York Report Part 3

Ratings on the seven aspects.

The criteria were designed to portray as full a picture as possible of the use of the exemplars by individual social workers. This section discusses and presents the findings on each of the aspects of the exemplars that we analysed.

Aspect 1. Are exemplars signed and dated?

An important aspect of recording is that authorship is clearly attributed and marked. This would include signing by the social worker, the service users – including the carers and, in some case, other key professionals. For example, one of the exemplars, The Placement and Information Record, is designed so that the range of personnel involved in the child’s care can sign consent for a child or young person to be looked after.

Our sample contained 16 Placement and Information (or equivalent) records. None of these contained any signatures, including the social worker, the child and the person holding parental responsibility. Others failed to identify workers who had completed the process.

At this stage of the process authorities were using a paper system for consents: in each case the signature page was printed off, signed and filed in a paper file. None of our pilot sites had a document imaging or scanning system to enable paper documents to be electronically integrated into the records. Authority B did plan to have the facility to record activity electronically, suggesting that IT development, training and effective supervision could address these issues in time.

Aspect 2. Are Service Users views expressed in the exemplars?

One of the aims of the ICS, as of any recording system, is to facilitate the involvement of the child and family in the assessment and ensuing stages of the social work process. The first criterion used was therefore designed to test the ways in which and whether service users’ views were expressed. Some exemplars, for example, the core assessment, have a specific section for users, carers or parents to input material. For the purposes of our analysis, in cases where a first person statement by a user was recorded, the rating would have been Good. In fact, none of the exemplars we analysed contained such an entry. In some cases the social worker had included a summary of user views: the few ‘Good’ scores that were given were for the Chair’s Report of LAC reviews. Two of these reviews contained excellent summaries of the views of the child by the chair person. In cases where there was a coherent summary by the worker completing the record the rating was Intermediate.

Table 8.6 Are Service Users views expressed in the exemplars?*

Authority		Poor		Intermediate		Good
		n	%	N	%	n	%
A	Process	12	54	7	32	3	14
	Disability	22	39	19	34	15	27
C	Process	17	53	9	28	6	19
	Disability	12	49	10	38	4	15
Total		63		45		28

*includes exemplars where this material is not specified separately

The relatively high figure for the disability sample in Authority C may arise from the high usage of short break care over extended periods of time in this sample. The reviews for short break care did contain summaries of user’s views by review chair persons. These findings raise issues in relation to both social work practice and the design of the exemplars which will be discussed later.

Aspect 3. Is a holistic picture of the family and child presented?

As a major element in the development of the Electronic Social Care record, the ICS needs to contain details of the child, the family and their environment, and to ‘tell the story’ from referral through to closure.

Table 8.7 Is a holistic picture of the family and child presented?

Authority		Poor		Intermediate		Good
		n	%		%	n	%
A	Process	3	15	5	24	13	61
	Disability	38	68	15	27	3	5
C	Process	20	62	8	25	4	13
	Disability	8	31	8	31	10	38
Total		69		36		30

Table 8.7 presents a variable picture. Across the disability teams, there is a substantial difference, Authority A scoring 68% Poor compared to 31% in Authority C. In the Process study the pattern is reversed, so that Authority A exemplars provide consistent evidence of a holistic picture (61%) compared to Authority C (13%). Again, this marked difference invites analysis of the culture of the authorities, the way that the ICS has been implemented and its use by different teams. The absence of document imaging and sophisticated scanning technologies to capture incoming reports and assessments from other agencies was a further reason why the exemplars contained no dialogue, ie. one side of the ‘conversation’ did not have access to the other. Further, splitting up the story into sections made it difficult to follow the narrative and to sometimes access key elements of the case. However, since the number of cases in this element of the sample is small, hypotheses need further testing and analysing with data from other parts of the research.

Aspect 4. Does the exemplar demonstrate analytical thought?

The ICS derives from the Assessment Framework and the Looked After Children System, tools which were designed to encourage the analysis of families and of their work by practitioners. This aspect of our analysis was based on an examination of the links between the information collected for a particular task in each section and the reason given for making the decision or professional judgment.

Table 8. 8 Does the exemplar demonstrate analytical thought?

Authority		Poor		Intermediate		Good
		n	%	n	%	n	%
A	Process	4	19	6	27	12	54
	Disability	31	55	22	39	3	6
C	Process	19	59	6	19	7	22
	Disability	10	39	4	15	12	46
Total		64		38		34

While the numbers of exemplars examined is small, Table 5.8 does suggest a positive use of analysis within the care management teams in Authority A and the disability social workers in Authority C, and the Intermediate scores suggest some use of analysis across some dimensions of the exemplars.

Since our study does not comprise a before and after component we are unable to comment on any changes from previous recording systems. However, our findings have resonance with research on the Assessment Framework. Cleaver and Walker (2004) examined evidence for analysis in core assessments and found analysis was lacking in 26.5% of the core assessments analysed and in a further 26.5% the recording was only descriptive. Only 35.3% had a completed analysis identifying the child’s needs and service provision (Cleaver & Walker p 316). The findings reported here suggest that the ICS has not, at this stage at least, produced evidence of improvement in the use of analysis in social work practice on our sites. Social workers capacity to analyse their cases may, of course, be encouraged and improved by dedicated training. The extent to which it is encouraged or diminished by the system which they use to record their case material will be addressed by other parts of our study, but will also need further testing.

Aspect 5: Is there coherence of decision making?

Good decision making is an essential component of effective practice. In defining this aspect we judged whether the decisions recorded in the exemplars reflected coherence across the process from assessment through to review. The nature of the exemplars means that some have a clearer decision making path than others. For example the Referral and Information Record has a number of clear pathways (e.g. No Further Action, signposting to another service, Initiating a section 47 enquiry or Initial Assessment) whereas a LAC review or Core Assessment invites the worker to make a number of more overarching decisions about services to be provided to a family or child. The decisions vary in complexity. The task here was to chart the process from gaining information through the decision making process within and across exemplars in a particular case, and to ascertain its coherence.

Table 8. 9 Is there coherence of decision making?

Authority		Poor		Intermediate		Good
		n	%	n	%	n	%
A	Process	3	14	1	4	18	82
	Disability	18	32	23	41	15	27
C	Process	11	33.3	11	33.3	11	33.3
	Disability	9	37	4	13	13	50
Total		41		39		58

The outstanding finding is that, in the care management teams in Authority A, where there were 8 Initial Assessments and 8 Referral and Information Records, the decision making pathways appeared less complex and were more clearly identifiable. For example a team leader has to make and record a clear decision about a referral – which is, for our purposes, easier to track. At the same time because many of the exemplars were incomplete, it was difficult to establish whether a decision was coherent or not. For example, the one record of a strategy discussion that we analysed was blank, except for recording the nature of the allegation that the child had made and the ensuing telephone strategy discussion. Although there must have been a decision following the strategy discussion (and in the case examined it can be deduced from the Record of the Outcome of a s47 enquiry that the decisions was to continue with a joint Police – Social Services investigation), this is not clear from the Record of Strategy Discussion exemplar. The incompleteness of some exemplars, illustrated here, makes judging the coherence of decisions difficult but also throws up concerns about how their use in providing evidence of sound decision-making.

Aspect 6. Is evidence used/cited to substantiate opinions, care planning and decisions?

In this aspect we sought to establish whether information generated and collected by the ICS exemplars is used as evidence for decisions and planning for families and children. Thus, for example, in one case of a disabled child who was looked after, a series of reviews charted the breakdown of a placement and the move of the child to a new placement. Here we sought to examine whether, in the choice of the new placement, evidence from the analysis of the previous breakdown was used in the choice of the new placement. Likewise, the Referral and Information Records and the Looked After Children’s Reviews were examined for evidence to support decisions made about referral and planning.

Table 8. 10 Is evidence used/cited to substantiate opinions, care planning and decisions?

Authority		Poor		Intermediate		Good
		n	%	n	%	n	%
A	Process	0	0	5	23	17	77
	Disability	25	45	23	41	8	14
C	Process	13	41	8	25	11	34
	Disability	9	35	7	27	10	38
Total		47		43		46

Table 8.10 presents a mixed picture. The relatively high proportion of Good ratings in the Process Sample of Authority A perhaps again reflects the high number of Referral and information Records and Initial Assessments in the sample which the focus groups, reported in Chapter 5, suggested were found easier to fill in.

Leaving aside the Process sample, an amalgamation of the Poor and ‘Intermediate’ ratings indicates that there is not a well embedded use of evidence in the exemplars. As with previous aspects, these findings are equivocal, reflecting issues in practice and the stage of transition to ICS rather than a straight demonstration of ways in which the system encourages social workers to use evidence in the exemplars.

Aspect 7. Is the ICS exemplar an effective professional tool?

This final aspect sought to judge the ways in which and whether the exemplars are effective professional tools. This would include, for example, assessing how well information on the progress of the case was recorded and whether it included clear details about other agency involvement. Could other social workers pick up the records and be confident they were accurate and up to date? Could managers use them for supervision…and so on? A Good rating required an exemplar to have at least three ‘Good’ scores on different aspects; a Poor rating required at least three ‘Poor’ scores. While our results are limited by the size of the sample and by the range of exemplars that we were provided with, evidence from other parts of the study supports the analysis here.

Table 8. 11 Is the ICS exemplar an effective professional tool?

Authority		Poor		Intermediate		Good
		n	%	n	%	n	%
A	Process	1	9	4	18	17	73
	Disability	11	20	29	52	16	28
C	Process	13	38	12	35	9	27
	Disability	10	38	3	12	13	50
Total		34		38		55

The ratings for the process cases in Authority A and the disability cases in Authority C reflect the pattern that has already emerged. Leaving aside the aspect rating service users views, these two groups have achieved Good ratings more consistently than other groups. However, this must take into account that the process cases in Authority A largely comprise two exemplars, The Initial Assessment and the Referral and Information Record. These are shorter and less complex than many other exemplars, a factor that, taken alone, might mean better and more completion rates.

The relatively high Intermediate scores for disability cases in Authority A and process cases in Authority C reflect the partial completion and quality of the recording already demonstrated. This could be transitional; it could reflect variations in practice and the need for further training. Further longitudinal research would be necessary to provide some answers.

The Exemplars.

The above analysis examines the ratings of the exemplars that were made available to us and suggests some hypotheses. This section of the report will look in more detail at some of the key exemplars.

1 Exemplars not included in the analysis

As Table 8.3 illustrates, our sample does not contain every exemplar, or a complete set of exemplars. For example there are no Assessment and Progress Records and there is not a full sample of all of the age ranges of the Core Assessments. Only one authority (A) provided Chronologies to be examined and they were not included in the analysis of aspects. Their content was inaccessible on paper because the chronology currently is not a functioning electronic document. Other issues with the Chronology exemplar are discussed later.

2 Exemplars with a low number of examples in the overall sample.

i) The Outcome of section 47 enquiries.

Only four section 47 Outcome Reports were sent to us because of the low number of cases in the Process Study. These exemplars contained useful information. For example, the outcomes are recorded and in one there is a concise summary of the views of the young person.

ii) The Placement Information Record and related exemplars.

The sample contained seven of these exemplars, reflecting the relatively small numbers of young people looked after at the time of the fieldwork in the Process study and the fact that Authority A had constructed a new exemplar, entitled Essential Information for Providers, used for children who had extensive short break care. While these records were only peremptorily completed and the aspects not rated highly in our analysis, this record was regarded by workers and by the substitute carers as useful.

iii) Core Assessments.

Our sample comprised 5 Core assessments from Authorities A and C. This is the major assessment tool of the system and we had hoped for more. In the case of Authority A, which implemented the system in December 2003 in its Disability Team and March 2004 in its one care management team, the low number is somewhat surprising although perhaps mirrors Cleaver and Walkers (2003) finding that in only 3% of all cases was a core assessment completed. A possible explanation in Authority A could be that the disability cases were of longstanding. Another factor, suggested by the disability sub study and focus group data, is that this team was unsure of the value of the ICS or whether the Core Assessment exemplar is appropriate or helpful for their work. Chapter 11 and the Disability Study Report provide more detail about this. Notwithstanding, our analysis suggested that, in one case where the child was moved as a result of placement breakdown, it may have been appropriate to undertake a Core Assessment .

Core Assessments feature highly in the process sample from Authority C. However, the analysis revealed so many blank sections that the research team felt obliged to check that the exemplars sent accurately reflected their content on the database, which they did. One possible explanation is that these exemplars were only recently introduced to this Authority and, at this stage, the social workers were not confident about using them. However, there was a substantial difference in the Core Assessments sent from the Disability team in the same Authority, which scored highly on the analysis of aspects, and which was established at the same time. This stark contrast can not be explained without further longitudinal evaluation of usage.

3 Exemplars with a larger number of examples in the sample

i) The Referral and Information Record.

The sample contained 20 of these records. The ratings vary across the spectrum and it is difficult to establish any consistent patterns. Variations across the pilot authorities are stark.

The disability sample in Authority A were all open cases before ICS was introduced so there were no Referral Records in our sample. The consistently positive rating in the Process Study sample from Authority A possibly relates to the fact that this exemplar is a referral for - and so a gateway to - service, noting a decision whether or not to take further action which does not require evidence. As observed previously, the exemplar is short and may well be used because staff regard it as fit for purpose and easy to complete.

However, conversely, the use of this exemplar by the Disability team in Authority C is poor. There were a large number of blank sections This is a new team, attracting a high number of referrals. This again poses the question whether there is something inherent in the nature and structure of the exemplars that made them of less value to this team, or whether the newness of the team means the workers are unfamiliar with the exemplars, or a combination of both.

