looked after children services

Inspection of looked after children services Medway Council

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Inspection dates: 15-19 July 2013 Reporting inspector Sarah Urding HMI

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Age group: All Published: 23 August 2013 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 Medway Council Inspection of safeguarding and looked after children 1

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Record of main findings 24

Medway Council 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 to the quality of service provision for looked after children and care leavers. The inspection team consisted of five of Her Majesty’s Inspectors (HMI) and one additional inspector. The inspection was carried out under under section 136 of the Education and Inspections Act 2006

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About this inspection

2. The evidence evaluated by inspectors included:

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About this inspection

 discussions with children and young people receiving services, front line staff and 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

 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

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About this inspection

 a review of 29 case files for children and young people with a range of need in addition to sampling pathway plans and personal education plans. This provided a view of services provided over time and the quality of reporting, recording and decision making undertaken

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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 Good (Grade 2) A service that exceeds minimum requirements Adequate (Grade 3) A service that only meets minimum requirements Inadequate (Grade 4) A service that does not meet minimum requirements Medway Council Inspection of safeguarding and looked after children 3

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Service information

4. Medway Council has approximately 65,000 children and young people under the age of 19 years. This is 24.5% of the total population. The proportion entitled to free school meals is 16%, which is below the national average. Children and young people from minority ethnic groups account for approximately 20% of the total school age population, compared with 17% in the country as a whole. The largest minority ethnic groups are 3.1% Black African and 2.4% White Eastern European. The proportion of pupils with English as an additional language is 11%, which is lower than the national figure.

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Service information

5. At the time of the inspection there were 400 looked after children and 209 with care leaver status. Children looked after are supported in a range of placements; 127 Medway foster carers, caring for one or more children; one children’s home and commissioned placements from 52 external providers. Medway has in place a virtual school to support learning for looked after children.

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Service information

6. Services for the majority of looked after children and young people leaving care are provided by the Medway Looked after Children’s Team, with the rest provided by the Safeguarding, Children with Disabilities and Referral and Assessment Teams.

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Service information

7. Medway Council has an early help offer for children and families on the edge of care provided within the Partnership Commissioning Division and Inclusion Division of the local authority and in cooperation with other agencies. Services are delivered through a range of settings including 19 children’s centres; schools and community settings; youth settings; and via partnership arrangements with, for example commissioned services from the community and voluntary sector. Medway Council Inspection of safeguarding and looked after children 4

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Grade 4 (Inadequate)

8. The judgement for overall effectiveness is inadequate .

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Grade 4 (Inadequate)

9. Medway staff and managers are working hard to improve service provision for looked after children. Since Ofsted’s inspection of child protection arrangements in January 2013, which highlighted significant weaknesses, work has focused on ensuring all children are safe. Inspectors identified that action to strengthen other services is now being taken. However, many changes have been recent and have not yet had the opportunity to impact, so deficits within services for looked after children remain. Inspectors saw no looked after child at immediate risk of harm. However for children and young people entering and leaving care, not all cases have an up-to-date assessment that fully sets out the current risk factors. It is therefore not possible to determine if opportunities were missed for children to become looked after at an earlier stage or if risks are being identified and reduced when children return home. Overall outcomes for

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Grade 4 (Inadequate)

children and young people looked after are poor in relation to their emotional health and wellbeing; their educational achievement and continued opportunities for education, employment and training.

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Grade 4 (Inadequate)

10. There are delays in the completion of initial and review health assessments and notifications of arising children’s health needs by social workers to the looked after children nurse. The looked after children’s nurse is not consistently informed about children becoming looked after. Child and adolescent mental health services (CAMHS) are not sufficiently meeting the needs of looked after children. The quality of personal education plans is too variable and they do not reflect a holistic understanding of the child; although an improving picture is seen in relation to care leavers in employment, education and training, performance remains significantly below that of comparators.

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Grade 4 (Inadequate)

11. Since the appointment of the Director of Children’s Services (DCS) in September 2012, an increasing clarity of service priorities has been developed and focused action taken to provide a solid foundation for moving the service forward. Appointments to key posts have been made and are already improving some aspects of service provision for children albeit from a low starting base. For example, since April, changes in the management and delivery of the independent reviewing officer (IRO) service is bringing improved focus on outcomes in care planning; IRO’s are providing consistency to children in the absence of a stable workforce with improving performance seen in relation to visiting children prior to their reviews and in the monitoring of plans in between reviews. However, there remains drift and delay in the monitoring of cases for some children Medway Council Inspection of safeguarding and looked after children 5

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Grade 4 (Inadequate)

because of inconsistent social work management oversight and the provision of a clear, recorded rationale for decision making. The recent introduction of a principal social worker role is focusing on quality assuring the work of social workers via a series of audits. However, this is not yet ensuring consistency in the quality and timeliness of assessments and plans or a timely assessment of risk in all cases. The local authority has, as part of this work, been robust in identifying very recently that currently a high proportion of looked after children’s cases when audited are inadequate. This is helping to inform a focus for improvement. An escalation protocol with Cafcass has been formalised and there has been a reduction in time spent in pre proceedings and proceedings. However, children and young people looked after still experience delay due to some poor quality social work assessments and frequent changes of social

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Grade 4 (Inadequate)

worker. Plans to improve services include increasing the focus on feedback from children and young people. A customer relationship adviser is now collating and evaluating complaints from children and young people and improving complaints accessibility. However, children and young people are not yet consistently informed by social workers about complaints or how to access an advocate.

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Grade 3 (Adequate)

12. The local authority is actively addressing inadequacies in service provision for looked after children. However many of the changes are very recent or are not yet fully implemented and it is too soon to see the impact of these changes in relation to improving outcomes for looked after children.

