Setting

Rachael Wardell, Director of Children’s Services, Surrey County Council Claire Fuller, Chief Executive, Surrey Heartlands Integrated Health and Care Board Fiona Edwards, Chief Executive, Frimley Integrated Health and Care Board Lisa Townsend, Surrey Police and Crime Commissioner Tim de Mayer, Chief Constable, Surrey Police Simon Hart, Independent Scrutineer

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Dear Surrey Local Safeguarding Partnership

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Joint targeted area inspection of Surrey

This letter summarises the findings of the joint targeted area inspection (JTAI) of the multi-agency response to children and families in Surrey who need help.

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Joint targeted area inspection of Surrey

This inspection took place from 6 to 10 March 2023. It was carried out by inspectors from Ofsted, the Care Quality Commission (CQC) and His Majesty’s Inspectorate of Constabulary and Fire & Rescue Services (HMICFRS).

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Headline findings

Children and families in Surrey have access to a broad and predominantly well- coordinated range of family support and early help services. For some children, this support is making a positive difference in their lives. However, not all children are receiving the right help at the right time. Strategic leaders from the police, health agencies and the local authority are developing a greater understanding of practice across the partnership. This is leading to an improved awareness of strengths and the further areas for development. The partnership is investing in a clear shared vision of early help, and they are increasingly working well together. The partnership has engaged well with partners in the community and voluntary sector and the large number of borough councils. Surrey is one of the largest counties in the country, made up mainly of a number of small towns. A strength of the partnership is the

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Headline findings

recognition that not one size fits all and the need to develop the local help offer consistent with local need. The partnership is receptive to internal and external challenge. While improvements have been made, the partnership has not yet had sufficient impact on the quality of early help provision for all children and some inconsistency remains to be addressed across the county.

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Headline findings

Leaders across partner agencies recognise that there is more to do to embed the understanding and delivery of the local early help offer within Surrey. Despite committed and effective work by some schools and education providers, and a desire on the part of the wider partnership to engage with them in the development and delivery of early help services, the joint working between some education providers and the wider partnership of agencies remains weak. Not all children who receive early help services and could benefit from a coordinated plan and an identified lead professional benefit from having these in place. For some children, this limits the effectiveness of the support they are receiving.

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What needs to improve?

 Oversight of the quality and effectiveness of early help provision by the Surrey Safeguarding Children’s Partnership so that the partnership is assured that the right children are receiving timely, coordinated multi-agency support.  Referral agencies and parents being consistently informed of the outcomes of referrals.  Information-sharing between partners, to enable partners to support children more effectively.  When children are stepped down from statutory intervention, the rationale for doing so is always clearly articulated and includes relevant partner agencies’ views and input.

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Strengths

 Referrals about children made to the integrated front door receive timely and proportionate decision-making, resulting in appropriate initial actions to ensure children’s welfare is promoted.  Senior leaders are developing a shared vision for early help in Surrey across the partnership.  The broad range of locality-based early help and family support services available to children and families.

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Main findings

The children’s single point of access (CSPA) is the integrated front door, which receives referrals about children. Decision-making for most children is timely and proportionate to the presenting concerns and needs. Most referrals are made at the right time for children and are screened effectively by professionals in safeguarding partner agencies. The need to gain, and in limited circumstances to override, parental consent is routinely considered and understood by all partners. In a small minority of cases, parents are not informed which agencies will be contacted for information about them and their children, inhibiting their capacity to make informed decisions about whether they agree to such information being sought. The domestic abuse adviser in the CSPA uses their specialist knowledge to help identify the impact of abuse on children. They promptly direct families to the appropriate service. Leaders know there is more to do to ensure that parents and referrers are informed

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Main findings

of the outcomes of activities undertaken by CSPA. Safeguarding partners in the CSPA mostly have a good understanding of thresholds and know what information to share with partners and when.