There follows an example of the potential for electronic integration of information. The duty team received a referral by email from a Voluntary Organisation that works with women who are the subject of domestic violence. It was a particularly detailed and well presented referral. The detail of that referral had been electronically cut and pasted into the exemplar with the additional essential details being also completed. This was the only record in the sample that had any contribution from another agency; and that contribution was not a direct entry but as stated a ‘cut and paste’ operation.

ii) The Initial Assessment Record.

The sample included 18 of these records. The ratings on these exemplars are among the most positive, especially in relation to the use of evidence to support decisions and of analysis in considering outcomes. This might be a result of familiarity with a more straightforward task. The Initial Assessment is a familiar process to social workers, being well established by the Assessment Framework. However, although this assessment is the means of deciding the next course of action for a referral, there is no section on the exemplar to record users’ views.

iii) Children and Young people’s Care Plan Parts 1 and 2.

The only Planning exemplars received were from Authority A. The Care Plan should be the core driver of the service that a child or young person receives as it is key to record building and planning to meet the assessed needs of a child. This exemplar is designed to summarise the plan for the provision of service with clearly defined goals and outcomes.

In the 30 exemplars examined, only 4 clearly stated the views of the young people. In no cases was this in their own words or, in the case of the disability study, other appropriate personal communication system (see Disability Sub study for further discussion). Again, the question arises as to whether this reflects poor social work practice or signals an inherent difficulty with the records themselves. Young people engage in their reviews, attend them and social workers state in their reports to reviews the views of young people. Since there is some substantial engagement of young people in the planning and review process it is reasonable to query why their views are not directly expressed in the exemplars and in particular within their care plan. Additionally, although the ICS is an electronic record, none of the social workers were using portable computers (e.g. tablets) in order to directly enter the views of the young people on their visits. Additionally, the technology of the design of the exemplars assumes that the written word is the dominant form of communication (see the Disability Sub study for further discussion).

iv) Social Workers’ reports to LAC reviews.

The sample (excluding the Chair’s Report, analysed separately) comprised 22 of these exemplars, most (18) from the Disability Team in Authority A. Only one involved a young person in full-time care, the rest being extensive users of short break care where the children were in well established placements. While the exemplars were very brief and scored low on the rating of the aspects it was clear that a great deal of information was passed in other ways between carers, parents and workers. As previously indicated, data from other parts of the study suggests that this team did not consider that the design of the ICS sufficiently addressed the specific needs of disabled children and their families.

v) Chairs’ report of LAC Review.

This exemplar, nearly all again from the team described above, was well represented in the sample for the reasons already discussed. These exemplars were amongst the fullest we analysed, containing good summaries of both the review and the case. This may reflect the experience of practitioners who become Independent Reviewing Officers, or may suggest that this exemplar is fit for purpose.

Conclusion.

This record study is compromised by the relatively small size of the sample, the under representation of child protection cases, the lack of some ICS exemplars and that only two sites are represented. The overall summary of the exemplars rates 35.7% of them as Poor, 34.3% as Good and 30% as intermediate in relation to completion and quality.

This Chapter suggests that some of the exemplars are more readily completed than others and that some of the exemplars are not used at all. Additionally, the data reported in Chapter 4 reports that some are not acceptable to other key agencies – eg courts. There are important issues relating to coterminous paper files and the capacity of the system to enable letters and reports from other agencies to be scanned in. There are difficulties with signatures and dates. There are specific issues for their use with children with disabilities and the exemplars are not user friendly.

Of course, since this study does not include a comparison of practice before, as well as after implementation, any concluding comments on recording can not be attributed solely to the ICS. Written paper records also have shortcomings as we know to our cost from the range of Enquiry Reports, such as the Laming Report (2003). Notwithstanding, our study has evidenced some specific deficits. Pulling together the main findings, there is, as with data reported upon in other Chapters, striking commonality and common concerns.

The exemplars require a large amount of standard information. We found that some exemplars, especially the Initial Assessment, were completed more fully than others, and that some questions, such as date of birth, were more likely to be completed than others. Large sections of exemplars are blank, the reasons for which are unclear. Some exemplars are not used at all. The quality of the information is not always good and it is difficult to follow the narrative of the story and to get a holistic picture of the child and family. There is little evidence of analysis and the incompleteness of some exemplars made analysis of the coherence of decision making difficult. For a number of reasons paper records are still kept, and authorities currently lack the capacity to scan in incoming reports. None of the exemplars examined contained a first hand report from a service user, and none were signed either by professionals or by the children and families concerned. Information about ethnicity and religion was often missing, especially for new cases.

Various explanations for the problems are possible. Firstly, the results may represent the problems of transition to a new system. Once the system, with all its attendant difficulties has settled, the difficulties described may reduce. Secondly, the findings may pose questions about social work practice. Previous work has found a great deal of variety in, for example, the quality of assessments (Cleaver and Walker 2004, and SSI 1997), raising questions about the knowledge and skills of practitioners. Training may affect the use of the system by practitioners in different teams with different cultures. Only a longitudinal evaluation would address this. Thirdly, there may be problems inherent in the design of the ICS. The incompleteness of the exemplars, the difficulty in following/telling the story, the variability in analysis and use of evidence, for example, might reflect a design problem. One hypothesis is, therefore, that ICS exposes poor practice, raising the question – does this system encourage, or have the potential to encourage, good practice precisely because of its totality. The record study alone does not enable this possibility to be pursued, and needs to be seen in connection with the Download study, the technology case study and the questionnaire and focus group data.

Chapter Nine

The Time Study

Introduction

Social workers were very concerned about the time required by ICS. Generally they saw this as excessive. The purpose of the time study was to put some figures on these concerns. More specifically it aimed:

1. To assess how much time was taken to complete different exemplars
2. To distribute this time between the different activities involved
3. To identify factors that influenced the time taken

If we could answer these questions we would be able to make a more informed assessment of how realistic the social workers’ concerns were. We could also assess how far the system required time spent on activities the workers did not value (e.g. time entering data) as against time on activities they did value (e.g. time with clients). Finally an understanding of the factors that influenced time spent (e.g. differences by authority) might suggest ways of saving time.

Method

We wanted accurate data on a representative sample of completed exemplars. We had to balance this requirement against the need not to overload our respondents and with a wish to obtain information on a range of exemplars and not just on those that were most frequently used. As a result we decided:

• To focus on exemplars concerned with the core activities of assessment, care planning and review
• To limit our requests to a maximum of 12 exemplars per team and 2 per worker
• To ask team leaders to achieve targets numbers of exemplars (e.g. 4 initial assessments from their team) subject to the above constraints

Our method was developed from the work of Cleaver and her colleagues and was retrospective. We asked team leaders to distribute forms to workers who had completed the latest example of the exemplar in question. For example, if the team had a target of four initial assessments the forms would be given to the workers who had most recently completed them.

We chose this retrospective method for two reasons. First, we did not think we could justifiably add to social workers’ burdens by asking them to complete time sheets as they went on. Second, we faced the problem that any prospective method of picking up cases would yield a large number that would not be completed over the time available.

We are satisfied that our method represented the best compromise available. We also believe that it has yielded some very useful data. That said, we need to recognise that it has severe limitations. These include the following:

• Retrospective estimates are clearly rough and ready. They can show that there are large differences in time between different activities. They cannot provide precise accounts of time spent.
• There are conceptual difficulties in allocating time between activities and cases (e.g. how does on divide time spent interviewing a mother when there is more than one child in a family). There are similar difficulties over meetings with more than one agency or involving professionals and family members.
• We have evidence that many assessments begin but do not formally end. These will not be included in our study but will take time. We cannot therefore estimate the total amount of time social workers spend on the system but only the time taken on completed cases.

Overall we received 72 completed questionnaires. One came from an unidentified authority, 21 from one of authorities, 39 from another, and 11 from the third. Essentially the third authority only had one team, so it effectively met its target. The other authorities each had targets of 48 cases. They met 44 per cent and 81 per cent of their targets respectively. Overall the authorities met two thirds of their allocated target.

We have no method of checking how far the team leaders were able to carry out our other requests (e.g. to focus on the latest complete examples). Our assumption is that they will not have been able to do this completely (for example, workers may have been ill, or the latest completion may all have fallen to the same worker). We do not, however, think that these biases are likely to be sufficiently great to invalidate our main conclusions.

Results: Average Time on Different Exemplars

We divided the time spent on different exemplars into six categories:

• Time spent in consultation with other agencies
• Time spent in supervision or other consultation within the worker’s own department
• Time spent in direct contact with child or family
• Time spent in contact with other informal networks (e.g. neighbours)
• Time spent entering data on the computer
• Time spent in other activities (e.g. analysis, travelling etc)

In theory these activities can overlap. For example, it is possible to have direct contact with a child in a meeting with other agencies and social services staff. This could lead to ‘double counting’. So we also asked for an overall estimate of the time spent on the review at the end¹³.

As a check on the consistency of our information we added the total time spent on the ‘sub-activities’ and correlated this with the overall estimate. The correlation was very high (r=.998). The following tables relate to this overall estimate.

Table 9.1 Estimate of hours spent by type of Assessment

As can be seen from Table 9.1, initial assessments were estimated to take much less time than the other activities. Reviews and core assessments were both estimated to take more than a week of time.

How does the time spent on assessments vary?

All the estimated times with the exception of the initial assessment have very large standard deviations. This implies that there is a very considerable range in the time taken to complete assessments.

This situation is most easily illustrated with histograms giving the distribution of times for the different exemplars. Figure 9.1 gives the chart for initial assessments. As can be seen the majority of assessments cluster around 10 hours with a small number of ‘outliers’ that either take less than five hours or – in one case – more than 25.

Figure 9.1 Estimate of Total Time in Hours Spent on Initial Assessments

Figure 9.2 gives comparable information for the remaining forms of assessment and review. Again there are two quite different distributions. Most of the assessments, plans and reviews take around twenty hours. As might be expected there is variation around this average with some taking longer and a minority less. There is a however a small group of cases, about 14 per cent of the total that take very much longer than this – between 133 and 196 hours. This small group clearly has a major influence on the overall average. They cannot simply be ignored for they are too numerous to be treated as statistical blips. Their influence on the time required is real. At the same time we need to understand why their demands are as they are.

Figure 9.2 Estimate of Total Time in hours Spent on Assessments, Plans and

Reviews

Time Spent on Different Activities

As already explained, we asked the social workers to divide the time between six different activities¹⁴. Table 9.3 gives an estimate of the average time spent on these activities by the type of exemplar.

Over the sample as a whole most time (an average of nearly nine hours) was spent on ‘other activities’, a category that includes travelling. The next largest block of time went to seeing the child and her or his family (8 hours), followed by consultation with other agencies (6 hours) and entering data (between 4 and 5 hours). Relatively little time was spent on consultation within the agency (2 hours) and hardly any time with the informal network outside the immediate family.

Table 9.3 Average Time spent on 6 Activities by Assessment Type

It should be remembered that these ‘overall’ figures do not come from a random sample of assessments, plans and reviews. They are therefore rather poor guides to how social workers spend their overall time. Rather more interest attaches to the differences within assessment types. These show that the relative amounts of time spent on the different activities varies by assessment type.

• In initial assessments time goes in almost equal amounts on direct contact with child and family, entering data and ‘other activities’. Some time is spent on consultation with other agencies.
• In core assessments the most important activities in terms of time are, in order, ‘other activities’, ‘consultation with other agencies’, ‘direct contact with child and family’ and ‘data entry’.
• There is a similar order for child plans but data entry is relatively less important
• Reviews show a different pattern. ‘Contact with the child and family’ takes most time, followed by ‘other activities’. ‘Contact with other agencies’ and ‘data entry’ still take up time but they are proportionately much less important.

These figures cast some doubt on the claim that social workers are nothing but ‘expensive clerks’. It is true that they spend a lot of time at a computer – each core assessment, for example, appears to take on average at least a day to enter. In no case, however, is data entry, on average, their predominant activity.

There is, however, a caveat to this conclusion. As we saw earlier, the average figures are very heavily influenced by a small number of cases that take up an enormous amount of time. If we omit those cases which took up more than 100 hours, the relative importance of ‘data entry’ increases (see Table 9.4).

Table 9.4 Time spent in hours on Selected Activities

Note This table is restricted to cases where the social worker estimated the total time spent as less than 100 hours

As can be seen in these ‘more typical’ cases social workers spent on average more time entering data than they did on consulting with other agencies. In the case of core and initial assessments they also spent more time entering data than they did on seeing the child or family. Such comparisons may explain the view that social workers are being ‘turned into clerks’.

Factors influencing the time spent

As we have seen there were a small number of cases (6) that took up a great deal of time. Four of these involved children who assessed as being at risk of harm, a difference that was almost but not quite significant. Their most striking characteristic was that they were young. Excluding initial assessments, half the children under the age of five in the sample fell into this group.

The second factor that clearly influenced time spent was local authority. For statistical reasons we concentrated this part of our analysis on the two authorities that returned most cases¹⁵. The results were as follows:

• Authority 1 spent more time on initial assessments than authority 3 but the difference fell just short of statistical significance
• Authority 3 spent significantly more time on core assessments than authority 1 (p<.001)
• Authority 3 spent more time on care plans than authority 1 but the difference fell just short of statistical significance
• Authority 3 spent more time on reviews than authority 1 but the difference fell just short of statistical significance
• These differences were not affected by removing the small number of cases that took up an unusually large amount of time
• The pattern of differences was essentially the same if attention was concentrated on individual activities (for example, within core assessments authority 3 spent more time on direct contact and entering data than did authority 1)

This pattern of differences is probably not explained by differences in the documentation and implementation of ICS. These differences certainly existed. If, however, they explained the differences in time they would probably have more of an effect on some activities than others. For example, the differences in documentation might be expected to result in pronounced differences in the time spent on putting in data but much less of a difference on the time spent with the child or family. In practice all the differences seemed to be in much the same direction. So, perhaps, one needs to look to other variables for an explanation – for example, the expectation of individual team leaders or variations in resources available.

