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Reflecting on practice through PRISM

Friday 21 September 2018

Author: Jillian Ingram

Jillian Ingram, Child Protection Consultant at CELCIS, explains how a new model for shared learning has helped child protection in North Ayrshire

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I took up post as Lead Officer for North Ayrshire Child Protection Committee in October 2007. At the time, Her Majesty’s Inspectorate of Education (HMIe) was responsible for leading on the very first round of Joint Inspections of Services to Protect Children and Young People. North Ayrshire’s inspection began in December 2007, and I was immediately introduced to a whole new world of “joint self-evaluations”. 

Joint self-evaluation meant multi-agency partners (social work, police, health, education, SCRA, housing, legal and third sector) coming together to assess how well services work together. Using this evidence, we were able to improve our practices to support better outcomes for children and their families. Our rolling programme included specific reference to measuring the impact of improvement plans.

We worked hard to ensure that front line staff and families using child protection services all had a voice in relation to evaluating services.

We established that while we had a growing body of evidence about our practice, the impact this evidence was having on actually improving practice was patchy. We needed to bring front line staff along with the Child Protection Committee through our learning and improvement cycle. As well as embedding processes to involve front line staff in contributing to the evaluation of services, we needed to extend this to include multi-agency peer reflection on learning from this evaluation; consideration of findings; and improvement planning. 

We thought that the more effectively we can engage participants with the improvement plan, the more likely it is that they will share ownership of this and work to implement it.

As we began to develop a model for this type of learning, we agreed that we wanted to create a safe space for practitioners where local practice could be reflected upon openly.  This meant we could potentially be in a situation where staff directly involved in any given case were present, when their practice was perhaps being challenged by peers. Naturally, this caused us some initial anxiety, so we continued to debate the best way of creating safe spaces for staff.

Learning from Wales

When Wendy Rose, an Honorary Research Fellow in the School of Social Sciences at Cardiff University, attended a meeting of the Scottish Child Protection Committee Chairs Forum (now CPCScotland) in 2013 she presented work on establishing new arrangements for undertaking child practice reviews from Wales. 

She gave an example of a GP attending an open learning event with multi-agency colleagues - social workers, teachers, other health practitioners etc. - where the GP’s practice was challenged. After the event, the GP had fed back to the facilitators that although this had been difficult to hear, it had helped her to reflect on how to improve her practice.

PRISM is born

This example was the green light we needed to take forward our thinking and North Ayrshire Child Protection Committee launched PRISM – Practice Reflection and Improvement Short Module. I don’t know who was more nervous at the first morning – the facilitators or the participants! 

We knew we had people in the room who had been directly involved in the case we were discussing, and others who worked in teams that had not performed well.

We shared the story of the case – a little boy who was living in very neglectful home circumstances, where a number of services were involved but no one was keeping the needs of the child in sight – pausing at certain points to reflect on key aspects of practice.  
We had brought together six to eight participants in mixed groups so that different multi-agency perspectives were represented at each table, and we had prepared prompt questions to facilitate reflection at key points.

Every person in the room participated fully and everyone was respectful of the practice that was being reviewed. Participants moved beyond focusing on what had “gone wrong” and instead gave thoughtful consideration to the challenges that get in the way of good practice.

Making a change to practice

Towards the end of that first PRISM, we shared the improvement plan that had been agreed. One key aspect of this was how the change to our child protection procedures - introducing a standard multi-agency review meeting three months following a child’s name being removed from the child protection register – was now better understood.

The PRISM participants shared that having looked at this little boy’s experience and reflecting on how services could have worked better together to meet his needs, the change in local procedures had new meaning for them. They understood the context in which this change had come about and, more importantly, they could see the link between the learning from the case review and improvement action to change procedures that had resulted from this. The staff felt more confident in implementing this change of procedure.

Experience of delivering PRISM over four years has shown that staff are more than able to look at the evidence put before them, identify learning and challenge their own and others practice to improve in light of this. 

We know that the test always comes when staff are back on the front line, continually managing risk within dynamic, conflicting and highly charged environments.  Providing staff with more opportunity to access multi-agency peer reflection, such as through PRISM, can help to better equip them.

The path to success

The success of PRISM is owed to many contributing factors:
•    To those who support and undertake the resource intensive work involved in joint self-evaluation activity
•    To those who contribute to the evidence base for joint evaluation such as staff and family members who participate in focus groups and surveys
•    To North Ayrshire Child and Public Protection Chief Officers’ Group who prioritise joint evaluation and improvement work and hold North Ayrshire Child Protection Committee to account for this.
•    And, finally, to PRISM participants who, time and again, provide evidence that staff involved in this very complex, demanding, challenging work, somehow retain the energy and optimism to fully engage in opportunities to keep improving what they do, for the benefit of the infants, children, young people and families that they serve.

Jillian Ingram is Child Protection Consultant at CELCIS.

Interested in developing PRISM in your own area? We have a downloadable guide for you.

Please add a comment

Posted by Paul McCruden on
In Moray the Child Protection Committee adopted the PRISM methodology to ensure that learning from Initial Case Reviews reached supervisors and practitioners across the Children's Services Partnership.
PRISM is used in two ways. Firstly to provide learning and initiate improvement with the Team Around The Child. These sessions take place with small groups of staff who have been directly involved in the case. The reflexive nature of the session is emphasised by facilitators who were involved in the ICR.
PRISM methodology is also used to initiate learning to larger groups of staff of 40 -100. In these sessions which tend to last half a day the participants are informed of the review process before being asked to consider the multi-agency chronology for the case. The participants are placed in multi-agency groups and are asked to consider a series of questions set to illuminate learning.
Overall the sessions have been evaluated very positively and many attendees report having light-bulb moments as a result of the reflexive nature of the discourse. We are convinced it has proven to be a valuable method of initiating learning and improving practice.
Posted by Jillian Ingram on
Paul, thank you very much for your comments. It is great to hear about other areas developing PRISM as a way to support improvement in practice. The term "light bulb moments" resonates with the experience in North Ayrshire too. It is so important that practitioners are provided with opportunities to reflect on their experiences in protecting children and young people in order to identify their own learning and continue to improve their practice. This can help keep both children and staff safer.
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