KNOWSLEY JSNA REPORT CHILDREN IN NEED AND AT RISK OF HARM

Children in Need and at risk o f h a r m JSNA

September 2015 (new data released November 2015)

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This report

This report has been prepared by Knowsley Council in consultation with the Knowsley Clinical Commissioning Group (CCG) and partner organisations of the Health and Wellbeing Board (HWB). Its purpose is to set out current understanding of issues relating to Children in Need in Knowsley, based on analysis of the latest available data.

It is one of a series of reports that inform Knowsley‟s understanding of local health and wellbeing priorities, based on analysis of needs, and set out in its Joint Strategic Needs Assessment (JSNA). Other JSNA reports cover topics that relate closely to children and young people‟s mental health, and these are available on the Knowsley Knowledge JSNA website. They include:

 Looked After Children  Children In Need or at risk of harm  Child & Family Poverty  Children with Disabilities & Complex Needs  Schools Capacity & Admissions  Educational Attainment and Attendance  Employment and Unemployment

This report is based on the most recently published formal statistics. Where later data is available but still classed as ‘provisional’ it will only be referenced if it signals significant change. New data releases will be monitored to ensure that the report can be updated as necessary. C o n t a c t s

For information about this report please contact:

Matthew Carey, Senior Analyst, (0151 443 2671)

[email protected]

Further information

For a PDF copy of this report, and other research intelligence products, visit Knowsley Knowledge – the website of Knowsley‟s JSNA

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This review deals specifically with those Children In Need referred to and supported by Knowsley Children‟s Social Services. Whilst Children with a disability and Children Looked After (those children referred to fostering or adoption services and currently in the care of the Local Authority) are included in analysis of referrals, assessments and CIN demographics, specific intelligence on these populations is covered in a separate JSNA report.

Section 17 of the Children Act 1989 defines a child as being in need in law if:

 He or she is unlikely to achieve or maintain or to have the opportunity to achieve or maintain a reasonable standard of health or development without provision of services from the Local Authority;  His or her health or development is likely to be significantly impaired, or further impaired, without the provision of services from the Local Authority;  He or she has a disability.

A number of acronyms are used throughout this document:

CYP – Children and Young People

CIN – Children In Need

CLA/LAC – Children Looked After/Looked After Children

PLAC – Privately Looked After Child/Children

CP/CPP – Child Protection/Child Protection Plan

CSC - Children‟s Social Care services

NFA – No Further Action

CSE – Child Sexual Exploitation

LSCB – Local Safeguarding Children‟s Board

Although not included in the CIN cohort, there can be significant overlap between services supporting children involved in anti-social behaviour, gangs and other Youth Offending issues, intelligence on this is included in the Crime JSNA.

Contributors

The majority of this report is based on evidence and analysis from the following organisations:

 Knowsley KMBC  Ofsted  DfE

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Executive Summary

This summary is intended to provide a stand-alone briefing on current intelligence about children in need (CIN) in Knowsley. What are the most critical CIN challenges facing Knowsley?

 There have been increases in the number and complexity of cases across Children‟s Social Care (CSC) services, with significant increases in referrals for Neglect and/or Abuse and a rise in referrals from police and other legal agencies (e.g. courts or probation services) leading to no further action. The proportion of referrals made is amongst the highest in the country, a significant number of re- referrals are made which had previously resulted in No Further Action (NFA).  Neglect is the most cited reason for children to be referred to children‟s social care and for becoming looked after. Cases are increasingly complex, requiring more time and resources. Qualitative research also suggests that domestic violence is an increasing concern as a contributory factor in child social care referrals.  There has been an increase across Childrens‟ Social Care (CSC) services in all aspects of work. In addition to the increase in referral rates, children subject to Child Protection Plans and Children Looked After numbers have also risen in the last year. This is possibly a consequence of a limited early help offer, and CSC either dealing with families too late or too many times before the right intervention is provided.  Cases involving children being referred appear to be more complex and regarded as "high tariff". Examples would include those young people at risk of Child Sexual Exploitation (CSE) in the community and those involved in gun and gang crime.  Marked increase nationally and locally in the number of referrals and cases of neglect. Neglect and abuse referrals have nearly doubled in Knowsley since 2013.  The most significant parental factors present for Children In Need and Child Protection caseloads are domestic violence, parental mental health issues and substance misuse. These factors overlap in many cases and high incidence locally mirrors the national picture for vulnerable children.  Locally and nationally the scale of hidden CSE poses a significant challenge for services and practitioners, .Knowsley has set up a multi agency CSE team in response to these challenges.

Following an inspection conducted in May 2014, Ofsted rated Knowsley CSC services for Children who need help and protection as inadequate, and the effectiveness of the Local Safeguarding Children‟s Board (LSCB) as inadequate. Key challenges highlighted by the inspection team included:

 Widespread failures and inconsistent practice across help and protection leaving some children and young people at risk of suffering harm.  Children who need help and support experience drift and delay in the support provided.

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 Early help services lack co-ordination and don‟t always work with the right children and families at the right time. Too few Common Assessment Frameworks (CAFs) are completed and not all are of the right quality.  Thresholds for referral to social care are not consistently applied by partner agencies and Children‟s services. This leads to a significant number of cases being inappropriately assessed

What is the scale of the problem, and who is most affected in Knowsley? Knowsley has a population of nearly 33,000 children and young people under the age of 18. This is 22% of the total population in the area. At March 31st 2015, there were 201 children subject to child protection plans. There were 306 children being looked after an increase of 10.5% on the previous year. Every year, the Department for Education (DfE) conducts a survey of children in need across local authorities in England. The survey is submitted in the Summer following each reporting year, and out-turn published by the following November.

 Referrals to Children’s Social Care: in 2014, 3,312 children, or 1025.7 per 10,000 Children and Young People (CYP) population referred for assessment to Knowsley‟s Children‟s Social Care. Provisional 2015 figures show a drop in referrals to approximately 722 per 10,000, or 2,500.

 Numbers of Children in Need (CIN): 1,181 children, or 365.7 per 10,000 CYP population supported Knowsley Childrens‟ Social Care in 2014. Early 2015 figures show a rise to 1299 children in need, or 401 per 10,000.

 Numbers of Child Protection Plans (CPP): 185 children, or 57.3 per 10,000 CYP population subject to a Child Protection Plan in 2014. In 2015 this has risen to 201, or 62 per 10,000.

 Children looked After: 257 children, or 79.6 per 10,000 CYP population in the care of the Local Authority. In 2015 this has risen to 306, or 94.5 per 10,000.

A number of factors have been identified as contributing to the risk of harm to children. Significant factors include households where drug or alcohol misuse are prevalent, where parents suffer from mental health issues, and households where children are exposed to domestic violence. Although Children are at risk of harm in all types of households, higher incidence in poorer areas has been noted across the country and Knowsley‟s high levels of relative deprivation may contribute to higher referral and assessment rates compared to less socio-economically challenged areas. Children at risk of harm due to association with gangs and drugs, as well as those at risk of CSE,and criminal expolitaion is increasing. These cases are very complex and challenging, as often children have already suffered significant harm.

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Have things been improving or getting worse? Despite an increase in referral rates overall CIN numbers had fallen regularly to March 2014. Referrals have reduced markecly in 2014/15, however the CIN cohort has increased to 1,299 but is still some way from the 2011 peak of circa 1,500. Increased referrals in 2013/14 were in part due to a higher number of initial contacts from Police and other legal bodies, the higher rates included more younger children (0-11 years old) as a proportion of the overall cohort, and an increase in neglect referrals. Numbers of children looked after have increased for the first time since 2008, whilst Child Protection Plan (CPP) cases have risen 30% since 2013, the first increase in number in five years. This trend has continued into 2014/15 with a provisional 20% rise in child protection plans and 25% increase in children looked after. The complexity of cases is reported to have increased posing greater challenge to services at the initial assessment stage. Anecdotal evidence suggests higher awareness due to media focus on recent high profile abuse cases and the resulting greater public scrutiny. It is suggested that alongside changes in national protocols and policy that this has led to heightened awareness of child safeguarding issues and has contributed directly to increased referrals. How are things expected to change over the next few years? Although the CIN population was marginally lower in 2014, the number of referrals and subsequent assessments had increased. Children are less likely to be included on the CIN register as the proportion of assessments resulting in no further action increased; there had also been a slight decrease in the length of time cases remained with CSC. In the short to medium term it is anticipated there will continue to be an increase in CP and CLA activity. Early figures for 2014/15 show an increase in all cohorts despite a reduced referral rate. How do we compare with national and regional averages, and statistical neighbours? At March 2014, the Local Authority‟s CIN population was higher than National rates, but much lower than statistical neighbour levels per 10,000 population. Whilst higher than average, CIN population rates are within the expected range given levels of deprivation and are not amongst the highest across all Local Authorities (LAs). Knowsley has slightly higher rates of CPP and CLA than statistical neighbours, although the much higher level of CSC referrals in 2014 than near neighbours was the most significant difference. At 1025.7 referrals per 10,000 children, rates were amongst the highest in England, with only six other authorities above the 1,000 mark, in the subsequent year referrals have fallen to closer to previous years. A rate

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of 772 per 10,000 in 2014/15 is still expected to exceed National rates when published.

