Social services Children+adults – broadly separate areas of activity

In the news… Who pays? Saville Rotherham ‘grooming’ case Adoption rates Winterborne home Care quality at home Rotherham UKIP row

Social services: who for? Elderly Disabled Children esp. those at risk Mentally ill Long-term ill Anyone “vulnerable” – asylum seekers

Children’s social care

Social services: who provides? Social care – “multi agency approach” – often more than one provider involved. Central govt. sets framework of duties/responsibilities/standards Providers are: Local authorities (social services providers are counties; unitaries; London boroughs) Health bodies – Primary Care Trusts The Police (children at risk/abuse issues) Charitable groups eg NSPCC/Barnados

Children’s Services Protecting at risk children one of most important jobs of social services Arrangements changed fundamentally by Children’s Act 2004 (post-Lord Laming inquiry into death of Victoria Climbie) Policy of “Every Child Matters” introduced Local Safeguarding Children’s Boards Act also established Children’s Services Departments for local councils – bringing education and social care for children together

Care of children Role of social services (the council): Promote general welfare of children Encourage children to be brought up in family setting Protection (safeguarding) Work with parents in child’s best interests Provide accommodation for children where necessary (Tracy Beaker)

Children’s services – Local Children’s Safeguarding Boards Set up by each local authority following Children’s Act 2004 Set out how different agencies will collaborate to deliver services/monitor effectiveness Boards have three levels of action to ensure welfare of children:

Safeguarding boards ii Levels of action: Activities to prevent maltreatment or impairment of health or development (eg ways to identify cases of neglect/abuse) Pro-active work to target specific groups – children in need but not suffering abuse/neglect Reactive work to respond to neglect/abuse

Children at risk - Child Protection Plans Child Protection Plans have replaced child protection registers Plans are drawn up by professionals following initial child protection conference Social services – (the council) - co- ordinate action to safeguard children through “inter-agency” plan Plans set out how child is to be protected Children may be taken out of home

Children taken into care – why? Underlying principle: Where children are at significant risk of harm and there is on-going risk Types of harm: Neglect Physical Abuse Sexual abuse Emotional abuse Children can be registered under more than one category

Baby P – Lord Laming report 2009 Failure of agencies to share information Social workers over-stretched Red-tape+form filling hampering front-line staff “Over-complicated, lengthy and tick-box assessment+recording system.” Child protection seen as ‘Cinderella Service’ Too many authorities failed to adopt his reforms following Victoria Climbie report in 2000 “It seems like they have to do all this form filling. Their bosses make them do it but it makes them forget about us” – 16-year-old in care

Care Orders Only for children under 17 Applications for such orders go to Family Proceedings Court (normally Magistrates Court) Orders are applied by councils where: Child is at risk of significant harm and care is below reasonable parental standard

Care Orders Social services assume parental responsibility but parents must have reasonable access Interim care orders: where council is seeking full care order. Last max. eight weeks, unless court grants renewal

Supervision Orders Where child is placed under supervision – but not necessarily taken into care - with councils having a lesser duty to “advise, assist and befriend.” Families must be allowed to bring up child if possible Can be made for abandoned/lost children

Emergency Protection Orders Where child is deemed to face an immediate danger and harm Made by courts Last up to 8 days Can be extended by court if satisfied risk still exists Parents can challenge after 72 hours

Serious Case Reviews Purpose of SCRs: Are there lessons to be learned from the case about how professionals and agencies worked? Identify clearly what those lessons are, how they will be acted on, and what is expected to change as a result Improve inter-agency working

SCRs – when? If child sustains a potentially life- threatening injury or serious injury through abuse or neglect If child has been subjected to serious sexual abuse A parent has been murdered A child has been killed by a parent with a mental illness If case gives rise to concerns about inter- agency working to protect children

Care Homes Councils must provide Community Homes for children in care Private homes must be registered by the Commission for Social Care Inspection Homes may be run by charities, eg Barnados Usually mixed (boys and girls)

Fostering Can be short or long term Seen as preferable to care home environment Foster parents: no legal custody or full parental rights (but may choose to adopt later) Must be approved by social services Are paid+have allowances for clothing/holidays etc

Fostering ii Prospective foster parents vetted by social services to assess if appropriate Social services retain right to make regular spot checks – can remove children if necessary Required to undergo statutory training

Adoption Eligible children must be < 18 And be a child for whom returning home is not possible Adoption orders sever all legal ties with natural birth family Confers parental rights and responsibilities on new adopting family Birth parents lose legal rights/cannot take child back

