Looked-after Children/Social Work Reform

Tim Loughton Excerpts

Thursday 20th October 2016 Westminster Hall

[Neil Carmichael (Stroud) (Con)]

I beg to move,

That this House has considered the Fourth Report from the Education Committee of Session 2015-16, on Mental health and well-being of looked after children, HC 481, and the Government response, Cm 9284, and the Third Report from the Education Committee of Session 2016-17, on Social work reform, HC 201, and the Government response, HC 733.

It is a pleasure to serve under your chairmanship, Mr Gapes. I am grateful to the House for the opportunity to debate the Select Committee on Education’s work on children’s services and the mental health and wellbeing of looked-after children, and on social work reform. Our Committee has a large and growing set of responsibilities, so it is an extremely good use of time to debate two of our reports at once. I appreciate the House’s indulgence. I pay tribute to the specialist advice we have received from Dr Matt Woolgar; Professor David Berridge, our adviser on such matters; and Marion Davis, also one of our advisers. All three contributed massively to the value of our work, and that is much appreciated.

During our inquiries, we heard from children in care, care leavers, foster carers, social workers and other front-line mental health workers. We visited the excellent services provided by Trafford Council, and we took evidence from a young woman in care and two carers with experience of mental health services. Our meetings with children and professionals in Trafford and Westminster were crucial to the recommendations we made. I thank all those who gave their time to speak to us; they spoke in a very helpful and frank manner.

There are significant challenges to overcome in both looked-after children’s mental health and social work reform. The responses from the Government to our recommendations were, frankly, a little disappointing. We need urgent action to solve problems with mental health services for looked-after children, but the Government have not acknowledged the urgency, and have passed the ball to an expert working group, rather than making the immediate changes that the Committee pressed for. Indeed, many of the people contributing to that working group will be similar to, if not the same as, those who contributed to our findings. Our recommendations on social work reform have largely been ignored. During our inquiry, it was clear that there are things that need to change, but again, the Department has not really taken what we suggested on board.

I shall start with the Select Committee’s inquiry on the mental health and wellbeing of looked-after children. Following a report on child and adolescent mental health services by the Health Committee and an update to the Government’s statutory guidance, we felt that it was a policy area that required scrutiny, so we launched our inquiry in September 2015. Almost half of children in care have a diagnosable mental health disorder, and they are significantly more likely to experience poor health and educational and social outcomes than their non-looked-after peers. Let us not forget that children in these situations are children of the state, because of their special circumstances. Our inquiry took evidence from experts including Sarah Brennan, chief executive of YoungMinds; Professor Peter Fonagy from NHS England; and Natasha Devon, founder of the Self-Esteem Team.

In April this year, we published our report. We found that provision for looked-after children with mental health concerns is poor in many areas throughout England. That variance should be of concern to us all. Some local authorities are providing integrated services, with a strong focus on multi-agency working and support for key workers such as foster carers and school staff; others are not. A significant number are failing to identify mental health issues when young children enter care, and services are turning away vulnerable young people for not meeting diagnostic thresholds, or for being without a stable placement. So there is good and there is bad, which is not acceptable. We found that methods of assessing children and young people’s mental health and wellbeing as they enter care are inconsistent, and too often fail to identify those in need of specialist care and support. For that reason, we recommended that all looked-after children have a full mental health assessment, carried out by a qualified mental health professional.

Leaving the care system can be a time of significant upheaval and disruption, and the period is likely to be even more unsettling for care leavers with mental health concerns. In short, it is the cliff-edge problem. We found that support for young people leaving care is inadequate and based too heavily on inflexible age restrictions. We therefore recommended that care leavers be able to access CAMHS up to the age of 25, rather than the current age of 18, and that the initial assessments of those entering care be carried out more thoroughly and consistently.

We received a huge amount of evidence on the capacity of CAMHS to respond and treat looked-after children and young people. We heard too many times that CAMHS refuse to treat young people who are without a permanent settled placement. The young woman we took evidence from, to whom I referred earlier, said that she had been waiting for CAMHS for more than two and a half years, but had been unable to access services because she had moved a staggering 13 times during that period. We recommended that CAMHS never refuse to see children or young people without a stable placement, or delay access to services until a placement becomes permanent. In recognition of the distinct challenges that looked-after children and young people face, we recommended that they have priority access to mental health assessments by specialist practitioners, and that subsequent treatment be based on clinical need.

The Government’s response acknowledged the vulnerability of looked-after children and the need for timely and effective mental health diagnosis and treatment. We are pleased that the Government have set up an expert working group for looked-after children’s mental health and wellbeing; however, having conducted a lengthy and detailed inquiry on the issue, we are disappointed that so many of our recommendations have simply been referred to that group. We will monitor the working group’s progress, and look forward to receiving updates from its co-chairs in due course, because we are very interested in the subject.

