Analysis Of Responses To The Consultation On Draft Statutory Guidance For Parts 4, 5 & 18 (Section 96) Of The Children And Young People (Scotland) Act 2014

5 Wellbeing

5.1 Section 2 of the draft statutory guidance concerned what is meant by the term 'wellbeing' in relation to children and young people in the context of the Act. This section of the draft guidance related specifically to Part 18, Section 96 (1-7) of the Act. However, the concept of wellbeing underpins the Act as a whole and is fundamental to understanding the other parts of this guidance.

5.2 The consultation asked four questions about Section 2. Questions 2 and 5 sought general views on wellbeing as discussed in the draft guidance, while Question 3 asked specifically about explanations of the eight wellbeing indicators and Question 4 covered descriptions and examples of wellbeing concerns.

5.3 There was a great deal of overlap in responses to these four questions. Thus, respondents' views are discussed in terms of the specific focus of the questions in the following discussion. Issues which were raised frequently in responses to Questions 2-5 (in particular, the interface between wellbeing and child protection, and inconsistencies between the draft guidance on wellbeing and the GIRFEC principles) are discussed in the analysis of Question 2 and are not mentioned again in this chapter to avoid repetition.

Q2: Definition of wellbeing in the context of the Act

5.4 Question 2 referred to Section 2 of the guidance as a whole and asked, 'Do you think the draft guidance on wellbeing provides clarity about what wellbeing means in the context of the Act?' Table 5.1 below shows that 72% of organisations and 5% of individuals agreed, while 28% of organisations and 95% of individuals disagreed.

Table 5.1: Question 2

	Yes		No		Total
Respondent type	n	%	n	%	n	%
Local authorities	15	(94%)	1	(6%)	16	(100%)
Health organisations	14	(88%)	2	(13%)	16	(100%)
Partnership bodies and joint responses	11	(79%)	3	(21%)	14	(100%)
Other national public sector bodies	5	(100%)	0	(0%)	5	(100%)
Third sector organisations	14	(50%)	14	(50%)	28	(100%)
Professional groups	7	(70%)	3	(30%)	10	(100%)
Other organisational respondents	5	(50%)	5	(50%)	10	(100%)
Total organisations*	71	(72%)	28	(28%)	99	(100%)
Individual respondents	2	(5%)	39	(95%)	41	(100%)

* Two respondents ticked both 'yes' and 'no'. These responses are not included in the table.

Percentages do not all total 100% due to rounding.

5.5 Altogether, 105 respondents (96 organisations and 9 individuals) provided comments at Question 2.

5.6 There were many positive comments about the guidance on wellbeing and efforts to set out a workable definition of a complex concept. Some found the guidance easy to understand and the examples useful. They described it as clearly laid out, and thought it provided a useful reminder of other information that was already available elsewhere.

5.7 Respondents thought the links to and reiteration of the wellbeing indicators were helpful in showing the multidimensional nature of the concept and how the wellbeing domains interact. The emphasis on a holistic approach to wellbeing and recognition that children and young people can thrive in different circumstances was welcomed, as was the focus on identifying strengths as well as concerns in assessing wellbeing. Some thought that the definition could be helpful in encouraging professionals to work together to meet the needs of the whole child and in supporting more consistent use of the wellbeing indicators. Respondents also thought that the links between the draft guidance and the UNCRC were helpful.

Issues requiring clarification or additional guidance

5.8 Despite a generally positive response to the wellbeing guidance, some organisations described it as too vague and open to subjective interpretation. Some felt that sharper definitions were required for operational purposes and that the draft guidance was not clear enough to deliver the aims of the Act. A number of themes emerged from the comments, as discussed below.

Use of terms

5.9 Respondents frequently noted that the terms 'wellbeing need', 'wellbeing concern' and 'wellbeing risk' were used interchangeably and inconsistently and that they were not clearly defined. They thought that a clearer distinction was essential in order to implement the Act effectively and consistently. Some also thought that a distinction should be made between 'measuring' and 'assessing' wellbeing and that one term should be used throughout.

Interface between wellbeing and child protection

5.10 A major concern was a lack of clarity around the interface between child protection and wellbeing, and the idea of a 'continuum of wellbeing'. Organisations wanted further clarification on how the concept of wellbeing fits with the concept of (significant) harm and thresholds for child protection in order to ensure that children are protected. Respondents stressed that the need for timely intervention in respect of child protection should not be overlooked in the broader process of assessing wellbeing. On the other hand, the lack of clarity on where child protection sits on the wellbeing continuum could result in child protection measures being put in place when a more measured, preventative approach would be more appropriate.

