safeguarding and looked after children services

Inspection of safeguarding and looked after children services Hartlepool

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Inspection dates 07 June to 18 June 2010 Reporting inspector Martin Ayres

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Age group: All Published: 16 July 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 Hartlepool Inspection of safeguarding and looked after children 1

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The inspection outcomes: safeguarding services 5

1. Overall effectiveness 5 2. Capacity for improvement 7 3. Areas for improvement 8 4. Outcomes for children and young people 9 a. The effectiveness of services in taking reasonable steps to ensure children and young people are safe 9 b. The effectiveness of services in taking reasonable steps to ensure that children and young people feel safe 9 5. The quality of provision 10 6. Leadership and management 12

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The inspection outcomes: services for looked after children 19

1. Overall effectiveness 19 2. Capacity for improvement 20 3. Areas for improvement 21 4. Outcomes for children and young people 21 5. The quality of provision 26 6. Leadership and management 28

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Record of main findings 32

Hartlepool 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 two of Her Majesty’s Inspectors (HMI), one inspector from the Care Quality Commission, one additional inspector and two shadow inspectors. 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 children and young people 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 of a serious case review undertaken by Ofsted in accordance with ‘Working Together To Safeguard Children’, 2006.

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About this inspection

ƒ A review of 28 case records for children and young people with a range of need and seven health care records. 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 the local authority contact, assessment and referral centre undertaken in November 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 Hartlepool 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. Hartlepool is a unitary authority located in the Tees Valley area of North East England. It has a population of approximately 90,000 people of which approximately 25% are children and young people aged 0-18 years. Most of the population live in the compact urban area although there are expanding suburbs and some small and distinct rural villages within the area. The population is predominately white British with 1.2% of the overall population from minority ethnic groups. Hartlepool is one of the most deprived areas out of 354 local authority districts in England. Childhood poverty is comparatively high at 28% both in regional and national terms.

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Service information

5. The local strategic partnership (LSP) acts as the Child Poverty Partnership Board and works closely with the Safer-Hartlepool Partnership, the Children’s Trust and NHS Hartlepool, which commissions health services from a range of NHS Trusts in the area. The Children’s Trust comprises of a strategic board, an executive and several operational groups including a stakeholders group of young people. Hartlepool Safeguarding Children Board (HSCB) sits within the wider partnership. Policing is delivered through a local command structure of Cleveland Constabulary.

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Service information

6. Children’s social care is provided through the Child and Adult Services Department and includes a contact, referral and assessment service, several long-term teams and specialist provision, including for children with disabilities and an out–of-hours service. There are eight designated children’s centres. Out-of-hours services are commissioned through an arrangement with Stockton, Redcar, Middleborough, and Darlington. There are currently five secondary schools, 30 primary schools, two special schools, one pupil referral unit and a range of nursery settings in Hartlepool. There is one college of general further education, one sixth form college and two schools with sixth form provision. Youth services are delivered through three main youth centres plus satellites. Youth offending services are provided through the Safer Hartlepool partnership.

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Service information

7. At the time of this inspection 163 children and young people were being looked after by the local authority mainly in local foster homes and 135 children and young people were subjects of child protection plans. In total, 523 children and young people assessed as being ‘in need’ were receiving social care services and 334 children and young people had a statement of special educational needs.

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Service information

8. Commissioning and planning of child health services and primary care are undertaken by NHS Hartlepool (PCT) and services are delivered primarily through North Tees and Hartlepool NHS Foundation Trust (NTHFT). Accident Hartlepool Inspection of safeguarding and looked after children 4

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Service information

and Emergency and community health services are provided across North Tees and Hartlepool. Child and adolescent mental health services (CAMHS) are provided by Tees, Esk and Wear Valleys Foundation NHS Trust. Hartlepool Inspection of safeguarding and looked after children 5

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Overall effectiveness Grade 2 (Good)

9. The overall effectiveness of safeguarding services is good. The Children’s Trust and Hartlepool Safeguarding Children’s Board (HSCB) provide effective leadership and thresholds for access to services are clear and understood across the partnership. Families benefit from a wide range of local provision with good examples of joint working between agencies to meet the assessed safeguarding needs of children and young people. Partnership working between social care, education, health and third sector partners at both strategic and operational levels is good with a particularly strong emphasis on ‘teams around’ primary and secondary schools (TAPS and TASS) and in children’s centres (TACC). Provision for children and young people with disabilities and/or learning disabilities and other vulnerable groups is good and informed by detailed needs analyses. Headteachers identify outstanding support for children and young

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Overall effectiveness Grade 2 (Good)

people with special educational needs and/or disabilities. Support for attendance, behaviour and safeguarding responsibilities are of high quality and have a positive impact on outcomes for young people.

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Overall effectiveness Grade 2 (Good)

10. There is a good track record of continuous improvement of services with examples of learning from a serious case review, national reports, local initiatives and projects. The one serious case review commissioned by HSCB in the past year was evaluated as good by Ofsted and action has been taken to respond to the areas for development identified in the most recent unannounced inspection of contact, referral and assessment services. Performance against key indicators is at least in line with regional and national averages, with evidence that the local emphasis on prevention is having a positive impact in facilitating early intervention for children and families. All child protection cases are allocated to suitably qualified social workers who report that they receive regular supervision and good management support.

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Overall effectiveness Grade 2 (Good)

11. The quality of initial assessments is good and they are produced in a timely manner. Decisive action is taken to respond to the needs of children identified as being at risk of harm and processes for collecting and sharing relevant information are robust. Core assessments seen in the course of this inspection vary in quality and some lack detail and analysis. However, this has already been identified by the area through local audit arrangements and plans are already in place to improve practice. The most recent core assessments seen during the inspection show improvement. Performance management processes are adequate with routine reporting of quality and performance to the HSCB and Children’s Trust. Children and young people and their carers are asked for consent to access and share records and are given information on complaints. The outcome of complaints has been used to improve service developments. The role of the Local Authority Designated Officer (LADO) is well

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Overall effectiveness Grade 2 (Good)

Hartlepool Inspection of safeguarding and looked after children 6

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Overall effectiveness Grade 2 (Good)

established and understood and the management of any allegations against staff is effective.

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Overall effectiveness Grade 2 (Good)

12. The contribution of education services to safeguarding children and young people is good and aspects of the work are outstanding. Highly effective leadership and direction from the local authority ensure that safeguarding is a high priority in all schools and educational establishments. Education outcomes are improving for vulnerable and socially disadvantaged groups as well as for all pupils. All schools demonstrate a high level of commitment to promoting well- being, self-esteem and a safe learning environment, which makes a strong contribution to pupils’ academic achievement. This is reflected in recent school inspection findings, where safeguarding, including safer recruitment, has been judged to be outstanding in the majority of schools most recently inspected. Safeguarding training and briefings provided by the local authority are of good quality and effectively ensure that the workforce in schools is up-to-date with

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Overall effectiveness Grade 2 (Good)

training and developments. Effective preventative work and collaboration between schools have kept the rate of permanent exclusions very low. The few who are excluded receive well targeted support in the pupil referral unit and most return quickly to school. Headteachers and designated safeguarding teachers report that advice and support from the Duty Team and social care are easily accessible and their response is timely and appropriate.

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Overall effectiveness Grade 2 (Good)

13. Health Chief Executives, Trust Chairs and executive directors confirm that the level of professional challenge both within the LSCB and internally at the Trust board meetings and in governance and safeguarding children committees is good. The HSCB and health services hold each other to account in delivering serious case review action plans and the HSCB business plan. NHS Hartlepool is leading the work across the North East SHA region with good progress being made in the development of contract performance indicators and monitoring tools which include specific performance indicators for safeguarding children. Safeguarding training for general practitioners is comparatively low at 64%, although this shows a small increase from the previous year. General practitioners are also not well represented on HSCB. Only 18% of dentists and 57% of opticians completed level 2 training in 2010 and records show that no

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Overall effectiveness Grade 2 (Good)

pharmacists have received safeguarding training. There were no validated health training records available during the inspection to evidence appropriate levels of health workforce training.

