Looked-after Children/Social Work Reform

Emma Lewell-Buck Excerpts

Thursday 20th October 2016 Westminster Hall

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gapes. I thank the hon. Member for Stroud (Neil Carmichael) for opening this important debate, and his colleagues on the Education Committee for their excellent work on the two reports that we are discussing. I of course acknowledge the Minister’s commitment in this area, and I know that he and everyone in the Chamber are dedicated to improving the lives of our most vulnerable children. That is why it is all the more disappointing to read the Government responses to the reports.

The Committee based its recommendations on an extensive body of evidence from experts in the industry—evidence that clearly showed why more action and less talk are needed. In the “Mental health and well-being of looked-after children” report, the Committee rightly recommended that a dedicated mental health assessment by a qualified mental health professional be completed for all looked-after children, so that healthcare professionals and local authorities have a solid and consistent foundation on which to plan the best care for a child.

The report further recommended that all children who need access to child and adolescent mental health services get it in a timely fashion. That makes total sense when we consider that almost every looked-after child has endured some form of trauma, from those who have suffered the most unimaginable brutality to those whose parents, for whatever reason, cannot care for them or protect them from harm. In fact, as the hon. Member for Stroud said, at least 45% of children entering care have a diagnosable mental health condition, and 75% of children in care have some kind of emotional or behavioural difficulty. It is therefore astonishing that the recommendation was not accepted.

The Government’s record overall on CAMHS is dire, with children waiting years for specialist help. With that in mind, will the Minister tell us what the ratio of CAMHS workers to looked-after children in England is, and whether he think that the number of CAMHS workers is high enough? Will he also tell us what impact he thinks his Government’s cuts have had on CAMHS overall?

I was similarly disappointed that the Committee’s recommendation that CAMHS be made available to all care leavers up to the age of 25 was rejected. The Government believe that the configuration of local mental health services is a matter for commissioners to decide, on the basis of local need. Even the statutory guidance, however, is clear: decisions on the transition between services should be based on the needs, wishes and feelings of the young person concerned, not the cost considerations of local commissioners. Once a young person turns 18, they are referred to adult mental health services, and we all know that the Government’s record on adult mental health is even more concerning, and that budgets for mental health trusts continue to be slashed.

The Government response does not specifically answer the question of how CAMHS provision will be improved, or how they will tackle the huge waiting lists, which lead to unnecessary suffering. From my own experience, I know that there is nothing worse than working with a child or young person who is desperately crying out for professional help that is simply not available. The social workers and carers who have to deal with these situations day in, day out, have to watch the young person in their care suffer while they feel completely helpless. That is why the Government’s rejection of the Committee’s recommendation that foster carer and residential carer training be supplemented with mental health and emotional wellbeing modules is disappointing. If carers are not fully equipped to do their job, their ability to sustain care for a child can be reduced. That could have a devastating impact on a child, who is left to forge—sometimes many—new relationships with different carers.

I noticed that the Government responses deflected many answers on to the new expert working group on the mental health of looked-after children. I make no criticism of the experts appointed to the group, but further consultation is wholly unnecessary, as the hon. Member for Telford (Lucy Allan) said, especially since both the co-chairs have already submitted evidence to the Committee. Consultation will simply cause further delays, and delay means that more children will suffer unnecessarily. Will the Minister tell us how many children he thinks will be left suffering on waiting lists while that review drags on? Does he accept that the condition of many of them will deteriorate as they wait for services? I have seen that myself in children waiting for long-term fostering or for adoption. A child’s pool of potential carers will decrease as their condition worsens, and as the years go by and he or she gets older, the pool decreases even more. For far too many children, that means never getting to feel the security and stability that long-term fostering or adoption can bring—all because of unnecessary delay.

Heartbreaking as that is, there are far worse scenarios for children in the system, which is why social work reform is so important. The Committee’s report on social work reform makes a number of common-sense suggestions. I appreciate that the Minister has a difficult job. Getting things right for children and families is not an easy task; it is difficult and complex terrain. Successive Governments have battled with how to provide the best and safest social care system for children, but now there is an abundance of official and other expert advice to draw on, so we should see some action and results—but we do not.

