Welcome to the NSPCC Learning podcast, where we share learning and expertise in child protection from inside and outside of the organisation. We aim to create debate, encourage reflection and share good practice on how we can all work together to keep babies, children and young people safe.
George Linfield (Producer):
Welcome to the NSPCC Learning Podcast. This is the second half of a two part podcast series, recorded in July 2023, looking at the UK government's strategy to reform children's social care in England, 'Stable homes, built on love'.
In the previous episode, we interviewed Josh MacAlister, who chaired the Independent Review of Children's Social Care in England. In his foreword to the review's final report, Josh described the need for a care system that will get alongside and strengthen the families and communities that children grow up in.
In this episode, a panel of experts from within the NSPCC are going to discuss how the proposals laid out in 'Stable Homes, Built on Love' can achieve this goal. The discussion will focus on the proposed reforms to family support and early help services, what these might look like in practice, and how they might meet the needs of children and families.
Hi, I'm Eavan Mckay. I'm Senior Policy and Public Affairs Officer here at the NSPCC and my brief focuses on children's social care and child protection.
Hi, I'm Matt Forde. I'm a Partnerships and Development Director here at the NSPCC. I'm responsible for the services that we run in partnership with others, with a big focus on the early years and on the prevention of child sexual abuse.
Hi, my name's Rachel Holdcroft. I'm the Strategic Service Manager at Together for Childhood in Stoke on Trent. So I oversee the direct casework and the development work here in Stoke, all of which focuses on prevention of child sexual abuse.
Stable Homes, Built on Love' talks about providing families with the right support at the right time and proposes the roll-out of new, multi-disciplinary family help teams to provide earlier support to families so they don't reach crisis point. This will involve bringing together targeted early help and child in need into a single family help service.
So, my question for you both to start is what are your thoughts on these proposals in principle and what do you think is needed to help them work in practice?
The principle that we want to do is get alongside families at a time that helps them, that is a good one. I think there are some missing parts of the story. The care review, right from the start, the case for change for the care review, said we need to do more to help families and identify the context of poverty and inequality.
The review report itself said that we have to address that wider context that drives the demand for children's social care and the stress on families and the impact that has on outcomes for children. And I think the other dimension that isn't present there or isn't visible, is an understanding of the particular importance of early childhood and of getting it so that families with very young children, from pregnancy onwards, get the support that they need to be able to give the children a start in life that makes all the difference.
When you think about children's social care, what heaves into view in your mind is a teenager in a children's home or maybe in a foster care placement. But actually the majority of children in the children's social care system had their first encounters with children's social care before they were five, and a very sizeable chunk of the children actually, in our social care system are under five. And it's a testament to the failure to support those children that we have children spending a whole childhood in a care system rather than in families.
I agree with and echo, really, what Matt has just said there. I think the other thing for me just to add is that as a sentence or a principle or as a declaration, I think most people in this profession would support the idea that we bring together early help services for families and offer that support to create stable homes at the earliest point possible.
One of the concerns that I would have is that in practice we would need skilled, well-resourced practitioners who are able to deliver that type of service. And the other concern is around what early health actually is. So across the nation there's different thresholds that are applied when determining whether or not a family would qualify for an early help service. And, I kind of say that in inverted commas.
That differentiation and thresholds can create national inequality. And I think what we need to - what needs to underpin this principle is universal, positive protective messaging. So tackling a problem before it's happened, so that we're not waiting until families are in crisis or in need of help. We're already giving those positive messages, and that's exactly what Matt's just said. So from pregnancy, right through the early years; informative, practical, accessible, positive messaging and help to be shared, you know, is shared with families at that point. That way, there's trust in services that's built so that if they need additional targeted services, that trust, that relationship and that mutual respect is already embedded in practice.
Yeah, I completely agree. And I think that point about what do we mean by early help as well is a really important one. So Matt, you've already talked about babies, infants and the needs of babies and infants, and that was definitely a question I wanted to pick up. The specific needs of babies and infants, as you say, is definitely not a strong focus in 'Stable Homes, Built on Love'. We know babies and infants are the group that are most at risk of abuse and neglect and potentially less child with a social worker. They're also the group who are least seen by agencies and services. What would a future children's social care system that truly meets the needs of babies and infants, what would it look like?
Other ways of describing what it would look like would be about how it's experienced by families. Hearing the voice of children who are under five; it's also about understanding what what their parents need to be the parents that they want to be, and to understand their experiences in the world and to understand how they may well be experiencing incredible stress. Locked in poverty, families involved in the child protection system. They're in double jeopardy because they have all of the pressures and stresses that come from inadequate income, insecure housing, living in hard-pressed neighbourhoods, and then family crisis that's led them into interaction with children's social care and that experience of working with children's social care can often be further stigmatising and stress-inducing for families.
