Meeting documents

Social Services Committee
Tuesday 12 November 1996

Date of meeting: 12.11.96
Document type: Report
Committee: Social Services Committee
Title: Gloucestershire Area Child Protection Committee - Annual Report 1995/96

Abstract (plain text version of the report)
Annual Report of the Gloucestershire Area Child Protection Committee 1995/96
Contents
Foreword by F.A. Davies, Deputy Director of Social Services,
Chair of the ACPC page 2
Gloucestershire Area Child Protection Committee page 3
Review of Activities 1995/96 page 6
Preventing Child Abuse page 11
Protecting Children page 12
Policy and Procedures page 14
Training page 15
Appendices
I Membership of the Gloucestershire Area Child
Protection Committee page 18
II Terms of Reference of Gloucestershire ACPC and
Local Liaison Committees page 19
III Child Protection Statistical Review 1995/96 page 20
Foreword
Whilst, as can be seen from this report, the work of the Gloucestershire Area Child Protection Committee spanned many areas during 1995/96,
I make no apologies for focusing within this foreword on the outcome of the case review overview report in relation to Charmaine and Heather West.
This overview report was compiled by the Bridge Child Care Development Service and published at the conclusion of Rosemary West’s trial. Hundreds of copies of the report were published and distributed widely to the media, professional associations and other Area Child Protection Committees. (Funding from the Social Services Inspectorate allowed a copy of the report to be distributed to the Chair of every ACPC in England and Wales.)
The report, in its conclusions and recommendations, drew attention to a wide range of issues including communication within and between agencies, the dangers of children going missing and the need for all agencies to have clear policies on the storage, retrieval and disposal of records.
The most important issue highlighted by the report, however, was the importance of listening to children. In the words of the report:
“The actions of those who listened to the West children have provided a salutary lesson to all professionals working in Child Protection, whether Social Workers, Teachers, Doctors, Lawyers, Police or the Judiciary, not to dismiss lightly the comments of children (however apparently bizarre).”
In addition the report comments:
“Once the pending court case is completed we hope that the ACPC will want to draw the attention of the Department of Health to the importance of taking the comments of children seriously in Child Protection investigations as this case has identified, and to carefully evaluate what is being said. We hope in turn the Department will want to draw this issue to the attention of the Lord Chancellor’s Department, the Home Office and the Department for Education and Employment.”
The overview report was accepted by the ACPC and a sub-committee established to implement the recommendations. In addition to the many practical steps that can be taken in respect of a number of the recommendations the sub-committee has repeatedly considered and supported the reports sentiments in respect of listening to children. It is important that the deliberations of the sub-committee continue and lead to clear and firm actions to emphasise the importance of listening to children and that nationally the issue is pursued both by individual ACPCs and Central Government Departments.