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Grade 3 (Adequate)

13. The looked after children service is benefitting from the establishment of an improvement board following the child protection inspection in January 2013. The local authority appointed an experienced independent chair in April 2013. Monthly meetings have started and an adequate draft plan for improving the quality of provision is in place. Further work is being undertaken to strengthen the plan and a programme manager has been appointed to oversee its planning and delivery.

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Grade 3 (Adequate)

14. The inspection of safeguarding and looked after children arrangements in August 2011 judged overall effectiveness for looked after children as adequate. Some progress has been made in meeting recommendations relating to the provision of life story work for children and there are clear and effective contracting and monitoring arrangements in place for the commissioning of external placements. Action has been taken to address staffing shortages within the looked after children health teams and it is anticipated that this will improve the ability to provide timely assessments of children’s health needs. However, there is as yet no clear strategy for commissioning for individual services for children in place. This awaits the Medway Council Inspection of safeguarding and looked after children 6

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Grade 3 (Adequate)

jointly funded appointment between Medway Council and Medway Clinical Commissioning Group of an Assistant Director for Partnership Commissioning. This post was recruited to in June 2013 with the postholder commencing on 1 August 2013 to lead the strategic planning and commissioning for children who are looked after.

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Grade 3 (Adequate)

15. The local authority has taken prompt action to address the shortfalls identified in their own children’s home provision. Following an inadequate inspection outcome at an Ofsted inspection of The Old Vicarage in December 2012, the latest inspection in May 2013 judged the home as making satisfactory progress. Medway Council appointed a private provider to manage the service in July 2013.

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Grade 3 (Adequate)

16. Governance has been strengthened in order to focus the contribution of the Local Authority and partners on improving outcomes for looked after children. Proposals are in place to replace the children’s trust with Medway Children’s Action Network and there is a new and experienced chair of the local safeguarding children board (LSCB). The Corporate Parenting group is being refreshed in recognition of the need to reprioritise looked after children. Led by the recently appointed, lead member, a strengthened corporate parenting strategy is currently being developed. The local authority has not only protected services for looked after children amidst significant cuts in local government funding but has also made considerable investment to improve services and respond to the growing numbers of looked after children. Overarching priorities are coherently identified within the council plan and these are aligned with the health and

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Grade 3 (Adequate)

wellbeing strategy and underpinned by a local assessment of need. However, the looked after children strategy and placement strategy are currently in draft form and do not yet reflect a coherent ‘golden thread’ in service delivery or identify consistently clear targets in all areas.

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Grade 3 (Adequate)

17. There is an appropriate workforce strategy in place and activity is focussed on achieving workforce stability. Proposals in place to realign children’s services are underpinned by a professional capabilities framework produced by the College of Social Work and this integrates role descriptors and professional standards for social workers, managers and employers. The competencies of the framework have already been incorporated into the latest job profiles of Medway social workers. These recent changes have yet to impact on a clear understanding for social workers about role expectation and awareness of departmental policies and procedures. The review of the system is designed to promote efficient workflow between social work teams and improve the quality of practice through improved and accountable management structures. This demonstrates a good understanding of the current weaknesses in service provision.

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Grade 3 (Adequate)

18. Further capacity has been created to manage the proposed changes by an extended handover period between the interim Assistant Director for Medway Council Inspection of safeguarding and looked after children 7

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Grade 3 (Adequate)

children’s services and the permanent Assistant Director, who was recruited in February 2013 and took up post on 8 July 2013. The authority is committed to ensuring that the right people are appointed to the right posts. The appointment to the role of service manager for looked after children in April 2013 is providing greater scrutiny and challenge to improve services. The next step recognised by the authority is to secure more stability in the frontline social work service to improve the quality of practice.

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Grade 3 (Adequate)

19. The views of some looked after children and care leavers are effectively contributing to service improvements. For example, in the recruitment of senior managers; training foster carers and about how reviews can be improved. There is an active and well-established Children in Care council. However, more needs to be done to ensure that the majority of looked after children can contribute and benefit. As currently not all looked after children and young people are well informed, for example about access to free leisure passes; advocacy and the complaints procedures.

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Areas for improvement

20. In order to improve the quality of provision and services for looked after children and young people in Medway, the local authority should take the following action.

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Immediately:

 ensure there is a clear and documented analysis of risk evident for all children and young people who are entering or leaving care

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Immediately:

 ensure the timely notification by social workers to the looked after children nurse of children becoming looked after and information about children’s health care needs

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Immediately:

 improve the quality and consistency of management oversight and decision making, in particular ensure managers clearly record their decisions and the supporting rationale for the decisions made

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Immediately:

 ensure that social workers inform looked after children and care leavers about the complaints process and the advocacy service available to them so that they can effectively convey their views and influence the development of services they received.

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Within three months:

 Complete initial health assessments for looked after children within statutory timescales and provide timely completion of health histories to assist care leavers in their transition Medway Council Inspection of safeguarding and looked after children 8

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Within three months:

 ensure that an appropriate CAMH service is available for looked after children and care leavers to support their emotional health and wellbeing

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Within three months:

 routinely undertake robust, evidence based assessments of the changing needs of children looked after that reflect children and young people’s views and experiences and inform planning

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Within three months:

 ensure that children’s care and pathway plans are outcome focused and routinely reviewed by managers

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Within three months:

 continue to improve the quality and use of personal education plans to raise the attainment of looked after children and care leavers and narrow the education and training attainment gap between them and the rest of the children and young people in Medway

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Within three months:

 ensure that children experience consistent relationships with social workers who know them well and ensure that their holistic needs are met

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Within three months:

 continue to reduce drift and delay for children and young people by robust independent reviewing officer challenge and the implementation of a range of rigorous performance management mechanisms

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Within three months:

 improve the quality of case file audits to capture the experience of children and young people and make an assessment of their outcomes against a set of clear criteria.

