Response to Consultations

Ending the need for food banks: consultation on a draft national plan

Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We welcome this opportunity to comment on Scottish Government’s draft plan to end the need for foodbanks. We recognise its importance in the delivery of services that are human rights-based, and person-centred, and the critical understanding of the impact of, and correlation between poverty and social inequalities.

As a result of poverty – not a shortage of food – too many people don’t have enough food in Scotland. People in communities across the country have responded incredibly to the growing need, whether by volunteering at a food bank or donating cash and food. Yet there is widespread agreement that food banks should not need to exist – everyone should have enough money to buy food and other essentials. As noted within the consultation document “The primary driver of food insecurity and the need for food banks is insufficient and insecure incomes”.

As social workers, we see poverty within the wider framework of human rights, equality of opportunity and of social, economic and environmental justice; poverty restricts people’s choices and their ability to take part in society.

Social Work Scotland supports the basis of compassion, kindness, respect and the upholding of human rights that has been used by Scottish Government in the development of the plan to end the need for foodbanks as a primary response to food poverty.  It is also heartening to see that Scottish Government recognises the innovation, commitment to fairness, partnership approaches, and integrity that has been and continues to be,  demonstrated by Social Workers and other public services at the height of the COVID19 pandemic response, and that the learning from this period is the foundation to this response.  We are entirely supportive of the Scottish Government’s vision that;

“Everyone has a sufficient and secure income to be able to access food that meets their needs and preferences. Where financial hardship does occur, coordinated local responses prioritise access to emergency financial assistance and money advice alongside access to holistic support services. Where help to access food is needed, this is provided in a way that maximises dignity and reduces future need. Delivering this in practice will take leadership and action at all levels across Scotland”.

 Consultation Questions

1. Do you think that the approach outlined is consistent with the vision to end poverty and the need for food banks? Is there anything else you think should be included?

Yes

The equal focus on prevention and response is much needed and demonstrates an understanding of the requirement to have a multi-tiered approach to address this complex issue.  It is important that whilst prevention of food insecurity is the aim, there remains support available to people who require practical support, and that this support is rooted in the values of dignity and respect.  The approach also demonstrates the interconnectedness of income, employment opportunities and the cost of living, and their impact on individuals and families.

2. Do you think that the actions underway will help to reduce the need for food banks as a primary response to food insecurity?

Don’t know.

Whilst there is undoubtedly a huge amount of initiatives both in place and planned, the complexity of associated and contributory factors that have led to the increased use of, and need for, foodbanks over the last five years, make it impossible to say whether these will result in a reduction in their use.  That said Social Work Scotland broadly supports most of these initiatives.  In particular, the commitments made in the Fair Work Plan, and the work being undertaken via Social Security Scotland to maximise income from social security.  These, alongside preventative measure such as those introduced to address the cost of living; the increase in free childcare hours, the introduction of national money advice services, and the commitment to the expansion of eligibility to free school meals for all primary school age children, will undoubtedly have a positive impact.

We would however, urge caution over the use of shopping vouchers in place of food bank referrals as there is the potential that these would further stigmatise individuals and families who are experiencing food insecurity.  Their use may be a very good alternative for some; however, this would require careful thought, planning and consultation before being introduced as a policy.  Related to this, a further exploration of the concept of prepaid cards such as those used in the “Best Start”scheme, which includes consideration of unintended consequences – such as stigma, would be helpful. A Menu For Change has also done helpful research on the effects of shame on accessing support services around food inequality.

3. Do you think that the suggestions for what more we plan to do will help to reduce the need for food banks as a primary response to food insecurity?

Don’t know.

As above, whilst the commitments outlined within the consultation paper are positive, due to the complexity of the issue it is impossible to say what impact they will have on the need for food banks as a primary response to food insecurity.

4. Is there anything else that you think should be done with the powers we have at a national or local level to reduce the need for food banks as a primary response to food insecurity? [Open comment]

The commitments outlined demonstrate a, much-needed, broad lens with which to view and address the issue of food insecurity.  As noted above, food insecurity sits alongside wider poverty issues and particularly for children, areas such as school uniforms, attainment gap and access to leisure. Therefore, effective tackling of food poverty needs to sit alongside the wider poverty agenda.

5. Do you have any views on how we intend to measure impact, and what would give you confidence that we are moving in the right direction? [Open comment]

The impact measures outlined within the consultation document are robust.  It would be helpful, as part of the collation of information from funded activities, as outlined in point 21, if qualitative data was collected, so that lived experience guides any future developments.

6. Is there anything else that you think should be considered in the development of this plan?

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It is important to note that there will likely be an increase in need for food banks in coming months given the current fuel crisis, coupled with the ongoing impact of the UK’s exit from the EU, and the COVID19 pandemic.  Social Work Scotland would also like to take this opportunity to note that social work services and charities have always provided food and fuel emergency provision in response to crises, and that crisis need is likely to remain, despite the laudable and right aim to reduce/end use of foodbanks.

Health & Wellbeing of Children and Young People

Health, Social Care and Sport Committee call for views

December 2021

Q1.  What are the key issues around health and wellbeing for children and young people in Scotland? 

Mental Health and wellbeing issues for children and young people have been highlighted over recent years, with increasing attention on the apparent increase in poor mental health. This is suggested as resulting from a wide range of factors from educational and exam pressures to the impact of poverty, caring duties and pressures of the on line world and social media. For young people facing adverse factors in their lives these pressures are increased. There is evidence from carers groups of the impact of caring responsibilities on the mental health of young carers who face isolation and lack the same supports as other young people (Carers Scotland, Scottish Government Carers Strategy); from care leavers around isolation and lack of support leading in some cases to an increased likelihood of self-harm (Staf, the Promise,); and from CAMHS of high demand, and an increase in eating disorders and more complex mental health issues in young people (reference work to develop the new Foxglove facility).

Young people are also significantly affected by the mental health and wellbeing of their parents and families, with circumstances such as drug and alcohol misuse, depression, poverty and poor mental health affecting children who come to the attention of social work services. For children with additional needs or disabilities, the proportion of those whose parents also experience poor mental health is significant with one authority quoting figures of three quarters of the care packages for young people with disabilities containing aspects related to the poor mental health of the parents. The COVID-19 pandemic has added to those pressures with an increase in another authority of 62% in children moving in to residential school/care due to their parents no longer being able to manage their care.

With factors so diverse, a whole family approach is required to really tackle issues of poverty and health and wellbeing. Positive impacts on adults around children and the reverse (negative impacts for adults) are inextricably linked to outcomes for any children or young people who are cared for by those adults. Therefore, to truly understand the challenges facing children and young people, we must see them in the context of their living situation, and to effectively support and address these challenges, we must seek to support those individuals that impact on them, and, crucially, to engage with children and young people to gain and understand that lived experience.

In addition to poverty and the exclusion from society this can bring, Significant Case Reviews provide evidence of both mental health issues in parents impacting on children’s health and care, and that transition arrangements between CAMHS and Adult Mental Health services, and more universal children’s services and those for adults, are a challenge. A related critical area is those young people whose needs do not meet the high threshold for an adult service, and thus often ‘fall through the net’ unless their health reaches crisis point. Compounding these transition issues, the lack of a partnership approach between mental health and substance use services, means that young people who uses services can be prevented from accessing mental health support. For looked after children there can be an additional challenge in accessing CAMHS. Due to the need to manage demand in many areas, those not in a stable living environment or not living in their home local authority area, can often be prevented from accessing this provision.

While much attention has been given to early intervention for children and young people, approaches and provision is varied across the country and funding is often very focused and patchy. This lack of an overall coordinated approach leads to inconsistency. Opportunities to utilise the community as an asset and provider of early support is also often lost

Q2.  What are the current challenges with improving the health and wellbeing of children and young people over the next 5 years?

The full impact of the Pandemic on families has yet to be understood but is undoubtedly affecting the health and wellbeing of children and young people and the adults who support them, and is likely to do so for many years. This is already being noted, and the briefings provided by Social Work Scotland, CoSLA and ADES for the Education Children and Young People Parliamentary Committee evidence session on 1st December on the impact of COVID-19 pandemic on children and young people, all highlight this, as do early research papers in this area. Additionally the, potentially life limiting, impact of delayed NHS Treatment due to the pandemic will undoubtedly impact on any children and young people for whom the adult is responsible. In single parent households and those where a parent or child has additional needs, or where a child is looked after, such loss could be catastrophic.

Mental Health issues for children and young people will be a leading health and wellbeing issue over the next five years. The challenge between mental health services and referring services, as noted in the previous answer, can feel like a “hard line” and one that tends to exclude rather than include. School and School Nursing boundaries are not always clear, with families sent back and forth between these agencies for lower tier mental health issues. Effective engagement of young people through channels that make sense are required. For example, there needs to be more done to create face to face supports and groups to connect teens at the earliest point in their mental health journey. This need not be focused specifically on mental wellbeing. Attention to how existing community groups and supports for children and young people – such as community education groups, youth organisations and sports groups – can be better utilised to enhance the wellbeing and mental health of young people would provide early and effective whole systems intervention and support. Many staff in such setting already provide this type of early intervention and support, and additional input would allow greater skill in signposting to more focused provision when required.

Another challenge is the pressure already been seen in the acute side of mental health care with the reduction in MHOs over the past years (SSSC data). Social Work Scotland welcome the recent short term investment in MHO workforce from Scottish Government, but would note that the skills and experiences of a social worker are needed to fill the gaps of those MHOs leaving the profession. To effectively support critical and enduring mental health in the future, in line with legislation, we need to invest in social work workforce

Q3.  What offers the best opportunity for improving the health and wellbeing of children and young people over the next 5 years?

A combination of opportunities are required:

• Improving mental health services and open access to these in a timely manner, so that children and young people do not face long delays leading to more entrenched difficulties by the time they access a service.
• More preventative and early intervention supports for children and young people, provided in a cohesive manner, across disciplines and areas (not all should be school based) and making best use of existing structures and opportunities for young people
• A focus on provision of such services to the more vulnerable for whom currently access is most difficult.
• Tacking poverty and supporting adults in children’s lives to better support the young people. Any action taken to improve circumstances for adults will almost always lead to improvements for children and vice versa – any action taken in relation to adults which makes their circumstances worse will almost always have an adverse impact on children in their care.
• Preventative and early intervention strategies that involve social workers, schools, and community groups.
• Reducing the mystery around good mental health being the purview of psychologists and psychiatrists,
• Engaging with those services that tackle poverty, disenfranchisement, social justice, and education, as a means of building resilience in the communities that can offer the long term support needed to help people thrive in their surroundings. Seeing mental health as connected to the wider public and social issues arising from austerity, investing in the areas people live and reducing the stigma of living in those surroundings will help people feel connected to and value their communities

To successfully invest in the preventative and early intervention of children and young people and support resilience in mental health, there needs to be significant investment in the social work workforce, to allow the relationship based practice, a core social work skill, to support a child and young person make sense of their environment, develop healthy and nurturing relationships, and embed self care practices into their lives. This should be a multi-disciplinary approach, incorporating education, health, and community based approaches, to maximise effectiveness. Alongside investment in social work support therefore, given the need for a multi-disciplinary approach, training and support needs of partner agencies should be considered to ensure that they have the skills to identify and respond promptly to health and wellbeing issues as they arise. There are examples of positive work in this area.

Q4.   How does addressing poverty lead to improved health and social care outcomes?   

Poverty and the impact on families is perhaps one of the most significant contributors to poor mental health and wellbeing. Poverty and the associated physical and mental health impact on adults and children are well documented. These include financial difficulties and debt and associated worries (rent arrears, worries about being evicted etc.), restricted access to a nutritionally valuable diet with the associated health, learning and growth benefits, relationship stresses, mental health concerns such as depression, social exclusion, limited access to leisure and wellbeing opportunities, substance misuse and the consequences for the health and wellbeing of both the user and their children. These all have a negative impact on parenting behaviours which in turn impact on children’s wellbeing and outcomes – both as children and then on into adulthood. Groups experiencing poverty are over represented in the welfare system and prison population and underrepresented in groups such as those attending higher education. Poverty also impacts on those in specific groups more than others – those with a disability, from an ethnic minority group or who have experience of the care system.

Supporting people to have access to basic human rights such as food, shelter, heating, clothing, will remove many of the stressors which trigger poor mental health and wellbeing in families. The whole system approach, tackling the underlying issues but also providing the graded supports needed for children and their families – in line with GIRFEC – are both needed to create the conditions for change. This combined individual and societal approach would support the ability of children and their families to engage in their communities. Though a theory promoted several decades ago, Maslow’s Hierarchy of Needs best describes this and why these factors are necessary in a child’s life to enable them to grow and develop.

Children’s Social Care Market: interim report response

As an organisation, we welcome the publication of the Competition and Marketing Authority (CMA) Interim report on the Children’s Social Care Market. The concern of the CMA to consider how market conditions impact on outcomes for children in care settings, and the clear aim to ensure that the market works to both protect children and improve outcomes is acknowledged.

Social Work Scotland  agree that market conditions and risks that may be acceptable in other settings could have serious implications for children who require state care, and that our corporate duty of care extends to ensuring that the conditions framing the care system work to improve that system rather than make it more complex. While recognising that aspects of the market in Scotland differ from that in England and Wales, there are significant similarities in terms of impact on children’s care provision. Our comments reflect the position in Scotland, but identify where issues have cross-nation significance.

Context:
Scottish children identified as unable to remain at home, and requiring alternative care provision, will primarily be cared for within alternative family placements, with a smaller proportion, around 10%, being looked after in a range of types of residential settings. Whilst the range of provision in Scotland is broadly similar to that within England and Wales, the legislative context is significantly different:

• Care and protection is provided within the Children’s Hearing System, which also oversees situations where a child has come in to conflict with the law. The hearing system is unique in its approach, with decisions taken by a panel of lay people.
• The term ‘looked after child’ in Scotland refers to:
  • children who are subject to compulsory measures of care (both at home and ‘in care’)
  • those subject to ‘voluntary’ care (section 25, Children (Act) Act 1995) where a person with parental responsibilities has requested that their child be accommodated by the local authority
  • those where parental rights have been removed from a parent/person with parental responsibilities and vested in the local authority.

Scottish Government returns distinguish between children looked after in community settings (home, foster care or kinship care) and those looked after in residential setting, and the legal status of looked after children.

• Registration with Care Inspectorate and adherence to the care standards is a requirement for all care provision for looked after children. Services are inspected against those standards.
• Kinship Care in Scotland has a specific profile. Looked after children placed with a kinship carer as a condition of a compulsory supervision order are deemed looked after away from home. Kinship carers in that situation must be assessed and approved in a manner similar to that expected of foster carers. There has been a policy thrust to accommodate more children in kinship care over the past decade, with associated provision and support for kinship carers.
• In Scotland, providers of alternative family care may not profit from their work.
• The right to continuing care – to remain in placement until the age of 21- is a principle Social Work Scotland supports. The implications for the wider care sector however are significant in terms of impact on availability of placements for children under the age of 18, and cost to local authorities.

