The Outcomes of Interagency Training to Safeguard Children

1
The Outcomes of Interagency Training to Safeguard
Children

• Prof. John Carpenter, Dr. Eszter Szilassy,
• Dr. Demi Patsios, (University of Bristol)
• Prof. Simon Hackett, (Durham University)
• _at_ JSWEC 2009

2
The rationale

• Training delivered on an inter-agency basis is a
  highly effective way of promoting a common and
  shared understanding of the respective roles and
  responsibilities of different professionals, and
  contributes to effective working relationships.
• Working Together to Safeguard Children (2006)
• Is it?
• Research funded by DCSF and DH as part of
  Safeguarding Children Research Initiative

3
Questions

• How is interagency training organised? Is the
  system robust?
• What kind of training is delivered and by whom?
• Does it work? i.e. do participants develop a
  shared understanding of their respective roles
  and responsibilities?
• Is it value for money?

4
Methodology 1

• 8 LSCBs in South West, London, North East and
  West Midlands
• Organisation and Delivery of Training
• Interviews with agency managers, training
  coordinators, trainers and trainees (n 60).
• Analysis of training plans and reports and
  Observation of Training Support Group meetings
  (6).

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Organisation of Training

• All but one have established Training Sub Groups
• Participation and commitment by agencies varies
• Budgets, contributions and funding mechanisms
  vary considerably.
• Programmes/course content usually developed using
  national guidance supplemented by local training
  needs, e.g. Serious Case Reviews.
• Organisation of training depends on 1-2 key
  people
• Training co-ordinator and administrative staff.
• Training delivered by highly committed PA staff
  and external trainers (Support varies).

6
Partner Agency contributions to LSCBs
7
Seven dimensions of effective partnership working
Shared commitment to goals and values
Interprofessional trust and respect
Interdependence of outcomes
Effective partnership working
Role clarity
True cooperation
Focus on quality and innovation
Cultural congruity
Source West and Markiewicz (2006)
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LSCB training what kind of Partnership?

• Mandated/forced (but NB no extra resources
  provided).
• Often previous history, e.g. ACPCs.
• Shared commitment small group
• Responsibilities delineated (in Working
  Together).
• Clear objectives (but outputs (courses) rather
  than outcomes).
• Accountability to LSCB.

9
Course content re Common Core

• Safeguarding and promoting the welfare of the
  child
• Inter-agency working, incl.
• Communication and teamwork
• Assertiveness
• Policies and processes
• Sharing information.
• Confidentiality
• Gillick
• Clear communication

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The Courses ( n 131)

• Responding to Child Protection Concerns (Level 1)
  (31)
• Working Together (Level 2) (33)
• Domestic abuse (22)
• Parental mental health (8)
• Drug using parents (8)
• Disabled children (11)
• Female genital mutilation (2)
• Children and YP with sexually harmful behaviour
  (10)

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The Courses

• 1, sometimes 2, days.
• 15-25 mixed groups
• Internal (PA staff) and external trainers
• Presentations of research, legislation, local
  policy and procedures
• Highly interactive small groups, case based,
  focus on roles and responsibilities,
  communication exercises.
• Informal and networking

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The Participants (n 2097)

• 87 women
• Identifying responding level 1 (n 437)
• 55 gt 5 yrs exp.
• 25 soc/wkrs, 21 nurses 19 teachers 2.5 Drs
• Working together level 2 (n 265)
• 63 gt 5 yrs exp.
• 26 soc/wkrs, 23 nurses 19 teachers 3 Drs
• Specialist courses (n 525)
• 0 gt 5 years exp.
• 25-81 soc/wrks 10-32 nurses 1-12 teachers

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Motivation

• Motive for attending
• 65-94 voluntary
• 6 - 35 required

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Evaluating outcomes

• Development of self-report measures of outcomes
  (knowledge, self-efficacy and attitudes)
• Participants assessed in a times-series design
  at
• Registration (T0)
• Start of Course (T1)
• End of course (T2)
• Follow-up after 3 months (T3)

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Responding to CP concerns (Level 1)

• Jade is an eighteen month old child. The health
  visitor has noticed a bald patch on the back of
  her head. She is worried and feels that her
  development is delayed because she isnt
  stimulated sufficiently.
• 1. Initiate Common Assessment Framework (CAF)
• 2. Make a referral to social services
• 3. No action
• 4. Do not know
• Primary type of abuse .
• No abuse ?

