Reported deaths of two brothers in Syria in 2014; it is understood they went with a friend to join their elder brother fighting for the Al-Nusra Front. Child W died soon after his 18th birthday (but travelled when he was under 18), and Child X died aged 17. The children had several siblings and grew up in Brighton but spent considerable periods in their parents' North African/Middle Eastern country of origin. It is understood that the family came to the UK because they opposed the regime in their country and at least one family member was killed for his political beliefs. The family left the UK for several years, and were victims of racism when they returned. The children disclosed physical and domestic abuse by their father and became subject to child protection plans; the mother separated from the father who spent long periods overseas. Child W and his sibling Q began behaving antisocially and became involved with Youth Offending Services. Siblings W and X left the UK in January 2014. Professionals believed the boys were in the parents' country of origin. Uses the SCIE (Social Care Institute for Excellence) Learning Together methodology to identify findings, including: professionals do not have effective ways to intervene in families who have suffered long standing trauma: this can increase the risk of young people being vulnerable to exploitation; efforts to support children so they are less likely to become vulnerable to radicalisation do not seem to address all the core issues. Recommendations include: practitioners need to have a greater understanding of, and curiosity about, the role and potential impact of culture, identity, gender, religion and beliefs on children.
      
 Title:  Serious case review:  Siblings W and X. LSCB: Brighton and Hone Local Safeguarding Children Board Author: Edi Carmi and Anna Gianfrancesco Date of publication: 2017  This case review report was deposited by the publishing LSCB(s) with the national SCR repository, a partnership between the Association of Independent LSCB Chairs and the NSPCC.  This report is available online via the NSPCC Library Catalogue. Copyright of this report remains with the publishing LSCB(s) listed above.                                 BRIGHTON & HOVE LOCAL SAFEGUARDING CHILDREN BOARD    SERIOUS CASE REVIEW:  SIBLINGS W and X   Identifying the strengths and gaps in multi-agency responses to vulnerable adolescents at risk of exploitation through radicalisation    EDI CARMI & ANNA GIANFRANCESCO  27 JULY 2017     CONTENTS  1 Introduction 1 1.1 Why this serious case review was undertaken 1 1.2 Summary of case 1 1.3 Structure of report 2 2 Scope of the review  2.1 Methodology 3 2.2 Review scope 3 2.3 Services involved 3 2.4 Research questions 4 3 Global, national & Local context 8 3.1 Introduction 8 3.2 Global context 8 3.3 National context 10 3.4 Local context 11 4 Context of professional involvement prior to review period 13 4.1 Introduction 13 4.2 Context of domestic abuse 13 4.3 2008-2010: Racism against the family increased 13 4.4 2010-2012: Recognition of safeguarding concerns 14 5 Appraisal of practice  15 5.1 Introduction 15 5.2 The period under review: January 2012 - november 2014 15    6 Review findings 20 6.1 Finding 1 22 6.2 Finding 2 27 6.3 Finding 3 33 6.4 Finding 4 34 6.5 Finding 5 38 6.6 Finding 6 42 6.7 Finding 7 46 6.8 Finding 8 49 6.9 Finding 9 55 6.10 Finding 10 58 6.11 Finding 11 61 6.12 Finding 12 63 6.13 Finding 13 69 7 Conclusions  72  Appendix: Review Team membership 73 7.2 Role 73 7.3 Agency 73 Glossary of terms 74 Endnotes 75        •  1 INTRODUCTION 1.1 WHY THIS SERIOUS CASE REVIEW WAS UNDERTAKEN 1.1.1 In May 2014 the LSCB agreed a Learning Review following the reported death of an eighteen year old British citizen in Syria, called sibling W in this report. He had gone to Syria with a sibling (sibling X) and a friend to join his elder brother, sibling P. It was understood that the boys were with the Al-Nusra Front, which in 2013 pledged allegiance to Al Qaeda. Whilst it was decided that the case did not meet the threshold criteria for a serious case review, a Learning Review was commissioned, in light of the fact that W was a child when he travelled to Syria and also because the risks to young people of radicalisation had become a concern in Brighton & Hove.   1.1.2 Following the reported death of seventeen year old X in Syria in October 2014, the earlier review was halted whilst decisions were made about the type of review to be undertaken given that X was a child when he died. There was awareness that the criteria for a serious case review were not fully met, but the LSCB decided to maximise learning by carrying out a full serious case review, with the involvement of an independent lead reviewer to work with the internal reviewers. 1.2 SUMMARY OF CASE 1.2.1 The review covers a period of nearly three years from January 2012 until the reported death of the seventeen year old sibling (child X) in 2014. The subjects of the review are siblings W and X who died in Syria. They are part of a larger sibling group, of which the five youngest, received services from local agencies. For the purposes of this report they are referred to as siblings P, Q, W, X and Y.  1.2.2 During the first two years of the period under review, many practitioners and services (see 2.3) were involved due to the involvement in anti-social and criminal activities of the youngest four siblings (Q, W, X and Y). There were also varying levels of concerns relating to the low level of school attendance of these four youngest children. Despite the significant resources provided, or offered, to the family, the four youngest siblings educational attendance deteriorated over time and their criminal activities continued.  1.2.3 In early 2014 it was discovered that three siblings were not in the UK and after a period of uncertainty over their whereabouts, the police learnt they had travelled to Turkey and were suspected of being in Syria. Before this, none of the professionals involved with the family considered that any of the siblings were at risk of being exploited by radicalisation, or at risk of travelling to Syria to join the fighting. A few months earlier some professionals understood that sibling P (already an adult) had travelled to Turkey to assist in the delivery of aid. Around that time there was a referral to the Channel panel for sibling X, where there was no evidence identified of him being at risk of being drawn into terror related activities.  1.2.4 During 2014 the focus of intervention changed following the discovery that three of the siblings had gone to Syria. At that point multi-agency involvement addressed the risks to the remaining siblings of radicalisation and in particular the possibility of them travelling. Also at that stage, agencies became aware of potential risks to other young people in Brighton & Hove, particularly in the siblings peer group.  2  1.2.5 Prior to this point, professionals had not identified that the children in this family were at risk of radicalisation, nor at risk of travel to join any wars abroad. As a consequence, the findings of this review relate mainly to the challenges for professionals in being able to provide effective help and support to children who have suffered trauma in their early childhood. This trauma provides the context for children becoming vulnerable to exploitation as well as to becoming involved in various risk taking anti-social behaviour. The impact of the adolescent search for identity for some can mean that vulnerability to exploitation through radicalisation is a particular risk. 1.3 STRUCTURE OF REPORT 1.3.1 The remainder of the report is structured as follows:  Section 2 provides a brief explanation of the review approach and the learning aims of the serious case review  Section 3 describes the global and national context in relation to radicalisation and the recent emergence of young people wishing to go to Syria  Section 4 explains the historical context of professional intervention with the family prior to the review period  Section 5 gives an overview appraisal of professional practice at the time (January 2012 - October 2014), summarising what happened and why  Section 6 presents the detailed series of 13 findings along with accompanying considerations for the LSCB  Section 7 provides the conclusions of the review  The appendix provides information on the review team who worked together with the lead reviewers in this serious case review  The glossary of acronyms and terms used in the report are provided at the end of the report    3  2 SCOPE OF THE REVIEW  2.1 METHODOLOGY 2.1.1 The review uses the SCIE (Social Care Institute for Excellence) Learning Together1 methodology; this is a systems approach which seeks to understand professional practice in context, and involves both the practitioners and the family in the provision of information about professional practice and in the development of the findings.  2.2 REVIEW SCOPE  2.2.1 Integral to this methodology is the focus on recent practice in order to facilitate learning that is relevant to current professional practice, as opposed to historic practice. The review examined in detail the period between 1 Jan 2012 – 31 Oct 2014, looking at multi-agency decision-making, assessments and interventions.   2.2.2 The historical context was also considered because it was identified by both practitioners and managers as being critical to subsequent events. 2.3 SERVICES INVOLVED 2.3.1 The services involved with the family during the period under review and who were involved in this serious case review are:  Brighton Housing Trust  Business Crime Reduction Partnership  Children's Social Work  Community Safety  Education providers for all the children: schools, colleges, PRU and additional pastoral support services  Family Intervention Project (now Integrated Team for Families) providing a consistent worker for three years, until the end of 2013  Local Domestic Abuse charity   Temporary Housing  National Probation Service   Community Rehabilitation Company  Police  Youth Offending Service 2.3.2 In addition there were other services involved with the family prior to the review period, in particular youth services and services offered but not taken up by the family, namely an Arabic parenting support programme (in Brighton & Hove) and an Arabic domestic abuse service in London.    4  2.4 RESEARCH QUESTIONS  2.4.1 Integral to the SCIE Learning Together methodology used for this SCR is the formulation of ‘research questions’ to provide a framework for investigation and analysis. These questions are agreed at the outset and identify which aspects of multi-agency safeguarding work it is hoped to learn more about. The review team (see appendix 1 for explanation) identified the following four questions:  How effective are current policies and procedures across local and national agencies within Brighton & Hove in identifying children and young people at risk of radicalisation2? [a) do they enable understanding of any safeguarding implications  and b) do they provide a framework to identify, assess, manage and review any safeguarding risk?  What can we learn about the links between radicalisation, familial and personal experiences and vulnerabilities that would help increase awareness of the issue and support staff and managers to recognise and respond to risk?    How confident are we that agencies and staff are able to understand the issues around radicalisation, have the tools, skills and knowledge to address it as well as having the confidence to engage in conversations with young people and their families about their culture, attitudes and beliefs?    What further support and resilience-building could the community as a whole provide to support children and young people at risk of radicalisation? REVIEW TEAM 2.4.2 This methodology uses the term 'review team' to denote the senior managers who work with the lead reviewers in the collection of data, analysis, feedback on report drafts and agreeing the report. Most of the review team participated in meetings and conversations with individual practitioners. See appendix 1 for details of the review team. LEAD REVIEWERS & INDEPENDENCE 2.4.3 The size and complexity of the report was recognised from the outset and hence involved three lead reviewers, one of whom was independent, as well as an independent consultant to advise the review team of cultural issues and help facilitate community and family involvement. 2.4.4 The independent lead reviewer is Edi Carmi, an accredited SCIE reviewer. She was part of SCIE and NSPCC's Learning into Practice Project [LiPP], which developed Quality Markers3 for serious case reviews, using this review as part of that research. She was involved in all aspects of the serious case review, from data collection, leading on analysis and one of the two authors of the report. 2.4.5 Anna Gianfrancesco, Head of Service (Adolescents), Brighton & Hove Children’s Services was involved in all aspects of the review, from data collection, leading on analysis and is the second author of the report.  2.4.6 Jeremy Prior, Detective Inspector, Sussex Police, an accredited SCIE reviewer, was involved in data collection and analysis, as well as providing feedback and agreeing drafts of the report.  5  2.4.7 Fiyaz Mughal, OBE, the Founder and Director of Faith Matters, provided a second independent lead role to the review as a cultural advisor. He participated as part of the review team in the data collection stages of the review as well as providing feedback and agreeing the report. Additionally he advised at all stages on cultural matters, contacted family members and the Mosques initially, provided information and drafted part of section 3. PRACTITIONER INVOLVEMENT 2.4.8 Thirty-eight practitioners (both current and ex-members of staff), who had involvement with family members (known in this methodology as the case group), were involved in various ways in the review:  Thirty Individual conversations with a lead reviewer and a member of the review team  Seven group conversations: with staff from schools, Youth Offending Service and with South East Counter Terrorism Unit (SECTU)  One telephone conversation with an ex manager in the Youth Offending Service  Three case group meetings during the review to contribute to the accuracy of the data collected, the analysis and emerging findings and for feedback on the final draft report  Meeting with two senior managers (Counter Terrorism and Director of Children's Services) to provide information of the strategic responses to this case 2.4.9 The large number of practitioners in the case group is a reflection of the size of the family and the type of services provided, which involved different staff involved with different family members, with some practitioners only involved for a short period of time.  FAMILY INVOLVEMENT 2.4.10 The parents and the surviving siblings were all invited to contribute to the serious case review.  2.4.11 The mother did meet with the lead reviewers and her perspective is explained throughout the report. She is severely affected by the loss of her two sons, and the wish for the safe return of her third son. She spoke of her devotion and love for all her children, wanting the best for them and trying to help and support them. She explained that the family had experienced difficulties in adjusting to the dramatic change in their lives brought about by political events in their country of origin and then to the very different nature of their lives in the UK. Previously they were part of an educated high status section of society, in contrast to life in Brighton where they were subject to racism and hostility from some individuals. When her children began to get into trouble with police in the UK, she was unable to share this with her own family in her family of origin, as this was not acceptable behaviour in the family. 2.4.12 The mother described how, although this disruption had an impact on their educational achievements, her sons were caring boys and wanting to help others. The mother articulated that her religion is vital to her and provides her with emotional support.  6  2.4.13 The mother explained that she had no prior knowledge of W and X's plan to go to Syria, and had understood her son P was involved in delivering humanitarian aid in the area. At that point in time the possibility of her sons being involved in any fighting was inconceivable to her.  COMMUNITY INVOLVEMENT 2.4.14 Information from the community was provided in 4 meetings with the lead reviewer/s and other member/s of the review team:  One meeting with the mother of another young person (over the age of 18 when he travelled) who was killed fighting in Syria, and had travelled with W and X   Two meetings with individual members of community groups  A meeting with representatives from local Mosques, including two Imams 2.4.15 The mother of the other young person contributed her perspective on the background experiences which can make young people more susceptible to being exploited into extremist ideology. This was in line with the findings of this review and is referenced in several findings. 2.4.16 Representatives of community organisations were invited to meet with the authors, managers from community safety and the LSCB business manager to hear about the serious case review and to provide their perceptions on how children can be better protected from exploitation into radicalisation.  2.4.17 This was a helpful meeting, attended by four people, but should be put into context as the beginning of such dialogue that will need to continue after this serious case review.  2.4.18 A further meeting was offered and attended by one person. Whilst only providing the thoughts and reflections of one individual, the conversation provided thought provoking challenges about how best to engage with the Muslim communities in Brighton & Hove so as to better support young people.  2.4.19 A third meeting between the lead reviewers and eight Mosque representatives discussed the findings of the serious case review and obtained valuable input to further develop these. 2.4.20 The perspectives provided in these three meetings are referenced in the findings, especially in findings 12 and 13. The learning from the meetings was around the need to construct a more effective working partnership with the community in consideration of the best ways to support young people at risk of exploitation into radicalisation.   LIMITATIONS TO THE REVIEW 2.4.21 Following confidentiality breaches around information that was being provided to the review, restrictions were put in place, impacting on the ability of the lead reviewers sharing draft reports electronically with members of the review team. This led to a much slower and extended process for obtaining comment and feedback via face-to-face meetings. 2.4.22 Whilst several ex- staff did return to contribute to the review, it was not possible to contact a few individuals. This has meant that it has not been possible to fully understand what happened on a few occasions; this is explained where relevant in the report.    7  2.4.23 Only the mother contributed to this review process. The father has declined efforts to include him in the review process and the surviving siblings did not respond to written invitations to do so.  8  3 GLOBAL , NATIONAL  AND  LOCAL  CONTEXT  3.1 INTRODUCTION 3.1.1 This serious case review was initiated as a result of the reported deaths of two young people in Syria, both of whom travelled there when they were aged under eighteen years old. Both died in 2014, the elder soon after his eighteenth birthday and the younger at age seventeen.  3.1.2 These deaths have highlighted safeguarding risks for children and young adults in the UK, who may be vulnerable to 'radicalisation'. This vulnerability may be linked to individual histories and circumstances (see sections 4 and 5), but is also associated with global events. 3.1.3 This chapter of the report explains the global, national and local backdrop for the children in the family at the centre of the serious case review. The independent cultural consultant for this serious case review has provided some of the content for 3.2 Global context. Brighton & Hove Community Safety has provided a report to the serious case review about the experience of the family as victims of racism: the information on racism in this chapter comes from this report. 3.2 GLOBAL CONTEXT MIDDLE EAST AND NORTH AFRICA 3.2.1 The Arab uprising across a series of national states, also known as the ‘Arab Spring’ started in December 2010 and reverberated across North Africa and the Middle East across 2011. This led to the overthrow of regimes in Tunisia, Egypt and Libya as well as varying levels of unrest in Syria, Yemen, Bahrain, Saudi Arabia and Jordan. 3.2.2 The Arab Spring was understood initially as a time of hope for many people, who perceived themselves as being oppressed in some of these countries. The cultural consultant advised the review team that this movement initially provided alternative democratic opposition groups to the existing Jihadist groups, like Al Qaeda. 3.2.3 By the middle and end of 2012, the circumstances began to change as Syria descended into civil war and, in both Iraq and Syria, sectarian violence became rife. In Libya, the overthrow and murder of Gaddafi led to internecine conflict between armed groups and what is described by the consultant on the review team as 'a divided and semi-lawless country'.  