Q13: Covid-19 - During the Covid-19 pandemic, it has been necessary to adapt practice to ensure continuity of child protection processes. Learning from the pandemic and examples of best practice will be incorporated into the National Guidance.
Are there adapted processes that you would like to see continued?
Stakeholder Event Themes
The main themes raised at the stakeholder events were:
The COVID-19 pandemic has led to new ways of working and has accelerated changes to ways of meeting and communicating in particular.
It will be important to consider which of those changes have been positive and led to more flexible and potentially efficient working. The consensus was that at least some of the practice changes – especially in relation to remote meetings – should continue post-pandemic.
Remote IRDs were generally reported to have been particularly successful, with increased attendance rates from across a range of key agencies.
Children, young people, and families have often found online engagement to be less stressful and a preferred way of taking part.
However, it is not right for everyone, and the needs of individuals will always need to be considered. Blended approaches are likely to be needed going forward.
The largest majority of respondents (39% of those answering the question) answered that to some extent there are adapted processes they would wish to see continue.
Around 95 respondents made a further comment at Question 13.
Wider system reflections
While many of the comments considered specific practice changes (discussed further below), others reflected on the impact of the pandemic of the wider system and overall approach to supporting children and young people. It was reported that the pandemic has raised awareness of social inequality in Scotland and its impact on children; when children are out of sight, out of reach or out of mind, the risk of abuse and neglect rises.
Strengths-based practice and resilience
It was reported that there has not been an increase in the number of children who are looked after and accommodated and it will be important to consider why this has been the case and understand the factors that build families' resilience, and how this process has impacted on professionals' understanding of the pressures facing families. It was suggested that the shared experience of the pandemic has addressed power imbalances and speaks to the evidence around positive outcomes achieved through strengths-based and trauma-informed practice.
In terms of the learning that should be taken from this recent experience, there was a call for a shift in focus around how we engage and view families' circumstances, moving away from the concept of creating dependency and acknowledging the importance of empathy and flexibility to address the pressures facing families, returning to the basics of good engagement. Related points included that:
- The lack of scaffolding and withdrawal of services may, in some instances, have contributed to building families' resilience and/ or removed some additional pressures for families.
- There may need to be a more focused effort to work towards de-registration, and to deliver effective time limited interventions to support families through solutions-focused work, and intensive services for most the vulnerable.
Flexible and responsive working and commissioning
While the conditions of a national lockdown have created severe difficulties for child protection assessment, practice and decision-making processes, it was suggested that the same conditions have also challenged services to become more dynamic in order to be more responsive to need.
A connected observation was that some of the changes of approach to working in partnership with the third sector have been positive. There was reference to the removal of some funding restrictions and flexibility of reporting mechanisms . The approach to working in partnership to adapt to challenges and respond to children and families' needs was described as transformational. Specific aspects highlighted included:
Being able to move much more quickly to offer practical and financial assistance for families.
Identifying a number of opportunities for families to participate in, and contribute to, discussions and processes about their lives despite the constraints of the pandemic. It was reported that some of the learning about delivering FGDM remotely has already been shared with partners.
However, it was also reported that the Third Sector has been significantly affected in terms of capacity and resources, meaning the availability and choice of services has reduced. It was suggested that the impact of this is, and will continue to be, significant.
Impact on vulnerable children and families
In addition to commenting on ways of working, respondents also addressed the impact of the pandemic on the number of vulnerable children and families, or on particular groups of children. It was reported that many of the factors which make children and young people vulnerable will have been exacerbated over the course of the pandemic. Other comments included that education hubs were generally reported to have not been effective enough in the first lockdown, with disparity across Scotland in the number of vulnerable children and young people accessing education hub spaces and the kinds of children and young people being supported.
In terms of the number of vulnerable children, comments included that:
- There will be many children not previously identified as vulnerable but now in need of support due to the stresses and pressures of family life in lockdown.
- Increased signposting to local services and resources has resulted in many families who should have been receiving additional help pre-COVID being identified and referred to family support services.
It was suggested that these issues raise important questions about perceptions of thresholds and the early identification of families in need. It was also suggested that the need for inter-agency and inter-partnership collaboration has never been greater.
Children and women living with domestic abuse: In research conducted by the University of Stirling in partnership with Scottish Women's Aid, women and children living with domestic abuse described their experience of lockdown as a further entrapment, exacerbating their experience of control and coercion. Children and young people indicated that their mental health was severely compromised.