Interface between wellbeing and welfare

5.11 Organisations identified a lack of clarity in defining and using the terms 'wellbeing assessment' in terms of the Act and 'welfare assessment' in terms of the Children's Hearings system. This was a particular issue for young people of 16 and over who are, or have been, looked after or who require 'continuing care'. However, it was also suggested that 'welfare' should be considered synonymous with 'wellbeing' in terms of the Act.

Inconsistency and lack of clarity in the wellbeing indicators

5.12 Respondents questioned if the wellbeing indicators outlined in the guidance were, in fact, 'indicators', 'outcomes' or 'descriptors'. Some identified a need for a framework of wellbeing outcomes and of indicators to support a consistent approach to assessment and service provision.

5.13 Some suggested the guidance should make clearer where and how the indicators are to be used, who will use them and for what purpose. Respondents also sought more detail on how the indicators will operate in the context of other legislation and guidance.

5.14 Respondents identified a need for greater clarification of the following:

• How the guidance on wellbeing practically supports preventative measures and early intervention, and children's rights in line with the UNCRC
• What is meant by 'resilience' and 'promoting resilience', and the concept of risk and risk assessment in assessing wellbeing
• The identification of strengths and how assets in some wellbeing domains could offset concerns in others
• The assessment process and the range of tools for assessing wellbeing
• How to involve children and young people in assessing their wellbeing.

Other comments and issues

5.15 In relation to the definition of wellbeing, respondents also highlighted:

• A need for further work on public perceptions and parents' and carers' understanding of wellbeing
• Concern about significant variation between professional groups on what constitutes wellbeing
• The need for a stronger emphasis on partnership working and on the role of third sector organisations in assessing wellbeing
• Other factors which impact on wellbeing which should be included, for example: the mental, social and emotional health of the child, developmental issues and the wider role of play in wellbeing.

5.16 Some respondents, particularly those in the third sector, suggested that the draft guidance did not sufficiently reflect the principles underpinning the Act, in particular the lack of focus on strengths in the explanations of wellbeing indicators and in the guidance on identification and assessment of wellbeing concerns. Respondents also suggested that the descriptions of the wellbeing indicators should be more consistent with the rights-based approach implicit in the legislation which was based on the UNCRC. It was suggested that a stronger focus on outcomes rather than concerns might result in a more positive, rights-based approach.

5.17 Some respondents thought that the draft guidance could do more to reflect the importance of prevention / early intervention in wellbeing by giving greater emphasis to this underlying principle throughout. More mention could be made of the role in prevention and early intervention of existing mechanisms including multi-disciplinary screening groups and population health measures.

Views from individual respondents

5.18 Some individual respondents thought the definition of wellbeing was helpful in recognising that children and young people can thrive in a range of circumstances. However, they considered that, overall, it was too vague and open to subjective interpretation, and that clearer definitions of wellbeing and of indicators of wellbeing were required. Their comments reflected general concerns about the Act as a whole.

Q3: Indicators of wellbeing

5.19 Subsection 2.5 of the guidance defines each of the wellbeing indicators as set out in Part 18, Section 96(2) of the Act, and points out in 2.5.2 that they are not discrete, but connected and overlapping. Question 3 referred to subsection 2.5 and asked: 'Are the explanations of the eight wellbeing indicators helpful?' Table 5.2 shows that 82% of organisations and 19% of individuals agreed, while 18% of organisations and 81% of individuals disagreed.

Table 5.2: Question 3

	Yes		No		Total
Respondent type	n	%	n	%	n	%
Local authorities	16	(100%)	0	(0%)	16	(100%)
Health organisations	13	(87%)	2	(13%)	15	(100%)
Partnership bodies and joint responses	15	(100%)	0	(0%)	15	(100%)
Other national public sector bodies	4	(100%)	0	(0%)	4	(100%)
Third sector organisations	18	(58%)	13	(42%)	31	(100%)
Professional groups	11	(92%)	1	(8%)	12	(100%)
Other organisational respondents	5	(71%)	2	(29%)	7	(100%)
Total organisations	82	(82%)	18	(18%)	100	(100%)
Individual respondents	7	(19%)	30	(81%)	37	(100%)

Percentages do not all total 100% due to rounding.