A contextual aspect relevant to the Scottish context, which may also influence the similar work in England, is the outcome of the independent review of the children’s care system, the Promise. This was accepted by Scottish Government and is now being implemented over a 10-year period in recognition of the fundamental change being sought. The first 3 year action plan is nearing the end of year one. While this is not focussing on commissioning, the foundation of the Promise is a change in the nature of the care system to ensure that all aspects from early intervention and
family support to family based and residential care, are underpinned by positive nurturing relationships which have the needs and voice of children and young people their heart. If the care system is to be transformed in this way there must be changes also in the market and commissioning which provides aspects of that care, specifically to allow it to be responsive to children’s needs rather than market conditions.

Flowing from this work, recent legislation – the Children (Scotland) Act 2020 has brought in additional provisions that required local authorities to place brothers, sisters, and those with a ‘brother or sister like relationship’ together. Where this is not possible, they must be placed near to one another, with contact plans for maintaining their relationships in an active manner that allows for change over time. This is a move which Social Work Scotland, and indeed the social work workforce, supports but which has implications for the market in terms of placement finding, availability and regulation of placements, and ability to meet the needs of the children being placed.

An additional factor within Scotland is the implications of the independent review of adult care undertaken following the initial stages of the Covid 19 pandemic. The resultant report – Independent Review of Adult Social Care – recommended the creation of a National Care Service for all adult social work and social care. The Scottish Government accepted all the recommendations within the report and moved in August 2021 to a consultation on the nature and scope of a National Care Service. The consultation period ended on 2nd November 2021 (you can read our response here). Unexpectedly, the consultation proposed extending the scope of a National Care Service to cover not only adult social work and social care but also children and
families, and justice services. The scale of change to service delivery and commissioning from a local to a national model will influence the social care market significantly, regardless of the ultimate inclusion or otherwise of children’s services with a National Care Service.

Comment:

Analysis of market outcomes

Social Work Scotland recognise the contextual and analytical approach taken to this work, which is well grounded and clear in the fundamental goal of improving outcomes for children. The analysis of the market provided in the interim report is a picture with which we concur and recognise. We agree that there are regulatory and other barriers, and that cross border placements create particular challenges. We would welcome the opportunity to explore both of these areas further with CMA.

While we appreciate and agree with the use of evidence and data from agencies such as Care Inspectorate as a benchmarking tool, we would note some caveats for consideration. Of note is the different way in which standards are applied to local authorities as distinct from third sector providers. For example, both may be registered, inspected and graded as fostering agencies, with those grades compared on an equal basis. The independent fostering agency grading is based on provision a foster carer service while a local authority grading will reflect a wider and more complex service; assessment and support of foster carers, assessment and planning for children and matching processes.

Emerging conclusions on the potential drivers of market outcomes
We agree with the three key conditions for an effective market

• Ability of local authorities to efficiently find and purchase appropriate placements for children at prices that reflect the cost of care.
• local authorities can indicate likely future needs of children to existing and potential providers, and current gaps in provision
• Providers can react effectively and quickly bring new supply to the market

The inherent challenge in the children’s sector is that placements are usually required at short notice. The impact of this is that matching considerations and children’s needs can become subservient to the urgency of identifying immediately a place for that child to live/sleep. This aspect is true within Scotland as well as south of the border. Consequently, the position of the local authority is inherently weaker than that of the provider, and the needs and required outcomes for the child placed are seldom the defining issue in sourcing a placement. The desire to meet assessed need is at the heart of social work and the challenges therefore do not sit well with our social work principles and values.

Additionally this leads to an uncertain market with providers responding to existing need and demand rather than local authorities being able to identify, predict and respond to trends in a proactive and managed manner. Examples of this are:

• The increase in external providers of fostering services operating in Scotland over the past 10 years as the need for family placements expanded with the reduction in residential provision
• The trend for external providers of both family based and residential provision to categorise their services as ‘specialist’ or ‘enhanced’ to both attract placements and increase prices.

The reality in Scotland has been that much of the need for externally purchased care is driven not from a need for specialist provision though this can be a factor, but from
a lack of basic local authority provision. The implications of greater understanding of the conditions required to enable reparative and trauma informed care has rightly led to smaller residential settings and restrictions on the number of children a foster care may look after. This sits alongside an increase in demand for placements and greater complexity of need at point of placement, as provision to support children and their families within the wider community increases. The policy and legislative framework for this is Getting it Right for Every Child.

Scotland is not a large country and related to this, provision for specific specialist needs is therefore not lucrative or always available. For example

• There is little family based provision for children with disabilities –their care tends to be provided the form of residential school placements with related rights issues
• Provision for those requiring secure care related to mental health issue is often sourced south of the border with all the ramification of this

Processes for setting up new provision is also a barrier. Appropriate checks are vital for ensuring that the care provided is safe and suitable, but the time these processes take can be prohibitive mitigates against creative and responsive service development. For local authorities there is the additional impact resulting from procurement legislation and Committee processes, which can contribute to delay.Working effectively there would be sufficient provision to meet a range of need, and to provide choice of placements to allow for matching considerations; a responsive market, and a more cohesive relationship between the local authority sector as purchaser and external providers.

Thinking on possible remedies, Social Work Scotland would broadly agree with the report recommendations and would welcome continuing conversations around exploration of recommendations for national or regional bodies with a remit around ensuring the right placements are available for children. Within this, we would emphasise the importance and need for local and responsive provision to ensure children can remain in their own community as much as possible. This has a particular relevance in Scotland given the implementation of legislation around sibling placements, and the legislative requirement to place brothers and sisters near to one another. The specific and additional issues related to rural and island authorities should be noted.Core to any future development is the ability of local authorities to engage appropriately with providers, both internal and external, and to have the ability to be flexible and responsive. As noted,we agree that cross border placements pose particular issues.

As an organisation,we have undertaken work in this area through our Fostering, Adoption and Kinship Sub Group (a network covering the spectrum of providers and local authorities) in conjunction with Scottish Adoption Register. This can be shared with CMA. This forum has also considered in detail issues arising from the increase in kinship placements and the implications of the legislation for cross council placements, with the resultant development of a draft Kinship Care Protocol. On a similar note, the Scottish Government, following discussion with kinship groups and agencies, has developed a Kinship Care Collaborative with the aim of reviewing the current ‘map’ or kinship practice and provision, and progressing improvements. While a national or regional approach is worthy of exploration, a change in structure in itself may not result in the desired change.

The importance of regional or national frameworks assisting and supporting local authorities and not resulting in additional steps and barriers in the placement sourcing process is crucial to any change. This should sit alongside ensuring local placements and capacity for local authorities to deliver on legislative and policy commitments linked to children’s rights e.g. UNCRC and Children (Scotland) Act 2020.

Financial analysis

The financial analysis and interpretation in the interim report resonates with Social Work Scotland’s knowledge and information from members. We would suggest that further discussion and consideration is required in this area, and should include learning form the adult care sector and both the challenges and remedies applied there. Social Work Scotland can facilitate access to this sector in Scotland.

Contact for questions or more information: admin@socialworkscotland.org

 A National Care Service for Scotland

SUMMARY OF SUBMISSION FROM SOCIAL WORK SCOTLAND, TO SCOTTISH GOVERNMENT CONSULTATION 

November 2021 

Social Work Scotland is the professional body for social work leaders, working closely with partners to shape policy and practice, and improve the quality and experience of social services. We welcome this opportunity to comment on the Scottish Government’s proposals for a National Care Service, and related reforms to social care, scrutiny, improvement, etc.  

This paper provides a summary of Social Work Scotland’s consultation response, profiling our position on key sections and issues (as identified by Social Work Scotland’s members). It is organised in the sequence we think issues must be considered, considering the social care system’s critical importance to the health and wellbeing of the nation, its complexity and delicate interdependencies, and the real risks to people if this process of change is not deftly planned, properly resourced and expertly managed. 

Please find our full response paper (PDF) here.

Please find our supplementary papers (PDF) here:
SWS NCS Supplementary Response – CARERS

SWS NCS Supplementary Response – FINANCE

SWS NCS Supplementary Response – RESIDENTIAL CARE CHARGES

Our overall position 

Over the past decade Social Work Scotland has taken every opportunity available to underline how pressing the need is for investment, paired with reform, across all aspects of social care and social work. The gap between Scotland’s ambitious rhetoric in these areas (often given weight in law) and our collective ability to deliver on it has steadily grown, fuelling disappointment, frustration and cynicism among those seeking publicly-funded support and those employed to deliver it. Ten years on from the Christie Commission, the preventative model of public services that it described also remains, for many, some way off. Closing this ‘implementation gap’ is a shared priority for Ministers and Social Work Scotland’s members.  

The reforms outlined in this consultation present opportunities to close that implementation gap. The COVID-19 pandemic has brought the social care sector to the brink of crisis, and further delay in making necessary changes and improvements is not tenable. We therefore welcome the prospect of co-creating a National Care Service for Scotland, helping to realise its potential and mitigate its risks. The National Care Service’s scope should extend to adult social care and social work, from where the impetus for these specific reforms came, and where the rationale for these proposals is clearest. But defining the boundaries of ‘adult’ social care and social work will be difficult, and we see real value for individuals and communities in maintaining social work as a holistic profession and service, with all its parts connected under a shared professional leadership. For these reasons, as well as our acknowledgement that reform is needed (and has been committed to) in all areas of social care and social work, we recommend that formal discussions, research led and lived-experience informed, are initiated immediately among relevant partners to determine what the best structural and governance arrangements are for justice social work, children and families social work and social care and mental health services. The fundamental questions being always: “will this change make it easier or harder for the people working in the system to achieve positive outcomes alongside people in their communities?” and “will this change progress or impede social justice in Scotland, in terms of poverty and inequality, discrimination and isolation, the environment and human rights?”   

It should be noted that we do not believe organisational structures, in themselves, have a direct impact on the quality of social care and social work, the experiences of people, or the outcomes achieved. Inspections and research have consistently concluded that formal structural arrangements matter much less than the quality of leadership and availability of resources. An approach to change which concentrates primarily on the structures, rather than the people that work within them, is therefore likely to fail in delivering meaningful change on the ground. But this is not said to dismiss structural change as unimportant. Structures can and do have an influence over how resources are allocated and managed, and the nature of leadership. We must get them right, if we are to enable the cultures and practice which the Independent Review of Adult Social Care and the Promise, among others, have called for. Moreover, if structural and policy change is a corollary to unlocking the financial and political investment that social care and social work require, then we must engage with proposals constructively. Social Work Scotland members are eager to share their experience and insight in the process of building a National Care Service that works for all. 

For the leaders of social work in Scotland, the National Care Service consultation has provoked some difficult conversations. We are not all of the same view about what represents the best next step for the profession, or what arrangements work best for the delivery of public services. But we are in complete agreement about the essential and unique contribution social work makes to achieving a socially just, healthier Scotland. Social work sits near the heart of social care, and at its best it can knit together separate components into an experience of assistance and support which feels personal and empowering from the perspective of an individual or family.  We will work tirelessly with any partner committed to helping social work achieve that reality for the diverse communities of Scotland.  

The case for change 

In considering the proposals in this consultation, Social Work Scotland members engaged with an open mind, sharing the view of Ministers that change is needed. There has been disagreement with the reasons for change set out in the consultation document, and with the specific changes proposed, but as an organisation we start from a position of acceptance that the status quo is not, nor should be, an option.  

In part this is because the voices of those with lived experience, whether in the case of the Independent Care Review or Independent Review of Adult Social Care, have made clear that changes must be made. But is also because our own members, and other social work and social care colleagues, have for a long while expressed their dissatisfaction with structures, cultures and policies which are often disabling, rather than enabling, of their personal effort and professional judgement. Eligibility criteria and inadequate workforce numbers which preclude them from taking preventative, empowering actions. Bureaucracy and systemic risk-aversion inhibiting them from developing constructive relationships with those seeking and/or receiving support. Legislation which pushes and pulls in contrary directions, or makes demands which the ‘system’ has no capacity to deliver.  

For social work to fulfil its potential, as a body of relationships through which the lives of individuals, families and communities are improved, we need to see change nationally. But the nature of the change needed is different for every local area. This is why our membership have articulated a variety of opinions in response to the consultation; no disagreement that change is needed, but caution about whether the changes proposed by the consultation are the right ones for their local community, or the group of people they support. In other words, no two parts of Scotland engage with these proposals from exactly the same starting point. This is perhaps best illustrated by the debate around children’s social work and social care, where a multiplicity of different arrangements currently exist, each with its own strengths. The consultation’s proposal to extend the scope of a National Care Service to cover children’s social work and social care has, therefore, been viewed by some as a logical continuation of current arrangements, while for others it represents a profound risk to existing partnerships (particularly with education). On balance, our members have concluded that a case has not yet been made for such radical change (i.e. moving children’s social work and social care into the National Care Service). We have reached a similar conclusion on justice social work. However, we are very aware that this conclusion does not preclude change. For all those local areas where children’s social work and social care are part of Health and Social Care Partnerships, a decision not to include these services in the National Care Service will mean significant change. Which is why the priority must be to initiate a national discussion about what the best next step is, in terms of structural arrangements for specific service areas, maintaining meanwhile as a horizon a strong, unified social work profession.           

Structures of accountability, governance and service delivery are just one part of consultation though, and proposals around eligibility and assessment, workforce development, commissioning, scrutiny, implementation and improvement are, among many others, all welcome. The case for change is strong in these areas, with clear potential to make things work better.        

As social work is so integral to Scotland’s various social care systems (e.g. children, adults, older people, etc.), and our social care, health and education colleagues so critical to achieving social work’s objectives, the focus of our members has always been broad and inclusive. We seek change in the whole system, as it is only when the whole system is working well that people and communities will notice improvement.  

But the consultation rightly makes a number of proposals specifically about social work, which we warmly welcome and endorse. Social work is a national profession without national structures. Despite being a statutory role, with legal responsibilities no other professional can fulfil, there is currently no mechanism for national workforce planning, or for the coordination of ongoing learning and development (or to protect the time of social workers to engage in that learning). The variations between local areas, flagged as a matter of concern by both the Promise and Independent Review of Adult Social Care, is baked into the system by there being, among other reasons, thirty-two distinct approaches to social work resourcing and management. The establishment of the National Social Work Agency, distinct from but in close partnership with the National Care Service, can be a means to address these issues. In addition to offering our strong support for the National Social Work Agency, we also advocate strongly in our response for the reaffirmation, through legislation, of social work professional leadership in the management of public services (through Executive Directors of Social Work on Community Health and Social Care Boards, and equivalents within local authorities). Our work around the implementation of self-directed support legislation continues to provide evidence (to add to much already in place from other sources) that the principles and spirit of the legislation are only achievable when professionals and others have autonomy and agency, able to make decisions and hold risk with confidence. That is only possible in areas where senior leaders make that possible for their teams. The principles of self-directed support, as well as duties around prevention and protection, are core to the social work role; the leadership of the profession can help embed them in all the organisations of which they are part.       

Finance  

As the Minister rights notes in his foreword to the consultation paper, “social care is an investment in our communities and our economy, so that everyone can take their part in society”. The Scottish Government’s commitment to significant investment in social work and social care is to be welcomed and applauded. But we are concerned that the additional funding being proposed alongside the consultation, at “over £800m”, will not be sufficient to realise the scale of change outlined by the proposals.  