How good is the available intelligence, and where are the gaps in our knowledge?

 There have been significant improvements in the last two years in data capture and comparative information outside the performance framework. However, Ofsted has challenged use of caseload data and noted poor record keeping as a critical issue.1

 There are extensive data sets available on all cohorts and service processes, available through the case management system – however subsequent analysis is strong on numbers but weaker on context and background.

 Performance of services is well documented.

 A lot of additional contextual information is currently hard to access in case notes, consistent recording especially in previous years makes comparisons on complexity and more detailed analysis problematic.

 The Ofsted inspection of Knowsley services found that the voice of children is not heard and their experiences are not fully understood, whilst Social workers place too much focus on the needs of adults. Whilst CLA views on services and the support they receive are well documented nationally and locally, wider CIN categories are not consulted as part of a statutory national framework.

Each of the Children‟s JSNA reports reference some of the currently available insight from vulnerable children whilst highlighting recording the experience of children as a key intelligence gap.

We have a commitment to broaden consultation with young people and their families and will be developing an insight plan to mainstream consultation processes in order to support service development and better hear the views of young people accessing our services.

Consultation should be designed with particular regard to the Office of the Children‟s Commissioners recommendations on hearing the voice of the child published in their report of December 2014 “Children and young people giving feedback on services for children in need: ideas from a participation programme”.

 Detailed information on Children Missing from home is a key gap.

1 Ofsted Inspection Report 2014 Inspection of services for children in need of help and protection, children looked after and care leavers

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 It is very difficult to say how many children and young people are being sexually exploited in the UK as a whole and in individual LAs because the hidden nature of the issue makes it harder to identify and there is no central system for recording cases.

Given that both professionals and victims can fail to recognise exploitation and that there is no national referral or reporting system, any approximate figure is likely to be massively underestimated.2

Locally, only four children on the CPP register at 31/03/14 where referred due to sexual abuse. However at December 2014, 17 children were monitored on the vulnerable pupils database following a referral of concerns of CSE.

2 'Real voices' - child sexual exploitation in Greater Manchester, Anne Coffey, MP

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Children In Need and at risk o f H a r m

Introduction

1. WHY IS SUPPORTING CHILDREN IN NEED IMPORTANT? Most children are able to lead normal, happy and healthy lives without the need for specialist or targeted services. However others have needs which go beyond the scope of universal services and require specialist support. These children are deemed to be children in need (CIN) and can include children where referrals have been made about their welfare and safety, those children who are subject to a Child Protection Plan (CPP) or children who have become looked after. A timely support package based on an early assessment of need is therefore crucial to enable the child to reach their potential and a failure to address these needs may place the child at risk and cause an escalation in their complexity.

Section 17 of the Children Act 1989 defines a child as being in need in law if:

 He or she is unlikely to achieve or maintain or to have the opportunity to achieve or maintain a reasonable standard of health or development without provision of services from the LA;  His or her health or development is likely to be significantly impaired, or further impaired, without the provision of services from the LA;  He or she has a disability.

LAs are under a general duty to safeguard and promote the welfare of all children in need in their area. LAs must do whatever possible to ensure sufficient services and measures are in place to promote a child being raised within its own family, if it is safe to do so. The LA is obliged to offer the following specific services/support for children in need in their area:

 Advice, guidance and counselling;  Occupational, social, cultural and recreational activities;  Home help (including laundry facility);  Facilities or assistance with travel to and from any services provided under the Act or similar service;  Assistance to enable the child and the family to have a holiday.

Given the challenges faced by children in need and the inevitable disruption to their education, outcomes for this cohort are significantly lower than that for children as a whole.

Across England‟s school population, CIN are three times more likely to have Special Educational Needs, to be eligible for free school meals (a proxy for child poverty), or be persistent absentees. They will miss twice as much school as the average child in England. Attainment outcomes are similarly depressed, nationally one third more CIN failed to reach expected levels in reading, writing and maths than the average 11 year old, whilst only 15% reached 5ACEM GCSEs including English and maths, compared to a national average of 57% in 2014.

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Knowsley England England 2014 CIN CIN all pupils Special Educational Needs (statemented/non-statemented) 58.1% 54.7% 17.9% Eligible for Free School Meals 70.4% 54.5% 17.6% Achieving level 4+ in Reading/Writing/Maths at Key Stage 2 45% 46% 79% Achieving 5 or more GCSEs grade C or above inc. English and Maths xx* 15.1% 56.6% Absence from school in 2012/13 academic year 11.2% 10.4% 5.2% Percentage of cohort who are persistent absentees 2012/13 17% 15.4% 4.6% * Cohort sizes for attainment in Borough too small to publish attainment, 2015 data available November 2015

Recent research has shown that the impact of Adverse Childhood Experiences (ACEs) such as childhood sexual or physical abuse, exposure to domestic violence or family dysfunction significantly increase the incidence of health harming behaviours in adulthood. Statistical research showed that ACEs could be responsible for 11.9% of binge drinking, 22.7% of smoking, 22% of violence perpetration, 59% of heroine/crack cocaine use and 38% of unintended teenage pregnancy across the country.3

Adverse Childhood Experience, or ACE‟s are a complex set of related childhood experiences that directly affect a child or, the environment in which they live, i.e. household dysfunction.

One of the largest ever studies into the long-term relationships between childhood maltreatment & later-life health and wellbeing was a collaboration between the Centre for Disease Control and Kaiser Permanente – 1995-97. The study found risks to long term health and wellbeing were increased by five direct adverse experiences – 1. Sexual abuse by parent / caregiver 2. Emotional abuse by parent / caregiver 3. Physical abuse by parent / caregiver 4. Emotional neglect by parent / caregiver 5. Physical neglect by parent / caregiver And five indirect adverse experiences - 1. Parent / Caregiver addicted to alcohol / other drugs 2. Witnessed abuse in the household 3. Family member in prison 4. Family member with a mental illness 5. Parent / Caregiver disappeared through abandoning family / divorce

3 National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England, Centre for Public Health

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ACEs are strongly related to development and prevalence of risk factors for disease and health and social wellbeing throughout the lifespan. Two in three adults reported at least one ACE during their childhood, more than 1:5 reported 3 or 4. Short and long term outcomes can result in a multitude of health and social problems, and as the number of ACE increases the risk for a wide range of health problems increases in a strong and graded way, responsible for increased likelihood of several significant life limiting outcomes including:

 Alcoholism and alcohol abuse, smoking, illicit drug use,  COPD, liver disease, heart disease  Depression, suicide attempts, fetal death  Health-related quality of life  Risk for intimate partner violence  Multiple sexual partners, STDs, early sexual activity, teenage conceptions, unintended pregnancy

The National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England, conducted by the Centre for Public Health measured the Increased risk (adjusted odds ratio) of having health behaviours and conditions in adulthood for individuals experiencing four or more ACEs in childhood.

 Pregnant or got someone accidently pregnant Under 18, 4.5 times more likely  Liver or digestive disease, 2.3 times more likely  Stayed overnight in hospital in last 12 months, 1.5 times more likely  Had a sexually transmitted infection, 30.6 times more likely  Morbidly Obese, 1.82 times more likely  Heroin or Crack user, 9.7 times more likely  Regular Heavy drinker, 3.7 times more likely  Been hit in last 12 month, 5.2 times more likely  Hit someone in last 12 months, 7.9 times more likely  Been in prison or cells, 8.8 times more likely

Impact on Knowsley residents

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2. WHAT IS THE SCALE OF THE CHALLENGE IN KNOWSLEY?

Knowsley has a population of nearly 33,000 children and young people under the age of 18. This is 22% of the total population in the area. At March 31st 2015, there were 201 children subject to child protection plans an increase of 8.6% on the previous year. There were 306 children being looked after an increase of 14.4% on the previous year. Every year, the Department for Education (DfE) conducts a survey of children in need across local authorities in England. As at March 31st 2015 Knowsley had:

 Referrals to Children’s Social Care: 2,500 children, or 772 per 10,000 CYP population referred for assessment to Knowsley‟s Children‟s Social Care.  Numbers of Children in Need (CIN): 1,299 children, or 401 per 10,000 CYP population supported Knowsley Childrens‟ Social Care.  Numbers of Child Protection Plans (CPP): 201 children, or 62 per 10,000 CYP population subject to a Child Protection Plan.  Children looked After: 301 children, or 95.4 per 10,000 CYP population in the care of the Local Authority.