3.2.4 This unrest enabled the rise of Jihadist groups across the Middle East and North Africa. In Syria, the secular forces that were opposing Assad started to lose ground to sectarian forces largely influenced by Al Qaeda and Jihadist narratives. One of these, in Syria, was the Al-Nusra Front, which in 2013 pledged allegiance to Al Qaeda4.  RISE OF MORE AGGRESSIVE JIHADIST GROUP: MID 2014 3.2.5 By mid-2014 a new and more aggressive terrorist group took over huge areas of Iraq and Syria. Its name was ISIL, (the Islamic State in Iraq and the Levant) or ISIS (Islamic State in Iraq and Syria). In 2014, the group declared the creation of a caliphate and shortened its name to 'Islamic State' (IS). The term "Daesh" (or Da'ish) has also gained  9  currency, both in the Middle East and further afield, to challenge the legitimacy of the group due to negative connotations of this Arabic acronym.  DISTINCTION BETWEEN ISLAMISM AND MUSLIM COMMUNITIES  3.2.6 The following explanation of the term 'Islamist' has been provided to the review by the independent cultural consultant to this review and explains the global context for the rise of this particular strand of belief, as well as the distinction between Islamism and the beliefs of the wider Muslim community. 'Islamism, sometimes referred to as Political Islam, is based on a revivalist tradition that came about as a result of a reaction to colonial rule and a desire by some groups in society to return to the literalist view of Islam so that Islam could encompass all of the needs of populations. This meant that political life would also be shaped by Shariah codes within Islam and that they would form the fundamental basis for not only moral but political values within society. Such Islamist movements believed that the revival of Islam could only take place if Shariah was placed at the heart of the country and where elements of modernity and social progress were seen as being part of the problem leading to the decay of the moral fibre of Muslim countries. Muslims on the other hand believe in Islam and the tenets of Islam as a faith by which they lead their lives. Many Muslims therefore believe in Islam as a guide to their lives but this does not extend to Islam being the driver in political life. Others believe in Islam as a guiding force for their lives and where they do not necessarily believe that Shariah should be the political basis on which to run a country... people can believe in Islam and be practising Muslims and even conservative in their religious views, yet they see religion as a personal aspect of their life. This distinction ... separates Muslims from Islamists.' SUNNIS AND SHIA 3.2.7 The difference between Sunnis and Shia is the largest and oldest in the history of Islam (BBC5). Members of the two sects have co-existed for centuries and share many fundamental beliefs and practices. But they differ in doctrine, ritual, law, theology and religious organisation 6. Many conflicts in the region have strong sectarian overtones. 3.2.8 In Syria, Iranian troops, Hezbollah fighters and Iranian-backed Shia militiamen have been helping the Shia-led government battle the Sunni-dominated opposition. Sunni jihadist groups, including Islamic State (IS), have meanwhile been targeting Shia and their places of worship in Syria and neighbouring Iraq.    10  3.3 NATIONAL CONTEXT UK GOVERNMENT RESPONSE TO TERRORISM: 'PREVENT' AND 'CHANNEL'  3.3.1 In July 2011 the government revised UK strategy for Counter Terrorism (CONTEST). This is a system of terrorism prevention and investigation measures designed to protect the public with 4 components Pursue, Prevent, Protect, and Prepare. Prevent is the element which aims to protect the public from the small number of people who pose a real terrorist threat. Preventing terrorism involves challenging extremist (and non-violent) ideas that are part of a terrorist ideology and intervening to stop people moving from extremism into terrorist-related activity. The scope of these measures includes extremism from all political quarters, including the far right and radical Islamist extremism.  3.3.2 Prevention involves supporting people who are at risk of being drawn into terrorist activity primarily through the 'Channel' process. This involves a multi-agency approach to identify and provide support to individuals who are at risk of being drawn into terrorism, including travelling abroad to fight in other countries. This relies on the agreement of the individual to receive such intervention. 3.3.3 During the period under review professionals were working to the June 2011 Prevent Strategy and the non-statutory guidance regarding the Channel strand issued to Police, Local Authorities and partners in 2012. The guidance sets out that, ‘Channel is about safeguarding children and adults from being drawn into committing terrorist-related activity’ (Part 1 paragraph 1.2).  3.3.4 The guidance sets out that, ‘On receipt of a referral Channel Police Practitioners must, using their professional judgement make an assessment of its suitability for Channel. A review of the information available must show a concern that the individual is vulnerable to radicalism’ (paragraph 4.4).  3.3.5 In 2015, new government guidance 7 placed a statutory duty on specified organisations to have 'due regard to the need to prevent people from being drawn into terrorism'. DEFINITIONS 3.3.6 Much of the language used to talk about these issues is itself the subject of debate, but for the purposes of this report the following government definitions8 are used:  Section 1 of the Terrorism Act 2000 defines terrorism as “the use or threat of action ... designed to influence the Government or to intimidate the public or a section of the public ... for the purpose of advancing a political, religious or ideological cause.”   Radicalisation is defined in the Prevent Strategy as “the process by which a person comes to support terrorism and forms of extremism leading to terrorism.”  Extremism is defined in the Prevent Strategy as “vocal or active opposition to fundamental British values, including democracy, the rule of law, individual liberty and mutual respect and tolerance of different faiths and beliefs. We also include in our definition of extremism calls for the death of members of our armed forces, whether in this country or overseas.”   Violent extremism is considered by the Prevent Strategy to mean the endorsement of violence to achieve extreme ends.  11  DEMOGRAPHICS OF PEOPLE TRAVELLING TO SYRIA FROM THE UK 3.3.7 When the Syrian civil war broke out in 2011, aid convoys were organised by British people, mainly over the age of 25. Some had been involved in aid convoys to Bosnia to help the besieged people of Sarajevo, so had the technical expertise and the co-ordination skills to make this happen. These aid convoys were humanitarian in nature and were mainly meant to deliver basic items to the people of Syria. This support was driven by a wish to assist in humanitarian activities.  3.3.8 The ongoing civil war and pictures and brutal stories of attacks on Sunni Muslims in Syria led to some people being activated to want to do something more and, in 2013, the demographic of individuals going to Syria changed to a younger age group, more commonly aged between 20 and 25. The initial desire to help the Syrians through humanitarian assistance led young men, women and families travelling to be part of a State which they believed needed their support or assistance. By 2013, some of those travelling were going to Syria to join IS to fight or sustain the group in other ways. Others were going to join other groups active in the region, such as the Al-Nusra Front. 3.3.9 By November 2013, the BBC was reporting the emerging news of British men mainly in their 20s, going to fight in Syria9 : 'The number of British Islamists who have gone to Syria to fight in the war there is in the "low hundreds".... One in 10 foreign militants in Syria is believed to be from Europe.... According to the Centre for the Study of Radicalisation at King's College London, most British jihadists are in their 20s, university-educated and Muslims of British Pakistani origin.' 3.3.10 In November 2013, Ifthekar Jaman, aged 23, from Portsmouth told BBC Newsnight10 that he had joined ISIS and had gone to Syria because: 'it was his "duty" because Muslims were "being slaughtered".' 3.3.11 Jaman is believed to have died in fighting in Syria in December 2013. In the Newsnight broadcast mentioned above, his brother had said that: "If he dies in his cause, then he's not died in vain, has he? He's doing a good deed." 3.4 LOCAL CONTEXT POPULATION COMPOSITION & DIVERSITY 3.4.1 The 2011 census demonstrates that Brighton & Hove is a city with a predominantly white population (94.2%). The Muslim community is the largest non-Christian faith group in the city, and in the census in 2011 accounted for 2.2% of the population. The Muslim population in the city, like in other parts of the UK is diverse including Bangladeshi, 'Arab' (a composite term), 'Asian others', 'White others', Pakistani, White British and Black African.  3.4.2 There are three established mosques in the city and all have a section for women to pray. Imams and key members of the three mosques operate independently.  Additionally, there are two Islamic societies and mosques at the two universities (University of Sussex and University of Brighton).     12  RACISM AGAINST MUSLIMS IN BRIGHTON & HOVE 3.4.3 Whilst there is, according to information provided to the review, little widespread evidence of reported racism against Muslims, there had been (prior to the period under review) some such activity in the part of Brighton where the family lived, some of which, but not all, was targeted directly at the family following media stories about a relative. 3.4.4 A Community Safety manager provided the following contextual information of the extent to which racism had been a feature in the area of the community in which the family were residing. Section 4.4 refers to the specific attacks on family members.  3.4.5 The children grew up in a locality in which there was a successful organised campaign in 2003 to stop the creation of a centre for asylum seekers following both pro and anti-demonstrations. This had involved various people settling into strong positions sometimes aligned with anti-immigrant/ anti BAME agendas of other groups and political parties. There had been protesters dressed as Osama Bin Laden (and a picture included a protester dressed in a KKK style white robe).     3.4.6 The appearance of anti-Islamic graffiti, in the locality where the family lived, was reported from 2007 onwards. This included in 2009 the use of 12 inch high lettering visible from afar, stating 'Behead all Muslims'. This deeply offensive slogan re-appeared several times.  3.4.7 The Community Safety report to the serious case review refers to organised right wing groups targeting the family (see section 4.4 ). Other activity, whilst directed at the family, involved wider area disruption, such as described in a complaint to the police of incidents being to create 'an atmosphere of hatred and mistrust' between the family and neighbours. An example of these incidents is: In January 2013, “a group of individuals, describing themselves as members of far right groups had to be removed from ..., having turned up with flags and megaphones shouting and falsely accusing a resident …, of being a Jihadist and a terrorist as well as various other slanders”. [complaint to the police in the Community Safety manager's report to the serious case review]. 3.4.8 The recording of Hate Incidents and the legislation associated with hate crimes was enacted between 1998 and 2001. However the oversight and monitoring within the police force varied, both locally and nationally. The same is true of anti-social behaviour; the monitoring of repeat victimisation was only formally established following the tragic death of Fiona Pilkington11 in 2007. From this case came the notion of the Community Trigger12.  3.4.9 Within Sussex Police, the monitoring of religiously motivated incidents has been a priority with work alongside victim support, but the Police Force level ASB and Hate Crime Board (which now exists to review hate incidents and provide scrutiny) was not embedded at the time of the incidents described in the review.   13  4 CONTEXT OF PROFESSIONAL INVOLVEMENT  PRIOR TO REVIEW PERIOD 4.1 INTRODUCTION 4.1.1 Whilst this earlier period, before 2012, is not the focus of the serious case review, what happened to the family and the agency intervention in this period is likely to have had a profound impact on the children's subsequent behaviour and their response to professionals. This context is therefore explained briefly, but professional practice is not analysed and appraised.  4.1.2 The family originated from a country in North Africa / Middle East and moved to the UK sometime in the late 1980s / early 1990s. It is understood that this move was due to their opposition to the regime in their home country and the regime's perception that some members of the family were influenced by Islamist (see 3.2.7) beliefs. At least one close family member is believed to have been killed due to his political beliefs.  4.1.3 The three young people who went to Syria are part of a larger sibling group of children born in the UK. The youngest five grew up largely in Brighton, with considerable periods also spent in their parents' country of origin. These five children are called siblings P, Q, W, X and Y in this report. Siblings P, W and X went to Syria, where siblings W and X died. Sibling X was aged under 18 years old at the time of his death, and sibling W was only just 18 years old when he died. 4.1.4 The history of agency contact with the family prior to the period under review involved instances of alleged domestic abuse, many incidents of alleged racism against family members and their home and the children alleging physical abuse by their father. 4.2 CONTEXT OF DOMESTIC ABUSE 4.2.1 Health services recognised that the mother was isolated, rarely leaving the house and wanting more help with the children. The father was often away on trips abroad. The first indication of possible domestic abuse was in 1996 and then again in 2000, prior to the family leaving the UK for several years. On their return to the UK there were further suspicions of domestic abuse.  4.3 2008-2010: RACISM AGAINST THE FAMILY INCREASED 4.3.1 The family returned to Brighton in 2008. Subsequently, they experienced racism from within the local community, according to information provided by the Community Safety manager's report to the serious case review. This is described in more detail in finding 3 but was linked to media reports of a relative who had been imprisoned abroad and released without charge. The racist incidents were reportedly sustained until 2010 and led to one alleged perpetrator receiving a caution.  4.3.2 Over time, siblings Q and W's behaviour changed and they began to defend themselves, retaliate and then were perceived sometimes as being the perpetrators of the incidents. From 2009 there began to be reports of the boys being involved in anti-social behaviour and crime, getting into fights.   14  4.4 2010-2012: RECOGNITION OF SAFEGUARDING CONCERNS  4.4.1 In 2010 the boys disclosed at a youth club that they had experienced physical abuse from their father, in relation to their lack of observance of their religion. The five siblings living in Brighton were made subjects of child protection plans for physical and emotional abuse. On the advice of professionals and consistent with the child protection plan, the mother separated from her husband and moved with the children to alternative accommodation. Following the retractions of the siblings witness statements, the CPS advised that no criminal case was to be brought against the father.   15  5 APPRAISAL OF PRACTICE 5.1 INTRODUCTION 5.1.1 The following provides a brief overview of what happened during the period under review, through an evaluation of the professional practice and services offered. Cross references are provided to the findings in section 6, where relevant.  5.2 THE PERIOD UNDER REVIEW: JANUARY 2012 - NOVEMBER 2014  ENDING OF CHILD PROTECTION PLAN: JANUARY 2012 5.2.1 The period under review commences with the ending of the child protection plan for the five siblings in January 2012. They were no longer considered to be at risk of physical or emotional harm from their father as they no longer lived with him, and at that point he was not in the UK. This decision was taken in full knowledge of siblings Q and W's increasing involvement in anti-social and criminal activity as well as low school attendance rates. This arguably could have met the threshold for a child protection plan for neglect, as despite the mother's attempts to care for her children, she had little authority over them. However, the reasons why the child protection plan was ended in the face of siblings Q and W's behaviour spiralling out of control is explained in section 6, finding 2.  5.2.2 At this point there had been a very large number of agencies involved with the family, as indicated by the list of those participating in this review (see 2.3). By this meeting there was appropriate recognition that there were too many people trying to help the family, and that an alternative approach might be more successful, involving fewer professionals, but with the intensive input of the Family Intervention Project (FIP) worker (who had by this point established a good relationship with the family). It was agreed to maintain services to the family, under a Child in Need plan, as opposed to a Child Protection Plan. See finding 2 for further discussion and glossary of terms for explanations of Child in Need and Child Protection plans.   CHILD IN NEED PLAN 5.2.3 There followed a period of eight months when the children remained subject to a Child in Need plan and continued to have both a social worker as well as the FIP worker.  5.2.4 The FIP worker tried to provide the relationship based intervention that had previously been considered impossible when there were numerous staff involved. The constant professional need to respond to urgent problems arising from particular incidents, as well as the concerns of potential eviction from the family home, meant the FIP worker had little capacity to address the underlying issues, such as the need for therapeutic support in relation to the trauma suffered as a result of the family's earlier experiences.  5.2.5 The fact that both the social worker and the FIP worker were men is not desirable for a family where there may be cultural issues, relating to gender roles. Ideal practice would be to have a system sensitive enough to such factors, and sufficiently resourced, so as to enable joint work by a male and a female worker. However, the system does not necessarily have the capacity to do this. In this case there is no evidence that the allocation to two male practitioners, and no female worker, was a factor preventing the  16  mother from speaking openly or which contributed to her difficulty in being able to parent her children effectively (see 6.4). But it is also not known what difference would have occurred had there been a female worker allocated. 5.2.6 In the autumn of 2012, Children's Social Work closed the case, having agreed the decision to step the case down to the FIP worker. This decision reflected the limited co-ordinator role played by the social worker at that point, as well as the difficulty in getting to see the siblings (see 6.4).  However, the case was closed, despite the deterioration of the siblings anti-social and criminal behaviour, as well as their non school attendance.  By this point the perception of the siblings as was changing; with the involvement of the Youth Offending Service with siblings Q, W and X as a result of their offending behaviour.   REFOCUS OF INTERVENTION FROM FAMILY SUPPORT TO MANAGING THE SIBLINGS BEHAVIOUR 5.2.7 The pattern of subsequent intervention became increasingly around managing the behaviour of the four youngest siblings, which continued to deteriorate in terms of both school attendance and criminal behaviour. The FIP worker tried to co-ordinate multi-agency involvement, which by this time also involved the community safety department. The focus of the work, by the design of the organisations involved at the time, was predominantly on managing the siblings' behaviour as opposed to reflecting on how to address their underlying vulnerabilities. The FIP worker did though attempt to do this, but the inability to see the young people sufficiently consistently to do such work was not possible, due to the siblings reluctance for such engagement (see 6.1).   5.2.8 The Youth Offending Service (YOS) was itself undergoing problems that year. The context was the recognition that the service required improvement, which led to a re-structuring and dissatisfaction amongst some of the staff, which in turn led to vacancies, staff sickness, the high use of agency workers and what some perceived as a chaotic period. 5.2.9 Against this background the service provided deteriorated for siblings Q, W and X, with their cases being held on duty in YOS for some considerable time, without allocated workers. This was accompanied by an element of distrust between YOS workers and the police, with the police considering YOS staff as being too 'soft' on their clients. This situation was compounded by the fact that the YOS workers were operating without knowing the full history of the siblings concerned, as the culture at that time did not involve reading the records from other parts of Children's Social Work. This was exacerbated as they did not have access to the numerous incidents when the police had contact with their clients, suspected them of having committed offences, but did not charge them (see 6.5).  