I imagine that the Minister in his response will tell us about the Munro report, the Step Up to Social Work programme, Frontline, the Innovation programme, What Works centres, partners in practice, the intervention regime and “Putting children first”, the Government’s vision for excellent social care by 2020. What the Minister might not speak about is the recent National Audit Office report, “Children in need of help or protection”, because it finds that actions taken by the Department for Education over the past six years to improve the quality of help and protection services delivered by local authorities for children have not yet resulted in services being of a good enough quality, suggesting systemic rather than only local failure.

In fact, the demand for help and protection is rising. Over the past 10 years, there has been a 124% increase in serious cases—ones in which a local authority believes that a child may be suffering, or likely to suffer, significant harm. Furthermore, the varied spending on social work has been found to be not related to quality. Will the Minister explain why he thinks that all the Government’s initiatives and changes over the past six years are not yielding results? Many of the NAO’s findings certainly echo the Committee’s analysis that there are significant weaknesses in the Government’s agenda, and that the reforms focus on

“changing structures potentially to the detriment of the people delivering this key public service.”

What is needed in the social work profession is continuity, stability and confidence, and a Government who can hold their nerve on how best to help children and families by putting in place and embedding good policies. The Government are failing to get the basics right. Those basics are: reducing social worker case loads; preventing experienced professionals from quitting the profession; training social workers in a holistic way; not fast-tracking them, and forcing them to specialise before they have even been trained in the basics; and amending IT and the bureaucratic process across the board to achieve the goal of getting social workers where they want to be—out from behind their desks and seeing the families with whom they work.

It is an absolute must that we start looking after social workers. A new professional body could go some way to assist us in that. It is simply no good demanding excellent social workers and excellent practice if social workers are not appropriately supported, including with safe working environments. Social work is a dangerous profession, with unmanageable case loads, impenetrable bureaucratic structures and poor pay. It makes me angry that social workers are not afforded the same protection and status as other professionals. We all need to remember that for every social worker who becomes unwell and cannot do their job, there are sometimes up to 40 children who lose the help and support of that social worker, who, for many of them, is the only constant in their life. Such a working environment would not be tolerated in Parliament; Parliament should not tolerate it for our social workers. Why will the Minister not implement the Select Committee’s recommendation about the wellbeing of the workforce?

A common feature of the Government’s response to the Select Committee’s recommendations on social work reform was deflection to future initiatives and reports, and future analysis of initiatives that are already in place. All I know about the future is that our children’s futures are at risk under this Government. The overall fact remains that the Government’s response does not tackle the crisis in social work because it does not address how to deal with the significant increase in the sheer number of people accessing the service. To do so, the Minister would need to admit what we all know: that the Government’s closure of Sure Start units and removal of early years help and family support, and their cuts, punitive welfare policies and austerity measures, are impacting everywhere, and nowhere more starkly than in the children and family social work arena, which by its very nature is interlinked with wider societal and economic issues. The Minister does not need to take my word for it; he could listen to the chair of one of the Government’s expert panels, who has said that

“investment is welcome, but we have to recognise that is against a backdrop of other financial pressures…and a history of disinvestment across the system for quite a number of years.”

The Opposition welcome the Select Committee’s work, but not so much the Government’s response, or their inability to accept the overall consequences of their policy making, and the drastic impact that those policies are having on everyone, but most importantly, vulnerable children and families.

[The Minister for Vulnerable Children and Families (Edward Timpson)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Gapes. I welcome this debate and the interest that the Chair of the Select Committee, my hon. Friend the Member for Stroud (Neil Carmichael), has shown in prioritising these issues for inquiry by that Committee.

There is a lot of ground to cover. It is always encouraging to get a ringing endorsement of everything that the Government are doing, but there are clearly still some elements of concern that I need to address. In so doing, I recognise, as others have, that hon. Members who are present share my commitment to improving the lives of vulnerable children. That is our joint mission and the underlying motivation for everything that we do in our privileged roles.