Adoption ii Adoptive parents must be > 21 Be able to provide stable + permanent home Need not be married; can be single; same sex couples can adopt No upper age limit No bar against those who are disabled adopting Adoption must be through an approved Adoption Agency or Voluntary Adoption Society approved by Secy. Of State

Adoption in Kent 2006 – 96 children adopted 2010 – 57 children adopted But only 28 approved adopters And…90 other children waiting “It is clear that there is a desperate imbalance between the number of those children and the number of approved adopters. The fundamental weakness in Kent is clear.” Martin Narey, ex-head of Barnados

Adult social services

Growing pressure We are an ageing society – people now living much longer than they were (+ have high expectations of what care they should get) More people over 65 than under 16 for the first time 10m people are over 65 – by 2050, forecast is 19m In 1900, 1% of popn. was > 65; 2000 it was 7%; by 2050, it will be 20% Number of people working beyond retirement age (65) has doubled in 10 years to 900,000

Growing pressures… Fastest growing sector of the population is the over-80s Currently, 3m are over age of 85 Forecast is that will double to 6m by 2030 Of govt spending on benefits – 65% of DWP budget goes on older people (£100bn in ) NHS spending on retired households: £5,200 NHS spending on non-retired: £2,800

Dilnot Commission – fair funding Govt. set up inquiry because of concerns about affordability of care – sustainability+fairness Driven by concern that anyone with £23,000 assets faces unlimited care costs Reported in June 2011

Dilnot Commission - recommendations Each person’s contributions to care costs should be capped. After cap reached, state support kicks in Cap should be between £25,000-£50,000. £35,000 considered point at which cap is set National eligibility criteria about who qualifies for care – currently set locally Cost to UK – approx £1.7bn

Govt. response to Dilnot Accepts principle of a cap Treasury reported to be considering cap of £75k not 35k £35k cap would cost govt. £1.7bn Issues… Would insurance companies come in at that level? Public not interested in planning for their care

Adult social services - Community Care NHS and Community Care Act 1990: shifted responsibility from NHS to local govt. Aim: to move away from institutional living to independent living Care is provided for problems associated with: Ageing Mental illness Learning difficulties Physical/sensory impairments NHS+Social services required to make Partnership Arrangements for care of individuals

Community Care: How it works Anyone with disability or any other social care need is entitled to a needs assessment: Old age/physical weakness Physical difficulties Sensory difficulties Learning disabilities Mental health problems

Community care: how? Assessments gauge what kind of help might be needed and can be provided in accordance with “eligibility criteria.” Councils usually have a system that grades level of need: for example, critical, substantial, moderate or low People most at risk given priority Individuals are given a care plan setting out what will be provided and by who Care may be secured through system of “direct payments”

Care plans Services to be provided Who will provide them Contact for issues or problems How reviews can be asked for if circumstances change

Community care – what kind of care? Domiciliary care services: such as – Meals on wheels Help with personal bathing or shopping Respite care (for carers too) Special equipment added to home – ramps; adapted furniture; stair rails Services often contracted out to private sector/voluntary sector. Charges can be made; often free

Community care – other help Support for deaf and blind Day care services – organise activities for people Recuperative and intermediate care services: short-term (few weeks) and intensive help to help recovery after illness; fall or other crisis. May be at a care home Respite care for carers, who may themselves need help (such as a break or holiday) Residential care in home – often bought in by council but how much is paid subject to means-testing

Who regulates – the Care Quality Commission (CQC) Independent regulator - replaced Healthcare Commission and the Commission for Social Care Inspection (CSCI) Regulates all health and adult social care services in England provided by NHS, local authorities, private companies or voluntary organisations Protects the rights of people detained under the Mental Health Act.

Care Quality Commission Care homes Domiciliary care providers Hospitals In all cases to “ensure compliance with required standards of care and welfare”

CQC ii All health and adult care providers must register with CQI (Health and Social Care Act 2008) Includes NHS trusts Registration designed to ensure compliance with essential standards of quality and safety Has power to conduct unannounced inspections Can issue fines and fixed penalties Withdraw registration, for eg from hospitals failing to meet cleanliness standards; close down departments or withdraw operating licences from entire hospital

Adult Safeguarding Boards Multi- agency: councils; police; NHS Role: Approve policy, procedures and guidance for safeguarding Approve a training strategy Monitor performance of statutory agencies Hold agencies to account Publish annual report