help: NSPCC briefing on home education

The NSPCC briefing Home education: learning from case reviews highlights 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.]

In the previous post I mentioned that the primary purpose of legislation is to protect the liberty of the individual. Historically the primary purpose of national government has been to protect liberty by defending the nation from attack from abroad, and of local government to do so by maintaining law and order.

But you’re unlikely to enjoy your liberty very much if you’re starving, sick or homeless. The massive increase in urban populations following the industrial revolution eventually resulted in the UK government, national and local, turning its attention to people’s quality of life. Over the last century or so national education, health and social care systems have been developed. Currently, education and healthcare are universal services, available to all. Significantly, social care isn’t.

social care for children and families

The parent of any child ‘in need’ according to the criteria set out in s.17 of the Children Act 1989 can request a social care assessment. The definition of a child ‘in need’ can be summarised as;

• unlikely to achieve or maintain a reasonable standard of health or development without the provision of services by a local authority
• health or development is likely to be significantly impaired, or further impaired, without the provision of such services; or
• disabled.

But there appear to be a number of hoops to jump through before a child ‘in need’ can hope to access support.

The first hoop is meeting the eligibility criteria for an initial assessment. Here, for example, are those of the Royal Borough of Greenwich. I’m not knocking the Royal Borough. Their criteria are explicit and specific. At least you know where you stand.

The second hoop is an initial assessment that determines whether or not the child is sufficiently ‘in need’ to be eligible for a core assessment. For many local authorities, the criterion for a core assessment is not so much about the child’s needs as about whether they are at risk.

The third hoop, the core assessment, presumably identifies what sort of support the child needs. Or not.

Despite s.17 of the Children Act 1989 saying

It shall be the general duty of every local authority…
(a) to safeguard and promote the welfare of children within their area who are in need; and
(b) so far as is consistent with that duty, to promote the upbringing of such children by their families,
by providing a range and level of services appropriate to those children’s needs.

the current focus of social care services appears to be on the safeguarding element of their general duties, not on the promotion of welfare element. The initial assessment prioritises safeguarding children already ‘in need’, not on preventing them from becoming ‘in need’ in the first place. This looks rather like locking the stable door after the horse has bolted.

In practice, it means you could be the parent of three children, each with complex disabilities and Statements of Special Educational Needs and repeatedly excluded from school, have a broken marriage and be estranged from your extended family as a consequence, be seriously sleep deprived, suffering from a bunch of mental and physical health problems and be unable to hold down a job because of your caring responsibilities, but if your children are not deemed to be at risk of harm or of harming others, you can still not be eligible for a core assessment.

Local authorities justify rationing support in this way by saying they must prioritise children who are most in need. On the face of it, this looks like a responsible use of taxpayers’ money. It isn’t of course. Low-level social problems don’t just resolve themselves because services are rationed; the costs are simply shifted elsewhere. Parents and children absorb many of the costs – financial and in terms of quality of life. Schools are expected to patch together the children’s lives and parents and children pitch up at GP practices with recurrent health problems. And in many cases social services end up having to support families anyway once their problems have escalated to the point where the children are deemed to be at risk of harm.

safeguarding

The task of safeguarding as presented in the seven SCRs involving home-educated children has three main features;

• identifying children already at risk
• monitoring their welfare
• intervening before they can come to harm

The focus of politicians, the media and the SCRs themselves has been on the failure to intervene in time to stop the children being harmed. The focus of those advocating increased regulation of home education is on monitoring the children’s welfare. The focus of social care assessments is on identifying children already at risk. It’s clear from the SCRs that none of the three features provide any guarantee that a child will stay safe – almost 30% of all children who were the subject of a SCR have had current or discontinued child protection plans. So why the focus on identifying, monitoring and intervention?

promoting welfare

The purpose of the seven SCRs was to examine the specific circumstances that led to a child coming to serious harm, not to catalogue all the support families received, so there’s little mention of what help parents asked for and what help they got. Most home educating families don’t want or need help, but in all seven cases cited by the NSPCC briefing parents had approached the authorities voluntarily at some point. That might simply have been impression management on their part, but let’s assume for the moment the approach was a request for help. What did they ask for? The evidence suggests that in six cases it involved specialist expertise; about developmental disorders, complex health problems, special educational needs, mental health and adoption. Specialist expertise isn’t always easy to access. Parents with children not deemed to be at risk have long reported difficulties getting it.