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Within six months:

 embed the use of the new electronic recording system to ensure a coherent understanding of the child’s journey

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Within six months:

 Raise awareness of a range of initiatives introduced to support and develop looked after children and young people, such as the availability of free leisure passes, the Children in Care Council and its role in supporting looked after children and care leavers to enable looked after children to maximise their life chances

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Within six months:

 improve the communication with and training of foster carers, social workers and care leavers’ personal advisors and promote post 16 options to help them make sense of and to compare, for example the staying put policy, education and training opportunities, the quality and value of pathway and transition planning, to support care leavers in making informed choices about their future life Medway Council Inspection of safeguarding and looked after children 9

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Grade 4 (Inadequate)

21. Outcomes for looked after children and young people are inadequate.

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Grade 4 (Inadequate)

22. Health outcomes for looked after children (LAC) and care leavers are inadequate. There are often significant delays by social work staff in the notification of looked after children requiring initial health assessments as well as sharing relevant information with LAC health team nurses. This contributes to delays in health assessments and can impair their quality. The resolution of this issue is currently under discussion between the designated looked after children nurse and senior managers and is acknowledged as an area requiring urgent improvement.

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Grade 4 (Inadequate)

23. Due to nurse shortages in the looked after children health team too many initial comprehensive health assessments for children looked after and care leavers within and outside Medway are in breach of the 28 day timescale as are looked after children health reviews and adoption health assessments. There are similar delays in the completion of health histories to assist transition for care leavers. Medway Clinical Commissioning Group has agreed funding to increase the number of nurses in the team to an adequate level and it is anticipated that the current inadequate delays in assessment will abate when recruitment is completed later this year. The LAC health nursing team works closely with paediatric clinicians where more specialist advice, assessment and treatment are required. Various approaches are being used to increase the level of young people over 16 to take up health assessments and advice, which takes into account their

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Grade 4 (Inadequate)

diverse needs, including a drop-in centre approach. However, this area of work is not effective and attendance rates by young people are a recognised area for improvement.

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Grade 4 (Inadequate)

24. There are adequate arrangements in place to ensure effective physical care of looked after children and care leavers. Immunisations occur on time and there is no delay or difficulties reported for accessing dental treatment. Similarly effective arrangements are in place for out patient care and looked after children nurses are notified when children looked after and care leavers attend A&E or receive in-patient care. Looked after children nurses attend or contribute to most statutory reviews. However, the emotional and mental health needs of children and young people are not being met and outcomes for too many are inadequate. The contract for provision of Child and adolescent mental health services (CAMHS) provision was recently awarded to the Sussex Partnership NHS Foundation Trust who is committed to the development of a small dedicated CAMHS Medway Council Inspection of safeguarding and looked after children 10

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Grade 4 (Inadequate)

team for Medway as well as access to adolescent psychiatry from within the Kent Medway contract. Although very recent progress has been made on clearing waiting lists for assessment, timely access to appropriate treatment for looked after children, adopted children and care leavers is still reported as inadequate. The new dedicated service provision is operational and fully on track as per the mobilisation plan. In the meantime the council is in some cases using alternative provision such as that provided through NSPCC’s ‘Letting the future in’ or Action for Children’s specialist therapy for children traumatised by sexual abuse. Some social care staff are also being trained in the use of recognised therapies to try and meet some of the high and increasing needs.

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Grade 4 (Inadequate)

25. The looked after children health team provides adequate focused health promotion activities and in particular various targeted preventative and awareness training courses on health issues to foster carers and care staff. Education and advice for colleagues including mental health training at tier 1 is also provided. Young women who are looked after or care leavers and those at risk of pregnancy or sexual disease are seen, if known, by sexual health nurses. Looked after children nurses can provide advice or appropriate onward referral of looked after young people who are mothers or pregnant.

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Grade 4 (Inadequate)

26. The looked after children health service ensures that children placed outside Medway receive appropriate and adequate physical health care. Many of these children are placed in Kent and all of these are assessed and reviewed by the Medway LAC Health nurses. For those children and young people placed in other local authorities adequate reciprocal agreements are in place to ensure effective health provision which is monitored through the Medway looked after children health team and through the statutory visiting and review process.

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Grade 4 (Inadequate)

27. The arrangements for ensuring looked after children and young people are safe are adequate. In all cases tracked, appropriate decisions were taken for children and young people to become looked after. However, the quality of risk assessment for children entering and leaving care is not sufficiently robust. Chronologies are not used consistently to inform decisions and historical assessments and records are often of such poor quality that it is not possible to determine if opportunities were missed for children to become looked after at an earlier stage. Similarly, the safety of decisions to rehabilitate children to their families is not always securely evidenced. For example, in one case examined a child has very recently been rehabilitated to the care of his parents without a risk assessment being undertaken. To address these deficits the local authority has introduced a new recording system and a children’s accommodation and

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Grade 4 (Inadequate)

placement panel (CAPP) to monitor children and young people entering the care system. Medway Council Inspection of safeguarding and looked after children 11

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Grade 4 (Inadequate)

28. Effective multi-agency arrangements are in place to safeguard children and young people missing from care and for care leavers under 18. A well- developed council database reliably coordinates incidents and there is effective sharing of relevant information between the council departments and the police as well as proactive monitoring where repeat absences or missing episodes occur. There is evidence of sustained promotion and appropriately targeted training around the risks of child sexual exploitation for looked after children and care leavers.