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Overall effectiveness Grade 2 (Good)

14. There are good, well embedded systems in place in Accident and Emergency services to ensure the appropriate identification of children and young people deemed to be at risk of harm, including the number of attendances and frequency. Primary care staff take suitable action to seek further information in order to follow-up attendance and non-attendance at clinics, although they do not have regular access to a designated nurse. The child death overview panel has good representation from all health professionals and attendance by partner agencies is particularly good. Hartlepool Inspection of safeguarding and looked after children 7

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Overall effectiveness Grade 2 (Good)

15. Staff recruitment processes are suitably robust and ensure that appropriate checks are routinely made including Criminal Records Bureau and histories of employment. The local authority undertook an audit of employment records in 2009 and found some inconsistencies in record-keeping. These are not significant in the context of safe employment practice and primarily relate to staff who have been in post a long time and to file structure and record organisation. Managers have confirmed that actions arising from the audit are now being fully implemented.

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Capacity for improvement Grade 2 (Good)

16. Capacity for improvement is good. Managers across the partnership provide effective leadership and ensure there is good awareness of all aspects of safeguarding in the area including intervention to protect the most vulnerable children and young people from significant harm when this is required. Capacity has been enhanced through effective partnership leading to good and some outstanding examples of collaboration, particularly in and around schools. Effective arrangements are in place to deliver a wide range of early intervention services including children’s centres and parent nurturing programmes. There is a strong contribution to services provided by the third sector, which is adding to capacity and innovative working arrangements. Political awareness of safeguarding is good and underpinned by clear strategic plans with clear priorities. The partnership has established an enduring track record of delivering improvements in safeguarding based on good self-

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Capacity for improvement Grade 2 (Good)

awareness, willingness to try new ideas and approaches and in responding to external reviews, including inspections. The area has been quick to tackle any areas for further development and where necessary, additional resources have been provided to increase capacity subject to appropriate levels of scrutiny.

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Capacity for improvement Grade 2 (Good)

17. There has been an increase in the number of child protection referrals which has led to a significant impact on workload pressures. This is being closely monitored by managers and action has been taken to increase the capacity of front line services and to monitor the impact on the overall quality of work produced. Although there are no bottlenecks in current service delivery, staff report being stretched at times of peak activity. These pressures are being actively monitored and staff feel confident that senior managers are aware and will take appropriate action to respond. Referrals and thresholds are well understood across the partnership and professionals use escalation processes well to challenge appropriately any decisions that are unclear. The increasing use of the common assessment framework, combined with outstanding work in respect of TAPS, TASS and TACCS, is enabling earlier forms of intervention to

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Capacity for improvement Grade 2 (Good)

meet identified need. School staff demonstrate a good understanding of their responsibilities, safeguarding processes and potential risks to the safety of children and young people in their care. Health visitors report that they have firm confidence in the use of TAPS, TASS or TACCS as a means to securing support for children in need and their families. Hartlepool Inspection of safeguarding and looked after children 8

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Capacity for improvement Grade 2 (Good)

18. The area has a good record in respect of user engagement and partnership working. The views of children, young people and their carers are fully considered in planning, although the recording of views is sometimes inconsistent. The scrutiny panel, comprising elected members, young people and officers, ensures outstanding user engagement in significant areas of service delivery with good impact following review. Joint workforce planning structures are in place and active work takes place to ensure staff are suitably skilled and trained to undertake the tasks concerned. The area has a good record in recruiting and retaining staff and in staff development and support. Staff morale across the partnership is good with clear commitment to the established and developing ways of joint working. Staff appraisal systems are used well to support staff in their personal development and to ensure the skills mix to meet current and projected demands are being monitored. Performance

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Capacity for improvement Grade 2 (Good)

management systems facilitate effective benchmarking of performance across the region and in a national context. Considerable effort is made to learn from other areas and to bring best practice into local systems.

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Areas for improvement

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

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Immediately

ƒ Ensure that core assessments are consistently completed to a common standard and suitably recorded to ensure user views are appropriately documented and needs and risks are clearly identified.

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Immediately

ƒ Ensure the electronic records clearly identify measureable planning objectives and agreed actions, are effectively linked to comprehensive supervision records and clearly show management oversight.

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Within three months

ƒ NHS Hartlepool in conjunction with the HSCB should ensure that staff in Accident and Emergency services receive appropriate advice and support on all safeguarding matters from designated health staff.

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Within three months

ƒ NHS Hartlepool in conjunction with HSCB should ensure that plans are in place to monitor attendance on level 2 and 3 training and that any gaps in respect of the attendance of specific groups of professionals are fully addressed. Hartlepool Inspection of safeguarding and looked after children 9

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Within six months

ƒ HSCB to ensure that board representation and attendance accords fully with national guidance. Hartlepool Inspection of safeguarding and looked after children 10

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children and young people are safe. Grade 2 (Good)

20. The effectiveness of services to ensure that children and young people are safe is good. The proportion of schools who are judged good or better for safeguarding during inspections exceeds the national average. Staff report that they have an up-to-date knowledge of safeguarding issues and training in child protection and safeguarding is of good quality. There are good procedures to monitor and check the safety of children educated at home and to track those who go missing from home or school. HSCB provides good leadership on all safeguarding matters and awareness of safeguarding within the partnership is strong. Children, who are regarded as being at risk, are identified through close collaboration between social care, education and health staff. Considerable effort is also made to raise general public awareness of safeguarding in the area and specific risks to children. Services are regularly audited for quality and

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children and young people are safe. Grade 2 (Good)

outcomes, leading to appropriate changes and developments. Safeguarding provision has been judged good and better in most service settings and there is a record of swift action where deficiencies have been found. An example is action taken to improve the consistency and quality of core assessments and to respond to the recent Youth Offending service inspection where safeguarding issues were identified.

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

21. Good action is taken to ensure that children and young people feel safe. Targeted action helps divert young people from potentially criminal or anti- social activity. In schools, multi-agency collaborative action successfully prevents difficulties escalating and keeps children and young people engaged in education. There is a range of positive activity in the community with effective targeted work in known ‘hotspot’ areas or with groups of children and young people. ‘Operation Stay-Safe’, for example, provides good support to those with drug- and alcohol-related behaviour issues through collaborative working between police, the youth service and social care. Schools provide very good and continuous safety advice.. The ‘Crucial Crew’ event is a memorable and highly effective means of providing advice to all Year 6 pupils on safety in the home, at the seaside, on road and rail, and on fire and firework safety. All but

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

one school have achieved National Healthy Schools Status which includes modules on healthy lifestyle, sexual health and staying safe. Anti-bullying work, led by the local authority inclusion team, is raising awareness and steadily improving outcomes. E-safety and cyber-bullying have been a recent focus for action and young people show good awareness of potential hazards.

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

22. Young people who spoke with inspectors said they mostly feel safe. They were confident that adults would deal effectively with any threatening Hartlepool Inspection of safeguarding and looked after children 11

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

behaviour in schools and reported that on-site CCTV in schools adds to their sense of well-being. Most said they felt safe in the community, although they avoid some places, including buses, where they experience alcohol-related anti- social behaviour. The local ‘Life in Hartlepool’ survey reflects these views with the majority reporting that they feel safe in school. However, over half of the respondents reported that they did not feel safe around town. In the survey undertaken for this inspection, 18 of the 19 children and young people reported they felt very safe and one reported they felt fairly safe. The majority of children and young people spoken to and surveyed felt that their views are considered in service delivery and acted on to improve their safety.

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The quality of provision Grade 2 (Good)

23. Service responsiveness in safeguarding, including complaints, is good. Thresholds for access to services are clear and understood across the partnership and are kept under constant review by HSCB. Awareness among all key partners on safeguarding matters is good with appropriate challenge at board level and between professional groups. Escalation policies are in place to ensure that where there are unresolved difficulties, there is a process for quick resolution. Needs analysis is good and there is a comprehensive understanding of local populations and specific pressures. Needs data are used well to inform planning and to target joint services. The Trust is tracking a cohort of 50 children and young people who are in receipt of a range of services in order to test the efficacy of those services and outcomes over time. The data derived will then be used to drive future planning. Performance management systems

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The quality of provision Grade 2 (Good)

are being used well. The self-audit of 28 cases conducted by the local authority as part of this inspection was suitably robust and identified outcomes for children and young people, areas of good practice and some areas for further development. Work is in hand to strengthen the audit tools in respect of case records, including health providers to ensure that they focus in sufficient depth on all aspects of assessment, casework and practice quality across the partnership.

