Oral evidence: Mental health and well-being of looked after children, HC 481Wednesday 16 December 2015
Oral evidence, 16 December 2015.
Witnesses
Tony Clifford, Head of Virtual School for Children in Care, City of Stoke-on-Trent, Carol Jones, Specialist for Leadership and Teacher Professionalism, Association of School and College Leaders, and Natasha Devon, founder, Self-Esteem Team, gave evidence.
Chair
Welcome to the second session of this important day in our inquiry. Could you first say who you are and who you represent?
Tony Clifford
I am Tony Clifford. I am head of the Virtual School for Children in Care in Stoke-on-Trent.
Natasha Devon
I am Natasha Devon, and I am the Department for Education’s mental health champion.
Carol Jones
I am Carol Jones. I am the specialist for leadership and teacher professionalism with the Association of School and College Leaders and a former headteacher.
Chair
Thank you very much. Funnily enough, I am going to be talking about what the National Association of Head Teachers has been saying. It has told us that schools are delivering emotional first aid for students with mental health problems. Carol, what evidence do you have for that?
Carol Jones
It is true to say that many schools are struggling to access resources, particularly CAMHS, due to diminishing resources and school budgets and a lack of consistency in the resources that are available to schools, particularly for mental health and wellbeing. Accessing the kinds of resources that our children need is a challenge for school leaders and for schools in general.
Chair
Natasha. From the vantage point of the DfE?
Natasha Devon
I go into about three schools a week and I completely agree that how much is available to support teachers varies, based on geographical location. My observation is that the threshold for what is considered to require medical intervention has increased over the past decade. What was once considered to be a severe eating disorder is now advocated in Heat magazine, and self-harm has been utterly normalised. From that point of view, teachers are dealing with things that were once dealt with by medical professionals.
Tony Clifford
Schools are struggling to access services in a timely manner, but on the other hand there are solutions to how this can be dealt with. Our approach is to co-design services with schools, so that rather than send the child out to a service, you bring the service into the school to work with both the adults around the child and the individual child. You have already had a submission from Bath Spa University, working with a group of virtual heads, about schools becoming attachment aware. It is a service redesign issue in my view.
Chair
That moves me quite well on to the next question, which is about the extent to which schools are actually commissioning mental health services, perhaps because local authorities do not have adequate provision. Is that something that is happening more and more? How can we calibrate that?
Tony Clifford
There is the possibility that schools will try to commission what they need. My view as a virtual head is that that is not necessarily the most supportive approach for a school. Although the school may then find that that service works with the child, how does it then ensure that all the other professionals around that child—I include foster carers, adoptive parents and people who are working with children on the edge of care as well—can understand what that intervention has provided for that child, so that the adults around the child can respond and adapt to it? There are some risks in single-agency commissioning of services, because unless all the other agencies around that child understand those messages and can work with them, that intervention is very likely to be ineffective. From the child’s point of view, that piece of work with that adult which has helped them to come to terms with trauma and loss may not be replicated in the responses of other adults around them, which can actually exacerbate trauma. Our approach is that schools need to become attachment aware, so that all adults in the school and all the professionals linked to the child have a common understanding. That is safer for the child and more effectively uses scarce resources. I am delighted by what the NICE guideline says about this, and if I had one key recommendation to the Committee, it would be to ensure that the NICE guideline, jointly commissioned by the DfE and the Department of Health, is implemented in full. Its recommendations are very clear about the understanding that schools need to have around such issues.
Chair
Natasha, you visit three schools a week. Do you consider Tony’s observations to be relevant and appropriate?
Natasha Devon
He is absolutely right that action needs to be joined up between schools and CAMHS. The DfE is trialling in 22 areas around the country a joint training scheme, so that teachers have a professional expert on the end of the phone whom they can call if they are presented with a student who is suffering. From a mental health first aid point of view, there are two things that would be really helpful. The first is that there should be specialised PSHE teachers. PSHE is the one subject in which there is not a specialist teacher in house, so it is left to teachers whose specialisms lie elsewhere to teach what is, in fact, an incredibly important subject in the curriculum. The other thing that every school should have is an in-house counsellor because not every student has the confidence or the knowledge to be able to seek the help they need outside the school environment.
