Safeguarding is Everyone’s Business

ISLE OF MAN

SAFEGUARDING FORUM

Thursday 22nd February 2018

Sefton Hotel, Douglas

WELCOME

Our new Independent Chair from April…

Glenys Johnston

PROGRAMME FOR THE DAY

1. Welcome

1. Opening remarks: Minister for Health and Social Care, Mr Ashford MHK

2. Dez Holmes: Risk, Resilience and Relationships – the Art and Science of

Engagement

3. Reflections and Projections: Paul Burnett, Independent Chair

4. Launch of the WebCertain e-learning package

5. Open Forum

6. Workshop Sessions

7. Evaluation and Feedback

Minister for Health and

Social Care

Mr Ashford MHK

Risk, Resilience and

Relationships: the Art and

Science of Engagement

Dez Holmes

Director, Research in Practice and Research in

Practice for Adult

Risk, Resilience and Relationships: the art and science of engagement

Dez Holmes

Director

Research in Practice

@dez_holmes

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Rescue Vs Reform paradigm

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If we designed from scratch…?

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Contextual

•Harms, risks and protective factors

•Assessment, intervention

•Place-based approach?

Transitional

• Developmental perspective

• Fluidity over time

• Requires alignment of systems?

Relational

• Person-centred

• Relationships as vehicle and intervention

• Capacity building

Participative

The power of language

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Hostile

Aggressive

Non-compliant

Resistant

Self- Deception

Highly

Resistant

Families where interventions are not providing

timely, improved outcomes for children

Non-effective

compliance

Disguised

compliance

Disguised

cooperation

Balancing support and scrutiny

› Most child protection work is complex and long-term

› Parents need support and to be able to trust professionals

› A caring, supportive approach does not compromise professional challenge and scrutiny

The first primary school was in a position to know about the struggles Mother had had in her own upbringing and in her relationship with Father. They were child-centred in their concerns, as well as sympathetic towards Mother. The school staff were consistently involved in attending and sharing information at Child in Need, and later CP, meetings

11 (Sidebotham et al, 2016)

Assessment & engagement

› Hearing the voice of the family - use family expertise in collaborative working between professionals and families

› Families may be unaware of the risks / vulnerability

› Families may not know where to go with concerns

› Family concerns may not have been heard or acted on

› Families may see their role as support not scrutiny

Father was not aware of the assessment… His views were never sought, despite him having parental responsibility, and… he had made allegations to court about his concerns regarding Mother’s drinking, mental health and her potential aggression

(Sidebotham et al, 2016) 7

Authoritative safeguarding and child protection

› Developing models and cultures of working that mitigate the complexity and ambiguity

› Providing effective supervision & support

Authority

Involves both confidence and competence; enables

practitioners to adopt a stance of professional

curiosity and challenge from a supportive base

Humility

Enables practitioners to recognise their limitations, to acknowledge and use their skills and strengths, and to seek to improve

their practice

Empathy

Grounded in the centrality of the rights and needs of

the child, while being sensitive (not colluding)

to the needs and views of the parents

13 (Sidebotham et al, 2016)

‘Resistance’? The evidence supports…

A Relationship Based Practice approach in conjunction with Authoritative practice.

Demonstrating empathy and relationship skills, balanced with an authoritative approach.

Practitioner/client relationships where the practitioner demonstrates empathy and listening and avoids the use of confrontation can be effective. Communication styles such as motivational interviewing are also helpful. (Robb 2014)

Client resistance is not something that solely exists

with the client, nor even something that is simply

produced by the context of child protection.

Rather, it is also to some degree a product of the

nature and the quality of the interaction between

client and worker. This is crucial because it puts

the spotlight on worker behaviour as both a

potential cause of resistance and also our most

important tool for reducing resistance

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(Forrester et al, 2012: 4)

(Howe et al, 1999)

So it is in relationships with other people that one learns to understand oneself. And by understanding one’s self, one begins to understand other people. Thus the world of relationships is both the problem to be solved and the means to its solution.

To develop normally, a child requires progressively more complex joint activity with one or more adults who have an irrational emotional relationship with the child. Somebody’s got to be crazy about the kid.

That’s number one. First, last, and always.

(Bronfenbrenner, 1971)

It’s about relationships

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Adolescence and attachment (Shemmings, 2011)

› Children who have experienced abuse/neglect may

experience ‘disorganised attachment’ (though beware pathologising)

› DA in infancy can lead to dissociative symptoms in adolescence and early adulthood, Likely to do things to make adults reject them.

