. Kerelaw School must continue to have a strong individual identity as an integral part of Children and Families Services.
10.18 This wish to "open up" Kerelaw and link it more closely into the Glasgow City Council management structure does not appear to have been popular, including, so far as we could tell from evidence, within parts of the SMT. However, some managers approved of his involvement of Kerelaw in certain HQ groups and it seems that he did achieve greater integration with management in Glasgow than had previously been the case.
10.19 The Principal's paper identified most of the problems which Kerelaw seems to have faced between 1996 and its closure. It acknowledged examples of good child-centred practice across the school, but stressed the importance of commitment to developing practice. Staff development and training were identified as a high priority. In particular, the paper emphasised the need for a more inclusive culture in which there was more working together and a stronger sense of Kerelaw having a single identity rather than a cluster of individual units. It also identified and spelled out the cultural challenge in the following terms (original underlining):
We have to work towards promoting an inclusive culture which values the individual and is clear about the service objectives. An inclusive culture requires everyone to have a clear understanding of roles, boundaries and decision making processes. An inclusiveculture requires a commitment to service provision and an end to divisive splits. An inclusive culture requires everyone to contribute to the ongoing process of development. An inclusive culture requires everyone to work within a framework of equal opportunities and anti-oppressive practice………At the heart of any organisation is the culture. We must begin the development of a new culture at Kerelaw School. Managers should be approachable and open to being challenged as well as challenging in a safe environment.
10.20 Consistent with his aspiration for a more inclusive culture, the Principal widened attendance at management meetings to unit managers, a change not welcomed by all members of the SMT. In early 1999 a School Development Plan was produced, but the Deputy Head (Open School)'s throughcare initiative was abandoned, mainly for budgetary reasons, and against her wishes. In March 1999 the Deputy (Open School) went on sick leave from which she did not return. When it became clear that her post was likely to remain vacant for some time, an acting Deputy (Open School) was appointed in early June.
10.21 In late 1999, the Principal reallocated SMT responsibilities by switching the Deputy (Secure Unit), who had returned to work, with the acting Deputy (Open School). This was not welcomed by the former, and was to cause division in the SMT thereafter. The new acting Deputy Head of the Secure Unit was confirmed as substantive Deputy (Secure Unit) later. According to evidence given to the Inquiry, the switching of Deputies was followed by the transfer of a number of staff from the Open School to the Secure Unit.
10.22 There had been criticisms by HMIE, following an inspection in September 1999, of the Unit's ethos, the structure of the educational curriculum, the effectiveness of leadership, and staff development and review, all of which were considered unsatisfactory. Concerns had also been raised during the Summer of 1999 by an advocacy worker. The management and staffing changes were accompanied by the promotion of arrangements to establish and fund psychologist-led programmes in the Secure Unit, intended to improve the management of young people in secure care and to make it more child-centred. Nevertheless, some managers took the view that the changes were damaging to the Open School as they removed its best staff, although evidence to the Inquiry established no consensus on that.
10.23 There was, however, a consensus that switching the two Deputy Heads was extremely divisive, destined to set back the achievement of the more inclusive culture which the Principal wished to achieve, with fewer barriers and a stronger sense of single identity. Although we were told in evidence that the outgoing Deputy (Secure Unit) "did not refuse" to move to the Open School, relations between him and the new head of the Secure Unit were unhelpful to the cohesion of senior management, and encouraged factional behaviour. Most former managers and some staff who gave evidence to the Inquiry referred to the fact that the two did not get on, and to the dysfunctional relationship in the SMT this created. The effects of this were not subsequently addressed.
10.24 Various changes in operations and procedures were introduced during 2000, and discussions with the Social Work Department on the proposed redevelopment of Kerelaw continued. In April 2000 a letter from the Council's Education Department to HMIE in response to the previous September's inspection which criticised the Secure Unit made clear that there was no likelihood of money being found to implement the curricular recommendations in the report. It cited the discussions taking place with the Scottish Executive on the redevelopment and possible resiting of Kerelaw to within the Glasgow boundary as a factor in this.
