Intro:
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. Earlier this year, the UK government published its vision for the reform of children's social care in England: ‘Stable homes, built on love’.
This is the first in a two-part podcast series, recorded in July 2023, looking at the 'Stable homes, built on love' strategy, its recommendations and how these might be implemented, and what potential changes might mean for social care professionals and the children they work with.
The Independent Review of Children's Social Care in England, which published its final report in May 2022, was a cornerstone of the government's strategy. The review was chaired by Josh MacAlister and aimed to produce recommendations for a social care system that provides intensive help to families in crisis, puts lifelong, loving relationships at the heart of the care system and acts decisively in response to abuse.
The NSPCC's Associate Head of Policy and Public Affairs, Abigail Gill, sat down with Josh to talk about the review's findings.
Abigail Gill:
Thank you so much for being here, Josh. This feels like a particularly timely discussion as this week on the 26th of July, the government has announced the pilot of the Family's First for Children Pathfinders programme, which are those local authorities who will test reforms.
And that feels like a really long time coming, but brilliant to see some of the recommendations that you set out in the review coming to fruition.
But before we get onto that, it would be great if we could go back to the beginning a little bit just to remind listeners about the review itself and where it came from.
The care review was heralded as a once in a generation opportunity to reset children's social care, and it was originally announced in the Conservative Party manifesto back in 2019, and it was something that the sector had been calling for for a really long time. So that must have felt like a pretty huge responsibility when you were appointed chair.
Can you talk to us a little bit about how you first set out to approach the review and what you really wanted to achieve from the outset?
Josh MacAlister:
Well, because it was such a big piece of work, my starting point was that no one person had the wisdom to be able to answer the question of how we better guarantee that the system provides safety, stability and love for children who need it.
And so the process within the time limits that we had... it was about 15 months or so that the review had to run. Because of that, we had to balance speed, but also having lots of open dialogue with people who've got direct personal experience of the care system, as young people growing up in it or as those who've left the care system but have care experience as an adult; parents who are often just as marginalised from the system as those young people themselves that rely on it; wider family networks, so kinship carers, whether that be grandparents or aunts or uncles, foster carers; and then practitioners who work in the system as well.
And we wanted to leave space for people to tell us what the themes of the problems would be, with all of the inherent contradictions of what some of those messages might be. You know, some of them don't fit neatly together.
But to get that really messy picture, that rich, messy picture of how we're doing children's social care at the moment in England and what needs to change, and then what some of the solutions might be. So it was unusual in a sense that we started the review with a call for advice rather than a call for evidence. We then did the call for evidence.
We then published within the first few months a document that set out what we'd heard about the issues and problems in the system. And we asked for feedback on that and we published the summary of that feedback. And then we did a call for ideas where we asked people to come forward and offer solutions. And in between all of that, we spoke to thousands of people who've got direct experience, did hundreds of visits.
We commissioned some research and rapid reviews of evidence, and we commissioned some standalone bits of analysis on the costs, the financial costs of the system and the consequences of poor outcomes.
So a huge amount of work was done within a relatively short space of time to try to find some sound recommendations that set out together would give us a chance to reset children's social care in England.
Abigail Gill:
And why was it such a landmark review at that time? Why was it so urgent that we needed reform then? And actually, you may want to reflect on where we are now as well and the context we're approaching reform in now as well.
Josh MacAlister:
There are some trendlines that have been there for a number of years, for decades actually. One being the total number of children growing up in care at any one time has gone up and up, to the point where we're now north of 80,000 children in England in care at any one time. The costs of the system have gone up and up, the total costs of children's social care.
And something within that, the biggest story within what's happened, is the shift from spending on services to help families that have got real challenges where some help could make the family home environment safer for children and actually improve the quality of life for the whole family. Spending on that has gone down dramatically, and that's happened at the same time as spending on care has gone up.
So there is real financial pressure and that cycle that we're in, of spending more on late intervention crisis costs, is at the expense of earlier effective intervention for families.
And then something else, which I think there is greater public awareness of now, and hopefully greater awareness of with policymakers, which is all of this stuff we call children's social care. You know, families that are struggling to raise their kids in conditions of adversity, child protection, where children are at risk of significant harm, and then children needing to live either with wider family networks or in the care of the state.
All of that has a direct effect on attainment in school, on how schools do, on health and how mental health services perform, on local authority, long term finances. And I think it's become more and more obvious that this hidden system is actually the glue and the fabric that's needed.
