Special edition, April 2021

The Care Review 2021: knocking on the neighbour’s door

A principal social worker in England

The failures of the Care System are the failures of individualism and scientific reductivism. The Care Review must seek its answers in the communities and cultures of the children it serves. It must see children as strands in Te Taura Tangata, the great rope of humanity, twisted and interwoven together into family and community, existing only because of our connections to one another. It must seek evidence not in the musings of academics, but in the slow evolution of cultural norms.

Here we see child abuse not as correlated to the ‘toxic trio’ but as a symptom itself of the failure of community to nurture, of society to provide. Here we see solutions not in removing a child from their family, but in strengthening the family around the child, and their relationships with the society (our society) from which they have become disconnected.

The French Philosopher Gaston Bachelard described the disjointed way in which human knowledge moves forward, not smoothly, but through the introduction of fundamentally different paradigms that cause epistemological breaks – cracks appear in the prevailing worldview and it quite quickly crumbles, being replaced by something completely new (Wikipedia, n.d.).

Our understanding of the human condition appears to be currently progressing through such a break. The battle between left and right to define the individual is slowly appearing more and more misguided as conceptions of the relational self emerge from diverse fields of research and thought. Instead of seeing relationships as being constructed by individuals, we are seeing more and more evidence that individuals are constructed by relationships.

This new paradigm sees the fundamental component of the human experience not as the individual, but as the relational. At the same time, neuroscientists like Antonio Damasio and Lisa Feldman Barret are establishing the fundamental role that our emotional, non-conscious mind plays in our consciousness, and the fundamental role our social context plays in forming our emotional landscape (Damasio, 2012), (Barrett, 2017). We are, even as individuals, fundamentally a constructed relationship between conscious, non-conscious, in turn constructed via our relationships with others.

Viewed through this relational paradigm, recent (small) phenomena such as the rise of the ‘flat’ organisational structure, the growth of the Bromley by Bow Centre’s model of social prescribing, and the success of the community paradigm in local government become part of the same story; when the individual experiences those around them as ‘knowable’ (ie their behaviour is reasonable and relatable) and trustworthy, these relationships provide the scaffolding for a healthy construction of self and others, and the healthy behaviours that emerge from these.

There is a mentoring programme in Baltimore called Thread, whose name denotes a ‘social fabric’ and since 2004 has woven a social fabric consisting of five volunteer mentors, ‘an extended family’ who have supported at risk young people for nearly ten years. Thread is a single project, set up by volunteers, but its outcomes are astonishing when set against the average Children’s Services Department outcomes, and its retention rate of unpaid volunteers is much higher that most Department’s retention rate of paid social workers.

If the relational paradigm is one of the contextual foundations for the Care Review, the other must be the increasing tribalisation of our political discourse. Jonathan Haidt explores how conservative morality and liberal morality are built on different interpretations of similar concerns, but our emotions then entrench this interpretation, closing us off from constructive debate (Haidt, 2012).

Many in children’s social work see inequality, and particularly poverty, as the most powerful driver of significant harm to children. There is a deep lack of trust in Conservative morality, and a discourse that often rejects the possibility of collaboration and compromise. This is harmful because it precedes the possibility of influence.

When we see a change of government as the only possible route to influence, our impact on the wider political discourse as a profession over the past 50 years must be interpreted as being almost zero. If we choose not to acknowledge this, and the fact that our government is mandated by a democratic vote and so reflects the collective views of the society in which we function, we are truly allowing our emotional need to feel correct to overwhelm our moral obligation to engage and contribute.

So let us consider the Care Review in this context – the problems and solutions that individuals face should be constructed as having primarily relational causes and consequences, and we should seek solutions to these problems through improving these relationships. The role for the Care System is to provide stability, not of housing or legal status, but of relationships. For children, of course, these relationships must provide for them more fundamentallygiving them the message that they are loveable and loved, an important thread woven within an unbreakable fabric of trusting relationships.

Anyone familiar with the Care System will have seen the incredible damage done to children by early relationships that have taught them other lessons – that people are frightening or at least unreliable, that they are worthless or flawed, that their emotional experiences should be hidden away from themselves and others. It’s not possible (or certainly not healthy), I think, to remember working with children like these as a social worker, without being filled with a deep sense of sadness, of injustice, and sometimes of shame at our inability to help them.

