The SAAF study: A randomised trial of SAAF - A Structured Decision-Making Tool.

ISRCTN	ISRCTN45137562
DOI	https://doi.org/10.1186/ISRCTN45137562
Protocol serial number	v1: 9th May 2014
Sponsor	Queen's University Belfast (UK)
Funder	Department for Education. Project Reference Number: EOR/SBU/2012105 (UK)

Submission date: 05/06/2014
Registration date: 15/07/2014
Last edited: 17/12/2020

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
Child protection assessments can be very complicated. Social workers often need to gather and analyse a large amount of information in order to make sound decisions about whether or not children are being harmed or are at risk of being harmed in the future. The Department for Education in England wants to know if the Safeguarding Children Assessment and Analysis Framework (known as SAAF) can improve social workers assessments and decision making in child protection cases. This study will find out how well SAAF works, and what things make it easy or hard for social workers to use it.

Who can participate?
Social services staff from Childrens Services Departments. Each department has to be willing to make teams of staff available for training and are happy for those staff to be randomly allocated into different groups for the study.

What does the study involve?
Six Childrens Services Departments in England have been recruited to this study. Social workers are randomly allocated into experimental or control teams. Those in the experimental teams will learn how to use the SAAF tool and are asked to use it on all child protection assessments for six months. For those in the control teams, social workers will not change the way they do their assessments. Information on child mistreatment for all the children that are being assessed during the time that the trial is taking place will be collected and they will be followed up for at least six months. We will also look at the quality of social workers assessments to see if assessments made using SAAF are better than those made without using SAAF. If we find that SAAF works well, then this study will help to improve how social work assessments are carried out with children in need of protection.

What are the possible benefits and risks of participating?
No risks associated with taking part in this study have been identified. Potential benefits from participation include improved knowledge and skills in undertaking child protection assessments.

Where is the study run from?
Queens University Belfast (UK) and The Colebrooke Centre for Evidence and Implementation (UK).

When is the study starting and how long is it expected to run for?
January 2014 to January 2016.

Who is funding the study?
Department for Education (UK).

Who is the main contact?
Professor Geraldine Macdonald
geraldine.macdonald@bristol.ac.uk

Contact information

Prof Geraldine Macdonald
Scientific

University of Bristol
Social Science Complex
8 Priory Road
Bristol
BS8 1TU
United Kingdom