Core indicators informing scale and trend: Activity (All numbers per 10,000 child population) 2011/12 2012/13 2013/14 2014/15 Number of referrals received in the period 888.1 822.9 1025.7 772 Number of children in need at point in time 437.3 371 366 401 Number of children subject of cp plans at point in time 47.9 43.6 57.3 62 % of referrals which are repeat referrals 32.3% 33.3% 36.4% 30.2% % children subject of a child protection plan who are NOT 0% 0% 0% 0% allocated to a qualified social worker % children looked after who are NOT allocated to a qualified 0% 0% 0% 0% social worker % children subject of a child protection plan for a second or 14.8% 11.7% 12.7% 13.5% subsequent time

Comparison over time: National and Statistical Neighbour comparisons (per 10,000 child population):

Referrals to CSC resulting in NFA To 31st March 2012 2013 2014 Knowsley 6.8 12.7 19.0 Stat Neighbours 7.3 5.4 4.4 England 15.6 14.5 14.1 4

4 https://www.gov.uk/government/publications/local-authority-interactive-tool-lait DFE October 2014

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CIN Rate To 31st March 2011/12 2012/13 2013/14 2014/15 Knowsley 437.3 381.3 365.7 401 Stat Neighbours 456.8 475.7 464.8 n/k England 325.7 332.2 346.4 n/k

CPP Rate To 31st March 2012 2013 2014 2015 Knowsley 48 44.1 57.3 62 Stat Neighbours 55.9 51.7 62.0 n/k England 37.8 37.9 42.1 n/k

Referral rates and levels of CPP are higher than both National and statistical neighbour levels, however referrals resulting in NFA are the most significant indicator above comparable areas, and last year rose against the national trend.

Cohort over time:

Referral numbers rose steeply between 2009 and 2014. From a low of 1,851 in 2009 numbers increased 180% to 3,312 in 2014. Despite this, the overall number of CIN remained relatively stable and actually fell to below the 2010/11 peak of 1,456 children. 2014/15 referrals fell significantly to 2,500, although an increase in the CIN cohort to 1,299 in March 2015 suggests systems changes rather than a reduction in need as the cohort appears to have stabilised in the last three years.

Referrals and CIN Cohort

3500 3000 Referrals 2500 2000

1500 CIN 1000 500 0 2008/092009/102010/112011/122012/132013/14

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The peak numbers of CIN in the 2010-12 period coincided with increases in National referrals, due in part to heightened public awareness and professional focus following the „Baby P‟ case and the subsequent reforms the inquiry lead to.5

Numbers of CLA and CPP have both risen in the last year, and the number of children subject to a CPP are at their highest in over 5 years. CLA & CPP Cohort

350 300 250 CLA 200

150 CPP 100 50 0 2008/092009/102010/112011/122012/132013/14

The needs of children in care are dealt with in greater detail in a separate JSNA report on Looked After Children.

 Initial Contacts

The highest number of CSC queries or „initial contacts‟, those that do not necessarily lead to a referral, come from the police and other legal services. This has increased from 34% in 2013 to 41% of contacts in 2014. This matches national trends where initial contacts are most likely to be made by police services.

Nearly two thirds of initial contacts do not lead to a referral. The proportion of queries leading to no further action has increased significantly in the last year, the highest proportion of these is accounted for by the increase in police contacts.

5 https://www.nao.org.uk/report/children-in-care/ National Audit Office November 2014

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Voluntary Initial contacts by service and Community Services Education Local 6% 8% Voluntary and Community Services Authority Services 17% Local Authority Services 2013/14 All Other 2012/13

Health All Other 11% Police

Education Police Health 41% 17% 0 1000 2000 3000 4000

Voluntary Initial contacts by service and Community Services Education Local 6% 8% Voluntary and Community Services Authority Services 17% Local Authority Services 2013/14 All Other 2012/13

Health All Other 11% Police

Education Police Health 41% 17% 0 1000 2000 3000 4000

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Outcome of initial contacts Other Referral to 3% social care 39%

Other

No Further Action

2013/14

Advice and Information provided 2012/13 No Further Action 58% Referral to social care

Advice and Information 0 2000 4000 6000 provided 0%

Outcome of initial contacts Other Referral to 3% social care 39%

Other

No Further Action

2013/14

Advice and Information provided 2012/13 No Further Action 58% Referral to social care

Advice and Information 0 2000 4000 6000 provided 0%

 Referrals to Children’s Social Care: There were a total of 3,231 referrals to Children‟s Social Care (CSC) in 2012/13 and at 822.9 per 10,000; Knowsley‟s referral rate was much higher than North West (619.7) and England (520.7) averages. Based on National figures the highest proportion came from the police service (31.5%) with a further third from health and education services (17.2% and 17%).

Referrals rose to 3,312 in 2013/14 or 1025.7 per 10,000; an increase of 14.4%. Nationally, the rate rose to 573 per 10,000 children, an increase of 10%.

Full referrals to CSC in 2013/14 came predominantly from police and other legal services. As with initial contacts, this has increased on the previous year. National data shows a similar pattern of increased referrals and increased police referrals across most Local Authorities.

Referrals in in 2014/15 fell to 2,500, analysis of sources and reasons for referral will become available by the end of the year.

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Source of referrals Other/unkn Individual own 9% 8% Other legal 6% Education Other/unknown services 11% Other legal Police LA Services 2013/14 Housing Health Health Services 2012/13 Police Services 28% 18% Education services Individual Housing 4% LA Services 0 500 1000 16%

Source of referrals Other/unkn Individual own 9% 8% Other legal 6% Education Other/unknown services 11% Other legal Police LA Services 2013/14 Housing Health Health Services 2012/13 Police Services 28% 18% Education services Individual Housing 4% LA Services 0 500 1000 16%

Referrals by individuals 9% of referrals were made by individuals rather than Family services. Nearly one in ten 88% referrals came from a family Acquaintance member of the child causing 2% concern. The remaining referrals are predominantly made by the child, strangers Self 9% make up only 1% of referrals by individuals. Stranger 1%

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17% of referrals are made by members of the Health Services. 50% of these are made by services other than GPs or Accident and Emergency, such as hospital ward discharge or hospices.

Local Authority referrals are predominantly internal to Knowsley, with most coming from within Social Care services for both children and adults. 23% of LA referrals have come directly from Social Care Services in other Local Authorities.

The main reasons for referral are for suspected abuse or neglect, or for family dysfunction, these account for 73% of all LA referrals.

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Family Reasons for referrals dysfunction 39%

Not stated (N0) Cases other than Children in Need (N9) Low income Family in 0% Absent parenting (N8) 2013/14 acute stress 14% Low income (N7) Socially 2012/13 unacceptable Socially unacceptable behaviour (N6) behaviour Family dysfunction (N5) 7% Absent Family in acute stress (N4) Parental parenting disability/illne 0% Parental disability or illness (N3) ss 2% Not stated Child’s disability or illness (N2) 4% Abuse or neglect (N1) Child’s disability/illne ss Cases other Abuse/neglect than CIN 2% 0 200 400 600 800 1000 1200 1400 32% 0%

Family Reasons for referrals dysfunction 39%

Not stated (N0) Cases other than Children in Need (N9) Low income Family in 0% Absent parenting (N8) 2013/14 acute stress 14% Low income (N7) Socially 2012/13 unacceptable Socially unacceptable behaviour (N6) behaviour Family dysfunction (N5) 7% Absent Family in acute stress (N4) Parental parenting disability/illne 0% Parental disability or illness (N3) ss 2% Not stated Child’s disability or illness (N2) 4% Abuse or neglect (N1) Child’s disability/illne ss Cases other Abuse/neglect than CIN 2% 0 200 400 600 800 1000 1200 1400 32% 0%

Family Dysfunction, at 1,364 instances in 2013/14, is the most common single cause for referral. Whilst this is a similar number to the preceding year, Neglect or Abuse referrals increased significantly, nearly doubling to 1,064 instances in 2014. Neglect referrals have seen similarly large increases across the country and account for one in three referrals.

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Outcome of referrals Signposting to other services 1%

No Further Other Action 19% 2013/14 No Further Action 2012/13 Signposting to other services Further Further Assessment required (inc Assessment Initial/Single) required (inc Other Initial/Single) 1% 78% Strategy discussion and/or s47 enquiry Strategy discussion and/or s47 enquiry 0 500 1000 1500 2000 2500 3000 1%

Outcome of referrals Signposting to other services 1%

No Further Other Action 19% 2013/14 No Further Action 2012/13 Signposting to other services Further Further Assessment required (inc Assessment Initial/Single) required (inc Other Initial/Single) 1% 78% Strategy discussion and/or s47 enquiry Strategy discussion and/or s47 enquiry 0 500 1000 1500 2000 2500 3000 1%

Most referrals will result in a further assessment, but one in five will result in No Further Action (NFA). NFAs have increased in the last year in tandem with the overall increase in referrals, however they are no more likely to be for one particular reason, with the proportion by referral reason similar to that of all referrals.

Reason for referral 2014 No % N1 Abuse or Neglect 1064 32% N2 Disability 48 1% N3 Parent Illness / Disability 52 2% N4 Family in Acute Stress 503 15% N5 Family Dysfunction 1364 41% N6 Socially Unacceptable Behaviour 249 8% N7 Low Income 2 0% N8 Absent Parenting 11 0%

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Referral cohort 31st March 2014

In 2013/14 two thirds of referrals where for children aged 0-10. Whilst older referrals where slightly more likely to be for girls, 53% of younger referrals where for boys.

Age at referral

16+ 266 8%

11-15 867 32% 0-4 27% 5-10 5-10 1099 11-15 16+ 0-4 1028 34%

0 200 400 600 800 1000 1200

66% of referrals where made for children below the age of 11. Referrals are most likely to be for children aged 5-10, children aged 16+ account for only 8% of all referrals made.