POSSIBLE OPPORTUNITIES IN 2013 TO UNDERSTAND MORE ABOUT THE DEVELOPING VIEWS OF THE SIBLINGS  5.2.10 There was no recognition that any of the siblings were becoming vulnerable to being exploited into radicalisation. Nor was there much understanding of the part that religion played in their lives and if there were changes in this over time (see 6.12).  5.2.11 There were though two opportunities for further exploration in relation to two different expressions of possible concern, one in early 2013 and one in autumn 2013.    17  5.2.12 In early 2013 one of the schools became concerned on hearing that some young people were converting to Islam and some had been paid money by a relative of the siblings to attend the gym behind a place of worship: the money was however a reward for attending the gym instead of their plan to sneak into the cinema without paying. The professional response at that time is discussed in 6.8, but the outcome is that no further information was obtained or received about the activities at the gym. 5.2.13 The second opportunity was as a result of a sessional YOS worker becoming concerned at the emotional way sibling X spoke about ' Americans' after he returned from a trip to his family's home country, which was in the throes of factional fighting. This led to a referral to the Channel panel, which concluded that sibling X was not at risk of being drawn into terror related activities. The professional response at that time is discussed in 6.8. 5.2.14 Both these instances were missed opportunities to learn more about the activities of the young people and to understand the links between young people in Brighton. However, this was at a point in time when the Channel Panel process was relatively new (with few children in Brighton & Hove having been previously subject to this process). Moreover at that time there was little local or national knowledge or understanding of the risks to children from being exploited into radicalisation to go and fight in wars elsewhere in the world. This is discussed further in 6.8.  JANUARY 2014: YOS PROVISION 5.2.15 By January 2014, the situation within YOS had much improved and sibling W had a new male worker with whom he had engaged and sibling Q was being provided with a male YOS social worker and a female substance misuse social worker. At this point there was evidence of sensitive service provision by skilled and experienced social workers attempting to address not just the current criminal presentation but issues relating to identity and culture. There was recognition of the need for therapeutic services involvement with an appropriate referral made to address the underlying vulnerability concerns for Q.  MULTI-AGENCY RESPONSES TO THE DISAPPEARANCE OF SIBLINGS W AND X 5.2.16 At the end of January siblings W and X left the UK. Over the next few weeks there was confusion around their whereabouts. The mother provided a variety of explanations to different professionals, which initially provided reassurance that the siblings were visiting family, as they had done on previous occasions. However due to there being no clear and consistent explanation as to their whereabouts concerns were beginning to be raised around their welfare. The initial explanation provided to the YOS and shared with community safety and local police was that sibling W was in the family's country of origin, having travelled with an older sibling (this sibling lived abroad and is not part of the Brighton household). At the same time sibling X's educational provider contacted the mother about X's absence, and was told he had travelled to his unwell grandmother in the family's country of origin.  5.2.17 It is of note that the father subsequently provided his own account to the media of being told his children had disappeared without saying where they were going, that he had immediately guessed they were joining their brother fighting in Syria with Jabhat al-Nusra, that he saw them in Turkey and tried to persuade them to come home.  18  Practitioners were not told of this journey at the time, nor that the father had tracked his sons down.  5.2.18 The mother of another young person who travelled from Brighton with W and X told the review that she had reported to police immediately she learnt her son was in Syria at the beginning of February. Sussex Special Branch investigated the boys' disappearance and discovered they had gone to Istanbul and were suspected to have joined sibling P and the Al-Nusra Front in Syria.  5.2.19 Meanwhile practitioners working with the family were unaware of this and their understanding of the boys whereabouts was that they were in the family's country of origin. Professionals continued trying to support the mother and consider what actions should be taken at this point. The extent to which there was appropriate information sharing during this period is considered in 6.9. 5.2.20 Sibling W was in breach of an Order, and his YOS worker appropriately investigated what actions needed to be taken when the offender is out of the UK. The options are limited to being able to put a marker for him at ports should he return to the UK and undertaking breach proceeding in court to ensure arrest at ports. The marker had been placed in the ports and the breach was in process, when the report of sibling W's death was received in April 2014. 5.2.21 Commendably a Brighton Housing Trust officer recognised the need for a referral to Children's Social Work on the 20.02.14, on the basis of mother's account of two of her children being abroad and she didn't know how or who paid for it. She thought they were with their elder brother, but was worried about their welfare and if they were coming home. She also mentioned that their father was also abroad, but had not known of their plan, and was himself shocked at their disappearance.  5.2.22 Appropriately, Children's Social Work initiated an assessment due to the mother being unable to protect her children and that there could be risk to the children still in her care. This assessment is of good quality, including the history of the family, issues around the family's culture, religion and beliefs and the father's alleged involvement in 'very extremist and radical actions' at an earlier point of time. Despite attempting to see children Q and Y, this did not happen, as the boys avoided the appointments. The mother reported that P was helping the aid effort in Turkey, and W and X were in the family's country of origin; however she feared they could also be involved with Syrian militants.   5.2.23 On 12.03.14, the decision was made that sibling X should be the subject of an initial child protection conference (see 6.10), in recognition of the risks identified in the assessment in relation to the mother's inability to keep her children safe and by police that X (along with several other young people) could be vulnerable to radicalisation. Finding 2 (6.2) explains the use of the child protection process in early April 2014 and notes that no child protection plan was made, despite the neglect concerns being more worrying than in January 2012, along with risk of radicalisation and travel. However, alternative plans were implemented which did involve active intervention by professionals, around the risk of radicalisation.   19  5.2.24 The realisation that the boys were in Syria led to shock and confusion initially within the multi-agency professional network, with assumptions being made that someone must have known or suspected this was likely to happen. The serious case review has found no evidence to support this, although there were some delays and uncertainty in the communications, arising from this new situation, which did not immediately fit into existing processes (see 6.10).  5.2.25 Finding 11 (6.11) explains the strong and co-ordinated responses that ensued as a result of the discovery that the boys had gone to Syria. This is a systemic strength with demonstration of sound leadership from the Chief Executive and senior managers of Brighton & Hove at the time. This involved responses, described in that finding, to address risks to the siblings in the UK and an evaluation of the risks to any other young people in the City, especially in relation to the risk of travel. 5.2.26 Following on the subsequent discovery that sibling W (by that time an adult aged just eighteen years old, but legally a child when he travelled to Syria) had been killed in the fighting, Brighton & Hove LSCB decided to use this tragedy to learn what more services could have done to support this family and also to identify children's vulnerability to radicalisation. An internal review was initiated to accomplish this. Following the death of sibling X, at the age of seventeen, it was decided to make this into a serious case review involving an independent author and an independent consultant. This demonstrated a LSCB keen to learn what happened, why and how to improve services as a result.   20  6 REVIEW FINDINGS INTRODUCTION The SCIE Learning Together methodology is based upon an approach which uses an individual case to provide a ‘window on the system’ 13 finding out whether weaknesses or strengths that have been identified in a single case are more systematic and widespread, and so leading to a broader understanding about what supports and what hinders the reliability of the multi-agency child protection system.  What makes learning from this case more widely applicable? This case is the first serious case review (as far as we know) that considers safeguarding in relation to the risks of children being exploited by radicalisation. What it tells us most about is the professional challenge when working with disaffected young people and families, in the context of a long history of trauma. Some of the findings are phrased as questions, reflecting that whilst available evidence points to such a finding, further work needs to be undertaken to establish to what extent this is a feature of the wider multi-agency system. The findings The findings in the table below are those the review team believe apply to the multi-agency systems in Brighton & Hove (and sometimes nationally), as opposed to just this one case. Because there has been a great deal of change during and since the review period, the findings are those that are still relevant to current ways of working.  The Review Team have agreed 13 Findings listed below. Some 'themes' or 'issues' appear in more than one finding; this is because in the Learning Together methodology, the focus of the finding is the aspect of professional practice. The right hand column below provides the aspect of the multi-agency system in which the finding is located (for more detail on how Learning Together categorises different systemic issues, see SCIE Learning Together to Safeguard Children14).   The findings do not provide concrete recommendations, but highlight inconsistencies in current practice norms and the potential consequences of leaving these unaddressed. Considerations are provided for the Local Safeguarding Children Board to take into account when formulating their response to this review, but are not intended to act as a list of actions for the LSCB.  The following findings are grouped around the following thematic areas:  Finding 1 discusses professional challenges in responding to adolescents in 'trauma', an underlying factor for professional practice with many adolescents and with their families  Findings 2, 3, 4 and 5 focus on systemic issues arising from adolescent risk taking behaviour and their needs for a flexible, accessible service, able to work holistically with young people  Findings 6, 7, 8, 9 and 10 focus specifically on working with children vulnerable to exploitation through radicalisation  Findings 11,12 and 13 consider Brighton & Hove's systemic strengths and obstacles to effective working with minority ethnic groups    21   No. Findings  Underlying pattern 1  Professionals do not have effective ways to intervene in families who have suffered long standing trauma: in such circumstances, the risks of young people being vulnerable to exploitation increases. Longer term work with families 2  Does the recent expansion of child protection processes to cover adolescents at risk of Child Sexual Exploitation or exploitation into radicalisation, adequately cover other types of adolescent risk of harm, such as that associated with truancy and involvement in anti-social, criminal or risky behaviour?  Management systems  3  The current child protection processes distinguish between children who are missing in the UK and those are who are suspected of being missing abroad; as a consequence the potential positive strategy involved in the formulation of a child protection plan is not provided for those who are suspected of being abroad. Management systems 4 In working with adolescents there can be a pattern of reactive crisis management as a means of handling the relentless stream of incidents; this minimises the likelihood of reflective thinking and analysis necessary to understand and tackle the root causes of the behaviour.  Longer term work with families 5 The systems of collecting and sharing data about young people who come to police attention, in Brighton & Hove, do not consistently provide all relevant information to practitioners so as to assess, identify and address safeguarding needs. Management systems 6 Do practitioners understand and know how young people are radicalised in Brighton & Hove and how to counter the propaganda that influences them into extremist thinking?  Longer term work with families 7 Efforts to help and support children so they are less likely to become vulnerable to exploitation into radicalisation, do not seem to adequately address all the core issues, as perceived by community members. Management systems 8  Professional responsibilities arising from the government's counter terrorism strategy are new, not yet fully understood by all relevant staff and subject to ethical dilemmas: this presents challenges in being able to reliably recognise both the risk of radicalisation and the links to safeguarding concerns. Longer term work with families 9  The lack of a well-established working relationship between  counter-terrorism police officers and other agencies can lead to an atmosphere of suspicion between professionals of inappropriate confidentiality,  which could compromise children's safeguarding.    Management systems 10 Does the timely and constructive response of Brighton & Hove to the newly identified safeguarding risks to children posed by radicalisation, represent a systems strength? Management systems 11 Does the multi-agency safeguarding system have the resources and strategies available to consistently help abused women and children from minority cultural backgrounds, if they fear that co-operating with statutory authorities could lead to the loss of support of their wider family and community? Management systems 12 Do practitioners have sufficient curiosity, knowledge, and skills to explore the role of culture, identity, religion, beliefs and potential divided loyalties experienced by some children and families? Longer term work with families 13  Brighton & Hove statutory agencies  have  insufficient knowledge about, and understanding of, local minority ethnic and faith community groups and how best to work together  to safeguard children, including those at risk of exploitation of local children into radicalisation. Management systems  22  6.1 FINDING 1 Professionals do not have effective ways to intervene in families who have suffered long standing trauma: in such circumstances, the risks of young people being vulnerable to exploitation increases. 6.1.1 This finding addresses the challenges for professionals when working with children and families, following earlier and unresolved trauma. If there has also been contact with professionals in the past, which ultimately has been unable to address the trauma, professionals will find it even more difficult to develop trusting relationships with adolescents to be able to intervene effectively. In such circumstances, young people may be more vulnerable to exploitation and professionals will be likely to find it more difficult to intervene effectively.    6.1.2 This finding is closely linked to finding 4 which is concerned with adolescent risky behaviour, which may also be associated with the impact of early trauma. That finding addresses the specific professional problems arising from working in the context of a relentless stream of incidents.  6.1.3 Finding 11 considers the specific impact of such trauma specifically in relation to domestic abuse experiences within the family and the need for professionals to understand additional cultural complexities.    HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.1.4 By the time the period under review commences, in January 2012, the children were aged twelve to seventeen years old. The family had been subject to a long history of contact with authorities, both in this country and abroad. The mother spoke to the authors of the trauma for the whole family of the changes in their home country, the impact of moving to Brighton where they suffered from racism.  6.1.5 The mother expressed her appreciation of the efforts of all professionals in helping her and her children. However, the evidence from staff is that by this time the adolescents were not responding to the efforts of practitioners to help them, often effectively avoiding contact. Furthermore, comments that have been made in media reports, in agency records and by other members of the community suggest that by January 2012 the children may have been feeling distrust in the ability of local professionals to be able to provide effective help to them.   6.1.6 In the case of the local Brighton & Hove agencies, family members experienced what they may have perceived as the inability of those charged with protecting the public and safeguarding children in relation to:  Racism from some members of the local community   Domestic and physical abuse within the family home 6.1.7 It should be noted though that the mother did not acknowledge feeling any lack of trust or faith in practitioners, when speaking to the authors. She is also an extremely polite person who understands that professionals always tried very hard to help the family. However, she also acknowledged that sometimes practitioners did not understand what was best for her children, citing how she encouraged them to bring their friends home rather than staying out with them, against the advice of professionals (who were  23  concerned that the friends were there all hours, causing noise, upsetting neighbours and then sleeping all day and missing school). She explained that culturally she knew it was right to show hospitality. Given the mother's politeness she may have not been able to explain that she disagreed with the advice she was being given. Earlier experiences of professional response to racism 6.1.8 The entire family had reported racist and religiously motivated incidents directed against them at home, in the city, at school and in the local community, which increased significantly from 2008 to 2010. This involved racist graffiti, verbal assaults and abuse, stone throwing towards the family and windows being smashed. This abuse at one point (according to the report submitted by the Community Safety Team to this serious case review) was occurring more or less daily and included targeting the children and the family home. Two of the siblings reported suffering physical attacks by people in balaclavas.  6.1.9 Due to the sustained assaults and abuse, the police installed a camera outside the family home. In 2009, incidents against the boys increased with them receiving threatening messages on Facebook and involving regular incidents in the park, where stones were thrown at them and fights occurred with other young people.  6.1.10 Police information to the review is that a great deal of work was undertaken which indicated a small number of people was suspected of being behind the abuse, but this did not lead to prosecutions. There were various reasons for the lack of such an outcome including:  the lack of evidence about who was responsible, issues of language and translation restricting the quality of available information  inconsistencies of the accounts (of the same event) provided by family members and on one occasion of the father's interruptions during an interview, when he encouraged his children to exaggerate the seriousness of the allegations being made  When suspects were named by the family they were spoken to by the police, arrested, interviewed and involved in identification procedures; however, the matters were denied and there was insufficient independent evidence to consider a prosecution, although one youth did receive a reprimand. 6.1.11 Family members were variously offered support as victims from the Community Safety Team but this was not taken up in any meaningful way. 6.1.12 As time progressed matters became more complicated as the relationship between the family and the police declined. The father at times would only communicate by letter. Some complaints were not reported for months after they had occurred, and it became increasingly clear that the siblings were retaliating to events and putting themselves in jeopardy of committing offences. 6.1.13 Despite considerable efforts by both neighbourhood officers and specialist teams, reviews of the investigations and the submission of some files to the Crown Prosecution Service, there remained insufficient evidence to proceed with the matters reported by the family. 