Chair
Would you mind dropping us a line on your thoughts on PSHE? It is something that we are very concerned about. We are writing to the Secretary of State on a relatively regular basis on the subject. One of my observations is that the Health Committee and the Home Affairs Committee are basically making the same point as we are, which is that more PSHE is needed in schools, and you have just said that as well. To strengthen our case further, I would be grateful if you could write to us about that.
Natasha Devon
Most schools have an understanding—but only because of Ofsted—that PSHE is mandatory and that not having a robust PSHE programme will prevent them from being labelled “excellent”. There is an awareness of that but, equally, there is no time in the curriculum for it and there is no budget, which leaves PSHE in a really precarious situation. sThere is a lot of bad practice going on in schools, in my experience. The first thing is the dreaded PSHE drop-down day where you have to cover everything from how to budget to how to be a man in the modern world to female genital mutilation—it all happens in one day. If you are sick or absent that day, no PSHE for you. You are also completely overwhelmed with the classes that you are presented with. The other is trying to shoehorn PSHE into form time, which is an average of about 20 to 30 minutes when the form tutor also has to register and deal with any disciplinary issues, so they are lucky if they have 10 minutes to cover incredibly important topics. I would like to see space for PSHE on the curriculum and a budget for it because, done right, it is the cornerstone of any wellbeing programme.
Chair
Thank you very much Natasha. Carol, do you think schools have sufficient funding and resources to deal with mental health issues?
Carol Jones
No. I would like to come back to the point that Natasha was just making about PSHE because it relates to funding as well. The Committee will know that last year there was an inquiry into PSHE, sex education and so on. I think we discovered at that Committee that there was also very good practice. We understand that there is an overcrowded curriculum and pressure on schools to raise achievement in EBacc subjects and traditional subjects. There is, of course, a specific demand. None the less, there is also very good PSHE practice in some schools. It depends so much on the values and vision of each school. In a diverse school system, everything depends on an individual school’s priorities and the time that they give to PSHE in the curriculum. For example, in my former school, we spent a significant amount of time on citizenship, PSHE, sex education, and mental health and wellbeing. Are there enough resources? No, of course not, but how we allocate those resources and how schools choose to use them is autonomous—dependent on each school leader and its governing board. It comes back to the vision and values of each school. There are some very innovative programmes on emotional health and wellbeing going on in some schools. For example, there is some interesting mindfulness work in schools—perhaps the Committee has looked at that. There is a longitudinal study of students who are undertaking wellbeing and mindfulness training in some of those schools. I am very happy to steer the Committee to some of those programmes should you wish it. There are also some helpful programmes on resilience and character building, which have had increased emphasis more recently. There is growing awareness in schools about the importance of emotional health and wellbeing but we, as schools leaders, always have to balance that—developing our PSHE programmes—against the priorities given to raising achievement and standards in traditional subjects, Ebacc and so on.
Chair
You have moved on to Caroline’s questions. Caroline, would you like to probe further?
Caroline Nokes
I might go back to Tash on this one. Presumably we all agree that if you want young people to develop emotional resilience and wellbeing, there needs to be space in the curriculum for them to be taught that in schools. Is PSHE necessarily the right place for that?
Natasha Devon
PHSE needs to be part of a spectrum of different solutions. It does not work in isolation, but it can be the catalyst—it lights a fire under the wellbeing programme and it can re-engage students with the topic and give them a renewed interest in it.
Caroline Nokes
I think it would not be too much to say that some of the young people who had been in care that spoke to us had a pretty negative view of the PSHE teaching they had received. Is that common? What more could be done to ensure that PSHE teaching is of the highest quality possible? Tony, you look like you want to say something.
Tony Clifford
I do, because the importance of PSHE is well stated by colleagues, but unless the messages that children are hearing in those lessons are played out across the whole school, what they hear in that subject will sound to them not authentic to that school’s approach, which is what Carol has alluded to. I would certainly argue—we probably agree—that good mental health is at the heart of learning and that attachment is the core of learning as well. Bergin and Bergin’s 2009 research talks about secure attachment being at the heart of learning and that teaching and learning is an attachment-like piece of work. Actually, what we need to see is this built into the whole school’s learning approach. We talked about initial teacher education and the importance of teachers coming into the profession understanding that this is a core learning process. We must emphasise that this is not an add-on; this is the basic of what is going on in good teaching and learning in any school and you can see it happening in a classroom. That works well for children in care and it works well for about 40% of children who will have some kind of mental health issue arising from childhood trauma.
Chair
This inquiry is about looked-after children and that is what we have to drill down and focus on.