Phone	+44 117 954 6729
Email	geraldine.macdonald@bristol.ac.uk

Study information

Primary study design	Interventional
Study design	A multi-site, cluster-randomised trial in which social work teams are randomised (stratified by site) to either use of SAAF in S47 and S17 assessments or management as usual.
Secondary study design	Randomised controlled trial
Scientific title	THE SAAF STUDY: A randomised trial and implementation evaluation of the safeguarding children assessment and analysis framework (SAAF) compared with management as usual for improving outcomes for children and young people who have experienced maltreatment or who are at risk of maltreatment.
Study objectives	Fewer children in the experimental (SAAF) group will be maltreated, measured by re-referral for reasons of maltreatment or becoming subject of a second child protection plan, because SAAF will improve the analysis and decision-making of social workers using it.
Ethics approval(s)	School of Sociology, Social Policy and Social Work School Research Ethics Committee, 16/05/2014, ref. EC/167
Health condition(s) or problem(s) studied	Child maltreatment
Intervention	Experimental: The Safeguarding Children Assessment and Analysis Framework (SAAF) is a structured approach to decision-making. It builds on the statutory guidance provided to CSDs on how to conduct assessments of children in need. Social workers in the experimental arm will attend a two-day training course by the developers - Children and Families Training. This will: 1. Help them to distinguish between the collection of relevant information on each of three assessment domains (Child's Developmental Needs, Parenting Capacity, and Family and Environmental Factors) and hypothesising how particular data might be related 2. Instruct them on the use of a series of grids to structure and critically appraise information, with particular reference to estimating the risk to the child if nothing is done, what needs to change in order to safeguard the child, and what interventions are best placed to achieve those outcomes, and estimates of parents capacity to change and their willingness to engage with an appropriate protection plan They will also receive the following materials to support their learning and further develop their competence: 1. SAAF User Guide 2. SAAF Instruments Record 3. Bentovim, A., Cox, A., Miller, L. B. and Pizzey, S. (2009). Safeguarding children living with trauma and family violence: evidence-based assessment, analysis and planning interventions. Jessica Kingsley Publishers 4. Access to resources on Children and Family Trainings website 5. Limited post-training telephone consultancy to discuss problems and issues that might have emerged The SAAF tools and training are designed to improve the quality of the assessments produced, and not to replace policies, practices or proformas already in use within the participating Departments. Social workers using SAAF may append or use information from additional tools or sources of information, but they will continue to use the forms required by their employer, and adhere to any other policy or procedure. Control: Management as usual comprises social workers adherence to the policies operated within each of the participating CSDs, as indicated above. Scientific contact details: Professor Geraldine Macdonald Professor of Social Work Queens University, Belfast, BT7 1LP Tel: 028 9097 1489 Geraldine.Macdonald@qub.ac.uk
Intervention type	Other
Primary outcome measure(s)	Child maltreatment Measures: using administrative data collected by CSDs: 1. Number of children who become subject to a Child Protection Plan (CPP) for a second or subsequent time (or for the first time following an assessment that did not result in a CPP), as a result of concerns linked to the original assessment 2. Number of reassessments or re-referrals as a result of concerns linked to the original maltreatment/perceived risk of maltreatment
Key secondary outcome measure(s)	Quality of assessments undertaken using SAAF Measure: 1. Specially designed quality assessment schedule, based on factors known to be associated with quality assessments, and including those aspects of assessments targeted by SAAF, namely, assessing the profile of harm / risk of future harm to the child; the severity of parenting difficulties and of family and environment factors, and prospects for successful intervention to prevent the child being (re)abused; the identification of appropriate interventions (logically linked to the risk assessment) and means of monitoring progress 2. Information gathered from social workers on their approach to assessment, information collected and their confidence in the assessment and, where relevant, the proposed child protection plan Relationship between SAAF assessments judgements, overall assessments and child protection plans Measure: 1. The extent to which the structured approach (55 judgements) are linked to the three summative assessments of harm, risk and prospects for intervention; to recorded variations in child protection plans, and to the primary outcome. 2. The extent to which the three summary judgements are linked with subsequent maltreatment or its absence Implementation Evaluation: An implementation evaluation is incorporated into this trial, which will examine the impact on implementation and outcome of such factors as the perceived relevance and accessibility of SAAF; resources required for, and barriers to, its successful implementation. Data will be collected via online surveys of social workers and in-depth interviews with key stakeholders e.g. social workers, managers, independent review officers.
Completion date	31/01/2016

Eligibility

Participant type(s)	Patient
Age group	Adult
Sex	All
Target sample size at registration	640
Key inclusion criteria	Childrens Services Departments (CSDs) willing: 1. To make teams available to be randomised to each arm in the trial 2. To make staff available for training, and to require all staff, irrespective of study arm, to comply with the research teams data requirements
Key exclusion criteria	1. CSDs where there are concerns about performance (e.g. special measures, other Department for Education involvement) 2. Where a major organisational restructuring is planned or under way 3. Where other risk assessment aids are being used, irrespective of whether they are being evaluated e.g. Graded Care Profile, Signs of Safety
Date of first enrolment	02/01/2014
Date of final enrolment	31/01/2016

Locations

Countries of recruitment

United Kingdom
Northern Ireland

Study participating centre

Head of Research Governance

Belfast
BT7 1NN
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Protocol article	protocol	20/11/2014		Yes	No

Editorial Notes

17/12/2020: Internal review.
09/05/2017: This trial is no longer stopped, the chief investigator Prof Geraldine Macdonald moved to a new institution and so this trial has been transferred to that institution (University of Bristol). The contact details have now been updated.
13/01/2017: This trial was stopped as the Chief Investigator left the institution.