6.1.14 The mother has acknowledged that the impact on them of constantly living with such threats to their safety was traumatic. The lack of any prosecution may have left the  24  children feeling that the authorities were unable to protect them from such attacks and it is not known what they understood was behind the lack of such intervention. Earlier experiences of professional responses to domestic and physical abuse within the family home 6.1.15 It is not possible to state the extent to which the background of alleged physical and domestic abuse affected the ability of family members to trust statutory agencies, but the professional experience of the reviewers leads them to accept that the children and their mother are likely to have suffered significant trauma through such experiences.  6.1.16 The siblings would not just have suffered the original trauma of the abuse, but also the events following making a disclosure i.e. the family break-up, move of home and the pressure to retract the allegations against their father. This is likely to have been perceived, to some extent, as an inability of the authorities to protect them and consequently is likely to have led to, at the least, a wariness of professionals. 6.1.17 Reports of domestic abuse suffered by the mother is discussed further in Finding 11, in terms of the professional understandings of cultural issues, and the potential impact these can have on the ability to provide effective support to victims.  Impact on professional intervention 6.1.18 Professional involvement from 2010, led to mother and children moving home, so as to be living apart from the alleged abuser (the father). However, despite much effort by professionals and the continuous input from an experienced and skilled social worker, (working as a family support worker in the FIP service at the time), it is not at all clear if the mother and children were protected from further abuse and were able to work openly with practitioners as there was knowledge of the father visiting their new home. Moreover, subsequent interventions did not lead to a safe environment for the children, as the mother was unable to ensure her children were safe, receiving education and avoiding risky behaviours. 6.1.19 Given the history and the possible perception that statutory services had let the family down in the past, more recent practitioners had no mechanism to work with the past trauma and be able to move forward effectively. By this point the four youngest siblings had found their own way of life in group risk taking activity (see finding 4). 6.1.20 Although there was some understanding that the siblings were suffering from the effects of early trauma, it was only in early 2014, that a new youth offending social worker made a referral for therapeutic intervention to CAMHS. However, the likelihood of any of the siblings being emotionally able to make use of such therapeutic services earlier is not known. 6.1.21 It is not known what the family really felt about the lack of prosecutions in relation to their allegations of racism and abuse, but by the period under review (after January 2012), professionals experienced difficulties in being able to work effectively with the family. The mother was accessible and seemingly co-operative, but struggled to implement changes, given her lack of power within the family and consequently her lack of control over her children, especially the youngest four, and in particular siblings Q and W.  The four youngest children avoided contact with professionals. The eldest of the five (sibling P), by contrast appeared open and responsive to professional interaction, but gave no indication that he was thinking of travelling to Syria, whether as part of a humanitarian aid convoy, or to join in the fighting.   25  HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE? 6.1.22 Where there has been domestic or other abuse within a family, the reporting of incidents puts alleged victims into a vulnerable position vis-a-vis the perpetrator of the abuse, unless they can be effectively protected by statutory agencies. Strategies that help are the removal of the perpetrator from the family, the offender working with professionals to change her/his behaviour or criminal prosecution of the offender. 6.1.23 If the perpetrator continues to have access to family members (regardless of written agreements or bail conditions), it is more likely that children and partners will wish to avoid criminal proceedings, so as to avoid further violence and also in the hope that the violence has ended. When this happens it becomes more difficult to intervene and support children and families, on subsequent occasions, as there is less trust by family members in the ability of authorities to protect them. 6.1.24 Relatively few perpetrators access services in Brighton & Hove, from the experience of the practitioners in this case, and there was doubt expressed about the availability of the right services locally. See finding 11 for further discussion around the cultural issues. 6.1.25 The likelihood of parents and children being disengaged from professionals trying to offer support is particularly a challenge when the children are teenagers and the family has had a long negative experience of authority, which in some cases can be over generations or in different countries. The likelihood of parents or children being able to engage is particularly relevant in the context of domestic violence and abuse of children, when they could fear repercussions of co-operating with authority.  6.1.26 Disengagement of children is particularly pertinent in instances where there are ongoing concerns about significant harm, but in circumstances where removal of the children is not considered to be in their best interests. This occurs most frequently in the case of older teenagers who are judged to be likely to 'vote with their feet' and return to their own family. These young people are also the ones who may have suffered much earlier childhood trauma. In such circumstances there can be a tendency to try less authoritative methods of support, in the hope that this will facilitate increased co-operation. This finding is linked to finding 4 regarding the wider difficulties professionals face in working with adolescents. HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.1.27 The mother of another young adult who died in Syria spoke to the reviewers about the trauma her son experienced both before arriving in the UK and subsequently in Brighton & Hove. This was due to repeated racist attacks and threats to kill. These led to constant family moves to escape the threats and her perception that 'being the victim is the crime', as the perpetrators in her experience were not prosecuted. Eventually she described how victims cease to report racist attacks as they no longer have any belief or trust in the authorities to be able to protect them. 6.1.28 The challenges faced by practitioners working with families which are well defended and not engaging effectively due to past history and trauma recur in serious case reviews. This can be through open lack of engagement, or through appearing co-operative, but in fact making few changes, as found with disguised compliance.    6.1.29 A recent serious case review in Newcastle (Child J, June 2016) highlights the mother's long experience of social work intervention as a child and as a parent, her ability to appear co-operative but not disclose the problems within the family, despite her  26  children being subject to a child protection plan and the provision of intensive support from a variety of services and professionals. She told the lead reviewers that even when she started to suffer from domestic abuse again, she knew she could not speak openly as she could not trust professionals to be able to help her, other than to remove her children.  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.1.30 This finding addresses the extremely difficult task faced by professionals once children are adolescents, if they have a long history of trauma. If this has also involved statutory interventions which may not have been perceived as resolving the particular problems facing family members, it is possible that family members will be wary of professional intervention. In such circumstances, young people may be more vulnerable to exploitation and professionals will be likely to find it more difficult to intervene effectively.   6.1.31 There are limited resources that practitioners are able to use in such circumstances if legal proceedings are either not possible or not in the interests of the children. Whilst developing a trusting relationship with families does help to some extent, it is unlikely to overcome deep seated defence mechanisms in families who have learnt through experience to be self-reliant and not disclose abuse. In these circumstances, children who have been abused and victims of domestic abuse are more likely to be vulnerable to further risk and harm.   6.1.32 The difficulties of professional intervention once the children reach the teenage years highlights the importance of being able to provide therapeutic services at a much earlier stage to children and the parents.   FINDING 1: Professionals do not have effective ways to intervene in families who have suffered long standing trauma: in such circumstances, the risks of young people being vulnerable to exploitation increases    CONSIDERATIONS FOR THE LSCB:  Are managers and practitioners able to articulate if they feel 'stuck' where there is lack of engagement or disguised compliance? Would a forum providing consultancy and advice in such circumstances, such as a multi-agency complex cases panel, be helpful?  Is there effective early identification of childhood trauma by universal services?  Do we have the right resources to provide support and intervention for children and young people, such as therapy, and are they used sufficiently? Does this include Early Help services able to provide accessible and timely support for children suffering trauma e.g. counselling provision within primary and secondary schools for children and parents  Are professionals across agencies able to identify older children who are suffering from earlier trauma? Do professionals know how best to intervene in such circumstances?   Do practitioners have the knowledge, resources and skills to develop relationships with young people whose previous experiences have led them to be alienated from society and/or disengaged with services?  27   Is the LSCB confident that there is sufficient action being taken now to address racism and racist attacks within the community, and that minority groups now feel confident that their reports of such incidents will be thoroughly investigated?   Do professionals have an understanding of the long lasting trauma in families of domestic abuse, including the continuing power of the perpetrator of the violence, even when s/he is no longer within the household?  Are specialist domestic abuse workers being used at the point when an alleged offender is arrested, so as to be able to provide timely support when there is 'space for action'?  Is there an awareness amongst professionals of the availability of remedies under the civil law to protect victims of domestic abuse? Are the new Domestic Violence Protection Orders (DVPO) being used and proving to be effective in safeguarding family members whilst police are conducting investigations?  Does the LSCB have an overview of the extent to which bail conditions are broken by the perpetrators of domestic abuse, and what action police take in response to this?   Is there a national problem in relation to the lack of power attached to police bail prior to an alleged offender being charged? If so should this be highlighted to the Home Office?  Does the LSCB have an overview of the frequency with which children retract statements of abuse by parents/carers, and the extent this correlates with continued contact in defiance of bail conditions and /or child protection plans?  6.2 FINDING 2 Does the recent expansion of child protection processes to cover adolescents at risk of Child Sexual Exploitation or exploitation into radicalisation, adequately cover other types of adolescent risk of harm, such as that associated with truancy and involvement in anti-social, criminal or risky behaviour? 6.2.1 Traditionally the focus of the child protection system has been on the quality and deficits of parenting, as opposed to the risk of significant harm per se to the child, regardless of the source of the harm. With the drive to address child sexual exploitation in society there has been increasing recognition of adolescent neglect as a safeguarding issue, when it exposes the child at increased risk of harm to child sexual exploitation, and more recently (in some local authorities) to radicalisation. 6.2.2 This finding concerns whether or not this broadening of the use of the child protection system is applied not just to those at risk of harm from exploitation, but for those adolescents presenting with the broad range of behaviour which could be considered to pose a risk to teenagers' welfare, such as  truancy, anti-social behaviour, substance misuse, dealing in drugs. In some instances such behaviour exposes the adolescent to further risks of exploitation by others. This is closely linked to findings 1 and 4.    28  HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.2.3 The initial concerns around the welfare of the children in this family was around physical and domestic abuse from their father, which led in November 2010, to the children being subject to a child protection plan under the categories of physical and emotional abuse (see 4.4). At this point they were aged between eleven to sixteen years old. Child protection plan 2010-2012 6.2.4 The protection plan was implemented following allegations by the five siblings that their father made them get up at 4.30am to study the Koran and punished them if he felt they were not studying properly. This could include making them stand against a wall for up to seven hours while he sporadically whipped them with electrical wire. 6.2.5 Initially the family remained in frequent contact with the father, despite bail conditions to the contrary, as they lived in his extended family's home. On the advice of professionals and consistent with the child protection plan, the mother separated from her husband and moved with the children to alternative accommodation; however, professionals believed that the father continued to have access to his children, with the mother powerless to stop this. 6.2.6 At that time police lacked means to stop the father visiting his children, despite it being against his bail conditions, because police bail, prior to being charged, does not provide effective powers when contravened. It is not clear if any professionals sought to support the mother to take out an injunction against him, with power of arrest. 6.2.7 The children were recorded, at the time, to have been put under pressure, by their father, to retract the statements they had made to the police. When subsequently seen by the police the boys said the situation had improved, and did not want their father punished. The CPS decided there was no prospect of a conviction without the direct evidence of the children, as the medical evidence was not conclusive: it was not possible to know how the injuries were caused and who was involved. The father had always denied having hit his wife or children and said that it was a racist vendetta by the youth worker, to whom the boys reported the abuse. Ending of child protection plan in 2012 6.2.8 At the beginning of 2012 the child protection plan was discontinued. The boys were aged between 13 years old and 17 years old. The plan was discontinued because the siblings were no longer considered to be at risk of physical abuse. The mother and children had moved and at that point in time the father was abroad and was reported to have stopped visiting their home when in the UK. The boys chose whether or not to see their father at the Mosque and at extended family members' homes. 6.2.9 The conference minutes make it clear that professionals understood that circumstances had, in many ways, deteriorated: the mother was considered to be trying her best to set boundaries, but her four youngest boys were effectively beyond her control. She spoke of being unable to manage the behaviour of siblings Q and W. Sibling P by contrast functioned well in all areas of his life and helped his mother. 6.2.10 The family was threatened with eviction due to the noise made by the boys and their friends at night. The four younger siblings' school attendance was low, ranging from 39.1% to 72%. There was a consensus amongst professionals of the difficulties in engaging the boys and of concerns about their increasing involvement in anti-social behaviour and, especially in the case of siblings Q and W, criminal activity.   29  6.2.11 The boys themselves expressed frustration to professionals on how their experiences of being victims of racism had been dealt with, along with feeling that they were experiencing harassment and racist police responses. Both the social worker and FIP worker found it difficult to see and engage the boys (except for sibling P), who were either in bed when workers visited the family home or out. 6.2.12 The deteriorating circumstances of the boys indicated that they were suffering significant harm because of the mother's inability to control them, which constituted neglect. Despite this, there was unanimous agreement to end the child protection plan and step down to a child in need plan. Partly this was associated with a systemic issue around the lack of use of the child protection system [at that time] for adolescent neglect. However, the minutes show that professionals felt that despite a large input of resources and effort by individual practitioners, the siblings had not engaged with professionals.  6.2.13 The conference minutes as well as information provided by practitioners to the review demonstrate professional 'helplessness' about what else to do, expressed by some as having 'no tools in the toolbox'. It was recognised that the child protection plan was no longer effective and that there might be greater success with this family through the use of a child in need plan. This was thought to have the advantage of working with the family in a less authoritarian manner, and that through the development of a strong relationship with fewer workers, it would be possible to effect change with the boys.   6.2.14 Seven months later, in August 2012, without evidence of any further success via the child in need plan, the case was closed to Children's Social Work, leaving the Family Support worker from the Family Intervention Project (FIP) to continue to engage with the family and to be the lead professional. The rationale was that he had a good relationship with the children and the mother. He was the only worker to be directly involved over a long period, but despite considerable effort and good relationships with the mother and children, there is no evidence the FIP worker had been able to improve the welfare of the children. 6.2.15 By closing the case to social care, the neglect issues relating to the boys being beyond their mother's control, were left to be managed in the early help services. The four youngest siblings' behaviour and school attendance had further deteriorated. All four were coming increasingly to the attention of the police, with siblings Q and W suspected of violent behaviour and sibling W being arrested for a number of violent offences (although no charges resulted, often due to the victims reluctance to proceed or identification issues).  6.2.16 From this point onwards, despite a great deal of input from the FIP worker and the involvement of the Youth Offending Service (YOS) and Community Safety the situation continued to deteriorate, despite the efforts of staff. The mother remained powerless to control her four younger sons and did not believe that they could be guilty of the anti-social and criminal behaviour of which they were suspected. The boys became more difficult to access, not keeping office YOS appointments, being out or asleep when the FIP worker visited the home and not attending school when arrangements were made to see them there. 6.2.17 There was no further consideration given to the use of the child protection system at this point, as it had not proved useful earlier and because adolescent neglect was not, at that time, being subject to child protection processes.  30  Child protection process 2014 6.2.18 By the end of February 2014, police investigations led to the view that the siblings had travelled to Turkey and from there possibly to Syria. Following meetings with senior managers (see finding 10), it was agreed that child protection conferences should be held on those young people considered to be at risk of travel and radicalisation. This demonstrated a clear understanding that radicalisation and the threat of travel is a safeguarding issue.  6.2.19 At the initial child protection conference for sibling Y in early April 2014, the concern is shared that siblings P, W and X may have gone to Libya or Syria to fight along with concerns that sibling Y's offending behaviour and non school attendance was increasing. At this point no child protection plan was agreed, instead another child in need plan was implemented, along with a referral to the Channel Panel. At this point the earlier neglect concerns remained, along with the new recognition of the safeguarding concerns relating to radicalisation. However, in contrast to 2012, Children's Social Work took a very active role in the child in need plan, the conference chair remained involved (chairing the child in need meetings) and the risks were closely monitored during the period under review and beyond.  HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE? Use of child protection system for adolescents 6.2.20 The appropriate professional response to adolescents identified as being beyond the care and control of their parents has always been problematic within a child protection system largely focused on children perceived to be more vulnerable, usually in terms of their age or stage of development. This has led in the past to adolescents being at risk of significant harm, due to neglect or because of sexual abuse (through exploitation) not becoming subject to child protection processes, but instead being provided with a range of support services, or being labelled as 'criminal' and provided with specialist provision.  6.2.21 The authors have been told, by practitioners in Brighton & Hove, that prior to 2012/2013 there was a local (and national) practice of rarely using child protection plans for older children, as there was a view that they were less vulnerable and less likely to respond positively to such interventions. This is reflected in government statutory guidance with Working Together to safeguard children (1999) defining neglect specifically in terms of 'young children'. By 2010, the term 'young' had been removed from the new guidance, but the culture of thinking of neglect of teenagers has taken longer to change.  6.2.22 With the increasing recognition that child sexual exploitation is a safeguarding matter, it is now becoming understood that the typical presentation by some teenagers of involvement in different types of risky behaviour can be indicative of underlying trauma. Moreover it is potentially a safeguarding matter as this can lead to being vulnerable to exploitation by peers and adults, into different forms of risky behaviour, including sexual exploitation and radicalisation. 6.2.23 Whether this cultural change in using the child protection process for child sexual exploitation has or has not become generalised to being used for other forms of adolescent neglect or abuse is not clear. Since the risk of exploitation into radicalisation and the risk of travel became known in March / April 2014, the safeguarding risks have been understood in Brighton & Hove, with the child protection process being initiated.   31  6.2.24 What is less evident is whether the vulnerability of young people out of parental control and involved in the broader range of risky behaviours is perceived as a safeguarding matter, and if so, at what point the child protection process is initiated. 6.2.25 Practitioners involved in this review commented that non engagement in education severely limits young people's life chances, but in itself would not come to the attention of other agencies outside of the school, or be perceived as a safeguarding issue, even if coupled with anti-social, criminal or risky behaviours. If sexual exploitation or radicalisation are also identified, it would now be perceived as a safeguarding issue. 6.2.26 There was a query expressed by some practitioners and managers whether or not there is a different professional response, depending on the gender of the adolescent involved in such activities, with a safeguarding response more likely to be initiated for teenage girls, than boys. On the positive side, the head of the adolescent service reported that recent changes of working between YOS, police and social work have identified a number of young people whose safeguarding risk had not previously been identified. This has been particularly relevant with young men whose risk taking behaviours and acting out of distress often manifests as criminal behaviours. 6.2.27 Also critical are the challenges to professional intervention (see finding 4) once young people reach this point in their development, if they and their families are unable to make effective changes. The final resort, if a child protection plan is unable to significantly help the adolescents, is care proceedings; however, this can be complex because such action may sometimes be considered as not, on balance, promoting the adolescents overall welfare, especially in the context of adolescents with views, wishes and feelings opposing such intervention.  HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.2.28 There have been a number of serious case reviews and other reports into child sexual exploitation which have highlighted the lack of use of child protection processes with adolescents in relation to sexual exploitation, such as 'The Brooke Serious Case Review'15 and the 'Serious Case Review into Child Sexual Exploitation in Oxfordshire' 16. 6.2.29 What there is less knowledge about is the extent to which the child protection process is used for those young people perceived as 'out of control' of their parents due to underlying vulnerabilities which make them at high risk of being exploited by peers and adults . 6.2.30 The experience of the authors as practitioners, managers and through undertaking reviews and audits throughout England has demonstrated the inconsistency and confusion there has been for a considerable period in relation to the use of the child protection process for adolescents, especially those perceived to be suffering from neglect associated with being beyond the control of their parent.   WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.2.31 Child welfare and protection are ‘wicked problems’ in that they cannot be definitively described, and there are no definitive and objective solutions. What kinds of issue count as a child protection concern, requiring a statutory response to protect and promote children’s welfare, and what such a response entails, changes with time and are often contested.   32  6.2.32 A safe multi-agency child protection system needs to be equipped to spot emerging changes in the realities of contemporary children and childhoods, as well as shifting moral stances, and respond and adapt creatively to tackle them.  6.2.33 Attitudes toward adolescents and understanding of the changing risks they face have undergone significant changes recently, particularly with recognition of CSE and radicalisation as forms of exploitation. There has been a considerable development of services for adolescents since 2014 in Brighton & Hove, with the city leading developments in a timely and constructive response to the newly identified safeguarding risks to children posed by radicalisation (see Finding 10). 6.2.34 However, this finding highlights some current ‘blind spots’ in how we view and respond to behaviours of adolescents. There are a broad range of behaviours that large numbers of young people are involved in locally, some of which expose them to harm, some of which are related to vulnerabilities due to earlier life experiences and/or parenting issues. Without early intervention it is likely that some children may be exploited by peers and adults, in a variety of different ways, including the possibility of radicalisation. If such scenarios are not included in the spectrum of child protection, this risks a system of tackling new symptoms, without getting to some of the underlying causes. 6.2.35 The risk of harm for such adolescents needs to be identified as a safeguarding concern and consideration given whether this does meet the threshold for the initiation of child protection processes. There has been considerable development of services for adolescents since 2014 in Brighton & Hove, but, as yet, it is not evidenced how this will have impacted on these circumstances.   FINDING 2: Does the recent expansion of child protection processes to cover adolescents at risk of Child Sexual Exploitation or exploitation into radicalisation, adequately cover other types of adolescent risk of harm, such as that associated with truancy and involvement in anti-social, criminal or risky behaviour?    CONSIDERATIONS FOR THE LSCB  Is the Board aware of how many teenagers would be subject to child protection and /or child safeguarding processes if all risky adolescent behaviour was included? Would the system be able to cope with this additional work? What impact would there be on other services?   Can it be ethically justified not to treat adolescent risk as a safeguarding issue, with child protection processes used when such concerns constitute the risk of significant harm?   What would the cost-benefit be overall?   Are there any significant differences of perspective between different agencies or professions?   Do the current strategies for working with adolescents now provide sufficient intervention to be able to safeguard young people who may be particularly vulnerable to exploitation, before it has been identified they have been exploited? If not, do we know what works to provide better support?  What practical issues would it raise to equip professionals with an appropriate range of options for help and interventions?   33  6.3 FINDING 3 The current child protection processes distinguish between children who are missing in the UK and those are who are suspected of being missing abroad; as a consequence the potential positive strategy involved in the formulation of a child protection plan is not provided for those who are suspected of being abroad. HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.3.1 When it was recognised that children in Brighton & Hove may be at risk of travelling to Syria, initial child protection conferences were held on each child identified. However, this did not include children who were already missing, thought to be abroad and already in Syria. So whilst a conference was held on the remaining child in the family in the UK, neither W or X were subjects of this meeting and no protection plan was made in relation to their protection, despite the fact they were both aged under eighteen years old at the time and clearly at risk of, or having already suffered, significant harm.   HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE? 6.3.2 The current procedures relating to children who are missing and whose whereabouts are unknown, but believed to be abroad, are different to those for children believed to be in the UK.  6.3.3 The procedures for children who go missing in the UK, include the use of strategy discussions, child protection conferences and plans. If the missing children are believed to be abroad, such processes do not apply. Instead this is a matter for the police and for the relevant agencies in the country where the child is believed to be.   HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.3.4 It is not known how many children who go missing abroad are or are not subject to child protection processes. However, Brighton & Hove's child protection procedures are not alone in distinguishing between those who are missing in the UK and those thought to be abroad. A recently published Hounslow serious case review (Anita B.) by one of the authors of this report concerns another child who went missing abroad and recommends that: 'The LSCB to raise with the London Safeguarding Children Board the need for the child protection procedures to specifically address the processes to follow when a child is missing abroad'.17  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.3.5 If children who go missing abroad are not subject to the child protection processes, and the investigation is left entirely to the police and the authorities of the country where the child is suspected of being, there may be a potential loss of both information and potential strategies to protect the child. For instance full involvement of parents, family and others in consideration of what actions could be taken to assist in helping the child to return.    34  FINDING 3: The current child protection processes distinguish between children who are missing in the UK and those are who are suspected of being missing abroad; as a consequence the potential positive strategy involved in the formulation of a child protection plan is not provided for those who are suspected of being abroad.    CONSIDERATIONS FOR THE LSCB  Can it be ethically justified to have different responses if a child is missing, dependent on where the child is thought to be and regardless of the risk of significant harm?   Does the lack of child protection processes, and the consequent involvement of local agencies and family in a child protection plan, reduce the potential role of the family or community in finding the child or returning the child to the UK.  Does the current distinction between those missing in the UK and those missing abroad sufficiently recognise the role of a child protection plan for children suspected of being subject to a forced marriage or exploited into radicalism?  6.4 FINDING 4 In working with adolescents there can be a pattern of reactive crisis management as a means of handling the relentless stream of incidents; this minimises the likelihood of reflective thinking and analysis necessary to understand and tackle the root causes of the behaviour. 6.4.1 This finding is linked to finding 1 about professional helplessness in the face of parents and children who are unwilling or unable to be able to make effective changes due to underlying trauma. This finding though addresses the professional helplessness in response to a constant stream of incidents requiring immediate responses. 6.4.2 This refers to the broad range of behaviour teenagers can be at risk of, such as anti-social behaviour and criminal acts, substance misuse, dealing in drugs, truancy, as well as the risk of being exploited by others (e.g. child sexual exploitation and radicalisation of children). Often teenagers drift in and out of such activities, and can be involved in more than one of them.   HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.4.3 One of the notable features of this case was that prior to the review period the siblings engaged with youth services and disclosed to a worker there that they were suffering physical abuse. As described in finding 1, although professionals from different agencies were still trying to work with the mother and the four youngest siblings, by the time of the period under review the four youngest siblings had become hard to engage. At times individuals were superficially compliant, but were not able or prepared to make or sustain significant changes. 6.4.4 Part of the explanation for this lack of meaningful engagement is likely to relate to family member's own history and experience of earlier professional involvement, which may lead to a lack of engagement with professionals, as described in finding 1. However, part also lies in the lifestyle that was a feature of the four youngest siblings' lives. This  35  involved frequently being out to the early hours of the morning; returning home with friends and not settling to sleep; missing school because they were asleep in the morning; involvement with other young people in group anti-social and criminal behaviour (including violent offences against others); substance misuse and suspected drug dealing. The four youngest siblings all were involved at varying degrees in the risky activities mentioned, although there was no awareness of them being exploited by others into radicalisation. 6.4.5 The FIP worker found himself responding to constant incidents and had difficulty getting to see the siblings, who were often asleep at home or out when appointments were made. Schools also were dealing with how to manage the siblings' behaviour when they did attend, and different YOS staff (including sessional workers or duty social workers) were seeing the children as individuals with a focus on their offending and anti-social behaviour.  6.4.6 Whilst professionals recognised that the siblings behaviour was indicative of having suffered early trauma and that they needed help to tackle the underlying root causes, they were unable to deliver this. The constant incidents, as well as the difficulty of meeting with the siblings, contributed to challenges in being able to develop a relationship based intervention, as well as reflective thinking and analysis.  6.4.7 Another obstacle could also be in the way services were delivered to the family, involving many different agencies and practitioners, each responsible for a particular presenting problem, or individual family member. This was recognised when the child protection plan was ended, and the FIP social worker became the lead professional. However, with the escalation in the criminal activities of the four youngest siblings, YOS became increasingly involved with the individual children and the family. By early 2014, there was recognition in YOS of the need to consolidate the service provided to sibling Q and joint work was undertaken by a YOS social worker, with a RU-OK (substance misuse) social worker.   HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.4.8 In recent years there has been a growing understanding of the vulnerability for adolescents of early unresolved trauma. Typically the multi-agency safeguarding system becomes involved with children due to increasing concerns about their vulnerability, which put them at risk of harm. Their previous life experiences are often, though not always, a factor in their increased vulnerability to risky behaviour.  Concerns typically include challenging behaviour, non-school attendance, alcohol and/or substance misuse, being missing from home, criminal activity, antisocial behaviour and vulnerability to abuse through underage sexual activity/sexual abuse exploitation and recently radicalisation. 6.4.9 During adolescence, parents (and for looked after children 'corporate parents'), often struggle to keep some adolescents safe. It is clear from what children tell us in the field of sexual exploitation, that without significant help, it is difficult to make changes in your life18.    6.4.10 An underlying obstacle in being able to engage young people who have suffered trauma, is the complexity of the difficulties they may experience. Services tend to focus on particular presenting problems as opposed to a more holistic intervention. So domestic abuse is referred to RISE, substance misuse to RU-OK, youth crime and anti-social  36  behaviour to YOS and emotional disturbance or trauma to CAMHS. This splitting of an individual's or a family's needs into different problem areas may in itself be an obstacle to getting engagement of those who have a history of experience with different professionals.  6.4.11 Local and national configuration of services is based around a 9-5 culture, with different services providing wholly distinct parts of the care provision. This is possibly least suited to adolescents who tend to be more active later in the day and at night. Also, some adolescents may have less understanding and tolerance of the need to obtain help / services from several places and many different people. A one-stop shop approach, with flexible forms of access at different times of the day is more likely to meet their needs. 6.4.12 Locally, there is now a new model of practice, with a specialist Adolescent Social Work Pod and Extended Adolescent Service which recognises the previous shortcomings of working with adolescents with multiple needs including high levels of vulnerability, risk taking behaviours and complex behavioural issues. Adolescent Services work with young people who are at high risk of sexual exploitation, radicalisation and/or who are at risk of entering care or custody. The services work to engage hard to reach young people, through building and maintaining effective relationships, through the use of innovative packages of support, intervention and care that are tailored to meet individual needs. This service provides a focus on relationship based practice which is hoped will be more effective in working with young people who are so alienated from authority. 6.4.13 The extent to which this commendable approach will be able to succeed with young people who have suffered high levels of trauma in the past and have become so alienated from society still needs evaluation. It should also be noted that it is still a service largely based on an office day, which may not in the past have always provided the support young people need at the times they are awake and active. However a very recent development provides an extended evening and weekend service, which aims to provide support to young people’s needs at the times they are awake and active.  6.4.14 A weakness of the adolescent provision remains that it does not include all services which need to work together, such as CAMHS and Youth Services and so cannot ensure a holistic approach, including therapeutic services.   HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.4.15 The dilemma around how to respond to the need to safeguard adolescents involved in risky behaviour is not restricted to Brighton & Hove, but is common to most geographical areas of the country. The report by NSPCC (2015)19 highlights that child protection processes and procedures tend to be designed for work with young children in the family context. Handson, E and Holmes, D (2013)20 (Cited in RIP 2014), suggest that adolescents need a more sophisticated model of risk and prevention. 