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The quality of provision Grade 2 (Good)

24. Children and young people and their carers have access to case records and their comments and views are recorded. The quality of recording in this respect is not always consistent, although service users were clear that they were aware of plans, the aims of intervention and the contingency plans. Case tracking indicates that children engaged with social services generally have good levels of involvement in planning their care. However, children who are of sufficient age and understanding are not always or consistently involved in child protection planning processes. The views of parents, carers and young people are clearly identified throughout the Children and Young People’s Plan on a range of issues and have influenced policy and practice. Complaints processes are accessible and users are reminded on how to use the systems including during care planning meetings and reviews. Complaints are used well to help

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The quality of provision Grade 2 (Good)

inform future service planning. As necessary, complainants are given access to appropriate advice and independent support. Hartlepool Inspection of safeguarding and looked after children 12

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The quality of provision Grade 2 (Good)

25. Service users report a high level of satisfaction with the quality of services they receive. Parents who spoke to inspectors were full of praise for the special needs and disabilities services, school provisions, extended services, parenting courses and social care. Young people felt that their views were sought and listened to in respect of health care planning and their views have been informally sought when reviewing accident and emergency waiting rooms. This has led to the rooms being more welcoming and less clinical, with age appropriate games and toys, thereby putting children and young people at ease during traumatic and stressful times. Children and young people in schools complete feedback questionnaires on the usefulness and provision of services from school nurses. Results show that children and young people have positively evaluated the services they receive.

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The quality of provision Grade 2 (Good)

26. Assessment and direct work with children and families are adequate. Initial assessments are produced to a good standard and are timely but the quality of core assessments is less consistent and some lack the level of detail needed to measure impact and outcomes. Work has also been undertaken to clarify care pathways and to reconfigure social care teams in order to streamline work moving from initial referral through to longer term interventions. Careful consideration has been given to co-working arrangements in order to maximise assessment capacity and to ensure the smooth transfer of work between teams. All cases are suitably allocated and timely action is taken in respect of all child protection referrals and risk and protective factors are clearly identified and acted upon. Children and families are visited regularly and visits are often in line or above statutory requirements. Staff supervision is

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The quality of provision Grade 2 (Good)

regular and social care managers appropriately oversee work and ensure that plans are implemented or modified as needs and risk change. However, the record of management oversight is not easily accessible within the electronic recording system.

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The quality of provision Grade 2 (Good)

27. Health staff in Accident and Emergency services at North Tees and Hartlepool NHS Foundation Trust report that they do not routinely meet with the named nurse for safeguarding and lack opportunities to discuss cases or to receive directly information updates. Policy changes are notified but only in email form with the risk they may not be consistently implemented. The emergency duty team which covers five local authority areas is commissioned by Hartlepool and provides an adequate service. This team is staffed by experienced and skilled staff but currently utilises several different databases, although these are dedicated for each local area. This team provides good advice and support to the range of professionals and potential referrers out of normal working hours. Communication with day time staff is good.

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The quality of provision Grade 2 (Good)

28. Staff in all agencies and users alike have commented on the effectiveness of the ‘team around’ approach in schools and children’s centres and the positive impact of this method of joint working. This approach and improved accessibility to services as a result. Good work is undertaken by all the key agencies and professionals in direct work with children and families. Together, they build comprehensive assessments covering needs, risks and Hartlepool Inspection of safeguarding and looked after children 13

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The quality of provision Grade 2 (Good)

protection objectives. Comprehensive and well-managed parent nurturing programmes are available in the children’s centres with effective contributions by the voluntary sector. Good legal advice is provided in respect of court work and appropriate decision making takes place to ensure child protection enquiries are thorough and timely. Joint work with the police in respect of domestic violence and hidden harm is effective. CAMHS staff are involved in the new emotional well-being partnership and have assisted with the development of a self-assessment matrix which is being used to help identify service priorities. Good senior leadership in health is aiding communication and challenge in respect of safeguarding and in ensuring important issues get appropriately aired.

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The quality of provision Grade 2 (Good)

29. Case planning, reviews and recording are adequate. Child protection conferences and reviews are undertaken within statutory timescales, despite the increased levels of demand. As a result, children are effectively protected by multi-agency plans. From the cases sampled during the inspection, multi- agency attendance at case conferences is good with the exception of general practitioners. Although there were good examples of child-centred planning and reflective and focused work with effective action taken, there is a lack of consistency overall in case recording. The templates used in the electronic recording system (ICS) for recording assessments and child protection plans do not readily support these aspects of work or provide reports that parents and carers can easily understand or know what is expected of them. Social care staff and partners make considerable efforts to compensate for this in planning

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The quality of provision Grade 2 (Good)

meetings but the quality of actual recording, although mainly up-to-date, is only adequate. The local authority is aware of the electronic recording problems and is actively working with the software provider to resolve the technical difficulties. Core groups and strategy meetings are being held in accordance with agreed joint procedures, but the degree to which core group meetings actively monitor child protection plans is variable. Referral rates have significantly reduced which demonstrates greater effectiveness in assessments, case planning and review.

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Leadership and management Grade 2 (Good)

30. Ambition and prioritisation are good. Partners demonstrate a strong commitment to the broad safeguarding agenda and for the delivery of services in localities which closely match local needs. These services are beginning to make a difference in improving the lives of some of the most vulnerable children and families. Service plans and objectives are explicit in terms of the priority given to safeguarding, and leadership across the partnership is highly visible in this respect. Education outcomes are improving for vulnerable and socially disadvantaged groups as well as for all pupils. There is a high level commitment to promoting well-being and self-esteem and in establishing safe learning environments. Recent school inspection findings in most schools have been outstanding in respect of safeguarding and safer recruitment. Hartlepool Inspection of safeguarding and looked after children 14

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Leadership and management Grade 2 (Good)

31. HSCB and the Children’s Trust provide good leadership and raise awareness in the local community regarding safeguarding and the need for vigilance. HSCB is effective in the range of work undertaken, including promotional events, training, case review, and policy and procedure development. The Board has been effectively chaired by the Director of Adult and Children’s Services but plans are now in place to appoint an independent chair. Attendance at the Board is generally good with good representation by key agencies and groups, including the voluntary sector. However, there are some gaps in attendance which require further examination in order to ensure attendance accords with the requirements of national guidance. One serious case review has been commissioned by HSCB and was evaluated as good by Ofsted. Lessons learned from this review have been disseminated, are being implemented and closely monitored by the Board.

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Leadership and management Grade 2 (Good)

32. Safeguarding training and briefings provided by the local authority are of good quality and effectively ensure the workforce in schools is up-to-date with training and developments. School staff demonstrate a good understanding of their responsibilities, safeguarding processes and potential risks to the safety of children and young people in their care. Schools report that advice and support from other agencies, including social care, are easily accessible and response is timely and appropriate. Schools’ collaborative approach to avoiding exclusion is highly effective. As one headteacher commented, ‘all schools have a commitment to the welfare of pupils in Hartlepool whichever school they attend’.

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Leadership and management Grade 2 (Good)

33. Priorities have been set in respect of young people who misuse drugs and alcohol, teenage conception rates and sexual health, domestic violence and child neglect. Joint assessments now take place which has helped to reduce the stigma associated with using mental health services and there are established and effective working arrangements with the dedicated paediatric nurses and youth worker for substance misuse. While the rates of teenage pregnancies remain significantly higher than the national average, good comparative progress has been made in reducing the overall rate by 12% when measured from the 1998 baseline. While this illustrates the impact of effective service prioritisation in the area, teenage conception rates still remain a most challenging area of service. NHS Hartlepool is able to track the number of pregnancies within each school, which enables the specialist teenage midwife, school nurse and education staff to undertake targeted work on sexual health

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Leadership and management Grade 2 (Good)

and ensure that services provide suitable support during pregnancy and enable eventual re-integration into school. The National Support Team has visited the area and NHS Hartlepool has demonstrated a willingness to learn and improve their service. One example is the appointment of a dedicated teenage pregnancy midwife, who has also worked with teenage mothers and reports a reduction in the number of second teenage pregnancies.