10.25 In May 2000, a redevelopment brief, part-funded by the Scottish Executive, was issued to the Council's Building Services, who later produced a Kerelaw Redevelopment Study report, which set out a detailed specification for a new build and the aims of the new establishment. It noted six sites within Glasgow which had been considered, but proposed a shortlist of only one, to which was attached an explicit warning about likely local opposition, a public inquiry, and planning delays. This warning was, we deduce, influential. Much later, when the decision to go ahead with rebuilding the Secure Unit was taken, it was on the basis that it would take place on the existing site in Ayrshire.
10.26 Written records and oral evidence to the Inquiry confirm that a number of reviews and initiatives to improve the management and operation of Kerelaw, and the Secure Unit in particular, were promoted between late 1998 and the end of 2000. As with earlier attempts at change, and consistent with the experience in many organisations, these encountered resistance, although the report of the inspection of the Open School by North Ayrshire Council in October 1999 had indicated that staff were positive about the new Head. One former member of staff who approved of the changes took the view, in evidence to the Inquiry, that [the Principal]:
did move things forward ensuring staff had more opportunities for training and developing practice…… He brought [more psychology support] into the school and got agreement that programmes took place during school time - this was quite a change……and [he] finally managed to turn the tank around
and we were told that in the Social Work Department:
there was a view that he had turned things around, that things were better at Kerelaw.
10.27 A contrary view, based partly on the priority given to the Secure Unit, the management and staff changes associated with that, and a perception that the Principal himself had "favourites", was that:
He caused an enormous divide and a lot of damage.
Further change at the top
10.28 Within a short while there was more change, when the Principal moved to Social Work HQ to take over as Head of Service. Following competition, he was succeeded in December 2000 by the Deputy (Education). Although his successor as Principal did not reverse his controversial switch at Deputy Head level between the Open School and Secure Unit, he quickly discontinued his predecessor's practice of including unit managers in senior management meetings. This change was welcomed by the Deputy (Open School). It is hard to quibble with a Principal's right to determine who should attend his meetings, but it is unfortunate, with hindsight, that the opportunity for leadership and communication throughout Kerelaw which a more inclusive approach to management meetings might have created was so quickly discarded.
10.29 It is apparent from papers seen by the Inquiry and from oral evidence that many staff welcomed the regime change. Comments in the context of an inspection in 2001 refer to the new Principal working to restore morale among certain staff. A number, it seems, found his predecessor's approach to achieving culture change challenging, and certain administrative changes had caused upset. We were told in evidence that, after the change in Principal, progress in some areas appeared to lose pace, with a number of planned improvements, such as in supervision, proving difficult to implement in full.
10.30 The Inquiry was told that relations between the new Principal and his predecessor began to cool. This was partly on account of the new Principal's unhappiness over the latter's alleged failure in his new role as Head of Service to "protect" Kerelaw from what certain managers and staff saw as an increasingly difficult client group. There was concern over the balance between young people from Glasgow and those from other authorities in the Open School, and we saw correspondence in May 2001 in which the Principal stated that for staffing reasons Kerelaw was only just coping with the current resident mix. His perception was that the Council was using Kerelaw as an emergency resource centre. This problem was in the Principal's eyes compounded by the delegated external management arrangements which the new Head of Service put in place, and which we discuss at paragraphs 13.16-13.17.
10.31 In the Summer of 2001, the Head of Service was reporting to committee that following staffing increases at Kerelaw, Glasgow City Council's usage would be held at 50%. However, by the Autumn the proportion had risen to 56%. According to senior managers at Kerelaw, by 2003 the proportion of places taken by young people from Glasgow reached 80%, although the statistics on resident numbers and place of origin provided by Glasgow City Council to the Inquiry do not substantiate this. We accept, however, that the proportion of admissions from Glasgow increased, as several sources referred to this in evidence, and we did see paperwork prepared by the Principal at the time which set out the figures. Admissions were reduced in April 2004 following representations by the Principal to external managers.
