safeguarding and looked after children services

Inspection of safeguarding and looked after children services Lincolnshire County Council

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Inspection dates 10 May 2010 – 21 May 2010 Reporting inspector Marie McGuinness HMI

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Age group: All Published: 21 June 2010 Website: www.ofsted.gov.uk This document may be reproduced in whole or in part for non-commercial purposes, provided that the information quoted is reproduced without adaptation and the source and date of publication are stated.

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Further copies of this report are obtainable from the local authority or at www.ofsted.gov.uk Lincolnshire Inspection of safeguarding and looked after children

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The inspection outcomes: safeguarding services 4

1. Overall effectiveness 4 2. Capacity for improvement 5 3. Areas for improvement 5 4. Outcomes for children and young people 6 a. The effectiveness of services in taking reasonable steps to ensure children and young people are safe 6 b. The effectiveness of services in taking reasonable steps to ensure that children and young people feel safe 8 5. The quality of provision 9 6. Leadership and management 10

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The inspection outcomes: services for looked after children 13

1. Overall effectiveness 13 2. Capacity for improvement 14 3. Areas for improvement 14 4. Outcomes for children and young people 15 5. The quality of provision 18 6. Leadership and management 20

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Record of main findings 23

Lincolnshire Inspection of safeguarding and looked after children 2

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About this inspection

1. The purpose of the inspection is to evaluate the contribution made by relevant services in the local area towards ensuring that children and young people are properly safeguarded and to determine the quality of service provision for looked after children and care leavers. The inspection team consisted of three of Her Majesty’s Inspectors (HMI), one additional inspector and one inspector from the Care Quality Commission. The inspection was carried out under the Children Act 2004.

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About this inspection

2. The evidence evaluated by inspectors included:

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About this inspection

ƒ Discussions with 87 children and young people and 62 parents and carers receiving services, front line managers, senior officers including the Director of Children’s Services and the Chair of the Local Safeguarding Children Board, elected members and a range of community representatives.

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About this inspection

ƒ Analysing and evaluating reports from a variety of sources including a review of the Children and Young People’s Plan, performance data, information from the inspection of local settings, such as schools and day care provision and the evaluations undertaken by Ofsted of four serious case reviews in accordance with ‘Working Together To Safeguard Children’, 2006.

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About this inspection

ƒ A review of 20 case files for children and young people with a range of need. This provided a view of services provided over time and the quality of reporting, recording and decision making undertaken.

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About this inspection

ƒ The outcomes of the most recent annual unannounced inspection of local authority contact, assessment and referral centres undertaken in August 2009.

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mean

3. All inspection judgements are made using the following four point scale.

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mean

Outstanding (Grade 1) A service that significantly exceeds minimum requirements

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mean

Good (Grade 2) A service that exceeds minimum requirements

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mean

Adequate (Grade 3) A service that only meets minimum requirements Lincolnshire Inspection of safeguarding and looked after children 3

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mean

Inadequate (Grade 4) A service that does not meet minimum requirements

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Service information

4. Lincolnshire County Council’s population includes 150,828 children and young people aged 0-18, of which 20% are aged 0 to 3. The proportion entitled to free school meals (10%) is below the national average (16%). Children and young people from minority ethnic groups account for 6% in primary schools and 8% in secondary schools which is below the national average of 26% and 23% respectively. The percentage of pupils who speak English as a second language has increased from 3.5% in 2009 to 7% in 2010;103 languages are spoken in Lincolnshire schools and there has been an increase of 12 languages since 2009. The largest increases are in Polish, Lithuanian and Latvian.

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Service information

5. The Lincolnshire Children and Young People’s Strategic Partnership was established in 2006 and became the Children’s Trust Board in April 2010. The Children and Young People’s Strategic Partnership is chaired by the Director of Children’s Services and is well represented by the appropriate partners and agencies. Seven local children’s partnerships representing the locality districts feed into the Children and Young People’s Strategic Partnership.

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Service information

6. Social care services for children are delivered by seven family assessment and support teams, seven integrated (health and social care) locality teams, children in public care teams, fostering and adoption teams, and a social care and health team for children and young people with disabilities. Looked after children are placed with 287 foster carers and in children’s homes provided by the council and the independent sector. A Virtual School supports the education of looked after children. Leaving care services are provided by Barnardos. Family support services are provided by the council and by Family Action, a third sector provider.

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Service information

7. At the time of the inspection there were 520 looked after children comprising 123 young children aged 0-5, 355 school age children, and 42 young people aged 16 and over. The leaving care service currently works with 383 care leavers.

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Service information

8. Commissioning and planning of health services are led through the Children and Young Peoples Strategic Partnership, with NHS Lincolnshire, and Lincolnshire County Council as the two lead commissioners. Acute Hospital Services are commissioned by NHS Lincolnshire and are provided by the United Lincolnshire Hospitals NHS Trust. Lincolnshire Community Health Services provide health visiting, school nursing and children’s therapy services, together with the minor injuries unit and walk in centre. Health services for children with disabilities are provided through integrated arrangements between the council and health services, and joint funding arrangements are in place. A Transitions Service for children with disabilities is also jointly funded between Children’s Lincolnshire Inspection of safeguarding and looked after children 4

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Service information

Services and Adult Services. Child and Adolescent Mental Health Services (CAMHS) are provided through integrated arrangements between the council and Lincolnshire Partnership NHS Foundation Trust and a Targeted Adolescent Mental Health Service works in partnership with schools.

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Overall effectiveness Grade 1 (outstanding)

9. The overall effectiveness of safeguarding services is outstanding. The council and partners have maintained a robust, consistent and successful focus to secure the safety and well-being of children and young people across a large and diverse county. This increasingly mature partnership ensures that it learns from mistakes by honest evaluation and review, and harnesses the skills and strengths across agencies to honour their commitment that every child is safe. As a result, statutory responsibilities are fully met and there has been a good track record of continuous improvement in performance across all key outcomes that support children’s safety. Outcomes are often above those found nationally. There is no complacency and leaders work to live up to their commitments and minimise risks. For example, the Lincolnshire Safeguarding Children’s Board identified improvements to the quality of serious case reviews

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Overall effectiveness Grade 1 (outstanding)

as a key priority. This has resulted in rapid improvements and recent reports submitted to Ofsted are of a very good standard. Lessons learned from serious case reviews have been robustly implemented and have helped partner agencies to engage well in the wider safeguarding agenda. The United Lincolnshire Hospitals NHS Trust has a dedicated serious case review investigation and implementation committee, which is ensuring that actions are fully embedded into practice. The Joint Area Review undertaken in 2006 judged staying safe as adequate and since then there has been significant improvement with staying safe judged outstanding at the Annual Performance Assessment in 2008. This progress has been sustained and the unannounced inspection of the contact, referral and assessment arrangements in July 2009, found no significant weaknesses in the provision of front line child protection services.