5.20 Altogether, 123 respondents (97 organisations and 26 individuals) commented further on the wellbeing indicators.

5.21 Respondents provided general comments on the indicators as a whole, and also specific comments in respect of each of the eight indicators.

5.22 The majority of organisations considered that the descriptions and examples of indicators were clear, generally consistent and helpful for practice. They thought it was helpful that the draft guidance described the indicators as overlapping rather than discrete and they also welcomed the links with UNCRC and SHANARRI.

General issues about the indicators for clarification or additional guidance

5.23 Despite a generally positive response, organisations raised some general issues about indicators and the way in which they were presented. There were concerns that the descriptions were very broad and vague and therefore open to subjective interpretation. Respondents were concerned that the inconsistency in tone, style and structure would lead to inconsistency in identifying and assessing wellbeing in practice. Some respondents suggested that the Scottish Government should check that the descriptions were consistent with other versions of the wellbeing indicators available in GIRFEC guidance, and that a link should be provided to definitive descriptions.

5.24 Some organisations suggested the draft guidance would be enhanced if the indicators subsection was linked to a clearer description of 'the wellbeing continuum'. A greater focus on the integrated nature of the indicators with more explicit examples of the way in which they overlap might ensure that practitioners did not assess them separately. However, others noted concern about the overlap and thought the descriptions in the draft guidance should be more specific to promote consistency in practice and assessment.

5.25 Organisations wanted clearer guidance on how the indicators should be used in practice to assess a child's wellbeing. Respondents saw a need for more detailed descriptions and more specific 'real world' examples to ensure consistent interpretation and a shared understanding of the principles and implications of the Act among Named Persons, Lead Professionals, practitioners, parents / carers and the public. Respondents frequently sought clarity on who should use the indicators, and how the indictors would be used with particular groups including looked-after children and those with disabilities.

5.26 Some organisations thought the indicators did not provide a coherent framework for assessing wellbeing and that the Scottish Government should instead develop an outcomes framework, dataset, and related indicators as part of national practice guidance. More clarity on how the indicators relate to outcomes and how outcomes can be measured was also requested.

Specific comments about the indicators

5.27 Some respondents thought that the explanations of the indicators should more clearly reflect the age and stage of children and young people, in particular very young children, and young people aged 16 to 26 covered by the Act. Others suggested that they were not always relevant to children and young people with complex disabilities or looked-after children, and adjustments should be made to reflect these groups.

5.28 Many respondents provided specific comments about and amendments to the individual indicator explanations. These included:

• Recognising the need for children and young people to learn to manage risk, which was covered under 'active' but not under 'safe'
• Including emotional and mental as well as physical health under 'healthy'
• Recognising children and young people's right to be heard and involving them in decisions that affect them, and also respecting their choices and autonomy under 'respected' and 'responsible'
• Greater emphasis on supporting children and young people in expressing their perceptions and views including communication, advocacy and other appropriate support under 'respected'
• Concern that the explanation of 'responsible' was not age or stage appropriate, was too prescriptive and inconsistent with the child-centred approach of GIRFEC
• 'Responsible' should be described in more positive, assets-based terms
• The description of 'included' should be linked more clearly to 'respected'.

Other comments / issues raised

5.29 Respondents frequently mentioned the need for training for Named Persons, practitioners and professionals in understanding and using the indicators for assessment and action. They also noted the need for training in getting the views of children and young people, especially those with communication difficulties or other disabilities.

Views of individual respondents

5.30 Some individual respondents found the breadth of the indicators helpful and thought they represented good parenting. However, it was more usual for individuals to say they were too broad and too open to subjective interpretation to be useful. Concerns were expressed about the need for more specific thresholds for intervention. Some suggested that the indicators should reflect the impact of real harm or disadvantage to ensure that resources were focused on those children who need them most.

Q4: Wellbeing concerns

5.31 Subsection 2.7 of the draft guidance describes wellbeing concerns and who might identify them based on observation and assessment. It points out the importance of context and other information in identifying concerns, together with examples, and describes a continuum of severity. Examples of wellbeing concerns are listed under each of the wellbeing indicator headings, recognising that indicators may overlap and that the list is not exhaustive.

5.32 Question 4 referred to Section 2.7 in the guidance and asked, 'Are the descriptions and examples of wellbeing concerns sufficiently clear and helpful?' Table 5.3 shows that 63% of organisations and 9% of individuals agreed, while 38% of organisations and 91% of individuals disagreed.

