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Paragraphs: 17.64
- 17.70 | 17.71 - 17.78
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17.64
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Monitoring performance plays a vital role in delivering good outcomes
for children and their families. Robust systems that monitor what
is actually taking place and its effectiveness is critical. The
fifth and final seminar addressed the question of how the performance
of the agencies involved in protecting children should be evaluated.
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17.65
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There was no doubt that the work of each of the key agencies supporting
children and families should be rigorously monitored. In the past,
the tendency has been to concentrate on the measurement of inputs;
for example, the size of the budget, the number of staff, or the
range of equipment used. This approach is of limited value and does
not address the more important question of what is actually being
achieved, and whether the lives of children and families are being
improved by the investment.
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17.66
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In recent years, some progress has been made in correcting this
deficiency. However, it was said that, in general, performance measurements
remain crude. Often what emerges from their analysis is still more
information about the quantity of activity, rather than about the
quality and effectiveness of the work delivered. Meaningful and
informative outcome measurements in the field of child and family
support are notoriously difficult to achieve. However, this should
not deter efforts being made to refine the current arrangements
for the evaluation of services.
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17.67
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For monitoring to be effective it has to be conducted against a
predetermined set of standards. The development of the National
Assessment Framework for children was seen as a means of bringing
together what had previously been the fragmented and uncoordinated
provision of services for children. Although still at an early stage
of development, it was seen to be capable of providing the sort
of outcome-based standards seen as desirable.
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17.68
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It was said that there is a marked variation in the quality of
internal monitoring among social services departments and police
forces. In social services, performance and measurement had to be
made relevant to outcomes for children and families. What matters
is that such measures continue to strengthen what is best for children
and families, and are not diverted from this by undue attention
being centred on targets set by central government. Performance
management among the police was described as "at best, ad hoc".
As regards child protection, it was said that until the protection
of children features in the Home Secretary's 'Police Priorities'
list, it was unlikely that steps would necessarily be taken at a
local level to improve the quality of police child protection teams.
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17.69
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It is intended that introducing clinical governance will make a
significant difference throughout the health service, but little
was heard to suggest that the monitoring of performance in relation
to the protection of children at a local level in the NHS has been
much developed so far. There was much discussion in general terms
about the need to develop a culture of self-audit - "empowering
the front line" - and providing mechanisms for medical practitioners
to talk about outcomes, and develop the ones that they regard as
important.
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17.70
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A healthy culture begins with high-quality leadership by senior
managers willing to 'walk the talk' and who are anxious to understand
the issues facing front-line staff. It grows once people are willing
to analyse their individual practice and contemplate change. That
in turn requires management being willing to adopt, not a blame-free
culture, but a learning culture. Individual responsibility had to
be recognised, but there needed to be a willingness to accept that
it was possible for teams and individuals to fail, to learn from
their mistakes, and to start again. In that context, performance
measurements become a means of self-improvement.
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Paragraphs: 17.64
- 17.70 | 17.71 - 17.78
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17.71
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There was a good deal of support in the papers received for the
idea that multi- agency working should be monitored on a multi-agency
basis. This is already an established feature of current practice.
In particular, in response to the Government's White Paper Modernising
Social Services, fieldwork is presently being undertaken to
prepare a report on the state of child safeguards. That involves
joint working by eight different inspectorates. This report has
now been published. This approach appears, for good reason, to be
widely welcomed. There was support for its extension so that, for
example, it covered regular inspection of police forces by such
'outsiders' at both senior and grass-roots levels.
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17.72
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The possibility of changes to the role of multi-agency bodies in
monitoring performance was considered.
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17.73
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There was considerable debate on the best way to learn from child
deaths. I was told that often Part 8 reviews carried out under the
auspices of ACPCs concentrate on organisational rather than practice
issues. There was said to be a lack of uniformity across the country
as to when Part 8 reviews are ordered. It was felt that benefit
could be gained by taking steps to ensure that practice lessons
are learned not just locally, but nationally too. Work on analysing
the effectiveness of Part 8 reviews has already been done in Wales
and is currently being done in England.
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17.74
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There was some discussion about the possibility of adapting the
Department of Health's 'Confidential Inquiry' system. This is used,
for example, in cases of maternal deaths and child protection cases.
The NSPCC's proposal for child death review teams was also considered.
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17.75
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There are clear advantages in ensuring that every death or serious
deliberate harm to a child known to social services is investigated.
It would remove the stigma attached to Part 8 reviews, it would
ensure that no cases were missed, and it would assist in the development
of preventive strategies more generally. Others thought such an
arrangement might be expensive and bureaucratic, adding further
systems and processes to those already in place.
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17.76
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The current arrangements for external inspection of children's
services are changing. It was said that the Social Services Inspectorate
(SSI) is moving from thematic inspections to a rolling programme
of inspections and is revising its methodologies. Joint reviews
in their present form between the SSI and the Audit Commission are
to end next year. A new Police Standards Unit is being established
in the Home Office. However, it must be recognised that the government
inspectorates operate annual programmes which are designed to ensure
that over the years, each of the key responsibilities of the services
have been inspected. This being so, it may well be that several
years will elapse between the inspection of the services dealing
with the safety of children. Something more than this is required.
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17.77
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In the week before seminar five, the Government announced the establishment
of two new inspectorates - a social care inspectorate (the National
Social Care Inspectorate) and a health inspectorate (the Commission
for Health Audit and Inspection). The two are to have similar duties,
powers and responsibilities and be placed under statutory duties
to co-operate with each other.
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17.78
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I hope these changes strengthen inspection and secure a more effective
way of monitoring the co-operation between agencies.
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