Age at Referral

129 16+ Male 137 Female 400 11-15 467

571 5-10 528

531 0-4 478

0 100 200 300 400 500 600

Re-referrals

One third of all referrals are a second or third referral for a child already identified by services. This is similar to national averages.

Re-referral Re-referral Reason for referral No Yes Total No Yes N1 Abuse or Neglect 702 362 1064 66% 34% N2 Disability 34 14 48 71% 29% N3 Parent Illness / Disability 29 23 52 56% 44% N4 Family in Acute Stress 341 162 503 68% 32% N5 Family Dysfunction 825 539 1364 60% 40% N6 Socially Unacceptable Behaviour 151 98 249 61% 39% N7 Low Income 2 2 100% 0% N8 Absent Parenting 6 5 11 55% 45% Grand Total 2090 1203 3293 63% 37%

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N6 Socially Unacceptable Behaviour 8% N1 Abuse or 30% of re-referrals are for cases of Neglect 30% suspected abuse or neglect, 45% for family dysfunction. This is in line with the proportion of total referrals for these N2 Disability 1% reasons and is similar to levels of re-referral

N3 Parent Illness / Disability in previous years. N5 Family 2% Dysfunction 45% N4 Family in Acute Stress Multiple referrals in year 14% 76% of re-referrals are only a second referral, these are predominantly referred due to family dysfunction, suggesting changing circumstances rather than high thresholds are responsible for an initial assessment resulting in „no further action‟.

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Assessment Outcomes 2013/14

Single Assessment (ICSCFAssess)

No Further Action Assessment Outcome No % Single Assessment (ICSCF) 2092 63.5% No Further Action 631 19.2% Single Assessment (10 Single Assessment (10 days) 486 14.8% Days) Strategy Discussion 41 1.2% CP Transfer from OLA 16 0.5%

Strategy Discussion Other action (incl. referral to other agency and provision of advice) 27 0.8%

CP Transfer From OLA - Transfer In Child Protection Conference Other action*

In 2013/14 four out of five assessments resulted in a further assessment process, one in five lead to no further action.

 Numbers of Children in Need (CIN): During 2012/13, there were a total of 1,237 children identified as in need. This equates to 381.3 per 10,000 which included 143 children and young people subject to a Child Protection Plan (CPP) and 237 Children Looked After (CLA). Although this figure fell compared to the previous year (437.30 per 10,000 in 2012) it was much lower than our statistical neighbours (454.0 per 10,000) but these levels of need were still higher than the North West (341.3 per 10,000) and England (332.2 per 10,000) averages.

During 2013/14, the cohort fell to 1,181 children identified as in need. This equates to 365.7 per 10,000 which includes 185 children and young people subject to a Child Protection Plan (CPP) and 257 Children Looked After (CLA). This compares to a national rate of 346.4 per 10,000 children.

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The scale of health and other inequalities

Socially unacceptable Abuse or Contributory factors in behaviour Neglect assessments recorded Self 10% Child Sexual 4% harm Other 2013/14 Exploitation Gangs 1% 23% 0% 1% Missing 1% Young Carer 1% Learning Alcohol misuse Physical Disability 8% Disability 4% or Illness 4% Mental Health 15% Drug Misuse 9% Domestic Violence 19%

During 2013/14 CSC services started to record factors contributing to the vulnerability of children in need, noting family or environmental circumstances relevant to the case. The most significant factors was domestic violence, a contributory factor in 19% of cases, followed by drug and/or alcohol misuse (17%) and mental health issues of the parent, child or other family member (15%).

% CIN At 31/03/14 by duration

2+yrs

1-2yr

6mths-1yr Knowsley England 3-6mths

<3mths

0 10 20 30 40 50

CIN cases in Knowsley are more likely to stay open for longer periods of time. At March 2014 a child was more likely to have been on the caseload of CSC for more than 2 years than national averages.

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% CIN Ending in 13/14 by duration

2+yrs

1-2yr

6mths-1yr Knowsley England 3-6mths

<3mths

0 10 20 30 40 50 60 70

Numbers of Child Protection Plans (CPP):

At March 2014 there were 201 children subject to a CPP, this equates to 62 per 10,000 population aged under 18.

At March 2014 there were 185 children subject to a CPP, this equates to 57.3 per 10,000 population aged under 18; this compares to a national figure of 42.1 per 10,000. During 2013/14, 77.3% of all CPP‟s resulted from either emotional abuse or neglect compared to the national and regional averages of 73%

143 children were subject to a CPP on 2013. This equates to 44.1 per 10,000 population aged under 18, and whilst this decreased from previous years (49.1 in 2011 and 48.0 in 2012) this was still higher than the North West (41.4 per 10,000) and England average (37.9 per 10,000). Knowsley did, however, perform well in comparison to our statistical neighbours (50.4 per 10,000).

Length of time on protection plan.

Cumulative Years Frequency % 0.5 138 75.00% 1 36 94.57% 1.5 3 96.20% 2 4 98.37% More 3 100.00%

Looking at long term or repeat CPP rates can give an indication of future need as these children on the edge of care are most likely to become CLA. Over two thirds of CPPs during 2013/14 were in place for less than 12 months, 4% for longer than 18 months and those over two years 1.6% (or 3 children). This suggests that where children are facing a second or subsequent CPP this is often due to longer term/mid-term issues rather than immediate concerns or new circumstances arising.

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The numbers of those children becoming the subject of a CP plan for a second or subsequent time during 2013/14 were noticeably higher than previous years (with the exception of 2011/12 where figures almost doubled from the previous year). During 2013/14, 81.8% of all CPP‟s resulted from either emotional abuse or neglect compared to the national and regional averages of 73%. Cases of emotional abuse have decreased since 2013 and cases of neglect have increased.

Number of CPP at 31st March by 2014 Multiple/ category Emotional Not Abuse Recomme Multiple/Not Recommended 38% nded 7% Emotional Abuse

Sexual Abuse 2013/14

Physical Abuse 2012/13 Sexual Abuse 2% Neglect

Physical Neglect 0 20 40 60 80 Abuse 39% 14% At March 2014, an equal proportion of the 185 cases where due to neglect (72 children) and Emotional Abuse (70 children). However, compared to 2013, there has been a marked increase in cases of neglect.

Younger children are much more likely to be subject to a CPP, with 68% aged under 10. However, there has been a marked increase in cases for children aged 10-16+ compared to the previous year. Number of CPP at 31st March by 2014 10 to 15 Age 29% 16 and over 16 and over 3% 10 to 15

5 to 9 Under 1 1 to 4 14% 5 to 9 2013/14 30% Under 1 2012/13

0 20 40 60 1 to 4 24%

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Children aged over 10 make up 28% of the CPP cohort (51 children), whilst the proportion under 5 is 38% (71 children).

Count of Case Age Number 2014 0-4 years 71 38.4% 5-10 years 63 34.1% 11-15 years 46 24.9% 16+ years 5 2.7% Grand Total 185

Cases are evenly split between boys (49%) and girls (51%), although older children are more likely to be female.

5-10 11-15 16+ Grand Gender 0-4 years years years years Total Female 34 31 29 94 Male 37 32 17 5 91 Grand Total 71 63 46 5 185

The increase in neglect cases and the higher proportion of older children supported is reflected in new cases brought between April 2013 and March 2014. Neglect cases have almost doubled, whilst the proportion of older children has nearly doubled in the 10-15 age range.

Child Sexual Exploitation

Recent high profile court cases and reports have raised awareness of the crime of child sexual exploitation. In late 2013 the interim report of the Office of the Children‟s Commissioner‟s two year inquiry into CSE in gangs and groups found that the equivalent of every pupil in three medium sized secondary schools was being subjected to sexual violence on a routine basis (2,409 young people).6

On top of this, in a 12 month period, there was the equivalent of 20 medium sized secondary schools at high risk of CSE (16,500 young people). It is generally agreed that this figure is an under-estimate. They also do not take into account CSE committed by lone perpetrators.

CSE is not limited to any particular geography, ethnicity, gender or social background. The evidence increasingly shows that it is a widespread problem and no one should assume that it does not happen in their area.

The majority of young people who experience CSE are not living in care. However, looked after children account for a disproportionate number of victims and can be particularly vulnerable. An estimated 20-25% of victims are looked after despite being only 1% of the child population.

6 Interim report of the Office of Children‟s Commissioner‟s two year inquiry into CSE in gangs and groups

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The CQC/Ofsted framework for thematic inspections of Local Authorities conducted over the Autumn/Winter of 2014 identifies the key cohorts of children at risk –

 Children and young people who are known to children‟s social care either because they have been the victims of CSE and/or have been identified as being at risk of being sexually exploited.

Only four children on the CPP register at 31/03/14 where referred due to sexual abuse. However at December 2014, 17 children were monitored on the vulnerable pupils database following a referral of concerns of CSE.

 Children and young people who are repeatedly missing from home, school or care.

In the twelve months to August 2014, 83 individual children were reported missing from care in a total of 160 episodes.

 Looked after children, including those placed out of area because of concerns about the risk of CSE.

 Children and young people who are described as “out of control”/ “beyond parental control” where missing from home is a feature.

 First time entrants to the criminal justice system where offences may be connected to CSE.