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Leadership and management Grade 2 (Good)

34. Performance management is good and is well embedded in the management culture of the council and partner organisations. Systems are in place to monitor key indicators with regular reporting to the HSCB, the Trust Hartlepool Inspection of safeguarding and looked after children 15

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Leadership and management Grade 2 (Good)

and the Safer Hartlepool boards. Services identify weaknesses and take decisive action to remedy any deficiencies. The record of continuous improvement is good. Financial management is well structured with effective political oversight and awareness. Performance assessed against key safeguarding indicators is at least comparable with other areas in the North East of England and in many respects is better. Timeliness of assessments and service responsiveness are good; re-referral rates have improved significantly and the effectiveness of child protection processes such as case conferences, reviews and strategy meetings, are all good. Children’s centres visited in the course of this inspection were able to demonstrate good use of data to underpin their work with children and families and to drive improvement. Breast-feeding rates are lower than national averages and measures have been taken to improve this through the provision

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Leadership and management Grade 2 (Good)

of a dedicated infant co-ordinator post and the UNICEF baby friendly initiative register of intent. Funding has been awarded to establish the peer support programme and an infant feeding coordinator has now been appointed.

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Leadership and management Grade 2 (Good)

35. Breast-feeding has been included in NHS Hartlepool’s metrics and as such has enabled this work programme to be embedded in other strategies, for example, the reduction of obesity and reducing health inequalities, the latter of which Hartlepool is a spearhead area. There are good systems in place to ensure that any child or young person who attends Accident and Emergency services has their general practitioner, health visitor if under five years, or school nurse if over five years, notified at the end of each shift. The Accident and Emergency information system provides good reports on the number of attendances of children and young people and the frequency of those visits, which is included in the letter to general practitioners. Staff send ‘patient attendance alerts’ to the named nurse and primary care staff on the same day the child and young person have been seen in Accident and Emergency and

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Leadership and management Grade 2 (Good)

primary care staff will appropriately request further information to follow-up attendance and non-attendances.

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Leadership and management Grade 2 (Good)

36. Alcohol is the main substance used by young people and rates of alcohol- related hospital admissions among young people are increasing. A needs assessment has been completed and information is being used to provide a range of targeted services to raise awareness and to assist those children and young people at risk through excessive consumption of alcohol. This is being closely monitored by the Safer Hartlepool board. An alcohol harm reduction self-assessment has been undertaken which is informing commissioning and partnership working. The mapping of data and usage is allowing for targeted work to be undertaken at ward level. There is a good seven-day service with daily liaison with Accident and Emergency departments by CAMHS to ensure there are no missed cases. All children and young people are seen prior to their hospital discharge and then five days after discharge. An education and risk screening tool has been developed for education staff and implemented in

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Leadership and management Grade 2 (Good)

schools to identify potential individuals at risk of harm and to promote good emotional health. Staff feel this has helped to reduce the number of self harming incidents and made staff more aware of the risk factors. Hartlepool Inspection of safeguarding and looked after children 16

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Leadership and management Grade 2 (Good)

37. The workforce strategy is appropriately targeted on ensuring staff in all agencies are able to operate in increasingly integrated ways and that they have relevant skills and experience to meet the assessed needs of individual children, young people and their families. All cases are suitably allocated and although current capacity is stretched, there are not, as yet, any bottle necks in the system Local managers are alert to particular pressures in work flow and act swiftly to provide additional capacity where needed. Elected members have responded quickly to well considered requests for additional resources and have indicated their willingness to respond in the future should work pressures demand additional resources. Although the overall thrust to more preventative work is having a good impact, the area is aware that there is an on-going need to maintain front line services to ensure that those children and young people

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Leadership and management Grade 2 (Good)

who are in greatest need and at risk of harm receive good quality and continuous services. Processes to ensure the safe recruitment of staff in all partner organisations are well embedded and fully comply with statutory requirements and national guidance. The council undertook an audit of staff records in 2009 leading to several pertinent recommendations for action.

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Leadership and management Grade 2 (Good)

38. User engagement is good with outstanding features. Children and young people feel that their views were sought and listened to, especially when planning and making decisions related to their care, including their own health care. The views of children and young people are routinely sought in all settings including schools and health services. Surveys and local questionnaires show that the children and young people value the services they receive. Children and young people, including those from vulnerable groups, play an important role in service development and scrutiny. They are able to contribute their views and influence strategic decisions through a wide range of youth forums and consultations. The work of 30 Young Inspectors has made a valuable contribution to service review and improvement across youth services, social care, CAMHS, community, transport and leisure.

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Leadership and management Grade 2 (Good)

39. Young people have contributed to an excellent review of homelessness through scrutiny. The young carers scheme is well managed and provides highly supportive and imaginative programmes to enable young people to have a voice in the services they receive and to enable them to participate actively in their own planning. There is good involvement of children and young people in school reviews and improvement planning. The views of parents, carers and young people are clearly identified throughout the Children and Young People’s Plan on a range of issues and have clearly influenced policy and practice. Case tracking indicates that children engaged with social services generally have good levels of involvement in planning their care. However, children are not consistently involved in child protection planning processes. Service users report a high level of satisfaction with the quality of services. Parents who spoke to

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Leadership and management Grade 2 (Good)

inspectors were full of praise for special needs and disabilities services, school provisions, extended services, parenting courses and social care. However, they felt that information about activities and events could be better communicated and that leisure activity for younger children remains too limited. Hartlepool Inspection of safeguarding and looked after children 17

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Leadership and management Grade 2 (Good)

40. Partnership working around schools is outstanding. A range of agencies are fully engaged in supporting and safeguarding vulnerable children and young people. They have a high level of commitment to frequent ‘team around the school’ meetings where tailored multi-agency support is planned for children and young people at risk of harm, under-achievement or exclusion. Children’s social and emotional needs are met well and there is strong evidence of success in preventing escalating difficulties and further vulnerability. The use of the common assessment framework is adequate and gradually increasing. Nevertheless, the relationship between ‘team around’ processes and use of the common assessment framework is insufficiently clear and some staff commented on the need to establish more defined pathways. Partnerships with colleges, the pupil referral unit and alternative providers effectively support vulnerable young people to remain engaged in education. Parents who spoke to

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Leadership and management Grade 2 (Good)

inspectors were extremely positive about the support from schools, for example in managing behaviour, supporting improving attendance and academic achievement. They were highly satisfied with the inclusive approach to supporting children with special needs and/or disabilities. Local authority support to schools is highly valued and headteachers identify exceptional support for special educational needs and/or disabilities. Support for attendance, behaviour and safeguarding responsibilities are of high quality and have a positive impact on outcomes for young people. There has been good use of the ‘circle of adults’ to learn from cases where there has been a serious untoward incident or near miss. An example of a self-harm incident was provided to demonstrate the success of this joint approach coordinated in this case by the HSCB.

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Leadership and management Grade 2 (Good)

41. Partnerships with stakeholders have led to improvements in service design and delivery. A good example is the seven day CAMHS offered with daily staff liaison with Accident and Emergency departments. Through this arrangement all new cases of young people under 16 years are identified with staff follow up on the paediatric ward when medically fit. There have been no missed cases using this system. There is 24-hour, seven days per week, medical cover from on-call CAMHS. This service is a shared within the region and as such there may not be a Hartlepool consultant always on call. If this is the case, the patient care is transferred next working day back to the Hartlepool team which maintains good continuity of care. All children and young people are offered a five-day follow up appointment; if they do not attend the general practitioner and other key professionals are contacted to provide appropriate follow-up for the young person. All children and young people who

p.19

Leadership and management Grade 2 (Good)

self-discharge are followed up. As a result of a request from education, a screening and risk tool has now been developed and implemented in schools and more recently in primary schools which is helping teaching staff assess potential individuals who are at risk of self harm. Early intervention work and preventative strategies are implemented well to keep children and young people safe.

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Leadership and management Grade 2 (Good)

42. Equality and diversity is good with some significant strengths in inclusive practice and preventative strategies. Tackling inequalities is at the heart of the Hartlepool Inspection of safeguarding and looked after children 18

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Leadership and management Grade 2 (Good)

Children and Young People’s Plan. The five key priorities are clearly focused on tackling inequalities in health and educational achievement, eradicating child poverty and narrowing the gap between the most disadvantaged groups and all children. Effective action is taken to ensure all children and young people achieve good outcomes. Schools are highly inclusive and diligent in safeguarding pupils. Effective preventative strategies support those at risk of exclusion to remain engaged in education and achieve well both academically and in their personal development. Vulnerable children and young people generally receive sensitive support tailored to their specific needs. However, case files do not always record important cultural information such as the ethnicity and religion of children. Work with asylum-seeking young people, those with behavioural difficulties and children and young people with special

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Leadership and management Grade 2 (Good)

educational needs and/or disabilities, is highly successful. Parents of disabled children are extremely positive about the quality of support they have received. Young people and families who speak English as an additional language receive good support and information through multi-lingual workers and literature. There is a good weaning support group dedicated to Polish women and led by midwives and health visitors. There is also a good asylum-seekers playgroup supported by health visitors at one of the children centres, which enables health inequalities to be assessed and actions to be taken.