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Overall effectiveness Grade 1 (outstanding)

10. The partnership’ s strategic commitment to providing early support to families has resulted in a transfer of resources from specialist to universal services and the Children and Young People’s Strategic Partnership is making significant progress. The use of the common assessment framework and the team around the child are ensuring that children and their families receive the right services at the right time. The commissioning framework has been in place since 2008, and is now under review. Commissioners and members of the Third Sector reported that the framework enabled creative and innovate ways of securing services to ensure equitable provision across the county. The third sector is particularly effective in providing early intervention and prevention Lincolnshire Inspection of safeguarding and looked after children 5

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Overall effectiveness Grade 1 (outstanding)

services which are sharply focused on the needs of individual children and families. The customer service centre screens all contacts safely and effectively to signpost families to the services that best meet their needs. It also provides good quality information from their initial contact and as a result all referrals to social care assessment teams are appropriate, decisions to undertake initial assessments are actioned within 24 hours of the referral, and there are no unallocated cases. Child protection referrals are responded to swiftly, ensuring children and young people are safeguarded.

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Capacity for improvement Grade 1 (outstanding)

11. Capacity to improve is outstanding. Strong leadership and the shared commitment across the partnership drive continual improvement very effectively across all key performance measures. Outstanding performance management arrangements make sure that prompt and robust action is taken to address any temporary areas of underperformance that are identified. A good example is the way that successful preventative working across the partnership is helping to ensure that more children are safeguarded at an earlier stage so that the number of children with child protection plans is appropriately low. More children are benefiting from thorough, good quality assessments enabling them to receive the services they require in a timely manner. Inter-agency and locality working is being successfully embedded across districts and partners and users of services evidence that the multi- agency ‘team around the child’ arrangements are working well.

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Capacity for improvement Grade 1 (outstanding)

12. Workforce planning and development are effective. Vacancy rates are low, including those across health providers. Managers are empowered to make decisions and they and their staff know their service well. Managers take swift action to tackle operational issues effectively, for example, establishing forums where practitioners can meet to discuss individual cases to produce effective and child-focused solutions. Children, young people and their parents and carers are becoming more involved in helping to shape services. For example, parents have had significant involvement in designing programmes which deliver parenting skills to improve their children’s life chances.

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Areas for improvement

13. In order to improve the quality of provision and services for safeguarding children and young people in Lincolnshire, the local authority and its partners should take the following action:

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Within three months

ƒ Improve access to Level 3 multi-agency child protection training for health staff. Lincolnshire Inspection of safeguarding and looked after children 6

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Within three months

ƒ Ensure that all health care staff are aware of the CAMHS pathway for access to treatment for children and young people.

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Within three months

ƒ Ensure that the arrangements for children missing from care, education and home are harmonised so that there is one single data record in place.

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children and young people are safe. Grade 1 (Outstanding)

14. Multi-agency working is successfully reducing risks to children and young people across Lincolnshire. For example, the number of children killed or seriously injured in road traffic accidents has continually reduced and the proportion remains well below the national average. Community safety prevention is also well prioritised. For example, 10,000 homes were visited by the fire prevention services last year to educate and provide practical advice on issues such as safe cooking. Such work has contributed to a reduction in the rate of children’s injury from accidents in the home and in numbers attending emergency health services. Outpatient services in United Lincolnshire Healthcare Trust operate a ‘did not attend’ notification system with regard to children and young people. This information is sent electronically to general practitioners and follow up action is taken. Good action is taken when children

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children and young people are safe. Grade 1 (Outstanding)

in care go missing and actions taken to support young people when they are returned are good and helping to reduce the number of repeat occurrences. However, the local authority is aware that more needs to be done to harmonise procedures for children missing from education and runaway children and action is being taken to address this.

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children and young people are safe. Grade 1 (Outstanding)

15. Emergency and urgent healthcare services are working effectively to flag safeguarding concerns and a notification system for health visitors and GPs is in place. The accident and emergency CAMHS pathway for out of hours does not, however, provide direct access to the CAMHS team, as referrals are made to either the crisis team, or the senior house officer on call in adult services. Assessments are undertaken and children and young people may be referred to CAMHS, but this is not always the case. Accident and emergency staff interviewed were unaware of the CAMHS pathway.

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children and young people are safe. Grade 1 (Outstanding)

16. Outstanding preventative strategies for children and their families are successfully and safely reducing the numbers of children entering the care system. This is against a national trend of rising admissions. Staff respond to contacts and referrals well, ensuring risks posed to children are well managed and any child protection concerns are swiftly actioned by suitably qualified and experienced staff. Together with the Lincolnshire Safeguarding Children Board, the Children and Young People’s Strategic Partnership is effectively targeting resources across the broad safeguarding agenda to ensure children are safe. For example, a coordinated response to learning lessons from serious case reviews has included multi-agency training, the dissemination of an escalation Lincolnshire Inspection of safeguarding and looked after children 7

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children and young people are safe. Grade 1 (Outstanding)

process for partners when they have concerns, and increasing the capacity of paediatricians to support child protection work. Key staff including designated and named nurses and doctors, and teachers for child protection, report they receive good regular training and high quality, timely individual support when safeguarding concerns arise. Access to Level 3 multi-agency child protection training for health staff is, however, insufficient. Health staff report that nominations have not been accepted as courses are oversubscribed. However, all health staff reported having access to e-learning training at Level 1 and 2.