The Government have participated in and responded to the Select Committee’s inquiries, but I want to take the opportunity to provide some further detail and, I hope, reassurance that we have a comprehensive, considered and compassionate plan to help to bring about the improvements that we all want to see to vulnerable children’s lives. I remind hon. Members that in July this year we published our “Putting children first” strategy. I am grateful to the hon. Member for South Shields (Mrs Lewell-Buck) for reminding everyone of that important document, which I believe represents the most thorough and ambitious reform agenda in this area for some considerable time. I am not complacent, and neither is that report, but it is a serious attempt to try to get children’s social care to where it needs to be.

The strategy sets out fundamental reforms across each of the three pillars on which the social care system stands or falls. The first and foremost of those is people and leadership. I agree with my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) that our system stands or falls on the quality and commitment of the people driving it. The second pillar is practice and the environment that we create for that practice to be able to improve, which we must do in a way that does not stifle practice through over-regulation and process-driven activity. Again, I agree with the hon. Member for South Shields that we do not want social workers sitting behind computers; we want them to work face-to-face with families to try to improve their lives, and we want to avoid risk-averse behaviours, of which process-driven activity is often a part.

The third and final pillar is governance and accountability. We need to be sure that what we are doing is effective and actually works. We must develop innovative new models for the pursuit of practice excellence, which has to be at the heart of this work, and remain firmly focused on improving outcomes for children. Only by taking action across those three fundamental pillars will we bring about the kind of transformational change that is needed in children’s social care.

As other Members have acknowledged, children’s social workers can have a genuinely life-changing impact on our most vulnerable children. Our vision is of a social work profession made up of fully confident and highly capable social workers who have been trained in the right way and have the right knowledge and skills, and access to the right supervision and support.

[Mrs Lewell-Buck]

The Minister may be coming to this, but I am curious: how will the Government measure the success of “Putting children first”?

[Edward Timpson]

I will come to how we will ensure that we are making progress. Several milestones are set out in “Putting children first”, which is a programme of work through to 2020. We will be able to measure progress by whether inspections of children’s services and our outcome measures for children in care improve, and we will have a whole suite of indicators that will give us a strong understanding of whether the work we have done and the measures we have put in place are having a positive influence.

Over the last six years, we have begun to lay solid foundations for achieving that vision. We have appointed a chief social worker, who has introduced the first definitive statements of child and family social work knowledge and skills. Working across Government with the Department of Health, we have developed the first four teaching partnerships, whereby employers and universities work together to ensure that university courses provide students with the right on-the-job skills. One of the problems in the past—I have seen this for myself—has been that too many social workers have come into practice without any first-hand experience of what it is like to be in a child protection situation. We need to change that.

We have invested almost £50 million since 2010 in Frontline and Step Up, which I make no apologies for mentioning. Those programmes have brought more than 770 high-calibre recruits into social work. We have expanded our assessed and supported year in employment programme to support newly qualified social workers entering the profession. To help the Chairman of the Select Committee on whether ASYE should be mandatory, I can tell him that 151 of the 152 local authorities take part in that course. We want to review that and see whether that level is maintained, because we think ASYE is an important part of social workers’ early experience of gaining professional knowledge.

We are under no illusions about the remaining challenges; there is still much more to do. The recent National Audit Office report on child protection performance was a timely reminder that the performance of children’s social care services is still far too variable across the country. We must acknowledge that although many local authorities provide a consistently effective core social work practice, the majority still struggle to do so.

The reviews by Professor Eileen Munro, Sir Martin Narey and David Croisdale-Appleby, among others, have given us a much deeper understanding of the issues faced by children’s social care. They describe a system in which initial social worker training is not universally preparing students for the challenges of the job, as I alluded to, and those already doing it often lack the time, specialist skills and supervision needed to achieve real change for children and families. The reviews also describe a system that focuses too much on management and is governed by prescribed approaches rather than excellent practice, and conclude that services have not always been designed around vulnerable children and that innovation has not been given enough space to thrive.

We are determined to address those challenges, as outlined in our “Putting children first” strategy. Going further and faster on our plan to drive up the skills and status of the children’s social work profession is central to that endeavour. To that end, I am working in partnership with my colleagues in the Department of Health to establish a new, bespoke independent regulator for social work that will set higher standards for social work both in what is expected of professionals in order to practise and in what is expected from universities and others providing initial social work education. It will also create a more rigorous approach to continuing professional development in social work—an area the Chairman of the Select Committee rightly raised—ensuring that social workers continue to develop throughout their careers, as called for in the report. In the past there has been too little recognition of the role this area has to play.

