## Childhood Neglect: Improving Outcomes For Children Learning Outcomes

To maintain the momentum of change. 	

## Audience Time 30 Minutes Groups 1-8 (Working Together 2010)

Preparation The trainer may need to set up video to show Best Practice example 4 that focuses on two versions of a supervision session.  This may help prompt discussion with in the groups of participants.

## Key Reading

Davys, A. and Beddoe, L. (2010) Best Practice in professional supervision: A guide to the helping professions. London:  Jessica Kingsley Publishers. HM Government (2010) Working Together to Safeguard Children: A guide to inter-agency working to safeguard and promote the welfare of children. London: Department for Children, Schools and Families. Hughes, L. and Pengelly, P. (2002) Staff Supervision in a Turbulent Environment. London:  Jessica Kingsley Publishers. Kadushin, A. and Harkness, D. (2002) Supervision in Social Work (4th edition). Columbia, NY: Columbia University Press. Morrison, T. (2005) Staff Supervision in Social Care (3rd edition). Brighton: Pavilion. Pritchard, J. (2000) Good Practice in Supervision. London: Jessica Kingsley Publishers.

## Links To Common Core

Common Core 5  Multi-agency working (skills: communication and teamwork). Communicate effectively with other practitioners and professionals by listening and ensuring that you are being listened to. Common Core 5 Multi-agency working (skills: communication and teamwork). Share experience through formal and informal exchanges and work with adults who are parents/carers.

This introductory slide highlights the title of the power point.

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Over the course of this presentation will focus on the role supervision can play, paying attention to the following themes:

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" the impact of working with and on behalf of children 
and young people experiencing neglect
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" effective supervision: what it includes
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" the role of supervision in keeping the child at the centre.
It is important to note at the very beginning that not all professions have a model of supervision which is familiar to social workers. Of course, the social worker participants may also not be experiencing optimal supervision. At the outset, it will be helpful to explore with participants of different disciplines where, and how, they obtain support and to note that the bulk of the presentation draws on material in relation to social work because that is the area that is most developed, but that they should consider how the principles can be transferred. 

## Child Neglect And

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Working with children and young people, who may be experiencing neglect, is a difficult task and one in which practitioners from different areas will require support if they are not to feel overwhelmed. The need for practitioners to have someone, often one step removed from practice to help them make sense of what they are seeing, hearing, thinking and feeling, and to use this to inform their assessment of what a child needs and their intervention is recognised in literature, inquiry reports, practice wisdom and evaluations. The next few slides look at that context. 
Gordon and Hendry in Howarth (2009) consider the role front-line managers have in supporting social work practitioners and this is a good chapter to recommend to social work participants who want to do more reading. Discussion point:  Show the group a video clip Scenario A and then divide them into small groups, asking them to consider the questions below and then feedback to the group. Play Scenario B and do the same - approximately 40 mins needed

## Scenario A

1.	 Does the response from the professional giving the advice support the practitioner to 
effectively safeguard this child or young person from neglect? 
2.	 If not, why not?

## Scenario B

1.	 Does the response from the professional giving the advice support the practitioner to 
effectively protect this child or young person from neglect? 
2.	 What approaches were helpful for the worker?  For example:

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" Asked relevant questions
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" Allocated sufficient time for discussion
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" Acknowledged serious concern of worker
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" Summarised workers concerns
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" Made time to review again in the future
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" Made written record
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" Focused on child rather than procedure/protocol

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" Prompted worker to find out more information
Child neglect and supervision This slide identifies three areas where supervision/mentoring/ management can facilitate good practice.

1) Support practitioners There is some evidence that practitioners working with children and young people who are experiencing neglect can feel disheartened and de-skilled and will need support and guidance in their role. You might want to refer them to Stevenson (2007).