Research shows that attachment security in adolescence exerts precisely the same effect on development as it does in early childhood: a secure base fosters exploration and the development of cognitive, social and emotional competence.

17 (Moretti & Peled, 2004)

Peer relationships (Coleman, 2014)

› YP remain hugely influenced by parents’ attitudes and

behaviour.

› Friends provide:

› companionship

› a reliable alliance (someone to be on your side)

› help (in times of need)

› intimacy (someone to share things with)

› self-validation (to show you are accepted by others).

› Open to the negative influences if have low self-esteem and low levels of support from home (Cotterell, 2007)

› Influence of social media – threats and opportunities. 18

Image taken from: http://ourvoiceteen.blogspot.co.uk/2012/06/my-teenage-brain-takes-that-as-insult.html 19

Vulnerability

› The totality of a YP’s vulnerability may not always recognisable from apparently isolated incidents (Bradford, 2004)

› Factors interact in complex ways, vary over time and between individuals, and are contextual

› Some risks serve a purpose to the young person

› Behaviour / ‘choices’ can eclipse all else

› Simplistic checklists / ‘predictive’ assessment tools are problematic

So, professionals must have time to really know young people to exercise judgment

Vulnerability is not static – service delivery must by dynamic too

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Risk-taking and adolescence

› Biological, psychological and social changes - more likely to engage in risky behaviours (Calkins, 2010)

› Can be positive - learn about harm and safety, find out the limits of sensible behaviour (Coleman, 2014)

› Ego-syntonic risks

› The challenges for us:

› identify most promising ways of engaging YP to divert them from risky behaviours

› address the impact of risky behaviours when they’ve already taken place.

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Adolescent ‘choices’ and behaviours

› Increased ‘risk-taking’, emotional highs and lows, sensitivity to peer influence – all underpinned by interacting social and neurobiological changes

› Adapted to harms experienced in earlier childhood

› Unmet needs - seek to meet via risky routes

› Adolescent choices are part of the problem and part of the solution

› Misinterpreted as rational informed adult ‘lifestyle choices’ Victims being denied appropriate support / permission to give up

› Conversely, professionals can minimise adolescent choice and agency

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“…all life involves risk, and the young, the elderly and the vulnerable, are exposed to additional risks and to risks they are less well equipped than others to cope with… The emphasis must be on sensible risk appraisal, not striving to avoid all risk, whatever the price, but instead seeking a proper balance and being willing to tolerate manageable or acceptable risks as the price appropriately to be paid in order to achieve some other good…

What good is it making someone safer if it merely makes them miserable?”

(Lord Justice Munby, Local Authority X v MM, 2007)

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Resilience can be defined as the ability to withstand and rebound from disruptive life challenges, strengthened and more resourceful.

(Walsh, 2008)

7 learnable skills of resilience

1. Emotional awareness or regulation

2. Impulse control

3. Optimism

4. Causal analysis

5. Empathy

6. Self-efficacy

7. Reaching out (taking appropriate risk)

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(Reivich, 2005)

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Steven’s wish list

1. Live at home with Dad

2. Go on holiday to Somerset

3. Have Christmas presents at home

4. See Toy Story 3 at the cinema

5. Have breakfast in the bacon shop

6. Go swimming to Hampton open-air pool

Neary (2013) 27

Risk enablement

Risk enablement means working to enable individuals through carefully considered risk-taking. Positive risk taking is a collaborative process of balanced decision-making in relation to risk, in which the stakeholders weigh up potential risks and benefits and take a shared problem-solving approach to try and find a way of managing risks.

(McNamara & Morgan 2014)

› Positive risk-taking is a way of working with risk that promotes enablement. It is important to remember that the ‘positive’ in positive risk-taking refers to the outcome not the risk

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Risk enablement and adult safeguarding

Shared features of positive risk-taking and Making Safeguarding Personal:

› The approach to risk is rights-based.

› People using services are kept well-informed in an accessible way

› The wishes of people using services are at the heart of decisions.

› The strengths of the individual are identified.

› Decisions are balanced; reasoning demonstrable.

› Decisions are regularly reviewed.