I am also bringing forward a new system of post-qualifying assessment and accreditation for child and family social workers. That is a key plank of our reforms, because it will provide, for the first time, a consistent way of ensuring that child and family social workers have the right knowledge and skills to do their jobs well. The new assessment will incentivise employers to invest properly in the development and support of their staff, as well as ensuring a mechanism for recognising the specialist skills that child and family social workers possess. Again, that work aligns with the recommendations of the Select Committee’s report. The consultation, which hon. Members are keen to see, is planned for publication before the end of the year, and I am sure they will want to contribute.

The assessment and accreditation system will also, for the first time, establish a consistent, clearly structured and well supported career pathway for child and family social workers, which will allow them to deepen their skills as they take on additional responsibility and, crucially, keep them in touch with practice. One of the problems we can all recognise is that in the past too many good social workers, as they gained experience, rather than remaining close to families and working their own cases, moved into management and behind desks. We therefore lose that expertise and the new crop of social workers coming through do not get the support they could have gained from those experienced social workers if they are no longer working with them.

Practice skill and expertise will be the most highly prized and rewarded asset across the whole career, from newly qualified social workers all the way through to practice leaders. Together, the reforms provide an opportunity and a solid platform from which to raise the status of child and family social work in the way the profession needs and deserves. They create the conditions for a strong, confident social work profession where practitioners are properly supported to thrive in very challenging front-line posts. The profession, and the children and families it serves, should expect no less.

I want to address the point made by the Chairman of the Select Committee about a professional body. It is right to say that over three years the Department for Education, with support from the Department of Health, spent more than £8 million of public money trying to set up the college of social work, but despite that significant investment the college was unable to secure the sufficient membership required to make it sustainable. However, I re-emphasise, as I did in evidence to the Select Committee, that it is important that there is a strong professional body for social work. It has to be sustainable, but also have a sense of ownership by the profession. It cannot be top-down; it has to be a bottom-up organisation. We want to continue to work with the British Association of Social Workers, other representatives of the workforce and the Department of Health to see how we can start to nurture and craft a professional body in that mould so that we have something that truly represents social workers and can go into bat for them when they need that.

It is also important to recognise that giving social workers the right knowledge and skills and setting high standards for practice will not on its own bring about the step change we need. Excellent social workers need to work within supportive and permissive organisations where they are given the flexibility to use their expertise in ways that have the greatest impact on children and families. As Eileen Munro identified, good social work is not about following processes and procedures, but too often that is what we have turned it into. We need a dynamic practice system where testing and evaluating new ways of working and learning from the best is the norm. We see that in other parts of public service, so why not in children’s social care?

It is our children’s social care innovation programme that is starting to foster that way of working. We have already funded over 50 projects and announced £200 million more for the future. We are also developing the first ever What Works centre for children’s social care. That is an important development, because for the first time there will be a repository of good practice for social workers to use and have confidence in for the work they do. We are also overhauling the serious case review process to better extract national learning when things go wrong.

We want to go further. The Children and Social Work Bill, which is currently before Parliament, includes a new power to innovate. Through that power, we are looking to say that, ultimately, excellent front-line social work practice should be defined not by the Government or Parliament but by local practice leaders, with more freedom to operate within a clear, safe statutory framework. Our “partners in practice” local authorities—eight of the highest-performing authorities—see the power as an important and potentially transformative opportunity.

The power has been criticised by some in the Lords. It is right that we debate that and that the quality of debate in Parliament is strong, but let us have a debate based on facts, not on unfounded propositions. Let me be clear: we do not want to privatise child protection services and we will not privatise child protection services. Indeed, there are already clear legislative restrictions on the outsourcing of children’s social care functions. It was never the intention to use the power to innovate to revisit those. However, to put it beyond doubt, we are amending the Children and Social Work Bill to rule out any use of the power in that way.

We will not remove fundamental rights or protections from children either. Our aim is to strengthen, not weaken protections. We want to let the best local authorities, led by leading-edge practice leaders, work in ways with more potential to make an actual difference for children instead of watching and waiting, hamstrung by excessive prescription.