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Grade 4 (Inadequate)

29. Engagement of agencies in planning for looked after children is variable. Attendance at looked after reviews is inconsistent, as is sharing of information as this is often reliant only on the individual commitment of professionals. There are good arrangements including a comprehensive database in place to enable investigation of allegations made concerning staff within the children’s workforce with access to looked after children and care leavers. Agencies and providers are aware of the referral system and where appropriate, investigations are carried out thoroughly. Referrals appropriately come from a broad range of agencies and providers.

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Grade 4 (Inadequate)

30. Adequate arrangements are in place for the monitoring of care placements both in and outside Medway. Statutory visits and reviews are largely timely although records do not consistently record whether the child is seen alone. There is recent evidence of more pro-active monitoring by IRO’s between reviews. With the exception of one of the council’s own children’s homes, which is now being run by a private provider, all children and young people are in placements judged adequate or better. A high number of children are placed in foster care either in Medway or within 20 miles of the authority. Placement stability is good and slightly above that of the England and statistical neighbour average. In cases examined children are experiencing stable and supportive care. However, it is acknowledged that there is drift in identifying the permanency plan and securing permanency including adoption. For children whose plan has

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Grade 4 (Inadequate)

identified adoption, appropriate effort is being made to reduce timescales to placement. For some children in their current placements statutory duties are not consistently fulfilled. For example, one child was placed for a substantial period in an unregulated friend and family placement.

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Grade 4 (Inadequate)

31. Arrangements to enable looked after children and care leavers to enjoy and achieve are inadequate. Attainment for looked after children is variable. In 2011/12 the percentage of looked after children obtaining 5 GCSEs graded A*-C including English and mathematics was particularly low at only 9%. The prediction for the current academic year is better at 17%, but still low and well below the national average. In 2011/12 at Key Stage 2 the percentage of children looked after reaching the expected level in English, Mathematics combined was low at 19%. The predicted outcomes for 2012/13 are significantly better at 47%. Medway Council Inspection of safeguarding and looked after children 12

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Grade 4 (Inadequate)

32. The performance gap between looked after children’s attainment and that of the wider school population within Medway has widened. The virtual head teacher maintains clear and accurate records of attainment and monitors looked after children’s progress against their personal education plan targets regularly. The rate of progress and achievement has not yet kept pace with all children’s progress and attainment within the local authority. The authority has an effective recording system that enables wider equality and diversity factors to be taken into account when recording attainment. Helpful records of the progress of looked after children placed outside of the local authority area are incorporated into the system.

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Grade 4 (Inadequate)

33. The head of the virtual school has implemented robust quality assurance arrangements and recent improvements in the quality of some personal education plans can be seen. However, the quality of personal education plans remains variable overall. There are examples of good practice with detailed records and involvement of the child in the process of completing the plan. In these examples, targets are specific, measureable and time- bound. In poor examples, records are perfunctory, with little sense of the child’s perspective or involvement. Clear and helpful guidance has been produced to direct and support designated teachers to devise accurate and effective personal education plans for looked after children.

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Grade 4 (Inadequate)

34. Looked after children receive effective support from designated teachers to enable them to access education in their schools and participate in school life. Permanent exclusion rates are good with no permanent exclusions for looked after children, however fixed term exclusions are just above the national rates but no looked after children were classified as persistent absentees. Financial support from the pupil premium enables a wider range of educational opportunities for looked after children to help them catch up, maintain or exceed their learning targets.

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Grade 4 (Inadequate)

35. Opportunities for children, young people and care leavers to make a positive contribution are adequate. Children and young people generally report they enjoy varied hobbies and leisure activities and are supported by foster carers to attend clubs, activities and family days out which is aided by initiatives such as free leisure passes. However, not all looked after children and care leavers are aware of this provision. Efforts to engage looked after children in youth service activities with participation recorded and analysed are appropriate. A good number participated in activities that led to planned outcomes including accredited achievements. However, participation rates are low at 17.5%. In some cases good efforts are made by social workers to successfully secure inclusive leisure activities for children with disabilities.

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Grade 4 (Inadequate)

36. Children looked after and care leavers make a good contribution to and help organise events and activities that show both their achievements and their influence in improving services. They speak out about their Medway Council Inspection of safeguarding and looked after children 13

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Grade 4 (Inadequate)

experiences of care to inform training and staff selection processes and helped with for example, the selection of the assistant director for children’s services.

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Grade 4 (Inadequate)

37. Independent reviewing officers are increasingly visiting children in placement between reviews, positively engaging children and gaining their wishes and feelings which are formally presented at looked after children reviews. A workshop undertaken with a group of children to enable them to chair their own looked after children review supported by the independent reviewing officer has been effective with 66 young people being supported to chair their reviews over the last year.

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Grade 4 (Inadequate)

38. The Children in Care Council is well established and very effective in working with the local authority. It has a central role in ensuring the local authority hears the voice of children in care and listens to their concerns, but has yet to reach the wider looked after children population. Looked after children involved in the Children in Care Council receive very effective support in developing good communication skills and achieve considerable gains in confidence to speak out about matters that concern them through the advocacy work of the Young Lives Foundation.

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Grade 4 (Inadequate)

39. The Children in Care Council has had an active involvement in training foster carers, social workers and others involved in supporting looked after children and care leavers in Medway. However survey reports to gain the satisfaction levels of looked after children have not been consistently used or successful. Looked after children have been unaware of specific surveys disseminated and say that the views of looked after children are usually sought through reviews or general conversations. A postal survey was carried out in July 2012 of 111 looked after children with only 10 responses which were generally positive about the independent reviewing officer service. Learning indicated that the methodology for 2013 needed to be changed to include face-to-face meetings to illicit meaningful information.