Tony Clifford
Absolutely, but this is not an either/or for a headteacher who has scant resources; this is a both/and. We need to be mindful of the pressures on heads. Actually, if you do this for children in care, who may be a small part of your population, you will benefit your whole school. Certainly, our research shows that.
Caroline Nokes
The Committee has previously said that PSHE should be statutory. If you talk to organisations like the Girl Guides, they say that it should be statutory and I think that you, Tash, would argue that. You are the DfE’s champion on mental wellbeing. If we are saying it, you are saying it and most of the youth groups out there are saying it, what more can we do to make progress and ensure that PSHE is embedded in the national curriculum and that the DfE accepts that?
Natasha Devon
That is a really good question. As far as I am aware—this is just anecdotal—Nicky Morgan is in favour of it being made statutory, so the question is: what more can we do? My hunch is that financial considerations are at the root of the decision not to make it statutory, because as soon as you make it statutory you have to give it a budget.
Caroline Nokes
Thank you for that. I will finish with a question on teacher training. We have heard a bit about initial teacher training and Tash mentioned having counsellors in every school. Who is the right person to deliver this sort of activity? Is it teachers? Can we skill them up adequately for them to be able to embrace the whole range of mental wellbeing issues our young people might face, or should it be specialists from outside?
Carol Jones
We need a combination of both. Initial teacher education is currently being looked at by the expert group and when Sir Andrew Carter reported and made his recommendations about developing a core curriculum for initial teacher education, he very helpfully suggested that there should be a focus on special educational needs. And, in addition to subject pedagogy, there should be a focus on teachers understanding how the brain works and how children learn and the emotional and mental wellbeing of children. That is very helpful and something we would support. I suppose that having a very well educated set of new teachers coming into the profession would be helpful. I was very interested in Ian Mearns’s point to the previous panel that there should be ongoing professional development for all teachers to understand how children learn and the emotional and mental wellbeing of all of our young people and, indeed, of our teachers as well. This should form part of the whole school culture in looking at what is an effective learning environment for everybody—adults and children. It is so helpful to have teachers themselves well equipped and prepared to teach a focused curriculum, whether it be through PHSE or other aspects of the curriculum, on emotional health and wellbeing. It is also very helpful to have experts in the field. I am interested in Tony’s idea of having a co-ordinated approach to bringing experts into schools to train and support the entire teaching and support staff population, so that we all, as a school, have an understanding of how important our awareness is in supporting our looked-after children’s emotional health and wellbeing.
Lucy Frazer
When we met the children in care, one of the girls came up with an idea. She said, “When you search ‘self-harm’ on Tumblr, it says, ‘Do you need help?’” Is that something that social media should be doing? Can we encourage that in other types of social media?
Tony Clifford
Can I chip in here? What you are asking links to what has just been said. If you imagine what happens there—if we give that young person access to a service very rapidly through social media, for example, and that young person then begins to realise that there is help and that they can begin to make sense of their own behaviour and how they are feeling, what then happens when that young person goes back into school and nobody else within the school environment understands the understanding they have now gained? I would say that we need to develop a core set of understandings around all professionals working with these young people—a baseline set of understandings, through the methodologies that have just been described. We then need—this goes back to the question about training—to bring in our specialists to work with the whole team around that young person, so that they can further make sense of what that behaviour looks like in practice. This is about enabling people to become emotionally literate, so that they can make sense of the young person’s behaviour and of what some of the more dramatic self-disgust and self-harming behaviours really mean and where they are coming from. You then begin to contain that anxiety within the system that so often leads to the child being shot straight out into something else. There is a linear pathway that is very risky. It can begin with that social media interaction. A rapid intervention service in the moment sounds wonderful, but if the system does not understand it and cannot contain it, that young person is, to some extent, being sold a lie. We have to be careful.
Lucy Frazer
The message could be, “Go and speak to your teacher.”
Tony Clifford
Absolutely, but if the teacher knows nothing about it, their response in the moment could exacerbate the child’s trauma. What we do is bring in our educational psychologists. We use the pupil premium funding that virtual heads now have—funding that is personalised to the child and follows them—in Stoke to have an additional educational psychologist who will work with not just the teacher who gets the initial response from the young woman or young man, but the whole team around them. That begins to contain the very traumatic set of circumstances for the child and for the team, and you begin to get an attachment community around that young person. That is how in Stoke we have maintained zero permanent exclusions for children in care since 2009.