10.32 The challenge of numbers and resident mix appears to have been a significant preoccupation from 2001 onwards, and may partly explain the slow pace of change. A review of staffing in 2001 resulted in the provision of substantial additional resources, as we note at paragraph13.9. A successful recruitment exercise for deputy unit managers for deployment at night, and for basic grade workers, followed. The review was the first since 1994.
10.33 A short period of stability in the SMT was disturbed in February 2002, when the Deputy (Open School) was moved temporarily to Centenary House. His position was backfilled by a secondment from HQ, which lasted until the Deputy (Open School) returned at the end of the year. In May 2002, the Principal sent a memo to the external manager outlining a number of priorities following a review of the Strategic Development Plan. These included establishing cognitive skills and anger management programmes in each unit, and reviewing the complaints procedure and external advocacy services, with particular reference to staff training and timescales for replies to young people. Other priorities included a review of the senior management structure, establishing a timetable to achieve universal SVQ training for staff, the appointment of a training officer to work on staff development plans, and revision of the supervision format for incorporation in staff development plans.
10. 34 These priorities reflected concerns raised over preceding years in reviews and inspection reports. A Training Manager was seconded to Kerelaw in June, but was in post for only a little over a year. An additional Head of Education post for the Open School was agreed, but a proposed new post of senior Depute Principal was not. The Principal's memo referred to the need to locate Kerelaw firmly within the spectrum of child care and staff support which Glasgow offered, and suggested the re-establishment of the Kerelaw Management Group. This was a "third tier" group involving Kerelaw senior management and external management which had been set up by the previous Principal and had met twice a year until the Summer of 2001. It appears that this suggestion was not followed up.
10.35 In January 2003 the Principal's Report to the Social Work Department for 2002 recorded progress against the Development Plan. It reported that a Cognitive Behaviour Programme and a Violence Reduction Programme had been introduced in the Secure Unit and that a worker from Who Cares? was in weekly attendance at the school. Successful recruitment of additional care staff for the Open School and deputy unit managers for night-shifts was noted. The report recorded the qualifications held by staff and looked ahead to likely Care Commission requirements. It commented on the load on the SMT, the size of which the Principal contended was only half of any private sector comparator.
10.36 For the future, the report identified among other things a need to improve the condition of the Open School, an aspiration to extend programmes to the Open School, to raise pupils' educational attainment, and for further training. It acknowledged that most staff had not undertaken refresher training for TCI and that it was vital that this was addressed in 2003 and 2004. The Principal's Report was discussed at a meeting in Glasgow in May 2003. Around the middle of 2003, the additional Deputy (Education) was finally appointed at Kerelaw, thus providing a separate Head of Education in each of the Secure Unit and Open School. This returned the SMT to the size it had been at the point of local government reorganisation in 1996.
HMIE concerns
10.37 Meanwhile, concerns had been growing in HMIE about the follow-up to the report of its inspection of the Open School in September 2001, which was published in February 2002. The inspection had judged a number of aspects of the education provision to be good, but 15 aspects were evaluated as "fair", an assessment which HMIE made to indicate significant weaknesses. The provision of residential accommodation and facilities and the use of assessment to guide the teaching process were evaluated as unsatisfactory. There were eight main points for action on the fair and unsatisfactory aspects, and the school and Glasgow City Council were asked to prepare an action plan indicating how they would address these.
10.38 There appear to have been difficulties with the action plan, which required a meeting involving HMIE, the Director of Social Work (at that time also Director of Education designate) and the Principal of Kerelaw, and the later attendance by an Inspector at a meeting with teaching staff at the school. Despite these meetings, concerns continued up to the next inspection in November 2003, which was the first integrated inspection involving HMIE and the Care Commission, and was led by the latter.