The Scottish Government has yet to cost some key proposals highlighted by Derek Feeley as necessary to “strengthen the foundations” of social care, around pay increases for social care workers and increased support for Scotland’s now one million unpaid carers, which in Feeley is wider that the “right to respite” in the consultation paper.  (These and other issues are discussed more fully in our supplementary submission on Finance). We estimate that the delivery of commitments already made by the Scottish Government, combined with the specific consultation proposals and other uncosted Feeley recommendations, would require over £1.5 billion of public spending in 2025-26 to realise. This figure assumes the scope of the National Care Service is adult social work and social care; if the scope is broadened costs will increase further, as all areas require investment to address unmet need.    

We were surprised that the consultation paper continued no questions on finance, apart from charging for residential care. Considering how critical the resourcing is to successful implementation of these proposals, this was perhaps a missed opportunity. But we hope in the stages that follow the consultation there will be forums established for consideration of the finance issues, within which we will be constructive participants, making available the information and knowledge we do have about how much it will cost to make the National Care Service vision a reality.    

Social Work Scotland members did note and welcome the emphasis in the consultation document on early intervention and prevention. These are, like protective interventions, part of the statutory role of social work. When we are properly resourced, social workers can directly improve the experience and wellbeing of individuals and families and communities, nurturing strengths and giving meaning to human rights. Such preventative action also has the bonus of helping to reduce or defer the need for more costly action at a later stage. We are eager to work with the Scottish Government and other partners to ensure the National Care Service, and all other structures from which social work operates from. We are keen to make the preventative part of our statutory role our primary focus, including working with others to address the material poverty, inequalities and deprivation in our communities.  

Access & Eligibility 

Reflecting on the substance of the Independent Review of Adult Social Care, and the experiences shared by people working in and receiving support through ‘social care’, this section of the consultation is perhaps the most important. All other sections of the consultation, and all the component pieces of a National Care Service, exist solely to create a safe, enabling context in which to provide care and support for all.  

With that in mind, our response cautions against an overly transactional and consumerist framing to social care and social work, in which all individuals are aware of their needs, are able and willing to articulate them, and eager to receive support. This is not the reality. In some instances individuals with the most acute needs actively avoid and reject the support available to them. Social work and social care are often about navigating the complexities of people’s lives, through a relational approach, to ensure that the needs of an individual are met. The National Care Service’s approach from assessment, eligibility and access through to support must properly reflect this, making possible the principles and standards of self-directed support in every case, not just the few.      

In a similar vein, we are also concerned about the consultation’s reductive narrative on the coordination of support. Care and support can (and is currently) coordinated by many different people, including by individuals themselves. But social work and social care are about more than just ‘care management’. In some cases the social work intervention alone will be all the support necessary, or will link a person into existing networks or in the community. In other cases protective actions may be necessary. The reduction of ‘care and support’ down to a process involving the coordination of various services not only creates risks for the public, it undermines and undervalues social work (and other related professionals) within the system.         

On eligibility criteria, we support a move away from “eligibility criteria in their current form”, but also note that “risk” is not in itself the problem. Risk is a constant and necessary part of our lives, and to engage an individual in determining and managing their own personal risks is the core objective of an empowering social work and social care system. It is important, therefore, that we take this opportunity to fully assess and understand the implications of reforming or abolishing eligibility criteria; we recommend establishing an expert panel to take on the task. It should assess the fiscal consequences of each option, and it should consider the realities of how demand management and rationing works in other services, particularly in the NHS.  

The place of social work within (and beyond) a National Care Service  

Without repeating comments made above, Social Work Scotland supports the establishment of National Care Service, and hopes to see social work at the core of its leadership, planning and delivery, shaping its ethos and culture. Where social work is incorporated into the National Care Service, close attention must be given to how the full breadth of the social work role, encompassing preventative and protective duties, can be realised. We will be eager participants in the coming ‘design stage’, helping to ensure we co-create a context which enables social work to provide the best support and care possible to people and communities. 

However, we seek further discussion and analysis about which specific ‘parts’ of social work should be included in the National Care Service. The commitment of the Scottish Government, supported by most political parties and partners, to establish an National Care Service for adult social care has, to an extent, precluded a discussion about the incorporation of adult social work. Social work and social care are distinct but interrelated things, and we cannot conceive how a National Care Service for adult social care would work without the inclusion of adult social work too. By virtue of the relationships between adult social work / care and drug and alcohol services, and relevant services in prisons, there is a strong case for including these also. But this has presented a profound dilemma for Social Work Scotland’s members. We believe that social work is stronger and more flexible when all its constituent parts (e.g. adult, justice, drug and alcohol, children and families, etc.) are located together within the same structure of leadership and accountability. But on the basis of the case made so far (as set out in the consultation), and mindful of the risks such major reorganisation presents, we have not been able to conclude definitively whether all of social work should be in a National Care Service, or just parts. Our recommendation is that Ministers work with partners, over the next year, to identify and evaluate the risks and benefits of incorporating the various areas noted in the consultation (adults, children and families, justice, mental health services, etc.), as well as others which have not been included but require consideration (e.g. homelessness). We do not reject the idea that inclusion in the National Care Service might facilitate improvement, but more work is needed to ensure that it is, when compared to alternative options, the right next step in the reform of these critical public services. All rely on partnerships between professional groups and services to succeed; reform must strengthen these, not undermine them.   

If, at the conclusion of this policy development process, social work is to be located across different accountability and leadership structures, further detailed work will be needed to clarify how connections between the various parts of social work will be maintained and enhanced, ensuring holistic assessment and support processes, and seamless and positive transitions for those whose care and support will need to move between (or require the simultaneous involvement of) multiple organisations. Social Work Scotland stands ready to assist in whatever way we can.  

Community Health and Social Care Boards 

We welcome efforts to reduce the variation in structural and governance arrangements in Scotland, identifying it as a barrier to developing and scaling up improvement. However, Social Work Scotland members representing all parts of Scotland, and particularly those based in remote and island communities, have called for some flexibility in the model of integration adopted for the National Care Service, to enable local areas to identify structures which work best for their communities, taking into account demographics, history, geography, local economies and existing partnerships.  

On the question of whether Community Health and Social Care Boards should employ other staff, we concluded early on (when considering these proposals) that it would be difficult to achieve the scale and nature of change required without a more radical approach to the employment of certain professions and other key personnel. The scale of the challenge is daunting, but we recommend that all relevant staff involved in the planning, management and delivery of social care, social work and community health are directly employed by the Community Health and Social Care Board, and together constitute the National Care Service workforce. We are not insensitive to the significance of this recommendation. For social work, as well as other groups, it would represent a seismic shift in working arrangements. But while few of our members actively seek disruption and uncertainty around their employment, every one of them are committed to securing the structures and systems that are most likely to deliver consistently high-quality social work, social care and community health services. Form must follow function, and if the objectives of a National Care Service are to be realised (let alone the more ambitious recommendations of the Independent Review of Adult Social Care) we cannot see how the Community Health and Social Care Board model can progress without direct responsibility for the relevant staff. 

Workforce planning, training and development 

Moves to extend and enhance national workforce planning in social care and social work are welcome. In our response we highlight the fact that the ‘social care sector’ is considerably more complicated than the ‘health’ sector, and the approach to workforce planning therefore needs to reflect that, in terms of the resources, staff and time allocated to it. There is also detailed work needed to properly assess current and future demand for social care and social work; framed in the context of rights, choice and empowerment, and taking account of demographic and inequalities data. It is not possible to plan for a workforce without a clear projection of the scale and nature of the work.  

On the training and development structures that flow from, and give effect to, robust workforce planning, we are again supportive of steps which will give social care and social work a national infrastructure through which to design and deliver the necessary changes. A good example of this might be exploring how we better reflect the diversity of our communities in the workforce, through education, training and recruitment, and supporting our existing workforce to look outwards at the changing demography, as well as at our own staff. We do not agree that the National Care Service should ‘set’ training and development requirements; that implies a unilateral authority inconsistent with a reality in which relevant professional groups are overseen by independent regulators, and supported by professional bodies or associations. Moreover, depending on the eventual scope of the National Care Service, certain professional groups will span various employment and accountability structures. Training and development requirements should be determined through collaboration among these bodies, and the National Care Service will have a key role in enabling the implementation of those plans.   

National Social Work Agency 

A National Social Work Agency is no panacea or silver bullet for the challenges facing social work and social care. But for those working in and leading the profession, the establishment of National Social Work Agency is a vital piece in the jigsaw of reform, providing the levers we collectively need to plan, develop and improve social work in Scotland. It should be complimentary to existing bodies, assuming responsibilities that currently no one holds, and bringing greater coordination in areas where various partners have a role but at present no clear lead.  

The current national arrangements for social work are messy and inefficient, with Scottish Government, employers, SSSC, Social Work Scotland, improvement bodies and many others all separately ‘leading’ on aspects of social work’s development. At best the current arrangements serve to hold things together. But if we are to affect the changes in social work systems and practice outlined by the Independent Review of Social Care and the Promise, and which the profession itself has called for, we need to create an enabling context. The National Social Work Agency alone cannot deliver that context, but conversely, the context cannot be created without the kind of functions and leadership a National Social Work Agency will provide. In our response we set out a number of possible benefits a National Social Work Agency might deliver, and we urge Ministers and partners to see the potential and value of this development.    

Please find our full response in the download link (PDF) below.

For further information, please do not hesitate to contact: 

Ben Farrugia
Director, Social Work Scotland
ben.farrugia@socialworkscotland.org 

The impact of the COVID-19 pandemic on equalities and human rights

JOINT SUBMISSION FROM SOCIAL WORK SCOTLAND AND SCOTTISH ASSOCIATION OF SOCIAL WORK TO THE SCOTTISH PARLIAMENT’S EQUALITIES AND HUMAN RIGHTS COMMITTEE INQUIRY

13^th January 2021  

Social Work Scotland is the professional body for social work leaders in Scotland. The Scottish Association of Social Work (SASW) is part of the British Association of Social Workers, an independent membership body for social workers across the UK.  Both organisations work closely with partners to shape policy and practice and improve the quality and experience of social services.  We are responding to this inquiry together, bringing together the views of frontline social workers and managers who are employed in the public, private and voluntary sectors, as well as those operating as independent practitioners. Our joint membership is diverse, and being located across all parts of Scotland, experiences throughout the pandemic have been highly variable, in line with the differences decisions and approaches taken by local areas. We profile in this submission here the common themes to emerge from their feedback over the past ten months.

KEY POINTS

1. While acknowledging that COVID-19 has manifested some new equality and human rights issues, overwhelmingly its impact has been to exacerbate existing inequalities and lay bare the fragility of the systems (services, people) who protect and give meaning to human rights. This is particularly the case for those individuals whose rights were more vulnerable prior to the pandemic, due to age, disability, gender, sexuality, socio-economic status, race and ethnicity, housing security, mental health, etc. Well-resourced public services (such as social work and social care) as well as an active civic society (including charities, voluntary organisations, etc) are essential to the realisation of Scotland’s vision of a rights-based, equal society. Instead, the funding of the social care system has fallen in real terms over the decade of austerity – in the opposite direction to increasing need due to demographic and other changes.
2. The many different dimensions of social inequalities create overlapping layers of disadvantage, which are multiple for many people; these have been tracked by the disproportionate impacts of the pandemic. In managing our ongoing response to COVID-19, and in our “rebuilding better” after, careful attention must be paid to the views and needs of these specific groups, ensuring plans take account of their vulnerability to the virus itself and/or its wider socio-economic and mental health effects, and deal with root causes.
3. Social work is a critical component in many public service systems. In children, adult and justice services, social workers mediate access to a wide range of support (e.g., child and adult social care), deliver specific interventions and protect the interests of those unable to do so independently. COVID-19 has restricted social work’s ability to perform these functions, due to staff absence, work-from-home restrictions, limited PPE (in the early stages of the pandemic) and prioritisation of other urgent issues. As a result of social work being less present and accessible, the rights of some individuals will have been affected. Social workers, with colleagues across social services, have worked tirelessly to minimise this impact, but there are limits to what can be achieved through remote working or with depleted teams. Vaccination holds out the promise of a return to face-to-face interaction and relational work on a much wider scale than is currently possible. However, the impact of COVID-19 on the profession, and the organisations which employ them, is likely to stretch over a number of years. Any plan to re-address the inequities and rights impact of the pandemic must have within it a commitment to address issues impeding the delivery of effective social work practice.
4. The pandemic has revealed the limitations of a ‘rights bearer’ and ‘duty holder’ framing of human rights. Corporate bodies, such as local authorities, may hold duties to uphold rights, but those corporate bodies are in reality just organised groups of people, all with their own needs, vulnerabilities and rights. The response to COVID-19 has, universally, forced employers to consider the welfare of their staff, and the urgency and risk of the work they are involved in. Within the NHS, that has led to the cancellation of operations and delayed treatment for thousands of people. For social work and social care, it has meant, in some cases, reductions in the level of support which can be made available. A realistic appraisal of the impact of the pandemic on rights and equality should highlight the responsibilities of employers to keep their people safe, and the enormous challenges they faced in the early stages, seeking to securing solutions which would enable professionals and others (such as social workers, social care staff and carers) to resume their work.
5. Just as people rely on other people to give meaning to their human rights, the rights of different individuals can sometimes be in tension, or even conflict, with each other. In some cases, an individual’s exercise of their right to put themselves and/or others into potential harm. It is the unique role of social work to assess an individual’s needs, understand their wishes, and to promote their interests and wellbeing within the framework of their human rights and the current service / resource context. Sometimes this involves taking decisions in an individual’s interests which are at odds with their (or a family or friend’s) wishes. Such situations demand a high degree of sensitivity and skill to manage, and are, by their nature, often contentious and emotive. We make this point to underline the importance of taking a broad and nuanced perspective in any evaluation of how human rights have been impacted in the pandemic. Every individual’s story is complex and multifaceted, and understanding comes from a breadth of perspectives.
6. The virus, its impact on people’s health, and the impact of the measures we have taken to contain its spread, have most affected least advantaged in our society (on all dimensions: income and wealth, housing, digital, social, etc). 2020 and 2021 will have served to exacerbate our existing inequalities. Our hope is that, in having these inequalities more clearly surfaced, and a wider proportion of the population made aware, through their own experiences, of the challenges brought about by low incomes, isolation and family stress bring, the public’s appetite for addressing the underlying structural factors will be strengthened.

QUESTION 1: HOW HAVE GROUPS OF PEOPLE BEEN AFFECTED BY THE VIRUS?

In assessing COVID-19’s impact on equalities and human rights it is helpful to distinguish between the effects related to (a) the virus and disease itself[1], and (b) the actions taken by public authorities to contain the spread of the virus and protect vulnerable groups, access to emergency services, etc. Social workers have been involved throughout the pandemic in mitigating the impacts seen in both domains (albeit the majority of our activity has focused on the issues created by state efforts to contain the virus, which have affected every member of society in some way).

(A) Impact of the disease

As has now been well documented, the disease COVID-19 does discriminate. It has, to date at least, disproportionately affected older people, those with underlying health conditions, members of our Black, Asian, and other Minority Ethnic communities, and people with low incomes or precarious employment (e.g., zero-hour contracts). The reasons for this prejudice are various, including, in these groups, higher than average numbers of people living together under the same roof (be it a care home or family home), exposure to the virus through public facing roles (e.g., public transport workers, nurses and healthcare assistants, etc.) and above average rates of pre-existing co-morbidities (e.g., diabetes, obesity, hypertension). These factors coalesce together into an increased risk of catching the virus, and then an increased risk of the virus manifesting a serious or fatal response.