It is so difficult to retain hope within a practice system that so regularly fails to achieve any positive change whatsoever. Caseloads may be high, levels of bureaucracy ridiculous, but it is the sense of hopelessness more than anything else that has led to so many good social workers leaving professional practice.

And yet we all have our happy stories too, a parent we really connected with, a young person we persevered with, or a child we enjoyed visiting and getting to know. We carry their memories with us as we move through our careers, and some of us are lucky enough to accumulate decades of memories – the intrinsic reward of the helper who has helped. Our Quality Assurance systems scratch around for more meaningful measures that can be collated from case files or even used to predict future risk, but seeing these measures as priority organisational tasks is absurd when considered from the context of the happy practitioner.

Although the solutions to the care crisis should be sought in communities, the Care Review should look also to the mechanisms of the practice system. Although the systems of checks and balances are well documented, what is less documented is the irreducible fact that there is only one single mechanism by which the entire practice system can actually create change for a child. That mechanism is the relationship between the practitioner and the family.

The Care Review must propose radical changes that funnel all attention and resources back to this relationship – the skilful practice of social work. Everything else is simply noise. Below I suggest some starting points.

For a profession obsessed with measuring, we know shockingly little about outcomes. We don’t know whether children supported by ‘outstanding’ departments do any better that children supported by ‘inadequate’ departments. Nor is there any clear correlation between spending and outcomes. We don’t systematically measure or even agree on what to measure as long-term outcomes for children in need. We know what their long-term outcomes are through longitudinal studies such as the ACEs study, but we have absolutely no idea, or even a cohesive logic model, for how our assessment and planning activities impact upon them.

Although it has totally failed to correlate it’s inspection findings with actual child outcomes, Ofsted has been highly effective in shifting organisational attention away from children and families and toward performance indicators, and the impact on social workers’ mental health everywhere has been horrific. No other organisation has caused such damage to our professional craft. The discourse on its negativity has been so limited because of its cult-like status amongst senior leaders.

The Association of Directors of Children’s Services is populated with otherwise intelligent and highly capable leaders who for some reason find it difficult to acknowledge that Ofsted inspections are largely meaningless beyond the incredible resources and distress expended at their anticipated arrival, constructed on the stories of being shamed and fired. Ofsted fixation is also arguably the main explanation as to why the path forward set out in wonderfully convincing argument by the Munro Review has remained largely untrodden.

In 2019 the Rees Centre put enormous energy and thought into an outcomes framework for the children’s social care. Sadly it has not been widely used or even debated. By starting with outcomes, Children’s Services departments, in collaboration with their lead members, could be expected to map out their service plans onto a logic model, and present this to Ofsted prior to inspection. The intended outcomes could be set by central government, or simply be a defensible interpretation of the Rees Centre’s framework. An Ofsted inspection would then simply become an observation of fidelity to the proposed activities, and a robust ‘in practice’ conversation about whether the logic model’s assumptions need to be reconsidered.

My partner is a pharmacist in a large hospital. Twenty years into a successful career she is in the second tier of senior management of the hospital. But she still does ward rounds three days a week, along with teaching at a local university. Social work is the only profession I know of where the task of applying our professional specialist knowledge is given over to the least experienced, and where the most successful are rewarded by being moved further and further away from professional practice.

An average DCS will have four layers of managers between themselves and the practice of social work, and 15–20 years of time passed since they were in practice themselves. In YOS, Leaving Care, and Early Help Services we have highly skilled practitioners with years of experience of social work, who we don’t allow to call themselves social workers or to benefit from the higher salary and security that comes with.

Teaching partnerships and co-delivered programmes have taken a step in the right direction, but our profession is still top heavy with senior managers and academics who have had to choose between practice and career progression. The Care Review should remove this choice. Every social worker must have as a requirement of their registration that they continue to practice directly with children and families.

The fundamental relationships in a child’s life should always be sought within their family and their community. It is necessary sometimes that children be cared for by a paid stranger, but this should always be seen as scaffolding – a framework on which to repair the existing social fabric around a child. This admittedly can sound naïvebut when we step back from the rigidity of the care system there are huge opportunities for creative engagement.