10.39 The report of the integrated inspection was published in April 2004. Progress towards meeting 5 of 8 action points was evaluated as fair and progress on 3, including management, was unsatisfactory. It was noted that on these little progress had been identified since 2002 and the school and the Council were again asked to prepare an action plan indicating how they would address the main findings of the report. The report also noted four key strengths. However, staffing levels in the units were said to be inadequate at times and there were concerns around climate and relationships, meeting pupils' needs, personal and social development and the structure of the curriculum, which were evaluated as "fair". Although the school had received additional funding from the Scottish Executive in 2002 for the improvement of educational attainment, planning for improvement was evaluated as unsatisfactory. The Inquiry learned that within HMIE informal concerns had been expressed about staff morale, poor direction and lack of management capacity.
10.40 The Inquiry learned that the Head of Education in the Open School raised concerns with the external manager following the April 2004 report. An action plan was prepared and sent to senior Education and Social Work management without, so far as we can establish, any comment by the Principal. We are not aware of any subsequent discussion, although by then the Millerston investigation was under way, there were signs of strain affecting the Principal and the SMT, and events leading to the decisions by the Council to suspend a large number of staff following the Millerston report began to move quickly.
10.41 In mid-June 2004, the Principal was moved for management reasons, as noted at paragraph 7.20, following the external manager's report to the Directors of Social Work and Education on emerging allegations of abuse of young people by staff. As had happened in late 1997, the person responsible for external management was appointed acting Principal of Kerelaw and remained in post until the closure, first of the Open School at the end of 2004, and then, some 15 months later, of the Secure Unit.
External management changes
10.42 There was also considerable change in the Social Work Department over the period. This had an effect on external management arrangements. Following restructuring, formal responsibility for external management of Kerelaw passed in 1998 from the District Manager to the Head of Service, a post which was equivalent in salary terms to that of the Principal. However, for practical purposes external management, in the sense of regular, direct liaison with Kerelaw, was delegated to a Principal Officer, Residential Child Care.
10.43 For a variety of reasons, including the wider responsibilities of the Principal Officer concerned, delegation proved impractical, and for the next two years the Head of Service had to take the responsibility herself, during what was to be a very testing time. She was appointed Depute Director Children and Families and Criminal Justice in mid-2001, and her place was taken by the Principal of Kerelaw. He designated a Principal Officer to take on day-to-day external management responsibilities for his former establishment. For reasons explained at paragraphs 13.16 and 13.17, the new Principal considered this arrangement inappropriate. This became a bone of contention and did not encourage a mutually supportive relationship between Kerelaw and HQ.
10.44 In late 2001, the Depute Director for Children and Families and Criminal Justice left the Council and a new Depute was appointed. In early 2002 the Head of Service resigned. The vacant post of Head of Service was filled in May 2002. The new Head of Service continued with the day-to-day external management arrangements which he had inherited. In August 2003 external management arrangements for Kerelaw were supplemented by the appointment of an acting Residential Services Manager, as a "consultant". From the Spring of 2004, the "consultant" acted up as Deputy (Open School) after the latter became ill. The Depute Director for Children and Families and Criminal Justice left the Council in 2005. The Head of Service also left. There were also 4 different Directors of Social Work between 1996 and the closure of the Secure Unit in 2006.
Training and development
10.45 Staff training and development should have played an important part in modernising Kerelaw, ensuring that its service was compliant with the new regulatory framework and responsive to changing expectations. Professional social work training since the 1970s aimed to provide a common knowledge base and transferable skills across all practice areas. This included all care groups - children, families, adults, older people - and all settings, whether community or residential. The emphasis was on ensuring that fieldworkers became qualified. There was no drive for residential care staff training until much later.
10.46 As a result, residential child care has struggled to achieve a qualified workforce. A significant issue has been deciding what qualifications best prepare potential residential care staff for the task. The debate about improving the training and qualifications of residential child care workers has gone on for many years and continues today. Much of the debate centres on what should be the core underpinning theories that staff need to learn about and what should staff know in order to understand children and to develop skills.