And I think for those who've got care experience, the reason why so many were keen to see a review that looked at the whole system was there have been previous attempts to look at just fostering or just residential care or just the child protection system. And actually it's in the connectedness of all of these things that you can, I think, get recommendations that lead to bolder action.
Abigail Gill:
Thanks, Josh. I'd like to think a little bit now about the sharper end of the system so to speak, the child protection end.
And obviously this review was going on alongside the work that the national panel was doing into the deaths of Arthur Labinjo-Hughes and Star Hobson.
What struck you at the time as a review as the most significant concerns from a safeguarding perspective and how did that feed into your thoughts around reforming the sharp ends of the systems, Section 47 and how we might bring children into the care system?
Josh MacAlister:
My reflections on looking at the whole system whilst the national panel were doing this work on the really tragic murders of Arthur Labinjo-Hughes and Star Hobson was that we've gotten ourselves into a situation where the volume of child protection activity has been vastly increasing. I mean, the number of child protection investigations we've had in England has gone up many, many fold.
And my worry looking at that was that the volume of activity was being seen as a proxy for quality. You know, almost to say, well, we're doing loads more investigation. Therefore, in some ways the system's safer and that is objectively not true.
My concern was actually that, perversely, having so much child protection activity investigating families was leading to us not being able to see the needles in the haystack. And actually, when you look at all of children's social care, 80 to 90% of the work that we're doing with families is not about significant harm. It's not about compelling families to change things because they're putting their children at significant harm.
It is consent-based. It's about support for families in order for them to be more successful in raising their children. And we've really muddied that child welfare-led response in the child in need arena with the minority of adults — sometimes parents, sometimes members of the community — who are, either intentionally or otherwise, really harming their children or children in the community.
And for those circumstances, the judgements about risk, the analysis that's required, the decision-making that comes with the power of compulsion. So that's what the child protection legislation allows. It is such that we need the most expert people doing that work and actually in the current system we often leave fairly inexperienced, fairly new practitioners with lots of families to work with, with the child protection decision-making.
And I think as the national panel reports have shown previously, when it comes to knowledge and skill on certain issues and quality of decision-making, as well as the multi-agency aspects of that, with the police and health and education, this is such that it warrants the most experienced practitioners with the time to be able to get alongside the family help services when there is a concern about significant harm.
What I've set out in the review is a design of the system where we would have ideally fewer child protection investigations because we'd have a calmer system, and because of that we'd be able to put the focus, the attention and the speed into addressing significant harm when it's needed.
And I say all of that with the recognition that there is no perfect system, there is no completely foolproof system, but there is one where we can have the conditions for really difficult judgements being made by the most experienced practitioners who've got the time and space to do so.
Abigail Gill:
We'll come onto workforce in just a second because I think that's really important to consider.
But when you were kind of gathering in the evidence for the review, did you find that there were any particular groups of children or children with certain characteristics who you felt that the safeguarding system particularly isn't working for right now? Any kind of trends, I suppose?
Josh MacAlister:
Yeah, lots. I mean, we did a specific bit of work on racial disparities within the children's social care system. And there's some worrying things, really worrying things that flagged.
One of which is for black and mixed race families. They move through the system really quickly, so they often don't get access to family help and family support services and get to child protection really quite quickly.
We also see the very strong contributory causal link between poverty and involvement of children's social care, particularly child protection, as well as being a concern about how we address child poverty, is also a direct challenge to the children's social care system to make sure that, you know, we're not making judgements about neglect and poverty that are confused, and being very intentional about the distinction between those two things.
Abigail Gill:
Thank you, Josh. That's really insightful and I think as well one of the things that has come out, particularly with the national panel, that we've reflected on a lot is that what's happening with babies and infants being particularly vulnerable as another group to abuse and neglect as well. And I know that came through quite strongly.
Just to go back to the workforce point. Obviously, your review set out a number of reforms that would have pretty significant changes to the workforce, and that has been taken forward by the government with 'Stable homes, built on love': the idea of the expert child protection practitioner, which is really good to see.
Can you talk to us a little bit about the challenges that professionals face in their work and how you think these reforms might address some of those challenges?
Josh MacAlister:
Yeah. So the main messages from practitioners were that they didn't have the time to work with families in the way that they wanted. A frustration that the system didn't develop and recognise expertise.