The impact of these increased risks has manifested in many ways, with individuals and families affected by some or all of the following:

Stress and anxiety

• Worry for self and family, about illness and/or social and financial impacts
• Worry about transmission of the virus to loved ones, known contacts, professionals and carers, colleagues, other residents in home or accommodation, unknown members of the public, etc.
• Worry about putting pressure on the health service, reducing its capacity for others.

Loss of income

• Actual reductions in income because not able to work

Loneliness (reduced human contact and self-isolation)

• Reduced in person contact with family, carers and professionals.

Recovered but with “long covid”

• Development of chronic health conditions, impacting on long-term ability to work, participate in education, society, etc.

Time in hospital

• Range of experiences including near-death and trauma, as well as the joy of survival
• Consumption of scare resources including deferment of services required by people with other medical conditions leading to ‘survivor guilt’.

Decline in mental health

• Various psychological impacts, exacerbating existing conditions and provoking new ones.

Death

• Loss of future lives
• Bereavements and long-term loss to loved ones, families, friends
• Financial loss to families and wider society (multipliers, taxation, etc)
• Loss of contributions to society, and local communities

This is not an exhaustive list, but it illustrates that, for those who have caught the virus the potential impact on their human rights cannot be more serious, with loss of mental and physical health, work, and even life. And with the knowledge that the COVID-19 virus does not affect all groups in society equally, but that all groups are interconnected, it is understandable that governments around the world have taken such drastic all-of-society action in their efforts to contain it.

(B) Efforts to contain the virus

The public health measures introduced to slow the spread of the virus only have historical comparators in wartime. Every aspect of life and every individual, family and community has been affected. The scale and severity of restrictions (on the economy, social contact, movement, etc.) has meant that the virus, directly or indirectly, has impacted the rights and wellbeing or every person in the UK. But as with the discriminate impact of the virus, affecting some groups more than others, the impact of efforts to contain it have not fallen evenly on society. As social work practitioners and managers we have had a front-line perspective on this throughout the pandemic; particularly in respect to people who are vulnerable or need additional support, for whom we provide or coordinate services. This includes children, families, parents, carers, adults with disabilities, older people and people involved in the criminal justice system.

Among the many impacts of restrictions over the past year, of particularly note in respect of this inquiry are:

Increased levels of poverty

• Poverty, much of which existed prior to the pandemic, is a key underlying factor for the escalation of crisis in many households[2].
• Financial pressures resulting from insecure or total loss of employment and/or insufficient government support (for example where individuals must self-isolate) has contributed significantly to financial insecurity. The Government’s commitment to free school meals and increased levels of financial support have ameliorated this to some extent, but the medium to long-term impact of increased anxiety within families (and to individuals within those families) may be serious.
• Increase in food poverty (with its concomitant impact on education, health, etc.).[3]
• Increases in applications for welfare and crisis support[4]. Accordingly, social work has faced increased demand for practical support around income maximisation and housing.

Digital poverty / inequality

• Some individuals / families have been able to continue to participate effectively in school, healthcare, routine assessment, etc. thanks to digital connectivity. Indeed for some people the move of many services online has been beneficial, removing the need and cost of travel, etc., and changing the terms of their interaction with professionals. However, for others the move online has meant marginalisation, and the loss of support / a service. The pre-existing ‘digital divide’ – reflecting inequality of access to knowledge, hardware, software, data and support – has been exaggerated, with those most likely to lose out being those already most disadvantaged. Digital connectivity is no longer a “nice to have” when essential services move online.
• The move online has also encouraged new types of financial fraud, increased exposure to on-line sexual grooming and the potential for other forms of exploitation of vulnerable people[5].

Disruption to referral routes for social work and social care

• Because engagement with schools, GPs, hospitals, etc. has significantly reduced, along with home visits by nurses, voluntary organisations, etc., referrals to social work or police for vulnerable children and adults have been disrupted, leading to delays in issues being identified. Early notification of concern is critical to prevent situations deteriorating further, leading to more serious problems.

Disruption to social work, social care and community services

• Social work and social care services entered the pandemic with insufficient capacity to meet demand related to population aging, widening inequalities and growing social care needs[6]. As the pandemic took hold, sickness, self-isolation and re-deployment reduced capacity further. Limitations on PPE, national guidance on home visiting and other factors also impacted on social work’s ability to reach people vulnerable or in need.
• Voluntary sector and community organisations / services forced to close (e.g. day services, etc.), restricting the opportunities available to certain groups, such as those with disabilities, to leave their homes, maintain relationships, etc.
• Public sector and independent (voluntary or private sector) providers of care and support forced to reduce the care packages they can service.

Increased isolation and loneliness, impacting on mental health and wellbeing

• Isolation and loneliness have increased across all sections of the population, with significant impact on mental wellbeing and mental health. However, for individuals and families who were already isolated (as too many older people, adults with disabilities and parents were) the closing of services and reduction of interaction / visits from family, carers, support workers, etc. has exaggerated this further.

Increased pressure within families

• Poverty (be it financial, food, digital, housing) creates stress within families. The government’s efforts to contain the COVID-19 pandemic have increased those pressures within many families.
• Further pressure has been built through individuals spending extended periods of time exclusively together at home, the demands of home schooling, disruption to exams, young people’s lack of access to friends, the general social anxiety about the future, etc.

As with the impacts of the virus itself, this list is far from exhaustive. What we have tried to illustrate is that the restrictions imposed have surfaced the significant inequalities which existed in society before the pandemic. And, moreover, that the fulfilment of people’s human rights relies on a broad base of civic and public services being accessible. This is particularly true for people and families with fewer socio-economic advantages. Remove the scaffolding from around individuals and communities, and the structure is less resilient to major external and internal stresses.

QUESTION 2: WHICH GROUPS HAVE BEEN DISPROPORTIONATELY AFFECTED BY THE VIRUS AND THE RESPONSE TO IT?

• Children and Families:

Children, as a cohort, have been particularly affected because of the disruption to education (from early learning and childcare through all stages of school) and the dramatic reduction in opportunities for play, peer and extended family interaction, creativity, learning, travel, etc. These opportunities, complementing formal learning, shape the adults we become. The absence of school and other child/youth activities has also significantly reduced the chance to identify issues early and offer help. That is particularly problematic for young people’s mental and physical health. The long-term legacy of these COVID-19 months is yet to be seen, but it is children and young people whose lives will be most shaped by it. The world of employment will be changed (possibly with fewer of the sort of jobs young people begin with), and public debt built up to underwrite the government’s response will shape public and political debate for decades to come. At an individual level, disruption to schooling and issues with mental health may determine many future choices.

Within the cohort of ‘all children’, specific groups have been affected more than others. For example, those affected by domestic abuse. Levels of domestic abuse in Scotland have been a persistent concern for social work, charities and policy makers for many years, but on the basis of calls to third sector helplines, the pandemic has led to increased prevalence. This is consistent with what we know about domestic abuse, and its relationship to wider stressors within the family. With services reduced or closed, and people encouraged to isolate as much as possible, we have reduced our collective ability to spot and respond to cases at the early stages. This has limited our capacity to protect the rights of children (and others impacted by abuse within the household). Our experience suggests that much greater support is needed for non-abusing parents and children, and that we must engage much more effectively and assiduously with perpetrators. Many local authorities and organisations were building these strengths-based approach (such as the internationally recognised Safe and Together™^[7]) at the start of the pandemic, but unfortunately work in some areas has had to be delayed to accommodate other priorities.

The true extent of child sexual abuse and child criminal exploitation through the pandemic has been hard to gauge[8], but we expect it to have increased. Third sector colleagues and the police draw attention to the significance of interaction between technology-assisted and direct contact abuse, and with the move of children’s lives online, the increased risks. The pandemic has underlined the need for a closer examination of the context of abuse outside the family, and a consideration of how to intervene in both physical locations and online platforms (a theme explored in a recent Social Work Scotland hosted seminar[9]). More generally, ensuring child protection during COVID-19 has been challenging, with the everyday monitoring provided by schools and other universal services reduced or removed. Social work professionals themselves have been restricted in their ability to interact with families, with reductions in home visits, supervised contact, etc. Colleagues report concerns about patterns of Forced Marriage, Female Genital Mutilation and Honour Based Abuse.

There has also been a disproportionate impact for children involved in the Children’s Hearings System and courts. Permanence decisions have been delayed, existing Orders have been rolled forward without expiry date (meaning that families risk being subject to state intervention longer than necessary), and only priority case have been heard by Children’s Hearing panels, potentially limiting access to services from social work and others. Figures provided to the Scottish Government (as part the monitoring of COVID-19’s impact) indicate that since March 2020 there has been a significant reduction in the number of children becoming looked after away from home.[10] At this stage there is not enough data and intelligence to confirm whether this is as a result of system changes or limited access to resources and not necessarily because of reduced need or better practice. This needs to be explored to ensure that children’s rights are not at risk from inaction.

The challenge of promoting the relationships and wellbeing of children looked after away from home has been accentuated by COVID-19. Social Work Scotland has been central to the development of a framework for decision making about contact[11], assisting practitioners make extremely difficult decisions.  For example, there have been significant challenges around contact, for example between children and birth parents, balancing the benefits with risks, such as spreading the virus to foster or kinship carers (often an older population) or between different parts of the country (which may have different rates of infection and restrictions in place). The limited number of safe physical environments for indoor contact has further restricted options.

Social workers have consistently reported how stretched and affected many kinship and foster carers, and the children in their care, have been, with individuals feeling isolated and disconnected from their normal networks (formal and informal) of support. Local areas have done creative work using virtual support and new models of practical, material help, but for many of these families it has remained a very difficult year. We take heart from the adaptation and resilience the families have shown, and the positive stories emerging of, for instance, effective family group decision making taking place which have kept children out of the care system.[12]

Families with children who have complex physical or learning needs have been particularly impacted by the closure of educational settings, having to assume 24 hour responsibility for care and education. There are specific risks for these families in terms of isolation and burn out without frequent opportunities for support and respite. And for those at or near school leaving age, the crucial transition planning for people with additional support needs (enabling them to make successful moves into further and higher education, or employment) has been disrupted, opportunities restricted.

(B) Adults

Adults living in care homes, whether older people or adults with complex needs, have been disproportionately affected by the virus and the response. In the first phase on the pandemic, there were high levels of excess deaths (compared to the weekly 5-year averages for 2015-19, not all of which were recognised on death certificates as COVID-19 related during the period before testing became more widely available[13].

Some social care workers in residential homes, and also in the community, have also died as a result of contracting COVID-19 through their work, as sadly has been the case for other groups of essential workers.

From a social work perspective, it became increasingly important to ensure that people’s human rights and mental health were being considered alongside (rather than secondary to) clinical excellence and infection control. Issues as varied as discharges from hospitals to care homes, restrictions on visits, limited interaction within homes, mass testing, use of Do Not Attempt Cardiopulmonary Resuscitation forms[14], have all presented complex and nuanced decision making. And they have proved highly problematic for many care homes, especially those supporting people with cognitive needs. The enhanced oversight of care homes duty, placed on Chief Social Work Officers and other professional leaders, was an attempt to ensure a balanced assessment of risks, rights and needs in shaping local strategies. As we write, the vaccination programme is being rolled out through care homes, and we hope this will enable residents to access their rights to see family and friends, and to ensure they get the full range of services and supports they need.

At the core of the social work role is public protection; assessing risks and benefits in an ecological model, with the aim of securing the best outcomes for an individual, with their needs and wishes met and interests protected. In some instances, social workers are empowered to take actions to protect the interests of an individual, possibly bringing them into conflict with the individual or their carer / family, who wish to take a different course of action. This is a difficult but essential role in a society where not all individuals, whether due to incapacity or circumstances, are in a position to determine their best interests alone. And while families have a undisputed right to inform and lead decision-making in such instances, it is the case that they do not always have access to all the information, or necessarily have the rights, needs and interests of the individual as their primary concern. Over the course of the pandemic, with the social work profession’s ability to perform this role has been restricted, leading to concerns about the welfare of such as for adults with incapacity. Due in reduced reporting channels (fewer agencies and primary care contact with people and families at risk of crisis) and restrictions on movement and interaction, it has been difficult in some cases to ensure the rights and welfare of some individuals’ are being maintained.

Early intervention and community supports are critical to maintaining good mental wellbeing and mental health. Where these are not available, we can expect to see more people reaching mental health crises. This is likely to be compounded where the economic situation is worsened. With people’s mental health needs going unmet, detention – a deprivation of an individual’s liberty – is being considered more frequently than we, as a professional group involved in such decisions, would like to see it. As officers of local authorities within partnership arrangements, Mental Health Officers (specialist social workers with additional qualifications in mental health) are not sufficiently empowered to ensure provision meets assessed need. To ensure the rights of individuals with mental health issues are upheld, MHOs (and other relevant professionals) need access to specialist and community resources, over which people are offered choice and control. We believe that decisions regarding detention should be made after face-to-face assessment of patients, but we are aware that due to staffing constraints, this is not always the case.  Whilst the number[15] of people being detained due to their mental health has risen during the pandemic, this is in line with year on year rises. There is evidence, however, from the Mental Welfare Commission that some of the safeguards around detention have been used less frequently than previously. We are concerned about the critical shortage of both MHOs and “Section 22” medical professionals.  We note that the Tayside Independent Review report “Trust and Respect” was explicit in finding that a shortage of Registered Medical Officers impacted detrimentally on the patient’s journey.

People who are homeless initially benefitted from the programme to ensure that everyone was off the streets, and the route map for “Everyone Home”[16] has been developed to make asking about homelessness an expectation across public services.  However, in order for this success to stand beyond the pandemic, public services must continue to be resourced appropriately to attend to the multiple underlying structural causes of homelessness (including additions, mental health, debt, etc.). Otherwise, we risk returning to pre-pandemic levels of homelessness (or higher, considering the precarious financial situation many people face), with the additional challenge of a diminished voluntary sector, its finances limited after a year of reduced income.

(C) Adults involved in the justice system

Justice Social Work delivers reports to Scottish Courts, provides or commissions community-based programmes as an alternative to prison, and is responsible for a range of expert risk assessment support to the police, prison service and Parole Board.  Requirements for physical distancing, and the universal impact on staffing through sickness, isolation and redeployment, have reduced the ability of justice social workers to deliver group programmes and coordinate unpaid work activity. This has a very significant impact, in terms of rights and equalities, on the individuals subject to relevant courts orders, effectively extending sentences and prolonging involvement with the justice system.

Both Social Work Scotland and SASW[17] have articulated concerns to the Scottish Government around the backlog of community order ‘unpaid work’ hours[18].  We believe that without a systematic reduction in the number of outstanding unpaid work hours (through revocation or variation of orders) there is a major risk that Justice Social Work (JSW) will be overwhelmed, with serious consequences for the wider justice system and the rights of both social work professionals and individuals and families, and victims. Whilst some funding has been made available to buy in support from the Third Sector, this will not release the number of hours necessary to meet the backlog in demand.

Before the Coronavirus pandemic there was an increasing focus on expanding early intervention measures such as Diversion from Prosecution and Structured Deferred Sentences which help individuals to avoid unnecessary contact with the criminal justice system and deliver swift interventions which can interrupt a cycle of offending. Many of the strategies now in place to deal with the backlog within the justice system require heavy input from CJSW, but simultaneously the capacity of CJSW has reduced[19].