Vocational qualifications
10.47 The Skinner and Kent reports endorsed the use of vocational qualifications as the basis for a continuum of education and training. Skinner recommended that priority be given to induction training for new staff, Higher National Certificate ( HNC) and SVQ for existing staff, and the Dip SW for managers. Kent noted 5 years later that progress towards a qualified workforce had been very slow.
Registration
10.48 The requirement for residential child care staff to be qualified was finally introduced under registration procedures in the 2001 Regulation of Care (Scotland) Act, and all residential child care workers will require to be registered by September 2009. Residential care workers with a range of different relevant qualifications will be able to register, but the minimum has been set at relevant SVQ 3 with evidence of any HNC-level qualification. The decision to accept an HNC regardless of the subject content has caused some concern within the residential child care sector, as it recognises the need for relevant skills without the complementary knowledge base.
Kerelaw
10.49 During the Inquiry, former staff talked to us about their experiences of training. Prior to the early 1990s, there appears to have been very little training offered to staff at Kerelaw. This improved in the mid-1990s due to the concerted efforts of the Deputy (Open School). She was instrumental in arranging for a basic introductory child care course "Signpost" to be offered to all staff. Many former staff told us they had really welcomed this course. We were told that she:
…introduced a training/induction programme which was very good. She was obsessive about it……was good at training.
10.50 Although most residential care workers started at Kerelaw without relevant qualifications, some described being given good opportunities and many did go on to gain SVQs and HNCs. A smaller number gained Dip SWs and management qualifications. Others talked of difficulties in securing access to training and having to fight for the time to complete even the most basic courses. Training of night staff, for whom there seem to have been few opportunities, posed particular problems. Some staff came to Kerelaw already qualified in social care or social work. Others had other relevant qualifications, for example in nursing or youth and community work.
10.51 Over time, a range of courses was offered to staff at Kerelaw from the practical, such as first aid and health and safety, to more specialist courses such as drug awareness and cognitive skills. Some of this training was offered "in house". Many Kerelaw staff attended training provided by SIRCC, which was set up in 2000. Latterly, staff from Kerelaw were accessing training at all levels through SIRCC. SIRCC's aim is:
to ensure that residential child care staff throughout Scotland have access to the skills and knowledge they require to meet the needs of the children and young people in their care.
10.52 As noted at paragraph 10.34, a Training Manager was seconded to Kerelaw in 2002 to draw up a training strategy and a training plan based on needs. The Training Manager was expected to provide and commission training, but not to have an oversight of the SVQ programme, in relation to which there appear to have been some concerns about the quality of assessment. This was a time-limited post for 2 years, although the individual concerned left after 11 months and the post was filled on a temporary basis thereafter.
10.53 The Principal's report for 2002 suggested that over 60% of staff had completed or were undertaking the SVQ 3, and just over a quarter had completed, were pursuing, or were due to start the HNC. Of the 7 unit managers, 3 were holders of the Dip SW, 1 had SVQ3/ HNC, 1 held a Certificate in Social Studies, 1 was working towards SVQ4 and 1 towards SVQ4/Dip SW. A note from the Training Manager in April 2003 recorded that 30 care workers were still without SVQ3/ HNC and that 37 needed to top up SVQ3 with HNC or complete SVQ4.
Physical restraint
10.54 In Chapter 8 we described the introduction of TCI, and considered it in the context of the abuse which took place at Kerelaw after 1996. We heard from a number of staff who remembered the introduction of TCI training by Strathclyde Region. Some suggested that, on reflection, it had not been promoted as a holistic method of working. A manager, who had not worked in Kerelaw at that point, talked to us about the impact of TCI on the residential child care sector in general. He suggested that the reason TCI took on such significance was that it was the first training of any kind offered to residential staff in Strathclyde. This, combined with a focus on restraint, rather than the wider purpose of TCI, may well have encouraged some staff to believe that a "safe" way to control young people was further up the skills agenda than training in more child-centred competences. In the view of Brian Corby 19 (quoted in Crimmens and Pitts 2000) a key lesson from inquiries is the need to ensure that:
…training is broad-based and focused on the needs of children rather than on non-abusive ways of controlling them.