F.A. Davies, Deputy Director Social Services
Chair of Area Child Protection Committee
Gloucestershire Area Child Protection Committee
The Gloucestershire Area Child Protection Committee recognises that the protection of children from abuse requires not only the application of appropriate experience, skills and resources, but also a commitment to joint working and effective liaison between all those involved.
The Gloucestershire ACPC, which meets every two months, provides a forum for senior managers and professionals from Social Services, Police, National Health Service, Education, Probation, the NSPCC, and others concerned with protecting children to meet together to achieve the tasks of developing, monitoring and reviewing child protection policies and practice in the County.
The major areas of activity of the Committee are:
u to establish, monitor and review local inter-agency procedures to be followed in individual cases.
u to promote and encourage preventative programmes aimed at diminishing child abuse and neglect.
u to increase professional and public awareness of the problem.
u to collect information on child abuse in the County, the demands made on agencies and their responses and to use this information to evaluate services available.
u to encourage and arrange training in the particular problems encountered and to assist in developing skills in the practitioners concerned.
u to inquire into cases of abuse and neglect where any child has died or suffered serious harm in Gloucestershire and to review significant issues arising from such enquiries.
u to review arrangements for inter-agency liaison.
In order to carry out these activities, the Committee has developed the following structure:
GLOUCESTERSHIRE AREA CHILD PROTECTION COMMITTEE
Chair: Fred Davies, Deputy Director of Social Services
Gloucester and Forest of Dean Local Liaison Committee
Chair: Mrs Liz Brown, Child Protection Co-ordinator
Tel: (01452) 425145
Cheltenham and Cotswolds Local Liaison Committee
Chair: Mr Geoff Tookey, Child Protection Co-ordinator
Tel: (01452) 425157
Stroud, Dursley and Tewkesbury Local Liaison Committee
Chair: Mr Duncan Siret, Child Protection Co-ordinator
Tel: (01452) 425158
Development and Training Sub-Committee
Chair: Mrs Georgina Robinson, Principal Officer, Child Protection
Tel: (01452) 426193
Multi-disciplinary Training Officers
Mr D. Lockheart, Mrs M. Ryan
Tel: (01452) 426857
Clinical Sub-Committee
Chair: Dr Ljuba Stirzaker, Gloucestershire Health Authority
Tel: (01452) 300222
Local Liaison Committees
These Committees meet four times a year. They are intended to promote the discussion of important local issues and to give an opportunity to identify needs or difficulties, and to resolve any problems. They report to the Area Child Protection Committee (ACPC), raising matters which are felt to be of either local or countywide interest. They are attended by local representatives from all the agencies involved in the work of the ACPC.
Development and Training Sub Group
The ACPC has to consider and deal with a tremendous amount of work. The Development and Training Group (DTG) assists the ACPC by undertaking tasks which need further research or wide ranging discussion and consultation. The group is attended by representatives from the ACPC as well as practitioners from a number of agencies.
A major task for the Group is the identification and prioritising of multi-disciplinary training needs and the support of the ACPC Child Protection Training Officers. These posts are funded directly by the ACPC.
The DTG was formed this year and is an amalgamation of the County Development Group and the Training Sub Group.
Child Protection Unit
The Child Protection Unit, although based within and funded by the Social Services Department, provides Independent Chairs for Child Protection Conferences, on behalf of the ACPC. The Chairs have no line management responsibility for individual cases.
The Unit consists of a Principal Officer, three Child Protection Co-ordinators, the Administrator and Secretarial staff.
The Co-ordinators, who chair the conferences, offer a consultation service to staff from all agencies and make an important contribution to the development of services and to training.
The Unit maintains the Area Child Protection Register and deals with and monitors all enquiries to the Register. It provides the statistical information which is needed in order to evaluate and develop the services offered to children in need of protection. Quality Assurance is also undertaken within the Social Services Department, to ensure that standards are maintained.
The secretarial staff act as minute secretaries at all Child Protection Conferences and the Unit provides secretarial and administrative support to the Area Child Protection Committee, its sub-committees and working groups.
Review of the year’s activities 1995/96
Trends 1995/96
The Child Protection Statistical Review 1995/96 can be found as Appendix 3 of this Report. The figures indicate some interesting trends.
A number of children are found each year in circumstances which lead professionals, friends and family members to refer them to the Social Services Department or to the Police. During 1995/96 there were 617 referrals to the Social Services Department, a slight fall on the 626 referrals of the previous year. However, this should be seen in the context of a 66% increase in referrals over 12 years.
The investigation of a referral represents a huge number of hours of work for the staff involved, all of a complex and demanding nature.
A proportion of the children whose circumstances are investigated will become subjects of a Child Protection conference. In 1995/96, there were 269 conferences. A number of children who are the subject of a Conference will be placed on the Child Protection Register. Gloucestershire’s Register remains the lowest in the country. It is interesting to note that, after the publication of the Messages From Research, a number of other Authorities have changed their Procedures and now have Registration rates comparable to this County.
Although the numbers on the Child Protection Register in Gloucestershire remains low, the comparatively high rate of Registrations for both sexual and emotional abuse makes it clear that we are not screening out cases which do not involve a physical injury.
The commitment to the needs of children and families for services is reflected in the graphs in the Appendix illustrating indicators and levels of need and harm. These show the impact that the service offered has on the child's situation.
Achievements
Major enquiries
The impact of the Cromwell Street enquiry was considerable for all agencies in Gloucester. The Bridge Report into the deaths of Charmaine and Heather West was very well received nationally and made clear the way in which the needs of the minor West children were met by a sensitive and professional response to the first allegation, a thorough and well conducted investigation and a continued willingness to listen to the children and to respond to what they were saying.
Other large scale investigations have continued, creating considerable demands in terms of financial and staff resources. This commitment will continue
ACPC budgets
The ACPC has funded a Training Officer post for some years, but all other expenses have been met either by Social Services or on an ad hoc basis by joint agency contributions.
During 1995/96 it was agreed that an ACPC budget would be created, to fund training, publications, research and commissioned work. Social Services, Health, Probation, Education and the Police will contribute, on an agreed formula. Social Services will continue to fund the Child Protection Register, the Social Services Department Child Protection Unit and to service the ACPC and its sub groups..
Child protection procedures
A major revision of the ‘Green Book’ procedures began in 1996. The revised manual will be printed and distributed later in the year.
The structure of the manual has been revised, for greater clarity and ease of reference. Current practice and new developments will be reflected and recent amendments will be included.
Child protection: messages from research
This Department of Health document was published in June 1995. Gloucestershire Social Services Department was represented on the Department of Health Advisory group for this publication. There has been lively national debate on the implications of current research into Child Protection and the publication has received wide dissemination in Gloucestershire with the researchers being given the opportunity to discuss their findings with practitioners.
