So Birmingham's finally published the Ishaq serious case review and it looks like her death was "preventable" -- take a look here: http://www.lscbbirmingham.org.uk/downloads/Case+14.pdf
It's also the first SCR to be published in full. It looks pretty good to me -- I like the novel-like summary of events at the start -- it makes it easier to get to grips with what went on than a bullet-point list (but then I did English at uni, so maybe that's just me)
I'm only a short way into the 180 pages (eep), but it also sounds like the authors tried to avoid naming and shaming and overly blaming.. Seems like it'd be pretty daunting for the SWs involved to have it published in full like this, doesn't it?
CommCare's story on it is here: http://www.communitycare.co.uk/Articles/2010/07/27/114991/khyra-ishaq-death-due-to-lack-of-information-sharing-says-scr.htm
In my experience, Doctors (GPs) and health visitors as well as schools seem reluctant or hesitant about making referrals to social services when the parents are middle class, articulate or educated.
Patient Confidentiality seems to prevent doctors talking to social workers.
I really think there are serious problems of trust (or lack of trust) between the medical profession and social work. I think GP surgeries should have social workers integrated into the surgery team.
Thanks Molly. I've had a quick skim. Seems to me another case where there is a belief by one of the adults that the child could have been possessed by evil spirits. This appears to becoming more common as we know from the Victoria Climbie case and subsequent research and an increase in similar cases. (It was also a feature of a Dispatches programme last night). As good as the SCR is, I think many of the recommendations are the usual ones we would expect. I'm a bit disappointed that there isn't something in there about tackling the growing issues around alleged child witches, managing cases of suspected deliverance and the belief in possession by evil spirits. Education and Social Work training and increased knowledge around this area is needed urgently.
I agree with all the above points.
On a different note, the LA I work within has recently significantly raised the thresholds for both assessment and intervention. This appears to be happening in many LAs, I wonder whether this SCR will make them think twice.
The SCR:
http://www.lscbbirmingham.org.uk/downloads/Case+14.pdf
was conducted by the NSPCC - hardly a 'frontline' Service in Child Protection any more! Surely accountability has to rest with the senior managers in Birmingham - if staff were not properly trained / equipped to do the job then responsibility has to rest somewhere. Birmingham is a massive Local Authority - that has both strengths and weaknesses - and has to ensure that as a 'bottom line' staff are competent - managers to undertake the responsibilities associated with management and social workers to undertake social work tasks
There must be a programme of annual competency reviews - if there is why were training / practice deficiencies not identified in respect of individual staff and remedial actions taken?
There were undoubtedly inter/multi-disciplinary issues also but for how many years and over how many Inquiries have these been previously identified?
Something is terminally wrong with Birmingham and it is well past the time that its running was taken away from the current senior management team / Elected representatives and given to new staff brought in by Central Government and subject to on-going close and detailed assessment. OFSTED passes its responsibilities over to the Governernment Office for the West Midlands (GOWM) - who, in turn, place the responsibility back on Birmingham! Yes, they attend meeting etc. but when will OFSTED make its next Inspection and what will the GOWM do if timescales from the SCR are not met?
PaulBarton: In my experience, Doctors (GPs) and health visitors as well as schools seem reluctant or hesitant about making referrals to social services when the parents are middle class, articulate or educated. Patient Confidentiality seems to prevent doctors talking to social workers. I really think there are serious problems of trust (or lack of trust) between the medical profession and social work. I think GP surgeries should have social workers integrated into the surgery team.
hear hear
One of the most significant factors in this Serious Case Review (and many others) is the aggressive and manipulative use of complaints procedures,legal action, verbal abuse of staff etc to deflect social work assessment. As a practitioner and report writer I see this kind of behaviour regularly. If allegations of racism are added, it becomes really toxic. The unconscious reaction to a threat is avoidance and this can be seen over and over again in SCRs. We avoid the frightening family and gravitate to the more co-operative ones. Parents who want to manipulate and deflect know this and use their skills to keep workers away. In my experience, primary school staff (as in this case) are also vulnerable to aggression although often best placed to observe changes in behaviour.