10.55 A report on staff training in July 2003 stated that the 1-day TCI refresher course run at Kerelaw was inadequate to update staff who had been trained more than a year earlier. It noted that as the TCI system had been considerably updated and amended in recent years (see paragraphs 8.32 and 8.33), it was important that staff were refamiliarised with it. In particular it recorded that during refresher training some staff were still referring to outdated TCI handbooks and holds which were no longer used. It was proposed that new handbooks be issued to all staff, including teaching staff, from the "ample supply in the storeroom", and that the two-day refresher course designed for use in other Council residential units should be used for all future updates, which should be carried out annually.
Impact of training
10.56 Many staff told the Inquiry they had little in the way of formal induction. They were simply told to shadow another worker to learn the ropes. There can be few surer ways to perpetuate an existing culture. When introductory training was offered through the "Signpost" course and subsequently the "Introduction to residential child care" course through SIRCC, it seems some experienced staff resented the expectation that they would complete these courses. The Inquiry also picked up a view among some staff that they had little to learn from "outsiders" who in their opinion did not understand residential child care.
10.57 But by no means all staff took such a position. Many staff welcomed training and valued the opportunities to improve their knowledge base and their practice. Some staff told the Inquiry about how much they had learned on training courses and how their eyes had been opened to new ways of approaching their job. They were able to refer to specific situations where they had used their training to make a difference to their care of children. However, how learning from training was shared with colleagues in the workplace was reported as another area for attention.
10.58 Some staff talked to the Inquiry with pride about the introduction of programmes in the Secure Unit and the opportunity this offered them to learn new skills which they were expected to apply immediately in work with young people. They described this as exciting and rewarding. On the other hand, some staff were critical of programmes and felt it was not the right approach to take in Kerelaw. These differences were evident at different levels, including among senior managers and visiting specialists. This lack of a shared strategic vision or shared theoretical perspective is regrettable, as it will have led to inconsistencies in approach and uncertainties among staff.
10.59 As we noted at paragraphs 9.54-9.60, there were deficiencies in supervision. Supervision provides an opportunity for a manager to develop an employee's ability to generalise learning and increase knowledge about how he or she learns. It also allows the manager to assess the worker's training and development needs and how they can be met. Deficiencies in the frequency and quality of supervision and in the evaluation of the impact of training on practice may partly explain why, although a substantial proportion of staff achieved qualifications, this did not lead to the kind of shift towards a more child-centred culture which might have enabled Kerelaw better to deal with the challenges it increasingly faced.
10.60 The Kerelaw experience is a reminder that gaining a qualification, while highly desirable, will not necessarily bring about change in the individual or in the organisation. A qualification is no guarantee that the holder has the attitudes or values needed for a particular role. If training is not accompanied by reflection on, and evaluation of, one's own attitudes and behaviours, or is not positioned within a shared vision of what the organisation is trying to achieve, its impact may be limited. It is disturbing that at Kerelaw training was not so positioned, and therefore did not deliver the practical and professional benefits which should have been expected.
Conclusion
10.61 There was little by way of shared values and clear vision at Kerelaw and limited capacity for change. With 4 Principals in 8 years - two of them in a temporary capacity - regular disruption in the SMT, and senior level changes in a rather distant Social Work HQ, it is not surprising that a programme of change and improvement around a common vision of the direction of travel for Kerelaw was not achieved. Some senior people saw the need to challenge the prevailing culture and there were attempts at change, but they either failed to take hold or faded away. One particular opportunity to bring about change was lost in the management churn. The potential of training was never fully realised because it was not positioned within a clear vision of the kind of organisation Kerelaw should have been aspiring to be.
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