Conclusion

The time study relied on retrospective estimates. For a variety of reasons it cannot be used for an overall assessment of the amount of time required by ICS. It does, however, suggest some conclusions. These are:

• The time required for assessment, planning and review is very considerable and could easily come to absorb the great bulk of social work time
• A small group of cases make very extreme demands on time and have a considerable effect on the average
• The demands of ‘data entry’ are considerable and in ordinary initial and core assessments take up slightly more time than direct contact with the family or child
• These demands are not, however, so extreme that social workers can be regarded as ‘nothing but clerks’
• The time demands of assessment, planning and review vary between cases and between authorities
• Much of this variation probably has little to do with differences in the form taken by ICS, stemming rather from the different degrees of concern generated by some very young children and, more speculatively, the varying time pressures on social work teams

At a general level the findings again raise the question of ‘what is ICS’. Clearly ICS reflects assumptions about the nature of social work. In the past social work has been seen as a ‘problem-solving’ activity, something that changes the world as well as understands it. For a long time the mechanism for achieving this change was believed to be the relationship between the social worker and the client. These past beliefs would sit uneasily with a situation where social workers spend much, probably most, of their time gathering information, making assessments and entering data on computers. That said, it is probably more the case that ICS embodies, and perhaps entrenches, more recent and, arguably more bureaucratic, ways of viewing social work than that it creates them. In this context it is perhaps arbitrary whether one regards the assumptions about social work as part of ICS or as part of the context that brought ICS about.

Chapter Ten

ICS and Questions for the Delivery of Social Work

The three previous chapters have brought together data that provides a picture of how the ICS is ‘practised’ by social workers and managers. The chapters have been intentionally data-led with limited interpretation or drawing of lessons and conclusions. The two chapters that follow this one present what we learned from talking to service users and carers, including those whose service links were with disability teams.

Before we move to the evidence from users and carers, we use this chapter to stand back somewhat from the data about practitioners and managers, and pull together an overall interpretation of the messages from the data hitherto. Most of this interpretation is based on what we have called the process study, but written with the whole of the previous data chapters in mind. We suggest a more structured analysis of the data, and a framework of interpretation. We take this still further in the final chapter where we spell out what we see as the inferences for action. We draw on the variety of documentation, key informant interviews, and focus groups within the process study. The level of the chapter falls between the data-led empirical chapters and the closing conclusions.

We have foreshadowed issues about the relationship between the ICS and social work practice. Chapter Five presented the fairly extensive data from the nine focus groups conducted with different stakeholders and at different stages of the study. They came to the surface also in the case study on the implementation group for Site C and we start off this chapter with a longer extract from a minute of that group in April 2005. We have quoted at some length believing that it captures a range of concerns that occurred, and with the reminder that Site C gave the most positive picture of ICS progress. This suggests that, insofar as any problems raised are generic rather than site-specific, then they will be at the lower end of problem-severity likely to be encountered in other authorities. This minute is dated about a full year into the ICS experience.

Box 10.1 Practice Issues in Site C

The Implementation Group completed an issue review to identify which issues are currently causing the social work practice to be at risk. The following issues were identified:

1. The use of the exemplars for the service users. It was generally agreed that the exemplars in their current form are not usable for service users. The documents are too lengthy and not presented in an acceptable manner.

2. Form design. The exemplars are poorly designed, repetitive and are difficult to complete.

3. Data integrity. There is a need to ensure that the integrity of the ICS solution is maintained through the quality of information provided and processed throughout the social care life cycle.

4. The exemplars do not describe the case easily. It was stated that the exemplars do not clearly describe the case when looking at the documentation. The forms should tell the story of the case and provide the reader with a clear understanding of what has happened. This is not the case.

5. The ICS solution does not accommodate the day to day changes. A. raised concerns over the way in which the ICS solution deals with day to day changes in the delivery of the care plan. The outcomes are clearly stated in the exemplars but the way in which the outcomes are delivered will change regularly. Minor changes are not handled in the documents provided, the guidance states that the care plan should be updated and a new care plan created but this is not practical.

6. There has been a workload increase in the Phase Two exemplar rollout. It has been generally felt that the Phase Two rollout of the exemplars has caused an increase in workload.

7. Which forms should be used? – The need for interim measures to ensure that the social work practice is not at risk. It was agreed that this is the most serious issue. Currently there is confusion and a lack of consistency on which forms should be used

8. ICS does not cover resource requirements adequately. A. stated that the ICS exemplars do not cover the requirements for Resources.

9. Benefits – We cannot see the benefit in the ICS solution. The current issues being encountered are causing social workers to become disillusioned over the real benefit in using the ICS solution.

The key phrases in this minute are reminiscent of the rather negative balance of opinion and experience in the early focus groups (Chapter Five).

What can we conclude from this and other data? We suggest there are five general interpretive conclusions. The Integrated Children’s System:

1. Contains a practice model that is inherent in the mode of ICS work.
2. Has a consequent tendency to shape social work practice in certain directions.
3. Has the ‘ability’ to render social work practice more ‘visible’.
4. Has the capacity to clarify and tease out social work practice.
5. Brings to the fore issues regarding the relationship between administrative and professional roles in social work.

At a more general level, the introduction of the ICS poses questions about the role of professional judgement and discretion, and we discuss these in the closing section of the chapter.

We might have added to this list that the ICS raises particular challenges regarding the relationship between technology and practice. In assessing the strengths and limitations of the ICT aspects of the ICS we need to take into account the fluidity of the implementation process, the newness of ways of working, and the volatility in some participants’ views of its merits and demerits. The two technology case studies had special value in this regard. They were carried out as almost the final major act of fieldwork. They were undertaken by an external consultant who crafted her analysis in almost complete independence of the views of the evaluation team.

Hence, while we regard these as central issues, the discussion of them falls elsewhere. The data falls in Chapter Four and the suggested issues and conclusions are given in more detail in the final chapter. A number of the matters discussed in these case studies are not strictly ICT issues, and overlap with concerns about exemplar language and design, and broader organizational practises. Some issues may also be transitory, associated with data transfer and file set-up.

Conclusion 1 Practice model

The ICS is founded on an understanding of social work as consisting of assessment, planning, intervention and review. We can characterize this sequence of assessment, planning, intervention and review as a linear model of practice. This poses the question whether practice models transfer across diverse forms of work with children and families.

It is also an outcome-focused practice model, consistent with the aspirations of the policy community. It is not clear how national policy aspirations of this nature may lead to change at local level. The implementation case study perhaps implies that, while information managers at CSSR level may espouse the outcome commitments of the ICS, there is much less evidence that this will trickle down to practitioners or even team leaders.

Third, it is a structured practice model. This stems from the extensive exemplars. Some parts of the exemplars as presently implemented (eg for aspects of the assessment process) allow a fixed number of characters in a box. Others are open ended. Thus, ICS ‘pre-codes’ aspects of practice¹⁶ and leaves others ‘open-ended’. This structuring partly pre-defines practice dimensions. The issue came up in the focus group at Site A. One practitioner in particular felt that the format in which the exemplars are set is very constraining in terms of not allowing social workers enough space to provide full and detailed descriptions.

With the core assessment documents there has been a debate about, you know, character limits. ‘Cos there’s a sense, you know, that social workers need to have their, you know, word counts limited, ‘cos they’re on occasion writing too much. And again you get into that debate, which I actually feel very strongly about, that social workers should be able to write as much as they see fit.

Closely connected with a structuring of social work, we observed in Chapter Five that participants often lamented the way the ICS is perceived as partializing social work, and as providing presumably unwitting support for proceduralizing practice such that it depends less on skill and more on following learned explicit rules.

It was in this connection that people effectively made a point about the 'chunkiness' of the ICS system. What they were referring to was the fact that one had to describe a person under a number of prescribed headings (education, identity etc). The effect of this was that the person and the story were lost, it was difficult to decide where to put particular bits of information and there was a danger of having to repeat oneself. Take, for example, an instance we encountered where a child, whose mother was alcoholic, and who as a result had to get up in the morning and get her siblings to school so that she herself was often late. It appeared to us that the ICS classification scheme would inevitably split this into a series of ‘chunks’ such that it would – even if fully recorded - be put under parenting, health, identity (if the child thinks of herself as a carer) or education.

This made it more difficult for the social worker to convey what had to be done in a crisp way.

When you want to do your child protection plan you lose the point of it, because you've had to reword it. To fit it into the different child needs, and you've had to split it up onto different pages and at different points of the report, whereas what we're used to doing is saying, “This is the story, these are the risks, therefore. Within this story there are these three children that have these needs as a result…”

A linear, outcome focussed and structured practice model has certain advantages. The most obvious ones are that it tends to render social work practice more visible, evidence-based and change-oriented. These are virtues not to be sniffed at (see, for example, discussion below under Conclusions 3 and 4). Yet they are not – rhetoric to the contrary notwithstanding - all encompassing. We noted in a previous chapter how Martin Davies has over the last two decades urged the limitations of seeing all social work is about change, to the neglect of recognizing the maintenance purpose of much social work practice (Davies, 1994). His argument applies, for example, to much work undertaken with children who have disabilities and their carers, and may account for the desire of those working in that field for an approach to work that does not assume an ICS-style linear model.

Conclusion 2 ICS the practice-shaper

At the most simple level the ICS has the potential to re-allocate the weight that is given to recording different aspects of practice and hence the emphasis given to them by practitioners¹⁷. We observed five areas where practitioners and managers believed they saw evidence, sometimes deleterious, of such shaping. First, as we have inferred already, the ICS challenges practitioners to consider what counts as ‘important’ or ‘serious’ work and what counts as less ‘serious’ or weighty. To illustrate from the Site C documents, a minute some months into the implementation reads:

There is still some ambiguity about the best process for recording non-complex Child in Need cases. In particular, it is not clear whether social workers should be using the child’s plan or whether it is sufficient to use the plan at the end of an initial assessment. (Minute 180305)

Identifying the issue for future discussion, the minutes later note:

In relation to non-complex Child In Need cases, is there a formal review of the plan and, if so, on what are those reviews recorded?

This is not merely a technical point about ICS recording ‘rules’¹⁸. In order to work out an answer to the problem, assumptions need to be made regarding what matters, and how boundaries become recognized between non-complex ‘Child in Need’ cases, complex ‘Child in Need’ cases, and child protection cases. We know, if only from the Victoria Climbié case, how such judgements are central to managing risk in social work. There is guidance in the Assessment Framework, and recording ‘rules’ within the ICS carry implicit answers to those questions.

Second, does the ICS emphasize or de-emphasize counselling roles within packages of care?

Section 51 referrals: A. noted the unsuitability of the referral and information record for referrals for Section 51 counselling (Site C Minute 180305)

The subsequent action minute records:

When requests are made for Section 51 Counselling, these are recorded on the ICS referral and information record, which is not a suitable document for taking such referrals. This process needs to be revised.

We are not suggesting that this single instance ‘proves’ that the ICS de-emphasizes counselling roles. We acknowledge the comment of a reviewer of an earlier version of this report, that this may be resolvable through adding an option box. But it is reasonable to pose the issue as a question whether exemplar development shapes rather than simply echoes accepted practice.

Third, we noted above that one concern was whether the ICS unhelpfully ‘fixes’ analysis and understanding of social work, by unwittingly making changes to analysis and associated plans less likely. While there are no technical reasons why ICS exemplars cannot treat a care plan as a living document, there remains, we believe, a serious issue that the ICS may risk introducing unintended consequences. We made several efforts to pin down the grounds for this concern, albeit with limited success. But the concern surfaced throughout the project. It was often expressed in the form of how to manage recording requirements, as for example when a social worker asked,

How do we record minor amendments to a plan? Do we copy the whole plan and amend it in the meeting or do we simply record those parts of the plan that have been amended without having to copy the whole plan?

Fourth, the issue or pre-structuring social work occurred in a slightly different context, in connection with the decisions made when the Exemplars were developed, regarding what parts of the forms were to be mandatory and what parts optional. The decisions are clearly practice decisions. Not everyone was happy with the state of play.

I’ve asked (for the) box on analysis to be become a mandatory question, because, for me, that is the key, you know to all of this, but instead we’ve got 101 other fields that are mandatory that aren’t ... key to the child and what is going on for this child. They are the key in terms of statistical returns and what have you, they are key in what the government needs to know, but they aren’t key in terms of what is going on for this child. (Focus Group Site A)

This participant seems to interpret the decisions surrounding mandatory form fields as driven by performance indicator agenda rather than the needs of the child. We realise that it is possible to argue that at different levels these two criteria are fully compatible – but that is not how it is seen at ground level. Assuming for the moment that such issues are matters of technical choice, it is possible that such problems will not always be easy to solve. Thus one social worker from a Disability Team in Site C is found lamenting that she

…sent a ‘postcard’ in September of last year noting my concern that there was not sufficient space on the Core Assessment to record the names of all professionals involved with children and families.

And asked

Has this matter been resolved? (Site C Minutes 180305)

The fact that no-one in the implementation knew the answer suggests perhaps not! The lament regarding the ‘checklists and truncheons’ agenda of the ICS is by no means new.

We had this previously with LAC…Despite the fact that there was…strong, very strong advice which said this is not what these records are intended for…I’m not sure we ever broke down that barrier with some social workers. (Key Informant, Site A)

Fifth, there was a perceived tendency for the ICS to ‘IT-ify’ social work, as one person expressed it. Terms such as ‘front end’ and ‘drop down’ enter the discourse as technical expressions for how ICS packages work on screen. They come to have more powerful metaphorical force as conveying something about how social work ‘works’ (both phrases were used in the focus groups when participants were apparently talking about practice, eg Site D). The most important way in which the language was seen as problematic was by virtue of its lack of suitability and understandability to service users – a problem we documented in Chapter Five.