Let us move on to the second report. At the start of the year, we launched an inquiry on the Government’s plans for social work reform—and they do have plans. Although the Government had previously made it clear that improving the quality of child and family social workers and children’s services was a priority, the lack of clarity on how the aim would be achieved meant that we believed it was an important area for us to look at. During our inquiry, we heard from social workers, social work academics, local authority leaders, and many more experts in the field.

Social workers deliver an incredibly important service to some of the most vulnerable children in the country, but evidence suggests that they are doing more work than ever before. Children’s social workers are managing increased case loads: we have the highest number of children in care for 30 years, and the number of children subject to a child protection plan has risen by 50% in the past five years alone. Just last month, Sir James Munby, the president of the family courts, issued a warning about what he terms a “clear and imminent crisis” facing care proceedings, because in the past 10 years the number of care applications going through the courts has doubled. Despite those increased workloads, it is important to remember what an important job social workers do. The number of children who die due to homicide or assault has fallen by 69% since 1985 and remains in long-term decline. That is thanks to the hard work of social workers, police and others. This is not a story of social workers not doing things; the question is how they are led and resourced.

Although we can never be complacent when it comes to the safety of children, the Government need to ensure that in making reforms we do not forget about the good work that children’s social workers do across the country, which often goes unnoticed. On behalf of the Select Committee, I thank social workers for what they do, and I want that message to be amplified.

We published our report in July. We found significant weaknesses in the planned reforms, and recommended important changes. Existing career pathways are confusing, and provision of continuing professional development is inadequate and inconsistent. A national career development framework is urgently required. Children’s social workers need much more assistance after qualifying to enable them to specialise. That became increasingly obvious as we carried out our work. During our inquiry, we regularly heard that it is vital that social workers receive a generic start, with specialisation to follow afterwards. In the current system, however, that is far too difficult to achieve.

The Government’s reforms do not focus enough on tackling endemic retention problems. The average social worker’s career is only eight years long, compared with 16 years for a nurse or 25 years for a doctor. Almost a fifth of social work jobs are vacant, and they are mostly filled by agency workers. Poor working conditions, caused by high case loads, negative media coverage and the blame culture, are a threat to keeping good, experienced social workers in place. We need manageable case loads for those workers, and a national workforce planning system to forecast supply and demand. We also need to talk about social work in a positive way. I have done that already, but it is very important that we do so frequently. Without immediate action in these areas, experienced social workers will continue to feel under pressure and undervalued, and will therefore leave the profession.

One of the biggest problems facing social workers is the lack of a professional body. The closure of the College of Social Work in 2015 has led to a significant absence of high-profile leadership for the profession. A new body would take the lead on a number of crucial functions and so drive improvement in the sector, for example by defining CPD and the post-qualifying framework; endorsing courses; promoting practice excellence; and shaping national and local policy. That really is the No.1 priority and could address so many of the retention issues. The Government should halt their regulatory reforms until they have figured out a way to help the sector to replace the College of Social Work.

Finally, we could not ignore the wider context in which children’s social workers operate. While we welcome the attempt to introduce innovation, the Government’s proposals are untested. We do not believe that there should be any expansion of the independent trust model until there is clear evidence that it works. Unfortunately, despite the Government agreeing with us on so many issues in their response, that response seems to show that they are determined on their course of reform and unwilling to reconsider it.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I declare my entry in the Register of Members’ Financial Interests.

Does my hon. Friend share my frustration that too often there appears to be an obsession with changing structures, titles and the nature of the vehicles delivering children’s social care, when what really makes a difference are some of the things that he has already mentioned, such as making sure that we do not have 20% vacancies for social workers in certain parts of the country—that is why there is such a huge variance in the number of children taken into care in different local authorities—and looking at the quality of the outcomes for these children? We should do that, rather than obsessing about the system, which is supposedly there to help these children. It is the people on the ground and to whom my hon. Friend quite rightly paid tribute—the too-often maligned social workers—who really help, but they are damned if they do and damned if they don’t.

[Mr Carmichael]

I thank my hon. Friend for making some really strong points. He is absolutely right about the obsession with structure, as opposed to the importance of the people operating within it. That is why I first of all pay tribute to social workers, and believe that their leadership and reputation need to be enhanced and protected through a professional body; that is something that the Government have to think about carefully.

Although we are happy to hear that the Government plan to consult on many of their reforms, we still believe that there is a lack of detail on how to tackle some of the trickier issues, such as the retention of social workers. Moreover, there is a lack of detail on how some of the proposals are to be taken forward, and how extensive and binding the consultation exercises are likely to be.

The Government said in their response to our report:

“We agree that the development of a strong professional body for social work is important.”