‘Messages from Research’ has much to contribute to an understanding of the Child Protection process but the findings of the Bridge Report into the deaths of Charmaine and Heather West serve as a reminder of the need to maintain vigilance and to listen to children.
ACPC Annual Conference
The Annual Conference was held in November 1995 and focused on the debate between ‘Children in Need’ and those ‘In Need of Protection’. The Department of Health publication, Messages From Research and the Bridge Report into the death of Paul were used as the focus for debate.
Training and Development Group
During 1995/96, the County Development Group and the Training Sub Committee amalgamated. Several people sat on both groups and as there was an overlap in responsibilities, the amalgamation of the two committees seemed an efficient and effective development. The group is responsible for undertaking specific tasks and making recommendations to the ACPC. The ACPC funds a Training Officer post. This year two officers have been appointed to the role on a job share basis. The demands on their time have increased dramatically during 1995/96 and the response to the training has been very positive.
Clinical Sub Committee
In response to Department of Health publications concerning the Child Protection responsibilities of health practitioners, a new ACPC sub committee was formed this year. This will allow a range of health professionals to advise the ACPC on current issues and advise the ACPC regarding the appropriate health representation on the Committee.
Research into the involvement of young people in Child Protection Conferences
Following a pilot study in 1994/5, the action research project, planned in collaboration with Reading University, has begun. Reflecting the emphasis of both the Children Act and of subsequent partnership guidance on the ‘needs and wishes’ of the child, this research aims to inform best practise by examining:
u how the views of children subject to Child Protection Conferences are gathered and interpreted by professionals
u whether there is a conflict between the child’s rights and what the professionals involved interpret to be the child’s best interests
u how professionals determine the ‘appropriate age and understanding of the child’
u the extent to which children’s closer involvement in decisions about their future can be either helpful or harmful to them
u how children perceive the systems set up to protect them
Thus far, the research has involved the completion of questionnaires by a wide range of professionals attending Child Protection Conferences, detailed interviews with the children’s social workers, and structured interviews with twenty children who have been the subjects of such conferences. This information gathering phase of the research is due to be completed by June 1996, and a preliminary analysis of the data will be presented in Gloucestershire in mid July. This presentation will also examine alternative strategies for informing and involving children, and how such approaches can be tested by future research.
Children who sexually abuse others
The policy and procedure agreed by the ACPC last year have now been implemented within the agencies, after a well attended launch and introduction. The procedure deals with children over 10 years of age who face legal action as a result of their behaviour. A small research project is being undertaken in the East Gloucestershire NHS Trust area, to measure the impact of the new procedure.
Information for families and professionals
The Social Services Department has produced a set of new leaflets for families and professionals involved in Child Protection investigations and conferences.
They are designed to give people the information they need at a time of high anxiety in a readily understandable format.
A leaflet has also been produced for Child Minders, to advise them on how to respond if they have concerns or suspicions about a child in their care.
Working with offenders who present a risk to the public
The Probation Service has appointed a worker to develop its work on risk assessment and risk management.
Complaints about registration
Working Together makes it clear that Child Protection Conferences are not tribunals with a right of appeal against the decision. Nonetheless, it is possible that a decision could be made on the basis of incorrect information. The ACPC has agreed that in these circumstances, families may ask the Chair of the ACPC to review the decision. There has been one request this year, which was not upheld.
Future Plans
Practice Standards Audit
Last year, the ACPC agreed to accept the Department of Health Child Protection Standards for all agencies. An Audit of a number off cases, on a multi-disciplinary basis, is planned for 1997. This will be conducted by the ACPC Practice Standards Sub Committee.
Child Protection Procedures
The revised procedures will be distributed throughout the agencies. The amendments will be highlighted during the distribution process.
Sexual offenders
An ACPC Working Group will plan a multi agency strategy for dealing with people who sexually offend against children.
Work on a joint Schedule One Offenders Register, to combine those held by Probation and Social Services, will continue.
Part 8 reviews
The Bridge Report into the death of Charmaine and Heather West highlighted once again the difficulties in obtaining full and standardised information when a report is required because a child has died. The ACPC will be working with the Bridge Consultancy to overcome this problem for any future reports into child deaths.
Child protection: messages from research
The debate into Children In Need and Children In Need of Protection will continue. Gloucestershire Social Services Department is attempting to define and identify children in need in this County and the Child Protection Unit has released a member of staff to undertake this work.
Further seminars on the Research will be offered to practitioners and the Social Services Department will continue to run team based training days.
Annual conference
The 1996 Conference will be held in November and will look at the impact of domestic violence on children.
Research into the involvement of young people in Child Protection Conferences
This research project will be completed in 1996 and will be published in collaboration with Reading University. This will coincide with the publication of a reader and training pack, sponsored by the Department of Health. Gloucestershire has been represented on the advisory panel which is working on the production of the training pack.
Preventing child abuse
The major focus of work with children who have been abused continues to be on discovery and investigation. However, there is a growing belief that preventing abuse should take a higher profile. Health Visitors have always had a role in advising parents and carers and this aspect of their work can be very helpful in preventing stressful situations building up to the point at which a child is harmed.
Preventative work takes many forms and the type of initiatives currently in action include:
u National campaigning by the NSPCC.
u Multi disciplinary training for all professionals, raising their awareness of the issue in order to help them identify problems at an early stage.
u Training for voluntary organisations, such as pre-school Playgroups.
u Work in Family Centres run by Social Services and Education Departments.
u Increased awareness of offending patterns of abusers.
A major issue in prevention is the need to keep the public aware of its ongoing responsibility to notify the authorities of situations in which they have reason to fear that a child is being harmed or neglected. Information from the public and from the families themselves are a significant factor in the prevention of further harm. Friends, relations, and the public, as well as parents who fear that they are at the point of hurting their children, need to feel confident that they will receive a helpful and professional response to a referral and to be sure that a referral is not a betrayal of trust, but a necessary and responsible way of protecting children.
Recent national research into the child protection process, in particular into the link between families in need and child abuse, has informed debate into prevention on a national and local level. The call for a greater awareness of the impact of child abuse investigations on families is an important one, but the need to maintain vigilance and to listen carefully to children was highlighted in the Bridge Report into the deaths of Charmaine and Heather West.
Protecting children
Child Protection is a process, with a number of stages and actions