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children and young people are safe. Grade 1 (Outstanding)

17. Good progress is being made in reducing teenage pregnancy rates. A new governance and reference group has been established which sets the strategic direction for teenage pregnancies. As a result, there has been an increase in the number of locations where the C-card contraceptive access scheme can be used, especially along the east coast which has a higher rate of teenage conception. Teenage pregnancy prevention services and substance misuse services are working well with parents and young girls. Substance misuse workers are working in night clubs and within dedicated safe zone areas and when young people at risk are identified, vulnerability plans are developed which are helping to keep them safe. Since 2007 the school nursing services have been offering a sexual health service ‘clinic in a box’. This service is offered through schools with 50% of schools engaging in the scheme. This is improving children and young people’s access to sexual health services.

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children and young people are safe. Grade 1 (Outstanding)

18. Agencies work successfully together to involve children who are at risk of anti-social behaviour and young people are increasingly involved in shaping services to better meet their needs and interests. Young people who spoke to inspectors affirmed confidently that their participation in a range of interesting activities was helping them to stay out of trouble. An increasing number of young people are attending such activities and parents are also involved and being supported to run their own youth clubs. The youth crime prevention team are working successfully with children and young people at risk of entering the criminal justice system and as a result there has been a consistent yearly reduction both in first time entrants into the system and in re-offending rates.

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children and young people are safe. Grade 1 (Outstanding)

19. Most regulated provision has been judged good or outstanding and residential services for children and young people with learning difficulties and/or disabilities are good. The proportion of schools judged good or better on safeguarding is higher than that found nationally. Joint work by agencies in schools is a strong feature in making children feel safe in their schools and communities. Action to promote anti-bullying is good. The Tellus Survey indicates that there has been a reduction from 54.8% to 34.2% of children and young people who had been bullied. Literature and programmes tackling all aspects of bullying are disseminated across schools, health and other services, such as the Youth Service. The MAX Respect programme which tackles bullying on school transport is beginning to have an impact with more young people feeling confident in reporting incidents. Young people spoken to during the

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children and young people are safe. Grade 1 (Outstanding)

inspection reported that adults listen to them and take appropriate action to prevent bullying. School nurses have held focus groups with young people Lincolnshire Inspection of safeguarding and looked after children 8

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children and young people are safe. Grade 1 (Outstanding)

relating to health needs. As a result of this, young people identified that they were being bullied due to suffering from acne. A new service has now been commissioned and early results show that they are feeling more supported and bullying incidents relating to this issue have reduced.

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children and young people feel safe. Grade 2 (good)

20. Partners demonstrate a strong priority to safeguard children and young people by ensuring that their views are regularly canvassed about what makes them feel safe and how to minimise risks. Children and young people spoken to during the inspection had mixed views but generally indicated they felt safe in their communities and especially safe at school. However, Youth Council representatives reported some concerns about safety on transport to and from school, and the council’s own perception surveys confirmed this.

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children and young people feel safe. Grade 2 (good)

21. Children and young people receiving services are aware of how to complain and make representations and they have easy access to a good advocacy service which is provided through the National Youth Advocacy Service. This service provides young people with confidence and assures a good level of independence.

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children and young people feel safe. Grade 2 (good)

22. Developing and enhancing the emotional development of children and young people are also part of the Children and Young People’s Strategic Partnership’s safeguarding and prevention priorities. This incorporates the Brilliant Lincolnshire strategy which includes action to tackle bullying in schools. As a result anti-bullying, including cyber bullying and e-safety, is being tackled well. In a recent survey, almost all children reported they feel safe, including from bullying, although in the secondary sector a number of respondents perceived some of their peers were subject to bullying. Nevertheless, pupils in school reported that direct and immediate action is taken when any incident of bullying occurs, and these incidents are reducing. Younger pupils also commented on how mentoring programmes are making a positive difference to their sense of well-being.

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children and young people feel safe. Grade 2 (good)

23. Pupils in primary, secondary and the special school visited, and young carers and looked after children, spoke with conviction about the good level of support they received from their teachers, adults in school, youth workers, and social care and health professionals who work with them. Following an evaluation, children’s services were aware that some groups, such as young people with learning difficulties and/or learning difficulties, felt more at risk from bullying. Programmes have been developed in schools and these are helping to build children’s resilience and confidence. For example, the Wednesday Group-United Voices is encouraging children with learning difficulties and/or disabilities to take part in youth clubs so they can have fun and develop friendships. A good number of disabled young people are also successfully engaged in the Duke of Edinburgh Award scheme. Lincolnshire Inspection of safeguarding and looked after children 9

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The quality of provision Grade 1 (outstanding)

24. The quality of service provision is outstanding. The threshold for access to the different services is clearly understood by all professionals including health staff and is appropriate. Staff reported they have received training to support their knowledge and understanding and there are clear strategic documents and threshold policies which ensure children and young people receive appropriate services. From the case files seen by inspectors, it was clear that thresholds for access to services are being applied consistently and appropriately.

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The quality of provision Grade 1 (outstanding)

25. The findings of the case file reading were consistent with those of the unannounced inspection. All referrals are allocated in a timely manner to a social worker and there are no unallocated cases. The quality of assessments is good overall, with a strong focus on risk, and children and families are receiving the right level of service they need and want. Social workers visit children regularly and this helps to safeguard them well. Swift action is taken to safeguard children when it is required. Section 47 investigations, child protection conferences and reviews are rigorous and timely. Well written and detailed plans are provided to child protection conferences which are well attended. Of the files seen during the inspection, comprehensive written agreements were in place and there was a strong focus on protecting children. Work with the courts is sharply focused to support the protection of children

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The quality of provision Grade 1 (outstanding)

experiencing domestic violence and there are special area-based domestic violence courts which help meet local need and ensure that these cases are fast tracked. Overall social workers are knowledgeable and energetic, and pursue agreed plans tenaciously. Good legal support is also available for families.

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The quality of provision Grade 1 (outstanding)

26. Performance management arrangements are rigorous with an exceptional and successful focus on improvement. There is an excellent level of professional and managerial challenge to ensure services are delivered to a good standard supported by robust case auditing arrangements. Workers know what they have to do and managers have clear systems to ensure accountability which workers said they liked and responded to well. Team managers receive daily, weekly, and monthly reports on individual social workers and teams which enable them to target resources effectively. Performance indicators and trends are regularly analysed and effective action taken to address issues.