People in prison have experienced significant additional curtailments to their rights as visits, time out of cell, meaningful daily activity and access to fresh air have all been reduced.  Numbers of people on remand have increased as has the length of time people are remanded impacting on people’s lives, housing, work finances and relationships. Children who have a parent or sibling in prison will experience the removal of the person from their lives in a more extreme way than even prior to the pandemic.

QUESTION 3: HAVE THERE BEEN SPECIFIC EQUALITY OR HUMAN RIGHTS IMPACTS ON GROUPS OF PEOPLE AS A RESPONSE TO THE VIRUS?

The Scottish Human Rights Commission (SHRC) recently published a report into changes to social care provision during COVID-19 and its impact on human rights[20].  It details the experiences of individuals receiving health and social care support, with a focus on the rights of persons with disabilities, older people, carers and children. The testimony of many of those who participated in the research is distressing, highlighting the serious consequences for individuals when support cannot be accessed.

The context around these experiences were the efforts of NHS, local authorities and independent care providers (working together as Health and Social Care Partnerships) to ensure support was available to meet all assessed (and anticipated) need, within safe staffing levels. Plans took into account high rates of staff absence, due to sickness and isolation. The restrictions, and necessary steps to protect staff, meant that many social workers and social care staff would be limited in their ability to work. The focus was on protecting critical services for those most in need. However, the timeframe for how long this would be needed was not clear at the outset, and the working assumption was that measures to reduce care packages for some (to ensure some access for all) would be required for weeks, not months. It is clear now that the impact of these measures varied across Scotland, reflecting different levels and types of pre-pandemic service provision and workforce demographics. But in all areas of Scotland those requiring social care support, and those caring for them, have been disproportionately affected by the pandemic because of the limits the reductions of support place on an individual’s independence (beyond the national restrictions everyone has had to adapt to).

Because many face-to-face support services such as day centres and support groups had their operations significantly reduced as a result of public health requirements, the pressure of continually caring for people during the crisis will also have had an effect on the wellbeing of carers. Carers who support their family members or friends to live independently have experienced isolation and reduced support, with many increasing their caring hours to protect the supported person from additional footfall into their homes and related risks of exposure to the virus.

The SHRC report calls for the social care system to be reimagined as a dynamic interplay within a social infrastructure which supports citizens’ human rights as individuals within families and communities. SASW and Social Work Scotland agree strongly with this vision, but take this opportunity to emphasise that it is only possible when the system is populated by sufficient numbers of skilled people, committed and enabled to deliver the best outcomes for individuals. Such a system, requiring a significantly larger ‘workforce’, is not possible within current funding levels. A return to pre-COVID-19 structures and mechanisms of support, even if funding were increased, would not address the issues flagged by the SHRC report.

It is likely that one of the effects of the pandemic will be to increase the number of people needing health and social work and social care support as a result of:

• The immediate impact of illness, loss and grief and trauma
• The economic impact which may mean more individuals and families experience derivation and poverty which is a key factor in bringing people to social services
• The longer-term impact of long-covid, the reduction in planned health treatment and the need for physical distancing reducing opportunities for preventative and early intervention means that more people will have higher levels of chronic physical, mental health and social needs.

We take heart from examples highlighted in the Care Inspectorate’s report, ‘Delivering care at home and housing support services during the COVID-19 pandemic’[21], where local partnerships successfully adapted and flexed their support to meet people’s needs during the pandemic. Teams in local government and the voluntary and private sectors have innovated and adjusted, put people’s needs before contractual hours. The capacity for change and positive reform is in place, and we look forward to the upcoming discussions about how to realise that, in response to the Independent Review of Adult Social Care.

Question 4: What do the Scottish Government and public authorities (e.g. local authorities, health boards etc.) need to change or improve: as a matter of urgency & in the medium to long term?

This question frames a critical debate in an unhelpful way. Locating responsibility for change and improvement solely with Scottish Government and public authorities not only presumes that they have the capacity / resources to effect changes, it encourages us all to see the problem as ‘theirs’ to resolve. The issues we have profiled in this response, such as poverty, structural inequalities and the public-civic infrastructure which give effect to people’s human rights, can only be addressed through both political and societal action. As with climate change, or changes to consumption that limit our impact on biodiversity, public authorities of all kinds are key players. But in democracies like Scotland, they move and act within a space we, the public, give them. Calling for public authorities to effect changes that will require significantly more resources, without our clearly accepting the need to provide those resources (through taxes, government borrowing or reallocation of existing spend), will simply perpetuate the public policy debates we have had for the past ten to fifteen years.

The funding of social care

Social Work Scotland and SASW are particularly concerned about the impacts of the deepening financial crisis in social care, which we have highlighted recently in our respective submissions to the Independent Review of Adult Social Care (IRASC).  The crisis also exists in children and families social work services, and criminal justice social work, which are not within the scope of the Independent Review of Adult Social Care.

Adult social care spending per head in Scotland has fallen dramatically for Scotland’s older people, less so in England but more than it has in Wales (see graph in download here).

Spending per head on adults aged 18-64 – mainly people with learning disabilities or physical disabilities, or in need of mental health support — has fared better, but in Scotland is back to the 2010-11 levels whilst the numbers of people living with disabilities, or with mental health problems, have both increased in Scotland, as in the rest of the UK. (The figures in the graph come from the Treasury’s Public Expenditure Statistical Analyses 2020).

Social Work Scotland’s submission to IRASC on Demographic Change and Adult Social Care Expenditure in Scotland ^[22]is mostly concerned with the Scottish Government’s own H&SC Medium Term Financial Framework (2018), which estimated the increased demands at 3.5% for adult social care as a whole, and 1% for the NHS.

We found that the estimated additional spend on 3.5% per year for adult social care is well supported by research in England by the London School of Economics using sophisticated modelling from survey data not available in Scotland.  That also shows that the additional demand for services for younger adults with a learning or physical disability, due largely to improved longevity, is at similar annual percentage increases as demand from older people.

However, our analysis does not support the lower increases for the NHS in the H&SC Medium Term Financial Framework – these are 1% per year for demography, compared to estimates by the Institute for Fiscal Studies of 2.2% per year for England and the UK as a whole (in their major study Securing the future published earlier in 2018).

Our analysis also does not support the annual workforce increases set out in the Scottish Government’s Integrated Health and Social Care Workforce Plan for Scotland published in December 2010, which stated that:

The Scottish Government’s Medium Term Financial Framework (MTFF) estimates that to address the effects of demand, we will require 1.3% per annum more NHS employees and 1.7% per annum more social care employees in the period to 2023/24”.

Those figures cannot be found in the MTFF and, we believe, are incorrect. In any event, Scottish Government funding to councils for adult social care has not been increased to the level required to meet demography, yet alone address the unmet need that has accumulated for survivors of the decade of austerity. Increased funding for social care needs to fully recognise the impacts of demographic change, in line with the Scottish Government’s own medium-term planning, and on a corrected basis for the NHS in Scotland.

The role and status of social work

Social work is one of the few ‘key worker’ professions which is, when able to operate as conceived, proactive and person-led. It exists (and in legislation is empowered) to take action in defence or support of people made vulnerable by their circumstances. Those we work with may be less likely to be heard, and may struggle to stay afloat when the scaffolding of support is stripped away (as it has been during COVID-19). Social work sees people in their own individual context, recognising that an individual’s relationships, strengths, interests, etc. constitute the person, and that to give meaning to their human rights is to reinforce and promote those assets. But we must also balance individual rights with those of others, and consider the risks of certain actions to the individual themselves, their families and wider society. Our role must be to enable those people to have a voice, and to provide protective support or intervention where that becomes necessary.

As illustrated above, before COVID-19 social work (and the wider social care system it underpins) was already facing significant financial constraint; demand and aspiration not matched by available budgets. The 2019/20 COSLA report Investing in Essential Services, highlighted the challenges local authorities face to meet the outcomes and targets identified in the national performance framework within existing resources, referencing specifically child poverty and vulnerable adults[23]. The strain that the social care system is under, and the conditions in which care professionals must practice, has been well documented in a range of reports from academics and institutions. The latest such report from the University of the West of Scotland (UWS) (Decent work in Scotland’s Care Homes) highlights a sector facing ‘systemic issues, a lack of respect and in need of cultural change’[24].

Within the current landscape, social work professionals – trained to respect and uphold human rights and work alongside individuals and communities (balancing and holding needs, risks and interests) – find themselves working in systems which can force them to be ‘assessors’ of risk and gatekeepers to over-rationedrvices.[25]  This not only means we fail to realise the human rights and outcomes potential of social work, but we slowly erode the enthusiasm and commitment of the professionals themselves.

While there has been positive innovation, acceleration of developments and much useful learning from the past year, the pandemic has made it harder to work alongside people and families at the challenging points and transitions in their lives. This has posed a unique challenge to social work, which is support based within and upon relationships. Feedback from our members has highlighted a number of further issues for the profession, limiting our ability to provide support and services and significantly affecting the working conditions and wellbeing of social workers. We would welcome any opportunity to discuss this further with the Committee.

Social Work Scotland’s Chief Social Work Officer (CSWO) committee has reported that the pandemic’s impact on the social work profession has been to compound pre-existing issues. These include dealing with real term reductions in budgets (which in turn increases workload on individuals), difficulties in recruitment, lacking visibility and authority in key decision-making forums, the disparity in social work and social care’s pay and conditions between health and social care partnerships. The split professional leadership across adults, justice and children and families is also seen, by some, to weaken oversight and coordination.

In July 2020 the Social Workers’ Union[26] reported that one third of social workers are considering leaving the profession as a direct result of the pandemic. The union released an action plan calling for increased mental health support, a social work recruitment drive and a pledge not to re-introduce austerity measures post-pandemic.

As we move through and, hopefully, out of the pandemic, we would like to see and contribute to a re-imagining of the role and functions of public services. People are not simply ‘rights holders’ and professionals (such as social workers) are not simply ‘duty bearers’; we are all people, facing the challenges presented by the context, trying to deliver the optimum outcomes for individual and society, while having to balance competing interests, rights, demands and priorities. Similarly, public services must embrace greater creativity in how they support people to give meaning to their human rights and find genuine wellbeing. That will require a workforce who feel equipped and empowered to do what they were trained to do. The Human Rights Taskforce due to report in March 2021 will, no doubt, be considering a range of ways that public services and others can achieve this, and the Independent Review of Adult Social Care and The Promise are re-imagining support services for key groups.

For further information, please do not hesitate to contact:

Flora Aldridge

Social Work Scotland

Flora.aldridge@socialworkscotland.org

Emily Galloway

SASW

Emily.galloway@basw.co.uk

[1] See World Health Organisation website: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

[2] https://www.basw.co.uk/media/news/2020/oct/port-storm-poverty-aware-social-work-pandemic

[3] https://www.trusselltrust.org/2020/09/14/new-report-reveals-how-coronavirus-has-affected-food-bank-use/

[4]https://scotland.shelter.org.uk/__data/assets/pdf_file/0008/1934099/Shelter_Scotland_briefing_LGCC_Homelessness_and_Covid_140820.pdf/_nocache

[5] IBID page 91

[6] See Social Work Scotland supplementary submissions to the Independent Review of Adult Social Care: https://socialworkscotland.org/wp-content/uploads/2020/11/SWS-Supp-Sub-1-DEMOGRAPHIC-CHANGE-AND-ADULT-SOCIAL-CARE-EXPENDITURE-IN-SCOTLAND.pdf; and https://socialworkscotland.org/wp-content/uploads/2020/11/SWS-Supp-Sub-2-ASC-EXPENDITURE-IN-THE-DECADE-OF-AUSTERITY.pdf.

[7] ABOUT THE MODEL – Safe & Together Institute (safeandtogetherinstitute.com)

[8] https://www.scra.gov.uk/2020/10/sexual-exploitation-of-children-new-research-report/

[9] https://socialworkscotland.org/contextual-safeguarding-event-2020/

[10] Coronavirus (COVID-19): children, young people and families – evidence and intelligence reports (various)

[11] https://socialworkscotland.org/publication/connections-for-wellbeing/

[12] The IRISS summary of a University of Edinburgh/City of Edinburgh Knowledge exchange project illustrates the value of this rights based approach in the most urgent of circumstances https://www.iriss.org.uk/sites/default/files/2020-06/recognition_matters_briefing_june_2020.pdf

[13] National Records of Scotland: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/weekly-and-monthly-data-on-births-and-deaths/deaths-involving-coronavirus-covid-19-in-scotland (Week 53)

[14] OLDER PEOPLE BEING PRESSURISED INTO SIGNING DO NOT ATTEMPT CPR FORMS – JOINT STATEMENT FROM AGE SECTOR ORGANISATIONS | Media | Age UK

[15] Detentions for mental health care during the pandemic – new report | Mental Welfare Commission for Scotland (mwcscot.org.uk)

[16] route-map-4.pdf (everyonehome.scot)

[17] Letter for Humza Yousaf, MSP, Cabinet Secretary for Justice from SASW | www.basw.co.uk

[18] https://socialworkscotland.org/briefings/reducing-the-backlog-of-unpaid-work-hours-coronavirus-scotland-act-2020/

[19] https://socialworkscotland.org/consultation/pre-budget-scrutiny-2021-22-justice-committee-call-for-views/

[20] https://www.scottishhumanrights.com/media/2102/covid-19-social-care-monitoring-report-vfinal.pdf, Chapter 3, page 15

[21] https://hub.careinspectorate.com/media/4171/delivering-cah-and-hss-during-the-covid-19-pandemic.pdf

[22] https://socialworkscotland.org/wp-content/uploads/2020/11/SWS-Supp-Sub-1-DEMOGRAPHIC-CHANGE-AND-ADULT-SOCIAL-CARE-EXPENDITURE-IN-SCOTLAND.pdf

[23] https://www.cosla.gov.uk/__data/assets/pdf_file/0021/14808/cosla-investinessentialservices.pdf

[24] https://dwsc-research.org/wp-content/uploads/2020/12/Decent-Work-in-Scottish-Care-Homes-Report-Final.pdf

[25] https://www.sehd.scot.nhs.uk/publications/DC20011129CCD8single.pdf

[26] SWU: Social Work’s Six-Point Urgent Action Plan | www.basw.co.uk

Domestic Abuse (Protection)(Scotland) Bill SWS response

Domestic Abuse (Protection)(Scotland) Bill SWS response

4 December 2020

Email contact: James Cox, Children and Families Lead, Social Work Scotland and Lorrette Nicol, Social Work Team Manager for the JII Project, Social Work Scotland

The Committee welcomes your views on any issue relating to the Bill. This could include views on any of the following areas or questions:

Support for the Bill in general and the main provisions

1. Do you agree that a senior police officer should be able to impose a short-term Domestic Abuse Protection Notice (DAPN), without first seeking court approval, as proposed in sections 4-7 of the Bill? If so, what advantages would a DAPN have over the existing police and court powers?

Yes. Use of the Domestic Abuse Protection Notice would allow for significant protective measures to be put in place until it would be possible to apply for these via the Courts. The step might be taken by the police as urgently as necessary – for example at night.

2. Do you agree that the civil courts should be given powers to make a Domestic Abuse Protection Order (DAPO), as proposed in section 8-16 of the Bill? If so, what advantages would a DAPO have over the existing police and court powers?