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Leadership and management Grade 2 (Good)

43. Targeted youth work and specific projects to raise awareness have helped young people to develop an understanding of cultural diversity. Imaginative activities have been developed to divert young people from extremist groups and anti-social behaviour. A strong focus on narrowing the gap between the outcomes of children and young people from socially disadvantaged homes and that of others is bringing about improvements in attainment for pupils in the most deprived wards. The proportion of young people from the most disadvantaged wards entering higher education has significantly increased to 46% of the total entering higher education. Pupils from minority ethnic groups do well at school and better than comparable groups nationally. Pupils with special educational needs and/or disabilities make very good progress and achieve well above average standards at GCSE for this group. Many inequalities are still evident in health outcomes and this remains a

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Leadership and management Grade 2 (Good)

key challenge for the area. Accessing the hard-to-reach and most vulnerable families also remains as a key challenge. Hartlepool achieved the challenging level 3 Equality Standard in December 2008. Further work has been undertaken to embed fully equality impact assessments across all activities and develop outcome-focused objectives. Information gathering, monitoring and data management for all groups, including by ethnic minority groups, have improved and are used effectively to target resources and to meet specific needs.

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Leadership and management Grade 2 (Good)

44. Value for money is good. Informed choices are being made about service costs and quality with examples of effective joint service commissioning, de- commissioning and contract development. There are also good examples of joint working with neighbouring local authorities and health partners in order to achieve best value and to increase capacity. These include agreement on agency staff recruitment costs, emergency duty arrangements and Hartlepool Inspection of safeguarding and looked after children 19

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Leadership and management Grade 2 (Good)

benchmarking placements. The voluntary sector is contributing in a constructive and innovative way and in many instances adding resources to commissioned projects. HSCB and the Children’s Trust have a good awareness of the local social care market and strive to achieve a good balance of services to enhance user choice and value for money. Management information is used well to monitor commissioned services. Outcomes for children and young people and scrutiny arrangements are outstanding leading to significant changes in the ways services are delivered to maximise the use of available resources. Hartlepool Inspection of safeguarding and looked after children 20

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Overall effectiveness Grade 2 (Good)

45. The effectiveness of services for looked after children and care leavers is good. The Children’s Trust provides good leadership, resulting in a shared vision and agreed priorities for sustained improvement. Statutory requirements are met including those for care, assessment, planning, review, and social worker visits. Long and short-term placement stability has steadily improved over the last three years, as a result of careful placement matching and good support to foster carers. Elected members demonstrate a strong commitment to corporate parenting and are champions for looked after children and young people. They offer good challenge and appropriate scrutiny of performance and meet regularly with looked after children and young people. All looked after children are allocated to appropriately qualified social workers. Outcomes for looked after children and care leavers are good and demonstrate that the council and

p.22

Overall effectiveness Grade 2 (Good)

its partners are meeting individual needs by providing safe care. There are low rates of criminal offending. Partnership working at all levels and between agencies is child-focused and committed to improving outcomes for looked after children and young people.

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Overall effectiveness Grade 2 (Good)

46. A good range of surveys and events provide looked after children and young people with a variety of opportunities to contribute to service improvements. This has led to changes in the way in which services are delivered, for example, increasing the range of opportunities for young people to contribute more to their own reviews. Targets for improving services are ambitious and consistently met. Performance for long and short term placement stability has shown sustained improvement over the last three years with targets being exceeded despite comparatively small numbers in the looked after cohort. A range of themed quality audits has been conducted and this is leading to measurable improvements in service, for example, in assessment processes and general case recording.

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Overall effectiveness Grade 2 (Good)

47. Good workforce planning has ensured that all looked after children are allocated to qualified social workers who have access to a comprehensive training programme and development opportunities. Good partnership working underpins key strategies for meeting the needs of looked after children and young people, including their health, education and social care needs. Appropriate arrangements are in place, through specialist and dedicated posts within the partnership, to target particular needs including emotional and mental health, substance misuse and sexual health. Hartlepool Inspection of safeguarding and looked after children 21

p.22

Capacity for improvement Grade 2 (Good)

48. The partnership has good capacity for improvement. The analysis of need across the partnership is good including for looked after children and young people. A good range of preventative services to keep children and young people appropriately out of the care system and teams around the primary and secondary schools are very effective. Although much has already been done to change perceptions of statutory services and to enhance early support services, partners acknowledge that there is a need to develop more innovative approaches for families who are most difficult to engage or reluctant to accept services. Quality assurance processes within children’s social care have been reviewed and strengthened with the introduction of a new audit tool. These processes have rightly focused on initial responses, assessment and safeguarding as opposed to the quality of care planning and direct work. Case files examined by inspectors showed improving practice in assessment, direct

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Capacity for improvement Grade 2 (Good)

work and care planning, although the format used for care plans is not always user-friendly. The council is working with systems suppliers to remedy this.

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Capacity for improvement Grade 2 (Good)

49. The partnership is self-aware and reflective and takes steps to ensure that it is proactive in meeting the needs of its population. There has been a 33% increase in looked after children over the last three years. As a result the authority has undertaken a review of new looked after children to examine the process of decision making. The review has concluded that the decisions made in the 21 cases examined were appropriate and made helpful recommendations which are likely to improve outcomes for children on the edge of care. With the introduction of personalised care and direct payments, there has been a change in the requirement of services and the partnership has already reviewed the use of a home providing respite care. As a result, there are plans to change the use of this home to accommodate the needs of children with moderate challenging behaviour, which will provide further capacity to support children and their

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Capacity for improvement Grade 2 (Good)

50. The commitment of managers and staff is high and morale amongst the workforce is good. A stable, committed and well motivated workforce shows determination to achieve good outcomes, has high aspirations for looked after children and consistently refers to providing services as if for their own children. However, caseloads in social care teams can be high at peak times and staff sometimes feel over-stretched. Managers are responsive to these stresses and take action to increase capacity, to enhance co-working opportunities and to provide additional support. Corporate parenting responsibilities are fulfilled and there is a sustained track record of improvement in most areas, with targets consistently met and looked after children and young people and care leavers achieving good outcomes. Recent structural change has resulted in co-locating the ‘settled care’ team with the leaving care team who are also co-located with

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Capacity for improvement Grade 2 (Good)

Connexions. This has enabled more consistent management of the teams overall. Children, young people and their parents who met inspectors felt their views were considered and expressed satisfaction with the services they had Hartlepool Inspection of safeguarding and looked after children 22

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Capacity for improvement Grade 2 (Good)

received. Children and young people spoke positively about their carers, social workers and schools. Regional commissioning of support services such as advocacy and independent visiting is good. There is one preferred provider for fostering and spot-purchasing of specialist residential care as required. Procurement processes actively promote safeguarding arrangements.

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Areas for improvement

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

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Within three months:

ƒ Care plans for looked after children and pathway plans for care leavers should be improved to ensure they are more specific in respect of objectives and timescales and are in a format that can be readily shared with looked after children, young people, parents and carers.

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Within three months:

ƒ Ensure that health records for looked after children and young people are up-to-date and contain clear and measureable plans which are readily accessible by looked after children and young people.

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Within three months:

ƒ Ensure that all young people leaving care receive a copy of their health history in a format that is clear and understandable and assists them in securing continuous health support.

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Within six months:

ƒ Independent Reviewing Officers should ensure that discussions and challenges prior to or during reviews are fully recorded and that agreed action arising are also appropriately documented.

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Within six months:

ƒ Ensure staff supervision records are fully incorporated within the electronic recording system and that the system readily facilitates access to the records.