It was also noted on several occasions in the focus groups that there were too many instances of IT-type language being used in ICS documentation.

… it’s things like ‘There are no care plan lines for this domain’. ….And things like ‘the environmental factors affecting the corporate parent’…..I think it’s just using that word ‘domains’– if someone said ‘your child’s welfare and needs’ or ‘family environment’ instead of domains that would be much better.

In the examples given by this participant the first is an IT metaphor while the second is an organizational metaphor. The general effect of metaphor language of these kinds is to suggest a firmly boundaried, packaged social work practice, with clear definitional demarcations. This may be what we hope for – or it may not.

We have taken a ‘strong’ position in arguing that in some instances the ‘medium’ of the IT is the ‘message’ of the practice. This view would not be shared by all those to whom we spoke. For example, a key informant argued that

…if there’s anything that needs to be done it’s to keep the notion of the record being something that’s separate from the assessment work itself, although it obviously influences it. (Key Informant, Site A)

However, this person immediately went on to acknowledge the reality of the issue by expressing concern that ‘practitioners who aren’t necessarily thinking very clearly or in depth themselves, that list of questions then will inevitably tend to guide what they go out and do’. The exemplar questions ‘become the technology of my practice’.

Conclusion 3 Making social work visible

There is a strand in social work thinking stretching back some years, and captured essentially by Pithouse in his analysis and description of ‘social work as an invisible trade’ (Pithouse, 1998). We have alluded to the way in which – at the policy community level – there have been references to how the ICS will evidence policy in the sense of making it visible, eg through gaining aggregate data from the ICS local systems about what is going on.

A parallel point can be made at practice level. One of our key informants, for example, agreed that one net effect of the ICS will be to make social work more visible. He referred to criticisms of ‘recording which doesn’t tell a story’. It is reasonable to interpret government application of ICT systems as designed to render practice visible - though it appears to be a certain kind of visibility, a performance culture visibility:

If the recording improves - I’m making an assumption here that it will have improved because what people are doing has improved - they’ll be more systematic, there’ll be more… clarity .. there’ll be well defined outcomes…that we can make some judgements about whether they’ve been achieved - in a way that’s much more difficult to do now. (Key informant Site C)

Asked if he saw the ICS as basically a means of improving administration or practice, a practitioner in one of the process study focus groups responded:

Oh well, we live in a realistic world where we know we’ve got PIs anyway so, you know, obviously the government’s motivation (for) some of …the formatting of all the information they’re asking for [is] related to the PIs anyway really. So there’s that sort of data collection ... element to it … That’s what the government set it up to do as well really.

(Focus Group, Site D)

Electronic and paper records were often compared in this context. The comparison is significant. If social workers ‘think on paper’ (Manager of the information section, Focus Group, Site D) what does this imply? The change to electronic records will not be a mere technical one, and important aspects of practice judgement may need to change. The same practitioner is speaking:

If we’re moving away from ... sending out referral forms (to) a system that is electronic and that we’re completing it at the point of contact, the initial point of contact, then that’s a massive shift in ... what the expectation is of our support services ... admin workers. (Focus Group, Site D)

More positively, ICS may bring a greater immediacy to recording. Another practitioner in a children’s disabilities team remarked later in the same focus group that service user rights may suffer under present paper record systems and they may be advantaged under ICS:

…sometimes people do handwrite things and you can’t always find them. You don’t know whether they’re entitled and if it’s got put straight into the system and it’s there. It’s going to be much easier to do the duty system really within our team. (Focus Group, Site D)

Conclusion 4 ICS the Disentangler

Conclusion 3 is a mix of positives and negatives. A more positive set of conclusions follows and extends the previous discussion. The ICS has the potential to disentangle, and bring into focus and clarity, issues that have been there previously but where existing recording systems rendered them less visible to practitioners and managers. We logged numerous instances of such practice connections in the early stages of the study, and subsequently focused them in two later key informant interviews with people in Sites A and C – those sites where the ICS had made some degree of progress. The reference is to

practice issues that … have arisen and they’ve been around, it’s just the .. disentangling (of) the process, in order to understand … how we make ICS work (that) … has brought it to the surface… ICS is the vehicle for that and it could have been something else. But…it was ICS and I … actually think in this particular case ICS will help us... through it as well.

(All quotes in this section are from key informants)

This ‘disentangling’ seems to have occurred at several points. For example, on routine updating of records,

It’s not an ICS problem, it’s … our problem really… I think what ICS has done is, yet again, has brought to the surface an issue that was already problematic ... well it wasn’t a problem, it’s become a problem with ICS because … in order to get the benefit from ICS we’ve got to have that bit done ... at the very front and it’s not being done as fully ... as it should be.

Disentangling also occurred regarding decisions as to whether information about someone should be treated as a ‘new’ case or as a ‘re-referral’. Asked whether ICS helped or hindered this issue or was neutral, the same person said,

I think it’s neutral, … I think the issue has arisen because we’re trying to disentangle the social work process and the relationship between it and the exemplars. Because we’ve been doing that in a very, very detailed way we’ve discovered this anomaly around re-referrals and… we’re trying to disentangle that one as well.

Pathway reviews also suggested a similar conclusion about the influence of the advent of ICS

Another issue that’s just arisen in the process of implementation... It’s around how we actually manage... the pathway plan process and where pathway plans fit in … to care planning generally.

ICS implementation also led to a broader clarifying.

The work that we’ve been doing on the process mapping has revealed some ambiguities around the … way in which we’re managing cases and the … point at which we transfer cases from our duty and assessment team to our locality team... and … what we discovered is that it’s a bit arbitrary really.

Similar arguments were put forward in relation to realizing the weakness of existing practice regarding gaining children’s views and when reflecting on the possible overall consequences of ICS regarding fuller records (Focus Group, Site D), though our sense from these exchanges was that this may not happen. Indeed, the argument in this section of the chapter is not that the ICS necessarily led to changes in services or the active resolution of problems, but to their visibility. The account of the implementation group in Site C illustrated that problems emerged but in most cases they remained on the table many months later.

Conclusion 5 Administrative and professional roles

There was considerable discussion at early ‘all site’ and national meetings regarding the intentions for the ICS of the respective roles of administrative and professional staff in regard to data entry and file maintenance. Our informal sense from these meetings was that officers at London and Cardiff levels were perhaps reluctant at that stage to give a strong steer, probably on the grounds that how to allocate roles and responsibilities is a local decision. The issue was summarized as follows by one of the focus group members at Site A:

…there is the very kind of pure view that it is a social work tool and that it should be inputted by social workers and there is another pure view which is that it is a system whereby social workers and support staff can input things at different stages. And that debate still goes on I think it would be fair to say.

We should make clear how we are using the ‘professional’/‘technology’/‘administration’ distinctions. We do not mean to imply in a sentimental way that ‘professional’ conveys autonomy, judgement and discretion, whereas ‘technology’ implies rule-governed behaviour. Technology and administration are themselves ‘practices’. But ICS does raise several issues about administrative practices and the role of administrative staff linked to teams. For example, the issue of who will complete the forms leads directly to this.

In the early months of the evaluation local discussion was usually about whether social workers or ‘secretaries’ would do it. A more textured response emerged to the effect that it is not either/or. Is ICS an administrative device? A practice device? Also what about families? A key informant suggested a fairly sensitive process of professional judgement and user rights when he described deliberations current at the time of the interview:

Well, I’d heard it described as (a) professional tool … but ...what we are trying to do is to … make it work… for families as well as for us because the vast majority of the work that we do with families is done in partnership with them and they have a right of access to their records anyway ... It doesn’t make sense to have - well it doesn’t make sense to me or to others to have - a set of … documents there for us and then to have to produce something separate for families. So what we’ve been looking at is how we can ... make extracts of the exemplars that will be ... understandable to ... families and acceptable ... to them.

The theme came up in a focus group, when a team manager – supported by the information systems manager - talked of the administrative staff:

I think it’s a lack of ownership and sharing… I think they feel as if the system’s going to be imposed on them and it’s going to make further demands rather than being helpful.

(Focus Group Site D)

The slippery notion of ownership cropped up in a key informant interview.

For me, one of the big things was “It’s your record, you’re the owner of the information, you’re the professional who’s collecting it. Do it, write it once and write it straight into the record”…But that has been formidably difficult to achieve, and is one of the major things which I don’t think we’ve achieved (for) a whole raft of reasons. (Key Informant, Site A)

Access between agencies was an oft-discussed but unresolved matter in the early stages, but tended to slide out of the picture, and become more a conventional grumble about the ‘failings’ of other agencies to fit in with social services ‘requirements’ on referral and the like. The differences were partly felt to be a central government/local government disagreement:

I think that’s another difference … The DfES when we went to speak to them about … ICS was that ... we were trying to say we see this as a multi agency approach … and for families to be involved - and they were very anti that. They said, you know, "it’s within the Children Act; it’s Social Services responsibility to carry out assessments so therefore it’s Social Services responsibility to do it not anyone else. You can ask other people…but that’s as far as it can go". So … we were really very disappointed at that response at that time and so, ‘cos we want to be much more inclusive. (Focus Group, Site D)

The difference was also seen as one between local agencies, and hence affecting service users:

Children’s Services Business Analyst: Wasn’t ... one of the main reasons we had such high input from the end users and the families because … it was envisaged that they would have access to the system from home?

Information Systems Manager: We also … wanted to give them access so they could see their own forms online and things but once we linked up to Health, Health refused to allow us to do that because that would give them access possibly to hack into Health. (Focus Group, Site D)

This suggests a significant unresolved difference of standpoint between key stakeholders – and a corresponding ambiguity as to how good practice may be evidenced.

Finally there was a more intangible sense of the demands that the ICS may make on administrative and practice roles. Language was used of the ICS system that gave us a sense that ICS has a ‘life’ of its own, which comes over in the way folk talked about ICS involving ‘ordering’, ‘feeding’ and being ‘hungry’ (Focus Groups, various occasions). Within these paragraph two points are intertwined – how to secure ownership of the ICS in CSSRs and how to involve other agencies.

Judgment, discretion, autonomy and the ICS

It would be unreasonable to expect the ICS to emerge fully formed from Day One. It is part of a general but gradual development of ideas about social work. In the past social work was variously seen as about relationships and about solving problems. It was essentially a personal activity based on transactions between worker and client. The changes in this set of ideas involve more emphasis on management, less dependence on the ability of social workers to exercise discretion and consequently more emphasis on systems.

Several times during this evaluation we overheard the – perhaps expected – concern that the ICS will lead to a (further?) loss of professional autonomy and increased routinization of practice. The concern is by no means new. A decade ago, for example, there were frequent concerns expressed regarding the popularity of managerialist models in vogue at the time, and for the whole of that period there have been concerns expressed in some quarters as to whether the thrust for evidence-based practice will lead to a reductionist, deprofessionalising of social work¹⁹.

We want to express caution – a prudence that stems from our sense that professional judgment may not be lost with ICS, though it will be played out in new contexts. For example, we have documented several examples of ICS practice at local level that could be construed as rule-breaking, or at least as creative system management that entails the development of local discretionary principles of application. Why was this happening? Let us assume a strong central insistence on implementing an ICS, alongside a widespread view at CSSR level that it is not feasible to implement an ambitious and fully-fledged ICS. In such a scenario – one not without plausibility - there may be more rather than less scope for professional judgment, at least in the short term. A cautionary note should also be expressed in that more reflective social workers will find ways of negotiating unhelpful aspects of imposed recording requirements.

I’ve noticed…with several changes over a number of years…that people who are producing good records of the work they do are doing it despite the framework within which they’re asked to do it. (Key Informant, Site A)

The influence of local autonomy is already evident in the ways that the national system and local systems relate. The policy community maintained a purposeful ‘hands-off’ stance to how local sites actually implement, and after an early period where the main line taken at local site level was that they should not meddle with the exemplars, there emerged an increasing and, as far as we can assess, widespread willingness to modify in order to make practice more manageable

We’re actually now looking at the content of the documentation in the way that we didn’t for the first twelve months because we tried to... keep the integrity of the exemplars because it was a pilot and ... it didn’t seem sensible to us to ... fiddle about with them before we tried them... So now ... we’ve tried them ... we’re looking at ways in which we can refine them without taking stuff out but just to make them ... the things that are helpful to practitioners… rather than things … that are seen as ... a hindrance.

(Key informant. Site C)

The ambiguous value of information

Finally, in more reflective moments, those to whom we have spoken were not universally convinced that more information would necessarily lead to better services for those on the receiving end.

It’s almost verging on the abusive when you, you know, you're asking a practitioner to have to fill all these things in, you're having to ask the family for these things three or four times, you know, however many times, and then you've got to take all the stack of paperwork in to a conference or whatever, you know, go through it all again. Whereas before you could do it on a family…with one report. (Cross-Site Focus Group)

In a passage of constant strong mutual affirmation, personal disclosure and vicarious pain, that bears rereading, this was explored in a round one focus group:

Team manager: And the idea’s about telling the story once isn’t it…?

Social Worker : Yeah. It’s like with the…core assessment isn’t it, you know, it’s like their life story’s there and they don’t have to keep repeating it and they can share that with who they need to share it with.

Information systems manager: I think there is also an argument to say that how much information should we bloody well record. (Laughs) (Affirmations from two group members)…

Social worker: I think it’s like for the looked after children, you know, some of the really personal stuff is all recorded …that you might choose better to forget, you know, ...

Information systems manager: Well why should anyone…

Social worker: …instances and things…

Information systems manager: …else need to know that.

Social worker: …and, you know.