And what the system would look like would be a system that had services that got alongside families, that stood with families, that said, "how can we help?" That said, "where are your strengths and how can we build on them? How can we actually give you practical and material help to alleviate some of this pressure?" And at the same time, let's try and understand where relationships need to be helped and where things might have gone wrong and we can get them back on track. It's not an either or, it's both.
The system would be something that was experienced by families as something that was genuinely there to help. So you wouldn't have to navigate, you know, hostile systems of appointments set in distant places at times it's difficult to get to that when you got there there would be food available so that your child wouldn't be hungry during the appointment and you wouldn't have to ask for it. It would be an expectation that your story wouldn't have to be told over and over again, that you wouldn't have to go back to the beginning ever, that you would... that you would experience workers being alert and oriented to try and understand what your story is, and they would have time to listen to you. So these are all characteristics of a system that would be getting alongside people.
The question, Eavan, that you posed was around what would a social care system look like? And I think we need to really consider what a social care system is before we can purposefully or meaningfully answer that question. So a social care system is beyond a social worker. The social care system for me needs to be all of that child, baby, infant, parent social network, including communities as well as just professionals. And if we're really going to affect change here, I think it's crucial to bring everybody on that journey with us. In Stoke and Together for Childhood we work very much in a community way and we have seen and we have evidenced just how powerful and influential communities are. They're part of that child's networks so they're key in providing that advocacy. It doesn't all need to fall... the responsibility doesn't fall just to the social worker.
I think if we're going to move with the times, if you like, we need to think beyond traditional social work models and when we consider advocacy, we consider it as a big picture. So those people in the community will see a different version of the parent and a different version of, once the child gets older, than perhaps we do as professionals. And it's only when we tie all of that together that we really get the full picture. And if we need to intervene, offer early help or more than early help support, we can do that most effectively and most safely when we all are together and we're all working towards a common goal which, ultimately, is keeping children safe.
And, you know, I think it's absolutely critical for babies and infants that they have advocacy, that their voice is heard. And for their voice to be heard, there's no shortcut. You need highly skilled people who are able to understand a baby or a toddler's experience through the way that they communicate and through understanding the quality of their relationships and to understand what has happened in their life; and to be able to communicate for others who are making decisions about these children or who are responsible for care for these children; to be able to communicate those children's needs. That is skilled work.
In the NSPCC, we have teams of multi-disciplinary professionals who are able to do that kind of work and we've demonstrated that that can be done. And, you know, a practice example for us is in our infant and family teams where we work with children aged zero to five who have been removed from their parents' care and who live with foster carers.
We work with the foster parent and the child to understand how that relationship is going and to understand whether or not it's good enough for that child's needs, given that nearly always they've experienced trauma, abuse, neglect. And in that context of infant trauma, we find that we can we can express that child's needs in their voice in a way that provides a record for them when they get older through a method we call narrative books. So we produce these books which explain: "Hi, I am..." — the name of the child — "I'm living with" — such and such, foster parents — "here's what's happened to me and decisions that have been made about me. Here's how I am." You know, it could be that "I'm someone that doesn't... When I first went to the foster parents, I didn't seek comfort because in my life before, I'd learned not, but know with my foster parents that's getting better." So it's that kind of articulating through an understanding of what children need. A narrative that is telling their story. If there is to be a system of advocacy for children in care, it really is crucial that infants get that kind of access to their voice being heard.
We talked a bit about multi-agency working to support children and families. The principle of multi-agency working and the desire to have these multi-disciplinary teams is in the strategy, and that's something that the Government has said that they're committed to. And as well, linking to what you were saying about working with the whole family, the government talk about this idea in the strategy of a family-first approach. So this means that local authorities will actively seek out and work with a child's direct and extended family and friends in considering the best forms of support for the child and their family. And I guess my question is on those two points, on the multi-disciplinary and multi-agency working and on this idea of working with the whole family and a family-first approach. We've talked about the benefits, of which there is the so many and thinking about this future system, I guess what are some of the barriers to making that happen? I'm curious to hear your perspective from a practitioner level.
What we find in practice, and certainly what I found in my practice, is that the way the system currently operates can perpetuate or can create conflicting priorities between organisations. So there would need to be robust working practices that ensure that all of those multi-agencies are working for a common goal without bias or prejudice and without their own priority taking over. The fact that the number one priority is the children and the family at the heart of this and at the centre of this. And I think you could speak to any practitioner who has experienced difficulty in driving forward plans because of bureaucracy or because of conflicting priorities or boundaries that their organisation might create.
