Summary 

This briefing summarises the overview report Improving the Effectiveness of the Child Protection System published by the Local Government Association (LGA) and the Early Intervention Foundation (EIF). It presents findings on what the evidence tells us is effective in improving outcomes for children in the child protection system. It considers what we know about what local areas deliver as part of the child protection system. It examines what we know about the overall effectiveness of the system and concludes with key findings and recommendations. It provides a very helpful overview of evidence on these areas to help leaders, commissioners and practitioners consider how they can develop and improve the effectiveness of their child protection work.

Introduction

This overview report was produced as part of a wider project on improving outcomes within the child protection system, commissioned by the (EIF) in collaboration with the LGA and supported by the NSPCC, Research in Practice and the University of Oxford. The project had five strands which are published as separate research papers. The overview report is based on these five research papers.

The five research papers are on:

1. Improving the Effectiveness of the Child Protection System – a review of literature;
2. Child Protection – a review of the literature on current systems and practice;
3. The use of research evidence regarding ‘what works’ in local authority child protection systems and practice: An analysis of five local authorities;
4. Trends in Child Protection: England – using trend data on 22 indicators;
5. An analysis of international trend data on child protection indicators.

The overview report and the five research papers can be accessed via the EIF website
http://www.eif.org.uk/publication/improving-the-effectiveness-of-the-child-protection-system-overview

The overview report sets the context for the report by highlighting the increasing demands on the child protection system in the current climate of financial austerity. This context presents a pressing need to ensure scarce resources are used to best effect.  The scope of the report and the work on which it is based did not include interventions and approaches provided as part of a local early help offer.  The evidence on effectiveness in early help is the core focus of the EIF.

What does the evidence tell us about what is effective in improving outcomes for children in the child protection system?

This section of the report focuses on what the evidence has identified as interventions shown to be effective in improving outcomes for vulnerable children. It makes several general points:

1. The success of any intervention depends on a number of common elements, the most important of these being the quality of the therapeutic relationship between practitioner and the child, parent or family;
2. Strengths based approaches which acknowledge the challenges parents face are likely to be more effective than overly focusing on parental deficits;
3. Parent focused interventions with clear logic models aimed at strengthening parent-child interactions and reducing child conduct problems appear to have value;
4. Where families are facing complex, multi-layered problems, an integrated package of support is required;
5. Components of the integrated package must be identified following assessment of the needs of the family and the interventions must be targeted according to the needs and the age of the individual children.

The report identifies the key findings in relation to the effectiveness of methods which focus on:

1. Parent-child relationships and associated outcomes:
   • To reduce physical abuse;
   • Where there is emotional abuse/harmful interactions;
   • For children who have been neglected;
   • For children who have been sexually abused;
   • Other maltreated children with trauma symptoms.

2. Supporting the parent, child or both where children are exposed to parents experiencing problems:
   • Where a parent is substance-dependent;
   • Where parents face complex problems.

3. For families where domestic abuse is present including findings in relation to victims of domestic abuse, children exposed to domestic abuse and perpetrators of domestic abuse.

The overview report sets out the detail of the findings in relation to the specific interventions that they found evidence of effectiveness for.  Some of the interventions will be familiar to many social workers and family support workers such as the Incredible Years Programme, suggested for use in families where physical abuse has occurred. Others will be less familiar and may have limited availability such as Parent Child Interaction Therapy or Child-Parent Psychotherapy (Lieberman Model). Other approaches such as Letting the Future In for use with boys and girls aged 8 to 17 who have been sexually abused are currently being evaluated by the NSPCC.

This section of the report is clearly set out and worth reading in full for those interested in the detail of the approaches for which the report finds evidence of effectiveness.

The report goes on to say that “Evidence of effectiveness is important, but is not the only consideration in making decisions locally about what to commission. Factors such as cost and fit with the wider local system are also important.  Making final decisions about specific interventions that could be delivered should be done by assessing potential interventions for both their feasibility and acceptability within the local context of resources and priorities.”

The gaps in evidence for some areas are striking.  The report notes the gap in relation to what works best to improve outcomes in cases of neglect. It also notes the absence of an evidence base for some common approaches such as Multi-Agency Safeguarding Hubs (MASH) which though widely adopted have not been subject to robust evaluation of their impact.

There is a lack of evidence for aspects of the social work role. The report says “More could be done to specify the role of evidence in relation to direct work with families, so that professional judgment is underpinned and informed by evidence.”

What do we know about what local areas are delivering?

This section of the report provides evidence from work by Research in Practice with five local authorities looking at what works in local authority child protection systems and practice.  The five authorities emphasised the importance of “a clear overall vision for the delivery of services to vulnerable children and families, corporately owned and supported throughout the organisation, in developing an effective child protection system.” Having an overall approach enabled commissioners and practitioners to commission services and interventions that fitted within the wider framework.

The local authorities were delivering some of the services highlighted as effective by the evidence review but it was not clear how far the services were available to all families that needed them or how many families had needs for which there was no well-evidenced intervention available.

