The NSPCC briefing Home education: learning from case reviews highlights a number of recommendations from seven serious case reviews (SCRs) published between 2008 and 2013 involving home-educated children. [The full briefing has since been replaced with a summary, but the original is still accessible here. Also note that the Serious Case Review for Child S listed in the NSPCC summary is for the wrong Child S.]
The task of SCRs is to examine why a child came to harm, why the harm wasn’t prevented and to make recommendations that should ensure those things don’t happen again. SCRs tend to be detailed and rigorous in their analysis, so I’ve taken the recommendations made in six of the seven serious case reviews (Child 5’s was available only as a brief summary) as a proxy for the factors involved in what happened to the children.
By my reckoning, the six SCRs made a total of 79 core recommendations – although there were additional ones in relation to specific local agencies. Some recommendations were made in more than one review. To get an overall picture of the key factors I ranked the recommendations in order of the frequency with which they occurred. Recommendations from more than one SCR were:
• contact the DfE or equivalent body regarding elective home education (EHE) and safeguarding (5 SCRs)
• issue local multi-agency guidance regarding EHE and safeguarding (3)
• training and development with regard to combative, aggressive or non-engaging parents (3)
• EOTAS teams made aware of safeguarding issue (2)
• monitor health of EHE children (2)
• ensure procedures were followed with feedback to referrers (2)
• ensure agreed actions were taken (2)
• provide evidence of managerial oversight (2)
• promote public awareness about safeguarding other people’s children (2)
23 of the recommendations (about 30% of the total) occur in more than one SCR, but most of those are in only two or three reviews, indicating that there’s quite a lot of variation across the six cases in terms of specific recommendations.
But if the recommendations are grouped together according to the factor they refer to, they cluster into five broad themes:
• children with disabilities – 3 (4%)
• behaviour of parents – 5 (6%)
• elective home education – 14 (18%)
• healthcare – 21 (26%)
• procedural issues – 34 (43%)
In addition, there was one recommendation about developing children’s sense of identity and ethnicity and another about contacting central government about issues outside the scope of the review. (The percentages don’t add up to 100 due to rounding.) In this post I look more closely at the top three factors. I’ll come back to the behaviour of parents and children with disabilities in later posts.
The NSPCC briefing is about home-educated children so it’s not surprising that most of the recommendations it highlights are about legislation relating to home education. But the SCRs are also about home-educated children, and most of their recommendations are not about home education legislation. Almost 70% related to either procedural issues and/or healthcare.
Problems with procedures have been the focus of media attention in recent high profile child abuse cases. In the six SCRs they include some very basic issues such as ensuring staff have appropriate training, making sure procedures are followed, that agreed actions have been carried out and improving communication between agencies. The only reference to procedural issues in the NSPCC briefing is in relation to professional awareness that there isn’t a safeguarding element in education legislation. I’ll return to procedures in a later post.
The briefing does mention health services (including, oddly, making recommendations for the Primary Care Trusts that were abolished months before its publication) but doesn’t go into detail about the role played by healthcare in the harm incurred by the children. That looks like a serious omission. Not only were health services actively involved in the lives of the children, in at least five cases it’s possible they could have contributed to the harm they suffered. Let’s take a closer look the role of health services in the seven SCRs.
Family 1 initially fostered some of the children privately, and later adopted them. The adoptive parent thought some of the children had ADHD/ASD/Asperger syndrome. One has to wonder what circumstances led to the private fostering arrangement and whether the children’s behavioural problems were solely attributable to the adoptive parent’s parenting style as the SCR suggests. Three of the children were prescribed Ritalin for excessive periods of time without the required regular reviews. Over-prescription of medication also featured in the case of Child 2, whose mother had repeatedly raised health concerns about her son. Not only was the dose too high for a child of his age, but Child 2’s mother was able to obtain the medication from her GP after the hospital had said it should be discontinued. Since the parents of Family 1 and Child 2 couldn’t have prescribed the medicines themselves, presumably health practitioners had felt there was a good reason to do so. Child 3’s mother also raised concerns about her daughter’s health before her GP removed the family from his list without following the proper protocol. Child 4’s family had extensive contact with health services. Child 5 had been referred to a clinical psychologist. Child 6’s parents stopped engaging with the authorities when they couldn’t get a clear diagnosis for his developmental problems. The mother of Family 7 had been attempting to artificially inseminate her eldest daughter, A, but the GP they saw after claiming that A (then aged 14) had been sexually assaulted and might be pregnant, failed to follow up her case because he didn’t believe their story.
The SCR also draws attention to the number of medical appointments Child 6 had – as an indicator of his mother’s misplaced focus on his health. She is suspected of fabricating or inducing her son’s illness and FII is referred to repeatedly in the SCR despite nobody appearing to be clear about whether or not Child 6’s health problems were genuine. In contrast, the mother of Child 4 had a track record of missing appointments. Between 1998 and 2008 she missed 129, a third of which were health related. In 2007, the year before Child 4 died, “the pattern of failed appointments escalated dramatically… 26 (20%) appointments were missed, as relationships with professionals deteriorated”. That means that in the course of a year the mother, then a lone parent with six children (several of whom had statements of special educational needs), was expected to attend 130 appointments including medical ones. That’s almost three a week. It’s not surprising that parents of children with disabilities complain that managing appointments with professionals feels like a part-time job. There are clearly some lessons to be learned from a system that expects lone parents to attend three appointments a week but sees missing one in five of them as a danger signal. One of the recommendations of the case review is that agencies should “provide evidence to demonstrate an effective response to missed or failed appointments” – the most obvious solution doesn’t appear to have been considered.
home education recommendations
The third most frequent factor referred to in the SCRs is home education – almost 20% of the total recommendations. Most of the home education recommendations were either about improving agencies’ knowledge of the legislation or about raising awareness of the issue the NSPCC is concerned about; that there isn’t a safeguarding element in education legislation – a concern that, as far as I can see, is based on an inaccurate understanding of the legal principles and on speculation rather than evidence.
The NSPCC briefing frames the recommendations from the SCRs only in terms of home education, so the unwary reader might conclude, wrongly, that the problems with procedures and healthcare arose only because the children were home educated. What the SCRs indicate is that most of the problems with procedures and healthcare – such as checking that actions had been carried out and over-prescription of drugs – were nothing to do with the children being home educated; they could equally well have occurred if the children were at school.
I should point out that I’m not attempting to shift the blame from parents, three of whom clearly neglected and maltreated their children. But if the focus of LSCBs and the NSPCC is on the wellbeing of children, it’s imperative that the real causes of harm are identified – even if public sector services are implicated.
So why would the NSPCC briefing make claims about home-educated children that aren’t supported by the data? Why would it present recommendations in a way that doesn’t accurately reflect the way they are presented in the SCRs? And why is the most frequently occurring specific recommendation in the SCRs about home education and safeguarding if there isn’t a problem with safeguarding home-educated children?
The answer, I suggest, is that the NSPCC is interpreting the data from the SCRs in the light of its concerns about possible risks due to home education, rather than basing its concerns on evidence about real risks. And the NSPCC’s concerns are, understandably, very influential amongst people who work in child safeguarding; two of the authors of the SCRs worked for the NSPCC at the time they wrote the review or previously.
Possible risk versus real risk; the subject of the next post.