Many local Women's Aid groups have reported that they were not included in local decision-making relating to the pandemic's impact on women, children and young people affected by domestic abuse, and were not consulted on which children and young people were offered places in hubs. However, there were a few areas in which Women's Aid groups were able to refer children or young people to school spaces.
Deaf children. It was suggested that the lived experience of deaf children needs to be taken into account. For example deaf children may be using British Sign Language in school as their preferred/principle language to access both learning but to also socialise with their peers. However this may not be the main language used in the home, reducing deaf child's access to fluent communication and full participation in everyday family life. This will inevitably pose a risk to deaf children's social and emotional well-being which practitioners working with deaf children and their families must be aware of and consider whether additional support is necessary.
Children with complex needs. It was reported that one development over the course of the pandemic has been greater support for children with complex needs, including those with have gone through trauma; as schools have had reduced attendance, some children with complex needs have had one to one support that could not be delivered when there was full school attendance. It was suggested that continuing this specialist intensive support will be critical to the development of these children.
Many of the comments focused on changes of approaches to holding meetings, with increased use of virtual meetings in a range of contexts. Examples given included CPPMs, LAC reviews, case conferences, IRDs, hospital discharge planning meetings, and Children's Hearings.
Some noted that such changes have been the only substantive change to practice they have made or seen during the pandemic and that otherwise all existing child protection processes have been retained. Others noted that they were already holding some virtual meetings pre-pandemic. For example, one area reported that their IRD process was already via teleconferencing and is a well-established and quality assured process.
It was frequently noted that virtual meetings offer some advantages for children and families and professionals. In terms of professionals, it was noted that virtual meetings have sometimes allowed key professionals, such as paediatricians, to attend in a way that they might not usually have been able to do. It was also noted that the virtual approach can be of particular benefit:
- In larger geographical, and especially rural and island, areas.
- For those working across a number of Child Protection Committee areas. It was reported that removing travelling time allows additional time for preparation and gives the capacity to attend more meetings than would have been possible before.
It was also suggested that the virtual approach is to be welcomed because it has helped facilitate faster recovery and intervention processes.
Other advantages of virtual approaches identified included that:
- Virtual meeting spaces have promoted gatherings of practitioners, especially those in rural areas and the Islands.
- They offer a range of options for training; for example being able to undertake development and awareness-raising sessions in a few hours, instead of having to take a 'day out' to travel.
However, most comments focused on the advantages or disadvantages for children or families. There were reports that for some families the use of technology to enable virtual attendance at meetings has worked well and supported their participation.
Further comments included that some children who have not contributed at meetings have been able to do so, including because they felt they had more control and could participate on their own terms, including leaving the online meeting if it was getting difficult, or asking questions they would have struggled to ask in face to face situations.
Other advantages identified for children and families included where family members and extended networks have been unable to participate in family meetings in the past (due to their geographical distance, health, mobility, access, transport issues and existing relationships), adapting meetings to include telephone and online engagement has enabled a wider participation and ensured a more robust, supported and resourced plan.
However, it was also noted that for some children and families engagement has been more difficult, particularly for families experiencing digital poverty. There were also concerns about the impact on children and their parents, and the implications for having their rights upheld. Specifically, how do we truly hear the voice of the child and of the parents? How are their views being collected and represented?
Other issues or concerns raised about virtual meetings included:
- Safety of parents and children is an issue where domestic abuse is a concern. It is extremely difficult to assess a situation and know who is present and what the dynamic is when online.
- It is not possible to read body language or make proper eye contact; being able to do this is crucial for relational practice.
- There are issues with reliability of broadband/Wi-Fi, particularly in rural areas, where participants are sometimes asked not to turn cameras on as this affects the signal. This relates back to the loss of relational aspects.
- Balance of power needs to be considered. Often families do not have adequate devices, compared to those of professionals, and some may be joining by phone while others are on video.
From a professional or practitioner perspective, it was suggested that:
- Virtual meetings will impact on the effectiveness of support and debriefing opportunities, especially for those who are newly qualified or lacking in experience.
There was a consensus that it will be important to retain flexibility as we emerge from the pandemic, including the use of technology to enable virtual attendance at meetings in some circumstances. However, there was also a clear view that virtual attendance should be offered as one of a number of options with the focus on choice rather than assuming any particular approach suits any particular child, young person or family member. It was also suggested that a 'hybrid' approach, with some people being present and others on-line could be a compromise that would work.
Some respondents sounded a particular note of caution and called for more reflection on what has and has not worked during the COVID-19 pandemic. This was sometimes associated with a concern that some practices might be retained primarily because they have proved cost effective.