I think the principle works well, but there needs to be really careful consideration as to how that principle is operationalised because the people that are going to be responsible for the success of children coming from safe homes that are built on love and are stable. It's the professionals that will need the support, they need to be well-trained, supported, resourced. Mutual respect between professionals and an understanding that there is that shared accountability. That's the overarching thing for me. That the accountability for the success of the whole plan that is underpinning the family needs to be shared across in an equally respectful way, shared across those and throughout the multi-disciplinary.
So if I could add to that, you've painted a really clear picture there Rachael of what a functional system should look like. The only thing I'd add to that is what would be the glue that would hold that together? It's not just structural or managerial action that's needed there. It's at the heart of it you need relationships with families; meaningful, supportive relationships. People are human beings and what they need is a human relationship with the professionals, and having at the core a productive caring relationship with the family involved will help you then work with, advocate for, stand beside that family as they navigate what will, no matter what, will be a complex system. And the relationship dimension of it really to me is the sort of 'X factor' that would make it all work.
And I think the start of having a workforce that can build those relationships starts at recruitment and really pulling out some of those values, behaviours and attitudes. And if we are genuinely going to work with families in a way that doesn't make them feel shame, then we need to do so with high levels of empathy and understanding. There are supplementary courses that people can access. So, throughout your social work training, teacher training, health visitor training, there will be modules that encourage the workforce to build relationships. How you do that sits with you and how you make it better sits at experience. So you will go out and there will be times where you might work with a family and things haven't gone to plan.
Coming back, having a strong supportive manager with a work culture that doesn't operate in a blame way. So we work through things together, talk things out with peers, with mentors, with your supervisor. How could you do this better? But then there is also training that can be accessed, such as motivational interview training, reflective practice training. There's reflective supervision. So I think it's not a one size fits all. I think it starts with recruitment and it starts with really employing people who've got a solid value base that aligns to social work. And then working with an open mind with other professionals, observing how they interact and communicate with families, and really learning back from families. So if things haven't gone well, if conversations haven't gone well, being open to that feedback from families: "okay, tell me what I could do better next time", and really bringing them into that conversation.
Yeah, I'm really glad you both brought up that point there about relationships and also the kind of the need to be able to equip social workers to be able to have that space to develop those relationships as well and to make sure they're strong. I guess one thing I'm thinking about is the proposals indicate that in this future system, when these reforms are fully rolled out, that non-social workers, so family health workers working alongside the family help teams — so these multi-disciplinary teams — may become the case holders for non-child protection cases. Are you supportive of this idea in principle and what would need to be in place to make it work in practice as well?
I think what's important is what would the skills be of the workers who would be supporting families? So would they have the ability to be able to understand children's needs, especially young children's needs, but children's needs in a developmentally informed way. Would they be able to understand what is important in parent-child relationships and how to assess what is going on. Would they have the ability to form caring relationships within a professional relationship with families, to enable them to navigate the stresses and pressures that they face.
The answer for social workers would be yes to most of that, although I do think we could do more to equip social workers with theoretical and practical expertise in child development, parent-child relationships, understanding intergenerational trauma. And I think the focus within children's social work has been dominated by assessment of risk, identification and assessment of risk and management of risk — and that's what dominates. That's a dominant paradigm. The risk paradigm. Really, having a more person-centred approach is something that all professionals maybe need help with recentring their practice.
I completely agree. I think it comes back to the first point we made around the principle is fine as long as it's safely delivered. And that is exactly what Matt's just spoken about there, the training, the support, the reflective supervision, but also the oversight. So I think I'm right in my understanding that whilst the case holders could be non-social workers, the oversight would come from a lead professional or somebody that was a qualified social worker that really did understand child safeguarding; so could have the safeguarding oversight whilst the specific actions within the plan were delivered and coordinated by another professional.
I think the difficulty again comes back to some of the professional boundaries. So, when we think about how do we form relationships, they don't happen overnight, especially for families who have got issues with trusting professionals because of previous experiences, you know, parents who are maybe care-experienced themselves or have had a difficult relationship with professionals are going to find it very hard to automatically trust somebody, whatever their title may be. The negative could come from giving the responsibility for the coordination of a family help plan or system to a professional within an organisation that is time limited. So if we can say to some of the organisations that we work alongside, they run 12 or 18 week programs, that may not be long enough. And then we're expecting families to form new relationships with a new co-ordinator. So there'd need to be some robustness around the lead worker remaining the lead worker and organisational time restrictions not playing into that or not becoming a priority. So if it takes six or seven or eight weeks to build that relationship, that doesn't mean that you've only got six weeks left because that's what we say as an organisation you're entitled to. However, I also think the relationship with some professionals outside of social work can be extremely positive.