 CSE and missing from home cases that have been closed within the last 6 months.

Knowsley has also set up a multi agency CSE team in response to tackling CSE and supporting children who are victims. The team consists of police officers, social workers, Barnardos, education and family support workers.

Categories of child sexual exploitation

The Barnardos „Puppet On A String‟ report defined three broad categories of child sexual exploitation. These were described in four four types as:

 Inappropriate relationships.

 „Boyfriend‟ model of exploitation; and peer exploitation.

 Organised/networked sexual exploitation or trafficking.

 Young People exploited via gangs

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There is significant cross over between the first two listed as they both involve an imbalance of power, which perpetuates the abuse and undermines the will of the victim to the extent that they feel unable to remove themselves from the position they are in.

There is evidence that children across all cultures, and including a significant proportion of children in the care of local authorities, can be at risk of sexual exploitation. Vulnerability and low self-esteem are the most common factors amongst children who are at risk of being sexually exploited. In some cases, peers who are already involved may draw children into sexual exploitation. An older young person or adult who poses as, and who they view as, their partner, frequently coerces young people into sexual exploitation. The young person becomes physically and emotionally dependant on “the partner”, and this may be reinforced by the use of alcohol and drugs. Over time, the young person‟s access to their friends and family becomes curtailed and they become alienated from agencies that may be able to identify and interrupt the abuse. Safeguarding children and young people from sexual exploitation requires two interlinked strategies: one aimed at supporting the child or young person; the other aimed at disrupting and prosecuting alleged abusers.

Young people experiencing Domestic Violence Co-ordinated Action Against Domestic Abuse (CAADA) work with Young People Violence Advisors (YPVAs) to support young people experiencing relationship abuse. Since the beginning of 2014, CAADA has been working with YPVAs to collate and analyse data on the support they provide.

Of the young people in this National dataset7:

 More than half are experiencing high risk domestic abuse. 67% of the young people who were risk assessed were found to be at high risk of harm. 53% of the young people were referred to Multi Agency Risk Assessment Conference (MARAC).  The vast majority are experiencing multiple types of current and historic abuse. 83% of victims supported by YPVAs were experiencing current abuse at the point of engagement, while 42% had also experienced abuse in the past. More than half of victims experienced emotional abuse (73%), jealous and controlling behaviours (68%), and physical abuse (57%). Almost half (49%) had experienced harassment and stalking. A significant number have complex needs and additional vulnerabilities. Of the young people supported, 1 in 5 had children of their own, and 1 in 10 were pregnant. Victims frequently experienced depression or anxiety (63%) or self-

7 Young People’s Programme data CAADA

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harmed (43%). Other vulnerabilities included sleep problems (36%), drug misuse (23%), eating problems (15%) and alcohol misuse (14%). 11% had planned or attempted suicide. In the last twelve months 1,292 cases involving a victim aged 16-17 were discussed at MARAC nationally, representing 1.7% of all cases discussed. There were also 677 young people aged 17 or below causing harm.

Locally, the 250 cases discussed at MARAC between October 2013 and September 2014 affected a total of 352 children, with 4 cases where the victim was aged 16-17 representing 1.6% of all cases discussed. This compares to a Merseyside rate of 2.1%. A further 3 cases involved young people aged 17 or below causing harm.

Vulnerable pupils

Locally, the Inclusion service monitors the school attendance of Knowsley‟s vulnerable children aged 5-16. Notification on referral is forwarded to the inclusion team from partner agencies including YOS, CSC, Family/school health, exclusions & attendance service. Categories of vulnerable children included in the data set cover -

SEN statemented children/ Children missing from Education/ LAC/ Runaways/ missing from home/ Child Protection & CSE/ YOS/ Homelessness/ Teenage pregnancy/ Young carers.

The data set has may help to meet identified intelligence gaps such as measuring the overlap in vulnerable cohorts where service level systems provide caseload notes rather than data; and mapping the pathways to multi service referrals taken by vulnerable children, e.g. „what proportion of TP cases where preceded by persistent absence, or exposure to DV?‟.

3. WHO IS MOST AT RISK? Demographically, the characteristics of the CIN cohort match the population overall, with low levels of BME and an expected gender split of slightly higher referrals and cases for boys which mirrors the national split. Geographically dispersed throughout the Borough, cases occur predominantly in the most deprived neighbourhoods and deprivation is persistently cited as a contributory factor. However the socio-economic make up of Knowsley means this rarely results in significant localised clusters which occur in many other urban areas (particularly large urban areas such as London or Birmingham).

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3.1 Children exposed to domestic violence

Locally and nationally it is difficult to be sure how many Parent children and young people are 72% Domestic violence affected by domestic abuse directly or indirectly. As with domestic abuse generally, it is widely under reported and unknown. Other household Reported figures show 352 member 9% children locally living in a household with a recorded Child 19% domestic violence incident in the twelve months to October 2014. However, as it has been estimated nationally that 1 in 20 children and young people experience severe forms of domestic violence which equates to potentially 1,800 children in Knowsley being affected.

Where evidenced, 669 cases, or 19% of CIN assessments recorded a concern over domestic violence. Although overwhelmingly parents/carers or other householders, in one in five cases the child referred is the one considered a risk to other family members. Further detail on the prevalence and impact of domestic violence is covered in a separate Domestic Abuse JSNA.

Child Protection Conferences - January snapshot

In January 2015 there were 37 child protection conferences (initial and review conferences). This is a higher number than a typical month due to seasonal variances (Christmas holidays impacting on workforce of social care and partners, and potential increases in domestic violence), but it does show how the issues of parental substance abuse, domestic violence and mental ill health interact.

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CPC parental factors: January 2015

Learning disability 3%

Learning difficulty 5%

Physical disability 3%

Drugs 38%

Alcohol 43%

DV - Victim 59%

DV - Perpetrator 49%

Mental Health 30%

Depression 32%

Personality Disorder 0%

Adults that pose risk to children 8%

Children's behaviour 3%

From this it is clear that parents experiencing domestic violence as a victim is the highest parental factor in CP conferences, followed by domestic violence as a perpetrator. The conferences record whether it is the female or male carer experiencing these factors, and all but one of the victims of domestic violence was the female carer.

In terms of cases where substance abuse (drugs and alcohol), domestic violence and mental ill health is present account for a quarter of all child protection cases in January 2015. There are, however, significant overlaps between domestic violence and substance abuse, and mental ill health and substance abuse.

This will be tracked to ascertain whether domestic violence has spiked following the Christmas period, and whether this is a true reflection of Child Protection cases.

A number of services are commissioned to support the victims and perpetrators of domestic abuse within Knowsley, however none are specifically targeted at children in households.

Knowsley currently commissions a range of services for victim survivors and their families and perpetrators of Domestic Abuse. Arrangements already in place to support those experiencing / perpetrating domestic abuse include:

. The Knowsley Multi Agency Risk Assessment Conference (MARAC) is a multi agency approach to supporting high risk victim survivors of domestic abuse and any children involved.

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. Independent Domestic & Sexual Violence Advocacy (IDSVA) Services are available to support victim survivors in high risk cases, providing advice and information at the point of crisis. IDSVA advocacy for high risk cases identified at MARAC supported 250 families, with 352 children in the year to September 2014. . Help and support is promoted throughout the year, including the White Ribbon campaign - an annual event encouraging people to wear a white ribbon and pledging never to commit, condone or remain silent about violence against women. . The Freedom Programme is offered in Knowsley, helping women to understand the issues of what domestic abuse is and how perpetrators use a variety of different tactics to control them. . Knowsley Council and a number of partner agencies have introduced Domestic Abuse Champions – dedicated people in organisations who staff can turn to for support.

InPACT, Knowsley‟s local male perpetrator programme, uses the Domestic Violence Intervention Programme (DVIP) which is a programme based on the Duluth model. This has two basic aims to:

. empower women and increase their safety . to stop men‟s use of violence and abuse

Of the 58 new referrals in 2013/14, a majority (30) were made via Children‟s Social Care, affecting at least one child in each case. During the year –

 2 CLA (children looked after) returned to full time care of parents on male partners successful completion of programme.  1 case closed by Children‟s Social Care after man completed programme.

Knowsley has its own, purpose built, refuge provision in one of the main townships. The building is owned by a large Registered Provider (Social landlord). The refuge is part of a number of refuge support services across the Liverpool City Region and the North West of England. The nature of a women‟s refuge is that it acts as a first point of contact for referrals coming through from Knowsley agencies and providers and also offers a reciprocal arrangement to other refuge provision to accept women and children who need to be offered safe accommodation outside of their home borough.

The building from which the refuge is provided has 36 beds and is designed in such a way that the service can support 9 families or 17 single women at any one time. This makes it a very flexible space that enables the service to provide a safe, supported environment to enable women and children to make informed choices.

In 2013/14 the refuge accommodated 53 women and 56 children; 15 of the women had an additional need due to substance misuse, 19 had a mental health condition.

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The Sanctuary Scheme provides security for properties which enable victims of domestic abuse to stay in their homes. Between 2011 and 2013 the Knowsley Sanctuary scheme supported 21 households.