I remember sitting outside the courtroom door as a young social worker. In this instance the parties were waiting to present an agreed plan back to the judge, so were relaxed. The two barristers (mine and the parents’) started discussing their recent holidays in the South of France with smiles on their faces and private school education in their voices. I looked at the parents and wondered how it felt to have the person supposed to represent you so deeply embedded in the world that is judging you. I suppose it felt hopeless. It is a feeling that grows the further up the hierarchy of concerns a child’s welfare moves, until the judge calls all parties back in and reads out their findings, and it is proven true with a legal order.

If the bonds of social fabric are trust and love (and they are), the judicial system’s affect is to ignore their importance, and often to actively weaken them. Our legal system is premised on the idea of justice being built upon fairness. Yet the processes themselves are deeply unfair on parents and incredibly wasteful. For thousands of years groups of human beings sat around the campfire and resolved their differences through participative democracy. When we compare the choreographed performance of the courtroom to these traditional community restorative practices they become farcical. We have an organisation in CAFCASS, filled with highly experienced social workers, who visit a child once and are then expected to advise the court and critique the local authority.

But there are alternatives – in New York parents who had already had their own children removed started organising and advocating on behalf of other parents in current proceedings. These ‘parent advocates’ and their allies in social work obtained power and influence and directed money saved from having fewer children in care to finance support for families (Tobis, 2013). In the UK so often these parents are isolated and without meaningful support.

CAFCASS resources should be repurposed from being just another layer of monitoring social work, and toward advocating for and supporting families in a proactive and generative way. CAFCASS should be overseen by a board of parent advocates and care leavers, its primary tools should be focussed around bringing wider families together to support and sustain parents, and holding the local authority to account for resourcing and enacting the support the family needs.

We should also significantly reduce the need for judicial intervention in the first place. The legal threshold for being in care should be lifted significantly so a 2–3 week respite placement arranged by a community organisation isn’t considered care. Too often what families need is respite and intensive support, and they should be able to access this without crossing the threshold for statutory interventions, and certainly without triggering the ‘permanency process’.

Cuts to early intervention services have left many local authorities caught in a vicious circle of directing more and more resources to high level, crisis driven work, and to extremely expensive placements when intervention comes too late. The ‘Grasping the Nettle’ Report and the Early Help Offer have become a distant memory for many LAs and when faced with 50% funding cuts these non-statutory services have been largely discontinued. And yet we have very clear evidence that Early Help services save money over time when delivered well.

There is a huge opportunity here for central government to take a similar funding pot to the Innovation Programme and offer it as 10–20 year bond linked to promising evidence informed early intervention projects, overseen by the WWC-CSC. The funding, along with the later savings, would be ring-fenced from other council budgets, allowing councils to employ permanent staff, secure leases on buildings, and to plan and monitor services in ways that are difficult when funding is rolled over every 6–12 months.

This paper has made four suggestions: Ofsted inspections to test logic models of practice, all managers and academics to keep a hand in practice, CAFCASS repurposed toward family advocacy, and long term bonds to fund expanded early help services. But as the relational paradigm emerges, we must also more fundamentally redefine our professional craft.

I attended one of Camden Council’s wonderful community activism conferences in 2018, where I learned of a community-base family group conferencing model which captures the paradigm shift we need to make. The model showcased how the entire floor of an elderly woman’s council block had attended her family group conference and collaborated to make a plan for her support.

We in Children’s Services need to reconstruct our professional task to be about engaging, supporting, nurturing the systems of family, culture, community around a child. We need to be brave enough, when a family needs support, to knock on the neighbour’s door and invite them to participate a little more in their community. I love the power of this idea and what it captures, how it challenges our thinking.

Social work must return to its communities, sit within them, and build meaningful relationships with them. The care system doesn’t so much need to be rebuilt as redefined – children already have a care system around them made up of people and relationships – we have enough evidence now that ignoring or trying to wholesale replace these has not worked. It is time to bow our heads in humility, and knock on the neighbour’s door.

A principal social worker in England

References

Barrett, L. F. (2017) How emotions are made: the secret life of the brain. Houghton Hifflin Harcourt.

Damasio, A. (2012) Self comes to mind: constructing the conscious brain. Vintage.

Haidt, J. (2012) The righteous mind. Vintage.

Tobis, D. (2013) From pariahs to partners: how parents and their allies changed New York City’s child welfare system. OUP USA.

Wikipedia (n.d.) Retrieved from en.wikipedia.org/wiki/epistemological_rupture.