› Practitioners are reflective and legally literate

(RiPfA, 2016)

Risk aversion to risk enablement

› ’Risky/vulnerable’ people

› Worst case scenario

› Focus on physical (someone getting hurt)

› Medical problems, limitations, what’s gone wrong before

› A senior/ lead professional takes decision (and gets blamed if it goes wrong)

› Risk of specific situation

› Consider benefits too

› Social, emotional also (hidden harm/ benefits)

› Strengths, resources (outside services), what’s worked before

› Person & supporters, range of professionals share responsibility for managing risks

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3 Conversations Model

› Conversation 1: Listen and connect

› Conversation 2: Work intensively with people in crisis

› Conversation 3: Build a good life

(Partners4Change, 2017)

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Strengths-based questions 1. Survival questions: How have you managed to overcome/ survive the challenges that you have faced?

2. Support questions: Who are the people that you can rely on? Who has made you feel understood, supported, or encouraged?

3. Exception questions: ‘When things were going well in life, what was different?’

4. Possibility questions: What do you want to accomplish in your life? What are your hopes for your future, or the future of your family?

5. Esteem questions: What makes you proud about yourself? What positive things do people say about you?

6. Perspective questions: ‘What are your ideas about your current situation?

7. Change questions: What do you think is necessary for things to change? What could you do to make that happen?

(Saleebey, 2006: 87)

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Resilience and participation

› Relationships are paramount (Coleman, 2014)

› Self-efficacy, positive identity development, aspirations - commonly associated with resilience

› CYP as ‘assets’ (Young Inspectors, Student Council) and as active agents

› Children's rights to protection and participation are mutually dependent and indivisible

(UNCRC)

› Implications for practice EH care leaving? Are

we ‘equipping’ or ‘managing’?

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Participation in CSE* practice (Warrington, 2016)

› Involves work with children individually and collectively to:

− Access information, resources and support

− Exercise autonomy & choice

− Experience of a sense

of control

− Influence & inform

change

* Or youth offending,

Mental health,

Education, etc

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Research and Policy

Communities

Services

Peers

Individual care

When we deny victims’ self-efficacy…

“I was basically a puppet. When they [the police] wanted me, I had to do it. When they didn’t want me, I heard nothing.”

“Workers expect you to tell them everything about your lives but then they tell you nothing about theirs . ... That’s how the men work too – they find out everything about you then don’t even tell you their real name.”

(See Camille Warrington’s work) 35

Participation as protective

Consequences of CSE Benefits of participation

YP don’t recognise exploitative situation

Critical thinking/better understanding (AYPH, 2014)

Lack of power/control Agency and decision-making power

Isolation/sense of ‘difference’ (Reid & Jones, 2011)

Sense of belonging (Hagel, 2013)

Stigma Approval/acknowledgement (Batsleer, 2011)

Low self worth/lack of purpose

Helping others (Batsleer, 2011, Levy, 2012, AYPH, 2014)

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(Warrington, 2016)

What is RBP and where did it come from?

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› RBP focuses on the relationships we form with families and the complexities of these encounters

› Identified in Munro report as essential to good social work practice

› Roots in early social work practice where family/worker relationship was central

› Evolved in response to concerns about managerialism and bureaucratisation of practice and how individuals’ lived experiences got lost

(Ruch, 2005; Ruch et al, 2010; Munro, 2011)

Core principles of RBP

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› Recognises the complexity of human behaviour and relationships: people are not rational beings

› Understands anxiety as a natural response to distress and uncertainty, and manages it within an attachment framework

› Acknowledges social welfare practice as complex, unpredictable and full of uncertainty

› Emphasises use of self and the role of intuition

› Recognises that establishing meaningful professional relationships is the key to engagement

(Ruch, 2005; Ruch et al, 2010; Munro, 2011)

RBP and ‘recognition theory’

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› Recognises parents as individuals with own desires and needs, achievements and abilities

› Recognises parents’ role in wider society

› Encourages self-belief and a positive identity

› Avoids the shame, anger and indignation that people feel if not recognised for who they are

› Promotes a ‘give and take’, reciprocal approach

› Acknowledges parents as an end in themselves, not just in relation to protecting their children

(Turney, 2012)

Key features of RBP in action

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› Communicating respectfully: trust, honesty and feeling safe

› Sharing goals: being clear about concerns and taking parent with you

› Practical assistance and understanding parents’ own needs, while ensuring child remains central focus

› Being reliable, available and building service round family’s needs

(Mason, 2012)

Empathy

“Skill at sensing other people’s emotions, understanding their perspective and taking an active interest in their concerns.”