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Main findings

On receipt of a referral into the CSPA, children’s social care staff, rather than the health practitioners based in the CSPA, determine what health information should be sought. This may limit the opportunity for effective analysis of a broader range of health information and reduce the scope for decision-making based on the holistic needs of the child or family.

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Main findings

Within CSPA, joint triaging of police early help referrals between police and children’s social care provides an opportunity for joint decision-making. All these decisions have a clear rationale recorded.

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Main findings

Daily hub meetings in the CSPA and an extended consultation line for schools allow for case discussion between partners. These helpful discussions provide opportunities for effective information-sharing, to enable children and families to receive the right level of support. This includes children affected by domestic abuse and risks in relation to exploitation.

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Main findings

A weekly multi-agency safeguarding meeting enables health professionals to be made aware of the outcome of their referrals. This multi-agency meeting is well attended by children’s social care and a range of health professionals. This means information-sharing on the outcome of referrals is timely. However, information is not consistently shared with all relevant health services, meaning that not all GPs are aware of the outcome of referrals made about children’s welfare.

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Main findings

Not all children who could benefit from a coordinated multi-agency assessment and early help plan receive one. The quality of early help assessments is variable, and some contain limited information about children and their circumstances. For some children, plans are well matched to need and are used well to monitor progress. However, this is not the case for all children. Targeted early help work is sometimes delivered without being fully coordinated with relevant partner agencies. This increases the risk of duplication, or gaps in support, and can limit how effectively agencies work together to identify increasing risks or children’s changing needs. For some children, there is a lack of professional curiosity and too much focus on parents’ needs. This limits a full understanding of these children’s experiences and needs and increases the likelihood of risks being minimised.

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Main findings

Team around the family meetings are held when children are the subject of support through the family centres and targeted youth support. However, for some children, the frequency of these meetings is not proportionate to presenting need. Although many partners attend and contribute to multi-agency planning, this is not routine for all children for whom wider partner involvement would be beneficial, meaning that for some children there is a lack of a clear and focused joined-up plan. The voice of children is not consistently sought or impacting on the plans for all children. The lived experience of children is not always known and understood. While examples of child-led focused work were seen, this work is not consistent. This limits the understanding of children’s circumstances and needs and reduces the effectiveness of planning for some children.

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Main findings

Children and families have access to a good range of services that form a continuum of early help support. This includes help from a range of community-based organisations. Early help is an ongoing offer and there is generally, though not always, an understanding across the partnership of the variety of services available. Some of these services are community-based and can be accessed without the need for formal referral or assessment, removing some of the barriers that prevent children and families from asking for help when they need it. The range of locality- based commissioned services is enabling an increasing number of children and families to receive help, preventing their needs escalating to a level that needs statutory intervention.

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Main findings

Schools and other education providers are committed to supporting local children and have developed a range of services. However, these services are not always tailored to local need across the county, nor are they always joined up with the wider multi-agency early help offer. Multi-agency information is not always shared effectively, which hampers schools’ ability to give the right help at the right time.

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Main findings

The specialist teaching service for inclusive practice (STIPs) is valued highly by schools, as it provides bespoke support for children, families and school staff. This support draws on the work of other agencies. Education leaders are currently focused on supporting earlier identification of children with additional vulnerabilities, through training and developing school-to-school support. They have also embarked on targeted work with specific schools informed by multi-agency input from social care and health.

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Main findings

Where children’s support needs are easily identified, support is provided and children make progress. However, the commissioned targeted early help work carried out in the family centres and through targeted youth support is increasingly complex. This includes working with increases in parental conflict, adult mental health issues and children with additional needs, including the need for emotional health support. Early help practitioners know their families well and develop strong relationships with them. However, there is not always embedded multi-agency practice with the advantage of specialist knowledge or provision and shared thinking to help practitioners meet the needs of children with more complex needs.