Child is harmed or neglected.

Someone recognises or suspects the harm or neglect.

A referral is made to the Social Services Department or the Police.

Enquiries are made and an investigation begins.

If the enquiries show that the child has been harmed, or is at
significant risk, a Child Protection Conference is held.

If the Conference decides that the child remains at risk, the
child’s name is entered on the Child Protection Register.

A Child Protection Plan is agreed.

The situation is reviewed regularly at a Review Conference.

When the situation has changed so that the child is no longer
felt to be at risk of harm, the child’s name is removed
from the Register.

Throughout this process, a number of cases ‘drop out’ at each stage, because enquiries show the child is safe, either because the allegation is not substantiated or because the family are co-operative and able to protect the child from further harm.
Investigation
The investigation of referrals needs to be carried out in a way which is sensitive to the needs of children and their families whilst ensuring that the welfare of the child is paramount. The process is monitored within the Social Services Department by the Child Protection Unit, using agreed Quality Assurance Standards.
Child Protection Conferences
u Gloucestershire has had a policy of inviting parents to the conferences held about their children since 1989. Parents need to hear exactly why professionals are concerned and their involvement and participation in the conference leads to Child Protection Plans which are more likely to work.
u The involvement of children and young people in conferences is currently under national review. In Gloucestershire a long term research project was commissioned in 1992/93 to discover what young people think about this and what form their involvement could take. (e.g. should they attend conferences in whole or part, should they have an ‘advocate’ who attends on their behalf, should they be encouraged to make written comments and how?) A small sample of children have already been interviewed. The Research will be completed in 1996/97 and its results will help to shape policy. Currently around 14% of conferences are attended by young people.
Registration
The Child Protection Register records the names and details of children who are felt to be at risk of harm within their families, from Physical, Sexual or Emotional Abuse or of Neglect.
The Register is kept centrally, at the Child Protection Unit in Shire Hall and is confidential. Professionals from the ACPC agencies have 24 hour access to the Register, via the Child Protection Unit during working hours and the Police at evenings or weekends, to allow them to check the status of any child about whom they have concerns.
It is a vital tool in the protection of children.
u If the Register is checked more than once awareness is raised that there are concerns about this particular child.
u The importance of checking the Register whenever there are concerns about a child or when a referral indicating abuse is made is vital. The number of checks to the Register continues to increase as a result of constant publicity within the agencies.
Child Protection Plan
When a child is felt to be at risk of harm and is placed on the Register, it is important that everything possible is done to protect the child in the short term and to change the situation in the long term. A Child Protection Plan is written to ensure that all the agencies, and the families, work in co-operation to ensure the child is protected and that changes are made. The Child Protection Plan outlines how this will be done and who will be involved. With the necessary professional help and the co-operation of the family gained through their participation in the process, most situations do improve so that the child’s name can be removed from the Register.
Review Conferences
The Review Conference meets every six months, or more often if necessary, to discuss the Child Protection Plan and to decide if the child is still at risk. Reviews are an important part of the process of protecting children as they encourage full discussion and assessments of changes that have been made and of what still needs to be done. Review conferences can be very helpful and encouraging to families or can alternatively raise new areas of concern at an early stage.
Removal from the Register
The goal of the whole Child Protection process is to ensure the long term safety of the child and to reach the point at which the child’s name can be removed from the Register. The removal of the child’s name from the Register is an important way of demonstrating to families that the situation really has changed.