But not all the help needed was so highly specialised. In two cases, there were problems with housing. Child 3’s mother had sold all her furniture in an attempt to avoid the house being repossessed; it was during repossession that her daughter’s body was discovered. The chaos and tragedy into which Child 4’s family was precipitated appears to have been triggered by the mother’s attempts to improve their circumstances; she went on a diet, her partner moved in and she planned to relocate the family to a better neighbourhood. But her ‘healthy eating’ regime deprived her children of food, her partner had a troubled history, and she couldn’t get a tenancy transfer until she had ‘tidied up’ the house – the children had scribbled on the walls. Mrs Justice King, hearing the application for a care order for the surviving children, noted the chaos that the family descended into as a result of the mother’s partner attempting to lay laminate flooring throughout the house. Without wishing to trivialise the tragedy that followed, the outcome might have been very different if a lone parent with six children, some of whom had significant learning difficulties, had had access to old-fashioned services like meals on wheels and home help.

In some cases, the help the families did get appears to have made things worse. One parent experienced frustrating delays getting responses from the EOTAS service. Health interventions included two cases of over-prescription of medication, no conclusive diagnosis, being removed from a GP list and a suspicion of Fabricated or Induced Illness. Parents did get appointments with professionals – 130 in a year in one case, but the focus of social care appeared to be on assessing the risk to the children, rather than providing the support the family needed to lessen the risk. This might go some way to explaining the ‘combative’ and ‘aggressive’ attitude of parents.

Social workers, understandably, point out that a focus on high profile cases where they have failed to prevent children coming to harm doesn’t take into account the thousands of children that they help. That’s undoubtedly true, although I’ve never heard social workers elaborating on what sort of help families get; a recent interview on Radio 4’s Woman’s Hour (from 33m 40s) is a case in point. But I don’t think it’s the social workers who are responsible for the difficulty families have in getting help; the way social care services are designed makes this situation inevitable.

it’s the system

Most of us, at some times in our life, are faced with challenges we can’t cope with on our own. Some people have robust social networks they can call on for help. For others, their social networks are part of the problem. That’s what public sector services are for; to help people cope with those challenges.

In the early 1900s, the first social worker training course offered by the University of Birmingham included topics like British constitution, industrial history, economic analysis, statistics, law, and sanitation and hygiene. The emphasis was on understanding the wider context for the problems families faced. In the intervening decades, the focus has shifted from designing systems that improve people’s lives, to resolving individuals’ specific problems, to, more recently, a preoccupation with procedures.

For example, the 2013 statutory guidance Working Together to Safeguard Children reads less like statutory guidance than a handbook consisting of 97 pages of advice. Some of the advice is probably useful – there are flow charts for different types of cases, for example. But is it really necessary to tell experienced professionals planning a strategy discussion that it “might take the form of a multi-agency meeting or phone calls and more than one discussion may be necessary” (p.33)? It’s not surprising, with this level of micromanagement and the dire consequences of not paying attention to it, that local authorities’ focus is on following the procedures related to safeguarding rather than on promoting children’s welfare.

failure demand

If people don’t get the help they need when they need it, their problems don’t just go away. Services then have to deal with repeat referrals, complaints and worsening problems. This is what John Seddon calls ‘failure demand’ – demand caused solely by a failure to do the job properly in the first place. Successive governments have believed that the obvious way to deal with shortcomings is to use carrots and sticks to get services back on the strait and narrow. Unfortunately, the obvious way isn’t always the most effective. The focus of those working in the public sector has gradually shifted away from serving the public towards collecting the carrots and avoiding the sticks.

