Scottish Government

Growing Support

Appendix A Lay Members Report

Since 1995 SWSI has included lay people in its inspections and reviews. Marion McArdle and Margaret Allison are both parents interested in improving support to parents in difficulty. Marion is a parent of a child with special needs who regularly uses health and social work services. Margaret is a volunteer with her local Children's Panel.

We were asked to participate in this review as lay members in July 1999 and have since been major contributors in all aspects of the review. We took part in all aspects of fieldwork activity including interviews with service users, practitioners and managers and had access to all information gathered for the review.

In each of the five local authorities we visited the review took the form of two phases. During the first phase we read through case files and interviewed strategic authority management personnel. This was new territory for us and so it took us a few days to 'find our feet' and begin to recognise what was good both in recording and practice, and what needed to be looked at and improved. It was interesting to observe the differences in recording techniques used by the social work departments and the health services. As a Review Team we encountered some resistance from the Health Department in regard to accessing case files because of issues of confidentiality.

The second phase concentrated on interviews with social work, health and education professionals. We also interviewed professionals and service users in focus groups and individual family members. For us the most important aspect of this phase was meeting with parents, extended families and carers and finding out exactly what they thought of the services provided and how they felt they could be improved.

Support services for vulnerable families varied throughout the five local authorities but family centres were valued and appreciated across the board. These were seen as an important resource, without stigma, and seemed to us an ideal place to offer multi-agency support.

The areas where support services for vulnerable families did not do as well would also vary throughout the five local authorities. However, here there was a recurring theme, which needs to be addressed, regarding the difficulties agencies seem to have with working together - 'joined up working'. Often professionals were quite unclear about their own roles and that of professionals from other agencies. Confidentiality is important but sometimes it was seen as a barrier between agencies. We felt that families would welcome more sharing of information between professionals in order that they can receive the necessary help and support and perhaps access the appropriate resource much easier and quicker. One parent said, 'I'm fed up telling different professionals the same story, why don't they all get together and help me sort out the problem'.

Being involved in this review has given us a fascinating insight into services as users and providers see them. We have formed some conclusions about some of the aspects we feel could be improved.

We saw little evidence of managers being 'in touch' with what was happening at grass roots. This situation must improve to allow service users more say in how they would like to see services develop and to make managers more aware of the problems both for users and their professionals in the field.

Focus Groups consisting of professionals and, separately, service users, seemed to embrace this unique opportunity to air their views. They often had good ideas for improving services. This type of forum should be encouraged in the future.

The role of the social worker has to become more focused on effecting change. At present their skills appear to be misdirected, spending a great deal of their time assessing and monitoring rather than planning and developing strategies which will bring about changes in attitude and behaviour within families.

One parent said to us 'I have had a social worker for the past 15 years and nothing has changed, in fact things have got worse'.

We were very concerned at the lengths social work departments would sometimes go to maintain a child within the parental home when there was clear evidence that it was not in the child's best interest to remain there. There has to be a clear distinction between what social workers consider to be in the parents' best interests and what is considered to be in the child's best interest. The best interest of the child has to be paramount.

If we are to support vulnerable families with very young children it is essential that they receive medical help and advice right from the start. It is important, therefore, that every child is registered with a GP and is allocated a health visitor.

The role of the health visitor also needs to be looked at. A caseload of 250 children does not allow sufficient time for health visitors to identify and address the particular needs of vulnerable families. Reducing their caseload would enable them to spend more time working with vulnerable families and intervening when necessary at an early stage.

As stated above, family centres were universally considered by families to be an extremely useful resource. They offered support in various forms, from practical help on how to look after a very young child, dealing with behavioural problems, parenting groups, and mutual support groups where mums could meet other mums who had the same problems. We feel that family centres could be used as the main focus for providing initial support to vulnerable families by providing support from a trained health professional or social worker, who would make an initial assessment of the child's needs and refer families to the appropriate specialist. This kind of child support worker's remit would also include monitoring ongoing concerns and alerting specialists to intervene if necessary at an early stage.

If we are to help vulnerable families with young children it is important that this assessment is needs led and not budget led. It is vital that the appropriate resource is available at this stage in a young child's life if we want them to thrive and develop and take their place as valued members of our community.

The area which we highlighted as needing the most improvement in is that of inter-agency collaboration. We feel that this will require a whole new cultural change before any great improvements are made. The need for inter-agency training is extremely important if we are to begin to break down the barriers between various agencies as it is important that professionals value each other's role and therefore become more willing to work together, trust each other and share information.

Finally, during the course of this review we visited many different social work and health department offices. Health department offices were usually of a very high standard. This contrasted dramatically with the very dilapidated condition of some social work department offices. The poor condition of these premises needs to be improved in order that they are more welcoming to families and provide a better working environment for staff.

It took the review team four months to complete the fieldwork for the review. Sifting and analysing the information gathered and preparing the report has taken a long time. We are very glad the report is now published. As lay members we were impressed by the dedication, hard work and professionalism of the social work inspectors and the health and education reviewers with whom we worked most closely. The review was carried out in a fair, courteous and respectful manner.

As lay members we were very aware of the responsibility we had to the children, parents and families who took part in this review. We feel strongly that our task was to assure them that they were being listened to and their views and feelings would be reflected in our findings in this review. We are very grateful to everyone who shared and trusted us with their 'life stories' and experiences of these services. We hope that our presence as 'ordinary people' made them feel more at ease during the interviews.

To everyone who helped us - thank you.