Team manager: Yes, that’s right. (Focus group, Site D)

The Business Analyst subsequently added:

…with regards to the core assessment, you’ve always half jokingly said it’s almost like bullying a parent when you’re asking all of these questions for every child and it’s quite an impact on ... the family… Could be summarised basically and just say the amount of information that we do have to collect on some…families in situations is abusive really²⁰.

Themes and Conclusions

The recurring themes from the process study can be summarized as follows.

First, the cluster of concerns about the time demands of the ICS occurred in every dataset. The evidence suggests that is in part due to the process of familiarization with a different set of recording formats and partly due to a shared belief that the ICS is inherently (at least as currently conceived) an extremely time-hungry system of working. Format issues, perceived redundancy for some user groups, and language were all connected to this perceived problem.

Second, the accusation that the ICS restricts and constrains the reflective practitioner did not go away. This is largely connected to the tacit model of practice – linear, structured, partialized, outcome oriented – upon which the ICS appears to rest. This may ensure better basic minimum standards for less skilled social workers, but it is not likely to lead to an overall higher practice norm.

Third, the ICS does appear to shape social work practice. In some ways this is positive – by serving to clarify, make visible and ‘disentangle’ practice processes and decisions. In other ways it is almost certainly negative – by obliging solutions to what counts as more or less serious work; potentially ossifying analysis; by taking further a de-emphasis in recording on reflection, and by bringing in technological language to describe practice²¹.

Fourth, the evaluation suggests that the potentially extensive implications of the ICS for how professional and administrative roles are defined and related require review and research.

Fifth, the problems associated with ICT and Exemplar design issues pose a picture of at best unrealised potential. The extent to which these succeed in forwarding the central policy agenda remains to be resolved.

Sixth, the tension between potential and achievement perhaps received its sharpest statement in the study of social practice for children with a disability. While it is probably not surprising to encounter a continuation in the ICS of concerns about services to children with a disability that were present in the previous LAC system, the data gives a relatively grounded picture of practice that does not reassure.

Finally, an underlying issue little discussed in the evaluation is the relationship between records and practice. The ICS seems to push forward a continuing change in the purpose of social work records. The shift is well captured by one of our key informants. Speaking about the purpose of records, he recalled:

…the notion of process recording…which was about an exploration of self in relation to the work you’re doing and a reflection on your practice as much as it was in the nature of the issues that are around for the person you are dealing with.

He commented,

I think the time is…certainly now long gone where we…either need or it’s appropriate to hold on a child’s record social work musings of the kind that are right and proper in training but not appropriate for children’s records. Rigour in analysis, yes, but not ramblings…around, yeah. (Key Informant, Site A)

While this position is controversial, it does highlight a partly hidden dimension of systems such as the ICS.

In the next chapter we draw on the data directly from service users and carers, before finally synthesizing the conclusions from the study as a whole, and making recommendations.

SECTION E

USERS, CARERS AND THE ICS

Chapter Eleven

Children, Young People, Carers and the ICS

There are two primary sources of direct data regarding the responses of children and carers to the ICS - the disability study and the process study. There is a further source of indirect data that flows from the interviews and focus groups with practitioners. The disability study is reviewed in the following chapter. Evidence from the social worker interviews in mainly found in Chapter Five. In this chapter we explore the responses from the process study of children and young people, and their carers regarding the ICS.²²

We have reviewed ways in which the methodology for this part of the study was truncated due mainly to the implementation delays (Chapter Three). A total of nine interviews with young people were completed for the process study part of the evaluation and seven interviews with carers across two pilot authorities. Out of this sample there were six paired carers and young people. There were, therefore three interviews conducted with young people for whom no carer had consented to be interviewed. Of the interviews with children and young people, all were conducted with different young people, However, one of the carer interviews was a follow-up telephone interview. We conducted a second interview with this particular carer because she was due to take part in an ICS review the day after the first interview took place and we saw this as an opportunity to talk to a carer specifically about the review process in some detail. One of the carers we interviewed was the key worker of one of the young people in the sample and she worked in the residential children’s home in which the young person lived.

Regrettably, due to the implementation difficulties the plans for a subsample of young people to make audio diaries were abandoned in order to dedicate time to ensuring that we could gain the richest data possible from the interviews with children/young people and carers. The birth parent interviews also had to be abandoned as only one young person offered us consent to interview a birth parent and despite exhaustive attempts to contact this person through a social worker, we had no success in gaining consent to be interviewed. Interestingly, however, three of the carers we interviewed were actually the birth parents of the young people with whom they were paired. These three young people were all children in need. We did therefore conduct three birth parent interviews although not in the way we had intended to for this specific part of the study.

There were comprehensive pilot and schedule development exercises completed with volunteer young people from another local authority. Of the young people who consented to be interviewed only two had experienced a previous system of recording information to ICS. In virtue of this and also the fact that no young people were aware that the system of recording information had changed, data about how young people have been affected by the transition to ICS from previous systems was very hard to collect.

As is often the case when conducting interviews of this kind, many of the responses given by young people were very brief and detailed explanations of their thoughts and feelings were, in most cases, few and far between. It is for this reason that some of the questions that are quoted from the interview transcripts may seem leading. On many occasions, a degree of prompting in the form of asking a more specific follow-up question after a general initial question seemed appropriate in order to gain a fuller sense of what the young person’s real sentiments might be.

Sampling

The first stage in our sampling process was to ask a sample to be drawn up by our main contact in each local authority based on the criteria set out in the original bid. We then sent out information packs to the social workers responsible for each of the young people in the sample in order to invite young people and their carers for interview. In the information packs was an information leaflet detailing the nature and purposes of the evaluation, a cover letter, inviting the young people/carers to be interviewed and a consent form with a stamped addressed envelope to be sent to the University. Response rates were not spectacularly good. In one authority, for example, information packs were sent were sent to eighteen pairs of carers and young people and six young people and four carers replied consenting to be interviewed. Perhaps more seriously, our local site gatekeeper contacts reported they were unable to locate a sample that matched the agreed criteria. Further problems were encountered whilst conducting fieldwork. Two carers in particular were not at home on the several occasions when interviews had been arranged. In the case of one young person, who had consented to be interviewed, it became apparent that she had changed her mind and wanted no part in the evaluation.

There were ten young people transcripts and seven carer transcripts, from two local authorities (A and C) and the table below summarises the young people sample. The data was analysed using Atlas.Ti.

Table 11.1 Process study transcripts by Authority and type of case

AUTHORITY	MALE	FEMALE
A	2	2
C	3	3

AUTHORITY	LAC	CIN	CP
A		1	3
C	5	1

Carers’ Experience of Social Work and the ICS

Throughout this chapter it will be clear that service users and carers knew very little and in several cases nothing at all about the ICS. On this ground alone, the evaluation poses an immediate difficulty for one of the central policy platforms of the ICS – that it would enhance service users’ involvement in the social work process, and would make decision-making more transparent. Neither of these aspirations has been delivered thus far by the ICS. Indeed, there is some evidence that, ironically, it may have led to some – temporary at least – loss of user engagement and involvement. We will see that this may be due partly to the possibility that service users will experience the ICS as more demanding and time consuming, and partly for reasons we have hinted at previously, to the effect that social workers may view it is being in service users’ best interests if they are not ‘burdened’ with details of the ICS.

Much of the interview time with carers was taken up with listening to carers’ general views about their involvement as carers. While this may seem redundant, it is relevant. Insofar as users and carers feel listened to, understand the language of professionals, are trusted to maintain high levels of confidentiality, and so on, the more likely that the ICS will be seen as keying into their concerns and respecting them. Hence we start this section with brief allusions to what it was about being a carer that appealed to them and was valued by them. We continue down this track with a brief illustration from carers’ experience of review meetings – the area of practice on which they had most to say and held the most developed opinions. We also touch on their assessment of the nature, extent and quality of information received from the local authority social workers.

We then move to more explicit evidence regarding the ICS, and review how much carers appeared to know about the ICS, whether they were aware of shifts in their relationships with social services and if these seemed to be linked to the advent of the ICS. In connection with this, we listen to what they had to say about the nature and level of involvement and partnership with professionals.

Being a carer

When carers reflect on what they particularly value regarding their work as carers, we can probably infer aspects of their likely response to the ICS. For example, Caroline²³ said that what she most and least enjoyed about being a carer was:

Achieving something when I see the look on their faces, … like say you come home with a new jumper or something, whatever, and ‘oh’ you can’t put a price on it you really can’t, and say they’ve had a bad day and you then you can talk with them and then we talk it all through with them and they appreciate it.

I: What would you say you least enjoy?

… I would say when there’s issues, and you having to ground them, and you know, you say like ‘you’re not going out tonight’. I don’t like doing it, but you’ve got to have a boundary somewhere to make them realise you know, they can’t do it and they’ve done wrong, and I don’t like doing that I would say.

Along with other carers she appeared to locate the rewards and costs within the relational dimension of her role. Correspondingly, carers welcome the relational aspects of their links with social workers, either positively when they ‘work’ or negatively when they do not. Thus Sue remarks of the way information ought to be reciprocally conveyed,

a lot of it is .. face to face communication isn’t it?…When it comes to a child .. you do need the face to face communication because .. your face can say more than what the words can say can’t they? If you’ve got a genuine concern, sometimes the expression on your face can show them more…

There was considerable variation in how carers evaluated their links with social workers. On the whole, they typically viewed information as related much more to the individual social worker rather than the system level of the service. This suggests that the ‘technology’ of the ICS may not be seen as the primary criterion for service quality. For example, Natalie made stark contrasts between the three social workers she had encountered in her carer role. Commenting on the adequacy of the information received, she said:

The social worker that we’ve got at the moment, she’s a bit vague… she never seems to write anything down, she never knows when she needs to be coming and when she doesn’t, she’s vacant I would say for a nicer word. But the one we had before she was brilliant, she kept us up to date and told us everything and everything was going along, and she spoke in what I would call layman’s terms, rather than the technical jargon.

Similarly, Sue remarked of a link worker,

I mean the one I’ve got he is absolutely fantastic bless him. He’s a lovely man, he really is. He’s bin involved wi’ me for a long, long time and ... you know, there’s times I ring him up and I’ll say “X, I need to talk to you off the record” and he goes “Right, OK, fair enough, let’s go”.

The element of continuity was clearly valued by this carer - ‘He’s been with me every step of the way’ - who compared him with others, concluding that ‘sometimes they’re not just there’.

There were criticisms of the amount and kind of information given, and also a perceived probability of having to ask for information that they believed should have been given to them unsolicited. Caroline grumbled that ‘I don’t think they give you enough information’ and added, ‘I would say we need more information on the children’s background… it’s only basic, and you shouldn’t have to [ask]’.

Carers varied in whether they found the language of documents straightforward or not. Caroline was unhappy that ‘you’re just getting paperwork and paperwork all the time…I mean they do try and make it as small as they can but it’s just all the time’.

It’s like the wording, the words are so like long, instead of being, like, okay, use the words that people know what they mean, because you know some people you think ‘What does that mean?’ I mean okay they’ve got more education and everything, but I'm just a normal person and I don’t know half of these big words.

She added an interesting aside that ‘It’s nice for the big words to be there, but…I think it makes you more naïve’. The remark is not straightforward. It is possible that she respects ‘big words’ as evidence that services are being run by informed professionals who should posses expert knowledge. But it also highlights the risk that more comprehensive documentation may have the unintended result that service users as a consequence feel worse off – an anxiety that has surfaced at several points in the evaluation.

Poor information channels – both in level and quality - result in children being disadvantaged. Thus Denise remarked:

we don’t always have those regular visits...Some social workers are really good at corresponding and keeping in the picture and others aren’t, you know, aren’t as good at that…I mean … they’ve said that they tell X things that’s going on .. but really they don’t explain it at his level.

Even good social workers could be seen as rather detached, and barely remembered. Denise later recalled, ‘I’ve just remembered who his social worker is, it’s X and she hasn’t taken over very long and she has been very good’.

The different elements of social work were discussed in the interviews, but it was Review meetings that figured most prominently in the minds of the carers. On the whole, the positive aspects of these meetings just about outweighed the negative. Jenny, for example, thought that the young person in her care had a good idea about why the review was taking place.

I explained it all to him and he filled in the form, filled the little boxy form to fill in, to tick the boxes.

Sue opined, ‘I’ve never come across a really bad one’ (ie Review meeting). Kate was clear that she had enough opportunity to express her views in the reviews. But when commenting on the feedback she received was less enthusiastic.

You get a .. how can I say, a slip of paper what she’s put on it, you know, but … a fortnight ago we had a thing from the head of education to say everything … was to plan, you know what I mean, from, well I don’t know, from the main … I suppose, and I thought well it isn’t a plan really, not as I wanted it, you know.

Samantha was also generally happy with the review process but was left with one important reservation that stemmed from what she saw as failings in communication and advance information that were insensitive and jeopardized the wellbeing of the child.

Carers and the ICS

The evidence we have reviewed thus far is relevant in that is suggests significant ways in which the general experience of relationships with social workers will create an agenda and a lens through which carers will filter how they see the ICS. To state the obvious, if Reviews are seen as supportive and for which they are well briefed, then the advent of the ICS is likely to be set within that positive context. The converse inference needs no stating.

When carers were asked if they knew about the ICS, the researchers explored the issue in several ways and approached it from different angles. We are reasonably sure that the conclusions we are about to draw are as well founded as is possible.

First, it is important to distinguish what the carers knew about the ICS as such, and what they knew about the evaluation. It was apparent that in several cases the carers knew about the ICS only because they had been briefed, more or less fully, about the evaluation team’s request for an interview, and otherwise knew little or nothing about the ICS. Natalie’s response illustrates this well. Asked if her social worker had ever mentioned the Integrated Children's System to her she replied:

No, she gave me the envelopes that you would obviously…for people, and she said ‘Oh, here’s something you might like to do’, and gave me the envelopes, and I went ‘What’s this?’, and she said X would get, you get a gift voucher at the end of it, and X went ‘Oh, I’ll do it!’