Anderson (2000) conducted research with 151 child protection workers in US. She found the following factors: 

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" emotional exhaustion
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" de-personalisation of clients
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" reduced sense of personal accomplishment.
2) Help maintain focus on the needs of the child There is also some evidence that the focus can shift from the child - either on to the parents, or to the practitioner's anxieties or fears. Stanley and Goddard (2002) describe their research with practitioners in Australia and the UK. They found that when practitioners were anxious or fearful, in order to minimise the threat to themselves they also minimised threats to the child from their family (of acts of commission and omission). 3) Analysis One of the findings of a number of inquiry reports is that practitioners have sometimes not analysed the meaning of the information they have gathered in terms of what it means for the child's lived, day-to-day experience and that analysis has been lacking from some assessments and intervention. To read more about analysis trainers might want to recommend Helm (2010). We know that anxiety has an impact on our capacity to think, feel and act and supervision/support can play a key role in helping the worker to contain anxiety and analyse the meaning for the child. The concept that supervision can help analysis by containing anxiety is explored by a number of writers including Morrison (2005). Wilmot (2008) argues that:
'One of the primary tasks of supervision is the containment of anxiety, our own, the clients'
, the supervisees' and all those in the wider system' (p95).

Ruch (2007) notes that practitioners need a secure relationship (with team, manager, organisations which will 'afford practitioners a space where unthinkable experiences can be processed and made thinkable and manageable'
.

Trainers may also want to make a link to the Children's Workforce Development Council document 'Inspiring Practice: A guide to developing an integrated approach to supervision in children's services' (2010). This is available on www.cwdcouncil.org.uk/assets.

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Following the death of Peter Connelly in Haringey, Lord Laming's (2009) report made recommendations in relation to supervision that have been incorporated in to the most recent statutory guidance (HM Government 
2010). Lord Laming's recommendations were that:

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" The Social Work Task Force should establish guidelines 
on guaranteed supervision time for social workers that may vary depending on expertise.
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" Working Together should be revised to set out the elements 
of high quality supervision focused on case planning, constructive challenge and professional development.
Munro (2010) highlights the importance of good quality supervision stating that 'to work with families with compassion but retain an open and questioning mindset requires regular challenging supervision' (p18). The first part of this slide is self-explanatory, depending on where they are working, and their role.  Some professionals in universal or specialist services who come into contact with children who are experiencing neglect may not have a formal system of supervision. 

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However, even where there is a culture or an expectation of supervision, for example, in social work, the experience of practitioners as to the amount and quality of supervision varies. Baginsky et al. (2010) conducted a survey of practitioners and front line managers as part of the Social Work Task Force. They found that practitioners reported supervision that focused on the managerial aspects of the task.

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There are a number of definitions of supervision in the literature, and this one is taken from Tony Morrison. Morrison was committed to the role of supervision in practice, and this text is a key one for supervisors. It contains a good mix of theory and research and exercises that can be used by supervisors. He also worked with the Children's Workforce Development Council to provide a guide for supervision (Right from the Start) which some of the participants may well have seen. However, there are other definitions (Coulshed and Mullender 2006) to help participants focus on outcomes for children, young people and their parents.  They argued that 'The overall purpose of supervision must be to enhance the standard of work undertaken so that, in turn, vulnerable members of the public will have an improved quality of life' (p163).

This is taken from Working Together (HM Government 2010), and it looks at how good supervision can improve practice with children, young people and their parents. The Trainers might want to draw specific attention to the role supervision can play in avoiding drift for children and young people who are 'bumping along the bottom' experiencing chronic, ongoing neglect (Stevenson, 2007).

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One of the critiques in some previous inquiries (for example, Lord Laming's 2003 report in to the death of Victoria Climbié) is that workers have not been clear about their roles, and part of this is about good induction. Trainers might want to draw out the role of induction in helping workers to be clear about their roles, responsibilities and accountabilities. 

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They may also want to make a link back to the earlier slides on anxiety, at a time of change (i.e. new job, change in role, organisational change) practitioners are likely to be more anxious, and consequently need to be clear about their role (and its limits). The trainer might also want to refer to Kadushin and Harkness (2002) who mention the need for supervision to ensure a degree of predictability noting that 'unless there is predictability, it is difficult to coordinate individual workers decisions, and ensure children and families get a consistent service' (p83).