Policy and procedures
In order to ensure a consistent approach to Child Protection, multi disciplinary guidelines, the ACPC Child Protection Procedures, have been produced and adopted by all the agencies. This is known as “the Green Book” and a copy is held by all professionals who are in a position to become aware of children at risk, as well as by those who investigate referrals. There are 1,500 copies of the Green Book distributed throughout the ACPC agencies. The Green Book is held by libraries and is thus available to the public.
New legislation, research, reports and fresh ideas on practice issues all effect the way in which Child Protection work is undertaken. The procedural guide needs to be constantly reviewed and if necessary amended to ensure it remains a helpful working document. A major review and revision is under way, to ensure that it more adequately reflects current practice.
Training
Gloucestershire ACPC has long accepted that ‘effective child protection depends not only on reliable and accepted systems of (inter-agency) co-operation, but also on the skills, knowledge and judgement of all staff working with the children’ (Working Together - 1989). In the light of recent research on the subject (‘Working Together in Child Protection’ - Birchall & Hallett: HMSO 1995), and in addition to the development of policies aimed at fostering the effective management of difficult cases, the ACPC also reaffirmed its view that to achieve these goals, staff should - wherever possible - undertake child protection training in multi- disciplinary groups.
Programme 1995/6
A ‘pool’ of some 6,000 staff from various agencies were identified as having direct contact with children in their day-to-day work. Of this group, the largest proportion come from Education, followed by Social Services, Health and Police. With this scale of potential demand, it was agreed that there should be four levels of training offered, and that these should be targeted at appropriate staff/care groups. These were:

Despite a change of training personnel during the course of the year, 1995/6 has been a particularly productive one.
1. Basic
Some 5,000 leaflets on the identification of abuse and its subsequent management were distributed to all front line staff in the county, in an attempt both to provide staff with basic information and to raise awareness of the need for vigilance. In addition, over 20 one and two day Introductory courses were run for staff from all agencies.
2. Practice:
A wide variety of workshops and seminars was run under this heading in the course of the year. In particular, considerable emphasis was placed on
a) Children who Abuse Others, where training reflected both the introduction this year of the ACPC guidelines on the management of such cases, and - more recently - a workshop on therapeutic work with abusing children;
b) Risk Assessment: several workshops have taken place for staff involved in post-conference core-groups to explore the ACPC ‘Guide to Assessing Risk to Children’.
Additional courses have been run this year on Court Skills for staff likely to be involved in care proceedings; ‘The Child, The Court and The
Video’ - DoH report on the workings of the Memorandum of Good Practice; Joint Investigation training for police and social workers.
3. Management:
Training within this field was run exclusively for Social Services Department staff this year. However, a multi-agency event for first-line and middle managers in all agencies is planned for in July 1996
4. Policy:
The Dartington Research - ‘Messages from Research’ - has informed all recent training events and has additionally been the main focus of half day seminars given by some of its authors. In addition, this year’s Annual Conference - “Families in Need” - explored the balance which needs to be struck between the implications of this research and the conclusions of the Bridge Report into the death of baby Paul in Islington.
Numbers trained 1995/6
In all, 929 staff have attended a total of 1,234 staff training days

Outcomes/ Evaluation/ Review
The effectiveness of the training programme is monitored in a variety of ways throughout the course of the year, with both participants and their managers having the opportunity to comment on the usefulness of individual courses. In brief:
1. Managers identify training needs by a variety of means - e.g. individual contact discussion at ACPC, Local Liaison Groups, County Development and Training meetings and team meetings.
2. Training Officers draw up the overall programme and individual courses to meet the identified needs of groups of staff. Details of this programme are widely circulated (2,000 copies were distributed this year).
3. Approved staff attend the course and provide feedback on its usefulness both by completing an evaluation form for the trainer and by direct feedback to their manager.
4. Managers feedback information on the impact of existing training on staff performance, together with any new training needs or issues, to the trainer via the channels outlined in 1 above.

Though time consuming, this process does allow:
u training to be responsive to changing needs;
u some assessment of the effectiveness and quality of course content;
u training (and training officers) to become a more integrated part of the mainstream of service provision.

The course evaluation form for participants has recently been revised to take account of additional factors such as agency variations. However, the format used for most of the year, which asked people to rate the courses on a scale of
EXCELLENT/ VERY GOOD/ GOOD/ FAIR/ POOR/ OF NO USE AT ALL,
indicated that 81% scored the courses at ‘excellent’ or ‘very good’, 18% at ‘good’, and 1% at ‘fair’.