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The quality of provision Grade 1 (outstanding)

27. The outcome of complaints, including those made by children and young people about staff, and concerns raised about services are responded to well and are systematically used to inform service development. For example, a parent who had attended a team around the child meeting made an informal complaint and the response enabled the parent to state her concerns; this led to work with the family being reinstated which was a good outcome for the family. Lincolnshire Inspection of safeguarding and looked after children 10

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Leadership and management Grade 1 (outstanding)

28. Leadership and management of safeguarding services are outstanding. Highly competent, ambitious and strong leadership by senior officers in the council and in the NHS, and by elected members and partners, coupled with the successful integration of agencies, is enabling the delivery of a wide variety of early intervention and prevention programmes and services across the County. This has resulted in good support for families and fewer children entering the child protection system. This committed and motivated leadership has led to a trend of sustained and continued improvements with safeguarding outcomes being at least good and in some cases outstanding. A culture of continuous improvement is embedded across the council. The Children and Young People’s Strategic Partnership and the Lincolnshire Safeguarding Children Board are swift to act if they see performance deteriorate. Additional resources have been

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Leadership and management Grade 1 (outstanding)

allocated to safeguarding services to increase the capacity of the workforce so that increasing demands on front line services can be responded to effectively. Ambitious and achievable targets are set and almost all are met. The effective use of the customer service centre to screen and appropriately signpost contacts ensures that, for example, 100% of referrals that are referred by them to social work teams result in initial assessments being undertaken which is exceptional performance. The use of the ‘System 1’ database is increasing and enables effective sharing of information across primary care practitioners including GP, community nurses, and the dedicated safeguarding and the Children in Public Care teams. Some staff, however, reported short notice requests to attend case conference and strategy meetings which adversely affected their contributions at these meetings as they did not have long enough

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Leadership and management Grade 1 (outstanding)

to prepare reports. Lincolnshire has taken a leading role in developing an effective Child Death Overview Panel and this has been recognised as an example of good practice by the East Midlands Strategic Health Authority. There are clear guidelines agreed between NHS Lincolnshire and United Lincolnshire Healthcare Trust for the response to child deaths and forensic investigation and staff are appropriately trained to carry out these arrangements.

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Leadership and management Grade 1 (outstanding)

29. Senior managers across the partnership have created a very positive culture which enables and encourages staff to deliver effective safeguarding services. Staff in the different agencies who met inspectors are proud to work for Lincolnshire, are confident and committed to providing a quality service for children and families.

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Leadership and management Grade 1 (outstanding)

30. The performance culture is embedded across the partnership and excellent performance management arrangements are in place which has driven a continued trend of improvement in virtually all outcomes for safeguarding services. Good work has been undertaken to enable social work teams to identify pressure points and identify solutions. The use of performance monitoring data within health services is becoming better understood and is now being used more effectively. For example, early implementation of Lincolnshire Inspection of safeguarding and looked after children 11

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Leadership and management Grade 1 (outstanding)

strategies, such as breast feeding and obesity in childhood are now being put into place.

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Leadership and management Grade 1 (outstanding)

31. Participation is a key strategic theme across the partnership and a strong participation strategy ensures children and young people, including vulnerable groups, are encouraged to participate and make a difference. They are active participants in planning processes for universal and targeted safeguarding services, including health led services, and there is consistent evidence that their contributions lead to sustained improvement in outcomes. For example, parents seen at a Sure Start centre reported that they are helping to shape the services they receive and designing programmes to develop parenting skills and tackle the sense of isolation parents feel. There is regular use of the Parent Partnership, a group of parents who have children with learning difficulties and/or disabilities, to help evaluate the effectiveness of services and to develop future services. For example, they have recently been involved with the review

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Leadership and management Grade 1 (outstanding)

of special educational needs services. Users’ views are also canvassed during the commissioning process. One such example is the ‘lost luggage’ group within CAMHS which has involved young people in a project considering stigma, bullying and harassment . The Lincolnshire Partnership Foundation Trust uses their young governors effectively; for example, they were recently involved in consultation with regards to sexual health and substance misuse. The local health strategic plan has funded a marketing strategy through a media campaign using social networking sites such as Twitter, Facebook and YouTube. This campaign is helping to raise awareness of sexual health and in doing so, aiming to reduce teenage conceptions.

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Leadership and management Grade 1 (outstanding)

32. The Children and Young People’s Strategic Partnership and the Lincolnshire Safeguarding Children Board provide highly effective professional leadership and there is good representation by the third sector who report that, strategically and operationally, integrated services work well together. The third sector plays a lead role in providing early intervention services for 6 to 12 year olds including outreach work in schools and with families. The thriving young carers’ service is an outstanding example of partnership work. The service has grown from four young people identified in 2001, to a current membership of over a thousand. This initiative, driven by young carers, has created a strong network for young people who have a shared need and has successfully used a range of strategies to overcome challenges presented by the rural nature of the county. A linked but separate Young Adult Carers’ group is a recent addition,

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Leadership and management Grade 1 (outstanding)

again developed in response to a need identified by the young people themselves.

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Leadership and management Grade 1 (outstanding)

33. The Children and Young People’s Plan developed in 2007 did not fully reflect the strong active priority which is now being given by the partnership to tackle inequalities and narrow the gap. Since the development of that plan in 2007, detailed equality impact assessments have been produced across services. Departmental managers receive regular reports on progress towards the targets with action plans for improvement, and these ensure a strong focus is maintained on meeting the diverse needs of children, young people and their Lincolnshire Inspection of safeguarding and looked after children 12

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Leadership and management Grade 1 (outstanding)

families across a large county. Strong leadership is successfully supporting partners to improve practice. This is ensuring children’s services are well-placed to support the council in achieving the challenging Level 3 of the local Government’s equality standard.

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Leadership and management Grade 1 (outstanding)

34. Services work successfully together to identify and meet individual needs and improve outcomes particularly for the most vulnerable. For example, a strong focus on improving outcomes for children and young people from more disadvantaged homes has resulted in the gap between them and other young people narrowing at a faster rate than that found nationally. Good action has also led to over 80% of primary aged pupils with English as a second language making better than average levels of progress in their learning. Staff report having access to translation and language line services, which they have used effectively. The relocation of school nurses into disadvantaged areas is supporting effective action to reduce health inequalities. Health services responded well to demographic change and appointed a Polish speaking midwife who works successfully with the local Polish community, promoting early appointments and access to maternity services. Midwifery services are

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Leadership and management Grade 1 (outstanding)

also working well with local prison and probation services, attending case conferences and strategy meetings on unborn and newly born babies. Partners have ensured that children and young people on the local RAF base and Traveller children have access to good quality health prevention strategies. Although there has been progress in reducing inequality in terms of access to services in the most rural areas, the Youth Council reports that transport remains a high priority for improvement.