Yes, Social Work Scotland agree with such powers, which would allow the Court to tailor the DAPO to the specific requirements of the case under consideration.

• It is likely to be protective of a woman who is at heightened risk of punitive action by the abuser if she takes the initiative, in that that an DAPO  would not be sought by the woman but by those taking on responsibility to protect her.
• The use of an DAPO could give some much needed space in which a woman could be supported in consideration of safety and options for herself and her child(ren).
• Social Work Scotland recognise that domestic abuse is the major cause of known women’s homelessness in Scotland. There are likely to be many instances of homelessness caused by domestic abuse that are not recorded as such. It is contrary to the rights, safety and wellbeing of women and children to be be pressured to leaving their home and move to refuges or temporary homeless accommodation for lack of alternative options. We therefore believe this step to be a practical support for one dimension of Scotland’s Homelessness action plan, Ending Homelessness Together.
• Lack of recourse to Legal Aid would not prevent a woman being protected by such an order.
• DAPOs would be congruent with Scotland’s Equally Safe strategy
• DAPOs would  be compliant with the European Convention on Human Rights (“ECHR”) Articles 2, 3.
• DAPOs would be in line with expectations within the Council of Europe Convention on Combating Violence Against Women and Domestic Violence (the Istanbul Convention), for example within  Article 52, which recommends that parties to the Convention have provisions for DAPOs.

Extension of the provisions to other types of family relationship or circumstance

3. Section 1 of the Bill requires the two people covered by the DAPN or DAPO to be spouses, civil partners or in an ‘intimate personal relationship’ with each other. In addition, the suspected perpetrator must be aged 18 or over and the person at risk must be 16 or over. Do you agree with this overall approach or do you wish to suggest any changes? In the Domestic Abuse Bill, that is currently making its way through the UK Parliament, a broader approach is proposed for England and Wales, extending to other family relationships and people sharing a house in other circumstances.

Social Work Scotland agree with this approach.

Other protective action may be supported by other legislation such Children’s Hearings (Scotland) Act 2011 for children and the Adult Support and Protection Act (2007) for vulnerable adults.

The Domestic Abuse (Scotland) Act 2018 does also provide for protection of children living in the house.

Processes to be used for imposing a notice or granting of an order, timescales and the role of the police

4. Under section 8 of the Bill only police officers would be able to apply to the court for a DAPO. Do you agree with this approach or do you think the power to apply should be extended to other individuals or organisations? If the latter, who would you wish to include?

Social Work Scotland agree with this approach.

5. Do you agree with the tests (set out in section 4 and section 8 of the Bill) which must be satisfied for the making of a DAPN and a DAPO respectively?

Social Work Scotland agree with these tests.

6. Do you support the definition of ‘abusive behaviour’ (in sections 2 and 3) which is a key component of those tests?

Yes. This definition is helpful in that it recognises the complexity of domestic abuse.

7. Under the Bill, a DAPN lasts until a DAPO (or interim DAPO) is made. A DAPO can last for a maximum of three months. Do you agree with the proposed maximum periods the DAPN and DAPO can last for?

Consultation within Social Work Scotland has not led to categorical views on the appropriate maximum length of a DAPO, which is affected by variables such as the length of time it may take for other remedies to be considered, applied for and heard; the need to avoid potential gaps in protective provision if they are needed; while at the same time protecting rights of the barred person and ensuring fair process for all.

8. Do you agree that breach of a DAPN and breach of a DAPO should be a criminal offence, as proposed in sections 7 and 12 of the Bill? Do you support the penalties proposed for breach of a DAPN and breach of a DAPO?

Social Work Scotland agree that a breach should be a criminal offence. Views have not been expressed on the proposed penalties.

The content of the notice and order – including how the Bill impacts children

9. Sections 5 and 9 of the Bill says which obligations a DAPN and a DAPO can include. As well as obligations relating to the person at risk’s home and contact with the person at risk, both a DAPN and a DAPO can impose obligations relating to a child usually living with a person at risk. Do you agree with the approach of the Bill under sections 5 and 9 or do you wish to suggest any changes?

Social Work Scotland agree with the approach of the Bill.

10. Do you think the Bill is clear about what should happen when the terms of a notice or order conflicts with an order relating to children imposed under family law?

This could be made explicit. The need to take in to consideration the welfare of any child whose interests are affected is made clear

Removal of a domestic abuse perpetrator’s interest in a Scottish secure tenancy

11. Do you agree with the approach in section 18 of the Bill, introducing an additional ground to end a social housing tenant’s interest in a tenancy? If so, what benefits does this power have over and above existing statutory powers?

Yes. We consider it probable that, as intended, this will reduce the risk of a person at risk having to make themselves homeless in order to escape abuse from someone living with them and to give them interim protection so that they have time to seek longer term remedies if needed.  We recognise that this will work by giving social landlords new powers to apply to the court to end the tenancy interests of the perpetrator if the perpetrator is a sole tenant, a joint tenant with the victim, or a joint tenant with the victim and others. Survivors of abuse should therefore be able to continue to live in the family home.

Additional issues not covered by the above

Your response does not need to cover all of these areas and you can focus on those that are relevant to you or your organisation. Also, you are welcome to cover other areas in your submission that you think are relevant to the Committee’s consideration of the Bill.

12. If you are responding on behalf of an organisation, what impact (if any) would the Bill have on your organisation? Is there any issue associated with the Bill you wish to comment on, not already covered by questions 1-9?

There is likely to be an added flow of direct family social work follow up contact which could be triggered and immediate assessment or support needs which were not previously obvious. This would be positive as it brings those needs to the fore, but there could be associated resource implications.

Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill: Letter from Social Work Scotland

HEALTH AND SPORT COMMITTEE

FORENSIC MEDICAL SERVICES (VICTIMS OF SEXUAL OFFENCES) (SCOTLAND) BILL: LETTER FROM SOCIAL WORK SCOTLAND

05 June 2020

RE: Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill

Dear Convener,

Thank you for your letter of 21 May, inviting Social Work Scotland’s response to Committee members’ questions arising from evidence provided by Children 1st. The evidence provided by Children 1st raised a number of important issues, and we take this opportunity to make explicit our broad support with much of what was said by Chloe Riddell. Fragmentation of children’s experience across multiple policy domains makes it harder to provide the joined-up, multi-agency response (underpinned by shared values and principles) which children need, and which Getting it right for every child seeks to deliver.

We have attempted to answer the Committee’s questions fully below but please request clarification or further information where necessary.

Q1. What are your views on the general principles of the Bill in relation to children and young people?

In our letter to the Committee of 26 February 2020 we welcomed the Bill’s provision for 16 & 17 year olds to self-refer for a forensic medical from a Health Board, on the basis that it represented an improvement on current arrangements. More generally, we support the Scottish Government’s objective of ensuing children have access to the healthcare and holistic support necessary for recovery, irrespective of when child sexual abuse is disclosed (e.g. through the development of the Clinical Pathway for Children and Young People).

However, although we strongly support the principles of the Bill in respect of adult victims, and of the Bill’s provision for self-referral for individuals over the age of 16 (ensuring they can access a forensic medical examination, treatment and support without delay), our primary consideration remains children’s welfare and wellbeing.
In this respect, the interface of this Bill’s provisions with child protection processes is of particular importance. In our view the professional responsibilities (including those of all health clinicians) to safeguard the wellbeing of children cannot be overemphasised. Anything which risks undermining or confusing those responsibilities should be reassessed. The Bill itself, as currently drafted, does not
itself undermine those responsibilities. But as noted in February, we are concerned that in implementation (the translation of this Bill from its intentions to reality) it may unintentionally do so.

Scotland is progressing reform of its children’s policy framework across multiple fronts simultaneously, but not always in coordination with each other. Taking each item on its own Social Work Scotland is often broadly in agreement with the objective. But the failure to properly consider the interdependencies between some agendas, particularly in respect of how they will impact on systems, practice and professionals on the ground, does cause us significant concern. Moreover, not all agendas are equal in their structural significance, and in our view a number of developments cannot properly proceed before others are concluded. We have in mind specifically the renewal of the national child protection guidance, the principles and processes of which must underpin other relevant systems. Ideally, work on
updating the national child protection guidance would be brought to a conclusion before other policies are progressed.

We recommend that it is explicit, either in the Bill or accompanying documentation, that in provision of forensic medicals to 16 & 17 year olds child protection remains a paramount consideration, and in the exercise of professional judgment about whether significant harm has been experienced (or is at risk of being experienced) communication with social work and police will likely be necessary. The benefit of
such a discussion would be to situate the information about the young person’s experience in context, enabling a better understanding and assessment of risk and need.

Finally, while we understand that the focus of this Bill is tightly defined to sexual abuse, other forms of abuse (such as physical abuse and neglect) also involve for medical examinations / investigation, and the need for effective coordination is essential. Other medical examinations are currently provided for through the National Health Service (Scotland) Act 1978 and a Memorandum of Understanding between
Health Boards and Police Scotland. This Bill does not preclude child centred coordination between agencies concerned with the safety and wellbeing of the child or young person, but accompanying documentation could be strengthened to emphasise its importance. Those who conduct joint paediatric and forensic examinations following alleged sexual abuse may also find evidence of neglect and
physical abuse and other urgent health needs; that holistic assessment must be available to all children, including those who are 16 & 17 and self-refer under these Bill’s provisions.

Q2. Would you would like to see any additional provisions in the Bill and if so what they should cover?

As stated above, our main commentary on the Bill relates to need for professional judgement to be exercised with a clear consideration of the need to share information with partners (e.g. local authority and the police) in order to determine whether the individual’s experience is indicative of significant harm, or the risk of significant harm. From there, appropriate steps can be taken, if necessary, to
support and protect the individual.

Q3. Do you consider that the provisions in the Bill support the Barnahus approach? Is the Bill Barnahus ready?

Barnahus is recognised as an internationally leading approach to responding to child victims and witnesses of abuse. Among the core components of the approach are:

• Ensuring that the best interests of the child informs practice and decisions;
• That the right of the child to be heard is fulfilled without repeating interviews;
• That the child is interviewed and supported by specialised and competent professionals, in such a way that it does not re-traumatise them and which provides best evidence obtainable at the time;
• That interviews and examinations are carried out in a multidisciplinary environment in one child-friendly premise, offering support to the child and caregivers without undue delay and in which they can begin the process of sharing experiences safely;
• That the child is not obliged to appear in court, avoiding the need for traumatic cross examination.
• Working within a co-ordinated plan that provides such therapy and support as may be needed

The Bill does not prevent these aims from being realised, but similarly it does not obviously facilitate them either. In respect to interviews and examinations being carried out in a multidisciplinary environment, within one child-friendly premises, it could be argued that the Bill, by encouraging greater investment and specialisation within certain NHS locations, makes that aspiration more difficult.
However, it is acknowledged that Barnahus’ development is still at an early stage in Scotland. The first detailed indication of how a Barnahus might operate in Scotland will be provided by the pilot taking place in North Strathclyde, bringing together a partnership of police, health, social work, family support, courts and many others.

The House will have facilities to record evidence and provide children with access to support to recover, as well as to participate in protection and safety planning. The plans include development of facilities for forensic examination of all forms of abuse, including forensic medicals, meaning the children referred would not need to go to hospital (unless it was a particularly complicated or urgent case where a hospital
setting was required).

While the Bill’s establishment of a statutory duty on Health Boards to provide forensic medicals is compatible with Barnahus, it does not address fundamental issues around the coordination of services necessary to deliver a holistic assessment. For this Bill to be facilitative of the Barnhaus approach, we would suggest that it needs to attend to how Health Boards contribute to multi-agency, team-around-the-child processes.

Q4. What changes could be made to ensure that there aren’t any unintended consequences in relation to the development of a Barnahus approach?

Delivery of an effective Barnahus approach will depend on prompt and careful collaborative discussion between many organisations / agencies, so that all the component parts of examination, interviewing and care are co-ordinated and delivered promptly and properly. The way this will work for a 16 or 17 year old selfreferring for a forensic medical requires careful consideration. An unintended consequence we want to avoid is 16 and 17 year olds who may face significant ongoing risk not having the same opportunity for protective investigation, action and support as other children (including, in time, accesses to a Barnahus).

Q5. Would you prefer children to be included in this Bill or addressed in separate legislation?

Children are considered in this Bill in relation to the need for forensic medical examinations under the Age of Criminal Responsibility (Scotland) Act, and in relation to self-referral for young people over the age of 16. We think it is important these sections remains. However, it may be appropriate within this Bill to recognise the necessity for appropriate co-ordination of services in relation to the investigation of
abuse, and the necessary steps to protect the safety and wellbeing of children affected.

Q6. Do you consider that the provisions in the Bill to restrict self-referral of forensic medical examinations to young people over the age of 16 are appropriate?

We recognise the difficulties that many children and young people have in coming forward to share their experience. We must do everything possible to ensure a careful, co-ordinated and trauma informed response when a child does signal for help. This signalling may occur gradually or suddenly (often in the midst of crisis). What does or does not emerge is often determined by the sensitivity of the listener
and the degree of emotional and physical safety experienced by the child. The pace, place and skill with which our response is conducted are critical for protection and recovery.

In our view, where there are concerns that a child (including 16 and 17 year olds) may have been subject to sexual abuse, inter-agency sharing of information within child protection processes should apply. In order to consider the best possible conduct of investigation, action and support, information must be shared early. We support the Bill’s option of self-referral to age 16 in the hope that this will widen the
bridge to access to services for some who would not otherwise have come forward. But our primary interest here is in how we respond and protect any child who has been subject to abuse, regardless of their age.

Q7. Should the age at which self-referral services are available be lowered or raised and why?

We have been generally supportive of the Bill’s provision for self-referral at age 16, on the basis that other legal structures (including the age of consent) use this age. But while we do not believe chronological age is an accurate reflection of a child’s capacity and maturity, we would not support lowering the age of self-referral further. This is because we would not want to give a false impression to children under the age of 16 that their self-referral would be kept confidential in any circumstance. The
requirement of forensic medical for an under 16 would necessarily require the initiation of child protection processes, and any move which made that unclear to children or professionals should be avoided.

Sexual abuse and the associated abuse of power is so often enabled by secrecy. Secrecy is sustained by fear. Some children and young people seeking help do not want police involved because of threats from perpetrators; threats of violence or other serious consequences to themselves, or those they care for. However, a child’s fear of involving the police or social work is not a reason to deflect from a careful, thorough inter-agency response, which places children’s interests and views at its core. Our collective focus must be on ensuring children of any age feel confident to disclose to someone they trust, and that our response is joined-up and supportive, redressing (rather than exacerbating) their trauma. Our system must also be equipped to spot the signs of significant harm, and take appropriate action as
early as possible.

Q8. Is there a possibility that the promotion of self-referral for those aged over 16 may unintentionally act as a barrier to younger victims?

We do not believe the promotion of self-referral will act as a barrier, so long as the routes of referral / raising concern are clear and effective for younger victims. The barriers to younger victims are more likely to relate to the failure of individuals in positions of trust and responsibility to listen and attend to the signals and signs of distress (or beginnings of an account given to whomever is trusted enough to listen).

Q9. Would there be any situations when self-referral for people under the age of 16 would be appropriate?

Please see our response to question 7.