In respect of feedback from managers, this has been generally good, and is reflected in the increased numbers of nominations for the coming year.
Future funding
The operation of multi-agency child protection training in 1995/96 has been clearly dependent on the continued financial support of the ACPC, with each of the constituent agencies, centrally, making a commitment in line with an agreed formula based on previous take-up of places. It is, however, recognised that such commitments are likely to come under increasing pressure in the future, both from the general curbs on public sector spending, and from the impact of devolving budgets and accountability within individual agencies.
Appendix I - Composition of the Gloucestershire Area Child Protection Committee 1995/96
Members
Mr F.A. Davies Chair, Deputy Director of Social Services.
Mr J.A. Saunders Vice Chair. Head of Pupil and Student
Services, Gloucestershire Education Department.
Mrs. W. Bartlett Oxtalls School, Gloucester
Dr A. Chaudhuri Local Medical Committee Representative.
Miss A. Corbett Senior Community Nurse,
East Gloucestershire NHS Trust.
Mrs. R. Crane Principal Crown Prosecutor,
Crown Prosecution Service
Mrs. J. Cummings General Manager,
Gloucester Royal Hospital NHS Trust
Mrs M. Gorton Senior Nurse, Child Protection,
Severn NHS Trust.
Mr S Hemming Assistant Chief Probation Officer,
Gloucestershire Probation Service.
Mr Holland Williams Head of Service Social Work RAF (UK).
Mr D. Pettit NSPCC.
Mr W. Powell County Council Legal Services.
Dr L. Stirzaker Consultant, Public Health Medicine,
Gloucestershire Health Authority
Mr. S. Thorpe Head of Operations,
Gloucestershire Social Services Department
Dr E. Treharne Senior Clinical Medical Officer,
East Gloucestershire NHS Trust.
Mr R. Turnbull Assistant Chief Constable,
Gloucestershire Constabulary.
Dr E. Wintersgill Consultant Paediatrician
(Community Child Health) Severn NHS Trust.
Advisors
Mrs G. Robinson Principal Officer,
Child Protection and Adults At Risk.
Mr D. Lockhart ACPC Training Officers.
and Mrs. M. Ryan
Major J. Foster Army Welfare Services.
Appendix II - Terms of
Reference
Terms of Reference of the
Gloucestershire ACPC
(i) To co-ordinate the work of all Agencies engaged in Child Protection work.
(ii) To lay down policy and procedures to be followed for the efficient detection and further management of cases.
(iii) To promote and encourage preventative programmes aimed at diminishing child abuse and neglect.
(iv) To encourage training in the particular problems encountered, and to assist in developing skills in the practitioners concerned.
(v) To increase professional and public awareness of the problem.
(vi) To collect information on child abuse in the county, the demands made on agencies and their responses, and to use this information in evaluating the services available.
(vii) To receive reports and to inquire into cases of neglect and child abuse where any child has died or suffered serious harm in Gloucestershire.
Terms of Reference of the Local Liaison Committees
(i) To concern itself with the effectiveness of local practice and procedure implementation.
(ii) To identify issues arising from cases practice and local situations, and to decide upon appropriate further action.
(iii) To offer the opportunity for the exchange of information on practice between key agencies.
(iv) To make recommendations to the ACPC on current practice and the need for change.
(v) To identify training needs on matters of child abuse within the area.
(vi) To disseminate information (e.g. procedures, guidelines, publications) to all practitioners in all agencies.
Appendix III - Child Protection Statistical Review
These statistics are drawn from the Child Protection Annual Statistical Review, available from the Social Services Departments Information Group. At the beginning of this last reporting year, the monitoring forms were upgraded to collect more data pertinent to today’s Child Protection analysis needs, some extra detail of which is included here.
In line with Department of Health statistics, previous years ‘rate per thousand’ have been changed to ‘rate per ten thousand’, throughout the document.
Referrals to Social Services Area Teams
Trends
For the ten years to 1993, there had been a steady increase in the number of referrals made to the Child Care Teams in Gloucestershire. They have risen from 221 in 1984 to 611 in 1993. This ten year period covered two re-organisations and a new recording system. 1994 showed a large increase to 700 referrals, no doubt partly triggered by media headlines. In the year to March 1995, the rate of referrals fell to 626, and for the last 12 month period fell slightly to 617. This is the first time that numbers have fallen in two consecutive years, and the referral rate is now at 1993 levels. Indeed, compared to 1992, referrals have increased by only 4%. Over that same period the total population of under 18s has increased by 6%.

This year, the small fall in referrals is reflected in the rate per 10,000 under 18 years, enhanced by the rise in population of this age group.

Source of Referrals
During the last year, the proportion of referrals to Social Services teams coming from informal sources including families and the general public fell from 28% to 24%. Those from statutory organisations rose slightly from 43% to 45% of the total. For the second year running, there has been a fall in the percentage of referrals from the Police. The proportion of referrals from Education has held steady, whilst there has been a slight increase from Health sources.