Lucy Frazer
I just want to understand this: is there a role for social media?
Natasha Devon
Research that has been conducted by YoungMinds—we work closely with them, and I know you have had them here—suggests that if a child is suffering from a mental health issue, the first thing they are most likely to do is turn to the web, so there is a role, but with two provisos. First, what the internet can do—Tumblr is a perfect example—is bring everything to an equal level, whether that is really sound advice by a top psychologist or something that has been written by a random blogger. We need to give young people the ability to discern what they are seeing, which is why critical thinking with regard to the web is a huge part of the lesson that I teach in schools. I also think that regulation is really key, because a lot of other people don’t understand that pro-self-harm and pro-anorexia websites often begin as support forums, but they attract people who have issues and are not regulated.
Suella Fernandes
I have a quick follow-up for Carol. Some of the mental health issues relate, in my observation, to anxiety, low self-esteem, eating disorders and the failure to build relationships. You mentioned the use of mindfulness. I wonder whether you could say a bit more about how that has worked, what form it has taken and what effect it has had on those particular issues.
Carol Jones
Mindfulness is being used in several schools now. In fact, I think that seven pilots are working with the Wellcome Trust and Oxford University, which are looking at the impact of mindfulness in schools. They ensure that a group of teachers are trained in teaching mindfulness to young people. So far, it looks very positive. It looks as if it is having an impact not only on their own behaviour, emotional states, wellbeing and so on, but on the children around them and the ethos of the school.
Suella Fernandes
Can you give a concrete example?
Carol Jones
Yes. The Camden Academy[1] is currently running the programme and has had teachers trained in such a model, and there are other schools as well. I can research them and send that to the Committee. Certainly, they have seen a reduction in incidents of challenging behaviour and violence, an improvement in the general ethos of the school and a reduction in exclusions. It is probably worth looking at that in more detail. We certainly welcome the outcomes of the longitudinal, long-term study—Oxford University’s work with the Wellcome Trust. It is obviously not a panacea for everything; it is a more preventive, long-term programme that will hopefully have a more general impact on the schools that are involved. To return to the emotional crises for some children, we know that accessing CAMHS and the other organisations that we have referred to is problematic for some schools. In crisis situations, some schools are resorting to referring children to A&E and so on. We need to be aware of the crisis, as opposed to the long-term preventive work that some schools are beginning to involve themselves in.
Chair
When we spoke to young people before our formal sessions, many of them made the point that schools and CAMHS don’t always work well together. That obviously caused them anxiety and sometimes further difficulties. How can we improve that relationship?
Tony Clifford
I want to pick up on what has been said. I am going to repeat myself, in a sense. In Stoke, we work with heads, CAMHS and educational psychologists to co-design a whole-school approach. The young person’s frustration will be that, if they have had a good CAMHS intervention and they go into classrooms in which teachers don’t understand, they won’t get the response they were looking for. That won’t help them or the teacher. We are duty-bound, however we co-design and co-commission, to ensure that our experts in the field are able to influence the culture around the child. My optimistic view is based on working with a group of virtual heads. We have seen that you can do whole-school training at a fairly simple level to explain that the brain is pattern-seeking and survival-oriented, and that connections on the outside build connections on the inside—simple stuff—and teach people emotion coaching that draws on mindfulness, in terms of staff managing their own responses and feelings in the moment to help the child manage their responses and feelings in the moment, which is an attachment-like relationship. For example, in a small-scale study in which we tracked 85-plus young people across 10 schools, you can see a halving of behavioural incidents in school, a halving of fixed-term exclusions and SDQ scores—it is really important that we implement them across the piece—lowering for those children. That is a very small-scale piece of research, and one of the things that we must do is further research into cost-effective interventions that can be done in school—not the high-level, reactive stuff but the low-level, preventive stuff. We need to give heads a very clear message about what they can do to make that difference to the whole-school culture. There are huge pressures on heads—I have been a head, as well as being a virtual head—and they have massive competing agendas. We need to bring them clear research that says, “If you do this across the whole of your school, it is doable and it will make this much difference.” It very much has to be an outcome-based approach.
Michelle Donelan
You said before that the rate of exclusion was zero for a period of time following the attachment studies, but what other proof is there that it actually helps the mental health of looked-after children?