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Leadership and management Grade 1 (outstanding)

35. Value for money is outstanding. Rigorous performance management of resources and the use of financial benchmarking are embedded across services to challenge and achieve cost-effective service improvement. There are numerous examples of savings being redirected into front line services to meet need as a result of thorough evidenced-based reviews of provision. For example, a fundamental budget review of transport costs led to restructured services and accrued savings being redirected to increase the capacity of social workers to reduce case loads to a manageable level. An innovative approach to reducing the costs of small-scale financial transactions, through the use of a ‘Procurement – Card’, that all staff can use to purchase goods, is ensuring efficiency savings which are also being redirected to front line services. The Young Carers Service, resourced originally by the Children’s Fund and a successful Lottery bid is now mainstreamed and funded via the Carers’ Grant

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Leadership and management Grade 1 (outstanding)

with a commitment from the Primary Care Trust to provide an additional £500,000 this year. The Young Carers Service has established good links with the Youth Service, the Healthy Schools Partnership and Primary Care Trust, and has led to cost-effective partnerships and improved outcomes. Lincolnshire Inspection of safeguarding and looked after children 13

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Overall effectiveness Grade 2 (good)

36. Strong and determined leadership across the partnership ensures looked after children are prioritised and as a result, their life chances are being increasingly and successfully improved. In every setting visited during the inspection, partners eagerly reflected this shared priority and spoke with enthusiasm of the impact of their work. Timely support provided through the common assessment framework and ‘team around the child’ processes are successfully providing prompt support for families and children at times of significant crises in their lives. For example, parents spoken to during the inspection reported how successfully services within a local children’s centre were supporting them to build their confidence and helping them to develop fruitful relationships with their children. These services are having a demonstrable impact in preventing children entering the care system unnecessarily.

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Overall effectiveness Grade 2 (good)

37. Statutory requirements are well met for looked after children and concerted action has ensured there is a good track record of improvement both in service quality and outcomes. For example, in the high quality fostering and adoption services which were judged outstanding and good respectively in their last Ofsted inspections. Children make good progress in their learning and there are lower than average rates of young people involved in criminal activity. Whilst the proportion of care leavers in suitable accommodation is also improving and higher than the national average, care leavers who spoke to inspectors had varying views about the support they had when moving in to independent living and in the quality of some of their accommodation.

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Overall effectiveness Grade 2 (good)

38. Children’s services have invested heavily in the workforce and this has ensured that all looked after children are allocated to qualified social workers. Social work vacancies are low and there were no reported vacancies within the children in care health teams. The council have a very good track record of retaining their staff. Front line staff in all agencies who met inspectors were confident, determined and proud of their work with children and families and this has resulted in improving outcomes for looked after children.

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Overall effectiveness Grade 2 (good)

39. Children and young people are provided with a variety of opportunities to contribute their views. In a recent survey, 119 out of 133 looked after children reported that the placement they are currently living in is the right place for them and a high number knew what was in their care plan. Looked after children and young people spoken to as part of the inspection also confirmed that they contribute well to their reviews, and make good use of the advocacy service. Lincolnshire Inspection of safeguarding and looked after children 14

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Capacity for improvement Grade 1 (outstanding)

40. The capacity for improvement is outstanding. Partners have demonstrated good leadership and an exceptional focus on driving continual improvement in the outcomes for looked after children over time which is underpinned by very strong and effective performance management processes. This ensures that any temporary areas of underperformance are tackled resolutely and enables good practice in teams and services to be recognised and shared. For example, the council is fully aware of the varying experiences of care leavers in the support they receive when moving in to independence and are currently tackling the issues. The strong focus on improvement has resulted in good or outstanding judgements in almost all safeguarding outcomes in regulated settings including children’s homes and the fostering and adoption agencies.

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Areas for improvement

41. In order to improve the quality of provision and services for looked after children and care leavers in Lincolnshire, the local authority and its partners should take the following action:

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Within three months:

ƒ Ensure all looked after children and young people receive annual health assessments.

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Within three months:

ƒ Consult with care leavers to ensure all care leavers are well supported into independent living in an appropriate and safe setting.

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Within six months:

ƒ Strengthen individual educational target setting for looked after children and young people

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Within six months:

ƒ Ensure equitable access to a transition team, including an assessment of their health needs for all children and young people with complex needs, learning difficulties and/or disabilities.

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NHS Lincolnshire should take the following action:

ƒ Ensure there is an effective mental health and emotional well being transitions service for all children and young people and particularly for care leavers. Lincolnshire Inspection of safeguarding and looked after children 15

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Outcomes for children and young people Grade 2 (good)

42. The health needs of looked after children and young people are addressed well. Looked after children attend a higher proportion of schools that are judged good or better for promoting good health than the national average. Dental needs are well met, with 94% receiving a regular dental check which is much better than the national average. All looked after children health assessments seen during the inspection were of good quality and completed fully, with action plans in place and evidence of actions being completed. However, there has been a reduction in the proportion of young people having an annual health assessment from 91.9% in 2009 to 82.4%. Partners are aware of this and taking appropriate action. For example, work is underway to ensure performance is more closely monitored and funding for a dedicated health coordinator post has been established, whose responsibility will be to ensure health assessments and health actions are completed. Looked after children

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Outcomes for children and young people Grade 2 (good)

have good access to the full range of health services from a dedicated looked after children health team, and they are able to ‘fast track’ access to a dedicated CAMHS team.

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Outcomes for children and young people Grade 2 (good)

43. Foster carers receive a good range of services to support them in meeting the emotional well-being of the children, and carers are offered individual support and advice when they need it. This includes dedicated CAMHS workers, a community nurse, an educational psychologist and a CAMHS clinical coordinator who meet as a group monthly to monitor progress. A CAMHS worker is now the vice-chair of the foster panel. This has improved working arrangements with social care teams which has in turn led to the provision of targeted health training and more effective support for new foster carers. Mental health training has also been provided to the headteacher and staff of the Virtual School to enhance the support they can offer to looked after children and young people.