Q10. Are the provisions in the Bill, or should they be, in line with child protection guidance?

National child protection guidance is currently being updated. Our answers to questions above, relating to the sharing of information among professionals, highlight where we think the Bill (or perhaps more pertinently the Bill’s accompanying documentation) could be improved.

Q11. If the expectation is that a self-referral by a 16 or 17-year-old may initiate child protection processes, why should the self-referral provision not extend to people under 16 years old?

Please see our response to question 7.

Q12. Are there specific issues that relate to looked after children, over the age of 16, in accessing self-referral services?

The legal status of the child should not affect their access to any medical services, forensic or otherwise. All children may feel isolated or locked in to the secrecy of their experience if they are afraid, or do not realise that what is happening is abuse, or if they are being abused by people who hold positions of trust and responsibility in relation to them. What is particularly important in respect to looked after children, as well as many other groups of young people, is to ensure that they are made aware of the services available to them. Special attention should be made to ensuring carers, social workers, health practitioners, advocates, colleges, teachers and pastoral staff have an understanding of these changes.

Q13. Are there specific issues that relate to children with children and young people with disabilities or additional needs that should be considered as part of the Bill?

Careful inter-agency planning of services is needed for any child who may have been abused, but its necessity is particularly evidence for those who require support for communication and physical access. These realities underline the need for detailed planning in the implementation of the Bill.

Q14. Do you consider that the provisions in the Bill should be extended to cover alleged child perpetrators of sexual assault and rape?

Children who are involved in harmful behaviours towards others may themselves be victims of neglect and abuse including sexual abuse and when a forensic medical examination is ordered then this process and all other investigative processes should be conducted with consideration of the safety and wellbeing needs of that child. The Age of Criminal Responsibility (Scotland) Act 2019 provides for this.
These processes should be co-ordinated between agencies but this Bill may not need to cover matters that are covered in the Age of Criminal Responsibility (Scotland) Act 2019, and will be covered by forthcoming guidance on that act.

Q15. Are there specific data protection issues that need to be addressed in relation to children and young people?

We understand that the retention service under the Bill has been developed with consideration of an individual’s need for private and family life, specifically in relation to self-referral, allowing victims time to consider whether to make a report to the police, balanced against other interests, including the protection of health or the protection of the rights of others. All children and young people provided with
forensic medical services need help to understand what information could be shared and how, and for what purposes, with and without permissions.

Q16. Should information from forensic medical examinations be linked/ be part of an individual’s healthcare record?

Our understanding is that sexual health records are retained separately from other health records, and cannot be shared without patient permission. They are therefore not shared with the GP (without the patient’s consent) and so do not automatically form part of the individual’s healthcare record.
A summary of findings shared with a GP would assist in developing a holistic understanding of a person’s physical and mental health care needs. However, the retention and sharing of medical information is not an area of specialist expertise for Social Work Scotland. We assume that information governance issues including questions of storage and retention of digital images will form part of the continuing work of the CMO Taskforce in the period leading up to publication of the Clinical Pathways Guidance for both Adults and for Children and Young People, later in 2020.

If a summary of findings does become part of an individual’s healthcare record, then the data protection issues in relation to access to records for a child under 16 would involve current criteria. Young people with capacity would have the legal right to access their own health records and could allow or prevent access by others, including their parents. They should not be given access to information in their health
records that would cause them serious harm or any information about another person without the other person’s consent. Parents would be allowed to access their child’s medical records if the child or young person consents, or lacks capacity, and it does not go against the child’s best interests. If the records contain information given by the child or young person in confidence the information should not normally be disclosed without their consent. Divorce or separation does not affect parental responsibility and a person with parental responsibilities would presumably be allowed reasonable access to a child’s health records. Access to health records for a young person or an adult who was subject to such an investigation as a young child would require careful handling and support, as with access to other records that include information about abuse.

Yours sincerely,

Alison Gordon, Chief Social Work Officer for North Lanarkshire, Co-Chair Social Work Scotland Children and Families Standing Committee, and Social Work Scotland representative on the National Child Protection Leadership Group

Jacquie Pepper, Chief Social Work Officer for Perth and Kinross, Co-Chair Social Work Scotland Children and Families Standing Committee and Social Work Scotland representative on the Child Protection Guidance Revision National Steering Group

CPC Consultation: National Guidance for Undertaking Learning Reviews

CPC CONSULTATION (Scotland): National Guidance for Undertaking Learning Reviews

Email contact: James Cox, Children and Families Lead, Social Work Scotland, on behalf of Children and Families Standing Committee Chairs, Jacquie Pepper and Alison Gordon

SECTION 1 – INTRODUCTION

Question 1(a)

Do you think that the introduction within the proposed new Learning Review Guidance makes it clear what the guidance is about?

Yes

Please explain your answer.

  Question 1(b)

Do you think that the removal of the terms “initial” and “significant” case reviews will streamline current variations of the review processes across Scotland?

Yes, it is much clearer in relation to reviewing child protection situations that meet the criteria.

Please explain your answer.

SECTION 2 – KEY FEATURES OF LEARNING REVIEWS

Question 2(a)

Do you think that this section clarifies the purpose of Learning Review and is the paragraph on creating preconditions for learning helpful? Please provide your comments here:

Question 2(b)

Do you think the revised criteria for undertaking a Learning Review is appropriate and clear for Child Protection Committees?

Yes

Please explain your answer.

 Question 2(c)

Does the guidance reflect the learning culture we are trying to achieve in Scotland?

Yes

Please explain your answer.

 Question 2(d)

Should any other information be added in relation to parallel processes in this section (p7)?

Yes, it needs to consider other processes noted in the comments box below.

Please explain your answer.

SECTION 3 – INITIATION OF A LEARNING REVIEW?

Question 3(a)

 After consideration of the gathered data the guidance states a nominated person or sub-group will then make a recommendation to the CPC as to whether or not to proceed with a Learning Review (p10). Is the information provided in Template (Annex1.3) for that purpose enough?

Yes

Please explain your answer.

Question 3(b)

With reference to the paragraph on media interest (p11) do you have any examples of situations that are not covered within this section? Please provide your comments here:

Question 3(c)

Is the information provided in the guidance clear when a situation does not meet the criteria for a Learning Review? (p12)

No

Please explain your answer.

SECTION 4 – UNDERTAKING THE LEARNING REVIEW

 Question 4(a)

Whilst not prescriptive to acknowledge local variations;

• Are you satisfied with clarity of the expectations as described for CPC’s when setting up a Review Team to conduct a Learning review using a systemic approach (p14) and;

• Are your satisfied the roles of the Chair and the Review Team are clear (p15)?

Please provide any comments on this section you may have here:

Question 4(b)

The skills, attributes, experience, and knowledge associated with the various roles within a Review Team are outlined in Annex 4 (p44) of the guidance. Do you think this supports the local process of appointing the identified people to undertake these roles?

Yes

Please explain your answer.

Question 4(c)

A Learning Review is a collective endeavour to bring together agencies, individuals, and families to learn from what has happened in order to better protect children and young people in the future. Is the information provided around family liaison (p18) helpful?

Yes, it outlines the expectations when setting out to conduct a review

Please explain your answer.

Question 4(d)

The purpose of a Learning Review report is to identify key learning points and how and why that learning has emerged throughout the review process. Reports should be clear, succinct, and as anonymous as possible. Is the information provided in this section of guidance (p21) clear on both the purpose of the report and its publication? Please provide any comments here:

SECTION 5 – DISSEMINATIONG AND IMPLEMENTING LEARNING

Question 5(a)

Does the information provided in relation to the dissemination and implementation of learning from a Learning Review at national and local level meet your requirements? Please provide and comments here:

OTHER CONSIDERATIONS

 This section offers those reading the draft guidance an opportunity to make comment on the following areas;

• Process Map (page 24)

Please add your comments here:

• Annex 1 – Templates (pages 27 – 40)

Please add your comments here:

• Do you have any other comments about the draft guidance?

Raising the age of referral to the Principal Reporter

SUBMISSION FROM SOCIAL WORK SCOTLAND, TO SCOTTISH GOVERNMENT CONSULTATION

07.10.2020

Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We welcome this opportunity to comment on proposals to raise the age of referral to the Principal Reporter, and make clear our strong support for this development.

1. Do you agree that the maximum age of referral to the Reporter should be increased to 18?

Yes. We agree that, with some important caveats, the maximum age of referral should be increased to 18, for all grounds.

The proposal presents some clear benefits, including.

• Alignment of key child welfare and wellbeing systems and processes with the UN Convention on the Rights of the Child (UNCRC), extending protection and support to all children and young people under the age of 18.
• Attuned decision making for 16 and 17 year olds in need of compulsory supervision, care and protection, taking account of the evolving maturity of each young person in the context of their relationships and circumstances.
• Progress realisation of the Getting it right for every child practice model, clarifying the national framework for inter-agency assessment and planning for children and young people, which in turn will facilitate greater consistency of practice locally.
• Encourage the development or adoption of approaches to supporting the needs of children and young people, in contrast to criminal justice processes which often engender feelings of isolation, alienation and stigma.
• Congruence with legislation already in force in Scotland, which define a person to be a child up to the age of 18. However, there will remain a need for wider legal review, addressing the body of relevant law which describes adults as individuals over the age of 16. Of particular relevance for social work is the overlap with Adult Support and Protection legislation.
• Greater flexibility in the review of plans, support and progress in respect of 16 and 17 year olds subject to Compulsory Supervision Orders (CSO).
• Help improve transitions from children to adult services, clarifying and reinforcing the responsibilities of public agencies towards 16 and 17 year olds, as well as further eroding the idea that 16 or 17 is a suitable age at which children become ‘adults’ and ‘independent’.
• Accord with the intentions in the Promise, helping to ensure that Scotland does more to avoid the criminalisation of children, and deals with them in a way that is responsive, age-appropriate, need (not behaviour) orientated, proportionate and trauma sensitive. Moreover, the extension of the right of referral increases the chance that 16-17 year olds will have their ‘cases’ dealt with in an environment that upholds their rights and allows them to effectively participate in proceedings.

However, the proposed change will not, in itself, improve children and young people’s experiences, or contribute to improved outcomes. Change will come through implementation, and that must be assiduously planned, effectively led, properly resourced (both in terms of the implementation process itself and the changing profile of demand on services) and underpinned by an infrastructure of facilitative administration (data, evaluation, learning, business management support, etc.) A proposal such as this is only as good as its implementation, and Social Work Scotland is of the strong view that much more attention needs to be paid to implementation in general, and to the implementation plan for this change specifically.

Moreover, in considering this specific proposal, implementation will need to take account of:

• The profound and ongoing impact of Covid-19 on the system’s potential to deliver the increased capacity raising the age of referral is likely to entail. From a pre-Covid capacity of 700+ Hearings a week, the system is now seeking deliver approximately 200 a week, by means of a blended model that balances the health, wellbeing and rights of all involved. With an increase in poverty and family stress likely over the coming year, social work activity (already at above trend levels) may lead to increases in care and protection referrals to the Reporter. The system will respond with determination, attempting to absorb and adapt as much as it can. But ultimately more demand must be met by greater investment and expansion of capacity. ‘Raising the age of referral’ could end up being a lowering of the standard of service, if it becomes a doorway through to services which under-resourced and over-stretched before covid-19. That would potentially increase risk, diminish trust in the system, and unsettle victims.
• The net increase in referrals to the Principal Reporter is likely to be swelled further by revisions to Sentencing Guidelines in relation to young people and young adults. The guidelines, when implemented, will affect the numbers of social work assessments which need to be undertaken, and plans to be implemented. These developments have a system-wide impact. The recent consultation on those guidelines acknowledged that a realignment of resource from adult criminal justice and youth justice services (where they exist) towards children and families services would be needed, but there has not, as yet, been any effort to quantify that, or to work out how the process of realignment would be managed. Furthermore, there will be a net combination impact in terms of referral and demand from (a) commencement of the Age of Criminal Responsibility (Scotland) Act 2019; (b) revision of the National Guidance for Child Protection; (c) commencement of the Equal Protection from Assault (Scotland) Act 2019; (e) national roll out of the Scottish Child Interview Model (joint investigative interviewing of children and young people); (f) developments prompted by the expert report on harmful sexual behaviour by children and young people; (g) the Standards and Pathway for Secure Care; (h) revised national guidance for Care and Risk Management; (i) and new Clinical Pathways Guidelines in relation to children and young people who may have experienced sexual abuse.
• Different legal
• The messages from the Promise challenge us to re-think our entire approach to responding to needs of children and young people, including Children’s Hearings. This proposal is about extending part of our current system to incorporate 16 and 17 year olds. From the perspective of those overseeing reform of Scotland’s care system, that may not be the step (with all the associated costs) which they recommend.
• Implementation will need to plan for the diversity and range of needs that may need to be met, ensuring that opportunities for necessary skills development are in place for professionals and volunteers involved (teaching, coaching, observation, feedback). There may also be increases in demand for residential and fostering placements, which will need to be factored into a plan and properly resourced.
• The implications of shifting patterns of concern that are likely to emerge; for example, a rise in digitally enabled abuse and criminal exploitation, including organised child sexual exploitation; sexual abuse more generally; increases in hate crime; or, impact of teenage neglect
• The fact that some individuals do benefit from involvement in the adult criminal justice system, with its different legal thresholds and accountability / monitoring processes.
• Baseline and ongoing data capture will be essential to understand what works; in particular the outcomes from interventions within a supervision order. As consistently highlighted by Audit Scotland, without the relevant performance information we are unable to clearly identify what we need to target, or how to target effectively.

Finally, a number of Social Work Scotland members noted that the proposed reform should not be seen as means by which to extend the availability of, or access to, ‘services’. The extension of referral criteria to 16 and 17 olds should be done because it is the right thing to do from a rights and evidence perspective. If the objective (whether explicit or implicit) is to increase the scope of responsibility placed on local authorities (in particular social work) and other partners, it will have to be met through a combination of this change and sustained investment. One without the other will not deliver change. In the past compulsory orders have, our members suggest, been used to ensure services are allocated, rather than because compulsion was strictly necessary. Such action is understandable, when all involved wish to see the right support provided to an individual. But the identification of an implementation authority does not, in itself, stimulate an increase in available resources needed to address the individual’s needs. And in delivering on the Promise we know that we need a range of services that provide responsive, persistent / ‘sticky’, and relationship based practices for a range of needs, a points on a continuum from early help (before challenges become problems) through to structured, programmatic responses to harmful behaviour. The economic and financial context for local partnerships, and especially for social work, is a source of deep concern. A substantial increase in demand for services against a backdrop of acute and chronic budgetary pressure would be to introduce a systemic risk, potentially undermining the system as whole.

2. If the age of referral is increased to 18, are the existing grounds of referral to a Children’s Hearing sufficient?

Probably not. Although compulsory supervision may not always be necessary or effective, there are growing concerns across the UK about child criminal exploitation, where an individual or group takes advantage of an imbalance of power to coerce, control, manipulate or deceive a child or young person into criminal behaviour. A young person may have been criminally exploited even if the activity appears consensual. It may be helpful, and would be congruent with the UNCRC, to provide flexibility to refer in relation to these sort of concerns.

3. What are your views on the potential implications, including resource, of increasing the age of referral to the Reporter for local authorities, Police and other service providers/organisations?