The usual quarterly pattern was reversed, with the lowest number of referrals during the July to Sept quarter, possibly because of the unusually hot, dry weather last year.
Gender and Age of Children
The referral ratio was three females (59%) to every two males. The average age of children referred was 7.7 years, a drop from 8.2 years during the previous year. The number of referrals in the 5 to 9 age group showed a slight rise.

Differences between Areas
Stroud continues to have the largest number of referrals, and now has nearly one third of the county’s referrals. Over the previous two years it was a quarter of the county’s referrals. In terms of population, the referral rate for Gloucestershire is 49 per 10,000 under 18 years old. Stroud’s current rate per 10,000 is 79, followed by Cheltenham with 69 per 10,000. Cotswolds on the other hand, has a rate of 23 per 10,000. Forest referrals have fallen by 57% in the last year (from 83 to 47), halving the rate per 10,000 under 18 year olds. Previous years referrals have been 109 and 81.

Child Protection Conferences
The majority of cases referred to the Social Services Department are resolved without the need for a Child Protection Conference. Currently, this is approximately two out of every three referrals. Either the initial concern leading to the referral was unfounded, or a solution which protects the child and helps the family is reached. However, in some cases, enquiries and investigation uncovers concerns for the safety of the child and a Child Protection Conference needs to be held.
In 1995/96 there were 617 referrals to the Social Services Dept, leading to 269 conferences involving 513 children.

The number of Conferences held during the last year has decreased marginally in number from 279 to 269, but are still a quarter more than in 1992/93.
Of the 269 conferences held, 229 were monitored. The remaining data and comment in this Conference section refers to the 229 that were monitored.
Initial and Review Conferences
Of the 229 conferences monitored, 66 were initial conferences and 163 were review (follow-up) conferences. The initial conferences considered 129 children, and 307 children were discussed at the follow-up conferences, which, in the main, take place six months after the initial conference. The average time of a conference was 1 hour 26 minutes, varying from under half an hour to exceptionally four hours.
The number of Conferences held where the children were already known to Social Services Department has increased. In certain cases, conferences discuss a specific incident which has been investigated


Ages of Children when Conferenced


The number of Under 5’s are consistently the largest proportion of children conferenced.
Legal Status of Children at time of Conference
In 1995/96, nearly two thirds of children brought to Conference were not in the Care of or under the Supervision of the Social Services Department.

Reasons for holding a conference.
The statistical information collected shows whether the conference was an initial or a review conference. New recording procedures came into effect at the beginning of the current year. These show ‘Receiving in from other counties’ and other minor categories in the ‘review’ group.


Attendees at the Conferences
The Child Protection Conferences draw together professionals from all the agencies who have relevant contributions to make. The majority of Conferences are attended by the family Social Worker and/or the Team Manager. The County Council Legal Department is also a regular attender, as are the Health Visitors and the Police. Other professionals, for instance, Child Health Service Doctors, GPs representatives from schools, Probation Officers, Family Centre Workers, and others, attend less often, depending on the particular case. On average, 7 professionals attend each conference.

The percentage by category of attendees remained very similar to last year, except that the. Police and Health Visitor/Senior Nursing Manager attended in 61% of conferences compared to 76% last year. Field Social Workers and the County Solicitor attended in over 90% of conferences, SSD Team Manager in over 80%. Health Visitor, HV/SN Manager, Police and school representatives attended in over 50% of conferences.
Some professionals sent written comments rather than attending the conferences.
Parents at Conference
Parental involvement has a very high priority in Gloucestershire and this is illustrated by the fact that at least one parent is invited to attend most of the Child Protection Conferences. During the last year there were only 3 conferences where the mother was excluded, and 9 conferences where the father was excluded. Parents are ‘not invited’ only in situations where it is felt that there is a risk of violence or where the parent is ‘not available’ to attend.
Mothers accepted and attended 76% of conferences, an increase of 4% on last year. Fathers attended 50% of conferences, an increase of 8% on last year. ‘ Other parent figures’ attended in 20% of conferences - last year a step parent attended in 17% of conferences. Mothers, and/or fathers, attended a slightly higher percentage of initial conferences than review conferences.
Children of the family are sometime invited and, in 1995/96, children attended 53 conferences. This represents 23% of conferences held, an increase of 9% on last year.
The majority of parents who attended (68%, a drop from 84% last year), are seen by the person chairing the Conference before the meeting begins. This is a way of helping parents face a stressful situation by preparing them as sensitively as possible.
Conference Locality Patterns (Conference Rate per 10,000
under 18 years)


The Child Protection Conferences are monitored by locality.
This revealed differences in pattern between Social Service Areas, part of which was due to the change in Social Services Area boundaries to equate with District boundaries. Broadly, the three Social Service urban Areas have higher conference rates per 10,000 under 18 years old compared to the three Social Service rural Areas. The conference rates were very similar to last years with the exception of Cheltenham, whose rate fell from 27 to 20 per 10,000 18 year olds.
Indicators
At the end of each conference, the chair assesses what are considered the levels of need and harm relating to that conference. The following table demonstrates the impact that Conferences have on cases.