Tony Clifford
My reference to the rate of exclusion is in my local authority, and it actually predates attachment-aware schools. When I came in in 2009, we didn’t have this programme, but I recognised that, to make the difference, it was no good my going to a headteacher and saying, “You can’t do this, and you can’t do that, because you are damaging children” unless I also brought them a training programme that made sense to them, that they could incorporate into a very packed curriculum and that was deliverable on the ground. That is why we do that. We have drawn on the work of Bath and North East Somerset Council and Bath Spa University, which were leaders in the field, but this is now being spread across the country. The evidence base is small but growing, and I ask the Committee to look at the Bath and Bath Spa submission because it contains some very interesting data on what you would hope is happening as a result of that whole-school approach. We certainly need to do more research in this area.
Michelle Donelan
Do you think that relatively small change can have a significant impact on children’s lives?
Tony Clifford
Absolutely, because if you look at the disproportionate effect of permanent exclusion on a child’s life, what happens is the domino effect. The child can no longer be in that school, the foster carer cannot cope, the placement breaks down, the child moves out of area and, as we have already described, they then have to start from scratch in a new environment. We absolutely have to create stability for that child, and the Rees-Bristol research on how we improve educational attainment for children in care talked about linking educational attainment data to social care data and SDQs. If you put those factors together, stability is the key. We will create stability when we have attachment-aware schools.
Michelle Donelan
Can you build attachment theory into other areas of mental health support, such as health assessments?
Tony Clifford
Yes, because if we are trying to take a holistic view of the child, I would argue that we shouldn’t just be trying to create a whole series of medical diagnoses. I work with young people who will sometimes have five different “disorders”—they will have OCD, ODD, ADHD, ASD—but when you look at the heart of that, and I am thinking about a particular young person at the moment, his fundamental issue was his attachment difficulties. Those diagnoses, which are high-level, expensive diagnoses to make, could have led that young person to a very, very expensive placement that we actually could not find nationally. What we have done instead is to continue working with the whole team around that child. He has stayed where he is living, he has stayed in his educational provision and he will go into a mainstream college, which will cost about a hundredth of what it would have cost to put him into the provision into which he might otherwise have gone, so it is cost-effective to build this into the totality of our approach from the highest end to your basic school understanding.
Suella Fernandes
How effective do you think virtual schools are in supporting the mental health of looked-after children?
Tony Clifford
The virtual head has been a statutory post since 2014. A group of us were privileged to work with the Children and Families Minister on an expert group, and across that group of virtual heads, our No. 1 thing that we most wanted was for schools to become attachment aware. We also wanted the pupil premium to sit with the virtual head, so that the money could follow the child. I would like to put those two things together, because they are linked. Colleagues have talked very well about the value of personalised budgets, and what we are really saying is: given the instability in many of these young people’s lives and how long it may take them to recover from trauma and abuse, how do we keep the plan close to that child? I think the virtual head has a key role. It is a challenge back to my colleagues nationally that we take this on board and that we actually co-design what is necessary in a local authority area to meet the needs of our children. We are beginning to do that. We are a very new professional body and, at the moment, we are trying to form ourselves into a national association, having already got a national steering group. But if you looked at our development plan, that will be No. 1 on the list. We realise that I have 880 children in 185 different settings and the number of young people I am working with is growing at an incredibly rapid, and to some extent, anxiety-provoking rate. I cannot do that on my own. What I can do is task myself to co-design with colleagues what is necessary to hold that child. That is a legitimate challenge back to me. The data that come out should demonstrate that that piece of work, which goes back to the research question, has made the difference. The Rees-Bristol research is very encouraging in that respect, because it describes care as a protective option. The problem we have is that we tend to measure the impact of care against too limited a dataset and tend to compare care with the whole population rather than with, for example, the child-in-need population. If you do that and make the right comparison, you see a huge impact. Part of that lies with the work of a teacher with a child, which is a relational activity that we must support, so I build from that child outwards, in terms of our system design. It is the right challenge and it is the heart of what I do in my job.
Caroline Nokes
Can I just ask about the mental health services and schools link pilots? Specifically to Natasha, how do you think this is working and how does it fit in with your role?