6.4.16 The central government policy for many years to improve access to early help for families alongside the importance of statutory agencies intervening early in any maltreatment on younger children, may have impacted on the system's ability to respond to the needs of older children. Nationally it is reported that resources have been redirected and youth work services have been cut. This, alongside an assumption that adolescents have a greater resilience to the impact of abuse, (Gorin and Jobe21, cited in Research In Practice 2014) has left a gap that leaves adolescents without a  37  system that can adequately respond to their complex and differing needs except on an agency-by-agency basis.  6.4.17 A further obstacle to intervention with this age group is the lack of knowledge in the workforce about how to manage adolescents who have suffered trauma from an early age.   6.4.18 What is recognised by practitioners though is that activity based activities can be the best way to develop relationships with troubled youths, and it is of concern that youth services which provide these have in some places been threatened due to the current austerity measures.  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.4.19 Young people, who have suffered trauma in the past and who, for whatever reason, do not have trust in professionals to be able to help and support them, may be more likely to be vulnerable to risky behaviour and experiences. The form this takes will vary depending on the adolescents own history and social contexts. Such behaviour is most likely to present practitioners with constant streams of incidents that require immediate attention and deflect any purposeful strategy to provide intervention able to address underlying root problems, 6.4.20 In order to be able to safeguard young people such as this, we need to develop flexible services designed to be able to work with individuals, family groups and peer groups in a way that is acceptable to adolescents and at a time and place that will meet their needs. In particular we need to provide a service that is able to respond to incidents without being diverted from planned strategies of intervention.    FINDING 4: In working with adolescents there can be a pattern of reactive crisis management as a means of handling the relentless stream of incidents; this minimises the likelihood of reflective thinking and analysis necessary to understand and tackle the root causes of the behaviour.   CONSIDERATIONS FOR THE LSCB  Are flexible services for young people sufficiently valued and developed in Brighton & Hove and designed to meet teenage lifestyles e.g. 'one stop shop', extended hours and out-of-hours services able to meet needs  What strategies are there in place to address practitioners needs to be able to be reflective, as opposed to reacting to constant incidents? Is the Board assured that this is effective and producing more positive outcomes for children?   Does the new service for adolescents adequately assess and work with the individual as both vulnerable and as someone involved in anti-social behaviour?    Is the new adolescent service in Brighton & Hove being evaluated? Does it provide  a sufficiently 'joined up'  and holistic service able to work with adolescents in different ways, including activity based interventions, provide therapy, joint working , working with individuals, family groups and peer groups according to assessed needs  38  6.5 FINDING 5 The systems of collecting and sharing data about young people who come to police attention, in Brighton & Hove, do not consistently provide all relevant information to practitioners so as to assess, identify and address safeguarding needs. 6.5.1 This finding concerns the need for those working with children to be able to make valid assessments of need and risk based on full and up-to-date information of the contacts children have with police, both as a victim or a suspected perpetrator of offences. It refers primarily to the collection and communication of information both within police and between police and other agencies in relation to the large numbers of children who come into contact with officers, because they are suspected of committing an offence, but which does not lead to prosecution.  6.5.2 The police's important safeguarding role here is recognised in Working Together22 (2013 and 2015) where it states that 'Professionals should, in particular, be alert to the potential need for early help for a child who... is showing signs of engaging in anti-social or criminal behaviour'. For the police this involves the investigation and prosecution of crimes, as well as identifying children's safeguarding needs and participating in the child protection process. 6.5.3 The reviewers have been advised that in recent months changes in practice (associated with the emerging findings of this review) have happened in information sharing practice, which will resolve the difficulties described in this finding. However, it is too soon yet to know how effective the changes have been and it is not clear that the changes include all the contacts with police that need to be shared. HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.5.4 The perceptions of many of the practitioners working with the family at the time was that the siblings were likeable young people, who had been victims of racism and this had led them to retaliate and get involved in anti-social behaviour and minor criminality. When asked if the boys were involved in violent crime, social workers and youth offending officers said that they were not.  6.5.5 This professional perception by those involved at the time is strikingly different to the facts as presented by the police chronology for this review. This shows, especially in relation to siblings Q and W, extremely frequent contact with police, at times several times a day. It also showed that although police were in frequent contact and that they were often suspected of involvement in aggressive and violent offences, these were rarely prosecuted due to lack of evidence. 6.5.6 Examples of this pattern of behaviour include the following events reported to police over 8 days in February / March 2012 (this was extracted as an example from a very long chronology provided by the police):  Day 1: an unprovoked attack on Spanish student by group of young people - sibling W arrested but insufficient evidence to charge him with wounding with intent, although another member of the group was charged  Day 1: both siblings Q and W were part of a group who were reported to regularly torment the owner of a car and one of the group (not one of the siblings) was arrested for damaging the car  39   Day 1: parent found messages from sibling Q on son's telephone indicating Q was selling drugs (reported to police)  Day 1: sibling Q part of group stopped by police for causing a disturbance  Day 2: sibling W alleged to punch a drunk to the floor and continuing punching him on floor [despite being named by witnesses, W was never interviewed or arrested because the victim did not want to pursue charges]  Day 2: a student struck in face allegedly by another sibling  Day 2: sibling W part of group that committed a burglary (mobile phone stolen), sibling W was arrested but not charged due to insufficient evidence, but others in the group were charged  Day 2: sibling Q part of group who assaulted foreign student on the bus, and he allegedly struck the student on the face  Day 7: Report from member of public that sibling W shouted and then struck a man before getting onto a bus (this was not followed up by the police, despite the identification of sibling W)  Day 8: an Italian student punched in the face causing possible loss of sight (one of siblings amongst group suspected) 6.5.7 This pattern of offending continued throughout the period under review in relation to siblings Q and W, and over time the two younger siblings also became involved in the criminal justice system. Sibling P was never involved in such behaviour. Siblings Q and W were suspected of being involved in many more crimes than they were charged with, including selling of drugs, burglary and assaults. Some of these were particularly violent crimes, especially in relation to individual foreign language students in Brighton & Hove. The attacks were vicious, usually being committed as part of group activity against individual victims. 6.5.8 While the police were seeing these young people as criminals and committing anti-social behaviour, regularly picking them up in the early hours of the morning, this information was not communicated to others, and in most cases did not lead to prosecution.  6.5.9 The police have explained that the reasons for lack of prosecution for the offences varied, from insufficient evidence, the victim not wishing to pursue the matter (sometimes associated with suspicions of intimidation), to identification problems and on occasions possible lack of follow-up or sufficient investigation by police. 6.5.10 The boys' safeguarding needs, for example being frequently out in the early hours of the morning, were also not identified, though this should indicate parental neglect. This links to finding 2 and the extent to which some aspects of risky adolescent behaviour is perceived to be about safeguarding needs. In consequence, the police in some instances appear to have neither fully investigated the siblings for suspected offences, nor identified the boys' behaviour as indicative of their safeguarding needs (which would then need referral to other agencies). 6.5.11 In exploring the difference between the level of police contact and arrests, with the knowledge of the boys offending behaviour, the YOS staff explained that they would only (at that time) be informed of convictions, so were unaware of the level of contact the siblings had with the police.  Moreover, it is not clear if police recording systems  40  would have provided police officers with the entire picture of such contact, in particular the many occasions when contact did not lead to an arrest.  6.5.12 The frequency of the contacts with police, whether they led to arrests and prosecution or not, illustrate clearly the boys’ life style and arguably their own needs to be safeguarded from involvement in such activities. However, such information was not analysed within the police force, nor shared with other agencies. 6.5.13 From January 2012 the children were no longer subject to child protection plans, but had the pattern of offending been more fully understood, this may have raised questions about the need for the re-involvement of Children's Social Work and use of the child protection system in relation to their neglect, due to being beyond parental control. HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.5.14 In Sussex and elsewhere in the UK, there has been a system for at least 20 years of police providing Children's Social Work (or now the multi-agency safeguarding hub or MASH23) with notifications every time there is direct contact with a child. Most commonly this has been in relation to domestic abuse incidents. The notification additionally includes a risk assessment to assist recipients in determining the action to be taken. In Sussex the current form is called a SCARF24, and is sent to the MASH, where a decision will be made as to the need for any further action. Prior to the SCARF the form used was called a MOGP/1. 6.5.15 During the process of this review there has been much discussion within the serious case review team to understand why this system did not consistently work in this case and the extent to which this reflected a more widespread problem. One of the police representatives on the review team confirmed that the policy for sharing MOGP/1's and SCARFs with Children's Social Work services has always, and remains, in place. However, prior to 2006, when electronic notifications were introduced, a separate process had been developed to notify Children's Social Work services of children who were suspected perpetrators of crimes or anti-social behaviour (as opposed to being the victims of crimes). This was initiated by custody when someone was arrested. The MOGP/1 then ceased to be used for this type of contact. However, over time, systemic changes in crime recording occurred, which led to the notifications of criminal activity to Children's Social Work ceasing.  6.5.16 A finding in another serious case review in Brighton & Hove (Child E, 2016) also identified this problem, with 9 out of 10 contacts with police (of the child who was the subject of the review), not shared in 2013. That review refers to a planned routine audit to be undertaken by police of SCARFs through the introduction of new audit measures for the Safeguarding Investigation Units. This is a welcome initiative by the police. 6.5.17 Another factor may be around culture at the time, with some practitioners in both police and YOS expressing resistance (in the review process) to taking account of information about police contacts in the absence of convictions, on the basis of the offences not being proven. Whist clearly such information is not of the same status as convictions, it does provide information about the adolescents' behaviour and peer group that are critical to assessments. 6.5.18 During the process of this review, senior managers acted upon the emerging learning and made changes to improve information sharing between police and children's social work services, including the YOS. The new process involves police providing information  41  when a child is arrested. It is too early to say how successful this has been. Moreover, it is not clear that the new system enables sharing information of all contacts, and it may be that if a child is not arrested for a suspected crime nor identified as a victim, the information may not be shared within the police, nor with other agencies.  HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.5.19 The obstacles to the consistent and reliable communication of police notifications to other agencies frequently arise in serious case reviews around the UK, as well as in audits undertaken by the independent lead reviewer. Typically the problems encountered are:  Incidents discovered in a serious case review that were not communicated to other agencies  Incidents not communicated by the police officers to the police child protection team, so not always available to social workers  Police not having sufficient resources to do this work, so make individual judgments when it is critical to do so  Children's Social Work or MASH being swamped by such notifications and struggle to process them consistently (this was also mentioned specifically by police in the review team as having occurred in the force area) 6.5.20 Whilst information sharing problems emerge in different ways in different places, there does appear to be widespread difficulties in the consistent communication of all direct police contacts with children. But if such contacts are more reliably communicated, there may be an impact on the resources in MASH which may not have the ability to undertake reliable screening of all such notifications. WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE                  MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.5.21 Anti-social and criminal behaviour of children and young people is a safeguarding issue and could constitute a child protection concern, so such information from the police needs consideration in ongoing assessments.  6.5.22 When young people are perpetrators of crimes against other children or vulnerable adults, the child's behaviour could stem from their own inner distress. Such circumstances need careful evaluation and it is important that this information is communicated, so that any welfare needs of the child is able to be assessed and identified.  6.5.23 The information about the level of contact between police and a young person is relevant for any practitioner working with the young person. However, for social workers in the Youth Offending Service, such information is particularly critical, as the focus of the work is the young person's offending. If practitioners working with young people around their offending behaviour are unaware of the extent of, and range of, suspected criminality, then their assessment of risk is likely to be flawed, as well as any resulting plans that are predicated on the assessment. Such relevant information includes when children are in contact with police when they are out in the middle of the night and when they are part of groups involved in criminal behaviour, even if this does not result in an arrest of the individual concerned.  42  FINDING 5: The systems of collecting and sharing data about young people who come to police attention, in Brighton & Hove, do not consistently provide all relevant information to practitioners so as to assess, identify and address safeguarding needs.    CONSIDERATIONS FOR THE LSCB  Do front line police officers understand their safeguarding role and know when information needs to be shared with other agencies? Is there a need to define what information should always be communicated to whom and where they may be discretion?  Does the LSCB accept that Youth Offending Service staff need to know about every contact of a young person with the police, not just when the young person is convicted? Are there any other practitioners who need this information e.g. other social workers, community safety and Protect officers?  Would it help children's welfare if schools were informed of their pupil's contact with police?  Does the LSCB have sufficient information with regard to where the obstacles lie in the information sharing process, both within the police force and then if communicated to MASH?  Is there a need for a formal information sharing agreement between the police and other agencies around information sharing on children who come to the notice of the police, including those arrested for suspected offences and those not arrested but involved with others in such activity?  If this information is routinely communicated, will systems in MASH be able to deal with the rise in notifications?  Do practitioners need any guidance about how to take such information into account in assessments?  6.6 FINDING 6 Do practitioners understand and know how young people are radicalised and how to counter the propaganda that influences them into extremist thinking? HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.6.1 Prior to the discovery that the siblings and their friends had gone to Turkey/Syria in January 2014, there had been no suspicion of Brighton & Hove young people being radicalised and thinking of travelling to join any of the various factions fighting in Syria. The only concerns identified at the time (as described in Finding 8) related to related to the emotional outburst against Americans by sibling X, the conversion of some other young people to Islam and being encouraged (by a relative of the siblings) to attend the gym behind a place of worship, instead of being involved in anti-social activities. The presence and leadership of sibling P at this gym was perceived universally as re-assuring: he was considered to be a sensible young man, who supported his mother with his younger siblings, did well in his studies and appeared to have a bright future.  43  6.6.2 Local practitioners do not know how, when or why the siblings decided to travel to Syria. Their mother’s understanding is that the boys travelled for humanitarian reasons. Whatever their motives for travel, the Police understood that the boys died participating in the conflict in Syria. Comments that have been made by other young people and their families subsequently suggest that some family members were considered to be 'high-up terrorists' by peer groups members. 6.6.3 The lack of detection of changes going on within the family, despite frequent contact with professionals, suggests that the young people were skilled in hiding their thinking. It is of note that sibling P has subsequently spoken online of researching what was going on in Syria and watching videos that 'pushed me to go there' as people 'called out for help'. He advised those who were going to Syria to keep it to themselves and that 'parents are the last people you should tell'. It is of note that the mother told the report authors that she had no knowledge of her children's plans before they left home, and whilst she knew her sons cared about the plight and suffering of others, she never suspected they had any intention to join the fighting in Syria.   HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.6.4 One of the features of child abuse, especially in relation to sexual exploitation is the way that children do not 'tell' and feel loyalty and/or fear towards the exploiter/s, such that they keep what is happening a 'secret' from parents and those in authority.  6.6.5 Another feature that is identified as increasing risk to children's safety is the vulnerability of some children on the internet. This has been increasingly pertinent in terms of being sexually exploited by strangers. Barnardos25 research in 2015 identified the following ways the internet provides opportunities to exploit children including:  Enables children to be accessible and perpetrators anonymous encouraging risk-taking  Young people who are vulnerable may have shown no previous signs of such vulnerability, so are not easily identified - often first parents know is when police inform them of the abuse 6.6.6 There are characteristics of radicalisation of young people that have similarities to that of sexual exploitation, especially with regard to the use of the internet as a way of reaching children, grooming them and convincing them of the need for secrecy before ultimately exploiting them. 6.6.7 In a report to the High Court26, Silke and Brown (2015) explain that there is no single root cause of radicalisation and that social relationships are one of the key elements. Young people aged from 14 years old are being recruited by Islamic State and ' connected through siblings, friends and individuals known to them'. 