The facile response in many reports is 'better supervision' but I do not think that it is as simple as this, there is a whole hierarchy of sub departments, quangos, lawyers etc in place to support intimidation of staff and little to back them up. We are operating on a complaints system developed primarily for community care users in the early 90s with little regard for its manipulation by devious parents.
There is a need for some serious academic research to examine this behaviour and to generate practical approaches to deal with it perhaps through fictitious case studies. Senior managers also have a role in ensuring that joint visits can be resourced and also that complaints are not used as a routine method by parents to achieve outcomes that are not in the interests of children. Or maybe in these straightened times, we can assemble best practice examples through this forum! I might start a thread.
As a side note, I was surprised that such a clear case of frustrated access was not dealt with more formally. There is the facility to apply to Court for a Child Assessment Order under the Children Act 1989, a little used power but would permit the assessment of children's health without removing them from home. On the other hand, the size of the workloads described in the report would probably make informed discussion virtually impossible.
adarnefoedd
Excellent post, Your take on it has been my reality (and I suspect many others) as regards working with parents who know how to work the system to their own advantage. With unsupportive managers (who want you to be all things all of the time and practically crawl to the complainant) for a social worker trying to keep the child's welfare at the centre, it's a very lonely place. Couple that with excessive work loads and it's a recipe for disaster.
Any SW who has been subject to Serious Case Review and the LA Complaint procedure will know what a harrowing and frightening experience it can be. Any one can be wise after the event. If you had about 6 cases you just might be able to do everything that is procedurally expected. No one will stop children being seriously hurt or killed. I don't think anything will now shift this blame culture and it's no wonder SW's are leaving in droves.
Hi all - I thought this was an interesting response from Unison: http://bit.ly/b0BARv
They're saying cases like this prove social workers should work in pairs on child protection, one practitioner focused on the children, one on the adult. Focus on Khyra Ishaq's mother was certainly a problem in this case, as you were saying, adarynefoed. And reading the SCR, it sounds like Khyra's mum used the fact her family were black and Muslim as a way to put off social workers and other practitioners/authorities -- saying her children were bullied at school due to their race, and at one point, when police came to the house to do a check, saying her children were treated differently because they were Muslim.
This is an extremely difficult area -- how can social workers remain culturally/racially sensitive and yet recognise when service users are using their minority status, whatever that may be, as a wall between them and practitioners/authorities? Tricky.
Thanks, adarynefoedd, for pointing out that social workers have legal powers to deal with frustrated access.
When the school first raised concerns with social workers there was a reluctance to treat the referral as a child protection investigation and to recognise that an immediate response was needed. It took them 6 weeks to accept that there was a need for an initial assessment, and then another 3 weeks for a home visit to be made! By demonstrating their lack of concern in this way, and implying a lack of urgency over the initial assessment, I imagine it would have been more difficult to persuade a court to grant a Child Assessment Order (though they could have tried).
I've always thought that the social worker was the key to good child protection work. In this case there are too many examples of bad practice by social workers, that only serve to discredit the profession further, and little evidence of an understanding of the fundamentals of good practice. The whole approach to this case strikes me as very unprofessional. I'm surprised that the Serious Case Review fails to get to grips with the deep-rooted problems caused by the laissez-faire culture in Birmingham Children's Services and insufficient attention is given to the reasons why formal procedures are not followed correctly.
It is well know that the competence with which section 47 inquiries are handled will crucially influence the effectiveness of subsequent work. The prevailing culture in Birmingham seems to be one in which the focus on child protection matters is weak and management has shown repeatedly that it is failing to address this problem. The SCR should have been much more upfront about this and suggested an urgent need for a change in the management culture. Good social work practice will only happen if there is a clearer focus on child protection.
The most salient point in the SCR was that the social worker had an "excessive" caseload of 50 cases.
This is not an excessive caseload. It is an immoral caseload.
Mr Radford, from the shining light of child protection that is the NSPCC, made not one recommendation regarding caseloads. To me this is shameless.
Until Mr Radford, Ms Munro, OFSTED, Mrs Shoesmith, Mr Balls, Mr Loughton et al and all who sail in the good ship bullshit get to grips with this singular matter, they are wasting yours and my time.
Until there are reasonable requests made of social workers, SCRs will continue to be a voyeurs paradise with no learning taking place.