I will quote from Eileen Munro, because we still value her views on how we are performing and the work we are doing:

“I welcome the introduction of the power to innovate set out in the Children and Social Work Bill. This is a critical part of the journey set out in my Independent Review of Child Protection towards a child welfare system that reflects the complexity and diversity of children’s needs. Trusting professionals to use their judgment rather than be forced to follow unnecessary legal rules will help ensure children get the help they need, when they need it.”

She is not a lone voice: the Children’s Commissioner, the Society of Local Authority Chief Executives, the Children and Family Court Advisory and Support Service, Catch22, Achieving for Children and the children’s social worker all hold similar views.

[Mrs Lewell-Buck]

The concern about the Children and Social Work Bill seems to be that the Government have been completely unable to say exactly which functions local authorities will be able to opt out of. Bearing in mind that a lot of the functions they have around children protect them from harm and keep them safe, is it not understandable that there is huge concern out there about where the Government are going with that?

[Edward Timpson]

Perhaps I can give the hon. Lady some examples of primary legislation where local authorities have asked that they be able to use the power to innovate where that is currently restricted in law. Under section 25 of the Children Act 1989, independent reviewing officers must be appointed for every looked-after child and they have to have regular reviews. We know that children often say that they do not like that. There are children who are in very stable placements for whom that can be disruptive and they ask for that not to happen, whereas other children need more intense oversight from an independent reviewing officer. That is one example of where local authorities want to have that flexibility.

There are also some anomalies that I am not sure many people appreciate. For instance, under section 66 of the 1989 Act, any child who is not cared for by a family or a guardian for 28 days counts as privately fostered and as such receives the same duties as other looked-after children, with visits and so on. That ends up capturing children coming over to language schools, which the local authority have to go and visit, to check on their welfare, despite those children being on a foreign exchange trip. Those are just some examples of measures where the local authorities that have shown an interest—we have to remember that this is a permissive power—would want some flexibility, in a safe and controlled environment, to test to see whether there is a different way of providing services that is absolutely focused on improving children’s outcomes more than anything else.

[Mrs Lewell-Buck]

Will the Minister give way?

[Edward Timpson]

Briefly, because I want to make sure I finish my speech. I have not got on to mental health yet.

[Mrs Lewell-Buck]

Just one quick point for clarity: am I right to assume that the Minister is saying that anything is open as long as the local authority applies to the Secretary of State, or will it be just the two examples he has given? I am struggling to see what exactly is in the mix. This seems to be open to anything.

[Edward Timpson]

There are restrictions to the legislation that local authorities can apply to be disapplied. A local authority has to make the application itself and it has to consult with the local area. It then has to submit that application to an expert group, which will consider it and publish its findings. Even then, there has to be an affirmative resolution in both Houses before that local authority can test out that new way of working. I met the hon. Lady yesterday to talk a little bit about this and other areas of shared interest. I am happy to provide her with more details and I also suggest that we agree to meet again, so we can make sure that all of the information is provided.

The chairman of the Education Committee, my hon. Friend the Member for Stroud, raised the issue of trusts, which I will touch on briefly. I in no way think that creating children’s social care trusts is a panacea for all ills. In most cases, when a local authority fails it will be able to improve its services with the right support, as is happening in Cumbria, Surrey and Buckinghamshire at the moment. However, where failure is persistent or systemic, it is right that we look carefully at whether the capacity for improvement exists in the local authority. We now have commissioners who go in and undertake a three-month review before reaching their conclusions and recommendations on the way forward.

Leaving services within council control is sometimes found to be the best approach to securing improvement, as in Bromley and Dudley, for example. In other cases, local authorities themselves agree that an independent trust model will create extra improvement capacity and help to turn things around, as is the case in Birmingham and Sunderland. Sometimes, where failure is deep-rooted and an authority does not have the capacity to improve itself, service control must be removed by my Department. I will not apologise for doing that. We cannot simply sit back and watch authorities fail over and over again, year after year, without trying new ways to bring about improvement. There is a growing bank of evidence following recent Ofsted inspections in Doncaster and Slough of services improving following the move to a trust after years of failure. Ofsted has particularly highlighted the strengthening of leadership and management in those trusts, which are critical components of any successful organisation.