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Outcomes for children and young people Grade 2 (good)

44. Strong, successful actions are taken across the partnership to safeguard looked after children and those on the edge of entering care. Risks are managed exceptionally well and a number of outreach services work to ensure children are kept out of care wherever this is safe to do so. Children’s cases are allocated to qualified workers who are confident, competent and well supported. Performance management and quality assurance arrangements have been strengthened through the Independent Reviewing Officers. Arrangements to commission good quality placements that meet the needs of children are well established and impact positively to ensure placement stability which is a key factor underpinning positive outcomes. The training given to foster carers is also helping to maintain placement stability and ensures that they have the skills to promote emotional well being more effectively and therefore improve outcomes for young people. Placement stability is good. A

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Outcomes for children and young people Grade 2 (good)

Lincolnshire Inspection of safeguarding and looked after children 16

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Outcomes for children and young people Grade 2 (good)

high percentage of young people are placed in local authority foster care, above the national average, and the fostering service was judged outstanding in its most recent inspection. Children placed outside the county benefit from clear care plans and frequent contact with their social workers.

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Outcomes for children and young people Grade 2 (good)

45. Almost all looked after children and care leavers spoken to during the inspection said they feel safe, happy and secure in their placements, school and immediate environment. They reported strong relationships with their carers and social workers and were confident they could name adults they would talk to about any worries. Young people said they were being well supported to achieve and to develop positive self-esteem and they reported that they felt safe once they had become looked after. Most young people said that their experiences of being looked after were positive once the right placement was found. Carers who spoke to inspectors felt well informed about individual children’s safeguarding needs and had all benefited from timely and good quality training to respond to them. Young people said they understand their health, care plans or Pathway Plans and participate well in their regular reviews.

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Outcomes for children and young people Grade 2 (good)

46. Good and successful partnership working is helping to raise aspirations and standards and to improve the enjoyment and achievement, attendance and progress of looked after children. Schools are well informed of looked after children’s circumstances. They support carers and social workers well in partnership with the Virtual School team to help them raise aspirations for children and young people and encourage them to achieve their goals. Targeted actions by schools and the Virtual School team are helping to ensure fixed-period exclusion rates are low, and there have been no permanent exclusions since September 2009. Achievement has improved rapidly at Key Stage 4 and although they are still performing well below the standard of pupils overall, as reflected in the national picture, achievement has risen at a faster rate than that for similar pupils. Since 2006, the proportion attaining five GCSEs

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Outcomes for children and young people Grade 2 (good)

grade A*-C has risen from below the national average for looked after children to above it. Local authority data show that looked after children make at least satisfactory and often good progress in their learning at both Key Stage 2 and Key Stage 4 despite the difficulties many faced before becoming looked after.

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Outcomes for children and young people Grade 2 (good)

47. Relationships between the virtual headteacher, his multi-agency team and schools are good. Designated teachers for looked after children and headteachers spoken to by inspectors said they valued the effective access to resources, advice and support. Good, timely and informative training is provided to designated teachers which keep them up-to-date on their statutory responsibilities and on emerging developments. Headteachers and teachers say they particularly value the developing ePEP, the on line personal educational plan. While the ePEPs successfully encompass all important and relevant contextual information, performance information and the views of children and key professionals, the Virtual School headteacher is aware that short, medium and long term target setting for individual children requires some improvement. Through their regular visits, school improvement partners successfully challenge

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Outcomes for children and young people Grade 2 (good)

Lincolnshire Inspection of safeguarding and looked after children 17

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Outcomes for children and young people Grade 2 (good)

schools on the progress of vulnerable groups including looked after children and challenging targets for improvement are set and often met as a result of the discussions. The virtual headteacher rightly recognises the need to work more closely with schools and school improvement partners to capture pupils’ progress information more regularly in order to evaluate the impact of actions and support on looked after children’s achievements more effectively.

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Outcomes for children and young people Grade 2 (good)

48. Effective use is made of personal educational allowances and other targeted funding to meet needs, such as one to one tuition, the provision of laptops and individual support within children’s care placements. Carers are provided with good support in times of need and good training helps them to assist children with their learning. Strong and effective partnership working with the children with disabilities team and health is making a positive difference to the enjoyment and achievement of young people with profound or complex special educational needs

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Outcomes for children and young people Grade 2 (good)

49. A recent survey of looked after children and care leavers indicates that they are positive about their lives and opportunities. The rate of looked after children entering the youth justice system or who are cautioned or convicted remains low. There are effective diversionary activities which successfully supports interventions that include one-to-one support. They also benefit from good support from the crime prevention partnership and youth services. Looked after children are well prioritised by all partners and they are increasingly able to access a range of out of school enrichment, leisure, cultural, artistic and sporting activities, which they say they enjoy. As a result of consultation, more children with learning difficulties and/or disabilities are able to access short- break provision and good holiday activities. Partners include schools, the Virtual School, Lincoln University and services across the seven local districts. For

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Outcomes for children and young people Grade 2 (good)

example, looked after children involved in the Joint Universities Mentoring Project were full of praise for the range of exciting activities and out of school projects they attend when they spoke to inspectors. They particularly appreciate having someone independent and young to talk to in times of need.

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Outcomes for children and young people Grade 2 (good)

50. Pledges to young people have been approved by senior managers although there is further work to do to ensure that each young person and care leaver is aware of these and able to use them responsibly to secure the support they need to achieve their potential. The fledgling Children in Care Council is already helping to raise elected members’ awareness of issues that matter to looked after children and has contributed to a number of projects which will make a positive difference. For example, they have been involved in the design of a new welcome pack for children who enter care. However, establishing a regular and representative council for the young people in this large and sparsely populated county remains a challenge. Other ways to seek the views of looked after children and care leavers have been established such as collating these through the National Youth Advocacy Service.

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Outcomes for children and young people Grade 2 (good)

51. The impact of partnership working to support and improve care leavers’ economic well-being is adequate. In 2009, the proportion of care leavers aged Lincolnshire Inspection of safeguarding and looked after children 18

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Outcomes for children and young people Grade 2 (good)

19 in education, training and employment was above the national average. This represents a good improvement from 2008. While the number of care leavers entering university is steady at around seven annually, over 140 young people last year went into further education. Approximately one fifth of care leavers are currently taking part in the Barnardos apprenticeship scheme. Young people who spoke to inspectors are full of praise for this scheme, the support from their key workers and the impact they think it will have on their future employment opportunities. However, they wish that more young people could also benefit from this good provision.

