ISRCTN - ISRCTN45137562: The SAAF study: A randomised trial of SAAF

Plain English Summary

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

Trial website

Contact information

Type

Scientific

Primary contact

Prof Geraldine Macdonald

ORCID ID

Contact details

University of Bristol
Social Science Complex
8 Priory Road
Bristol
BS8 1TU
United Kingdom
+44 117 954 6729
geraldine.macdonald@bristol.ac.uk

Additional identifiers

EudraCT number

ClinicalTrials.gov number

Protocol/serial number

v1: 9th May 2014

Study information

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.

Acronym

Study hypothesis

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

School of Sociology, Social Policy and Social Work School Research Ethics Committee, 16/05/2014, ref. EC/167

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.

Primary study design

Interventional

Secondary study design

Randomised controlled trial

Trial setting

Other

Trial type

Quality of life

Patient information sheet

Condition

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

Phase

Not Applicable

Drug names

Primary outcome measures

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

Secondary outcome measures

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.

Overall trial start date

02/01/2014

Overall trial end date

31/01/2016

Reason abandoned

Eligibility

Participant 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

Participant type

Patient

Age group

Adult

Gender

Both

Target number of participants

Six CSDs will participate in this trial, with 48 teams and a maximum of 640 social workers. They will provide data for approximately 1800 assessments

Participant 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

Recruitment start date

02/01/2014

Recruitment end date

31/01/2016

Locations

Countries of recruitment

United Kingdom

Trial participating centre

Head of Research Governance
Belfast
BT7 1NN
United Kingdom

Sponsor information

Organisation

Queen's University Belfast (UK)

Sponsor type

University/education

Website

Funders

Funder type

Government

Funder name

Department for Education. Project Reference Number: EOR/SBU/2012105 (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype

Location

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data