I've seen family support workers do exceptional work with children and families. I've seen health visitors, school link workers really make a difference. And some of that comes because they have that really positive relationship. It's a non-threatening relationship. It's not a shameful relationship. It's not a relationship that brings any kind of stigma because these are universal services that all families are entitled to that may then become targeted, but it doesn't bring with it an element of threat or an element of shame or an element of stigma. It's a more nurturing model. The relationship underpins the plan. The success of the plan is to do with the structure, so it's the wider system and how that structure supports the delivery.
One of the things that workers need to do to be able to be part of a non-stigmatising conversation is to respect families' rights to say no to elements of things. You've been signposted over here and over there. If that's not going to work, and family says so, can we please listen to that. And similar points about picking up the one time that somebody says something, you have to respond that one time. Particularly when people talk about things that they think are shameful, like not having enough food. Or are really suffering, you know, financial hardship, those sorts of issues that if they're said once, you have to pick them up. And that's really not about the grade of worker is it, it's about how we equip people with an orientation to help and provide the support to them to be the helpers. And also that we continue to learn and lesson from lived experience.
Starting with the idea of "what is the experience of the family" leads us also to asking that question of "what's the motivation of this policy?" And it kind of links to your earlier point, Rachel, about who decides who will lead the cases, for example, when it is a family help worker versus when it is a social worker? I think that feels really crucial because it has to be, you know, whilst there can be so many benefits to the possibility of having a wider field of professionals — or non-professionals as well, you talk about that Matt as well as it not being so professionalised but a wider group of people who can work with families — it has to be about if it's right for the family and it's right for the child, rather than it being motivated by anything else. And it feels like, you know, what we can't have is the idea that family health workers could be a silver bullet to saving money because that is not in the interests of children and families at all.
The government plans to introduce a new lead child protection practitioner role. So this practitioner will have a minimum of five years social work experience and will complete advanced specialist child protection training. Our understanding is this new role will be across the system. It won't just be for family help teams. My question is around... what are your thoughts on this new role? Thinking about the benefits to the system it could have, but also any risks you might foresee in terms of the implementation.
To me, the crucial issue is what are the advanced skills and knowledge that this person would have. The way that we've structured child protection as a social work-led activity has locked into a professional framework that doesn't really value expertise. That, you know, if you progress as a social worker, you become a manager and stop being involved with families. Whereas in health professions and mental health, for example, psychologists and psychiatrists and psychotherapists progress to become consultants who are at a higher level of skill and expertise, but continue to be in practice with families.
I think that is the kind of structure we should have professionally around the social work professionals or child protection professionals who are doing the most complex and challenging work. They should have... they should have a level of skill and expertise that's commensurate with the complexity of children's needs and families' lives. But it's what that is, because my concern would be that it would be a kind of amplification of the risk assessment mode that our system is locked in. And it would really need to be supplemented by skills which understand how it is you help families.
I mean, to understand how we negotiate the benefits system; how you improve families' ability to care for themselves and bring in adequate income; how you understand mental health, and what it is that drives the stresses that undermine mental health; to understand intergenerational trauma; parent-child relationships; infant trauma, to understand what it is that pressures on whole families and whole communities. Those are dimensions that are kind of missing from, you know, the fairly arid assessments of risk that result in — I'm oversimplifying — but result in ultimatums to families to change things by a certain time or there will be action, instead of getting alongside.
So, in terms of that lead professional role, I think having a social worker and somebody with that level of safeguarding expertise is crucial in ensuring that all of the — whoever is that's leading the plan — and all of the multi agencies that are part of that plan, there does need to be somebody that can always bring this back to "how safe is this child?" and can knowingly, with expertise, be able to answer that question, support the professionals to demonstrate that curiosity when necessary, really challenge professionals to keep thinking about safety as well as their own expertise. So that role is crucial in that space. And I think whether that's a lead professional or another title, having space or the opportunity to grow and develop professionally for a social worker is really important. And it might support some of the issues around retaining good staff because you can see a progression opportunity.
I do think in terms of continuing to make sure that the child remains safe in the family and that the plan is effective, in terms of meeting the needs, but ultimately keeping the child safe; to have that professional, whether it's a lead social worker or a social worker, having oversight of a plan is crucial. That's how we keep children safe. That's why social workers are here; because we want to keep children safe. And when they're not safe, we want to take action to bring them back to a place of safety.
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