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Outcomes for children and young people Grade 2 (good)

52. Transition arrangements to support care leavers into independent living are satisfactory. There has been an increase in the percentage of care leavers accessing suitable accommodation and this is now above the national average. The council’s recent care leavers’ survey indicated that those who responded were generally positive about their transition into independent accommodation. However, the group of care leavers who spoke to inspectors had very mixed views. A few felt very well supported by an excellent key worker, but others raised significant concerns about the quality, suitability and safety of accommodation offered and the support and advice they received to secure it.

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Outcomes for children and young people Grade 2 (good)

53. A range of opportunities for looked after children with learning difficulties and/or disabilities is helping them to successfully continue their education from the age of 16 to 19. One young man spoke enthusiastically about his successes in the sixth form. His carer was full of admiration for the support and care provided by his school and other agencies. A transition team supports young people with complex and profound disabilities from the age of 13 to 25 into adult services. However, it only has the capacity to support 100 young people at any one time. Thresholds to access the service are high, requiring the presence of three complex long-term conditions, and consequently there are a number of young people unable to access this support. There is no dedicated service for care leavers with mental health needs, and work with young people requiring this service is often provided too late which impedes the ability of

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Outcomes for children and young people Grade 2 (good)

young people struggling with health issues to stabilise into independence.

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The quality of provision Grade 2 (good)

54. Strong partnership working is ensuring that safeguarding needs and risks in relation to individual looked after children are well understood by all staff and are addressed effectively. This is also having a demonstrable impact on the reduction of children coming into the care system. For example, good quality multi-agency working in children’s centres is successfully supporting children and families at times of significant crisis and this is helping to avoid some children entering the care system. Parents spoken to by inspectors say this is making a difference to their own self-esteem and well being and helping them to develop successful relationships with their children Lincolnshire Inspection of safeguarding and looked after children 19

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The quality of provision Grade 2 (good)

55. The individual and collective needs of looked after children and care leavers are understood and used well to inform service review and development. The ethnic identities of young people entering care are well recorded and analysed to achieve the best possible match of placement to needs. Placement planning is commendably child-focused and resources are deployed flexibly and imaginatively. The partnership has diverted resources to build the capacity of foster carers. For example, foster carers report that they have been given practical and financial support to make adaptations to their homes to meet the individual requirements of young people with special or additional needs. Young people spoken to by inspectors said they valued the enterprise of the adults in their lives: for example, in obtaining grants to enable large sibling groups to remain together in foster care. Carers seen by inspectors

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The quality of provision Grade 2 (good)

expressed high levels of satisfaction with the expertise and availability of supervising social workers and other professionals who support them in caring for children, including those with complex physical or emotional needs and who display challenging behaviour. These and other measures are contributing to good and improving rates of stability for children in their placements.

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The quality of provision Grade 2 (good)

56. NYAS, the independent advocacy service, provides a good and comprehensive service to support looked after children and care leavers to express their individual views. A sustained programme to raise professionals’ awareness, a regular presence in all residential care settings, and a range of attractive age-appropriate materials are encouraging an increasing take-up of this service by young people. The service also links young people with independent visitors and supports them through formal complaints when needed. The impact and outcomes of the advocacy service are well evidenced in an annual report which summarises learning points from the individual and collective perceptions of the young people. Findings from this report have prompted plans to change the name of the Children in Public Care teams to Looked After Children teams and a review of the leaving care contract with Barnardo’s. This has now been amended to reflect the increased number of

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The quality of provision Grade 2 (good)

young people needing support. However, some concerns remain about the service. For example, a care leaver made a formal complaint about not having an allocated leaving care worker and a few care leavers who spoke to inspectors expressed similar concerns.

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The quality of provision Grade 2 (good)

57. An annual report on complaints relating to children’s services is presented to elected members. Elected members are strongly represented on a recently refreshed corporate parenting panel which includes a young person and the panel has good potential to support the developing Children in Care Council. However, the local authority is aware that further work is needed to ensure that members of the corporate parenting panel are routinely informed of issues arising from comments, compliments and complaints from looked after children about the services they receive. The council is also aware that further sustained work is needed to ensure that the panel has the capacity to meet the Government’s expectations of elected members and the full range of their corporate parenting responsibilities. Lincolnshire Inspection of safeguarding and looked after children 20

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The quality of provision Grade 2 (good)

58. Assessments demonstrate high standards of professional competence in direct work with children and their families. Care is taken to ensure that the views of children and their carers are heard and make a difference to assessments and care plans. Young people seen by inspectors confirmed that they are able to express their feelings and that their views continue to be taken into account throughout their care career. Carers who were seen are positive, committed and demonstrate a high of level of insight into the challenges they are helping children to overcome. Carers are encouraged to and do see themselves as part of the team working with children and are well informed about the good range of resources available to them. All attested to their role in contributing to life story work and were aware of the importance of collecting photographs and memorabilia of the children’s time with them.

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The quality of provision Grade 2 (good)

59. Robust planning ensures the appropriate use of alternative arrangements, such as adoption, special guardianship orders and friends and family placements to prevent children and young people remaining in care unnecessarily. Permanency planning arrangements are clear and well established for children who cannot return to their birth family or extended family.

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The quality of provision Grade 2 (good)

60. Young people are able to make informed choices about how they are involved with reviews of their care or pathway plans and are supported to use these in ways that are helpful to them. Most young people spoken to during the inspection reported that they talked with the Independent Reviewing Officer before the meeting and felt that their voices were heard and made a difference to their plans. This is encouraged by social workers and carers, who also ensure children have access to independent visitors where needed.

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The quality of provision Grade 2 (good)

61. Independent Reviewing Officers chairing statutory reviews ensure care plans are progressed satisfactorily. There is evidence that the commissioned advocacy service and Independent Reviewing Officers are escalating concerns effectively where there is risk of drift in children’s care. Disruption meetings are routinely held following unplanned placement endings which are independently chaired and constructively used as a learning opportunity. Changes have been made as a result of lessons learnt, including taking more time to introduce children to carers when they first enter care or when a planned change is being managed. There is a robust system to ensure that complaints made about staff by children are promptly and effectively dealt with.