Increasing regulation in response to service failures, which is how government has responded and what the SCRs and the NSPCC recommend, won’t help. It will simply add to the services’ workload and make it even more difficult for them to help the people who need it. Counter-intuitively, what would reduce demand and service failures is making social care universally accessible and ensuring that front line professionals have the expertise, resources and flexibility to help prevent minor problems escalating into major ones. Not only is that likely to reduce overall demand but it could also make people’s lives better.

the dead sheep in the stream and new special needs legislation

Many years ago, on a walking holiday in the Lake District with friends, the conversation turned to how clean the water in the mountain streams might be. One of the more intrepid members of our party said; “So it would be OK for me to drink this?” “Probably,” replied an experienced fell-walker, “But not if there’s a dead sheep in the beck higher up.”

mountain stream

I was reminded of this incident by my local parent carer group newsletter. Not that there was anything wrong with the newsletter itself, but it included a couple of articles about the proposed legislative changes for the support of children with special educational needs and disabilities (SEND). The proposals include;

• joint planning and commissioning of services by local authorities and Clinical Commissioning Groups
• individual support specified in a single Education, Health and Care (EHC) plan
• support extended to age 25 and
• that families of children with EHC plans should have the option of a personal budget.

The proposals have, overall, been welcomed. However, concerns have also been expressed.

The changes were first put forward in March 2011 in a Green Paper entitled “Support and aspiration: A new approach to special educational needs and disability”. I was involved in the responses of several groups to the consultation that followed and the general feeling was that it was difficult to comment on the viability of the proposals because they hadn’t been set out in enough detail. The Department for Education’s response to the consultation, “Support and aspiration: A new approach to special educational needs and disability – progress and next steps” was published in May this year and draft legislation was published in September. The Department for Education appointed 20 pathfinder authorities to pilot and evaluate the proposed changes, with a final evaluation due in the summer of 2013 – almost a year later. Queries from interested parties about how the proposals would be implemented were generally greeted with advice to wait for the pathfinder reports. In the event, not surprisingly, the pathfinder evaluation has been extended and it is likely that the legislative programme will be delayed until after the final pathfinder evaluation is published.

In discussions about these changes, I’ve felt like a Cassandra, prophesying doom and gloom whilst many around me have remained relentlessly upbeat. After all, the fact that there’s a SEND Bill at all shows that the current government recognizes there are problems with the current system, and the proposed changes show that the DfE knows what the biggest ones are. Many children are likely to benefit from the changes. But in my view the proposals merely tweak problems caused by much more fundamental factors in the system, and that if these factors aren’t addressed, the current set of problems will simply be exchanged for another. One parent I sat next to in a meeting kept saying “At least it couldn’t be worse than the current system.” Well, actually it could. It could be like the situation prior to the Warnock report in 1978, which recognized that many able children were denied a suitable education because of a physical disability, and many less able children were considered ineducable. Or, as I suggested, the legislation might result in a set of problems that are simply different to the current ones.

Components of a service

A service – whatever it is and whoever it’s for – has to have several components. First, expertise. The people offering the service need to know how to accurately assess their clients’ needs and how best to meet them. Second, capacity and resources. An effective service will need enough people with the right expertise and sufficient equipment, materials, buildings etc. Thirdly, before designing the system the service will need to carry out a requirements analysis for all the people who need the service – usually described as a needs analysis in the case of children with SEND. No service would have an unlimited budget, so once planners and commissioners know what the needs are, they can then decide what expertise and resources are going to be most cost effective and what service users can probably manage without. This might seem self-evident and might appear to be what central and local government are doing already, but since the current system of support for children with SEND clearly isn’t working – and I would argue that it never has worked, in terms of ensuring that most children with SEND achieve their full potential – there must be something going wrong somewhere.

What’s going wrong?

