Case Escalation Process

1. Introduction and Legislative Framework

1.1 The Independent Reviewing Officer (IRO)

Section 118 of the Adoption and Children Act 2002 amended Section 26 of the Children Act 1989 by introducing a new statutory role of Independent Reviewing Officer (IRO) with the responsibility of reviewing looked after children cases. Local authorities are required to appoint IROs. The IRO's role is to ensure the implementation of the child's care plan or decisions relating to it with the expectation that child centred practice is being delivered in a timely way.

One of the key functions of the IRO is to challenge the local authority where any concerns arise within the care planning process for a child. It is expected that IROs establish positive working relationships with the social workers of the children for whom they are responsible. Where problems are identified in relation to a child's case, for example in relation to care planning, the implementation of the care plan or decisions relating to it, resources or practice issues, the IRO will, in the first instance, seek to resolve the issue informally with the social worker and/ or the social worker's managers.

In these situations, the IRO has the duty to negotiate with the local authority management, in the first instance informally. Should this not result in resolving the issue the IRO should consider taking formal action and escalating his/her concerns up to the highest level. The case escalation process is set out in Table 1 showing escalation from Level 1 through to Level 4 where appropriate. "The IRO must advise staff at an appropriate level of seniority of this failure. Senior managers then work to resolve the failure within a timescale that meets the needs of the individual child" (The Children Act 1989 Guidance and Regulations - Volume 2: Care Planning, Placement and Case Review para 4.40). The complete procedure through all levels should not take longer than 20 days.

Where the IRO considers the escalation process is not achieving a resolution for the child in a timely way and it is considered that the failure to implement aspects of the care plan might be in breach of the child's human rights, the IRO in liaison with their line manager and the Manager (Safeguarding and Quality Assurance) seek 'independent legal advice' which is provided by Bedford Borough Council which could lead the IRO to make a Section 118 referral to the Children and Family Court Advisory Service (CAFCASS). CAFCASS is able to bring legal proceedings to achieve a remedy.

1.2 The Child Protection Chair (CP Chair)

The 'Laming report 'The Protection of Children in England: A Progress Report' published on 12 March 2009 was commissioned in response to the death of Baby P in Haringey. The report contained 58 recommendations designed to ensure that the changes to the child protection system following the Climbie inquiry in 2003 are effectively implemented. The report evaluates the current state of safeguarding systems for children and concludes that sufficient structures and procedures are in place to protect children. However, the report goes on to point out that it is only the robust and consistent implementation of these procedures that will keep children safe.

Laming stresses that "senior managers should be confident that decision making, communication and information sharing within and between each of the local services is effective in keeping children safe... they should support and value first-line managers ensuring that management oversight of decision making is rigorous and that the lines of communication between senior managers and frontline child protection staff are as short and effective as possible."

Child Protection Conferences are central to the multi-agency decision making process that keeps children safe from harm. They bring together family members and those professionals most involved with the child to share and analyse the information which has been obtained about the child's developmental needs and the parental capacity to meet those needs. The conference makes judgements about the likelihood of the child suffering significant harm in the future and decides whether the child is at continuing risk of significant harm. If the child is likely to suffer significant harm, (s)he will require inter-agency help and intervention delivered through a formal Child Protection Plan. The primary purposes of this plan is to prevent the child suffering harm or a recurrence of harm in the future and to promote the child's welfare. The Child Protection Plan outlines the action required to safeguard and promote the welfare of the child. It is crucial; therefore, that the social work input to Child Protection Conferences is of the highest possible standard.

To ensure that Child Protection Conferences in Bedford Borough are effective protection mechanisms, this escalation process provides a clear structure for CP Chairs to escalate concerns and mirrors the procedures for Independent Reviewing Officers for children looked after.

2. Reasons for Raising Concerns

There are various situations where an Independent Chair might have concerns and initiate the case management escalation process. It is a matter of professional judgement as to what level of escalation is needed and the impact on the child is the significant factor.

2.1 Concerns that may be dealt with at an informal level

• Poor preparation by the social worker for the Looked After Review or Conference;
• Quality of reports provided at Review or Conference;
• Repeated absence or late arrivals at conference or review meetings;
• Inadequate management oversight/supervision of a social worker;
• Concerns about lack of effective partnership working with parents.

2.2 Concerns that might need formal escalation

• Assessments/care plans not being completed/progressed in time;
• Key documents not completed;
• Non-completion of actions within timescales;
• Social worker visits to the child/ren not being within the expected timescales;
• Concerns about the quality of risk assessments;
• Workers not following Bedford Borough Council policy and procedures;
• Discriminatory practice;
• Evidence of poor partnership working amongst agencies which has compromised the effectiveness of a CLA Care Plan or Child Protection Plan;
• Concerns about lack of child participation;
• Avoidable drift and delay in children's plans;
• Health provision;
• Education provision;
• Placement choice/standard of care;
• IRO not being consulted about final care plan.