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Grade 4 (Inadequate)

40. A satisfactory and established annual reporting process outlines information on the number and type of social-care complaints, comments and compliments that Medway Council have received during the period April 2012 to March 2013. Social workers reported that they do not routinely advise looked after children on how they can make a complaint. An advocate service is available but information about this not routinely provided by social workers. Independent reviewing officers advise children of their right to complain both at looked after children reviews and when they visit young people in their placement. Information supporting effective informal resolutions, with the support of the Young Lives Foundation, is not currently captured to draw lessons from themes and improve the service. Although the recent appointment of a customer relationship officer in April 2013 is improving the collation of complaints.

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Grade 4 (Inadequate)

Medway Council Inspection of safeguarding and looked after children 14

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Grade 4 (Inadequate)

41. Multi-agency working to prevent offending and re-offending is adequate and well established. There are effective working linkages between the Integrated Preventive Service, Youth Offending Team, Police, Medway Integrated Looked after Children (MILAC) team and Medway Youth Trust. Between 2011/12 and 2012/13 the total number of looked after children and young people open to the Youth Offending Team reduced from 60 to 36. During the same periods however, the numbers of looked after children re-offending has only reduced from 14 to 12. The cohort of re- offending looked after children present complex and significant problem behaviours.

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Grade 4 (Inadequate)

42. The impact of services to improve the economic wellbeing of looked after young people and care leavers is inadequate. The education and training performance gap between looked after children and the national average for all pupils post 16 has not closed. In 2011 the percentage of children who were looked after and in full-time education at the end of compulsory schooling was 69%, lower than statistical neighbours and the national average. Some 21% were unemployed, much higher than comparators. Medway Council has recently taken positive action to overcome barriers to care leavers’ participation post 16 years, supported by the Medway Youth Trust and wider partners. The percentage of looked after children and care leavers not in education employment or training at June 2013 was 26% which is an improvement on the previous quarter at 30%.

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Grade 4 (Inadequate)

43. A good range of education and training provision is available at post 16 including a wide range of vocational options . For example, good provision has been made available for six vulnerable young people aged 16-25 years offering a robust multi-agency package to promote healthy lifestyles; educational/training opportunities through colleges or apprenticeships and preparation for independence. Active relationships with information, advice and guidance and sexual health providers, support the package. All young people gain a life skills accredited qualification as a minimum outcome. An adequate number of care leavers are accessing higher education.

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Grade 4 (Inadequate)

44. In many pathway plans young people’s views are clearly, if briefly expressed. The quality of recording in pathway plans is variable, with better ones providing detailed and comprehensive information with clear targets set, whereas others are brief and unhelpful. Care leavers report that they had made a contribution to their plans and many had these routinely updated. However some pathway plans sampled were poor with incomplete information, no objectives, actions or responsible people identified.

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Grade 4 (Inadequate)

45. Many transition plans are good. They contain a clear and detailed record of care leavers’ future plans, needs and aspirations and the range of support and further development needed to get them to where they want to be. Good engagement with the Youth Employment Service through the Medway Council Inspection of safeguarding and looked after children 15

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Grade 4 (Inadequate)

designated personal advisor is effective and young persons’ views are taken into account.

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Grade 4 (Inadequate)

46. Medway offers good access to suitable accommodation for care leavers with 90% of care leavers in suitable accommodation at aged 19 in 2011/12 which is higher than comparators with the most recent data showing an improvement at 95.9%. Medway enabled 15 young people aged 18 or over to remain in their foster placement in 2011-12. The staying put policy is only very recently developed but offers clear guidance to practitioners in relation to the provision of continuing support for young people in foster placement beyond the age of 18. This is underpinned by a set of outcomes focused priorities for care leavers. Clearly defined aims of the service set out to meet the diverse needs of young people and equip them and support them for independent living. Not all social workers are aware of this.

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Grade 4 (Inadequate)

47. The quality of provision is inadequate.

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Grade 4 (Inadequate)

48. Decisions made for children and young people to become looked after are not yet timely in all cases. Numbers of looked after children, while decreasing, remain higher than statistical neighbours. Risk is not clearly or consistently identified or assessed by social workers and managers and there is generally poor recording by managers as to their rationale for decision making. During the inspection, two cases were referred back to the local authority highlighting delays in decision making about children coming into care. This has been compounded by high caseloads in the contact referral and assessment team where there has been a high turnover of staff and where some looked after children cases are held.

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Grade 4 (Inadequate)

49. Expectations for conducting on-going assessments of needs and risks for looked after children are not well defined or consistently applied by operational managers and social workers. Although examples were seen of thorough and current assessments of needs, inspectors found too many cases where assessments of looked after children were absent or insufficiently recent to identify current needs. This included assessments of need presented by social workers to looked after children’s reviews. Too many assessments are limited and do not lead to a comprehensive understanding of children’s holistic needs. There is variability in accessing specialist assessments in relation to emotional needs and mental health, with some good assessment work undertaken by the Tavistock. However, in other cases this was insufficient to address the child’s needs.