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Main findings

Children and young people with difficulties with emotional well-being and mental health benefit from a significant array of commissioned services. Services such as the ‘Big Brother, Big Sister’ mentoring programme are enabling long-term mentoring relationships to be built between children and trusted adults, to meet children’s needs. However, some staff spoke about long waiting lists to access services. For example, some children requiring support to deal with emotional and mental health difficulties and those who have experienced high levels of entrenched parental conflict are having to wait too long for services. This exacerbates the anxiety of staff in targeted early help when dealing with complex work, leaving them feeling that the complexities of the work exceed their level of training.

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Main findings

Processes to step up children to statutory services are often not robust enough. Such decisions are not consistently made with the input of relevant partners, which inhibits the making of informed decisions based on a clear appraisal of all relevant multi-agency information. When decisions are made for children not to be stepped up, next steps are not explicit in terms of actions to be taken to further minimise risk or to improve children’s well-being. There is no formal review of such decisions to determine whether progress is being made and whether, as a result, a decision in relation to step-up needs to be made. There have been some repeated interventions with some children, meaning they are stepped up and down through services too frequently. As a result, for some children, support can be disjointed and consequently less effective.

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Main findings

Step-downs for children supported by statutory services are not routinely informed by a re-evaluation of risk and need. The input of relevant partners into such decisions is limited, inhibiting the effectiveness of partner agency information in informing such decisions.

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Main findings

Persistent work by targeted youth support workers to engage children is making a difference in the outcomes for some children. Targeted work focusing on the risks of exploitation and safety planning is helping to keep some children safer. There is clear tenacity in engaging with both children and families. Workers work well to help rebuild relationships and they work well in partnership with police and with youth justice and school inclusion services. However, this is not always happening to ensure that all agencies are clear on the purpose of their involvement. Children and young people known to the youth justice service benefit from health assessments from a youth justice nurse, ensuring that their physical and mental health needs are met.

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Main findings

Supervision is provided in all agencies across Surrey. Professionals across agencies value the support they receive from flexible and adaptable leaders. However, the supervision is inconsistent and does not always have an impact on improving outcomes for children and families. Management oversight does not always provide a holistic analysis of progress which measures the impact on children’s outcomes.

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Main findings

Many practitioners across the partnership, including those working with children at lower levels and earlier needs, have relevant expertise, experience and knowledge, but it is not clear how work is matched to the needs of children. Early help staff report they are increasingly working with highly complex family situations above the level they think is appropriate for them. Despite persistent efforts with some families, staff are struggling to progress the multifaceted needs of children. Therefore, some children are not receiving the requisite help and support swiftly enough from the most relevant agency at the right time. While the partnership has developed a clear escalation policy for when partners have differing views regarding the level of intervention children need, some partner organisations do not routinely use the appropriate channels to raise or escalate concerns. Leaders recognise there is a need

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Main findings

for this to be more established and for practitioners and managers to take responsibility for raising issues if they are concerned about the impact of work on children’s evolving situations.

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Main findings

Strategically, partners are developing an understanding of local needs and developing a system of monitoring and quality assuring practice. The joint strategic needs assessment uses detailed data and gives a good overview of the current and future health and social care needs of the population of Surrey. This is enabling the partnership to focus on the local delivery of early help services across the county. This information is being used to inform commissioning decisions based on local need and centres of population, including the 27 largest population centres across the county. Leaders know they have more to do to enhance their understanding of the quality and impact of early help work and consistent understanding of thresholds across the partnership. While some multi-agency audits have focused on aspects of early help, the absence of specific multi-agency audits has hindered the partnership’s understanding of the impact of early help work on improving outcomes for children.

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Main findings

There is a shared commitment across the partnership to engage with children and families to gather their views, influence commissioning decisions and to co-produce services. The partnership acknowledges there is more to do to implement this. In its 2023 work plan, the safeguarding partnership has stated a desire to work more closely with the Surrey User Voice and Participation Team (UVPT) and to bring the views, concerns and priorities of the UVPT user groups into the work of the partnership. While some work has been undertaken to gather the voices of children, such as creating a buddy system between members of the Surrey Safeguarding Children’s Partnership and the UVPT, the impact of this in informing and influencing service delivery is limited.