(Holroyd & Field 2012)

“The ability to put yourself into someone else’s shoes and finding out that they pinch”. L Tyler (1965)

“Empathy is the ability to enter into, and understand the world of another person and to communicate this understanding to him or her”. Egan (2002)

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Effective, responsible & caring challenges/probing

› Earn the right to challenge/probe by taking time to develop a good relationship

› Prepare the person prior to a challenge/probe- use a softener & explain the reason for the probe/challenge

› Observe changes in body language

› Give individual a ‘way-out’

› Keep the reason for the challenge/probe in mind

› Challenge/probe individuals to clarify their values/beliefs and to explore possible consequences

› Challenge the individuals thinking rather than the individual or their autonomy

› Sometimes highlighting what can be praised before making a challenge can help.

› Be specific and give concrete examples in your wording

Love and Listening

“The most basic of all human needs is the need to understand and be understood.

The best way to understand people is to listen

to them.”

(Ralph G Nicholls)

“The first duty of love is to listen”

(Paul Tillich)

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Thank you 44

Reflections and

Projections

Paul Burnett:

Independent Chair

Reflections

Safeguarding is Everyone’s Business

Children, Young People and Adults are safe

through effective policies, procedures and

practice

Areas of safeguarding risk are addressed

The workforce is ‘fit for purpose’

The voice of service users is heard and acted on

Overall performance

Actions set out in our Business Plan

SCB: 93.5% of actions completed (44/47)

SCB/SAP: 92% of actions completed (56/61)

SAP: 72% of actions completed (37/49)

Average 86% completion rate.

Completed actions are not outcomes of course…

Safeguarding Everyone’s Business

Passage of the Safeguarding Bill

97.5% attendance rate at Boards;

Board evaluated as appropriately focused – and

streamlined;

7 Safeguarding Forums held 2015 – 2018 which

equates to1,260 places

4 editions of Safeguarding Matters

SAB website launched and other publications

Local networking: third sector, faith sector,

parents/families

Safeguarding Everyone’s Business

Extend our reach especially in the community

Maximise use of technology and social media

Break down some of the continuing ‘silo’ based

working practices

Ensure that we maximise the impact of the new

legal duties to safeguard and co-operate.

Policies, Procedures and Practice

Significant developments in both children and

adult safeguarding

Single assessment and NARRATES framework,

Signs of Safety

Making Safeguarding Personal, Self-Neglect,

Hoarding

Practice Guidance for Information Sharing and

Data Protection

Improved compliance with safeguarding

standards evidenced, in children’s safeguarding,

through monitoring of action plans from our last

audit

Policies, Procedures and Practice

Impact evidence for children’s safeguarding

254 families accessed CwAN support – 25% more than

last year

278 children and families accessed CwCC support

93% of parents completing feedback recognised things

had improved

Child Protection numbers volatile but within target range

Numbers of children requiring care consistent and within

target

Comparison with data in UK would reflect

positively on the Isle of Man

Policies, Procedures and Practice

Impact evidence for adult safeguarding:

Slight reduction in alerts in 2015/16 but upward

trend this year – 268 to date (221 last year)

Source of alerts indicates wider understanding

of adult safeguarding and thresholds

Strong performance on Making Safeguarding

Personal in terms of people seen and wishes

and views sought – over 90%

Policies, Procedures and Practice

Some delays in monitoring impact of compliance

audits in adult safeguarding

Consistent implementation of policy and

procedures within and across services –

including threshold awareness and application

Impact of practice guidance and GDPR

implications for information sharing and data

protection

Compliance in shared services and in

commissioned services

Areas of Safeguarding Risk (Children)

Neglect: Launch of new neglect pathway

CSE: Pathway and risk assessment tool and

multi-agency planning toolkit

E-Safety and E-Bullying – ‘Island Shield’

Specialist mental health

Areas of Safeguarding Risk (Joint)

Transitions

FGM – policy and pathway

Drug and Alcohol related safegaurding risk

Domestic abuse

Clarification of role of Safeguarding Boards and

other partnership bodies for commissioning and

delivery

Commissioning

Areas of Safeguarding Risk (Adults)

Hoarding

Neglect and Self-Neglect

Financial Abuse

Homelessness

Links with Registrations and Inspections re

provision in residential and care settings –

including adults with learning disabilities and

older people

Workforce ‘Fit for Purpose’ (Children)