Natasha Devon
It has only been running on the ground for a matter of weeks, so it would be really difficult to tell you how it’s working. One of the key things about my role, I feel, is that I am able to provide a voice for teachers at Government level, because I meet and converse with so many of them. Certainly from a teacher’s point of view, what they would appreciate is knowing where their responsibility ends and CAMHS responsibility begins. There are three layers to mental health in school: there is prevention, mental health first aid, and then, there is when you need to refer something on because it has become bigger than either of those. Within prevention and mental health first aid, in terms of wellbeing in school, a programme that includes lots of different things is the main place where that needs to be administered. However, having listened to all the comments that have been made here today, I would be really wary of designing any kind of one-size-fits-all approach for schools. You can go to two state comprehensives that are two miles down the road from each other and they will have a completely different culture from one another.
Caroline Nokes
Can I ask a really specific question on that? Have you identified any differences between local authority maintained schools and academies?
Natasha Devon
Yes. Academies tend to have more freedom to design their wellbeing programme in their school, so, in my experience, they are trying more innovative things, which sometimes really work and sometimes don’t. They will go one of two ways, but what I would like to see is the DFE providing a menu of suggestions for teachers, because even each year group within a school is different. Each form is different, and teachers know their pupils the best. If we can take the best parts of mindfulness, CBT and all the other things that we know work and improve the culture in a school, and then give teachers a menu of options that they can design specifically for their school, that bespoke approach is going to be the most effective.
Caroline Nokes
To take you back to the specific remit of what we are looking at, do you know if any work has been done in these pilots to specifically target looked-after children, or is it a whole-school methodology?
Natasha Devon
As far as I know, they have not specifically targeted looked-after children.
Caroline Nokes
Do you think there are likely to be any qualitative outcomes that would indicate a difference?
Natasha Devon
Everything is being means-tested, so there will be some kind of evidence that you can look at.
Tony Clifford
In Stoke, we are looking at working with our heads to design what they need for their schools. I would support your view that a one-size-fits-all approach—“You must only do this one intervention for every child”—is clearly not sensible. This is more analogous to—within literacy, you would expect all teachers of literacy to understand phonics. That still allows teachers to be immensely creative about how they work with children to give them a love of reading in their classroom. In the same way, if we have a common set of understandings about how children learn and how attachment and trauma can affect learning, you free up teachers to be creative and to pick up some amazing interventions, like mindfulness. You liberate them to work with the child safely. I absolutely support the view that you should then say to that teacher, “This is what you can do; it’s doable in the moment, but around that are professionals who will work with you and support you.” The level of supervision for teachers in schools compared with the level of supervision for social workers, foster carers and CAMHS workers is a real cause for concern. I would say the level of supervision for heads is also. Therefore, you will get fight, flight and freeze responses that can lead to permanent exclusion, and you will have heads saying, “I couldn’t do anything else other than permanently exclude this child. I am heartbroken by having to do it.” What we have to ask ourselves is: where was the support for that person in that moment to make those decisions? It is often sadly lacking. That core understanding is a protective factor. The huge drop-out of newly qualified teachers often lies in the fact that they are, in terms of their emotional literacy, sadly lacking. That is not a criticism of them; it is a criticism of how our initial teacher training equips those young people to understand what they are seeing in the children they are working with.
Caroline Nokes
Can I take you back to what you said about a lack of support for heads and ask you the same question I asked Tash? Is there a difference between support for heads in academies and in the local authority maintained sector?
Tony Clifford
For me, as a virtual head, there is no difference between how I would work with a head in a free school, an academy or a maintained school. From my point of view, these are all my children—these are all my schools, and I am corporate parent. That is an expectation I have of myself, because I am working with 185 different schools and you have to get to the heart of the matter with all of them. Some of this stuff sounds deceptively simple, but if you peel back the layers in the tragic story of a young person who has had multiple care placement breakdowns and been to multiple schools, you will find the same pattern repeated. I was a head in a special school—a very high end one—having worked in maintained standard schools. I was picking up children at 15, and when I read their case file, the pattern of behaviour that brought them to me, having been permanently excluded from everywhere else, was the same pattern of behaviour they displayed as a five-year-old when they first got permanently excluded. The pattern was repeated over and over again. Nobody had unpicked that pattern, and at the heart of that pattern was the child’s damaged attachment to their birth parents, their ongoing display of that trauma and the lack of capacity and understanding around them to contain those issues. As a five-year-old, it was doable; as a 15-year-old regularly assaulting whoever happened to be around, that became increasingly difficult and expensive for the system. The core understanding is essential to maintain the young person and to maintain our heads and our teachers; we have to put the whole thing together.