3.2 People with disabilities In 2014 4% of assessments (124) noted physical disability or illness of the child or other family member as a contributory factor. In one third of cases the child in need had a disability or illness. Other Physical disability household Parent member 55% or illness 5% Learning disability Parent Other 19% household member 11%

Child 76% Child 34%

4% of assessments (132) noted a learning disability of the child or other family member as a contributory factor. In most cases (75%) the child in need has the learning disability.

Amongst local Children in Need in Knowsley Learning Difficulties are the highest noted form of disability, followed by Autism, or Asperger‟s Syndrome, this mirrors the national levels of disability in the CIN cohort, although it is much higher in Knowsley at 39%, compared to 29%.

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% CIN At 31/03/14 by disability

OtherDisability Vision PersonalCare Mobility Learning Incontinence Knowsley Hearing HandFunction England Consciousness Communication Behaviour AutismAsperger

0 10 20 30 40 50

Although rates have not changed across England since 2013, levels of Autism/Aspergers within the CIN cohort have increased significantly in Knowsley, it is not clear if this is an increase in identification or incidence. The needs of disabled children are dealt with in greater detail in a separate JSNA report on Children with disabilities & complex needs. CIN cohort disabilities by type - 2013

OtherDisability Vision PersonalCare Mobility Learning Incontinence Hearing HandFunction Knowsley Consciousness England Communication Behaviour Autism/Asperger

0% 10% 20% 30% 40% 50%

3.3 People with drug and alcohol problems 9% of assessments (286) record drug misuse as a significant factor in the case. In most cases (77%) a parent is the drug abuser, although 28 cases were recorded as the child being the person of concern.

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Parent Parent 77% Drug misuse 91% Alcohol misuse

Other household Other member household 13% member Child 3% Child 6% 10%

7% of assessments (233) record alcohol misuse as a significant factor in the case. In most cases (91%) a parent is the alcohol abuser, although 13 cases were recorded as the child being the person of concern.

Locally, substance misuse treatment is commissioned from CRI, an Adult and Young People Service providing recovery services, treatment that also has an intensive DIP (Drug Intervention Programme) working closely with Public Health England and Liverpool John Moores University. The locally commissioned services operate as Knowsley Integrated Recovery Services (KIRS) and works in partnership with the police, probation and the prisons providing assessment, treatment and recovery services, in secure settings and in the community.

In 2013/14 805 children lived in households where clients were receiving treatment for substance misuse. CRI Knowsley also recorded 361 children of clients receiving treatment who did not live in the same household.

Children with Children Children with Children Partner (incl with Grand- Other Family Children Children with Client ex-partners) Parent Member in Care Elsewhere

805 216 45 38 20 42

* April 2013 –March 2014 KIRS Annual Report

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3.4 People with mental health problems

14% of assessments (474) record mental Parent health issues as a significant factor in the 73% case. In most cases (73%) a parent is the Mental health person of concern, although 90 cases were recorded as the child being the person of concern. Other The needs of children with mental health household disorders are dealt with in greater detail in member a separate JSNA report on Childrens 8% mental health & wellbeing. Child 19% 3.5 Risk Factors for CSE

Research has shown that a number of factors can increase a young person‟s vulnerability to sexual exploitation.

In its 2011 report, Puppet on a string: The urgent need to cut children free from sexual exploitation, Barnardos‟ identified a number of risk factors increasing a child‟s vulnerability to CSE. These include disrupted family life and domestic violence, a history of physical or sexual abuse, disadvantage, poor mental health, problematic parenting, parental drug or alcohol misuse and parental mental health problems.

We also know that some groups of young people are more vulnerable to targeting by the perpetrators of sexual exploitation. These include children living in care, particularly residential care, those who are excluded from mainstream school and those who misuse drugs and alcohol.

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4. WHICH AREAS OF THE BOROUGH ARE MOST AFFECTED?

As with so many other factors affecting Concentration children‟s development and future outcomes, of referrals to the geographic distribution of CIN and CSC CSC referrals coincides significantly with the areas of the Borough with the highest levels of deprivation. Specific intelligence on areas affected by deprivation is detailed in the Child & Family Poverty JSNA. Referrals, assessments and subsequent CIN cohorts are largest in number and as a percentage of the child population in the Kirkby area of the borough. This is the case for all key CIN cohorts. The highest localised concentration of CIN occurs in the North Huyton and North Kirkby areas. Almost half of all CPP cases are in Kirkby.

CSC Referrals by ward CSC Referrals 2013/14 Ward 2012/13 2013/14 2012/13 2013/14 Central 1124 34% Cherryfield 161 149 6% 5% North 1218 37% Halewood North 61 47 2% 2% South 914 28% Halewood South 70 118 3% 4% Other 37 1% Halewood West 130 124 5% 4% Kirkby Central 119 199 5% 6% Longview 230 271 9% 9% Northwood 258 312 10% 10% Page Moss 178 230 7% 7% Park 93 184 4% 6% Prescot East 190 229 7% 7% Prescot West 59 91 2% 3% Roby 25 35 1% 1% Shevington 75 103 3% 3% St Bartholomews 86 63 3% 2% St Gabriels 124 143 5% 5% St Michaels 128 131 5% 4% Stockbridge 211 156 8% 5% Swanside 51 33 2% 1% Whiston North 88 90 3% 3% Whiston South 106 159 4% 5% Whitefield 162 207 6% 7%

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CPP by ward CPP 2013/14 Ward 2012/13 2013/14 2012/13 2013/14 Cherryfield 9 15 7% 8% Central 46 24.9% Halewood North 3 5 2% 3% North 92 49.7% Halewood South 0 4 0% 2% South 47 25.4% Halewood West 12 6 9% 3% Kirkby Central 7 18 5% 10% Longview 7 15 5% 8% Northwood 10 20 7% 11% Page Moss 9 17 7% 9% Park 11 9 8% 5% Prescot East 13 12 9% 7% Prescot West 2 6 1% 3% Roby 2 1 1% 1% Shevington 7 12 5% 7% St Bartholomews 3 0 2% 0% St Gabriels 5 2 4% 1% St Michaels 3 6 2% 3% Stockbridge 13 5 9% 3% Swanside 0 0 0% 0% Whiston North 4 7 3% 4% Whiston South 6 4 4% 2% Whitefield 11 18 8% 10%

5. HOW DO RESIDENTS, COMMUNITIES AND STAKEHOLDERS VIEW THIS ISSUE?

The regular local survey “Children‟s Voice” provides information on different service users, this focuses on children in care or those adopted after fostering. Whilst CLA views on services and the support they receive are well documented nationally and locally, however wider CIN categories are not consulted as part of a statutory national framework.

Evaluation of Family First delivery of Troubled Families/Stronger Families programme is currently underway – the eight family case studies forming a part of the review will include insight into the views of children engaged with the service.

The recent Ofsted inspection of Knowsley services found that the voice of children is not heard and their experiences are not fully understood, whilst Social workers place too much focus on the needs of adults.

This reflects the national picture to a degree, as following the final report of the Munro review, Munro commented on the importance of understanding the experiences of children and young people and whether services made a difference

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to their lives. The Office of the Children‟s Commissioner has since published its findings on principles for participation programmes for children in need. 8

Whilst CLA views on services and the support they receive are well documented nationally and locally, wider CIN categories are not consulted as part of a statutory national framework.

Each of the Children‟s JSNA reports reference some of the currently available insight from vulnerable children whilst highlighting recording the experience of children as a key intelligence gap.

We have a commitment to broaden consultation with young people and their families and will be developing an insight plan to mainstream consultation processes in order to support service development and better hear the views of young people accessing our services.

Consultation should be designed with particular regard to the Office of the Children‟s Commissioners recommendations on hearing the voice of the child published in their report of December 2014 “Children and young people giving feedback on services for children in need: ideas from a participation programme”.

6. HOW DOES THIS ISSUE IMPACT ON SERVICE PROVISION AND USE? There has been an increase across Childrens‟ Social Care (CSC) services in all aspects of work, including an increase in referral rates, children subject to CP Plans and CLA numbers. This maybe a consequence of a limited early help offer, and CSC either dealing with families too late or too many times before the right intervention is provided. Cases of children and young people being referred appear to be more complex and often regarded as "high tariff". Examples would include those young people at risk of CSE in the community and those involved in gun and gang crime. There also appears to have been an increase in cases referred due to neglect.

This is the continuation of a wider national trend as identified in the October 2012 ADCS report 'Safeguarding Pressures Phase 3‟. Neglect is the most cited reason for children to be referred to children‟s social care and for becoming looked after. The report suggests cases are increasingly complex, requiring more time and resources. Qualitative research also suggests that domestic violence is an increasing concern as a contributory factor in child social care referrals. These increases in need and the growth in the complexity of cases alongside falling budgets inevitably leads to reduced resources and puts additional pressure on services to effectively deliver for the most vulnerable. Service delivery now has a

8 Children and young people giving feedback on services for children in need: ideas from a participation programme Office of the Childrens Commissioner, December 2014

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higher profile following public inquiries into a series of major cases. Political, public and press focus has undoubtedly added to these pressures.