The Department for Education seems to have decided that the problem lies in the way support services are planned, commissioned and delivered. Planning and commissioning aren’t joined up enough, despite local authorities having integrated children’s services for nearly a decade. The process of statutory assessment is too cumbersome and takes too long, even though in principle, assessments could be completed within weeks, rather than months. Support doesn’t go on for long enough, despite adult services being available. Local authorities aren’t allocating finance in the most effective way, even though it’s their job to do so. Consequently, the planning, commissioning and delivery of the system are being changed. Since the people who designed the current system presumably thought it would work, and viable processes for planning, commissioning and delivery are already in place, a key question does not appear to have been asked; what made the system go wrong in the first place?

The dead sheep in the stream

This is where the sheep in the stream analogy comes in. Imagine that you live in a farmhouse at the foot of a mountain. The farm is too remote for a mains water supply and for three hundred years the inhabitants have relied on water from a stream fed by a spring halfway up the mountainside. The purity of the water is renowned locally and the only problems ever reported have been that the stream flows sluggishly during extreme droughts. Then one day everyone at the farm gets sick. The illness is identified as a water-borne one and further investigation reveals the source – the body of a sheep lying in the stream just below the spring, hidden in a densely wooded area where sheep rarely stray. The farming family is advised to boil their drinking water or install a purification unit, but they might not need to do anything that involves that level of inconvenience or expense. It’s quite likely that simply removing the body of the sheep from the stream and letting the water flow for a couple of days would allow farmers to continue drinking the spring water for the next three hundred years without mishap – provided no more bodies end up in the stream.

Requiring local authorities to undertake joint planning and commissioning, implementing EHC plans, extending children’s services to 25 and providing personal budgets are all the equivalent of the farming family boiling their water in pots instead of kettles or installing a more sophisticated purification unit – while there’s still a dead sheep in the stream that’s contaminating the water. So what’s the equivalent of the sheep? I’d say it was a problem with each of the three components of service provision I mentioned earlier – expertise, capacity and resources, and requirements analysis – not downstream in the system near the point of delivery where most of the amendments are taking place, but further upstream.

Expertise

First, let’s look at expertise. Recent independent reports have indicated a lack of expertise with regard to children, in the education (Lamb, 2009), health (Kennedy, 2010) and social care (Munro, 2011) sectors. Despite the Warnock recommendation that children with SEND be taught in mainstream schools where possible being implemented since 1978, it’s only since 2009 that teachers have been required to have SEN training and that new special educational needs co-ordinators (SENCOs) have had to be qualified teachers. Teaching Assistants (TAs), who now make up around 25% of the mainstream school workforce, are generally not qualified teachers and don’t necessarily have any educational training, but are often the people who spend most time with children with SEN. A recent study (Webster & Blatchford, 2012) revealed that teachers aren’t usually trained to work with TAs, so many TAs are having to work ‘on the hoof’ in the classroom with little or no preparation with a child with learning or behavioural problems. The study found that when TAs worked with the rest of the class for part of the lesson so teachers could spend time with the children with SEN, the achievement of the pupils improved and teachers understood their learning difficulties better. What’s puzzling is how this situation arose in the first place. Here’s an extract from a piece about SENCO training published in the Times Educational Supplement in May 2009.

The [training] courses have been set up to address serious concerns about the perceived “low status” of Sencos and to raise the profile of special needs and disabilities in schools.”

I find it intriguing that although the professional status of SENCOs and poor awareness of special educational needs might be relevant issues, the TES reporter frames SENCO training in those terms of rather than in terms of the expertise required to help all children learn. What does this say about perceptions of SEN?

Capacity and resources

A second factor is capacity and resources; I’ll talk about capacity first. A recurring problem for parents of children with SEND is how long it takes to see professionals who can carry out assessments. Often all children get is repeated assessments; because of limited service capacity sometimes parents (and occasionally teachers) are expected to implement therapies even though they have no idea what might be causing the child’s problems or what outcomes to expect. Another recent report (Bercow, 2008) suggested that speech and language therapy in England was a postcode lottery, and there doesn’t seem to have been a significant improvement since then. The British Psychological Society has expressed concerns (not for the first time) about cuts in the number of educational psychologists employed by local authorities. Google ‘shortage occupational therapist’; and you’ll find reports from various parts of the globe. Then there’s resources. Parents report problems getting wheelchairs and nappies; even the NHS website says that there might be a waiting list for assessments (waits for the actual wheelchair aren’t even mentioned). My local occupational therapy service apologized for the delay in providing therapy for my son. One problem was that they hadn’t been able to access his school to show teachers how to integrate exercises into his school day. Another obstacle was that because their equipment takes an hour to put up and an hour to dismantle, the only time they were able to book a room large enough and available for long enough for them to treat several children in one day was during the school summer holidays.