So, often, if you wanted to get on and do well in your career, it meant moving away from practice, which has been a long-standing problem and I'm definitely not the first person to highlight that. In fact, it's very, very frustrating reading previous reports and then hearing the same thing again about that. So it's not a system that privileges expertise in the way that it should.
And given how challenging and difficult the work is intellectually and emotionally and then also access to resources. So, practitioners being, you know... Even if they did have the time, even if they were recognised for their expertise and they were surrounded by colleagues who were able to stay for a long time and know the families really well and know the service really well, if they know that the family could benefit from a particular intervention or service and then that service isn't there, that can feel just as frustrating. And so, those were the main... They were the main issues.
And, in responding to those, the reason why the review's gone for pushing through its recommendations on major changes to family help is in part because we want to see more practitioners freed up to be spending much more time in multidisciplinary teams where they've got the drug and alcohol worker, the domestic abuse worker, the clinical psychologist.
That the people that they are in a team with, being able as a team to provide the direct services and support to families rather than referring out, referring to services with waiting lists, or finding there is no service there, and then pushing the family down a route of a parenting programme because it's the only thing on offer. And we heard lots of stories from families about that.
Abigail Gill:
I suppose at the heart of a lot of this is the importance of that multi-agency working, which isn't a new phenomenon. It's something we've been calling for for a long time. Some local authorities already do it and do it very well. There are different models of it.
What do you think has been the key barriers actually holding that back until now? Because obviously there must be something if some areas are able to do it well but others aren't. What do you think could really unblock that and could it be stronger national leadership as well?
Because I think, from the NSPCC's perspective, what we're quite interested in is, you know, this is cross-departmental, this is cross-government and cross-departmental working needs to filter down at all levels of the system: at the national government down to the local authority level. And that's maybe not quite happening now.
It's one thing to tell local authorities to work in that way, but if national government aren't that feels a little bit disjointed. So I'd be interested in your reflections on that.
Josh MacAlister:
I think the biggest barriers to this, I mean, it's a locally-led system, right? So you need to create the conditions for local leaders to lead the system.
And what we see, both through the work I did on this review but also Alan Wood's work on safeguarding partnerships, is that the senior local authority executive officer and health officer and police officer are not routinely agreeing how to spend money together, how to share information together and how to delegate work together.
If you start from the family point of view — when it comes to multi-agency work, particularly on child protection, from the child or family point of view — and work your way back into the system, what practitioners would say is that it's really hard to get collaboration at the practitioner level on data and resources and joint decision-making and alignment around risk and harm.
And the reason it's hard to do that is because those bigger decisions around alignment have not been made by the senior folk. And in my view, every safeguarding partnership should have to publish every year the money they're spending together, the information sharing agreements that they have jointly signed and are in place, and the delegation that they have made to the operational leaders, so that they can create multi-agency teams to do child protection work.
Now, Ofsted, the DfE, any agency or body could, I think, fairly easily look at that paperwork once a year and stress test it to see: has every area got joint information sharing agreements in place, has every area got shared budgets being created and spent together? Those are the responsibilities of the strategic leaders.
And instead, we've got a vague, fluffy arrangement where we're asking people to come together and collaborate, but we're not really clear what we're asking them to collaborate on. We don't know how to test it.
And the consequence is felt at the operational level, where you've got practitioners running around picking up phones, trying to get hold of people to get a piece of information that's something they should be able to get instantly, through good information sharing.
They're trying to resource a plan for a family or a team so they can get the forensic expertise they need into that child protection response. And they can't because they haven't got the seniority to bang heads together. And we go round and round and round and it's hugely frustrating for people. And then we have a death and a national report that says agencies don't work well enough together.
And, you know, the NSPCC and its community knows this inside out and back to front, as do people that've done previous reports. It is very frustrating that this quite dry and potentially boring, dull subject of multi-agency working doesn't get the attention it needs because it's fixable.
And we basically need to force some people to make some decisions together at a very senior level and then hold them to account for doing it. That's what we need to do.
Abigail Gill:
There's certainly a lot riding, I think, on the refresh of 'Working together', the guidance which is out for consultation at the moment, as you say Josh.
Conscious of time and we are coming to the end, but it would be great just to touch on — probably one of the central facets of the care review — family help.
Obviously the review put forward a fully costed plan for family help, a new vision which was really exciting and it's great to see quite a lot of that brought forward by government in 'Stable homes, built on love'. I think one of the things that's been much discussed is the distinction between early help and family help. And obviously you had a certain remit with the care review and you had to cut your cloth in some ways.