Spotter's Badge to LongGone! We only just saw this this morning and BASW's Nushra Mansuri shares your feelings (the story about it is here: http://bit.ly/cOMs97 )
Not that we noticed this first thing (it's on page 95 of the SCR), but why isn't there more outcry about this? I'm surprised the tabloids have yet to have a field day with it..
How many more SW teams carry this kind of burden on a daily basis? When will management be challenged on their tatics to present caseloads as reasonable when we all know they are not, and why after all the children scandals that have made the press, has no one , including all of the professional bodies, ever followed through on an arrangement for a reasonable number for case loads. I think that in front line SW 20 cases is totally unreasonable , fifty, well words fail me.
How long will it take before 'the powers that be' realise that almost all serious case reviews have something to do with SOCIAL WORKERS' CASELOADS? Even with this knowledge, social work jobs are being cut. I work in a frontline team and my manager panics as soon as she knows I am over a certain number of cases (protective managers are needed). I feel so insulted when I hear how SWs are scandalised because I know we WORK SO HARD, often outside normal hours.
"Children's social care executive member Cllr Len Clark said the council had already reduced social worker caseloads by a third, transferring child-in-need cases to new family support teams"... I am a frontline social worker in Birmingham with 40+ kids on my caseload . It was very promising to read about the reduced caseload and other improvements in Birmingham. I find it strange neither I nor any of my colleagues have experienced any of these changes?! Please if somebody knows where Cllr Len Clark's Birmingham is let us know.
The most salient point in the SCR was that the social worker had an "excessive" caseload of 50 cases
Really excellent point unfortunately SCR methodology does not look at caseloads. The report author probably only knew about how local authority intake teams work second hand. It is easy to make judgments about decision making without taking into account the context. It is necessary to look at the overall workload in the team at this time together with the rate of referrals.
There is no way that any social worker can cope with 20 child care cases let alone 50. Repeated exposure to this kind of work stress not only damages the health of social workers but it affects professional judgment and the reaction of many workers is to prioritize the totally unavoidable tasks (such as turning up in Court) and ignore the rest. This kind of chronic stress causes social workers and team managers to switch off and burn out.Burn out leads to a degree of self preserving indifference. (hardly the best mind set for children's staff) Nobody with any sense of self preservation would stay in this environment hence the total reliance on agency staff, newly qualified staff etc. Although UNISON is belatedly addressing the plight of children's social workers, this kind of problem is endemic in some local authorities. Teachers by contrast would not put up with a class of 60 children. (but they have better Trade Unions). The waste of the last 13 years is that a lot of time and money has been wasted on planning, policy development and less needy groups whilst the front line service has been neglected and forced to spend time on form filling.
Perhaps SCR writers should be recently experienced at the coalface? Reports should contain a chapter on the organisational context.
There is no prescribed methodology for a SCR.
Have worked on them myself and it is a poor show if you do not talk to the practitioner about what was on their plate at the time, and if you dont have that "professional curiosity" in your approach to an SCR that Mr Radford banged on about in the report.
I welcome the publication of SCRs but that heightens the responsibility to get them right.
No doubt that OFSTED will rate this report, but in essence the report is flawed.
You are completely right regarding "Reports should contain a chapter on the organisational context" and you should be making that point forcefully to Mr Loughton and Ms Munro. SCRs should detail - caseload, individual and team, vacancies, timesheets, levels of sickness, supervisory arrangements etc etc
Thankfully I am in Wales and the Coalition does not rule because it is a devolved function. We have slavishly followed a great number of the English developments namely the Assessment Framework, ICS etc perhaps the time has come to go our separate way - hopefully.
By methodology, I was referring to the Chapter in Working Together. My experience is that the individual agencies interview the practitioners to do the Management Reviews. This is supposed to be by a person who has not been involved.
The Overview Report writer works on the IMRs, chronology and may ask for additional information but would not normally talk to individual practitioners.
The preparation of IMRs is long winded and potentially flawed and the process would be improved IMO by a single person (or pair) investigating from start to finish, a method used I think by the IPCC. The danger though is that individual agencies may not cooperate.
The other problem I think which is difficult to resolve is lack of access to the health records of the parents without their agreement.