7. DO WE HAVE EVIDENCE OF WHAT WORKS? In 2011 the DfE published commissioned research into what makes for good practice in the CSC assessment of children in need. The resulting review drew primarily from research conducted between 1999 and 2010 with additional supporting data and intelligence from a range of databases.9 The assessment of children in need and their families has attracted considerable attention over the past decade. Research studies, inquiries into child deaths and overviews of serious case reviews have consistently shown that assessment is complex and challenging, and that on occasion, practice has fallen short of the standard required. Five areas have been repeatedly identified as problematic: differential thresholds, a failure to engage the child, inadequacies in information gathering, shortcomings in critical analysis, and shortfalls in inter-professional working. The review identified the very wide and growing range of knowledge and skills needed when undertaking assessments. It also highlighted both a range of obstacles and the factors that contribute to supporting effective practice and the production of high quality assessments. KEY FINDINGS Good assessment is important, and contributes to better outcomes for children. Good assessment is related to improved chances of reunification success, and can contribute to placement stability for children - for example, by preventing delay and helping to ensure the provision of appropriate and adequate support for foster carers, kin carers and adoptive parents. It also has a role to play in early intervention strategies, contributing to the effective targeting of interventions. Poor assessments may expose children to risks of further maltreatment and placement breakdown. Instability in care often leads to a downward spiral with potentially far-reaching consequences including worsening emotional and behavioural difficulties, further instability and poor educational results.

Avoidance of delay contributes to better outcomes for children, particularly in terms of placement stability. Delays in assessment and decision-making in relation to the removal from home and placement of children can lead to difficulties in achieving permanent placements. Shortcomings in, or absence of, assessment of maltreated children at all stages from initial assessment through to the making of key decisions, for example, about whether a child is reunited with their family, are related to repeat abuse.

9 Social work assessment of children in need: what do we know? Messages from research - brief DFE 2011

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Key features of the organisational and professional climate needed to support good assessment practice include: A knowledgeable, highly skilled and confident workforce, supported by appropriate education, training and continuing professional development. Practitioners and supervisors need a sound knowledge base which includes good understanding of child development, the impact of parental alcohol and drug misuse, mental health problems, domestic violence and learning disabilities on parenting capacity and children‟s health and development, the importance of child observation and the need to promote the skills of analysis; A clear framework for reflective „clinical‟ supervision (individual and/or group) and other forms of case-based consultation, including support for practitioners working directly with children; Resources – in terms of time and staffing, as well as services available – to allow practitioners to complete assessments and plan appropriate interventions in a thorough but timely manner; Good intra-organisational and inter-professional working relationships; An organisational culture that supports reflection and learning (and the avoidance of a „blame culture‟); Electronic information management and recording systems that „work with‟ practice, are reliable and not unnecessarily time-consuming; and „Organisational health checks‟ or audits of the quality of assessments.

Current service provision and action s

8. WHAT IS THE CURRENT POLICY DIRECTION? 8.1 National The Munro Review

The child protection system has been undergoing a period of significant reform following the independent review carried out by Professor Eileen Munro in 2010, which found that the child protection system has become over-bureaucratised, focused too much on compliance and has lost its focus on the needs and experience of individual children.

The reforms are underpinned by three principles:

 Placing greater trust and responsibility in skilled front line professionals to do their jobs  Reducing central Government prescription and unnecessary bureaucracy  Building a system that is focused on the needs, views and experiences of vulnerable children

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Munro‟s reiteration of the key role of early help has been embedded in many of the government‟s policies and programmes. Early intervention remains a key goal for Childrens‟ Services work with all children and young people and particularly vulnerable groups such as children who are looked after.

Current Government Policy

Issue  Between 2012 and 2013, approximately 600,000 children in England were referred to local authority (LA) children‟s social care services due to welfare concerns. Social workers assess the needs of these children and ensure action is taken quickly to protect them.  Children are best protected when professionals are clear about what is required of them individually and when they work together. It is important to ensure the quality of social workers, and their responsibilities should be clarified.

Actions To improve the child protection system and the quality of social work:  statutory guidance clarifying the responsibilities of professionals will be revised;  ensure LA‟s whose child protection services are judged inadequate by Ofsted improve immediately;  reform serious case reviews (SCRs) so social workers learn from serious child protection incidents;  attract high-quality graduates through the Step Up to Social Work scheme and Frontline pilots.

Background An independent review of the child protection system (2011) led to:  revised statutory guidance on safeguarding children aimed at schools and LAs  A national panel of independent experts which advise local safeguarding children boards (LSCBs) about SCR criteria and the requirement to publish reports  Isabelle Trowler appointed as Chief Child and Family Social Worker  Changes were implemented with „Working together to safeguard children: a guide to inter-agency working to safeguard and promote the welfare of children‟  Social work pilots between December 2009 and March 2012 led to a law change 12th November 2013, providing all LAs the freedom to delegate their functions for looked-after children and care leavers to independent organisations  Sir Martin published an independent review of the education of children‟s social workers (February 2014) which provides 18 recommendations for the improvement of education of social workers. In line with the recommendations, a single statement of what they need to know to clarify guidance for child and family social workers is being made.

Consultation  The „Consultation on revised safeguarding statutory guidance‟ (12 June to 4 September 2012), sought views on 3 statutory documents from LSCBs, LAs, schools, social workers, and the voluntary and community sector. Children‟s views on the safeguarding and child protection system were considered

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 A consultation on proposals to allow LA children‟s social care departments to delegate some of their functions to third-party providers was launched 17th April.

Bills and legislation Legislation about child protection is covered in:  Local Authority Social Services Act 1970  Children Act 1989  Children Act 2004  Children and Families Act 2014”

Child Sexual Exploitation Review: Rotherham Following the review of child protection in Rotherham, the Department for Communities and Local Government has issued the following plan - Urgent reforms to protect children in residential care from sexual exploitation.

In short, the plan details the following actions:

Ofsted conducted a thematic review of Local Authorities‟ children's services work in combatting child sexual exploitation, and the inspection on how effectively South Yorkshire Police safeguards children and young people at risk, undertaken by Her Majesty‟s Inspectorate of Constabulary has now been published. Ofsted are also inspecting Rotherham‟s arrangements for children in need of help and protection, and services for looked after children.

The Government are already taking work forward on recommendations in a number of key areas. For example, the Chief Social Worker is working with local government and social work experts to understand the lessons from the Jay report for local authorities more widely and any implications for the Government‟s drive to improve front line social work practice. The National Policing lead for child protection and child abuse investigation has reviewed the national policing child sexual exploitation action plan in light of lessons from the Jay report.

In October, MP Anne Coffey published an independent report into Child Sexual Exploitation in the Greater Manchester area. This detailed local circumstances but also provides detailed information on the National picture of CSE with broader recommendations of value to all LAs.

Amongst the recommendations made by the report where:

 Investigate why, out of 12,879 recorded sexual offences, only 2,341 were taken to court and why, of those, just 1,078 led to convictions  A review into questioning and tone of cross examinations by defence barristers in child abuse cases  Appoint a child sexual exploitation "champion" to work with police, councils and young people

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 Develop a strategic approach to tackle the issue, like those in place for smoking, obesity, alcohol and drug abuse  All police officers to receive child sexual exploitation training - currently 21% have been trained  Train members of the community, including pharmacists, park attendants, bus drivers and hoteliers, to spot signs of abuse

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8.2 Local The Strategy for Knowsley: the Borough of Choice is the overarching strategy for the Borough. Its primary objective is to outline the Knowsley Partnership‟s long term vision to make Knowsley a place where people want to live and work. The strategy addresses mental health by focusing on the overall health and wellbeing of people in Knowsley.

All council and partnership strategies, plans, policies and programmes should ultimately support the achievement of this vision. Ten strategic outcomes have been agreed to help the partnership to achieve its vision for Knowsley. Three of these relate directly to our responsibility for Children in Need or at risk of harm:

Children get the best Everybody has the More people look Empowered, Safe, attractive, possible start in life opportunity to have after themselves resilient, cohesive sustainable and have the best health and and support others communities neighbourhoods opportunities to reach wellbeing throughout to do the same their potential their life

People are Knowsley has the Knowsley Improved outcomes protected from risks Quality conditions in place residents are for our most that can affect their infrastructure and to support empowered to vulnerable young health and environment sustainable business realise their people wellbeing growth economic potential

Specific policy and priority action for protecting children from harm and identifying and supporting Children In Need within the Borough are detailed in the following key documents:

 Knowsley Safeguarding Children Board Plan 2013/14 – The plan outlines the LAs four key pledges delivered via thirteen key priority areas:

1. We exist to protect our children and young people from harm, and to promote their welfare

Priority 1 Serious Case Reviews/ Child Death Overview Panel Priority 2 Safeguarding Children Priority 3 Audit and Quality Assurance Priority 4 Domestic Abuse Priority 5 Child Sexual Exploitation

2. We will hold partners to account, and be accountable for our work

Priority 7 Scrutiny Priority 8 Governance & Accountability

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3. We will improve knowledge and understanding about children in Knowsley

Priority 9 Information Sharing & Intelligence Priority 10 Knowsley’s Children annual welfare report

4. We will communicate and engage with our stakeholders and communities

Priority 11 Communication Priority 12 Engagement with CYP, Stakeholders & partners Priority 13 Operational Management of sub groups

 Corporate Parenting Strategy The Borough‟s Corporate Parenting Strategy outlines the Authority‟s commitment to providing quality fostering and adoption services for looked after children and the measures taken to support care leavers.