6.6.8 Silke and Browne refers to recent research which 'suggests that in up to 20% of cases family members played a key role in introducing and initiating to an extremist movement. In contrast, friends played the key role in almost 50% of cases.'27 6.6.9 Online environments are another major recruitment method, although Silke and Browne suggest this frequently relies on 'real world' contacts. Also online propaganda suggests that those in authority in communities may have been corrupted by working for European authorities, don't understand and are not to be trusted.  44  6.6.10 This suggests that those who are being 'groomed' into radicalisation are less likely to be able to share and discuss their changed views and consequently become more vulnerable to exploitation, becoming part of a secret world. 6.6.11 In a meeting in Brighton and in a telephone conversation and an email exchange with one of the lead reviewers, Alyas Karmani, counter extremism expert and Imam, spoke about how the powerful social media machine creates messages that indoctrinate individuals, through immersive engagement, that can be as much as 100 hours per week. These powerful and emotive messages can be very compelling if an individual does not have anything to counter them. Moreover, if the grooming process involves such considerable individual time commitment, the ability of professionals to be able to counteract such pressures is extremely difficult. 6.6.12 Each individual is unique in terms of their own vulnerabilities that make them susceptible to radicalisation, this is often exacerbated by poor emotional wellbeing and a low baseline in regards to Islamic teaching and understanding, which means that they do not have resilience to the extremist message. Karmani refers to experiences of racism accentuating a sense of exclusion and being on the 'outside' and overall disconnect from society, family and institutions for young people. Without support and guidance for young Muslims to enable them to navigate and negotiate issues related to identity, inclusion and integration they become vulnerable to radicalisation. At the same time young Muslims need safe spaces to explore challenging issues that are seen as taboo such as sexuality, foreign policy and 'jihad'. 6.6.13 This highlights the underlying challenge for practitioners and for parents in identifying those at risk of being exploited and knowing how to counter the influence of the propaganda that adolescents are exposed to on the internet and through social networks. If young people are being discouraged from sharing their views with parents and those in authority, the opportunity to identify risk, intervene and try to de-radicalise the young person is very small.  HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.6.14 The independent cultural consultant for this review explained that one of the most important elements that have become associated with the rise of Islamic State (ISIS) in 2014 is the use of social media. This aims to pull young men and women to the growing territory that they had occupied in their expansion across Syria and Iraq. This promoted a perception of the suffering of the Sunni population in Syria and promoted a narrative that Sunni Muslims across the globe had an Islamic duty to join ISIS in the drive to push out Shia armed groups and Assad’s forces, from Sunni dominated areas.  6.6.15 The use of video material highlighting mass civilian casualties and messages through thousands of Twitter accounts, run by determined ISIS followers and sympathisers, drew in human and other resources to the growing Islamic State. A Brookings University analysis of ISIS social media accounts during the period of October 4th through to November 27th 2014, estimated that there were no fewer than 46,000 Twitter accounts that were supporting ISIS.28 6.6.16 Through the use of a multitude of social platforms, young people came across ISIS material, including videos of civilians suffering death and ISIS fighters standing up to Assad and Shias (whom the Jihadists regarded as ‘unbelievers’ or non-Muslims). This resulted in some vulnerable young people being drawn into Iraq and Syria, sometimes through a desire to protect civilians and to help the people of Iraq and Syria.   45  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.6.17 Traditionally, safeguarding children has centred around issues of parenting, and supporting parents to be able to keep their children safe. With the arrival of online risks, it is increasingly difficult for parents and professionals to be confident that they know what is influencing children whilst they are using the internet. This has increased the numbers of children vulnerable to grooming and exploitation. Moreover, those at risk are a wider group of young people, some of whom will not be considered conventionally at risk in terms of safeguarding. This particularly applies to being groomed into radicalisation, which can appeal to a wide variety of young people, including those who are successful and appear well integrated into UK society. 6.6.18 Parents and professionals often do not understand the different elements of social media, in terms of its impact, messages, sites and changing format, so it is difficult to discuss and explore with young people.  6.6.19 In this very quick moving environment, it becomes difficult for those in authority to develop effective strategies, when perpetrators on-line will change and adapt their techniques to avoid detection.  FINDING 6: Do practitioners understand and know how young people are radicalised in Brighton & Hove and how to counter the propaganda that influences them into extremist thinking?     CONSIDERATIONS FOR THE LSCB  How to provide children and young people with information and evidence to counter the propaganda that they may be accessing on the internet and the impact of peer pressure via social networking: to be effective this will need to address the appeal of belonging to particular groups, who provide a strong identity, promise the resolution of the world's problems and social injustices  How to equip parents and professionals to be able to identify risks and be able to intervene effectively?  How to encourage young people to talk freely about their thoughts and beliefs, when they may be discouraged through those who wish to exploit them and/or through fear of being reported to Prevent and the Channel process?     46  6.7 FINDING 7 Efforts to help and support children, so they are less likely to become vulnerable to exploitation into radicalisation, do not adequately address all the core issues, as perceived by community members. 6.7.1 This finding focuses on the issues community members raised in the meetings held as part of this review. These were considered critical in terms of helping to minimise the risk of children being exploited by radicalisation.   HOW DID THE ISSUE MANIFEST IN THIS CASE REVIEW? Basic need for self-esteem in childhood 6.7.2 The core issue explored in one of the meetings with community members was around the need of all children to have self-esteem. However, early experiences of racism in nursery schools and primary schools were described as leading to children becoming alienated and as a consequence more vulnerable to searching for ways to feel better about themselves through other means. This could involve anti-social and criminal behaviour, or could lead into a desire to identify with others of their community elsewhere in the world.  6.7.3 There was concern expressed that schools are not able to protect Muslim children sufficiently from racism and that with the ending of required reporting of incidents, there is no longer awareness of the level of hate incidents within schools. 6.7.4 Positive Muslim role models (along with those from other minority groups) need to be invited into schools, so as to provide all pupils with an understanding of the variety within the Muslim community and the diversity within society. It was suggested that Muslim women might be a useful resource here, rather than relying on the input of religious leaders. Also there is the need for schools to be more welcoming to BAME parents from the outset, so they are involved in the school's community, and that members of the community, including mothers, are involved in school life, explaining about the culture. 6.7.5 The meeting explored current efforts of the various Muslim communities to provide self-esteem for their children. This particularly occurs through involvement in educational and social activities linked to the Mosques. But such activities to support children are not considered to be always able to counter the negative racist experiences some children suffer at schools and in the wider community. 6.7.6 The basic need of a child to be proud of her/his identity was discussed, and then from that position of positive self-esteem, they are able to be part of a diverse and integrated society. However, the ability of children to be able to achieve this without more change in schools was questioned. There was a suggestion made by one person, that if schools continue to be unable to meet Muslim children's needs, attendance at faith schools might provide a better basis for developing the self-esteem necessary to become fully functioning members of UK society.  Other issues raised by community representatives: 6.7.7 The role of the internet was discussed and its influence on young people, with messages about Shia killing Sunni having a profound effect on the young people, who perceived their Sunni brethren to be under threat. However, the motivation of the young people  47  who travelled from Brighton & Hove was described to be about the provision of humanitarian aid, albeit, once there, they were able to be exploited by others. It was recognised that the influence of the internet is a challenge, but solutions to this are more difficult to identify. 6.7.8 The community representatives expressed their support for the aims of the Prevent agenda, but frustration with the methods used which are not considered to be working, Prevent is perceived as a tool to 'spy' on Muslims and is not trusted.  6.7.9 The view was expressed that the policy of arresting all those who return from Syria deters any young people who have gone from being able to admit this was a mistake and returning to the UK. Such a policy was considered to increase the risk to young people. However, those present at the meeting were unable to say if this had a bearing on any of those from Brighton & Hove who have travelled. It was accepted that given the risks of terrorism, there is a need for an investigation of anyone that returned, but also that, depending on the outcome of this, does not necessarily lead to imprisonment. HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE? HOW PREVALENT AND WIDESPREAD IS THE ISSUE? Low self-esteem and links with racism and bullying 6.7.10 Links between low self-esteem and troubled (and troublesome) behaviour in adolescence are widely recognised in the literature on child development. This links to the difficulties professionals face working with children who have long standing experiences of trauma, as discussed in finding 1.  6.7.11 The impact of low self-esteem has wide ranging effects on all aspects of children's development, including increasing the child's vulnerability to exploitation by others through all means including the internet. Data from survey of pupils 6.7.12  The Brighton & Hove Safe and Well at School Survey (SAWSS) is an anonymous online survey conducted annually by primary and secondary schools during lesson time. It has been undertaken for the last 7 years. The 2015 survey involved 9206 young people aged 11-16 years old. Its main findings were that:  There has been a significant fall in pupils saying they have been bullied - from 26% in 2005 to 14% in 2015; it is thought this reflects the work undertaken in schools.  The most common forms of bullying were verbal bullying, associated with appearance  Those most likely to suffer bullying (in this survey) are those receiving extra help at school and those who do not identify with the gender they were assigned at birth  83% of students reported ‘my school helps me to get on with others including people from different religious and cultural backgrounds’, but this dropped from 88% in 11-12 year olds to 78% in 15-16 year olds  6.7.13 In general the report supplied to the serious case review noted that 'there was no significant difference between Black & Minority Ethnic (BME) students compared to those who identify as White British (16% and 13%), but Chinese students are  48  significantly more likely to state having been bullied (30%). Lesbian, Gay or Bisexual (LGB) students (28%) and students unsure of their sexual orientation (22%), are significantly more likely to be bullied than heterosexual students (13%)'. 29 6.7.14 The above suggests that the experience of children in Brighton & Hove schools may have significantly changed since the brothers of this case review were at school. However, whilst the report provides data on bullying, it does not report on racism. If it did do so, it may be that a different picture would emerge.  6.7.15 Related to this is the drop in perception (as children get older) that the school helps pupils getting 'on with others including people from different religious and cultural backgrounds' (see last bullet point at 6.10.12). This may suggest that more work needs to be targeted at older pupils. 6.7.16 In 2016 the survey for the first time looked at bullying in relation to ethnicity, religion and those born outside the UK. At both primary and secondary level the demographic reports for 2016 does not show that BME students are significantly more likely to report they have been bullied than White British students. While those born outside the UK are slightly more likely to report being bullied in both the primary and secondary school survey. However, in school level reports and focus group discussions some ethnic groups do come up as more likely to be bullied and experience school racist and religiously motivated incidents (rather than bullying), often dressed up as banter.  Internet 6.7.17 The role of the internet as a potential tool used by those exploiting children is identified in a number of serious case reviews, especially in relation to child sexual exploitation.  Prevent role 6.7.18 The issues raised by the community representatives in relation to national policy on Prevent and the treatment of those that return, are concerns that are spoken about nationally and have led to the Muslim Council of Britain planning to set up their own programme to stop people becoming involved in terrorism. This is reported as planning to focus on the message that violence should never be used, and avoid what is perceived as an 'ideological purity test meaning western foreign policy cannot be criticised, and the government is only prepared to work with those who do not challenge it'30 If this plan is implemented, it has the advantage of the community taking an active role in the protection of members, but it is not yet clear how it will operate together with the Home Office's Prevent scheme.  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.7.19 Brighton & Hove agencies have taken on board the need to respond to radicalisation as a safeguarding issue, and to develop policy and service initiatives to promote the welfare of BAME young people.  6.7.20 The community representatives were particularly emphasising the critical importance of further improving the ability of nurseries and schools to promote all children's self-esteem. This would be a positive step to safeguard children and make it less likely that they will be involved in the wide range of behaviours (see finding 5) associated with troubled adolescents.    49  FINDING 7: Efforts to help and support children so they are less likely to become vulnerable to exploitation into radicalisation, do not seem to adequately address all the core issues, as perceived by community members.    CONSIDERATIONS FOR THE LSCB  How to promote the self-esteem and positive self-image of all children at nurseries and schools in Brighton & Hove?  Is there a need to re-introduce reporting of racist incidents within schools?  The need to report on pupils experience of racism, as well as bullying, for example via the annual Brighton & Hove Safe and Well at School Survey  How can Muslim communities be increasingly involved in schools and youth groups so as to increase collaborative working to better support children?    The need to openly discuss the work of Prevent locally with community groups and whether it is possible to make any adjustments in methodology locally, so as to increase the trust of local communities  How can members of the different Muslim communities work together with local agencies to counter the propaganda that children are exposed to via social media?  6.8 FINDING 8 Professional responsibilities arising from the government's counter terrorism strategy are new, not yet fully understood by all relevant staff and subject to ethical dilemmas: this presents a challenge in being able to reliably recognise both the risk of radicalisation and the links to safeguarding concerns. 6.8.1 This finding focuses on the professional responsibilities to recognise and respond to the possibility that individuals have been radicalised.  The governments counter terrorism strategy (CONTEST) involves identifying people who may be at risk of being drawn into terrorist activities and providing support to them via the 'Channel' process. This involves an assessment by Prevent police staff, a multi-agency panel meeting to consider the risk posed to the individual and the offer of support of an intervention provider if the individual is identified of being at risk (see 3.3.1- 3.3.5). 6.8.2 With the knowledge of children travelling to Syria from 2014, there has been a greater understanding of the safeguarding risks to young people of being radicalised. This contributed to the governments recognition of the need to strengthen the guidance for authorities and in 2015 published the current guidance which explains the statutory duty on professionals to have 'due regard to the need to prevent people from being drawn into terrorism'.31 HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.8.3 The news that siblings W and X had gone to Syria, with two young people from Brighton, was a total surprise and shock to professionals who knew the boys. This possibility had never been identified and there was also no recognition that the siblings were vulnerable to radicalisation, travel or participation in conflict.  50  6.8.4 During the period under review Surrey and Sussex Special Branch explained that they were unaware of any children being vulnerable to radicalisation in Brighton & Hove, even where adult members of families had been identified as people of interest. At this point there was no knowledge of any Brighton & Hove resident, whether child or adult having travelled to join terrorist organisations abroad; nor was this on the agenda as a possible risk. Even when it was known (in November 2013) that sibling P had gone abroad the previous month, it was understood that he had gone to undertake humanitarian work (see section 3).  6.8.5 In this context, comments made by the siblings in anger to police officers would not have been perceived at the time as particularly significant, and may not have been that unusual as a way of expressing anger by young disaffected people. Examples of these are:     "Allah will seek his revenge for me, do what you want to me, see what happens when judgement day comes, you will all go to hell" [2012];   During arrest and while in custody sibling X shouted at officers they would die as they did not follow Allah, that they would burn in hell on judgement day and that the day was coming very soon [2012].  6.8.6 A year later though, it is of note that practitioners were beginning to be more sensitive to potential radicalisation and in 2013 referrals were made to Community Safety and Prevent following concerns identified firstly at a school and secondly by a sessional youth offending worker.  School referral to Community Safety and Prevent 6.8.7 In the first instance, the school were already sensitive to radicalisation due to another young person previously being identified as vulnerable. In this context, in early 2013, a learning mentor was concerned about the vulnerability to radicalisation forming within a friendship network. The learning mentor heard, from a young Muslim pupil that:  Some friends had converted to Islam  They had been paid money as a reward for attending the gym at the rear of place of worship (rather than committing anti-social behaviour) and   The payment was from an extended member of the siblings' family who had previously been imprisoned, but released without charge (see 3.4.1).  6.8.8 The school also mentioned as worrying was the type of material the young person was accessing on his phone, which, in relation to Israeli army and Palestinian confrontations, led to comments of how 'disgusting the Jews were'. The school's concern led to a referral to Community Safety.  