Examples of other adaptions
In addition to the frequent reports of a move to virtual meetings, there were also reports of other changes or developments in response to the COVID-19 crisis. These included:
- Developing local operational groups, which ensure support is available to those not known to statutory services. These were described as a positive development that has brought people together to meet needs and overcome barriers caused by COVID.
- Digital authentication of documents for Children's Hearings.
- Adding another layer of risk assessment at every level, including asking families further questions before visits, exploring safe care, issues around contact etc. This was described as helping to support the process of how professionals undertake home visits.
Development of guidance
It was reported that sportscotland has worked with partners to develop and share a range of resources to ensure that the return to sport is as inclusive as possible. These include guidance around online coaching and on child wellbeing and protection considerations when delivering sport at a distance.
Learning and post pandemic practice
While a number of respondents highlighted emerging evidence and experience around changing ways of working, the importance of considering any learning carefully, and carrying out the necessary analysis and research, was also raised.
As noted above, there was a call for more reflection on what has and has not worked during COVID-19, which was sometimes associated with a concern that some practices might be retained because they have proved cost effective. There was a concern that practice is often reactive, and even with the best intentions the needs of vulnerable children and young people are often overlooked. The associated suggestion was that current practice and procedures in relation to Covid-19 need to be kept under continuous review.
In terms of external sources for learning, there was reference to a recent research report by the Nuffield Family Justice Observatory, which identifies serious concerns about the impact of virtual meetings on parents and suggests that the disadvantages of holding case conferences virtually outweigh the advantages, especially for families taking part. A loss of relationship-based practice, lack of scope for reflection, concerns for parental safety, and difficulties in managing tensions were cited as concerns. However, it was also reported that research by Harry Ferguson et al highlights some of the positive aspects of child protection practice which has been adapted during the pandemic, and points towards the benefits of a hybrid approach to some aspects going forward.
There was also reference to a rapid learning report from the Royal College of Psychiatrists (Reimagining the future of paediatric care post-COVID-19: A reflective report of rapid learning from the Paediatrics 2040 project team), which details that utilisation of virtual platforms / audio-visual technology is an innovation that paediatricians want to take forward into the future, but that putting appropriate guidelines and frameworks in place will be essential.
In terms of other issues to be explored, and learning to be reviewed, suggestions included:
- Understanding of the harms associated with COVID-19 and the associated restrictions.
- Ensuring robustness of processes in a digital environment. In particular, ensuring online safety for children and staff.
In relation to specific aspects of practice to be explored, suggestions included the shortened multi-agency assessment which has been in use in some parts of the country since March 2020.
It was suggested that this learning should inform any incorporation of adapted practice into the guidance. In assessing adapted practice, it was suggested that consideration should be given to whether the change of practice would have happened had it not been for the pandemic; if not, it will be important to be clear about why the practice would be retained. It was suggested that children's rights and the needs of families must be at the heart of those determinations, with families not coming second to bureaucratic procedure. Other comments included that it will be important to listen to, and consider, feedback from families.
Possible changes or additions to the guidance
There were a small number of suggested changes to the draft guidance, including that the current section on Learning from adapted practice during the Covid-19 pandemic may well have to be extended as it provides only general information as opposed to any guidance.
In terms of the current coverage, other comments included that:
- It seems to focus on the legal implications of the pandemic and how this needed to be adapted.
- There is no reference to the additional child protection concerns that have arisen as a result of COVID-19, for example school closures and the impact on vulnerable or at risk children of being out of school for a number of months.
It was noted that the guidance will be in place for at least 5 years, and it was suggested, therefore, that there should be a shift away from a specific focus on COVID-19 to responding to a public health crisis. General emergency planning-related suggestions included:
- Adding a section entitled 'Contingency planning' in the event of a global pandemic or other emergencies which would have an impact on operational child protection practice.
- Adding live links to COVID-19 Supplementary guidance and consider the use of live links to future impacts or where contingency planning is required.
In terms of other possible changes to the guidance, suggestions included:
- Adding examples of best practice in relation to how statutory services have engaged with vulnerable children during lockdown.
- Adding national examples of blended approaches to facilitating planning meetings for children.
- Adding more detail about supporting children and families to use technology safely, so when they are spending more time online learning and connecting with the outside world they are still fully protected.
- The Learning and Development section could mention the importance of virtual child protection training, and the need for all agencies to think creatively about their role in inter-agency training locally and nationally.
Developing guides establishing the best way of using online video conferencing for IRDs.