16
Action Knowledge range of scores (potential -9
to 9) (N 466)
17
CAS type of abuse scores (means) (range 0-9)
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Working Together to Safeguard Children (Level 2)
1-2 days

• Provides opportunity for participants who have
  already received basic child protection training
  to improve understanding and knowledge of their
  own and others responsibilities.
• Provides opportunity to explore with colleagues
  from other agencies challenges related to working
  together.

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Outcomes Attitudes to Interprofessional
Learning

• Examples
• 1. My skills in communicating with other
  professionals would be improved through attending
  interagency safeguarding training
• 2. Interagency training is likely to help to
  overcome stereotypes that are held about the
  different professions

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Attitudes to Interprofessional Learning (n
297) (range 9-45)
21
Attitudes to Interprofessional Interaction

• ? There is a status hierarchy in safeguarding
  work that affects relationships between
  professionals
• ? Professionals who engage in work to safeguard
  children do not always communicate openly with
  one another
• ? It is easy to communicate openly with people
  from other safeguarding children disciplines
  p

22
Professional and Interprofessional Relationships
in Safeguarding

• ? I have a good understanding of the roles of
  different professionals who engage in work to
  safeguard children p
• ? I lack confidence when I work with people
  from other professions p
• ? I am comfortable working with people from
  other professions p
• ? I feel that I am respected by people from other
  professions. p NB

23
Safeguarding Disabled Children Scale (examples)

• Compared to non-disabled children, disabled
  children who say they have been abused are less
  likely to believed by adults.
• I would personally feel confident that I could
  correctly identify a disabled child who had been
  abused.
• Physically disabled children are over 4 times
  more likely to be abused than non-disabled peers.
• I am clear about my roles and responsibilities
  when abuse of a disabled child is alleged or
  suspected.

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Safeguarding Disabled Children (results)
25
Outcomes for participants (interviews after 3
months)

• Outcomes (knowledge, self-efficacy, attitudes)
  are very positive.
• Develop networks
• Opportunities to use knowledge and skills varies
  according to opportunity.

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After 3 months

• Service users gain from the fact that we develop
  networks which can be called upon for
  helpincreased access to services for parents
• training has helped us be aware of different
  perceptions and how to communicate with
  professionals in a different way
• Dont know really right now but my knowledge has
  increased as has my confidencebut in the longer
  term it will, i.e. when I do have such clients

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What predicts scores at T2?(i.e. what predicts
amount of learning)

• The course?
• The participants age, gender, ethnicity?
• Years since qualification?
• Profession?
• Voluntary or compulsory?
• NB controlling for T1 scores.

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Methodology 3 cost

• Direct and in kind costs of providing training.
• Training co-ordinator office
• Training subgroup
• Trainers (internal as well as external)
• Venues
• Costs (in time/) of participating in training.

29
Costs of delivering training for agencies Site
ATotal 99k
30
Site B 80k
31
Costs, value for money?

• The mean cost per day/course was just under
  2,000 (range 1,567 - 2,863).
• The full economic cost per head/day at between
  102 and 119, depending on the level of the
  course and the number of participants.
• Independent sector 130/150 up to 230.

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Headlines

• Interagency training is liked
• Its effective
• Knowledge, self confidence
• Understanding and respect for those involved in
  safeguarding
• (Almost) everyone learns
• and good value for money.
• But it relies on goodwill and is vulnerable.

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Implications

• Nationally
• Funding is essential.
• More training courses are needed.
• SDU should prioritise and disseminate key
  training issues for LSCBs.
• Trainers need EBP, including standards and
  accreditation.
• Build courses into postqualifying CDP
  frameworks.

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Locally LSCB Training Groups

• How to ensure more robust and shared arrangements
  for delivering training.
• Participation How to bring in doctors, police
  and adult practitioners.
• Decide that the impact of courses be evaluated
  (pre-post).
• Strengthen support to trainers
• Training for trainers
• Recognition

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Thanks!

• My email contact is on blue sheet.
• j.s.w.carpenter_at_bristol.ac.uk