Table 5.3: Question 4

	Yes		No		Total
Respondent type	n	%	n	%	n	%
Local authorities	12	(75%)	4	(25%)	16	(100%)
Health organisations	13	(87%)	2	(13%)	15	(100%)
Partnership bodies and joint responses	7	(50%)	7	(50%)	14	(100%)
Other national public sector bodies	2	(67%)	1	(33%)	3	(100%)
Third sector organisations	15	(50%)	15	(50%)	30	(100%)
Professional groups	7	(70%)	3	(30%)	10	(100%)
Other organisational respondents	4	(50%)	4	(50%)	8	(100%)
Total organisations*	60	(63%)	36	(38%)	96	(100%)
Individual respondents	3	(9%)	31	(91%)	34	(100%)

* Two respondents ticked both 'yes' and 'no'. These responses are not included in the table.

Percentages do not all total 100% due to rounding.

5.33 Altogether, 125 respondents (100 organisations and 25 individuals) made comments. In general, organisations found the descriptions and examples of wellbeing concerns helpful and they welcomed the emphasis on context and holistic assessment of the wellbeing of children and young people.

Aspects of the draft guidance requiring greater clarity

5.34 Although respondents generally thought the descriptions and examples of wellbeing concerns were helpful, they often considered that the level of detail was inappropriate for statutory guidance and that the descriptions and examples would be better set out in practice guidance. Others suggested that the descriptions and examples could usefully be clearer, more detailed, and more relevant to practice. Still others suggested that the distinction between statutory, operational and practice guidance was unclear in subsection 2.7 and that it was important to understand what was required by statute as opposed to professional judgement or practice.

5.35 Respondents frequently asked for clarity about the definitions of a wellbeing need, concern and risk. In particular, the references to 'wellbeing needs' in 2.7.1 blurred the distinction with 'wellbeing concerns' which was the intended focus of 2.7. There were also concerns about inconsistent use of terms between the Act and the guidance, and between the draft guidance and other advice and guidance on GIRFEC.

5.36 Paragraph 2.7.2 of the guidance included examples of situations which might give rise to a wellbeing concern and it was suggested that they could be more varied and include the impact of parental behaviour and issues on a child or young person's wellbeing. Some respondents suggested the inclusion of examples of maternity-related problems that might impact on a child's wellbeing at birth; specific concerns related to poverty and inequality; and post-school transition. Others sought more clarity around the implications of 'socioeconomic circumstances'.

5.37 The statement in 2.7.2 that a wellbeing concern may be identified by a child or young person, or anyone who knows or supports them, was widely welcomed. However, some considered the focus in 2.7.4 on professional judgement in assessment, without reference to input from a child, parent or carer, was less helpful. As noted previously, respondents saw the potential for significant variation between professionals in what constitutes wellbeing. Thus, it was suggested that responsibility for identifying wellbeing concerns should be shared and it would be important to engage with other practitioners and professionals as well as with children, young people and families to understand concerns in a wider context. Third sector organisations thought that their role in identifying and addressing wellbeing needs could also be clarified in this paragraph.

5.38 Respondents described the examples in 2.7.5 as helpful in illustrating the importance of considering context and other information in identifying wellbeing concerns but they suggested that they should also specifically refer to the wellbeing indicators to demonstrate how multiple indicators interact. There was a view that, while the examples illustrated the importance of context, they failed to help strategic or operational managers understand how the duties upon them would work in practice. Following up examples used in Section 2 in later sections of the draft guidance might provide a clearer sense of the process as a whole.

5.39 Respondents again raised concerns about thresholds for identifying wellbeing concerns and for action in the context of 2.7. They thought greater clarity was needed in references to a 'continuum of severity' in 2.7.6 and sought national practice guidance to help them understand where different concerns might sit on the continuum from a 'minor adverse effect' to a child protection concern. Related to this, some respondents wanted a clearer definition of what constitutes an 'adverse effect' in 2.7.4 and suggested the Scottish Government provide greater clarity about 'standards' in moving towards a broad concept of wellbeing.

5.40 Some respondents thought that more emphasis should be given to the overlapping nature of wellbeing concerns in subsection 2.7.7 and to the fact that the list of examples is illustrative and limited. Some were concerned that the examples might be seen as prescriptive which could lead to a narrow understanding of the indicators among individual practitioners.