3. Informal Resolution

It is important for Independent Chairs (CP Chairs and IROs) to have a collaborative relationship with social work staff and management with the responsibility for ongoing care planning for the children in the care of the local authority and children subject to a protection plan, and recognise and report on good practice by individuals or teams.

Informal escalation/ case discussion is viewed as part of the quality assurance role of the Conference and Review Service. Wherever possible, the Independent Chair will attempt to resolve a problem by negotiation, including contacting the social worker responsible and their line manager, attempting to resolve the problem directly with the team. S/he should first seek to resolve difficulties face to face or by talking on the telephone rather than relying on e-mail. Where the concern is regarding a child's placement, the case discussion will take place with both the fostering team as well as the team who holds case responsibility.

The independent Chair completes a monitoring form after each LAC Review/ CP Conference which includes whether informal or formal escalation is required in this case. This provides the social worker and Team Manager full details of the strengths and deficits of the Review/ Conference. Where there is an informal escalation, the Independent Chair will confirm any discussion with the social worker/ team manager in an e-mail and also confirm whether the concern has been resolved at an informal stage. It is important that the Independent Chairs add Azeus case notes at point of escalation and when the issue is resolved, setting out the facts and how resolution was found. The Azeus case note should not be a reiteration of e-mails trails, but a general case note highlighting the overall reason the case has been escalated and whether or not this was resolved, including how resolution was found.

4. Escalation and Formal Resolution

Where issues relating to practice are identified and the Independent Chair is dissatisfied with the informal response or timely solution to the issue, s/he will continue to negotiate with management up to the highest level if necessary in order to resolve the issue.

There are four levels to the formal resolution process. Exceptionally when more urgent or serious concerns remain unresolved, the Independent Chair has the discretion to proceed directly to the level s/he considers most appropriate. This would usually be Level 2. Where any stage of the escalation process has been skipped, the Independent Chair will outline the reasons for this within the escalation. The stages are:

Table 1

For Levels 1 – 2, the Independent Chair will complete an Escalation form and e-mail it to the Team Manager. At each of these stages, a response is required within a maximum of 5 working days of receipt, unless the Independent Chair has specified a different timescale. It is noted that although there is some flexibility within the timeframe at each stage of the escalation process, as agreed by the Independent Chair, the entire process from start to finish must be completed within 20 working days.

Stages 3-4 will be managed through a meeting, which should be convened and chaired by the Officer who has received the escalation. The meeting should be independently minuted. All key personnel should be invited to the meeting. The Independent Chair may attend the initial part of the meeting to clarify their position and answer any queries the local authority may have regarding the issues escalated and to set out what would be required to prevent the matter progressing to the next level of escalation. In order to maintain their independency from the local authority's decision making process, the Independent Chair may leave.

If an Independent Reviewing Officers believes there is still a danger that the child's human rights may be being breached due to action or inaction of the local authority, (s)he may (in liaison with their line manager and the Manager (Safeguarding and Quality Assurance) seek 'Independent Legal Advice' which is provided by Bedford Borough Council to IROs which could lead the IRO to make a Section 118 referral to CAFCASS. CAFCASS is in some cases able to bring legal proceedings to achieve a remedy. Legal proceedings should only be considered as a last resort - i.e. in extreme cases where all other attempts to resolve the problem have failed. The additional delay associated with legal proceedings is not in the interest of the child, and every effort should be made to resolve the problem before such action is taken.

Where an Independent Reviewing Officer has been advised that the obstacles in the way of resolving the issue are outside or beyond the control of the local authority, the Independent Reviewing Officer should continue to escalate if the issues are impacting upon the ability of the department to meet the needs of the child.

5. Recording and Communicating that a Child's Care Plan or CP Plan has been Subject to Escalation

In the first instance the Independent Chair should place a record of any initial informal escalation on the child's Azeus record under case notes. The record needs to be appropriately worded to reflect the concerns in relation to the child's plan (the impact). It is the expectation that e-mail conversations are not 'cut and pasted' onto Azeus case notes, rather that the Azeus record provides a brief summary of the issue and whether it is an informal escalation or a formal escalation through Levels 1 to 4. It is important that the Independent Chair also adds an Azeus case note once the issue has been resolved and to set out the facts/how resolution was found.

The Independent Chair should keep partner agencies updated as appropriate.

6. Informing the IRO of any Significant Change in the Child's Circumstances

Under the Adoption and Children Act 2002 IRO Guidance (Regulation 8), the Local Authority must inform the IRO of, "Any significant change of circumstances occurring after the review that affects arrangements".

