Summary of Audit and Inspection activities and outcomes (Hackney)

August 2010 – July 2011

Building up a picture

QA Sub-committee Multi-agency Audits

QA Sub-committee Tier 2 Audit

Children’s Social Care audit of numbers of children subject to CP Plans

Ofsted unannounced inspection of Contact, Referral and Assessment services

Audit of Parental Mental Health cases (underway – no findings as yet)

SCRs & Case reviews

QA Sub-committee Multi-agency Audits

8 cases audited - each agency completes internal audit, findings shared at multi-agency workshop (with practitioners involved) where focus is on multi-agency working.

Sample – included children subject to CP Plans and CIN plans, thematic selection – Parental Mental Health, Disabled Child, Parental Learning Difficulty, long-term intervention, Parental substance misuse, etc.

Themes

• Good inter-agency practice and effective intervention on the majority of cases, with some examples of outstanding practice

• Some excellent examples of family engagement but mixed picture overall with need for persistence and regular review identified in long-term cases. Mixed pattern of engagement with/consideration of men

• Some good examples of effective engagement of wider family networks to reduce risk

• Particularly good coordination in relation to unborn/newborn babies with early referral leading to good engagement and planning

• Safeguarding responses to adolescents presented more challenges for professionals and source of some inter-agency conflict

Themes (cont.)

• Responses to domestic violence were variable between agencies with different understandings of risk

• Challenges of managing multiple risk factors and dangers of one issue predominating and obscuring others

• Risk of focus on one child’s disability/needs leading to other children being overlooked

• Where there were good handover/transfer processes between professionals this facilitated continuity and sustained engagement

• Examples of timely and regular communication between professionals and a readiness to work creatively leading to good outcomes for children

• Some unresolved conflicts between professionals and uncertainty from some about how to proceed when didn’t agree with decisions of other agencies

Going forward

• Continue with multi-agency audits – propose 6 in next year

• Refine audit process to include family involvement

• Ensure learning integrated in individual agencies and across agencies

• Ensure City case included in next cohort

Tier 2 Audit

Full day audit workshop • 18 managers and practitioners from range of agencies • CSC, YOT / Young Hackney, Health, TLT• 29 cases

Observations of 3 MAT meetings and 1 YPRRP meeting

Overall findingsNB. Scale of audit was insufficient to establish a reliable picture – these are indicative

findings only

Cases / Practice:• In the majority of cases audited, levels of risk and need were being effectively

identified and responded to. No significant concerns about risk management in cases audited

• In a small number of cases some potential risks not fully recognised - mostly related to domestic violence cases

• Threshold criteria seemed to be well understood and applied, although less true for individual agencies that are not part of the Triage or Panel arrangements. Notable gaps in the understanding and application of the Barnardo’s Risk Assessment tool relating to domestic violence.

• High level of inappropriate referrals to Children’s Social Care - particularly for cases referred by a single agency and not considered in a multi-agency forum. The standard of some referrals was poor with referrers failing to articulate what risks they thought were present and what level of response they expected.

Overall findings (cont.) Panels:• Multi-agency consideration and information-sharing appeared helpful in

identification of safeguarding concerns, monitoring and reviewing these and ensuring escalation to tier 3 where necessary; also promotes good inter-agency relationships and understanding of available services

• Panel systems benefit from access to the safeguarding expertise of social workers.

• Absence of defined links with adult service, particularly adult mental health services, identified as a significant gap within these arrangements.

• Need for professionals in all agencies to receive information and training about the Common Support Framework

• No apparent ‘link-up’ between panel arrangements for older young people and the panel arrangements for younger children.

• In meetings where a high volume of children or young people were being considered some instances where there was insufficient time to hold a full discussion with the risk that some needs and risks may not have been identified.

Recommendations for future action

Quality Assurance sub-committee should:

• Incorporate on-going audit and review of processes and services for responding to the needs of children at Tier 2 into their Quality Assurance framework – need to consider resource implications, propose twice a year

• Further auditing to include more in-depth exploration of a small number of cases – including ‘follow through’ of cases ‘handed off’ by Triage or referred on to preventative services by Children’s Social Care

• Recommend to CSF steering group need to undertake extensive awareness-raising of agreed processes and thresholds and that agencies need to ensure that staff receive this training

Recommendations for future action (cont.)

Quality Assurance sub-committee should:

• Ask the Children and Families Strategy Group to consideration the impact of the loss of Tier 2 Social Work services on service delivery and how safeguarding expertise can be made available at multi-agency meetings in the absence of this provision

• Recommend that the Children and Families Strategy Group ensures structures and processes in place to ensure information-sharing between the various panels (already responded to via the Partnership Triage Operational Group)

• Recommend all agencies raise awareness of the Barnado’s risk matrix for Domestic violence and support staff in developing skills in responding to domestic violence

Audit activity in relation to drop in number of children subject to CP PlansSignificant drop in numbers of children subject to CP plans in Hackney:March 2010 – 241March 2011 – 12711th July 2011 – 118

Audit of:23 conferences (46 children)8 families (14 children) where s47 did not lead to ICPC12 families (31 children) where case (non s47) remained in tier 3 and made subject to CIN plan

Audit findings triangulated with performance data, other internal audit processes and external inspection findings

Overall findings

• The decrease in numbers of children subject to CPPs does not indicate that children are being left at risk.

• Less children being referred to ICPC, children subject to CP plans for shorter periods, less children subject to plans on long-term basis

• Consistent approach to decision-making within conferences • Decisions made at Conferences are generally sound and

appropriate. • When children are subject to CP Plans, effective work is

being undertaken with families, including extended family members, to reduce risk

Overall findings (cont.)

• Assessments are appropriately identifying risks and timely and robust plans are being put in place to address these.

• There is increased confidence about the ability of professionals to manage risk effectively under Child in Need arrangements

• Where children do cease to be subject to CP Plans but some risks remain there is evidence that these risks are continuing to be addressed under CIN plans

• High level of support are available to children subject to CIN plans. Making children subject to a CP Plan is not viewed by local professionals as a way to engage agencies or to access resources

Ofsted unannounced inspection of Contact, Referral and Assessment services (May 2011)

No Priority Actions or Areas for Development

Strengths:• Innovative reshaping of services, collaborative approach with

partner agencies, robust quality assurance• Highly motivated and enthusiastic staff, supported by

knowledgeable, experienced and accessible managers• Quality of Core Assessments consistently high, through analysis of

risk and protective factors enabling effective planning• Ethnic, cultural and religious needs strongly reflected in

assessment leading to effective interventions

Meet requirements of statutory guidance:

• Unit structure has improved caseload management and supervision• Early interventions timely. Clear understanding and use of Child

Wellbeing Model• Appropriate decisions and management oversight on contacts and

referrals with seamless transfer to Access and Assessment• Child Protection enquiries thorough and timely, risk and protective

factors appropriately identified• Children and Young People fully involved in assessments• System in place for feedback to referrers• Common Support framework facilitates access to comprehensive

range of preventative and support services• Learning from SCRs disseminated to staff through lunchtime

seminars• Police and Council need to keep under review the referral process

for cases of domestic violence to ensure all cases are actioned within agreed timescales.

Some emerging ‘wicked issues’(including issues raised through the

Operational Forum):

• Promoting constructive professional challenge• Working with men• Safeguarding adolescents• Sexual Exploitation• Domestic Violence