Training delivered across the 4 levels for

children’s safeguarding

Post-training evaluation positive

Issues about non-attendance

Evaluation of impact of training on service

quality and outcomes still to be fully developed

through roll out of safeguarding competence

framework

Workforce ‘Fit for Purpose’ (Adults)

Secured £30,000 investment

369 attendees at basic awareness

Programmes on Making Safeguarding Personal,

Self-Neglect, Hoarding

Need for development of a adult safeguarding

competence framework – in development

The Voice of Service Users and Staff Heard

Communication and Engagement Plan –

website development, Safeguarding Matters,

Forums, Media releases

Engagement with groups such as Voices in

Partnership Council, Learning Disability

Partnership Board, Churches Alive in Man, CVO

Analysis of user views from CwAN, CwCC, child

protection and children in care reviews, Signs of

Safety evaluations, Making Safeguarding

Personal

The Voice of Service Users and Staff Heard

Need to extend both service user and staff

engagement through ‘mainstream’ service

systems – “how was it for you” processes for

service users, inclusion of safeguarding in staff

surveys.

Heavily reliant on social care teams at present

for front-line service user information

Engagement with Politicians

Annual Reports and Business Plans debated in

SPCC, CoMin, Tynwald

Increasing link up between Programme for

Government and SCB/SAP Business Plans

Commitments from Chief Minister

Achievement of our goal to secure a legislative

framework for our work.

SAFEGUARDING

BILL

3 Key Headlines

Creation of:

A single statutory Safeguarding Board broadly

covering the current work of SCB and SAP

Statutory Duty for those working with children

and vulnerable adults to ‘consciously consider

the need to safeguard children and vulnerable

adults’ when carrying out their work

A duty for partners to co-operate with each other

when carrying out safeguarding functions

Projections: Priorities for the Future

Implement the Safeguarding Bill

Ensure all the policies, procedures and frameworks

secure positive impact in terms of service quality and

outcomes

Reduce levels of prevalance in key risk areas: neglect,

self neglect, financial abuse, e-safety, mental health

Monitor risk in areas such as CSE, looked after children,

those with disabilities, older people

Enhance evaluation of training against competence

framework

Widen participation and engagement

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Launch of Basic Safeguarding Children and Adult e-Learning

programme

Safeguarding Forum

22 February 2018

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Who is this for? • All staff in agencies across government • Service Providers • Third Sector • Voluntary Sector • Youth and Community Groups

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This Adult Safeguarding e-Learning programme is for:

all staff who require Basic Adult Protection Training

and replaces the class-room sessions.

Adult Safeguarding Training for Managers (which will

be delivered in class room setting and advertised for this

target group on the learning management system.

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• Basic Safeguarding Children e-Learning programme is Level 1 in Multi-Agency Competency Framework

&

• Induction and refresher training for all Competency

Levels

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• Background to understanding Safeguarding Children and Adults.

• Lessons from inquiries.

• Signs and indicators of abuse and neglect,

• What to do if you have a concern about a child, young person or

vulnerable adult.

• How to access the right information for referral to Children’s Social

Care and Adult Safeguarding team using correct procedures

• Information about the Safeguarding Board Interagency procedures

• Guidance for organisations to create a safeguarding culture

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Assessment

Extended Learning

Videos of children talking about what helps when they have difficulties.

Links to local and national legislation, policies, procedures, Serious Case Reviews and influential reports.

These are for extending the learning and this information is not included in

assessment

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How to Access

If you haven't already applied and would like to attend a course, please login and apply through the training system here: http://iomscbtraining.co.uk/.

At the top of the page there is a tab “On-Line training” click there and that will bring you into both Adult and Child Safeguarding e-Learning programmes

If you have any problems please contact the LEaD SCB administrator for assistance on email at lead@gov.im or Tel: 687550 and Natalie Perkin Tel: 687552

Feedback to lead@gov.im

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http://iomscbtraining.co.uk/frontend/us

er/registration

If you know of someone who may be interested but

doesn't yet have an SCB Training Account, please

ask them to register here:

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Market Place

• Speak to staff at break about registering

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Benefits

Local amendments to information without further cost.

Up date information regularly.

Fits with changing organisational environments and need to be responsive and build learning culture

Feedback from users in 6 months and amend according to feedback

Available on Learning Management System WebCertain alongside the Programmes of class room training

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Share information in

agencies

Safeguarding E-Learning available now

QUESTIONS

OPEN FORUM

THANKYOU