Paragraph 3.74 of the IRO Handbook sets out what constitutes a significant change and Bedford Borough Children's Services has agreed that the IRO should be informed of the following:

• Outcomes of any Panel applications or presentations including; ARP, MAP and CSEP;
• Outcomes of presentations to the Fostering Panel or Agency Decision Maker;
• Unexpected changes in the child's placement provision (which may significantly impact on placement stability);
• Proposed change of placements, and where unavoidable, actual change of placements;
• Court Orders and outcomes from Directions hearings;
• Significant delays in completing any looked after review decisions;
• Any missing care episodes;
• Details of any strategy discussions/meetings or other meetings where IRO not present;
• Any period of exclusion from school;
• Outcomes from health assessments or medical consultations which identify/confirm any serious previously undiagnosed conditions;
• Notification of Strengths and Difficulties Questionnaire having been completed and logged onto Azeus;
• Unexpected changes in the child's family or foster carer's circumstances (births, deaths, etc.);
• Arrests, bail, and convictions;
• Serious accidents;
• Changes of allocated social workers;
• Unexpected proposed or actual discharge from care;
• Complaints from or on behalf of the child, parent, or carer.

A review will not be required for every change and the IRO will determine whether the change requires a CLA review to be convened. The IRO should consult with the child, where appropriate, and the child's wishes and feelings about the impact of the proposed change on his/her life should be taken into consideration in reaching a decision as to whether a review is necessary.

If, following communication with the social worker, the IRO is satisfied that the arrangements in the care plan continue to meet the child's needs or that the change does not have significant implications for the care plan and that a review is not necessary, a record of this agreement and the reasons for it should be placed on the child's file. The child and other relevant adults, both within the family and the professional network should be advised of this decision where appropriate.

In addition, the IRO Handbook requires that a review must be convened in the following circumstances, prior to any of the following changes being implemented:

• Whenever there is a proposal for a child to leave care before the age of 18, i.e. for a child to become a relevant child, rather than an eligible child;
• Wherever there is a proposal (which has not already been endorsed by the IRO) for the child to move from a regulated placement (e.g. foster care or children's home) to an unregulated placement (e.g. a semi-independent unit or "independent living" facility) before the age of 18;
• Prior to a child being discharged from a secure children's home or leaving custody;
• Wherever any unplanned change is proposed to a child's accommodation that could significantly disrupt his/her education or training (e.g. having to move school during the academic year or during a programme leading to recognised qualifications);
• Where a change of placement is proposed for a child who has remained settled and established with the same carer, or in a residential placement, for a significant period of time and where reports have previously indicated that the placement is appropriate and the child is going to school.

Please note that the Children's Homes (England) Regulations 2015 require that a review of the child's relevant plan is held where the child has been persistently absent from their placement, or where there are concerns that the child may be at risk of harm.

7. Informing the CP Chair of any Significant Change in the Child's Circumstances

The majority of changes in the child's circumstances are discussed at Child Protection Conferences. However, the CP Chair will need to be informed of significant changes at anytime. These include:

• Death, further injury or abuse to the child;
• Change of address, primary carer, primary carer's partner;
• The child has moved out of county;
• The child has become looked after or has ceased to be looked after;
• The child is looked after and a care plan has been agreed which is that the child will not return to the situation that led to the child becoming subject to a child protection plan;
• Court Orders and outcomes from hearings;
• Unexpected changes in the child's family circumstances (births, deaths, etc.);
• Changes of allocated social workers;
• Complaints from or on behalf of the child, parent, or carer;
• If it is not possible to implement the child protection plan for any reason;
• Concerns for the child have increased and an early Review Child Protection Conference (RCPC) is being considered/requested;
• Concerns for the child have decreased and an early Review Child Protection Conference (RCPC) is being considered/requested.

8. The Management Arrangement for the Conference and Review Service

The Team Manager (Conference and Review) is responsible for the line management and supervision of the Independent Chairs. The Manager (Safeguarding and Quality Assurance) is responsible for the overall service.

The role of these managers during the case management escalation process shall be:

• To provide clear supervision to the Independent Chairs, taking into consideration the issue being raised and providing feedback on the strengths and weaknesses of the concerns or disagreements being brought forward;
• To ensure that throughout the process, lines of communication remain open and clear and that the issue does not become clouded, personalised, or lost in other processes;
• To ensure that meetings take place on time and that they are present at all relevant meetings above the Team Manager level;
• To provide senior management briefing as to the view of the Conference and Review Service on the issue being raised and possible routes to resolving the issue;
• To ensure that if appropriate, independent legal advice has been sought by the IRO at the appropriate time; to discuss this advice in supervision and consider its possible implications for the issue being raised;
• Overall, to encourage and enable resolution prior to the issue reaching the Chief Social Worker.

These line management guidelines are not designed to hinder or minimise concerns raised by Independent Chairs. However, given the impact on Children's Services should the management escalation process reach the referral to the Director stage, it is crucial that there is clear and transparent evidence for senior managers of the Independent Chair management and supervision during the process of escalation.

9. Gathering Data on Formal Escalation and Resolution

The Team Manager will be responsible for the collection of data and will report on the number of Formal Case Management Escalations and the timescales reached in resolving them.

10. Escalating Concerns in Relation to Independent Chairs

It is important to recognise that Independent Chairs should also remain open to scrutiny and challenge if required. Wherever possible, the social work staff and management will attempt to resolve a problem by negotiation, including contacting the Independent Chair responsible and their line manager, attempting to resolve the problem directly with them. This can be escalated to the Manager if not resolved.