Thematic Review

A Thematic Review of Learning Lessons Reviews (2011-13) was undertaken in 2013 identifying the key learning from five completed reviews and the actions taken to address these.

  • Four of the five reviews were concerned with young people over the age of 16.
  • Two were young people who died as a result of hanging themselves. One of them was ‘looked after’ by the Local Authority at the time, whilst the other had previously been ‘looked after’ and was receiving ‘leaving care services’. They were both vulnerable and their self-harm and suicidal tendencies were not sufficiently identified, risk assessed or managed by agencies.
  • One was an adolescent who was subject to a Child in Need Plan and was assaulted whilst living in an adult homeless hostel.
  • The fourth was a young adolescent woman whose chronic neglect was not recognised and responded to in a timely manner and which almost resulted in her death.

The key themes identified and actions taken were;

To provide more consistent services for ‘care leavers’.

  • Outcome: The Children’s Social Work Service has updated its Practice Standards Manual to ensure that pathway planning takes full account of vulnerability issues in undertaking risk assessments.
  • Outcome: ‘Looked After’ children’s teams were established as part of the re-structure of LCC Children’s Services (2011-13).
  • Outcome: The Children’s Trust Board is promoting the development of a multi-agency ‘Young People’s Service’ to support vulnerable 16 – 25 year olds.


To ensure that statutory reviews of children and young people who are ‘looked after’ effectively scrutinise and robustly challenge the care plans in place.

  • Outcome: Responding to the requirements of the Care Planning, Placement and Case Review Regulations (2010) has significantly increased the authority and responsibilities of Independent Reviewing Officers and enabled better coordination of information from agencies at review meetings.
  • Outcome: The LSCP Quality Assurance and Audit programme for 2013/14 includes an evaluation of the effectiveness of care planning for ‘Looked After’ children and young people.


To develop a partnership approach to adolescent self-harm and thoughts of suicide.

  • Outcome: The LSCP has produced a Suicide and Self-Harm Strategy with a booklet providing guidance on how to respond to children and young people who self-harm or who feel suicidal.
  • Outcome: The LSCP will lead a city-wide briefing for front-line workers to raise awareness about self-harm and suicidal behaviours.


To ensure a consistent response to children and young people who become homeless.

  • Outcome: Implementation has commenced of the ‘Children and Young Person’s Housing Plan’ with the development of an emergency direct access unit for children and young people, providing short stay accommodation.
  • Outcome: Area based support and ‘trainer flats’ are to be established.

To develop and further expand ‘Early Help Services’.

  • Outcome: The partnership continues to invest in preventative services and in the development of new approaches (e.g. Family Group Conferencing).
  • Outcome: The continued use of the Common Assessment Framework will be considered in the development of the new Single Assessment Framework and process in 2013/14.


To ensure that appropriate support and oversight is maintained when a child or young person is ‘stepped down’ from being the subject of a child protection plan to being the subject of a child in need plan.

  • Outcome: A series of reviews and audits are being undertaken to better understand the nature and trends within the cohort of children and young people who are subject to child protection plans. Particular focus is being given to those on plans for more than 2 years and those who become subject to plans for a second or subsequent time. The findings from these will inform the further development of multi-agency child in need procedures.


To promote a more rigorous child focussed approach to the analysis of ‘risk’ and ‘need’.

  • Outcome: The LSCP has developed and is delivering a multi-agency ‘Developing Skills in Assessment and Analysis’ course which seeks to equip professionals to rely less on ‘adult reporting’ when undertaking assessments.
  • Outcome: The Children’s Services Practice Manual has been updated to stress the need for effective management oversight and scrutiny of assessments and to set out the Quality Assurance Framework of audits and service evaluation.