What are your reflections on how you had to distinguish between family help and early help? And even though you didn't look maybe in as much depth at early universal help and how that feeds in, you must have had to consider it as part of the broader ecosystem for children's services.
Josh MacAlister:
Yeah, in the review, we've got a definition of what we mean by family help. We put a number on it as well, of the number of families that fall into that category.
And we recognise that it isn't a universal service because it's providing really intensive help for families where children — and this is to quote the legislation — are at risk of not reaching a reasonable level of health and development. Now that's not the same agreement as universal or even, in some cases, broadly targeted early help provision. It does rest on that system of early help.
So, of course, there's a link between the two. I guess one of the things we have done over time is we've made a system that's very complicated for families, that involves them often being referred a lot through different levels and stages of a system.
And actually we spend a lot of money administering that referral system, sometimes at the cost of just providing the service. And we see this a lot in the child in need arena, where the original intention in the '89 Act was that local authorities provide a broad, flexible service in responding to families where children are at risk of not reaching a reasonable level of health and development.
And we've turned that over the years into a, in my view, risk-led precursor to child protection so that families often find they get more help at the targeted early help end of the system when there's no social workers involved and then risks escalate and they get a child in need plan and then the support drops off. Risks then escalate, problems escalate, and then they end up in the child protection system.
And having then had three different teams, three different referrals, three different assessments. And so the recommendation was to try and simplify that and say, look, if families require an intensive level of help and support in order for their child to reach a reasonable level of health and development, that should be a multi-disciplinary social work-led service that has got significantly larger sums of money being spent on it.
And we projected savings that that would create, off the back of existing interventions and models that have reduced the number of children needing to go into care. So it's a pretty watertight business case that we set out.
And I said that over four years we need to ramp up spending by £2 billion, and that would shift, you know, turn the tide in terms of where money is spent in the system. It would mean families get a much quicker, more human and dignified response from services. And, crucially, children would be able to live together happily and successfully with their families.
But all of that is built on a wider system of support from schools, from health visitors, from early years settings. And of course, there are links to that, but it is a distinctive system.
One of the things I've noticed is since the review was published, there are conversations about family help and family hubs and early help and we need to be careful not to conflate and confuse those concepts and ideas because they are distinct. And the review tried very, very hard to be precise in its language.
Abigail Gill:
That's helpful. And that's helpful, actually, food for thought for those of us that are working on that at the moment. You touch just on the the costing of the care review.
And, from a policy perspective, the NSPCC has raised concerns about the cost of reform and the delays to it, and also the pace, despite the fact that, as you say, the review sets out a fully costed implementation plan which could have been actioned pretty much immediately.
And now we are more than a year on, the Government has only just announced the first Pathfinder local authorities and we published economic analysis which shows that the cost of delaying reform by just the two-year Pathfinder period will cost the taxpayer an extra £1 billion. So, we're hopeful that reform is coming but it has been slow.
What are your personal reflections, just to finish, on how the government has taken the review forward and I guess what are your hopes for the future?
Josh MacAlister:
I think there are lots of areas of public services where we've got this problem of, if we're being really honest with ourselves, we can see that if we don't change course things will get more expensive.
And whether that's adult social care, the NHS, some forms of school support, definitely children's social care — they're on these trajectories where the outcomes are probably going to get worse and the costs are probably going to go up.
So the fiscally responsible thing to do is to frontload some of the spend that we will end up paying anyway on a reform programme that flips the balance, the long term balance of the system, and improves outcomes. The wider benefits of this are just so clear.
Every year, the costs of poor outcomes from children's social care, the costs of poor outcomes for children and their families, is well over £20 billion a year. We're spending money on that too. So, the economic financial case for this is only getting stronger.
I know the NSPCC are there, I'm there, lots of other organisations and advocates are as well, saying, you know, we're not going to let up on this. Government are going in the right direction. They need to go further. They need to go faster. And we're not going to let up because too many people's lives are on the line and the consequence of inaction is a social, moral and economic urgency.
Outro:
Thanks for listening to this NSPCC Learning podcast. At the time of recording, this episode’s content was up to date but the world of safeguarding and child protection is ever changing – so, if you're looking for the most current safeguarding and child protection training, information or resources, please visit our website for professionals at nspcc.org.uk/learning.