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Grade 4 (Inadequate)

50. In response to identified weaknesses in assessments, senior managers established a weekly children’s accommodation and placement panel Medway Council Inspection of safeguarding and looked after children 16

p.17

Grade 4 (Inadequate)

(CAPP) in May 2013 to bring consistency to risk assessment and decision making about whether a child needs to be looked after or remain in care. CAPP is well attended by a range of agencies, including the looked after children’s nurse and is chaired by the assistant director for children’s services. This brings appropriate scrutiny to decision making. When cases are presented to panel there is an appropriate and clear focus in relation to the threshold to care, a move of placement and permanency planning. Cases are regularly reviewed and there is early evidence to indicate that monitoring by CAPP is reducing some drift and delay and contributing to an appropriate decrease in looked after children. Although this is not yet the case for all children and young people the addition of a Permanence Panel is expected to drive down drift and delay further.

p.18

Grade 4 (Inadequate)

51. The Legal Gateway Panel (LGP) is beginning to show some recent impact with children in pre-proceedings processes reducing from 45 weeks to 32 weeks. Similarly, the length of legal proceedings is reducing from a very low base of 53 weeks to 46 weeks. However, this is still above the accepted timeframe and many children are waiting too long for resolutions about permanence.

p.18

Grade 4 (Inadequate)

52. Considerable variability is seen in relation to the voice of the child underpinning assessments and despite children being seen regularly by their social worker their views are not routinely recorded. There is variability also in relation to assessing the impact of individual children’s needs arising out of culture, religion, language, gender and disability. However, some individual examples of positive work were seen. For example: in relation to securing appropriate leisure facilities for children with disabilities; external training has been provided to staff to assist their understanding of the cultural needs of children from Eastern European families; work of the Valuing Parents Service is supporting timely care planning for children of parents with learning difficulties and reducing the need for care through community support for some children.

p.18

Grade 4 (Inadequate)

53. Not all children have up-to-date plans and as result the care planning for children and young people is not of sufficiently good quality with a number of plans being absent or inadequate. Too often plans are generalised and do not reflect specific actions due to the weakness in assessing children’s needs. Actions arising out of reviews are not always time specific or have not been effectively monitored to ensure actions are completed. Independent reviewing officers (IROs) do not consistently receive an updated care plan prior to each looked after children review and as a result care plans are being developed within review meetings. The IRO annual report indicates that this was the case for 26% of reviews held in 2012/13. In many of the cases seen by inspectors too many significant actions had not been progressed between reviews and this was causing drift and delay for children. Medway Council Inspection of safeguarding and looked after children 17

p.18

Grade 4 (Inadequate)

54. IRO’s are recently becoming more effective in contributing to the improvement of planning in cases for looked after children. IRO consistency for children is good and increasing numbers of children are being visited by IROs prior to their reviews. As a result, recent reviews show a clear reflection of the child’s views and an improved understanding of children’s needs. This is in the absence of social worker assessments and is contributing to a more informed understanding of the appropriateness of current care plans. The interim appointment of a Principal IRO in March 2013 has sharpened the focus of the IRO role and there is very recent evidence of IROs monitoring progress of plans in the last two months with clear challenge in relation to drift and delay being exercised.

p.19

Grade 4 (Inadequate)

55. Arrangements for reviewing the plans for looked after children are not yet timely for all children. Although there is improving performance, with 87.5% of reviews being held within timescale as at March 2013, the local authority accept that this not yet good enough. A system has been introduced whereby only the service manager can agree to the postponement of a review. Where reviews continue to be postponed there is evidence that this is only in circumstances that have a child focus and most are re-convened promptly although just outside the statutory timescale.

p.19

Grade 4 (Inadequate)

56. The local authority has a sustained track record of avoiding unplanned changes in placement with high number of children remaining in placement for more than two years. The local authority’s own data shows that while there has been a slight dip in performance in the last year, performance continues to be above that of statistical neighbours. Children who experience three placements or more remains stable and is in line with statistical neighbours. In cases tracked, children are experiencing good placement stability and good efforts are made to avoid unplanned changes. Foster carers report that they feel well supported by their supervising social workers and commissioned services say that matching children to appropriate placements is well considered.

p.19

Grade 4 (Inadequate)

57. A permanency panel is in the process of being developed and soon to be launched to scrutinise the progress of plans for children who are unable to return to the care of their parents. This is not yet in place and as a result the local authority cannot be confident that permanency plans are being progressed sufficiently swiftly for children. There was drift and delay in some of the case files seen. Recent plans considered by the CAPP and the LGP give good attention to considering a range of permanent alternative placements at the outset. These include good efforts to identify connected persons who are formally assessed by the fostering service. However, in some cases seen securing the permanence of children when they are not able to return to their family home was delayed. IROs until very recently have not been sufficiently robust in their challenge when plans are known to be drifting. Medway Council Inspection of safeguarding and looked after children 18

p.19

Grade 4 (Inadequate)

58. Plans are developed appropriately for some children to return home. Family group conferences are used well to identify support networks within the family in these circumstances. Family support workers undertake intensive good quality work to improve parenting and provide support to some families. However, in some cases, the planning and support to families after children have been rehabilitated is not well coordinated and in some instances delayed. In one case seen by Inspectors local authority procedures were not followed which resulted in a child being discharged from care without the IRO being alerted and before a comprehensive risk assessment was undertaken.

p.20

Grade 4 (Inadequate)

59. Due to a high turnover of staff, recent changes to organisational structures and system transfer points, children are experiencing too many changes of social workers and this is contributing further to the drift and delays that children experience. A lack of consistency in key worker for some children has hindered engagement and the building of positive relationships. Although there were some examples of good practice where social workers were able to demonstrate to inspectors that they knew the children well and were able to clearly convey their views. Care leavers have also expressed their dissatisfaction with the current arrangements for allocation of their cases to the duty system. This is under review by the local authority with plans in place for the formation of a separate team for care leavers with allocation of all cases to personal advisors. Significant improvements have been made through concerted performance

p.20

Grade 4 (Inadequate)

management to improve the timeliness of visits to looked after children. However, records of visits demonstrate a lack of purpose and it is not always clear whether children are seen alone.