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Outcomes for children and young people

52. Services to promote the health of looked after children are adequate. Carers of looked after children and young people are very aware of their role in promoting healthy lifestyles but their training is currently under-developed including in foster care preparation and development opportunities. Specialist nurses for looked after children and young people are co-located with the ‘Through-Care’ team, which facilitates good information exchange on new looked after children and young people and hospitals. Daily meetings held to Hartlepool Inspection of safeguarding and looked after children 23

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Outcomes for children and young people

screen cases and ensure that emergency and urgent cases are seen quickly. Health assessments are good overall, although record keeping and plans are inadequate in terms of their consistency, quality and identification of service objectives. Up to date health assessments and plans are in place for 97% of children and young people, 100% are registered with a GP, 98% have immunisations completed, and 94% have been checked by a dentist. Accident and Emergency information systems flag looked after children and young people as well as those adults with consenting rights and responsibilities. The older looked after children have a weekly evening health drop-in run by a specialist nurse and this is valued by young people, who felt that it was meeting their health needs. There have been four pregnancies with the year 11 looked after female cohort within the last 18 months (to January 2010). The partnership is very aware of this particular issue and is making strenuous

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Outcomes for children and young people

efforts to raise awareness and aspiration and to reduce conception rates. There is a dedicated social worker in CAMHS funded by the council and this post has enabled effective access to services. CAMHS also provide regular consultation opportunities for social workers and carers and this has prevented placement breakdown and supported school attendance.

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Outcomes for children and young people

53. CAMHS training is not currently available for foster carers but meetings have been held to establish their needs, leading to a training programme due to commence this September. The council has recently funded an assistant psychologist to review 100 questionnaires (strengths/difficulties) completed mainly by foster carers and teachers. CAMHS open cases can be appropriately identified and cross referenced to the questionnaires. Although there is no fast track access to CAMHS for looked after children, an access system based on clinical risk is working well.

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Outcomes for children and young people

54. There is good access to dental services which incorporates a specialist referral protocol for anxious children and children with special needs. Following a recent drop in dental attendances, dental hygienists have been commissioned to promote good dental hygiene session for looked after young people. All cases where looked after children and young people do not attend dental services are actively followed up and good effort is made to provide services around the individual needs of looked after children and young people. Education psychologists take their corporate parenting role very seriously and respond well to the needs of individual children and young people. Early access to educational psychology services is the same for out-of-area placed children both from Hartlepool and other local authorities placing children within the area. This is good practice.

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Outcomes for children and young people

55. Children and young people who are looked after, including care leavers, are prioritised and benefit from good quality safeguarding arrangements. Commissioning and procurement processes are robust and kept under constant review through statutory visits and by statutory reviews. All children and young people are allocated to suitably qualified social workers and care leavers have allocated personal advisors. Most children are placed with foster carers within 20 miles of Hartlepool and the few children who are placed further afield are Hartlepool Inspection of safeguarding and looked after children 24

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Outcomes for children and young people

well supported by local professionals from health, education and social care to ensure that their welfare is safeguarded and promoted. A comprehensive range of multi-agency services for looked after children supports placement stability and disruption meetings are held to inform future placement choice where needed. There is improving placement stability through better matching of placement to need and increased placement choice. Looked after children and young people live in stable and appropriate placements which provide good quality care and support. The quality of placements is regularly monitored and multi-agency care planning ensures that outcomes are regularly reviewed. Over 89% of looked after children have directly contributed to their reviews in the last year. Participation of looked after children and young people in reviews has been relatively stable over the last three years and represents adequate

p.26

Outcomes for children and young people

performance. Children and young people indicate they know who to speak to if they are worried about something and have good awareness of the complaints procedure and copies of their care plans. Robust systems are in place to track and follow up children and young people who are missing from care. All children and young people surveyed as part of this inspection stated they felt very safe and only one stated they felt fairly safe. Children and young people spoken to by inspectors confirmed that they felt safe in their placements.

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Outcomes for children and young people

56. The impact of services in enabling looked after children and young people to enjoy and achieve is good. Education and multi-agency support for children and young people who are looked after is well-targeted to need through the work of the virtual school and the strong collaborative approach of schools and other agencies. Schools have an inclusive approach and demonstrate a high level of commitment to ensuring that looked after children and young people have good opportunities to achieve as highly as possible. Their progress is carefully monitored and children and young people have up- to-date, regularly reviewed, and good quality personal education plans. National comparative performance data are suppressed because cohorts are so small. However, local authority data and tracking information indicate that most looked after children and young people make at least adequate progress.

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Outcomes for children and young people

57. Overall outcomes in tests and examinations at Key Stages 2 and 4 are lower than they are for looked after children and young people nationally and this remains a priority for the authority. However, many make good progress from their starting points, including children with special educational needs and/or disabilities. Highly effective provision in both mainstream and special schools is making a positive difference to the enjoyment and achievement of children with profound or complex special needs. All looked after children and young people have a personal laptop which aids them in their schoolwork. The virtual school headteacher regularly monitors plans for quality and tracks progress. Care is taken to place looked after children and young people in good schools, including those placed out of area. School placements are stable and where a move is necessary for the welfare of the child, it is managed well.

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Outcomes for children and young people

Transition planning is of good quality, ensuring continuity in learning and personal development. Support for looked after children and young people is a high priority in all schools and is of good quality. The fully inclusive approach Hartlepool Inspection of safeguarding and looked after children 25

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Outcomes for children and young people

ensures that looked after children and young people receive appropriate support and are included in all aspects of school life. Attendance has been a focus area and is rigorously monitored by the local authority inclusion officer. Good support to schools, carers and children and young people has helped schools steadily reduce absenteeism so that the attendance of looked after children is currently above the national average and consequently the rate of persistent absenteeism is low. Schools work effectively together to ensure that there are no looked after children or young people permanently excluded. The numbers who are excluded for a fixed term remains low. Early intervention strategies and good targeted support help looked after children make good gains in their personal development. The children who spoke to inspectors were extremely positive about the support they have received in schools for both

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Outcomes for children and young people

their personal development and academic achievement.

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Outcomes for children and young people

58. Opportunities for looked after children to make a positive contribution are good. Those who spoke with inspectors were positive about how they contribute to key decisions in their life. Those of school age are regularly involved in completing their Personal Education Plan (PEP), reviewing their progress and setting personal targets. There is good provision through PEPs to ensure looked after children and young people can participate in a wide range of enrichment activity relevant to their needs and interests. Additional funding is used to support their full participation. Recent examples include funded places at riding and then jockey school, and support with costs of clothes and travel to participate in a dancing competition. Looked after children and young people also have free access to regional museums, cultural, sports and leisure facilities. Care leavers are aware of their pathway plans and feel that they now

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Outcomes for children and young people

have good opportunities to influence key decisions with the ‘Through Care’ team.

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Outcomes for children and young people

59. Looked after children and young people contribute effectively to strategic planning and developing quality services through their work on the Corporate Parent Forum, the Multi-agency looked after children panel (MALAP) and the Children Services Scrutiny Forum. They have contributed to interviews of senior officers and were involved in the appointment of the Director of Children and Adult Services. A group of young people have been accredited in recruitment and interview skills. Schools ensure that looked after children and young people have a voice in decision making bodies and encourage them to take positions of responsibility and make choices about their education. The young carers scheme provides imaginative programmes to enable young people to have a voice in the services they receive and to participate fully in their own planning. Young people stated that they and their families had been given considerable

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Outcomes for children and young people

support by the project and this had helped them find space to see friends, attend school functions and to have the space to undertake homework, school projects and to prepare for important examinations.

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Outcomes for children and young people

60. Good preventative work with children and young people at risk of anti- social behaviour and strong partnership approaches to prevent offending have produced good outcomes for looked after children and young people. The Hartlepool Inspection of safeguarding and looked after children 26

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Outcomes for children and young people

police-led triage system is helping to avoid criminalisation and support young people who have committed low level misdemeanours or anti-social behaviour. The small number of looked after children and young people known to the Youth Offending Service are receiving additional support from inclusion officers and placement support workers to ensure good quality education and personal development continue. Multi-agency support for vulnerable children and young people of school age is very effectively planned and delivered through teams around the school. There is a high level of commitment to this preventative and supportive approach from a wide range of agencies, including police, social care, health and voluntary sector agencies.