There was a move from the high levels to low levels after the initial conference.
This was more marked with the level of harm indicator, where the mean score level has fallen from 2.1 to 3.7, showing that conference chairs believe that child protection procedures and input to the family are reducing risk to the child.
The Child Protection Register
Number of Children on the Register.
A snapshot in time is taken on 31st March each year to establish the number of children on the Child Protection Register. All Local Authorities undertake this and the Department of Health collates the data.
For Gloucestershire, the number on the Register had fallen slightly over many years to 1993, which had a total of 88. In 1994 there was a sharp increase in the number of children on the register, to 160. 1995 showed a slight fall in numbers on the Register to 154, and this year has shown a further similar small fall to 146.
1995 Data Comparisons
The Department of Health statistics for England for 1995 (the latest available), shows that Gloucestershire’s rate was well below the national average. Apart from Kingston Upon Thames (rate of 9 per 10,000 under 18 years - untypical), Gloucestershire together with Hampshire and Hertfordshire had the next lowest rate of 13 per 10,000 under 18 years, which is similar to the previous year. This compares with an average rate of 28 per 10,000 under 18 years old for the twenty counties making up the Southern England group, which itself has a low rate.
Comparisons with neighbouring Authorities numbers on the Register, and with the predicted rate for these authorities based on demographic and other factors, illustrates Gloucestershire’s current position. The 1996 data has been obtained by direct contact with the neighbouring counties, and shows a marked change in numbers and rates per 10,000 for Hereford & Worcester, and Wiltshire, over the last two years.


Category of Abuse
Although Gloucestershire has a lower than predicted rate of children on the Register, the reasons for registration indicate that the needs of the most vulnerable are being considered. Gloucestershire is broadly comparable to the latest national data issued by the Department of Health for the percentage of children by age group on the Register. However, the percentages by categories of abuse differ from the national norm. This authority has a much lower incidents in cases of neglect, which is traditionally higher in Metropolitan Districts and London Boroughs than Shire Counties. Conversely, emotional abuse, at 22%, is 9% higher than the national figure, and sexual abuse at 27% is 6% higher than the national average.
This Authority, amongst others, is increasingly showing more inclusions on the Register as ‘multiple’ abuse category. These may be an amalgam of two or three of the four base categories.


Ages of Children on Register
Over the last two years the percentage of children under the age of one has halved to 6%. The other age groups have remained reasonably constant.


Gloucestershire’s proportion by age groups for 1996 is quite close to national data, but with a smaller proportion of children under one year on the Register.
Children on Register by Social Service Areas
By proportion of the under 18 population, Gloucester has by far the largest number of children on the Register (57), and in fact has two out of every five county children on the Register. This is interesting given the relatively high number of referrals from Stroud.


Last year slightly more children were removed from the Register (159) than were added to it (151).
Time on the Register
The average time children had been on the Register as at the 31st March was 9.8 months. However, two fifths of children on the Register had been there for less that six months.
Legal Status of Children on the Register
The majority of children who are registered remain at home with their parents, with no court action felt necessary.


Additions to the Register
This year’s additions to the Register are compatible with last years - a small decrease from 161 to 151.


There were differences in the rates of children from each Area added to the Register, again primarily reflecting the difference between urban and rural Areas. The large number of referrals from Stroud do not seem to be reflected in higher registration figures.
Although it appears that there has been a substantial fall in additions to the register for sexual abuse over the last two years, 7 of the 10% of this year’s multiple categories includes sexual abuse.

Removals from the Register
Last year 159 children were removed from the Register, which is a fall of 8 from the previous year.


The cases of categories of abuse which were removed from the Register during the last twelve months were similar to last year.


For those removed from the Register, the average time spent on the Register again increased. This time from 10.0 months to 11.3 months.
Time spent on the Register

The proportion of young people on the Register for 12 to 23 months increased by 11 percentage points, whilst those on the Register for less than 9 months decreased by 15 percentage points. This decrease is not surprising given that the reviews are, in the main, being increasingly conducted six months after the initial conference.
A snapshot of the Register for the year would show:


Inquiries to the Register
The number of enquiries to the Child Protection Register increased significantly by 47% during the last reporting year. This large increase may reflect the efforts of the ACPC to encourage all agencies to make full use of the Register, and the increased publicity within agencies about the register and its importance.