 Early Help The Early Help strategy and the Children Looked After and Care Leavers Plan together detail the whole approach to supporting families to stay together (wherever it is safe to do so), minimising the need for children to become looked after and when the child needs to be looked after.

 Pan Cheshire Merseyside Multi Agency CSE Strategy 2013/14 Knowsley is a signatory to a wider Merseyside and Cheshire strategy to tackle Child Sexual Exploitation. The agreement details multi agency strategies across the partner agencies and standardised protocols and working arrangements across the area.

The principal guidance is Working Together to Safeguard of Children issued March 2013 (WT2013) and The Government‟s supplementary guidance issued to Working Together 2010 aimed specifically at Safeguarding Children and Young People from Sexual Exploitation. (WTSG2010)

Child Sexual Exploitation (CSE) is a key business priority for the Board. The strategy launched in June 2013 led to the establishment of a new CSE Working Group under the KSCB. Charged with preparing a CSE Needs Assessment for Knowsley, the board subsequently decided that the Working Group should become a standing Sub-group of the Board. This sub group, or Multi Agency CSE group (MACSE), has responsibility for operational delivery of the Pan Cheshire/Merseyside Multi Agency CSE Protocol (Version 10, 10th June 2014).

The sub group is supported by a MACSE Steering Group, working to deliver the Pan Cheshire/Merseyside strategy into local practice. The CSE steering group also provides a forum through which to carry out multi-agency strategic scoping work and deliver identified good practice nationally into local working arrangements.

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 Improvement plan in response to Ofsted Notice Following the Children‟s Services Ofsted inspection and subsequent Notice to Improve the LA has developed an improvement plan to deliver on the inadequacies raised by HMI. Whilst the primacy of the current policies remains, the improvement plan brings focus to the key areas of challenge and sets out a detailed action plan of how Knowsley will respond over the following 18 months and deliver on the following key outcomes:

The voice of children and young people is fully embedded in practice and service planning.

All practitioners working with children and young people have the skills needed to help and protect children, are well supervised and well managed.

All children, young people and their families receive consistent support, and are fully involved in making decisions about their lives.

Front line social work practice is consistently good and effective.

There is effective multi-agency delivery of early help.

All partners work together effectively to support and protect the most vulnerable children and families.

The Knowsley Safeguarding Children Board provides effective leadership, scrutiny and challenge.

A timetable for each stage of the improvement plan was set as follows:

June 2014 – September 2014 The period during which immediate action was taken to protect children believed to be at risk and to establish the structure needed to deliver sustained improvement. October 2014 – April 2015 The period during which action will be taken to strengthen our approach with partners to safeguard vulnerable children. May 2015 – September 2015 The period during which action will be taken to embed improvement in social care practice. October 2015 – April 2016 The period during which action will be taken to ensure improvement is sustained on a multi-agency basis.

9. CHALLENGES AND STRENGTHS Following an inspection conducted in May 2014, Ofsted rated Knowsley CSC services for Children who need help and protection as inadequate and the effectiveness of the LSCB as inadequate:

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An Improvement Notice was issued to Knowsley Metropolitan Borough Council on 16 September 2014 following the findings of inadequate performance and arrangements for „children who need help and protection‟, for „adoption performance‟ „leadership, management and governance‟, and for „effectiveness of the Local Safeguarding Children Board‟ as identified in the Ofsted inspection report published 30 June 2014.

The LAs Childrens Social Care Services where found overall to be inadequate, finding that:

“There are widespread or serious failures that create or leave children being harmed or at risk of harm.”

The effectiveness of the Local Safeguarding Children Board (LSCB) was also found to be inadequate:

“The LSCB is not demonstrating that it has effective arrangements in place and the required skills to discharge its statutory duties.”

A. Identified by Ofsted The following strengths were identified:

 Senior managers in the Council are self-aware and have already taken action to address key areas for improvement for children and their families  There are some good services of high quality which make a difference to those children and families who use those services  Children looked after benefit from stable relationships with their social workers and these children are listened to and many of them are positive about their placement and the relationships that they have with their carers  Children looked after play a valuable role in representing the views to inform service delivery  Care leavers are well supported in their accommodation, education and training and employment.

The following weaknesses and areas for improvement were identified:

 There are widespread failures and inconsistent practice across help and protection leaving some children and young people at risk of suffering harm  Too often children who need help and support experience drift and delay in the support provided  Early help services lack co-ordination and don‟t always work with the right children and families at the right time. Too few CAFs are completed and not all are of the right quality  Thresholds for referral to social care are not consistently applied by partner agencies and Children‟s services. This leads to a significant number of cases being inappropriately assessed  Social work assessments do not always consider all of the risks to children and are insufficiently child centred

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 The voice of children is not heard and their experiences are not fully understood. Social workers place too much focus on the needs of adults  The quality of record keeping is variable and often poor across social work teams, for example, little use of chronologies to gain understanding of historical factors which may be significant in assessment of risk  Too many child protection plans don‟t achieve long term change which means that some children get repeat interventions  Social workers don‟t get sufficient high quality supervision and there has been a high turnover of social workers in some teams which has prevented children developing effective relationships with their social workers  Newly Qualified social workers do not get sufficient support to enable them to develop  Some looked after children experience drift and delay through a lack of robust care planning and review  It takes too long from when a child first becomes looked after to when a child is adopted when this is in the child‟s best interests  There is insufficient challenge provided by Independent Reviewing Officers  The Local Authority does not have a robust strategy to ensure that sufficient suitable placements are available to meet the needs of all children looked after in Knowsley. Looked after children do not make sufficient progress in their education, particularly at key stage 4  For children placed outside of Knowsley, the virtual school does not hold sufficient information from all education providers which makes it difficult to monitor progress.

B. Challenges identified by intelligence and self evaluation

 Increases in the number and complexity of cases across CSC services.  Increases in referrals for Neglect and in particular significant increases in referrals from police and other legal services leading to no further action.  The proportion of referrals made is very high, amongst the highest in the country.  High numbers of re-referrals which had previously resulted in NFA.

Service responses to the ADCS survey on pressures in safeguarding (2014) highlight the following challenges:

 Recent increases in the number and complexity of cases across CSC services, particularly increases in referrals for Neglect and/or Abuse and a significant rise in referrals from police and other legal services leading to no further action. The proportion of referrals made is very high, amongst the highest in the country, high numbers of re-referrals are made which had previously resulted in NFA.  This is the continuation of a wider national trend as identified in the October 2012 ADCS report 'Safeguarding Pressures Phase 3‟. Neglect is the most cited reason for children to be referred to children‟s social care and for becoming looked after. The report suggests cases are increasingly complex, requiring more time and resources. Qualitative research also suggests that

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domestic violence is an increasing concern as a contributory factor in child social care referrals.  There has been an increase across Childrens‟ Social Care (CSC) services in all aspects of work. In addition to the increase in referral rates, children subject to CP Plans and CLA numbers have also risen in the last year. This is possibly a consequence of a limited early help offer, and CSC either dealing with families too late or too many times before the right intervention is provided.  Cases involving children and young people being referred appear to be more complex and regarded as "high tariff". Examples would include those young people at risk of CSE in the community and those involved in gun and gang crime. There also appears to have been an increase in cases referred due to neglect.

10. SOURCES OF EVIDENCE AND FURTHER INTELLIGENCE Direct sources of intelligence and evidence;

 KMBC CSC CIN and CPP cohort data (end of year report) 2014  KMBC CSC Monthly activity report  KMBC CSC Monthly Scorecard  KMBC Children & Young People Needs Assessment, 2013  Knowsley Safeguarding Children Board Plan 2013/14  Knowsley response to ADCS Safeguarding Pressures Research: Phase 4, 2014 Annual Children in Need Census DfE Characteristics of Children In Need 2012/2013 & 2013/14  Ofsted Inspection Report 2014 Inspection of services for children in need of help and protection, children looked after and care leavers  ADCS 'Safeguarding Pressures Phase 3' summary report http://www.adcs.org.uk/news/safeguarding-pressures.html 2012  Local authority interactive tool (LAIT) DfE 2014  Young People‟s Programme data CAADA.

Related areas of evidence and intelligence

 DfE Social work assessment of children in need: what do we know? Messages from research - brief 2011  Puppet on a string: The urgent need to cut children free from sexual exploitation Barnardos‟, 2011.  National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England Centre for Public Health, World Health Organization Collaborating Centre for Violence Prevention, Liverpool John Moores University. 2014  Independent Inquiry: 'Real voices' - child sexual exploitation in Greater Manchester, Anne Coffey, MP. 2014  Interim report of the Office of Children‟s Commissioner‟s two year inquiry into CSE in gangs and groups, 2013. Child Sexual Exploitation Inquiry interim report - I thought I was the only one. The only one in the world

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 National Audit Office Report Children In Care November 2014 https://www.nao.org.uk/report/children-in-care/  Children and young people giving feedback on services for children in need: ideas from a participation programme Office of the Children‟s Commissioner, December 2014

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