Capturing what matters - how our IT systems help or hinder seeing children

Capturing what matters - how our IT systems help or hinder seeing children (Reflections from a Nuffield Foundation hosted Roundtable, 8 November 2023)

Linda Briheim-Crookall

Linda Briheim-Crookall is Head of Policy and Practice Development at Coram Voice, a children’s rights charity and part of the Coram Group. Linda has worked in policy, research and practice improvement for over 20 years, specialising in children in care and care leaver issues for the last 15 years.

The other day I was shown a new dashboard intended to help social workers find key information about a child more quickly from their records. The screen was full of red flags - how many times they had gone missing from home, played truant, police had been called to their home.
 

The dashboard was showing a fictitious child, but nowhere could I get a sense of who this child was supposed to be, what they were good at, what they enjoyed, what was important to them and what they wished to happen with their care. It struck me, what a challenge it would be for a worker seeing this screen, to focus on seeing the child, build on their strengths, and respond to what they said they needed.
 
I asked about this and was pleased to hear that the people who had developed the dashboard had thought a lot about this too. They had spoken about their system to young people. These young people recognised that their information may include risk factors, and felt it was important that it should be used to help them, not stigmatise them. However, the developers of the dashboard also said that they couldn't reflect the voice of the child and strengths based on information in the dashboard. There was no field on the child's social care record to draw this information from. It may be somewhere in their case notes, but not in a way that could easily be extracted or emphasised. Even if workers were asking the questions, there was no place to easily record it so it could be flagged. The system also could not easily be changed. The providers that design Case Management Systems would only include fields that were centrally mandated, and this wasn't. Local changes were costly and difficult to achieve.
 
All young people who have been in care have a right to request access to their records. Care experienced people talk about wanting to access files to put memories back together, fill in gaps in life, and see patterns in their past. The MIRRA project research at UCL emphasised how records are written, and what has been included or lost have a great impact on care leavers accessing their records. I have been in workshops where young people share stories about accessing their social care record. They often highlight they feel that the records reinforce a feeling of not being seen and understood. Too often what is retained does not reflect who they were, what they felt, or what they wanted.
 
It made me worry how the information held and how it is presented might skew the relationships children have with their social workers and other professionals. How easily they appear as problems to be solved, rather than children to nurture. It is human to respond to the information in front of us. If we are told Billy is challenging, we will be primed to look for difficult behaviour. If we instead read about Billy's love of writing, that he always turns up for English, won a poetry competition last year and has a close relationship with a teacher who encourages him, we see Billy in a different light. 
 
We need design in 'seeing the child' into the information systems we use. I've heard how some services have used case notes as written to the child. 'We talked about this', 'you wanted that' to shift cultures in the way records are written. There are others who have designed child friendly versions or plans or apps allowing young people to share their views, although these are not always integrated into the case management systems. Perhaps if we integrate more questions about the things that are important to young people this could help the care system focus on supporting these more. 

The Bright Spots programme has been working with children in care and care leavers to capture the things that they say make their lives good - e.g. trusting and supportive relationships, feeling safe and settled, and being involved in decision making. Our current work capture children and young people's views through surveys, but we are starting to think about whether we can redesign recording systems, assessments and plans so we focus more on what young people say to support their well-being. Things like the exploration of relationships with family and friends, how children and young people feel about where they live and who they live with, whether they feel safe and happy and if they think that they are doing well. Not in a tick boxy way, but in a way that starts conversations to help us understand them better. 

The systems we use should help us use information for learning, to take action - not just in terms of preventing bad things from happening but in building on and making good things happen in children's lives. The right systems may be able to support workers to be more strengths based and promote well-being by capturing protective as well as risk factors.