To give the Chairman of the Committee an opportunity to respond and conclude the debate, let me now turn to my hon. Friend’s interest in the mental health and wellbeing of looked-after children and care leavers. I thank members of the Education Committee for their insightful report and commend them for their ongoing interest in this important area. I know all too well, from my personal experience, the nature of the challenges that children in care often face and the impact that can have on their mental health and the health of those who care for them. That is why my Department is taking strong action to improve support for children in care and care leavers, including the introduction of the staying put duty, so that all young people leaving foster care can continue living with their foster families after the age of 18. More than 50% of 18 year-olds in foster care have taken up that opportunity.

We are also undertaking a national stocktake of foster care to better understand current provision and how needs are matched with skills. I look forward to working with the Education Committee in looking at the evidence it gathers for its own report in this area. We are piloting the staying close programme, which enables young people leaving children’s homes to maintain links with those homes, as recommended by Sir Martin Narey’s review of children’s residential care. We published a new, cross-Government care leavers strategy, “Keep On Caring”, which sets out what we will do right across Government to ensure that care leavers get the support they need and also outlines our ambitions for trialling new and innovative ways of working. We are also taking legislation through Parliament that will, for the first time, define what it means to be a good corporate parent for children in care and care leavers.

When the state decides a child’s needs are such that we must take on parental responsibility, it has an overwhelming duty and responsibility to be the very best corporate parent it can be. It is right that, like all good parents, that responsibility continues when young people reach early adulthood. The new corporate parenting principles ensure that responsibility is given the weight and significance it deserves across the whole country. I hope hon. Members will support it.

Central to delivering our responsibilities as corporate parents is the promotion and support of the mental health and wellbeing of children in care and care leavers. That is an issue we take very seriously and on which we want to make timely and sustainable progress that tackles the shift in mindset needed around mental health and brings improvements to practice. Only this week, my noble Friend Lord Nash introduced an amendment to the Children and Social Work Bill that will explicitly capture the role of local authorities in promoting the mental health of looked-after children as a core part of the definition of a good corporate parent, which is significant.

I share the concerns of the hon. Member for South Shields about child and adolescent mental health services. They have been undervalued and underfunded for far too long, and we need to do far more to tackle that. The Government are investing £1.4 billion over the life of this Parliament to drive improvements in mental health services for children and young people. In addition, we are making a specific investment of more than £10 million to support the mental health of young people in secure children’s homes, who are some of the most vulnerable people in our society.

In order to get mental health support for children in care right, the Department of Health and the Department for Education have, as hon. Members have said, established an expert group to ensure that the emotional and mental health needs of children and young people in care and adopted from care and of care leavers are better met. It is a collaboration between social care, education and health colleagues, parents and carers and care leavers themselves. It is a comprehensive piece of work to map out the care pathway for a looked-after child in need of mental health support; it is not just looking at the point of entry into the care system.

The principle of having a mental health assessment for all children being brought into care is instinctively attractive, but I know—and I know others who share this view—that we have to look at each child individually. There will be some children who, at the point they come into care, are still suffering great trauma from an event that has led to them going into care. That is not the right moment for them to have such an assessment. There are other children, such as newborn babies and others, for whom it would also not be appropriate.

The expert group is gathering pace and gathering that evidence. As my noble Friend Lord Nash said on Report, we will take seriously its recommendations. Those may come during the duration of the group’s work and may also include potential changes to legislation. That is a commitment we have made, and we want to make progress and make sure we do not lose this opportunity.

The reports discussed today pose a range of challenges to the Government. I welcome the healthy debate they have generated, because they help to keep the issue at the top of the agenda and maintain the momentum, not just for me and my Department but right across Government. I share the ambition of other hon. Members, and we are united in our commitment to improving the lives of our most vulnerable children. Hon. Members should be in no doubt that I recognise and accept that there remain deep-seated issues we need to resolve, but I and the Government are more determined than ever to show the resolve and commitment needed to rise to those challenges with our clear and ambitious plan for fundamentally reforming the system. Our vulnerable children deserve no less.