We have addressed this point in response to question 1, but to reiterate, we do expect there to be considerable resource implications for local authority social work, with increased demand for assessment, planning and action. With the increased recognition of the impact of harmful behaviour towards and by young people, those assessing needs and circumstances will likely take into account a network of relationships, within and beyond their family; that will require time and having people with the right skills. Unfortunately youth justice social work services have been particularly hard pressed by budget cuts, with some now absorbed into teams with wider remits (and therefore wider calls on their resource); close attention to the skills needed, and then investment in the development of those, will be necessary.

There may also be an increased demand on foster care and residential resources as a result of this change. And while at a macro level this policy development may precipitate, over time, a re-distribution of social work resource across sectors (from justice to children), such shifts should be neither assumed nor considered sufficient.

In moving this policy proposal to the next stage, it is essential that Scottish Government undertakes or commissions a detailed analysis of the resource requirements which will be necessary to facilitate implementation. The current method of estimating local authority costs (through consultations such as this, and information gathering through COSLA) is not adequate. Estimates of costs do not need to be perfect, but they do need to be good enough; and the only reliable judges of that will be the service managers and practitioners involved in designing and delivering services. Social Work Scotland strongly supports the extension of the right of referral to the Reporter, for all the reasons detailed above, but we are likely to oppose further development of these plans if we do not see a genuine effort at trying to understand, and then meet, the resource needs of each part of the system.

4. What are your views on the potential implications, including resource, of increasing the age of referral to the Reporter for SCRA (the public body which operates the Reporter service)?

Again, we have addressed this in our early answers. Reporters and Panel members are likely to require additional joint training in relation to the interlocking legislation which may be applicable in this age range. Including, importantly, adult support and protection. There will be additional challenges – and therefore skills and resources needed – involved in delivering virtual, blended and direct hearings with an increasing number of 16-17 year olds and their families. Time will need to be spent understanding approaches to assessment and intervention within this upper age group, and to some specific considerations (e.g. children with complex disabilities in transitional stages) which may affect decision making.

The change will also alter the interface between the Children’s Hearings and adult justice systems. Some young people will experience both systems. There will be a need for clear and accessible guidance, not only for SCRA and CHS, but relevant practitioners. Information for young people will need to be made available too.

Social Work Scotland members with experience in justice social work have also drawn attention to a feature of the Hearings system’s current flexibility that might be revealed as a flaw, under the pressure of referrals for 16-17 year olds. Neither the Children’s Reporter nor the chair of the Children’s Hearing panel are required to be legally qualified. This contrasts with Mental Health Tribunals, Justice of the Peace Courts (where the clerk is legally qualified) and Parole Board hearings. The only lawyer in the room is likely to be the family or young person’s representatives.

5. What are your views on the potential implications, including resource, of increasing the age of referral to the Reporter for Children’s Hearings Scotland

There would be a need for additional training and skills development among panel members and staff, for example in terms of the prevalent forms of abuse among this cohort, the nature of exploitation of 16-17 year olds, and harmful behaviour. There is a need for understanding of intersecting and complicating factors (such as drug and alcohol use), and for a trauma informed, age appropriate approach to the preparation of and conduct of hearings. The underlying impact of medical, nutritional, emotional, educational and supervisory neglect in teenage years must also be understood when panel members come to decision making.

Local authorities, SCRA and CHS can all expect an increased need for advocacy services under s122 of the 2011 Act following this reform.

6. If the age of referral to the Reporter was increased, are amendments required to ensure sufficient access to information and support for victims harmed by children?

Although there may not be a need for new systems, experience of preparing for implementation of the Age of Criminal Responsibility (Scotland) Act 2019 suggests that this is an area of great sensitivity, requiring very careful preparation and transparent explanation. Otherwise, beyond potential distress to victims, there will be loss of trust in the ability of the system to be robust, fair, purposeful and effective.

Beyond ‘sufficient information’ there may be scope for integration of restorative work within compulsory measures. The Hearings system cannot provide a punitive response, but such restorative work may bridge the gap between the explicitly welfare orientated measures of the Hearing and the needs of victims.

7. Any other comments

Members of Social Work Scotland’s Adult Support and Protection Network have noted that ta case study included in the consultation is inaccurate. They felt this highlights the lack of understanding in relation to ASP legislation and its application. The case study states “She could be made subject to an Adult Support and Protection investigation however that would depend on her capacity and whether she meets the statutory tests.”  However, adults can be supported under the ASP Act regardless of their capacity or non-capacity.

Sources used in the development of this response

• Arnot J, Mackie P (2019) Violence Prevention Framework Scottish Public Health Network
• CYCJ (2019) Preventing Offending : Improving our approach to workforce development
• Child Safeguarding Practice Review Panel (2020) Safeguarding Children at risk from Criminal Exploitation
• Couper S, Mackie P (2016) Polishing the diamonds: Addressing adverse childhood experiences in Scotland
• Raws P ( 2016) Understanding Teenage Neglect . Children’s Society
• Scottish Government, (2015).Preventing offending: Getting it right for children and young people
• Scottish Government (2019) Criminal Justice Social Work Statistics: 2017-18
• Scottish Government (2020) Harmful Sexual Behaviour. Expert Group Report.
• SCRA ( 2020) Scottish Children’s Reporter Administration Statistical Analyses
• Scottish Government (2019) Scottish Justice: additional analyses
• Scottish Prison Service (2020) SPS Annual Population statistics
• United Nations Standard Minimum Rules for the Administration of Juvenile Justice (“The Beijing Rules”) Adopted by General Assembly resolution 40/33 of 29 November 1985
• RCPCH (2014) Child Protection Evidence Systematic review on Teenage Neglect
• Social Work Scotland ( 21/8/20) Sentencing Young People. Submission to Scottish Sentencing Council
• Viljoen J et al (2016) Start V-Knowledge Guide

For further information, please do not hesitate to contact:

James Cox

Children and Families Lead, Social Work Scotland

james.cox@socialworkscotland.org

Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill

Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill

SUBMISSION FROM SOCIAL WORK SCOTLAND, TO EDUCATION AND SKILLS COMMITTEE CALL FOR VIEWS

02.10.2020

Social Work Scotland is the professional body for social work leaders, working closely with our partners to shape policy and practice, and improve the quality and experience of social services. We have engaged closely with Scottish Government and local government partners in the development of the Redress for Survivors (Historical Child Abuse in Care) (Scotland) Bill, setting out our position on key matters in response to the pre-legislative consultation (November 2019).[1]

Our response to the Committee’s call for views has been developed by Social Work Scotland’s national Historical Abuse Practice Network (which supports professionals involved in supporting survivors’ applications for records and redress) and Social Work Scotland’s Children and Families Standing Committee (senior managers in social work services). In response to the Education and Skills Committee’s questions:

1. The people who are eligible to apply to the scheme.

We agree with the proposed criteria for those eligible to apply, but note that Scottish Ministers will have the power by way of regulations (subject to the Scottish Parliament’s approval by affirmative procedure) to adjust the definition of “relevant care setting”. This would be by adding to or varying the descriptions of types of residential institution listed in section 18(3), or by modifying the detailed descriptions of each type of residential institution provided for in section 19.

The power to modify the definition of “relevant care setting” is said to be based on experience gained through the advance redress payment scheme, which has shown that additional types of care setting may come to light once the scheme is operational (paragraph 85 of the Policy Memorandum). On this basis the power seems pragmatic, providing potential flexibility in the scheme as we progress through installation and implementation. However, in view of the complexity of the care system and individual’s experiences, it is reasonable to assume that cases will present challenges to the current definition, and pressure for revisions. While we do not necessarily oppose future adjustment, the consequences for both the management and costs of the scheme may be considerable, and any such step must be fully consulted on (with all organisations and people affected) and properly scrutinised by Parliament. Indeed it may be desirable now, at this early stage of the Bill, for Scottish Government to provide some examples of the possible additional types of care setting which they predict may emerge, to ensure a full and detailed debate over how they should be treated.

2. The Bill’s definition of abuse

We agree with the Scottish Government’s intent to base the definition of “abuse” on that as set out in the Limitation (Childhood Abuse) (Scotland) Act 2017 (“the 2017 Act”). The broad definition provides a flexible and a proportionate approach, focussing on the experience of the survivor, rather than making a judgement that any form of abuse is, in and of itself, more severe than another. Recognition that abuse takes a variety of forms, and that all have damaging, long-term impacts must be respected. Each case must be evaluated independently, against the agreed assessment criteria.

3. The dates used in the Bill to define ‘historical abuse’

The dates used to define historical abuse, as that which took place before 1 December 2004, is appropriate. In opening up the scheme to those where the abuse took place before 26 September 1964, it will be demonstrably more inclusive than existing remedies.

4. The Bill’s definition of ‘in care’ and the places in which that care took place. 

There is no definition of “in care” within bill.  Therefore, it is understood that this question relates to the definition of “relevant care setting” as defined in sections 18 to 20. We have no specific issues with the two categories of care setting described; firstly, a residential institution in which the day to day care of children was provided by or on behalf of a person other than a parent or guardian of the child, and secondly, a place, other than a residential institution, in which a child resided while being boarded-out or fostered. We are also content with the definition of “residential institution” to mean a children’s home, a penal institution, a residential care facility, school-related accommodation, and secure accommodation.

However, in our response to the pre-legislative consultation we expressed unease about the exclusion of children who were in the care of medical professionals but for whom parents retained long-term responsibility for them. We noted that this “risks denying many individuals the right to redress for abuse suffered while in the care and protection of the NHS. It also insulates the NHS from appropriate accountability around how it fulfilled its responsibilities to the children in its care. […] The primary consideration in determining eligibility should be whether the state had a significant role or power in determining the placement of the child, and when the child was in that placement, had responsibilities for their care and protection.” We have engaged with Scottish Government on this point, and appreciate the complexity, and potential financial challenge, of including such situations in the statutory scheme. But we take this opportunity again here to stress that, as with some individuals who were placed in boarding schools for reasons other than simply parental choice, the Redress Scheme is likely to seem unfair. Moreover, as currently constructed the Redress Scheme situates the failures and responsibilities of the state with local authorities; as independent inquiries into historical abuse have consistently found, formal ‘in care’ settings are only part of the picture.

5. The process of applying for redress and what advice and support applicants might need, particularly in relation to the waiver scheme.

The process of applying for redress, and the advice and support provided to applicants, must be considered beyond the relationship with the Financial Redress Team alone. The scheme’s intention is to give survivors more, not less, choice as to how to pursue financial reparation. Accessible, independent legal advice is critical, as the introduction of the redress scheme does not, in itself, replace existing avenues of financial reparation. Civil litigation will remain an option, and in some cases may lead to higher settlements and a more definitive sense of closure / redress. However, survivors must be supported to understand these options fully, including the likely legal fees levied on a successful civil claim, and the nature of what is an explicitly litigious process. In our view, it is a considerable unknown around the Bill whether there will be a substantial increase in legal fees once the scheme is live.

For the waiver to operate effectively, it must clearly and specifically outline the period, people and organisations, and instances of abuse for which the survivor is accepting the redress payment. It is crucial that survivors have independent legal advice at this stage in order to make a fully informed decision.

Subject Access Requests will be critical to the process; in many cases provision of information to the redress scheme can only be met by invoking this right. Significant resource will be required by public authorities to fulfil their obligations to the statutory requests for personal information which the redress scheme will provoke. Comprehensive consideration must be given to how organisations covered by Subject Access Request duty are supported to undertake the work. Local Authorities increasingly experience demand outweighing resource. We strongly urge the Scottish Government, in the interests of applicants to the scheme, to fully fund public authorities in the delivery of this function. A constructive conversation has begun with Scottish Government on this matter, and we hope over the course of scrutiny of the Bill that our members can be reassured that demand created by the Act will be met by appropriate investment.

Inclusive to the process of applying, at point of entry to the scheme survivors must be offered counselling and support services. The impact of the redress process including accessing records, living through the redress process itself and re-living abusive experiences cannot be understated. A significant risk to survivors is being re-traumatised through this journey. Counsellors, social workers and support workers will be critical to supporting individuals through this process safely. Further detail on this critical provision, including how it will be resourced, would be welcome in the Bill’s accompanying documents.

6. The level of payments offered to survivors.

 We are broadly content with the levels of payments offered to survivors. Arguments may be made for higher or lower levels of payment, but we are satisfied that the Scottish Government has balanced the various factors in its calculation.

7. What you believe to be a ‘fair and meaningful’ contribution to the scheme from organisations responsible for abuse

 The details of this contribution, including the amount, structure, and timeframe, are not specified in the Bill or its accompanying documents. A key area of concern is the unknown quantum of the contribution. While it is assumed to be a significant proportion of the costs of redress payments as set out in the Financial Memorandum (£350m), there are various unknowns which will determine the total payments which will be made and, in turn, the extent of the financial contribution from organisations responsible for abuse.

We are aware conversations between Scottish Government and COSLA are ongoing, and a collective response from local government will emerge. The priority for Social Work Scotland is on the operation of the scheme itself, the support available to applicants, and the impact on social work departments. But from discussions among our members, a preferred approach to securing a “fair and meaningful contribution” was for SG to fund the entirety of the scheme in the first instance, with individual local authority contributions assessed on the profile of claim’s and liabilities of the former regional councils. Where areas have higher numbers of successful claims, clarity on equal or variance of contribution would need to be confirmed. Other members pointed to models such as the CNORIS (NHS) scheme, whereby costs are apportioned according to the losses by region. There is an annual actuarial review to assess the contributions made by each NHS board. However, we do recognise that such approaches would create a level of uncertainty for each local authority, which may not viable in terms of budgetary planning.

Indeed, bearing in mind the financial position that COVID has left authorities, we do think it is important that, whatever mechanism is agreed, phased payment of contributions will be necessary, to avoid a negative impact on services available to the public.

The civil litigation risks also cannot be understated or excluded from consideration. Whilst the redress scheme may award up to £80,000, there may be cases where the survivor has been advised by an independent legal advisor that their claim may result in a higher settlement through civil action. There may be a substantial increase in civil claims, with the associated increase in legal fees and compensation awards. All such cases would fall outwith the Redress scheme’s scope, and the calculation of ‘fair and meaningful’ contributions.

8. The process for dealing with applications to the scheme from people who have serious convictions.

 We agree with the process proposed for dealing with applications to the scheme from people who have serious convictions, on the basis that a public interest / human rights-based approach will be adopted.

9. The process for family members to make an application on behalf of a survivor who has since died.

We agree with the process for family members to make application to the scheme, as a ‘next of kin’ payment.

10. How to ensure that non-financial redress (e.g. an apology) meets the needs of survivors.

It is noted that the bill says very little about apology. Apology is referred to once in section 91, regarding reporting requirements. Public apology is without doubt a key aspect of non – financial redress and Scottish Ministers should continue to publicly acknowledge survivors’ experiences. Survivors should be consulted on how non-financial redress should look and feel for them, and further detail should be provided by Scottish Government on how priorities will be met. Social Work Scotland looks forward to working with Scottish Government and other partners on these aspects.

For further information, please do not hesitate to contact:

Ben Farrugia

Director, Social Work Scotland

ben.farrugia@socialworkscotland.org

[1] https://socialworkscotland.org/consultation/financial-redress-for-historical-child-abuse-in-care-pre-legislative-consultation/