5.41 There was a suggestion that the examples tended to focus on parental neglect or poor parenting and although relevant, a better balance could be achieved. Some suggested that more examples of situations where support to parents or carers could impact positively on children's wellbeing would be helpful. Other respondents noted that behaviour giving rise to a wellbeing concern may, in fact, indicate or mask other underlying issues or causes, and it was important that practitioners were aware of this. Some also suggested that the examples could usefully include more on mental and emotional health, and communication and physical disabilities.

Views of individual respondents

5.42 Individual respondents commented on the lack of clarity in the definitions of 'a wellbeing concern' and 'adversely affected', and also the threshold for identifying a concern and for intervention. The examples were described as limited and anecdotal.

Q5: Other comments on draft guidance on wellbeing

5.43 Question 5 invited respondents to provide any other general comments about the draft guidance on wellbeing. Altogether, 132 respondents (98 organisations and 34 individuals) made comments.

5.44 In general, respondents reiterated points made in response to Questions 2-4. However, they also took the opportunity to provide detailed comments on parts of Section 2 not covered by the other questions. Some clear themes emerged but there were also many detailed points about the subsections and frequent comments about how the guidance in Section 2 relates, or fails to relate, to other parts of the guidance and to the Act itself.

Aspects of the draft guidance requiring more attention and clarity

Lack of clarity in the draft guidance on wellbeing for young people of 16 and over

5.45 The guidance explains that the Act requires a Child's Plan for children and young people from birth to 18 years who are identified as having a wellbeing need which requires to be met by a targeted intervention (2.11). Organisations sought more guidance on assessing and addressing wellbeing needs for young people from 16 to 18 who may be in transition from school. Some felt that the guidance was oriented more towards younger children and the early years and that the wellbeing indicators needed to be made more relevant to young people and adolescents.

5.46 There was also a lack of clarity and consistency in the draft guidance in 2.13 on wellbeing for young people from 16 to 26 years who were, or who had been looked after (Part 9 of the Act) or required continuing care (Part 11 of the Act). It was unclear how the assessment of welfare for this group relates to the assessment of wellbeing, and there were concerns that assessing welfare using the wellbeing indicators might not be in the best interests of these young people. It was also unclear how the wellbeing needs of older young people would be addressed. There were concerns about the interface with adult services for this group.

Implementation issues

5.47 Respondents welcomed the five practitioner questions set out in 2.8.5 which were intended to help Named Persons to decide what action, if any, was required in following up a wellbeing concern. Some suggested adding a first question, 'Is the child safe?', or one about identifying positive wellbeing outcomes for the child, while others suggested a final question about whether the views of the child or young person and parents / carers had been considered. Some thought the questions focused too much on the individual child and should also reflect the role of the Named Person in supporting parents and carers as set out in 4.1.2 of the draft guidance. This has implications for sharing information and some thought more guidance was required on how professionals and Named Persons can interact with adult services and parents / carers to take account of parent / carer wellbeing.

5.48 Some respondents thought that the focus on the wellbeing of the child could lead to overlooking the impact on the child of the parent / carer's wellbeing and also underlying causes of wellbeing concerns. It was suggested that the guidance should be more explicit about how wellbeing assessments can take the wider factors affecting the child's wellbeing into account and seek to address these through services that support the wider family and community as well as the child. The point was also made that the focus on the individual child and their parents / carers led to individual circumstances being seen as 'the problem' when wellbeing concerns might reflect structural problems in society such as poverty and discrimination.

5.49 Respondents highlighted concerns about possible differences between Named Persons, practitioners and other professionals in their understanding, experience and knowledge of wellbeing for children and young people, and between services in meeting wellbeing needs. This could lead to conflict and inconsistency and pointed to a need for dialogue between Named Persons and other practitioners, and to joint training to ensure a shared understanding of wellbeing and its assessment.

5.50 A need for monitoring and evaluation of the impact of the approach on the wellbeing of children and young people was mentioned. Respondents discussed the need for further work to develop an outcomes framework and an increased focus on outcomes. Some called for a national level evaluation of the impact of the legislation and guidance on undertaking evaluation at a local level.

Views of individual respondents

5.51 Although more individual respondents commented on Question 5 than on Questions 2-4, they mainly restated their fundamental disagreement with aspects of the Act. Some thought the draft guidance was too ambiguous to ensure children were protected. There were concerns about inconsistency between the guidance and the Act and within the draft guidance itself about the involvement of parents / carers in assessment. The role of the Named Person was a particular concern in relation to sharing information, interference in family life, and the potential for disagreement with parents over assessment. Others considered that the Act was an infringement of civil liberties and an unreasonable extension of state control over people's lives.