p.20

Grade 4 (Inadequate)

60. The local authority has made a considerable investment in a new electronic recording system to improve the quality and coherence of children’s records. At the time of the inspection the authority was part way through, and on-track with, planned migration work from a legacy system to the new electronic recording system. As a result some records were held on both systems causing some variability of practice between teams. The migration onto the new system is due to be complete by Autumn 2013. Currently there is no coherent overview of children’s lives with the quality of records ranging from good to inadequate and whilst records seen are up to date, there are significant gaps in recordings with too many key documents absent, incomplete or inaccessible.

p.20

Grade 4 (Inadequate)

61. From a starting point of a very low base the local authority and its partners, led by the DCS, demonstrate recent ambitious leadership in a programme of planned improvements and structural change that was Medway Council Inspection of safeguarding and looked after children 19

p.20

Grade 4 (Inadequate)

accelerated by the judgements in the January 2013 child protection inspection. The subsequent notice of improvement which resulted in the implementation of the improvement board in April 2013 marked the beginning of complex and fundamental whole service change. However many of the changes are very recent or are yet to be implemented and it is too soon to see an impact in relation to improved service provision and outcomes for looked after children and care leavers. Quality of management oversight is improving but is not yet sufficiently driving improvements in frontline practice.

p.21

Grade 4 (Inadequate)

62. A new independent chair of the LSCB appointed in May 2013 is ambitious and confident that she can drive real change and acknowledges that the Board requires strengthening and a more focussed drive to become fully effective. To support this, an independently commissioned review of the Board’s effectiveness has been completed and reports in September 2013.

p.21

Grade 4 (Inadequate)

63. Senior leaders acknowledge that service development within children’s social care has been hindered by a lack of robust senior management direction and poor awareness of their service issues between October 2011 and Autumn 2012. Since the appointment of the new DCS in September 2012 an appropriate understanding of key priorities for looked after children has emerged. All of the work undertaken since the last child protection inspection has added to what is now a more accurate understanding of the service’s strengths and weaknesses at a strategic level.

p.21

Grade 4 (Inadequate)

64. It is less evident at an operational level whether managers understand the current weaknesses. For example, managers are unable to easily articulate the progress of cases, what stage their care plans are at or how many children are awaiting adoption/permanence. This means that inspectors cannot be confident that if delay was a feature that it would be quickly identified or dealt with. The council has recognised this and recent initiatives such as the CAPP panel, increased IRO scrutiny, improvements to the Legal Gateway Meeting and the setting up of a permanence panel, discussed elsewhere in this report, suggest that tackling drift in the system is now a high priority.

p.21

Grade 4 (Inadequate)

65. Changes to governance arrangements between strategic groups further demonstrates ambition and the Children’s Trust arrangements have now ended. In September 2013 a new partnership arrangement Medway CAN (Children’s Action Network) will take its place. The planned changes are positive, coherent and evidence clear vision and ambition to improve. Governance will be further strengthened by the introduction of an internal performance board chaired by the deputy leader of the council. However, these changes are too recent and too few have been fully implemented to demonstrate impact on outcomes for children. Medway Council Inspection of safeguarding and looked after children 20

p.21

Grade 4 (Inadequate)

66. The local authority’s high level strategic plan, the Best Start in Life Strategy is underpinned by a series of priorities which include looked after children as a key part. Commitments to children in care are outcome focused and measurable in relation to some corporate targets. These include increasing levels of participation in reviews as well as looked after children achieving five A-C grades at KS4. However, the strategy acknowledges the need to establish baseline data for events such as placement breakdown and recurrence of referrals to provide a robust basis for future target setting. There are similarly no set targets yet between initial health assessment and the commencement of treatment and/or support of carers or service provision for adopted children and their parents. Operational targets at team or service level are set at the children’s social care performance board and some are clearly set out in

p.22

Grade 4 (Inadequate)

the performance scorecard. Targets are benchmarked with other South East region authorities and performance compared on a quarterly basis.

p.22

Grade 4 (Inadequate)

67. Medway have a long-established corporate parenting group which includes a representative from health. The corporate parenting panel have championed some initiatives to add value to the experience of looked after children by challenging professionals to improve outcomes. For example, challenge to health partners about performance of completing health assessments has resulted in a marked improvement in compliance to a rate of 87%. The group also have secured funds providing individual bursaries for looked after children and for example are funding a young woman to complete her master’s degree at university. However, the local authority and the group itself acknowledge their effectiveness and record of challenge requires improvement. They have little direct contact with children and young people apart from annual children in care council events. Further, they have had little direct involvement in challenging

p.22

Grade 4 (Inadequate)

performance. There are plans to include looked after young people’s membership on the Corporate Parenting Group and to set up more regular meetings between Children in Care Council members and service managers.

p.22

Grade 4 (Inadequate)

68. Much work and sustained effort by senior managers has resulted in the development of a satisfactory performance framework and they have created a discrete performance intelligence hub for children’s social care. However, performance management and evaluation are not yet embedded and have only recently been implemented in a systematic way. As a result it is too early to see any meaningful or sustained impact. Since April 2013 fortnightly performance board meetings are held where all performance is scrutinised and areas of poorer performance are considered in more depth. For example, the timeliness of statutory visits. Service managers and their management teams attend the board and are held to account for performance and to report on remedial actions to be taken. Recently appointed managers acknowledge that many elements of looked after children and care leaver provision require improvement. The LSCB chair

p.22

Grade 4 (Inadequate)

acknowledges that the present quality assurance and performance sub- Medway Council Inspection of safeguarding and looked after children 21

p.22

Grade 4 (Inadequate)

group of the Board are not using available data for looked after children as effectively as possible and arrangements will need to be strengthened over the next year.