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Outcomes for children and young people

61. The impact of services in enabling looked after children and young people and care leavers to achieve economic well-being is adequate. There are some notable strengths in provision and accurate self-review is informing planning for further improvements. Small cohorts mean that local data are subject to year on year fluctuation. Young people receive good support, through Key Stage 4 PEPs, to help them access the most appropriate progression routes post-16. Good collaborative work between schools, alternative providers, the local college and work placements has helped to prepare young people for entry into a broad range of further education and employment. Those who are difficult to place receive mentoring support and practical help. For example, the council provides work experience and placements for up to six months to bridge the employability gap. The proportion of 16 year old care leavers in employment, education or training is

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Outcomes for children and young people

improving and is broadly in line with the national average for care leavers. However, the retention rate of care leavers in education, training and employment is less secure and 46% of former looked after young people aged 18 or over are currently not in employment, education or training. The small numbers of care leavers who are in custody are receiving regular visits and educational support to enable them to gain qualifications. Two former looked after young people are currently being supported through higher education. Support from Connexions advisers and the ‘Aim Higher’ programme is helping care leavers to raise their aspirations and make positive choices about the future.

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Outcomes for children and young people

62. Arrangements for transition into independent living are satisfactory. There has been an increase in the percentage of care leavers accessing suitable accommodation and most needs are met. Further supported lodgings are shortly to become available. A dedicated link worker effectively supports the development of independent living skills. Care leavers are generally satisfied with the level of financial support they receive and the council makes good efforts to ensure their aspirations are being actively fulfilled. Care leavers have access to services to support their mental health needs although the council recognises there is still some scope for improvement in transition planning. Pathways for care leavers with behavioural or social difficulties are generally well-planned with the exception of those with autistic spectrum disorders which are under-developed. Young people are not routinely given their personal

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Outcomes for children and young people

health information when they leave care. Hartlepool Inspection of safeguarding and looked after children 27

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The quality of provision Grade 2 Good

63. Service responsiveness is good with comprehensive preventative services in place for the majority of children and young people on the edge of care. The rate of looked after children is rising from a comparatively low base. A recent review of 21 cases of looked after children and young people who were new entrants to the care system recommended a sharper focus on providing preventative services to support those who may be more resistant to engage with services. The family group conference service is relatively new and it is anticipated this will enable more families to be supported within family networks. All looked after children cases are allocated to a suitably qualified social worker. There is good evidence of safe decision making regarding thresholds and appropriate use of authority to protect children. The ‘team around the primary school’ and ‘team around the secondary school’ are effective in identifying vulnerable children. The family support service has

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The quality of provision Grade 2 Good

recently re-organised and there is concern that the volume of contact supervision taking place is depleting the availability of intensive family support. To ensure equitable allocation of resources, access to family support is now through the newly established resource and placement panel chaired by the Head of Business Unit.

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The quality of provision Grade 2 Good

64. The complaints service is robust and there is evidence that complaints are responded to promptly and that outcomes are reported to the senior management team. However, there have been no consistent themes identified that would assist in learning. All looked after children and children in need have access to independent advocacy and there is an independent visitor scheme in operation. There is good awareness of the local authority designated officer (LADO) and allegations management is robust and effectively protects children and young people. The ‘ACORN’ therapeutic service, although currently under capacity, provides good targeted support to looked after and non-looked after children. Resources are well managed and management information is used well to improve services and identify needs. For example, a recent review of the respite care centre indicated that it had been under-utilised for the last ten

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The quality of provision Grade 2 Good

years. The use of this home has now been changed to enable children with moderately challenging needs to be supported. There is highly effective direct work with children and young people which supports consistently improving outcomes for looked after children and young people. Social workers report that this is aided by the current team structures which enable direct work in the through-care team to be protected. Visits to looked after children and young people exceed statutory requirements, reviews are held in accordance with timescales, and a good number of children and young people provide their views to their reviews. Children and young people spoken with had copies of their care plan and were fully aware of the complaints process.

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The quality of provision Grade 2 Good

65. An outstanding scrutiny review of fostering recognised that the service is good and made helpful recommendations to strengthen this provision. Collaboration with a preferred provider independent fostering association supports the high number of children benefiting from foster care. Foster carers Hartlepool Inspection of safeguarding and looked after children 28

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The quality of provision Grade 2 Good

report that they are well supported by a range of multi-agency services and that there is out-of-hours support. Where necessary, specialist placements are spot-purchased and procurement practice supports safeguarding. Children who are placed outside of the borough benefit from the same support as children placed locally; arrangements are made to ensure that they have access to leisure and they are visited and supported by social care, health and education staff from the borough. The Star Centre, which is based in a former children’s home, has been re-established to deliver services to looked after children and young people, including those not in education, and hosts a wide range of useful activities.

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The quality of provision Grade 2 Good

66. Assessment and direct work with looked after children, care leavers and their families are good and the assessments completed including the use of assessment and progress records. All of the cases viewed showed evidence of good outcomes for children and young people and in most there was effective analysis of historical information and some use of research to inform current judgments. Chronologies were in place in most cases but the quality was variable. There was strong and effective use of authority to protect children and evidence of assessments being reviewed and used to change care plans, for example, in decisions to rehabilitate children to birth families following court proceedings. However, not all assessments were documented in a sufficiently clear manner, and in a minority there had been delay in implementing some decisions following statutory reviews, although this did not affect the overall

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The quality of provision Grade 2 Good

outcomes for the children. The dedicated specialist nurses for looked after children and young people follow up all out of area placed children and young people and also provide a good service to looked after children and young people placed in the area by other local authorities in order to ensure their health needs are identified and action is taken to address them. Although there is no current and targeted mental health service for schools, plans are in place to establish this service by August 2011. In the meantime, practitioners are making good use of the ‘teams around’ schools model.

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The quality of provision Grade 2 Good

67. Decision making around the Public Law Outline is good but the family group conference service is under-used to enable families to use their own strengths to bring about change. In the cases viewed, there is evidence that direct work provided through the multi-agency network has improved placement stability, school attendance and self-esteem. This has prevented repeat offending and promoted sexual health awareness through home safety and baby-sitting skills programmes. The latter are well attended and have offered good quality and targeted support.

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The quality of provision Grade 2 Good

68. The quality of case planning, for looked after children and young people is adequate. The business unit manager chairs all permanency plans which has enabled close tracking and avoidance of drift. Care plans are generally up-to- date but they are not always in a user-friendly format which means that parents, children and young people sometimes find them difficult to understand. Not all care plans are comprehensive and tasks are not always clear with measurable objectives. The partnership is aware of this and working Hartlepool Inspection of safeguarding and looked after children 29

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The quality of provision Grade 2 Good

with the systems supplier to rectify this. Disruption meetings are being used following placement breakdown and learning is utilised to influence future care plans. Disabled children and their families are well supported with a range of multi-agency support services including respite care. The allocated social worker acts as the lead professional and co-ordinates the care package and outcomes for children in cases viewed were very good. CAMHS staff indicated that the provision of services for looked after children and young people has not been consistently effective in the past but this issue has recently been addressed and additional resources have been allocated by commissioners. Recent evidence indicates that the consistency of CAMHS delivery is improving.

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The quality of provision Grade 2 Good

69. Case reviews for looked after children are adequate. They are timely and held in accordance with statutory requirements. Independent Reviewing Officers (IROs) hold a caseload which ensures they are able to be a consistent feature in the lives of looked after children and young people. There is evidence that IROs provide effective challenge and that differences of opinion are discussed appropriately and to the benefit of children and young people. However, in some cases, reviewing officers did not evidence that they had reviewed the decisions made at a previous meeting and the quality of recording in reviews is variable. Although there are agreed systems for dispute resolution between IROs and the operational service these are not routinely recorded on the electronic recording system. Children report that they have the opportunity to contribute to their reviews, although IROs do not always meet them in

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The quality of provision Grade 2 Good

70. Case recording is generally up-to-date and of an adequate standard. However, it does not always indicate whether the child or young person was seen alone. The views of children and parents are not always recorded. Case summaries of the visit are of satisfactory quality but do not routinely analyse the content of the visit or how the actions in the care plan are being undertaken. Chronologies are available on most files examined although the quality is variable. Management oversight and supervision are not routinely recorded on the electronic case record. The electronic recording system was found to take a great deal of practitioner’s time and there is scope to streamline the system.