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Main findings

Leadership and delivery of early help services across Surrey are distributed across the county, reflecting the need to develop the local offer consistent with local need. However, these services would benefit from increased coordination and oversight from the safeguarding partnership. There is a broad range of provision across the county. This is delivered directly by the local authority and partners, commissioned through a number of agencies, including family centres, mentoring support, parenting outreach and a family support programme. Work is underway to develop a partnership model in each district and borough in Surrey which has a consistent offer. Leaders across partner agencies recognise there is more work to do to ensure that all aspects of early help activity and strategy are driven through one strategic governance plan. The partnership is aware of the need to strengthen coordination of early help provision. The development of an early help strategic board, while clearly

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Main findings

designed to improve understanding and coordination of early help provision, is in its infancy, with the terms of reference and membership still being agreed. It is too early to evidence the impact of the board on the coordination and quality of early help services.

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Main findings

The partnership demonstrates a commitment to developing multi-agency training and learning. Training is appropriately focused on key areas of practice such as domestic abuse, adolescent safeguarding and emotional health. There are examples of learning influencing service development, such as the work on prevention of adolescent suicide and sudden unexpected deaths in infants. However, there is insufficient evaluation of its impact in supporting vulnerable children. This is not sufficiently embedded or prioritised across all agencies and there is insufficient evaluation of its impact on improving the quality of the work undertaken in early help.

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Practice study: highly effective practice

Two-year-old Briony has been known to services since she was born, due to concerns relating to neglect and domestic conflict. After a period of statutory child protection and child in need planning, Briony was stepped down to early help in 2023 as sufficient progress had been made to address parenting concerns. An initial early help assessment and plan has been completed and there continue to be no concerns regarding care by her parents. Briony’s parents agree with continued support from early help and are accepting of the help and support offered.

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Practice study: highly effective practice

Multi-agency partnership work has been effective and it is felt that Briony is receiving the right support at the right time, which has made a real difference considering all the historical concerns around her mother’s care of her older children.

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Practice study: highly effective practice

Briony is now thriving under her parents’ care and is meeting her developmental milestones. It is anticipated that, with the support of early help, her parents are likely to sustain the changes achieved.

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Practice study: area for improvement

Thirteen-year-old Sarah has been the subject of a number of previous episodes of child protection and child in need planning relating to concerns around emotional abuse and parental conflict. She is currently receiving support through a family centre. The absence of a cumulative analysis of Sarah’s lived experience and her day-to-day life has hampered a clear and effective plan being developed for her. Planning has focused too much on adults rather than on the needs of Sarah, and multi-agency involvement in early help plans and planning is minimal. Levels of need have not been fully understood across the partnership or challenged when a premature decision was made to step down to early help. Information has not been exchanged effectively across the partnership, with some agencies not being aware of Sarah’s history.

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Practice study: area for improvement

There has been a lack of curiosity or understanding about Sarah’s early life experiences and a lack of analysis of the impact of her behaviours, for instance her attachment to her parents.

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Practice study: area for improvement

Sarah’s plan is not co-produced with her or her parents. Multi-agency involvement in her early help plan and planning is minimal, meaning that not all her needs have been met through a coordinated multi-agency plan.

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Next steps

We have determined that Surrey County Council is the principal authority and should prepare a written statement of proposed action responding to the findings outlined in this letter. This should be a multi-agency response involving the individuals and agencies that this report is addressed to. The response should set out the actions for the partnership and, when appropriate, individual agencies. The local safeguarding partners should oversee implementation of the action plan through their local multi- agency safeguarding arrangements.

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Next steps

Surrey should send the written statement of action to ProtectionOfChildren@ofsted.gov.uk by 9 August 2023. This statement will inform the lines of enquiry at any future joint or single-agency activity by the inspectorates.

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