Requirements analysis

And then there’s the requirements analysis. Under the 1989 Children Act, local authorities are required to keep a register of children with disabilities. This should provide the information they need to enable them to design support services. The register is a voluntary one in the sense that parents volunteer information about their children, and there are obviously questions over what qualifies as a disability, so at best such a register is only going to provide approximate information about the needs of children with disabilities in a given locality. But an approximation is all that’s required. In the past twenty years, it should have been possible to form a fairly accurate picture of local needs, trends over time and year-to-year fluctuations. But judging by recent reports, support for children with SEND has been getting worse, rather than better. So what’s gone wrong?

I suggest that because education, health and social care systems have been evolving piecemeal during this time, national government initiatives have cut across local authorities’ ability to use data to design effective services. For example, following the Warnock report in 1978, local authorities were encouraged to educate children with disabilities in mainstream schools where possible. An inspiring example of this is the collaboration between a mainstream junior school and a school for children with visual impairment described by Hegarty and Pocklington (1981). At that time, local authorities and individual schools had complete control over such initiatives. Then in 1988, the Education Reform Act introduced a compulsory national curriculum, followed in 1991 by national curriculum assessments, commonly known as SATs. Although there might have been good reasons for introducing both, they have each had an impact on the Warnock recommendation for the inclusion of SEND pupils in mainstream schools. If the performance of schools is assessed by pupils’ performance in standardized tests, systems pressures will inevitably lead to a tendency to marginalize pupils with SEND, either overtly – by schools discouraging admittance or by formal or informal exclusions – or covertly by simply not allocating sufficient resources to their education. Add to this the absence of SEN from initial teacher training and the reduction in SEN expertise within the education system as a whole due to a focus on children within the normal range and the closure of special schools, and no amount of tinkering with statutory assessments or who holds budgets will be able to compensate.

Failure demand

Overlooking shortcomings in factors that are upstream in a system means that whatever you do to problems downstream, they won’t get fixed. In fact the upstream issues create the need for further resources that wouldn’t be needed if the upstream problems were fixed. This phenomenon is what John Seddon calls failure demand – demand created solely by failures of system design. A common failure demand in the case of children with SEND is that avoiding early intervention in an attempt to avoid unnecessary costs often means that simple problems become complex ones, requiring expensive interventions later on. Not to mention the sometimes permanent damage done to a child’s self-esteem and the time wasted by teachers, parents and professionals trying to get problems resolved in the meantime. Providing sufficient resources to meet needs might not cost more; in fact, once failure demand is eliminated, costs can go down.

In short, until teachers, healthcare and social care professionals are trained to meet the needs of all children, not just those within the normal range, until there are enough people with that training working within the education, health and social care sectors, and until there are enough materials, equipment and space available to meet the needs of all children, the needs of all children will not, and cannot be met.

References

Hegarty S. and Pocklington K. (1981). “A junior school resource area for the visually impaired” in W. Swann (Ed.) The Practice of Special Education, Basil Blackwell/Open University Press.

Webster R. & Blatchford P. (2012). “Supporting learning?:.How effective are teaching assistants?” in P. Adey & J. Dillon (Eds) Bad Education: Debunking myths in education, McGraw Hill.

Acknowledgements

Photograph: Tullynaglack, Donegal, copyright Louise Price, used under Creative Commons http://commons.wikimedia.org/wiki/File:Mountain_stream,_Tullynaglack_-_geograph.org.uk_-_974248.jpg