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Leadership and management Grade 2 (Good)

71. The council provides strong and visible leadership to safeguard looked after children and young people through the Corporate Parenting Forum (CPF). Looked After children and young people and foster carers are actively involved and feel able to contribute. Through the leadership of the CPF, a scrutiny review of accommodation for 16 and 17 year olds has been undertaken resulting in new provision being commissioned. Children and young people are actively involved in a range of strategic planning meetings including outstanding scrutiny arrangements. The Children and Young People’s Plan places a high priority on the needs of looked after children and young people and all actions identified are being implemented. The draft looked after children and young Hartlepool Inspection of safeguarding and looked after children 30

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Leadership and management Grade 2 (Good)

people’s strategy is comprehensive and based on a sound analysis of strengths and weaknesses. Priorities for action are appropriately ambitious and effectively support improved practice for looked after children, young people and care leavers. Commissioning of children’s placements which includes some regional commissioning is well developed and promotes safeguarding. The contract monitoring process specifically monitors safeguarding outcomes. Managers from all partner agencies contribute well to the delivery of priorities and the MALAP provides a good forum for steering and implementing operational priorities set out in the Children and Young Person’s Plan. This has supported the implementation of the strengths and difficulties questionnaire to identify the emotional well-being of looked after children and young people and provide support and interventions where needed. Evaluation of practice is used to

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Leadership and management Grade 2 (Good)

secure service improvements. For example, the review commissioned to evaluate decision-making of children recently becoming looked after indicated that this was sound and identified a number of helpful recommendations which are being implemented.

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Leadership and management Grade 2 (Good)

72. Evaluation, including performance management, quality assurance and workforce development, is good. Structures and frameworks are in place to track a wide range of performance indicators on a regular basis. For example, the senior social care management group tracks performance monthly to ensure targets are being met or remedial action taken to deal with any deficiencies. Performance information is routinely reported to the Children’s Trust and other boards. Self-evaluation and audit arrangements are in place including single agency, joint agency and thematic audits. Thematic audits have included decision making about newly looked after children and supervision. The recently introduced quality standards in children’s social care provide a good framework for effective practice. However, the quality assurance tool currently in use is over-focused on procedural compliance and less on quality. Some key aspects of practice are not fully recognised within the tool such as

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Leadership and management Grade 2 (Good)

legal status, ethnicity and religion and this limits its effectiveness. The council recognises these limitations and is taking steps to strengthen the tool. The council and partners audited 28 randomly selected cases prior to the inspection. This demonstrated the capacity to be self-critical of some aspects of practice.

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Leadership and management Grade 2 (Good)

73. The supervision policy states that fortnightly supervision is provided and staff reported that supervision was regular, supportive and beneficial. However, case files examined did not consistently reflect the reported quality of practice discussions or routinely check that previously agreed actions had been completed. Decisions made were not always transferred to the electronic recording system. Procedures for safe recruitment are sound and there is a requirement that all recruitment panels involve a member of staff who has been trained. Workforce planning has led to the secondment of support workers to social work training and this is building capacity within the workforce. Newly qualified social workers are appropriately protected and supported. There is a stable workforce and very limited use of agency staff. However, caseloads for experienced staff are increasing and staff have indicated this may limit their

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Leadership and management Grade 2 (Good)

effectiveness. Senior managers are aware of this pressure, are closely Hartlepool Inspection of safeguarding and looked after children 31

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Leadership and management Grade 2 (Good)

monitoring any negative impact and will seek additional capacity if required. There is a good record of responding to additional demands.

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Leadership and management Grade 2 (Good)

74. User engagement is good with some examples of outstanding practice in all settings. There are good opportunities for children and young people to meet with elected members and senior managers. The involvement of looked after children and young people and care leavers in service planning, training events, consultation events, service delivery and their individual care review is good. They feel listened to and their views influence outcomes in a meaningful way, for example changes to the way their views are heard at statutory reviews, development of leaflets to accompany strengths and difficulties questionnaires. The virtual school headteacher sets high expectations for looked after children and young people and these ambitions are shared and prioritised exceptionally well in schools. The virtual school is highly regarded by schools. The quality of the partnership provides outstanding challenge and

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Leadership and management Grade 2 (Good)

support and strong teamwork is bringing about improving outcomes for looked after children and young people in most outcome areas. Detailed and accurate virtual school self-review supports good quality action planning which is fully focused on outcomes and the most important areas for improvement. Training and professional development for school staff are reported to be of outstanding quality by designated looked after children teachers. There are good participation opportunities for older looked after children and care leavers which are helping to improve confidence and build self-esteem. This has resulted in one care leaver gaining employment with the Youth Offending Service, and one gaining a council apprenticeship. There is a regular news letter ‘Chat-Box’ which is produced by children in care and circulated to all those in care. There has been some specific work with the younger age range, for example ‘Cook 4 Fun’

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Leadership and management Grade 2 (Good)

is run by an older young person in care for younger children in care. The young people’s council has agreed the pledge which was launched in August 2009 and is currently considering how best to monitor the implementation of the pledge. The authority commissions services for independent visitors and advocacy through a regional consortium.

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Leadership and management Grade 2 (Good)

75. Partnership working to meet the needs of looked after children young people and care leavers is good and is established at both strategic and operational levels. The council and partners provide effective leadership for looked after children and care leavers. Vision and priorities are clearly articulated at strategic and operational levels. A wide range of services such as CAMHS, police, children’s social care, health and education teams work effectively together through children in care meetings. There has been a recent re-organisation of the settled care and leaving care teams in order to enhance partnership working and co-working, including the Connexions service. The third sector is well engaged in service delivery and there are strong relationships in place with a range of providers such as Barnardo’s and Harbour. Regional commissioning with five other local authorities for advocacy services

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Leadership and management Grade 2 (Good)

and services for independent visitors are robust and well-monitored for quality and outcomes. Hartlepool Inspection of safeguarding and looked after children 32

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Leadership and management Grade 2 (Good)

76. Care is taken to match individual, social and cultural needs of looked after children and young people in foster placements as far as possible. Hartlepool participates in the North East Sahara project in a drive to recruit more foster carers from minority ethnic groups and to raise awareness of young people’s diverse cultural and social needs amongst white British foster carers. Placement stability has improved and the proportion of looked after children and young people experiencing three or more moves is below the national average. The very few asylum-seeking children who enter the care system are well provided for. Every effort is made to meet their language and cultural needs. Carers of children with special needs and complex disabilities are highly satisfied with the quality of support. The all-inclusive approach evident in schools and across all services means that looked after children and young

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Leadership and management Grade 2 (Good)

people have good access to a full range of enrichment activities and fully participate in school life. The young carers project is sensitive to the diverse needs of children and their families, has explicit policies in respect of equality and diversity and can demonstrate good outcomes in this respect.

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Leadership and management Grade 2 (Good)

77. Value for money is good. Specialist placements are commissioned as required and most children and young people are placed within reasonable travelling distance from Hartlepool to enable school attendance and contact to be preserved. There are effective arrangements in place, within the regional consortium, to purchase external placements within agreed price limits and service quality. The area has a thorough understanding of the local social care market and there are good examples of partnership working to achieve value for money from the resources available. Financial management across the partnership is good with effective scrutiny and oversight. Informed choices are made about the balance of services to meet assessed need and the partnership has a good understanding of the needs of the looked after population and the services required to meet these needs. Scrutiny arrangements are outstanding

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Leadership and management Grade 2 (Good)

with good examples of work to achieve innovative approaches to a range of important services. The Children’s Trust receives performance data from which to measure the impact of the services provided. A cohort of 50 children and young people are being monitored to evaluate the impact and effectiveness of joint services and to ensure services remain relevant to need and promote improved outcomes. Hartlepool Inspection of safeguarding and looked after children 33

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Record of main findings: Hartlepool

Safeguarding services Overall effectiveness Good Capacity for improvement Good 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 Good

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Record of main findings: Hartlepool

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

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Record of main findings: Hartlepool

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

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Record of main findings: Hartlepool

User engagement Good Partnerships Good Equality and diversity Good Value for money Good Hartlepool Inspection of safeguarding and looked after children 34

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Record of main findings: Hartlepool

Services for looked after children Overall effectiveness Good Capacity for improvement Good Outcomes for looked after children and care leavers Being healthy Adequate 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 Adequate Leadership and management Good Ambition and prioritisation Good Evaluation, including performance management, quality assurance and workforce development Good

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Record of main findings: Hartlepool

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

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