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Leadership and management Grade 2 (good)

62. Leadership and management of services for looked after children are good. Strong and determined leadership across the partnership, including the Lincolnshire Safeguarding Children Board and health trust boards, and increasingly effective integrated multi-agency working are making a tangible difference to the lives and outcomes of looked after children. For example, good partnership working with schools has resulted in significant improvements in the proportion of looked after children leaving school with five GCSEs grade Lincolnshire Inspection of safeguarding and looked after children 21

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Leadership and management Grade 2 (good)

A*-C since 2006. Executive leads across the agencies understand their role within corporate parenting and provide a good level of appropriate challenge to the council staff. The Chair of the Children and Young People’s Strategic Partnership meets with the council lead member to review and drive the development of children’s services, including those for looked after children. A well-informed lead member for children and young people and an increasingly effective children’s services scrutiny panel are successfully ensuring that looked after children are prioritised and their life chances enhanced by challenging services about their contributions to ensure good outcomes for looked after children. For example, they are currently looking at the issue of respite care for looked after children when their foster carers need a break. This is an issue that looked after children have brought to the attention of the scrutiny panel

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Leadership and management Grade 2 (good)

themselves through the Children in Care Council. Exception reports provided to the committee include detailed commentary on successes and how any identified areas for improvement will be tackled.

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Leadership and management Grade 2 (good)

63. Excellent performance management arrangements are in place. These successfully hold managers and staff accountable for their performance against targets, for actions taken to support children and their carers, and for action to improve outcomes. As a result, there is a trend of continuing improvement in virtually all outcomes for looked after children. Target setting to drive improvement is outstanding. Challenging targets are set after consideration of local performance, comparison against similar areas and the national average. They are monitored robustly each month to make sure that any temporary areas of underperformance are tackled decisively. Good, accurate, self- evaluation of what is working well and what needs to improve is informing the forthcoming Children and Young People’s Plan 2011 to 2014. Comprehensive consultation has included the views of looked after children, and a range of priorities are being developed to continue the drive for improvement.

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Leadership and management Grade 2 (good)

64. To support continuous improvement, children’s services invest heavily in the workforce and vacancy rates are comparatively low. Front line staff in partner agencies are confident, proud of their work with children and families and committed to delivering good outcomes for looked after children. Social workers welcome opportunities to share and resolve practice issues at a recently established forum and experience this as a meaningful opportunity to contribute to identifying service needs and developing policy. Staff report that they appreciate managerial supervision, guidance and direction and this is reflected in case files. Workers are sponsored for professional social work training and students are welcomed for placement in all operational teams. This is an area of good practice. Managers also say that they feel valued. They believe they are well-supported and empowered to lead and develop their

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Leadership and management Grade 2 (good)

teams and make decisions, and are fully accountable for delivering improvement. A new post has been established to further improve the effectiveness of health service support for looked after children which will improve the monitoring of health related data and provide a direct link to children’s social care teams. Lincolnshire Inspection of safeguarding and looked after children 22

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Leadership and management Grade 2 (good)

65. Services use many different ways to listen to and act upon the views of looked after children and their carers. Changes are often made to their care plans as a result of concerns or suggestions offered by young people themselves and this is making a positive difference. New child-friendly consultation documents have been produced, changes have been made to venues of key meetings, who is invited, and how the meeting is managed. Young people have also been involved in redesigning the consultation forms for their reviews

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Leadership and management Grade 2 (good)

66. Partnership working is outstanding and continuing to develop across all agencies and districts. Partnerships are particularly good in terms of preventative work to reduce the number of children at risk of entering the care system. Strong multi-agency working within children’s centres has enabled key workers to signpost or secure support from other services to help families in times of significant need. Family group conferencing is well-embedded and used flexibly to respond to a range of needs, including work to rehabilitate children who have been in care. As well as a reduction in children coming into care, there has also been a reduction in out of county placements.

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Leadership and management Grade 2 (good)

67. The promotion of equality and diversity is good. Teams work closely together to promote opportunity and to eradicate inequality. For example, the successful recruitment of foster carers from more diverse communities has increased placement choice enabling more children to live with families of similar cultural heritage and matching the individual, cultural or religious needs of looked after children more successfully. Specialist placements are available for asylum seeking care leavers that are appropriately sensitive to their individual life experiences and cultures.

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Leadership and management Grade 2 (good)

68. Value for money is good. Robust systems to evaluate value for money have been developed and there is clear evidence of efficiency savings as a result of action taken or issues identified. For example the high unit costs of residential care informed a budget review of social care which identified a high use of very expensive independent residential placements for children with very challenging behaviour or complex learning difficulties and/or disabilities. A successful strategy was developed which has built more capacity in local family placements through increased support to foster carers. Foster carers have been approved, trained and have access to professional support infrastructures to help them meet children’s complex needs. Consequently, more children have returned to their own communities within Lincolnshire and unit costs have reduced over the past four years, while at the same time outcomes for children

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Leadership and management Grade 2 (good)

have continued to improve. Lincolnshire Inspection of safeguarding and looked after children 23

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Council

Safeguarding services Overall effectiveness Outstanding Capacity for improvement Outstanding Outcomes for children and young people Children and young people are safe: effectiveness of services in taking reasonable steps to ensure that children and young people are safe Outstanding

p.25

Council

Children and young people feel safe: effectiveness of services in helping to ensure that children and young people feel safe Good

p.25

Council

Service responsiveness including complaints Outstanding Assessment and direct work with children and families Outstanding Case planning, review and recording Good Leadership and management Outstanding Ambition and prioritisation Outstanding Evaluation, including performance management, quality assurance and workforce development Outstanding

p.25

Council

User engagement Outstanding Partnerships Outstanding Equality and diversity Outstanding Value for money Outstanding Lincolnshire Inspection of safeguarding and looked after children 24

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Council

Services for looked after children Overall effectiveness Good Capacity for improvement Outstanding Outcomes for looked after children and care leavers Being healthy Good Staying safe Good Enjoying and achieving Good Making a positive contribution Good Economic well-being Adequate Quality of provision Good Service responsiveness Good Assessment and direct work with children Good Case planning, review and recording Good Leadership and management Good Ambition and prioritisation Good Evaluation, including performance management, quality assurance and workforce development Outstanding

p.26

Council

User engagement Good Partnerships Outstanding Equality and diversity Good Value for money Good

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