Second, the majority of carers were either quite clear that they knew nothing about the ICS or were sufficiently vague as to suggest they had either not heard or had not understood. Kate illustrates the problem pointedly. Until she had received leaflets from the evaluation team she had heard nothing about the ICS, and had heard nothing about the development ‘that social workers have a new way of finding out information and keeping it on a computer’. Yet this foster parent was involved in training other foster parents and later said of herself that ‘I’m one of these that ... because of my training, training others, I like to read about what’s happenin’, and find out things’. If carers who are clearly involved at a relatively extensive level in the activities of the CSSR – and who in this case came from Site C where the fullest implementation of the ICS had taken place – then it does not auger well for other carers.

This hesitancy and vagueness could be widely illustrated. Caroline said of the ICS, ‘I think it has been mentioned but there’s so much been going on in the past fortnight you know…’ Jenny relied to the same question that, ‘It rings a bell, but I don't think they’ve gone into it properly, but I was aware they were changing the system…We’ve had a letter just saying that things are changing’. Again it is worth emphasizing that all of these carers had been through the process of giving consent for the evaluation so presumably had been told something about the ICS. Jenny’s letter may even have been triggered by the evaluation.

It is possible that social workers may have referred to the ICS but without using the official name. This seems likely in some cases. But once again, we could not find hardly anyone who seemed confident that they understood what was at issue. Samantha said at one point that she had never heard of the ICS, but later when asked if the review experience had been any different from previous reviews, remarked ‘They mentioned that “Oh, we’ve got this new paperwork and all the forms to fill in ”’.

It seems possible to detect a process of explaining the ICS within the Review, but in a way that was seen as faintly chaotic, even if well-meaning. This extract illustrates a point that came out of the interviews – that carers seem to bump up against the ICS only when they get to their next Review. This might be a helpful way of managing the ICS changes, in that it leaves the potential (albeit largely unrealised if these interviews are to be believed) for demonstrating the relevance of the changes.

The sense of ICS as perfunctory and marginal cropped up elsewhere. When Sue was asked if she had heard of the ICS she said:

Sue: Yeah, ... I just had a chat with X’s Social Worker the other day because she’s got to do all these new forms and everything else so we had to run through a few bits of information that she already had but she just had to double-check before she puts it onto the new forms, if you see what I mean.

This does not sound at all promising. Sue recalls this as a checking for completeness and accuracy of existing information, and something that did not involve her in even seeing the forms.

Some of the responses from carers touch on whether they were sensitised to changes in modes of working (that by implication may be associated with the ICS). Some bluntly said ‘No’ (eg Natalie and Jenny). Others saw it as part of a general shift towards more ‘paperwork’. Caroline was aware that requirements ‘have all been changed because of the new rules and regulations so we had like loads of packs and paperwork’. Her comments on this trend were ‘It gets on my nerves’.

Because you’re just getting paperwork and paperwork all the time. I mean they do try and make it as small as they can but it’s just all the time…Some of it’s like the wording, the words are so like long… I mean okay they’ve got more education and everything, but I'm just a normal person and I don’t know half of these big words.

Samantha made recurring efforts through her interview to tell a positive story, and searches for good things to say. Later she recalled of the review process that

I think it’s about, I can remember the social worker saying her mum’s got a new form so, you know, you say that in your form but .. it does work well for X (…) in with what you expected it, it’s sort of explains (…) really well and .. it did make plans for what the future.

The fullest account of the experience of the ICS came from Sue, who was interviewed twice. She advised the evaluation team that she was to attend a Review meeting and would be happy to be re-interviewed the following day. In Box 11.1 we encapsulate her longer story of ICS within her Review. Her story was in response to an invitation from the researcher to ‘just take me through what happened during the review’

Box 11.1 Sue’s Encounter with the ICS

Well to be honest with it, with it being, you know, the one with new paperwork and all these ... the way it’s done it’s quite different to normal and it took a lot longer than our normal review, if you see what I mean?…But that’s only because, you know, we’re obviously getting used to the new system aren’t we?…That’s what I put it down to anyway. (I: Did it seem more detailed than usual? Did they seem to be asking different things?). Um ... instead of just saying (…) still having a dental appointment, they wanted like names and addresses and all that, which I’d already given to the social worker, I mean the social worker has been out to see me to check all of this information to give to the reviewing officer, so the, you know, all that information was already there. But the reviewing officer decided she wanted to go through it all (…) I’m like OK, which is, you know, it’s, I suppose ... it was her way of getting used to, you know, the new system, getting everything done, but it just, you know, seemed very long-winded compared to normal…I’m not saying that was due to the paperwork or anything else, it’s, I think it’s more to do with getting used to the new system and making sure that, you know, they’ve, they’ve got all the correct information and ... like that rather than it being a problem with the new system. Does that make sense?

(I: Yeah. How was it organised?) Not in the same running order (pause) you know, from what I can gather, you know, it was roughly the same running order, just a bit more detailed. (I: How long did it take in all?). An hour and three-quarters, which normally it is done in half that time, if you see what I mean…As I say I’m putting it down to the new system and everything else, making sure that they, they’re getting it right, it seems to me.

(I: How well do you think the review process worked?). Quite well, I mean ... it, I mean I haven’t (…) the children as long as all the issues are dealt with .. (I: Is there anything you would have liked to have changed about the way you received that information?) (Pause) No, I don’t think so. I mean most people at the review anyway I’ve worked with for such a long time, you know, I find it ... very comfortable to do a review, I don’t find any part of it sort of, ‘Oh my God’, you know, I find it very comfortable to do a review. I know who’s going to be there and… (I: Was the Integrated Children’s System actually mentioned at any point?). Well we were told at the beginning that it would be slightly different (…) slightly different this time (I: Was it done on a laptop or anything like that or…?). No, it’s all handwritten.

(I: Do you think it was clear to (child) why the review was taking place?). Well I’ve got to be honest she came in, sat down, said “What do you need from me?” ... and X told her what she needed to know and she said “Right, can I go now?” and left. (I: So she didn’t really feel the effects of the new system at all then? [laughs]). No, not really. She said “I don’t really want to be there and I know what’s going on in my life and (…) you sort it out for me”…She doesn’t have any concerns in that department. She was only in there about five/ten minutes and then went off (laughs).

The account is interesting in several ways. It illustrates how a carer makes effort to import sense and meaning to what is happening, and in this case in such a manner as to read the occasion in ways that reflect well on the efforts of the professionals. She sounds tolerant and willing to give social workers time to get new systems bedded down. It suggests that – at least in her case – young people may view engagement with adult professionals less enthusiastically than carers – a conclusion in harmony with the rather desultory responses of several of the young people to whom we spoke. The account echoes frequently voiced concerns from practitioners and to some extent managers, that the ICS brings with it increased time demands, and for Sue these were seen as associated with ‘paperwork’ rather than any significant shift in orientation to social work. This is similar to comments we have quoted from other carers.

None of this suggests that carers felt deeply involved or in partnership with social workers. Not everyone was as negative as Natalie. The following extracts are taken from two different parts of her interview. Asked if there was anything that was bad about the review process, she replies:

Still can’t get your opinions across very easily…Because you’re told to hush basically, and you’re trying to get your point across, but then you’re told to wait until the person has finished talking, which is okay fair enough, but by then it’s gone out of my head because I'm worrying about the next thing that they’re saying, so I need to get my point across there and then, and they’re not very open to that.

And later

You go in, you go and sit in that chair, and then you feel like your defences are up, because you’re waiting for people to have a go at you. It’s not a very nice process. If there was another way of doing it, it would be a hell of a lot nicer.

If Natalie was at one extreme, then Caroline’s views were as positive as anyone’s. Asked if she had noticed any changes in the way her views were taken into account, she explained,

I would say because they get more understanding with you as well as being understanding with them, they do listen … you know, they seem to give you more time when we get to know them better…Everyone knows my voice on the phone and I don’t have to say my name and it’s nice you know. They say ‘Oh, Hi Carol you alright?’

Of the review process she said ‘You felt good because someone was listening’. She expanded this to say:

I think they seemed to be getting more done… they mentioned a few things that never got done before nobody mentioned it, and like ‘I want this done now, why hasn’t it been done?’

Her comments need careful inspection. The impression she gives is that she is explaining a general improvement in the delivery of decisions, and is not alluding to something that is directly connected with the ICS. As we said at the start of this section, carers tend to view good work as being associated with the merits and care of individual social workers rather than system factors.

Children, Young People and the ICS

Young people were interviewed as part of the evaluation to explore their knowledge of ICS. In respect of that element of the study the results are straightforward and perhaps not remarkable. Of the 10 young people interviewed 7 had not heard of the ICS, one thought that he might have heard, and two said they had been briefed on it by their social worker as part of the participation this research.

The interview did not end there. It is not surprising that young people did not know about the ICS. It is, after all, largely a professional tool for social workers. So the interviews with young people sought to examine whether they had noticed any changes in the way that social workers collected information that might be explainable in terms of the introduction of ICS and also explored more general issues with the young people about their experiences of their social workers and children’s social services.

What do young people know about ICS?

Seven out of the ten had no knowledge of ICS. One young person clearly knew about it saying, when asked if he knew of ICS, referring to his social worker, responded, ‘He came round a little while ago and told us about it.’ What is less clear from the interview was whether the worker was briefing the young person because he had agreed to be involved in this research.

Another way of establishing whether ICS was having an impact on young people was to examine whether they had noticed any recent changes in the way that information was collected about them by their social workers. All were asked this; the object being to see if there was a correlation between the introduction of ICS and a change in the way that workers seek information. None were aware of significant changes or identified changes in approach in practice. Indeed, in social worker/young person meetings where assessments and information gathering occurs, paper would seem to reign supreme! Asked if the young person had noticed anything different about the way information about them was stored, the reply was,

They use paper a lot. Because my social worker used to sit there with a pen and folder, a big folder of paper.

A number of the young people in different sections of their interviews talk about social workers using paper and making notes – which is not surprising. When we looked at the implementation of the ICS across the four sites none of them were issuing social workers with laptops, palmtops or the like to enable data collection in the field to be electronic. Certainly the young people, when they made an observation, referred to paper.

Young people, their records and computers.

All participants were aware that children’s social services held records about them. The numbers in this sample are far too small to make any significant generalisations. Suffice to state that some were indifferent to seeing and accessing their records and others were wary of the fact that information was collected about them. One theme though did emerge from even this small number. Young people want their records to be secure and only shared with relevant people. As one young person put it:

‘Only my social worker should be able to look at my file…’

Security of information featured highly in their responses. They want their social worker to be responsible and professional in collecting and storing information if only to ensure that the next social worker knows what has happened in their lives.

‘Cos when I get a new social worker they look up my documents to see. They need to know everything about me first so they check it all…….they see what’s gone on in ma life.’

This young person cited a list of workers she had had over the years (as did a number of other respondents). She did not want to have to repeat everything to each of them. If ICS proves to be a good and accurate source of information then this ‘new social worker’ syndrome could be less painful for young people.

ICS is an electronic record, and we asked young people about computers and their thoughts about their records being stored electronically. This was a computer literate sample. Nine out of the ten used computers themselves for chatting with friends, looking up information, and as part of school work. Computers did not faze them, as they did some of the social workers in the focus groups! Six of them thought that using computers to store information was fine. As one participant said, computers are helpful because ‘They’re easier to use…safer…and you’d have to … know the password to get in to the files’. Hence the typical respondent thought that computers were easier, had a real understanding of security issues and valued electronic record storage on the grounds ‘It’s more safe, I think’.

Another person commented that her main concern was that her file should be accurate and secure. She was worried about security when told her files were now on computers. She said that she knew the files were about her, but didn’t feel that she owned them. Young people may be unsure whether electronic records are more or less secure than paper records.

As will become clear, many had some confidence in their social workers; they agreed that it was necessary to collect information about them but pervading their answers was a fervent and understandable wish that their life events were kept confidential. They displayed a sophisticated understanding that social workers would share information between themselves. They had first hand experience in some cases arising from several changes of social worker.

Interestingly one young person was asked how he would prefer to actually see his records and he said that, ‘I’d like to see it on paper.’ This appeared to be referring to how he would actually want to access his records since earlier in the interview when the interviewer had said to him that social workers had started to use computers to collect information he had said, echoing the views of other participants, ‘Well its okay, yeah.’ For this young person computers per se where no issue but it is easier to read paper! Perhaps a not uncommon view.

Young people and their social worker.

For the young people in this small sample a key element of their contact with social services was their relationship with their social worker. They spent time in the interviews discussing this relationship and a reading of the transcripts indicates that, given their family circumstances and the inevitability of their contact with social services, their relationship with their social worker is key. This has of course being a constant theme in much research, and mirrors what we learned from the carers.

In this study the views of one young person seemed to encapsulate what the young people wanted to say about their social worker. She said that what was most important to her was the way that social workers relate to her. She had experienced several and described them as ‘some good; some bad’. She valued explanations but they needed to be pitched at the right level.

Seven of the ten respondents made very positive statements about their social workers, though often qualifying them by indicating that although they are nice, they expected more from them than just niceness. The sense that being nice is not a sufficient condition to be a social worker is clearly stated here but reflected in other interviews as well. Here, for example a young person expects respect from her worker about whom she is fairly positive. ‘She takes me to McDonalds…..She gets me accommodation and that when I need it….she’s easy to get on with as well’. By way of contrast, the same young person said, when talking about some previous social workers who had held her case, ‘They just look down to you an’ that’.