However, they also said that they thought such a body

“would be one established by the…profession.”

We are a bit disappointed about that, because we believe that the Government need to be much more proactive in their efforts to replace the College of Social Work. I hope that the Minister will address that point when he rises to his feet.

The sector needs to be more heavily involved in this area, of course, but the Government have previously invested in the College of Social Work, and there is still a key role for them to play in the creation of a new professional body; it is not sufficient for them to say that the profession needs such a body while doing nothing to encourage its creation. The establishment instead of a Government-controlled regulator seems to suggest precisely the opposite: that the task of defining social work, and good social work practice, is being taken out of the hands of social workers. That is the opposite direction of travel to the one that we recommend. That is worrying, and we are concerned that the Government have not fully understood the significance of the move towards regulation, and away from supporting the creation of a professional body.

Social workers face pressurised working conditions, and the Government response suggests that action on that issue is not being taken quickly enough. Our recommendation that social workers nationally have manageable case loads was rejected. That was despite Ofsted saying that the local authorities that were judged to be good had almost always set manageable limits for their social workers—something we picked up on in Trafford. A recent National Audit Office report that was very critical of the Government’s action on improving children’s services also raised the issue of social worker case loads. We are disappointed that no immediate action on this front is planned.

In some cases, the Government’s response was to reject our recommendations without sufficient justification. For example, despite agreeing that the assessed and supported year in employment was important for newly qualified social workers, they rejected the recommendation to make it mandatory. We are unclear as to why they did that.

Both our inquiries revealed the pressures that children’s services are under. Our inquiry on the mental health of looked-after children found that CAMHS are overwhelmed, and that many specialist teams that offered targeted support for looked-after children have been abolished due to financial pressures. In some areas, children’s social workers face having unmanageable case loads, which is leading to low morale and poor working conditions, as was mentioned earlier by my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton).

Experienced social workers are exiting the profession in record numbers. As I have said, Ofsted has found that the local authorities that are judged to be good tend to be the ones that give their social workers manageable case loads; the Government must take account of that.

We also found that services were inconsistent across the country. I have already said this, but it is important to note that initial mental health assessments are highly variable. Many local authorities are not meeting their statutory requirement to ensure that all children are properly assessed on entering care. I would have thought that was of fundamental importance. While there are some good authorities—we cannot deny that, and we should always support those that are good—that support their children’s social workers with good leadership, access to continuing professional development and manageable case loads, far too many are still not in that category, or even in the vicinity of it. There are regions with significant retention problems, and it is clear from Ofsted reports that plugging the gap with agency workers does not bring about a satisfactory solution.

Both inquiries found that training and development for professionals in children’s services are poor. Children’s social workers lack a professional body, and their access to CPD is inconsistent and inadequate. Put simply, it is not good enough. A new professional body for social work, created with help from the Government, could define professional standards for qualifying and post-qualifying practice, and be given a mandate to define the CPD and post-qualifying pathways for the children’s social work profession. This debate is about a profession and the people within it, and we believe that they should have an appropriate body.

Training and support for foster and residential carers is highly variable, and many local authorities fail to equip carers with the knowledge and skills needed to support looked-after children with mental health difficulties. Foster and residential carers are professionals who need comprehensive and regular training in how properly to support children and young people in their care. We have recently launched a further inquiry on fostering, and we will look in more detail at the issues in the coming months.

Despite the Government agreeing with much of our thinking, the responses to both reports lacked the determined aim to implement change in an urgent fashion. It is hugely disappointing that the Government referred so many of the recommendations to an expert working group. On such an important and pressing issue, delaying action and effectively passing the buck is not helpful.

[Tim Loughton]

I share my hon. Friend’s frustration, but the frustration is worse than that: some of the recommendations in his Committee’s excellent reports relate to recommendations made in the Munro review, which reported in 2011. Since then, very little progress has been made on those recommendations, which have been looked at, researched and looked at again, and they remain unimplemented.

[Neil Carmichael]

I am grateful for my hon. Friend’s support. He underlines points that I have made, but he is absolutely right about the lack of progress since 2011.

I am pleased to have the opportunity to talk about these issues in the Chamber, because both reports are emblematic of our interest in the whole question of children’s services. I thank all the Members who have come to participate. Two of my colleagues on the Education Committee have done so, and I am grateful to them. We have a huge chance to make an important difference in both these critical areas. It is clear that we all share the objective of improving outcomes for children in care, and I do not doubt that the Minister is as keen as we are to see improvement. I am grateful for all that he has done in the past to demonstrate that commitment. We need a response to my questions, and an approach to our two reports that suggests a sense of urgency and a commitment to ensuring that we can deliver a better future for children in need of support and help. I commend those thoughts to the House, and I hope that the Minister will answer my questions in due course.