Earlier this year I worked in a borough in South London where I had nearly forty cases. I felt it was unreasonable and dangerous. I wrote to the GSCC who informed me that it was not in there remit to intervene however I was expected to assess what I could and could not reasonably carry out. When I tried to set boundaries I was ignored. One of my colleagues new to the borough and also from London told me that in her previous role she had a caseload of sixty.
I wrote to the RT Hon Ed Balls's office and asked when they were going to legislate and legally cap the caseloads of Social workers. I was told that the new task force were due to submit a report which Parliament would legislate on earlier this year. To date nothing has happened. It has long been my view that it is simply cheaper for our children to die than it is to pay appropriate wages, cap the caseloads and safeguard the profession. It appears the government want to have their cake and eat it leaving social workers as scapegoats for their unwillingness to invest appropriatley in the various services.
I agree with most of what you say Joanne. I have managed two front line child care teams. The first team were all hard working, extremely committed to working with children and families. They never complained about working late when required and would drop everything to assist a colleague with a difficult case. This was a long term team dealing with all looked after children, child protection with eight social worker carrying anything up to 40 care proceedings between them. We had four excellent family support workers based in the team. The second team was generic and much bigger (20 workers and two team managers). Family support services were based outside the team and came under a different line manager. Many of the social workers complained if they had more than two sets of proceedings, if they had to work late,were rude and dismissive to service users and showed a general lack of care and respect for the people using the service. This culture had been allowed to develop over many years. A number of workers were very good at protecting their caseload, one experienced worker managing to have 7/8 cases which seemed to keep her fully occupied as she ran around completing tasks that a family support worker could do with ease. Other workers worked extremely hard. One of the main problems in social work is that of ensurring workers are competent to do the task.Some managers are extremely reluctant to raise and address issues in respect of practice competence for fear of a complaint being made about them by the worker. Going down the capability route can involve a long and arduous confrontation with Unison. The GSCC have not helped with this. If you look at the list of workers who have been subject to conduct hearings, and the reason for this, it is clear that there is great confusion around what one local authority believes to be misconduct and another will accept as reasonable practice. It is both shocking and worrying.
Counting the number of cases people hold is not helpful. In the first team, referred to above, I developed a caseload weighting system that included a section asking the worker how she was feeling about her work, the pressures etc. What one person feels to be pressure may not be what another feels. Any analysis of social work practice must have a qualitative element . The second team, although they complained continuously about caseloads refused to use a caseload weighting system.
Social workers do need to be supported in their role but they also need to be committed to the task, which involves attending regular supervision, training etc. and managers need to be less fearful of addressing practice issues and also be fully supported when they identify poor practice.
No matter how hard working and concientious a social worker is, or how lazy and incompetent they are, you just cannot justify a caseload of fifty.
How is that justifiable and how can you challenge practice under those conditions?
I don't think that a fifty caseload can be justified. I would question how many of them were active cases and how many were sitting on the file waiting for closure. There are occasions when workers keep cases open either because it adds to the figures, avoids more allocation (or should) or they haven't been given time to conclude and close. The latter is a major problem with all the associated admin tasks involved. The demands of admin are a real issue. Bring back dictaphones and hand the tapes to admin staff to do the computer form filling or give social workers the mobile technology to do the task efficiently, that is if they feel competent with IT. More admin support and an increase of family support workers could help. Maybe then social workers could fully utilise their skills and get on with the tasks they were trained for.
I have known cases closed with the family in a worse situation than when the case was opened.
The family were in contact with CAMHS who should have been able to give support via the social workers nominally posted to the small CAMHS unit ( but I think they were either not in post or overstretched). Medical and Education professionals exacerbated a situation by not effectively dealing with a crisis. The social worker delayed doing anything positive. Sometimes social workers can come in too late and damage therapy which should have been provided by the GP.
Agree re: unnecessarily long hours spent on tasks that could be performed by others (add to the list arguing with management about getting contact supervised in cases where it is blindingly obvious supervision is needed - my personal bete noire). Disagree about the "50 easiest cases" - it isn't always easy to judge what is "easy" and what isn't - one day something is "easy", the next you are in the papers and an SCR is called for.
Sorry... was a slight exaggeration on my part... Was just trying to prove the point that its really not just about the number of cases,but about their complexity and the resource needed for each one.. which as you know can vary dramatically.