For six of the young people the predominant responses were positive about their workers, though the young people were demanding of respect. There were less positive comments in four of the responses but even then the underlying view came across that these were good people trying to help them. For example, for the young people insufficient social work time was an issue. Young people want to have time with their social workers and this featured more than the information they were recording about them. For example one said when asked if she had enough time with her worker

‘Yeah, sort of, but I only get about an hour when I see her…..but that’s alright.’

Another young person said when asked if her social worker gave her enough time said:

‘No. Because when she comes round she’s only here for like half an hour, we don’t hardly talk about anything……’

And

‘She doesn’t sound like she knows what she’s doing, she’s just like sits there and just says a load of stuff, and she always has to check herself, and she’s like she doesn’t know what she’s doing.’

There was a 50-50 split on whether social workers understood what was important to young people. ICS is about information gathering and young people were asked if they thought that social workers understood the important things in their life. If ICS is an aid to the improvement of practice it is possible that more young people would experience workers understanding the important issues in their life. Of course this could not be rigorously tested in this study since it was not a before and after study, although the majority of the sample had experienced social work before and after the ICS. Nonetheless their views on whether social workers understood what was important to them are interesting and valid. One young person said that her social worker did know what was important and had the time to listen. The young person talked about health, education and accommodation as important issues on which the worker listens her.

However social workers do not always communicate clearly with young people. As one put it talking of his social worker:

‘Yes; she’s nice, kind ...but she doesn’t explain things...doesn’t understand what I think (is) important.’

One person, who had earlier in the interview described her social worker as ‘she’s alright. And I think she’s quite nice actually’, also had the following exchange:

Interviewer: Do you feel as though you know enough about the way that social workers arrange things for you and your family?

Young person: No.

Interviewer: No? In what ways don’t you know enough would you say?

Young person: They use big words so I can’t understand them!

Finally in this section the words of one youngster seems to reflect the range of views that young people felt about a group of professionals who though they basically considered to be thoughtful, kind and helpful people left them with some issues. For example,

I’ve had four social workers. I didn’t like them - they never showed me anything they'd written down...wish she’d tell me more stuff... I would like to choose what they write down - that I'd like to go home!

And describing his image of a less than good worker

‘a bad one would be moody….and would come and see you a lot’

Young people and their involvement in assessments, meetings and reviews.

Five young people were looked after, and four of them clearly stated that they had attended their reviews. The fifth was less clear though talked about involvement in meetings. None of the young people who had been through the experience of a child protection referral about them was clear whether they had been to their child protection conference. They were teenagers and therefore one could expect that they would be invited to a conference.

One young person went but he received nothing in writing.

‘I have been to reviews; my mum, brother, sister and aunts were there - it was in a hotel...everybody had something to say. Before I went (name of social worker) talked to me and I got a leaflet…After it I didn’t get anything in writing.

But this was not the experience of all young people, so in the following exchange a young person from the same authority had a different experience She ‘sometimes’ wanted to be present at her review ‘Just to see what’s going on, what they’re talking about’. But seeing her review documents was not a pressing concern

Another young person said that she probably had received a copy of her review but, ‘I probably have been sent one but I just chuck all me letters in the bin!’ This is an important issue for ICS. Some of our findings elsewhere in this report illustrate the fact that workers regard the ICS product as complex, cumbersome and long, thus making following the narrative of the case story difficult. If professionals experience this, then young people, who on this limited evidence are reluctant to read their review reports, may well be further put off by being presented with complex records to read (whether electronically or on paper). None of the interviewees could be sure that they had seen ICS documents.

A recurring theme in these interviews is that the relationship and experience of their social worker or meetings matter more to young people than the record – as long as these are securely and safely stored and not inappropriately shared. So one young person, knowing herself well and not wanting a distressing incident, said she had recently declined to go to reviews ‘Cos I end up getting dead angry and just going mad so I just don’t go’. Another indicated that intervention in his life by social workers and others was quite frightening and he was clearly concerned about the experience rather than the record. Reviews were ‘quite scary… because it was like people around you’.

Conclusion.

The findings from the interviews of young people are presented by the team with caution and qualification and must be so received. They are nonetheless interesting and potentially important. The ICS had not yet impinged upon their consciousness in the pilot authorities. It had, of course, ‘hit’ the workers and all of the young people interviewed had social workers who were using ICS. They were, with one exception, unaware of it. As stated in the introduction, this in itself may not necessarily be important. However the interviews sought to discern changes in social work practice that might be attributed to the introduction of ICS. For this cohort of young people there appeared to be none.

However they were not ill-informed about electronic communication. All but one had access to a computer and presumably could have received an email asking for a contribution to a review or assessment. We know from our record study that in the exemplars we read there were no first person contributions by parents or young people; this cohort would seem open to using computers to do just that. So perhaps ICS users need to think about how to harness the very processes that ICS itself uses (IT) to extend the range of communication with young people. Could it be that workers find this more difficult than the young people? Perhaps this is something worthy of further exploration.

They were not worried about the development of computer records, as such. They were concerned about what happened to them, who had access and how securely they were stored. A number implied that computer records, in their estimation, were safer than paper records. They were happy for social services to share information about themselves (the reality was this happened every time they had a new social worker) but worried more about others having access, though this was not explored in depth in these interviews.

But if there is a finding from this survey it is that for this group of service users there is no substitute for a meaningful and fruitful relationship with their social worker. The relationship is all; they are sophisticated and not easily convinced by people just being nice to them. They want results (housing, health and education frequently cropped up in the interviews as did planning to go home for those in care) and look to their social worker, amongst others, to achieve those results. As far as they go these are balanced responses that try to be fair to the social workers but also seek to be honest. For example social workers, on the evidence of this small sample, still talk a professional language to young people that they do not understand. This is about practice not ICS and was important to this group.

The crunch is whether ICS can enhance that interpersonal relationship between worker and user. Suffice to say this group of young people know what they want from their social worker; they do not all reflect the same experiences but they reflect that workers ought to make a positive difference to their lives. They want to be listened to, respected and have outcomes that enhance their lives. In Chapter Twelve we explore these parallel issues in relation to work with children with disabilities and their families.

Chapter Twelve

The Disability Sub-study

This chapter presents a summary of the methods and findings of the disability study. Findings mainly concentrate on respondents' views on disability specific aspects of ICS. Further details of the study are provided in the full report (Mitchell and Sloper, 2006).

Aims and methods

Key aims of the disability study were to explore both social workers’ experiences of using ICS, in particular the exemplars, and their perceived relevance and appropriateness for disabled children, and parents' and disabled children’s experiences of how information had been collected under ICS. Where possible this was contrasted with previous experiences of information collection. Data was collected from children, parents/carers, and social workers.

Parents: sample and interviews

Families were recruited by disability teams in the four SSDs, 75 project information packs (15 to 20 packs in each authority) were sent to a purposively selected sample of families who had recently experienced an ICS assessment or review. In two authorities this was practically every family that had experienced ICS. Key sampling criteria were families experiencing ICS at different stages of assessment/review, children in different age ranges and with different types of impairment. Twenty two families agreed to participate.

Tables 12.1 and 12.2 provide details of the parents interviewed. Technical and practical ICS implementation problems experienced by the pilots limited the diversity of the sample achieved. Key problems were the small number of families actually experiencing ICS and the decision in three pilot sites to implement exemplars in a phased manner. When sampling took place not all the exemplars were in use, and these were not evenly spread across the sample.

Table 12.1: Families interviewed by type of ICS assessment/review in each authority

Authority No. of families interviewed Type of ICS assessment/review experienced Ongoing care review (short break or LAC) Core assessment Initial assessment or updated initial assessment with action/care plan A 8 8 0 0 B 7 1 0 6 C 5 0 3 2 D 2 0 0 2 Total 22 9 3 10

Table 12.2: Gender and age of the disabled children in families interviewed

Authority	No of families interviewed	Child’s gender	Age range of children (years)	Average age of children
A	8	7 male 1 female	9 – 16	14 years 2 months
B	7	3 male 4 female	10 - 18	14 years 5 months
C	5	3 male 2 female	7 – 16	11 years 10 months
D	2	1 male 1 female	12*	12 years

* Both children were 12 years old

Children in the 22 families had a range of disabilities, many were multiple and complex. Families received a variety of services and support organised by social services, and represented a range of socio-economic circumstances (including lone and married/partnered parents, those in paid employment and full-time carers)

The interview topic guide focused on seven broad areas:

• Assessment/review preparation of parents and child by the social worker
• Information sought from parents and the child during the assessment/review process
• Parent and child’s involvement and participation
• Information received about and knowledge of ICS
• Procedures of, and outcomes sought and achieved from, the assessment/review
• Parents’ evaluation of, and suggestions to improve, the collection and recording of information.

Pilot interviews were conducted with nine parents of disabled children. Interviews were then conducted with all 22 families. Four families preferred a joint interview with mother and father; the remaining 18 were conducted with mothers (including one foster mother). Interviews were held in the family home and, with each parent’s consent, were tape recorded. Interviews ranged in time from one to two hours. Before the interview, parents completed a short background questionnaire providing information on socio-economic circumstances and the child's disability.

Children: sample and interviews

Information packs included an introductory letter to the child, information leaflet and response form. In addition to the written communications, two symbols based letters and response forms (using Rebus and Boardmaker symbols) were enclosed. An audio version of project information was also produced, social workers were asked to send this to families as and when appropriate.

The children’s topic guide focused on only the child’s experiences of:

• Assessment/review preparation (including choices and feelings)
• Information sought (including likes/dislikes and understanding of the information process)
• Participation (including being listened to and feelings)
• After the assessment/review (especially feelings, outputs received and outcomes of these).

As children with different levels of cognitive ability would be interviewed, two topic guides were developed, based on the same themes but one was longer and consisted of more in-depth questions than the other. The researcher chose the most appropriate guide after meeting the child. In order to assist participants with communication impairments, a tool kit of rebus symbol based flashcards and key questions was used. Topic guides were piloted with five children aged between 10 and 17 years, whose impairments included learning disabilities and autistic spectrum conditions.

The pilot of symbols based interviews highlighted the importance of having a simple and short topic guide. For example, asking a question such as: ‘when you go to X (foster carers, respite unit) how do you feel?’ and then showing the child a range of symbols. It was also decided to include an opportunity for children to construct four symbol maps, as this would encourage active participation, provide a tangible outcome and be enjoyable.

The amended symbols based topic guide focused on four areas:

• Talking to my social worker - topics discussed, who present at meeting, who does most of the talking, and feeling listened to
• Leisure activities and school life
• Important people in the child’s life
• Identifying things that the child can do and things that they need help with (and for some, things that they would like to do or would like more help with).

Seven children were interviewed (see Table 12.3). Three children took part in verbal and four in symbols based interviews.

Table 12.3: Children interviewed in each authority by gender and age

Authority	No of children interviewed	Gender	Age (years)
A	3	3 males	16*
B	2	1 male 1 female	18**
C	1	1 female	15
D	1	1 male	12
Total	7	5 males 2 females	12 – 18 (age range)

* All 3 were 16 years

** Both were 18 years

Participants had a diverse range of disabilities, including Down’s syndrome, cerebral palsy, learning disabilities and autistic spectrum disorders. All interviews were conducted in the family home and lasted between 15 to 40 minutes, depending on the child’s level of concentration. Five of the seven children chose to speak alone with the researcher; two preferred their mother to remain in the room. With the child’s consent, interviews were tape recorded.

Social Workers: sample and interviews

Social workers who had conducted ICS assessment/reviews with participating families were invited to be interviewed, all 16 agreed to participate. Tables 12.4 and 12.5 show the sample varied in current position and length of time employed in disability teams. In terms of the latter, social workers in authority C stood in contrast to those in the other three authorities

Table 12.4: Current position of social workers interviewed

Authority	Total No. of social workers (all levels) interviewed	No. of team leaders interviewed	No. of senior social workers interviewed
A	6	1	3
B	4	0	0
C	4	1	0
D	2	0	0
Total	16*	2	3

* Although 22 families participated, 16 social workers were interviewed, as some social workers had more than one participating family on their caseload.

Table 12.5: Social workers’ time employed in families children with disabilities teams

Authority	No. of social workers interviewed	Time employed in Disability Team (Range)	Average time employed in disability team
A	6	5 years to 5 months	3 years 10 months
B	4	9 years to 1 month	5 years 3 months
C	4	12 months to 2 months*	9 months*
D	2	5 years to 2 years	3 years 6 months
Total	16	9 years to 1 month	3 years 4 months

* Recently re-structured families with disabled children team

The interview topic guide explored experiences of using the ICS with particular reference to its appropriateness for disabled children and their families. Themes explored were:

• Using the ICS

• differentiating between IT training and the ICS system.

• Views and experience of ICS

• using the exemplars: experiences and evaluations
• ethnicity issues
• inter-agency working
• family awareness of the ICS system
• family participation within the process of assessment/review information collection
• information routinely received by families
• electronic records: their role and impact so far.

• ICS and social work practice

• transferability of information – within/between authorities
• effects of ICS on social work practice
• discussion of disability and outcome related issues with families
• overall evaluation of the advantages and disadvantages of ICS.

Pilot interviews were conducted with two social workers. Telephone interviews were conducted with all 16 social workers. Prior to interview, social workers were asked to complete a questionnaire covering details of each family’s ICS assessment/review, evaluation of the usefulness of ICS exemplars used²⁴ and knowledge and/or use of the ICS website (www.everychildmatters.gov.uk/ICS). Interviews lasted between 60 to 90 minutes and, with participants’ consent, were tape recorded.