Carol Jones
I think the high-risk accountability system that we have applies to all school leaders, irrespective of whether those schools are maintained or academies. We are all subject to the same scrutiny. Therefore, that puts pressure on school leaders, particularly headteachers. I do not think it makes any difference as to whether they are maintained schools or academies. To return to the freedoms or the opportunities to which you referred previously, again it is impossible to decide whether this is attributable to being a head of an academy or of a maintained school. So much depends on the values and the school vision, and that can vary from academy to academy and from maintained school to maintained school. A school that has, at its heart, a vision that ensures that all children are supported and that emotional health and wellbeing are secure will ensure that it delivers a curriculum in an appropriate way, irrespective of whether it is through PSHE or other aspects of the curriculum. It is impossible to decide whether this is about maintained schools or academies.
Tony Clifford
In an increasingly free market in education, the virtual head has the pupil premium and we say to schools, “No personal education plan, no pupil premium,” which is a child-based commissioning approach and is what we shared with the Minister. That gives us some direct commissioning power with schools that are not doing what they ought to do—that can happen—and we need that protective factor for a child so that we can support good schools by giving them the funding they need when they need it for that child. We can explain to schools what the expectations are about getting that funding. We need that funding directly to go with that child via a virtual head, otherwise we could lose that protective factor in the system, and that is very risky for the child.
Chair
Can I just ask about the care plans? We discussed them a lot in the previous session but they have not really cropped up in this session. Were those useful instruments for helping to solve some of the problems that you have talked about, Tony?
Tony Clifford
Yes. As I am sure you know, every child, as part of their care plan, has to have a personal education plan. We have those in place from age two and, for us, that goes all the way through to 25 if that young person stays in education. That plan needs to contain in it sharp targets for professionals to support that child. They are about learning but they are therefore about all the things that support learning, including mental health. Our plans will include, for example, funding to support the adults around that child with the mental health issues so that that child can learn. That is where I would argue that the accountability joins up for that child. There is a concern that sometimes our personal education plans for young people are not good or sharp enough and are not completed in a sufficiently timely manner. But, actually, they can be a very powerful instrument. The leverage of the pupil premium—because a school, through writing a good personal education plan can pull down its £1,500 or £1,900 of pupil premium—is enough to actually bring in an educational psychologist to work with a whole team around that child for a number of sessions, which can make a huge difference to the child. There is a way of joining this up. Sharp plans are vital for accountability. That is something that Ofsted ought to be looking for in its inspections because if you inspect a school it is a fairly quick win to say, “Do you have a child in care? Could I see their personal education plan? Let me have a look at what is in there about that child’s mental health and how those needs are being met because when something goes wrong, that is what I will be coming back to.” That is a huge challenge. These are appropriate challenges for us and they do support the child.
Carol Jones
I would agree that personal education plans are very helpful because they bring all the agencies together. We have already alluded to the fact that there can be a tension between, for example, CAMHS and schools, but the personal education plan and the meetings that surround that ensure that the child is at the centre. All the agencies come together with that child to draw up very clear targets and aspirations for and with that child, and that is very helpful. The relationships can also become quite well established at the beginning of that PEP plan. So, yes, we see this as a positive move. Having said that, of course we might bring all the agencies together but we cannot always ensure that those agencies are well resourced. For example, there are schools that might not be able to access CAMHS and certainly cannot access educational psychologists. Gone are the days where many of us—I say this as a previous London head—could readily access ed psychs. They would often be absent at the PEP meetings and so on simply because the resources were not there. So, it is a good idea and, yes, a good way of holding all professionals to account and ensuring that the looked-after child is at the centre of the care plan. Nevertheless, we need to ensure that this can be backed up with adequate resources.
Natasha Devon
I just want to add to that. A couple of weeks ago I spent a day at the Red Balloon centre. I do not know if you are familiar with it. It is a place for severely bullied and traumatised children, many of whom have come from care. The centres are able to provide not only one-to-one tutoring, but counselling, and things such as nutritious meals and the entire care package at a cost of £10,000 per child per academic year. When you match that against the overall cost of where their life was probably taking them, it is nothing—so it can be done relatively cheaply.
Chair
I think that charity is a particularly good one, actually.
Natasha Devon
It is amazing.
Chair
Thanks for mentioning it today and thank you all for coming to this interesting, informative session. Oral evidence: Mental health and well-being of looked after children, HC 481 21 [1] Witness clarification: UCL Academy in Camden