The report highlights the lack of analytical capacity in local authorities. This is an obstacle to improving the use of evidence in developing child protection systems and practice.  There is also a lack of capacity to evaluate innovative approaches and changes to systems and processes.  In turn, this affects the ability to build robust business cases for the investment required in innovative approaches. One commissioner interviewed said: “We’ve committed ourselves to working in a different way, we’ve committed huge amounts of resources to do it.  But we don’t actually have … any sophisticated way of actually determining whether it’s a success or not.”

The report identifies that there are approaches being widely implemented which are described as “innovative but not yet evidenced”. These include the development of multi-disciplinary approaches focusing solely on safeguarding or which involved integration of safeguarding and early help functions.

Participants in the qualitative research felt it was important that social work was not seen as an island and that an effective early help offer is a vital part of an effective child protection systems.

The findings of the work in relation to the use of evidence in practice and individual practice are especially interesting. The report says “The potential for evidence to guide direct work with children and families was not consistently accepted, and there was a range of views on the role of evidence in this respect.” It appeared social workers interviewed did not see research evidence as able to inform ‘what to do’ and the specifics of work with families. There was a perceived lack of evidence as to what direct work should look like. This lack of evidence to inform direct work left some social workers feeling unconfident. This lack of confidence was seen as contributing to the tendency to refer on rather than consider what the social worker can do.

What do we know about the overall effectiveness of the child protection system?

The report notes the “limited picture” of the factors underpinning the increases in demand seen in recent years. The extent to which the increase is driven by changes to the system or changes in funding or changes in the child population is not understood. Whether there is a causal relationship between increasing poverty and homelessness and greater child protection activity is challenging to establish. The report sets out the statistics on the rise in demand over recent years. It says that the increase in demand does not appear to be driven by a lowering of the threshold for acceptance into the system.

The research found that the picture on child safety is mixed. There are positives such as people being more willing to speak about child maltreatment. However more needs to be done to understand how well the system is working for children.

There is an absence of a shared outcomes framework and a consensus on what good looks like in children’s social care. The data we have on the child protection system is focused on numbers of children and process measures. It does not focus on outcomes for individual children.  There are some indications about whether children are safer today through work such as the NSPCC annual reports “How Safe are our Children”.  This report notes that the 2016 How Safe are our Children report described some positive trends. These indicators include increased reports of abuse and neglect suggesting increased willingness to speak up and the long-term decline in the child homicide rate. The 2017 report has just been published and is available at https://www.nspcc.
org.uk/services-and-resources/research-and-resources/2017/how-safe-are-our-children-2017/.

There is more to do to develop agreement about what “good” looks like in child protection work and to understand how well the system as a whole is working well for children. It is of note that the researchers working on this report undertook an analysis of current data on measures such as return home from care, missing from care, offending and repeat child protection plans as some indication of child outcomes and how these related to Ofsted rating of children’s services. They found very little association. This led them to suggest the need for an agreed outcomes framework.

The research paper on international trend data on child protection indicators contains an overview of the data available.  However because of the differences in what data is published and definition of key terms such as what is counted as abuse and neglect it is very difficult to make comparisons between countries.

Priorities for Action

The report suggests we need to:

1. Support the use of evidence of effectiveness and overcome misconceptions about gaps in evidence by:
   • Communicating the nature of the evidence for child protection to local leaders and commissioners;
   • Guide local decisions by providing clear information about which approaches are likely to provide the most effective help and protection and those that have yet to demonstrate impact on outcomes for children;
   • Make it clear whether and how particular circumstances and local context might impact upon the effectiveness of an intervention.

2. Building ‘evidence literacy’ among local leaders, commissioners and practitioners;

3. Filling the gaps in the evidence. This will include ensuring evidence of impact is gathered for some of the widely used approaches where this is not available;

4. Supporting analytical capacity in local areas. This will help local areas understand the nature of their local demand.

The report overview summarises key implications for local leaders or those scrutinising local services. The advice is:

• Use evidence to understand local need and demand;
• Select interventions which have evidenced improving outcomes for vulnerable children and which match local needs;
• Where evidence of impact is not available, ask questions about other sources of evidence or knowledge that are being used as a basis for decisions.

The report proposes key questions for local leaders to ask and makes suggestions as to how to build evidence into local child protection systems.

The key questions for local leaders to ask are:

• To what extent does evidence feature in the design, business case and operation of your statutory child protection system?
• Do your local arrangements take account of the available research evidence about which interventions or approaches work in local child protection systems?
• Where new or innovative approaches are being considered, is there sufficient capacity available to evaluate their impact?
• How do you know and when are you told? Do you have effective arrangements in place for overseeing your child protection system?

The report highlights the need for greater collaboration that reduces the distance between the worlds of evidence and decision making with those working locally to support children and families in the child protection system in developing a  culture where evidence is routinely used in decision-making, commissioning and direct work with families.

It highlights the importance of ‘evidence literacy’ among local leaders, commissioners and practitioners so that at a practice level, social workers and frontline staff can feel more confident in using evidence and in playing a role in generating new evidence in improving the effectiveness of child protection work.