Data analysis

All interviews were transcribed. Analysis of parent and social worker interviews was conducted by a staged process of ‘framework analysis’ (Ritchie and Lewis, 2003) which provides a mechanism to identify over-arching themes across the transcripts. It allows for progressive data reduction, displays the data in matrix form (which facilitates examination of the data both within and between cases) and, importantly for verifying conclusions, includes a mechanism for tracing back to the source data. There are four key stages to ‘framework’: (1) familiarisation with the data displayed through reading transcripts; (2) identifying and applying a descriptive coding framework to the transcripts; (3) developing a more interpretive thematic framework and displaying key points of the coded data in a set of matrices known as ‘charts’; (4) tracing patterns and associations in the charted data, in order to identify over-arching themes and conclusions. In each of the stages 2 to 4, the analyst adopts a reflexive approach, checking tentative decisions on coding, charting and conclusions with the raw data.

To promote the reliability of the analysis, two researchers familiarised themselves with the data and worked together on the initial coding framework. One researcher then took the lead on analysis, with a sample of the coded material being cross-checked by the other researcher.

Separate frameworks were developed for parents and social workers. On completion of charting the themes, the researchers were then able to identify over-arching themes and draw comparisons between parents and social workers and also across the pilot authorities.

Recognising the different nature and depth of the children’s interviews, it was not appropriate to analyse these via framework analysis. The researcher analysed each interview separately, noting key points and ideas from each transcript, and then sought to identify shared themes and issues raised by the children.

Findings

Social workers’ views

We have included here a brief account of social workers' general views of using ICS as the views of this group further illuminate our understanding of issues experienced by practitioners and their team leaders in the full range of children and family social work. As will be seen, there are a number of similarities with the views of the social workers included in the Audit and Process Studies, as well as issues specific to children with disabilities. We then go on to summarise disability specific issues.

These findings should also be seen in conjunction with the Record Study Report in Chapter 8, as the exemplars examined in that analysis were the records of the families and children sampled for the Disability Sub study, and written by the social workers reported on here.

Advantages and disadvantages of the ICS for social workers

IT and implementation issues

Movement to electronic records raised both advantages and disadvantages for social workers. Advantages focused on the potential to make information sharing with social work colleagues quicker and easier, specifically for duty social workers seeking to access information quickly. Some social workers, those with technical knowledge and confidence, said transferring core client information across exemplars by self population was useful when it worked.

Technical problems were felt to be the key disadvantage of electronic records, in particular, anomalies and inconsistencies when trying to insert data, coupled with the system crashing. Frequent crashing was viewed as particularly frustrating. All viewed a dual system of electronic and paper records as a necessity at present.

Access and security

Issues of access and security raised a mixed response. Five social workers could not see any confidentiality issues that did not already exist with paper, four were ambivalent and six expressed concern. Three said the issue of access was had not been adequately considered. One suggested that families had not been adequately informed of the move to electronic storage of records, as they should have been.

Impact on families

All the social workers recognised that families would have seen little change in the move to electronic records; six expressed concern that electronic records were potentially less accessible for families. In principle, the potential to develop electronic communication between social workers and families was seen as a strength.

Helpful tools

Ten social workers reported that ICS exemplars brought an increased depth of information and a more structured format. They welcomed the more focused and specific questions as they guided the direction of assessments, created the possibility of better information transfer, and encouraged social workers to discuss and record families' expectations in a more coherent and uniform manner. This aim was seen as providing greater clarity of roles and responsibilities for all parties.

I think it clarifies responsibilities because the form says, this is what the child’s needs are, this is how we’re going to respond to the needs, who’s going to do it, when are they going to do it, how are they going to do it, what are they going to achieve, you know … (Social worker)

However, views were sometimes contradictory, as the need for more information was not always viewed positively and was felt to be counterproductive as professionals and families did not have the time or inclination to read this depth of information.

In addition, three social workers found the exemplars too prescriptive. Whilst it was recognised that the questions were those that many social workers had previously discussed with families, the underlying issue for these social workers was the potential challenge to their professionalism, in particular the ability to make informed judgements. This is part of a wider concern regarding professional autonomy, an issue discussed in Chapter Ten.

Problems encountered

Completing the exemplars raised a number of practical issues, the most frequent being the length of time to complete. All social workers interviewed said they took longer than previous forms to complete. Some saw this as a transitional problem. For others there were wider issues, as more time in the office form-filling was viewed as a potentially negative re-direction into a more administrative role, with less time available for family visits. These concerns were concentrated in authorities A and B.

The question of ‘where’ to insert information was also raised as some felt this was unclear. One effect was to make reports long and repetitive. While one social worker felt that separating information under numerous headings and sections fragmented reports and inhibited a holistic overview of family life, another felt this was due to a lack of understanding of the ICS and its wider aims rather than poorly designed exemplars. Training and understanding of ICS are clearly important issues.

Disability specific issues

A key concern was that the ICS exemplars were felt to be inappropriate recording tools for disabled children and their families. A cause of this was seen as the carryover from the LAC and the Assessment Framework of a child protection bias, especially the use of language such as ‘parenting capacity’ which was felt to be insensitive to parents with disabled children as it questions their parenting skills and commitment. Nine of the social workers in Authorities A and B viewed the ICS exemplars as a continuation of these problems rather than an improvement.

In authorities A, B and D a number of concerns about the use of the exemplars with children with disabilities were expressed. The social workers thought that disability issues remained peripheral.

Do you think the introduction of ICS had altered the emphasis that’s placed on disability? (Researcher)

I think it has just highlighted and just continues to highlight how perhaps more marginalised they [disabled children] continue to be... (Social worker)

They said the multiple and complex needs of disabled children cannot be slotted into a specific area of a child’s life or development. They were unclear where to record specific disability relevant information, or what was expected and felt that the ICS exemplars were in danger of producing potentially bland and generalised family information, with the specific care needs of a child and caring strategies of each family not at the fore.

Another issue raised was the mismatch between chronological age and cognitive development for disabled children, most notably demonstrated in Core assessments. Over half of social workers (nine) felt that core assessment exemplars were unhelpful for families due their focus on ‘standard’ developmental milestones and chronological age.

The core assessments are framed very negatively, what the child can’t do because they’re strictly by chronological age … It all comes out very negative, no the child can’t do this, can’t do that, they haven’t achieved that, they won’t do that and the parents comment on it as well. (Social worker)

This raised the problem of which core assessment exemplar to use, an age based one or one more appropriate to the developmental level of the child. It was felt to be important that core assessment exemplars provided specific opportunities to record alternative milestones and achievements for disabled children. For example, the 11 to 15 year Core assessment record focused on recording levels of achievement in SATS. Other achievements, especially educational achievements used by special schools (such as P scales) were not considered. Although it was noted that alternative achievements could be put in the summary box at the end of each section, a specific question relating to ‘other educational achievements’ would be welcomed, as it provides a positive focus recognising that disabled children frequently pursue other paths but achieve within these.

Working with disabled children, particularly children who have communication impairments, requires practitioners to use different modes of communication, such as drawing and symbols, to help them to obtain children’s views. The written word was felt to be the key mode of communication in ICS and was viewed as potentially exclusionary, as it meant that only the social worker’s written interpretation of a child’s drawing or symbol response could be included. In order to try and counter this, visual communication was stored in paper records. However, it was recognised that this could not guarantee that evidence of the child’s wishes/feelings would be taken on board, if only electronic records were read.

It was generally acknowledged that social workers frequently have to rely on parents or other adults who know the child well for children’s views, due to their complex communication disabilities. However, some (six from Authorities A and B) felt that, because of time pressures noted earlier, they were now more reliant than previously on parents in order to collect information and complete exemplars.

The times when I’ve been able to sit down and chat to a child about how they feel it’s so much better for them to have their voice, whereas, in a way I feel that, you know, we’re spending so much more time with the carers and less with the child, we’re marginalising the child. (Social worker)

Some social workers also questioned if one exemplar is appropriate for all family members. The exemplars were viewed as essentially ‘parent/carer’ forms, frequently meaningless for children and young people. Issues of inaccessible and jargonistic language, uninteresting formats/layout and also depth and degree of information recorded were noted as problematic. Few social workers sent children/young people a copy of completed assessments or forms, a ‘family’ copy generally being sent to parents. Separate, more appropriate exemplars for children and young people would be welcomed

Black and minority ethnic families with disabled children

Only four of the social workers had black and minority ethnic families on their caseload. Experience of completing exemplars in relation to ethnic and culturally specific issues was very limited. However, opinions diverged. One social worker did not feel that there were any differences in how ethnicity was addressed and information recorded in comparison to previous recording systems, while two found the exemplars unclear and confusing, in particular, where to insert specific cultural information.

Inter-agency working

All the social workers thought ICS had, as yet, little relevance to inter-agency working. They noted that professionals from other agencies could not access ICS exemplars or their operating system, and that very little information had been given to them. Other agencies still completed their own assessment forms and it was felt that few would want to change. Social workers either input data from other agencies directly onto ICS electronic files or placed a note on the electronic record and a hard copy in the client’s paper file. This was felt to be inefficient and burdensome for social workers. Only three participants highlighted the future benefits that ICS may bring for inter-agency working, by producing more focused information and through the potential to clarify roles and responsibilities. It was generally recognised that joint working relied on individual relationships and actions rather than general policies and that achieving closer inter-agency working and information sharing amongst professionals would take more than implementing ICS.

Written information for families

This question of how much and in what format information about an assessment or review should be provided to families was problematic. Only three social workers felt that ICS information was an improvement on previous information produced for families. The remainder felt that although ICS may potentially produce more written information, in practice, this was too long, unclear and confusing. This led social workers to choose what information to send to families, raising issues of unequal power relationships for some.

I’m gate keeping, I’m cautious about using that word because actually it’s about power relationships and it’s about me deciding what that parent should have what they shouldn’t have ...... but nevertheless I still do it because there’s a point at which you think, ‘gosh, this is a complete waste of time sending this’. (Social worker)

These are complex issues and raise wider social work practice considerations. However, here we note that, although a key aim of ICS is to establish more uniform practices and standardise information received across families, social workers’ individual practice inhibits uniformity.

Some participants indicated that sending reports out to families for signing and amending would lead to extra administration, an added burden that could not be coped with.

.....we don’t do that, this is another thing that we sort of said, this is how we’re going to work and use this, there is a bit for it to be signed but it’s a nightmare because it’s not just parents who have to sign it, there’s lots of other people have to sign it and … it’s just, we never used to have, it never used to be signed beforehand, so we’ve just decided that....we don’t do that part of it because again, it’s just completely time consuming. If the parents have got a problem with it they come back to us, so it doesn’t particularly mean anything anyway. (Social worker)

While this decision is understandable, it contradicts key aims of the ICS and demonstrates how different authorities are interpreting and modifying ICS. It also presumes that families will request amendments if they think them necessary. The onus is on parents to initiate these changes. However, the problem was located wider than ICS - within electronic records themselves, as it was felt that paper records had enabled parents to contribute more easily and had ensured that their comments were read and included within their file. At present, parents are dependent upon social workers/administrators inputting their comments or making amendments to their electronic record.

Social workers’ evaluations of parental participation

Three quarters of those interviewed had not considered family participation to be an aim of ICS. They were unsure how it would practically be achieved or how much impact it would have on parents’ experiences.

Similarly, when asked if ICS had changed parents’ level of participation, a quarter could not see any change, and a quarter could not make any pre and post ICS comparisons. Others felt that ICS may lead to a decrease in parental participation as a result of parents being in less control of the information inputted. In contrast, two participants (from Authority C) were more positive, feeling that a clearer focus on participation within exemplars encourages social workers to include parents.

I think it does focus you because you have to get the comments of parents, so it probably is a better assessment because it involves the parent, it focuses you into the fact that at the back it says parents’ or child’s comments, so it’s saying, hey, you can’t just do this assessment by yourself. (Social worker)

Social workers’ evaluations of children’s participation

Over half of those interviewed feared that ICS would lead to reduced participation and involvement for disabled children. Concern focused on social workers having less time to spend with children a result of spending more time in the office inputting ICS data.

It’s an ongoing problem that we, in the very nature of our work you need more time to be able to record meaningfully children’s information and, and allow them time to communicate their needs and I guess the knock-on is that we feel that because there’s so much more input on the keyboard and needing to be in the office to do that, you’ve actually got less time to do that. (Social worker)

For children with disabilities - especially those with communication disabilities – direct work takes time. Six social workers suggested that post ICS, they relied more on parents or other informed adults for children’s views. For social workers in Authority A, there was also concern that ICS was too focused on the written word because the format does not allow for alternative forms of communication. In contrast, social workers in Authority C felt that ICS had the potential to increase children’s participation, as exemplars formally required social workers to collect and record children’s views as a matter of course.

I think there’s a heightened awareness of the need to consult with children with disabilities and get them involved,....it really has pushed that because it’s on almost every form, you know, what’s the child’s view on this,.....so that’s heightened it in a sense. (Social worker)

These diverging perspectives raise complex issues about the social work role, not all of which necessarily involve ICS. For example, how much time should social workers have for informal family visits which they regard as important?

Social workers’ evaluations of recording outcomes

Current policy directives stress the importance of an outcomes focused approach, an objective of the ICS. Only five social workers made a clear distinction between the service provided (output) and its impact on families (outcome). Most did not use the term ‘outcome’, preferring to think in terms of families achieving their objectives.

Six social workers (Authority A) felt that ICS had not changed their well established ways of discussing aims and aspirations with families. In contrast, the remaining ten social workers felt that they now spent more time discussing and considering aims with families.

Well, it’s on every, every form now isn’t it, you know, the outcomes, I think we’ve just become more aware we’ve got to think in terms of outcomes for families and children through the system, probably through the ICS. (Social worker)

It was generally recognized that ICS focused more clearly on recording service aims and their achievement and encouraged social workers to discuss them with families, and several noted that such considerations could no longer be left until the end of the assessment process.

Parents’ views

Electronic records