Long Gone:SCRs should detail - caseload, individual and team, vacancies, timesheets, levels of sickness, supervisory arrangements etc etc
While nothing definite has been said, Munro and her posse are currently muttering about the SCIE model of SCRs, which you may already be familiar with. The focus of the model is on one-to-one interviews with everyone involved in a case, so potentially, with hope, that model would allow these factors/figures to come out? Of course the SCR author would have to make sure to highlight them strongly..
CommCare did a feature about the model and other issues around SCRs this week - http://bit.ly/b9oDLv
...And simple explanation of the model can be seen here - http://bit.ly/dBDBQI
I agree with the point about dictaphones saving time, but at the risk of seeming like a geek, the modern version of the dictaphone exists and will convert speech to text fairly accurately -- ever noticed the simultaneous subtitles on the tv news? If you speak in a clear voice on one of the top of the range recorders marketed by the leader in this field, as many medics do, then you don't need to bore the modern equivalent of a secretary with your droning on about dysfunctional families etc. -- the program does it for you. As you say, give the worker the technology and training, and it would save some time, if not exactly saving the misery. But Birmingham -- go back over years and read all the inspection reports. It's just too big. I have a personal liking for the small unitaries in areas of low transience in population (the opposite of Birmingham). That enables the worker to get to know who's on the patch, and makes risk assessment easier altogether.
Some of this reluctance derives not only from data protection and confidentiality issues, but also from the fact that we do not actually have confidence in the competence of social workers. This lack of confidence does not derive from some myth created by media demonisation of social workers which we unquestionably bought into (as social work practitioners often have you believe) but from our real-life dealings with them. We are only too aware of the real issue that involvement of incompetent social workers can actually make matter worse. It appears to me that too many Social Workers have a tendency to misread signs - they either read too much into things or miss them completely. Too many just do not seem to be able to simply apply a common sense approach to their understanding people and their behaviour. Sometimes, it is as if you simply are 'trying too hard' to see things you think you should be seeing - whether that is that there is actual abuse and risk or that there is no concern for abuse and risk.
The article in itself leaves me speechless - how can you be a child protection social worker and not expect to be able to deal with difficult decisions and challenging situations?! That is the bread and butter of your job. It seems that the article implicitly suggests that parents should automatically be co-operative - are you living in cuckoo land?? You have to work at gaining that trust and co-operation. It is down to you as competent child protection practitioners to be accurately perceptive, to apply your psychological understanding of behaviour in an objective and non-judgmental way, and to utilise your highly developed, key communication and interpersonal skills in order to gain trust and co-operation. And in those few highly difficult cases where the parent is intent on harm and avoidance of detection, be confident decision makers in applying the powers that you do actually have.
If you find that difficult, then I suggest child protection work is not for you.
Well said!
THANK YOU SOOO MUCH RoseA for taking such a balanced and objective view and for stating things that some social worker would rather not hear. There are excellent social workers out there, committed to the job, willing to put in extra time if the job demands, employing excellent work strategies and skills in order to make their case loads more manageable, being excellent problem solvers and being willing to just get on with things and work together professionally without the need to get into immature squabbles. On the other hand, ... there are those that are not like this... and seem to get away with it.
Competence IS an issue in Social Work. It seems to be that some practicing Social Workers would be much better placed as Support Workers as they simply do not have either the skills nor calibre to be effective Social Workers (for whom significant caseloads are a part of their job description, simply as).
It seems to be that, currently at least, anyone (regardless of calibre, intelligence (and that includes all kinds of intelligence including emotional) and skills) is allowed to become a social worker (providing you are socialist leaning in your ideology of course!).
Please, we need more people like RoseA to speak with such common sense. And less of those wishing to bleat on about how poor done they are working as a social worker. It is often these same bleating social workers whom appear to go on to suggest that an increase in pay will somehow (miraculously) make them more effective and efficient. Believe me, as an adequately-paid Social Worker (- yes you are adequately-paid), whom has CHOSEN to go into your line of work, you are not as poor done as those clients who have no choice put to struggle through their crisis 24/7. THEY can not go home at the end of the day to a better environment. like you can.