p.23

Grade 4 (Inadequate)

69. In December 2012 a quality assurance framework was developed and piloted between then and Feb 2013. The framework was fully implemented in May 2013 and audits have been undertaken in May and June. Whilst this is a positive development audit reporting is not yet sufficiently robust. For example, in respect of looked after children the audit makes one finding against a range of factors for looked after children such as care plans, leaving care issues, delays and children’s voice in assessments. However, the grade descriptors do not include looked after children in the area for judging assessments and they are only explicitly considered in care planning and reviews. All cases are judged against recording and supervision/management oversight. This results in the report not identifying exactly what specific changes need to take place to raise standards of practice.

p.23

Grade 4 (Inadequate)

70. The local authority has a track record of performance monitoring via a performance score card. This has had an impact in most areas monitored, showing improved performance, albeit for some areas from a low baseline. For example, the percentage of care leavers not in education, employment and training. However, the current score card does not cover all areas where improvements are required. For example, no data is monitored in relation to permanence. Some operational managers’ report system difficulties in being able to monitor compliance with the full range of statutory duties. This includes the completion of pathway plans, pathway plan reviews and whether care plans are updated following reviews.

p.23

Grade 4 (Inadequate)

71. The quality of frontline management oversight is weak. While social workers receive regular supervision, the quality of the recording of this is inadequate; is not sufficiently child centred; is overly focused on process and reactive to current incidents with very limited evidence of holistic reviewing of children’s circumstances and the outcomes of interventions. There is insufficient evidence of challenge to poor practice and evidence was seen of management instructions to social workers not being complied with resulting in no updated plan or assessment of children’s needs. This makes it challenging to trace a child’s journey or understand why things have happened. However, social workers report that immediate line managers are responsive, available and give clear direction on cases as and when needed. In the contact, referral and assessment team, caseloads are unacceptably high at around 40 and managers have

p.23

Grade 4 (Inadequate)

as yet been unable to address this and reduce caseloads to an acceptable level. Proposals are in place to restructure the service and create a team specifically for children in need cases but as yet that has not been implemented. Medway Council Inspection of safeguarding and looked after children 22

p.23

Grade 4 (Inadequate)

72. Commissioning activity is well established although there is presently no overarching strategy in place. This is currently being developed by the recently formed Partnership Commissioning Team. The team is a co- located joint commissioning team comprising the council and health. Governance arrangements are satisfactory with social care reporting to the cabinet and health to the clinical commissioning group (CCG). Budgets are pooled and the team focusses on areas where the two services overlap to meet need. Services are monitored robustly by the joint commissioning board in relation to outcomes, performance and value for money. However, the recently commissioned child and adolescent mental health service, which social workers and carers consistently report does not adequately meet the needs of looked after children, is according to the commissioning team data performing well. Inspection of case records

p.24

Grade 4 (Inadequate)

evidenced substantial delay in vulnerable young people accessing this service and no comprehensive assessment of the impact to their emotional wellbeing is being undertaken. In a very small minority of cases, and only as a result of tenacious work by case holding social workers, young people were accessing services provided by third sector or independent providers.

p.24

Grade 4 (Inadequate)

73. The sufficiency duty is met and responsibility is held by a sufficiency panel comprising housing, social care and commissioning partners. Care leavers are given priority in relation to supported accommodation and looked after children placements are provided via a mixed economy of private and public providers. Foster placements are procured in a preferred provider arrangement in conjunction with Kent County Council via the Kent Framework. Providers are required to alert the council when they are inspected and in addition the placement team routinely monitor provider reports. If a provider judgement moves from good to adequate they are required to provide an action plan which is monitored via a face-to-face monthly meeting.

p.24

Grade 4 (Inadequate)

74. A well co-ordinated multi-agency early help strategy ensures that children are well supported and this prevents escalation to the point at which care would be considered. Evidence based models of targeted, DfE funded, intervention are being used successfully with some very complex families. While they have yet to be formally evaluated family/professional feedback is positive and supported by outcome focused targets being met and sustained.

p.24

Grade 4 (Inadequate)

75. Medway has not had an effective workforce plan until very recently because prior to the appointment of the current DCS workforce issues were not given sufficiently high priority. Senior managers describe the change since her appointment as ‘phenomenal’ and that workforce development is now fully included in all strategic improvement planning. Recruitment and retention of social workers and managers has been problematic for Medway for a considerable time and current plans have not had time to fully impact. This has resulted in an unstable workforce, many changes in social worker for children and inconsistent competency. Medway Council Inspection of safeguarding and looked after children 23

p.24

Grade 4 (Inadequate)

In addition the authority have been heavily reliant on agency and interim workers to cover vacancies and although this is reducing several temporary staff are still in post.

p.25

Grade 4 (Inadequate)

76. Until very recently when the procurement of agency workers was brought under centralised control this, at times, led to poor quality staff being recruited. However, very recent plans have started to be implemented and a more positive picture is emerging. Good, coherent plans are in place to deliver a comprehensive programme of professional development and performance management with appropriate priorities that include management development, leadership, up-skilling the children’s social care workforce and targeted, focussed recruitment. With frontline staff aware and positive of the significant change in culture taking place. Medway Council Inspection of safeguarding and looked after children 24

p.25

Services for looked after children

Overall effectiveness Inadequate Grade 4

p.26

Services for looked after children

Outcomes for looked after children and young people Inadequate Grade 4

p.26

Services for looked after children

Leadership and management Inadequate Grade 4

p.26