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As with the previous slide this is taken from Morrison (2005). Here, trainers may want to highlight the role supervisors have in workers' development, by encouraging ongoing continuing professional development, and through enabling them to reflect in, and on, action 
(Schon 1987) during formal and informal supervision. Hughes and Pengelly (2002) use a developmental model to think about workers' development from newly qualified worker to an experienced one, and consider the role supervisors have in enabling being professional development. 
The developmental model has been critiqued by some writers as being overly deterministic, and not recognising fully that workers development will vary in different areas of practice depending on their skills, knowledge and values, as well as the opportunities they are provided with.

This is taken from the final report of the Social Work Task Force (2010). It stresses the significance of supervision, and the need for it to be seen as integral to practice, not an optional extra.

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Brandon and colleagues (2008) summarise some of the findings from the analysis of Serious Care Reviews and highlight the role of supervision. The review team examined 161 case files, looking at 47 in depth.

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The supervision triangle is taken from Hughes and Pengelly (2002). It is a way of thinking about the participants in supervision, and can be used by the trainer in small or large group to ask practitioners think about what might deflect attention from the child, and how they can 'bring' the child into the supervision session (metaphorically rather than literally - one suggestion would be to have an empty chair).

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Discussion point:  Ask participants to name the factors that might influence supervision and deflect attention from the child. Hughes and Pengelly (2002) look at 6 factors which can influence supervisor/supervisee and deflect attention from the child and the trainer may want to ask the participants consider the relevance of these factors in their current supervisory relationships.

1.	 Current or recent life events. 2.	 Certain types of work/specific cases can reverberate with past or 
present personal or professional difficulties.
3.	 Professional backgrounds and histories of supervisor and supervisee. 4.	 Recent events and history in the team or agency. 5.	 Clarity of work policies and availability of good relevant professional 
advice.
6.	 Interface between agencies (p.32).
The message which needs to be stressed is that one of the key themes to emerge was that in the majority of instances professionals failed to see things from a child's perspective, and think about what that child's day to day experiences are like, and what it feels like to be him or her (Ofsted 2008).

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 The trainer might want to refer back to the supervision triangle, and ask them to think how they can, or do, use supervision to focus on what it might feel like to be a child or young person who is experiencing neglect.
In the Western Isles of Scotland, children from a family experienced chronic neglect and multiple abuses. There was a range of professionals involved - health, education, social work, housing, and police. One of the key critiques was that although professionals shared information, they did not fully analyse what the information meant for that child or act upon the information. 

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Another critique was that as practitioners got to know parents they lost their focus on the children and found it hard to maintain what Lord Laming (2003) referred to in the Victoria Climbié Inquiry report as 'respectful uncertainty' about parents.

During the past decade, legislative and policy drivers - including the UN Convention - have placed children at the centre of assessment and intervention, and emphasised the importance of listening to the views of children in matters concerning them.  
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However, much of the research with children and young people, who have been in contact with the systems designed to protect them, indicates that children have often felt marginalised (Aubrey and Dahl 2006). 

The research also indicates that while practitioners believe that they have listened to children, unless they then take action, children do not feel that they have actually been heard (McLeod 
2008). There is also a suggestion that the practitioner's willingness to engage with children and young children is not just dependant on their knowledge and skills, but is also influenced by their views on children and childhood and whether they see children as active participants (Shemmings 2000). Trainers can refer to this research to help participants think about the role of supervision in helping professionals identify their values, and consider how they are involving children and young people who have experienced neglect, recognising that some children may need additional help to express their views and talk based interventions may always be the most appropriate method. The trainer should check with the group to identify what their key areas of learning have been and the key themes before flagging up these 3 areas:

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" Working with, and on, behalf children and young people who are experiencing 
neglect has an impact on practitioners, and good supervision and support is necessary to enable effective, child focused assessment and intervention. 
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" All too often the child has been ' lost' in assessment and intervention 
and so supervisors need to think how they metaphorically bring the child in to supervision and focus on their needs,
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" Research findings indicate that children feel marginalised. Given that 
children and young people who have experienced neglect may not have good sense of self, and a positive ' internal working model' practitioners need to bear this in mind when thinking about meaningful ways to engage and involve children and young people who have experienced neglect.