6.8.9 Community Safety appeared to have had less concern than the school about any potential radicalisation risks in this instance, partly because the payment was understood to be a one-off payment for food, to be shared amongst the boys, and to keep them usefully occupied. This re-assurance was also based on the fact that sibling P (considered a sensible young man) was known to be responsible for activities in the gym.  6.8.10 Community Safety appropriately passed the information to the police element of Prevent, but it was not shared with other agencies. The police staff member involved did not appear to recognise this as intelligence and it was therefore not placed on the force  51  system. It is not clear if or where this information was discussed subsequently, but it was not recorded against any person as a safeguarding concern, and was not subsequently available to assist in later risk assessments. This staff member has now left police employment. The serious case review has been informed that the individual's current contact details are not known, so it has not been possible to obtain any further understanding of why it was not perceived as relevant intelligence, or of needing further exploration. 6.8.11 The response from the Community Safety Team to this review provides an indication of why this opportunity (to learn more about the school's concerns of the links between the young people, their attendance at the gym at a place of worship and the potential for radicalisation of young people) was not pursued further at the time, other than passing to Prevent. The referral was perceived as being about the specific young person, who had spoken to the teacher, as opposed to the siblings in this family and the activities of the gym. This suggests some lack of understanding, at that time, of the need to focus not just on individuals but on the links between people and wider safeguarding issues. Since that time this lesson has been learnt in Brighton & Hove (see finding 10). 6.8.12 Also relevant is the difficulty there is in identifying what is a risk and needs further exploration. Taken singly, or even together, the concerns may not have met the threshold of needing further investigation at the time. However, the fact the school was concerned enough to make a referral, and to chase up what was being done about it, was indicative of needing further exploration with them of why this was being perceived as so worrying.  YOS referral to Channel Panel 6.8.13 The second instance relates to the referral to Channel Panel of sibling X in the autumn of 2013, following his making a heated remark against Americans. He had recently returned from a trip to his family's home country and made the remark to a sessional youth offending worker: she was concerned because of his lack of rational thinking. The worker commendably sought advice from management, who in turn appropriately sought advice from the Prevent Lead.  6.8.14 A Channel Panel was held in November 2013. This was early days for the Channel Panel process, with few children previously considered at such a forum and the police officers explained that this was the first time a new assessment format was used. The risk of travel was not on the agenda at that time, so the information shared that day of P being overseas, possibly in the family's home country or Turkey was not regarded as significant, but it was agreed that the police would look at this information.  6.8.15 Two attendees knew of the school's concerns that a friend of X had alleged he was paid to attend the gym at the Mosque (rather than committing anti-social behaviour). This information was not shared at the panel meeting. Partly this was because of the view outlined in 6.8.11 above, but it additionally reflected the narrow approach taken, at that time, by the Channel Panel, focusing primarily on the individual concerned, and not the person's wider family or social groups. 6.8.16 The panel concluded that there was no current evidence that X was at risk of radicalisation, which was appropriate given the information presented and discussed. Had the information about the gym behind the place of worship been shared it is not known whether this would have changed the outcome of the panel, or led to any further investigations.   52  6.8.17 The task of follow-up was left to a YOS worker, who was unaware of the concerns from the school. Moreover, X had completed his referral order at the YOS and contact with him was on a voluntary basis; he subsequently chose to have no further contact with the YOS.  6.8.18 The review has identified what they considered to be weaknesses in the conduct of these early Channel panel meetings, but have since then been addressed, including:  the restriction of attendees to only those practitioners involved with the individual (not the siblings or family)  the omission of Children's Social Work because they were not directly involved in the family   the lack of  follow-up work undertaken and vagueness in relation to the need or not for a review panel meeting  the lack of circulated minutes  HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.8.19 Staff involved in this case review spoke openly about their lack of knowledge of their safeguarding role for those vulnerable to radicalisation as well as their understanding on faith and religion. Whilst they had been trained about the function of Prevent and Channel, there is no training available about their own role in regard to this new responsibility. Several practitioners spoke about having to find their own training from a Mosque elsewhere, as they were not aware of anything suitable provided by the LSCB.  Ethical dilemmas 6.8.20 When to report concerns is a major ethical question for staff, with very different views existing about what does or does not constitute a risk of radicalisation. Adolescence is a time when children explore beliefs and religions, so what circumstances make conversion to Islam a risk? What does this also mean for children whose families are involved in extreme right wing politics, or who make racist comments? 6.8.21 This is possibly a particular issue for staff in youth clubs and schools, who are most likely to hear unguarded comments in their daily work, and can experience ethical conflicts about when to report these comments to Prevent and Channel.  Channel Panel 6.8.22 There has been considerable learning in Brighton & Hove, including from this case, about how to ensure the Channel Panel maintains a safeguarding focus for children. Since 2013, changes have been made with regard to the composition of the Channel Panel and its conduct. It now circulates the minutes (previously shared at a restricted level), holds review meetings when this has been agreed at the initial panel meeting and has decided that membership in the first instance is agency representatives and the involved practitioners. Whether or not this leads to better decision making about the risks to the child thought is not yet clear.  6.8.23 The national assessment remains a single agency assessment by Prevent officers, which tends to focus on the person of concern, and less so on their family and links, though these are now taken into account. It relies on the verbal inputs from other agencies to provide a holistic assessment of risk to supplement the police assessment.   53  HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.8.24 Information from other areas shows that other local authorities are grappling with how to implement Channel and Prevent and there is a variation in how this responsibility is being applied.   6.8.25 Differences in local authorities with regard to the organisation of the Channel process arise in relation to chairing arrangements. For example in Brighton & Hove, the Channel Panel is managed through Community Safety, and the Prevent co-ordinator (and until recently also the Channel chair) is a manager within that department. This led reviewers to look at other areas, where the model was different, with the chairing role being undertaken by senior safeguarding managers from social care and in one local authority an education lead chairs the panel and it is part of the Social Inclusion Panel for children. This provides a helpful focus on safeguarding children. Brighton & Hove have recently also changed to the model of the Channel Chair being the Head of Safeguarding for Children's Services: this is a positive change, which had been identified as learning of this review. 6.8.26 Agency participants vary in different authorities, from senior managers able to provide strategic input, to practitioners involved with the vulnerable person. 6.8.27 A further difference in service provision is around the need or not for specialist social work teams to undertake this work. This has been developed in Tower Hamlets in response to the complexity of cases referred including those not known previously to social care. This is in contrast to Brighton & Hove, where many of those identified as vulnerable are already known to social workers.      6.8.28 What is common to the sector is a recognition that this is new and to some extent everyone is learning how best to manage this responsibility and equip staff and managers to identify risks, to undertake holistic assessments and ensure that the process and the outcome address child safeguarding issues including the risk of radicalisation. Within Children's Social Work nationally a debate is whether it is best to equip all social workers to undertake this work, or whether a specialist team should be developed.  6.8.29 The extent to which the ethical conflicts are identified and debated is unclear nationally, but it is of note that one of the reasons for a specialist team in Tower Hamlets was that this would consist of staff who had received a relatively high level of specialist training so as to equip them to have the skills needed for this complex area of work, especially in relation to a higher level of disguised compliance than usually seen in social work cases. In contrast Brighton & Hove have taken the view that all staff need to be able to undertake this work, which makes sense given that those identified as vulnerable are often already known to social workers and other specialist services (in contrast to the experience of Tower Hamlets).  6.8.30 A further common challenge is how local staff can intervene effectively once such risks are identified, how this fits in with the work of specialist intervention providers and what to do when individuals decline such support. This is again subject to further ethical dilemmas, with some criticism nationally about the current processes. David Anderson Q.C. (Independent Reviewer of Terrorism Legislation), in his written submission32 in January 2016 to the home affairs select committee inquiry into the government’s counter-terrorism strategy, argues for the need for Prevent to be subject to an independent review. The need for this was in recognition that others have raised  54  concern that elements of Prevent were 'ineffective or being applied in an insensitive or discriminatory manner'. He quoted concerns of others that Prevent had become a 'toxic brand', that it divides communities and unfairly targets Muslims.  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.8.31 The recognition of the safeguarding risks associated with radicalisation has only been identified in the last couple of years. However, this realisation has been linked to child protection concerns given the outcomes for the children who have gone, such as the deaths of siblings W and X in this case and the disappearance of three girls who left their families in Tower Hamlets in February 2015 (and subsequent reported death of one of the girls).  6.8.32 For practitioners to undertake this new role of identifying children at risk of radicalisation, there needs to be firstly an understanding of the links to child protection so that the ethical basis for this work is clear. Secondly practitioners then need to have the knowledge, skills and confidence to undertake this work. 6.8.33 The real danger to children of such beliefs is being faced by some Children's Social Work departments, with decisions having to be taken whether such risks constitute grounds not just for child protection conferences and plans, but if children need to be removed from their families in order to be able to keep them safe. It is of note that Tower Hamlets in 2015 were faced with this dilemma, and did indeed obtain an interim Care Order on 'B', a 16 year old girl33  in August 2015. The judge stated that cases of this nature 'present a new facet of child protection where there is, as yet, limited professional experience or, for that matter, available training.' The judge concluded that B had suffered serious emotional harm and continued to be at risk in her parents' care.    FINDING 8: Professional responsibilities arising from the government's counter terrorism strategy are new, not yet fully understood by all relevant staff and subject to ethical dilemmas: this presents a challenge in being able to reliably recognise both the risk of radicalisation and the potential links to safeguarding concerns.    CONSIDERATIONS FOR THE LSCB  How can staff be supported in their responsibilities to report concerns about radicalisation, so that there is more clarity about what needs to be reported and why?  How do agencies counter the perceived risk that referrals to Channel / Prevent will limit free expression of political views and the withdrawal of individuals, families or part of communities from open discussion and debate?   Is it known if there are any ethical dilemmas for staff in this area of work in Brighton & Hove? If so how is this being addressed?  Do the changes to the local functioning of the Channel framework meet current best practice for holistic multi-agency assessments, including a focus on child safeguarding, involvement of all agencies involved with the child / family  and consideration of the risks posed to others in the family network?  What happens to concerns which do not meet the threshold of the Channel Panel, or who refuse to work with an intervention provider?   55  6.9 FINDING 9 The lack of a well established working relationship between counter terrorism police officers and other agencies can lead to an atmosphere of suspicion between professionals of inappropriate confidentiality, which could compromise children's safeguarding. 6.9.1 One of the expectations of practitioners and review team of this serious case review was that information would come to light, that had not been shared between or even within agencies, which would have led to the discovery that the siblings were being exploited into radicalisation and were intending to travel to Syria. In particular, some practitioners and managers suspected that counter terrorism officers had such information which was not shared prior to the siblings travelling. This is associated with a feeling amongst professionals that there must have been information available, which if they had known about, could have led to intervention to stop the boys travelling.  6.9.2 The serious case review has not discovered any information sharing weaknesses between counter terrorism officers and other agencies. Instead it has confirmed though that there exists a lack of belief of many practitioners that counter terrorism police officers will have sufficient understanding and experience of child safeguarding to know when to share information. There are a few examples where this has occurred and which highlights potential tensions that can occur between the two different priorities of the welfare of children and national security imperatives.  HOW DID THE ISSUE MANIFEST IN THIS CASE 6.9.3 Some practitioners and managers contributing to this review across different agencies, including parts of the police force, had the (mistaken) perception that:  Surrey and Sussex Special Branch counter terrorism officers must have had information relating to the activities and beliefs of the siblings prior to February 2014, which could have enabled the risk to them being identified  Surrey and Sussex Special Branch counter terrorism officers delayed sharing with others information about the siblings' whereabouts after they disappeared and that senior managers in other agencies may have not disseminated information they had in a timely way. 6.9.4 The lead reviewers met with senior officers from Surrey and Sussex Special Branch and were told that, until the discovery that the siblings had travelled in early 2014, there were no investigations involving children in Brighton & Hove (see 6.5.3 -6.5.5).  6.9.5 The speed in which information was and should be shared once the young people were known to have left Brighton is more complicated, due to the length of time it took to investigate and establish with sufficient certainty the boys whereabouts, and that they were likely to be involved in military operations, as opposed to joining in a humanitarian aid convoy. Until that time, as explained in section 3.3, those travelling to Syria were understood to be young adults who were seeking to provide aid.   6.9.6 SECTU first suspected the boys had travelled to Syria on the 12th February, when the entry was made into records. The police continued to investigate during February 2014 before formally informing the local authority Chief Executive at the beginning of March that the boys were thought to be in Syria. During that time the police pieced together  56  information, and only shared this when sufficiently confident of the reliability of their information that the boys had gone to Turkey and Syria.  6.9.7 By this time, members of the Muslim community had already contacted the Head of Community Safety because of their concerns that people were being treated differently if they returned from Syria, as opposed to those who went to join wars elsewhere. A meeting was held with the community representatives on the 26th February to discuss their concerns, with police attendance. Following the meeting a police officer informed the Head of Community Safety of the suspicions that at least 5 Brighton & Hove young people had gone to Syria, and that there were others who may be at risk of doing so. The number of 26 was mentioned. This information was immediately communicated to the Chief Executive, Director of Children's Services and other senior managers.  6.9.8 During March 2014, there was good information sharing between counter terrorism officers and the local authority, with further meetings held (on 11th and 12th), to share information and plan the strategy of how to safeguard other children in Brighton & Hove. There was (as far as those attending can recall), no constraints placed on other agencies around how this information could be shared within agencies. It has not been possible to locate any notes of these meetings to confirm this, perhaps because the meetings were outside of normal work processes. 6.9.9 When and how practitioners working with family members learnt about the whereabouts of the boys is less clear; the initial child protection conference held on Y in early April refers to 'it being feared that they [his brothers] may have gone to Libya or Syria to fight'. The conference chair did not actually know that the boys were in Syria or Libya, which probably reflects the inability of the police to state categorically that they were in Syria. However, subsequently some practitioners expressed the view that this lack of definitive statement was a lack of openness by senior management / counter terrorism. 6.9.10 The review has though established two other areas of information sharing deficits. Firstly in relation to the consistent notification of children coming to the attention of police as described in finding 5. The second issue related to the police information provided at the initial child protection conference held in April 2014, attended by Prevent officers as opposed to those from the local Safeguarding Investigation Team. These officers did not provide all the routine information expected at such meetings around the family, the contact of the child with police, and did not share that the siblings were by then believed to be in Syria (as opposed to having travelled to Turkey). Rather than share information participants recalled that it felt like the officers were there to collect intelligence from others. This weakness lay in the lack of experience and understanding of Prevent officers into child protection processes in general and child protection conferences in particular. HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.9.11 There are two potential ways for potential tension in information sharing between counter terrorism officers and other practitioners in the multi-agency system.  6.9.12 Firstly there is the potential for conflict between police investigations involving the security of the state and the principle that the 'Welfare of the Child is Paramount'. This principle, enshrined in the Children Act 1989, is behind information sharing arrangements between agencies. Whilst there is no evidence of any such conflict in this case, there is potential for this. The Director of Children's Services, when participating in  57  this review, reflected that whilst there had been no problems in information sharing between counter terrorism officers and social workers in this case, there was evidence in a subsequent case, later in 2014, of information not shared with social workers. 6.9.13 The second feature of the multi-agency system relates to the strong understanding of child safeguarding within the police safeguarding investigation team, which is not always reflected in partnership working with police officers outside of this specialism. Hence, for example, they are not used to attending child protection conferences and do not know exactly what information can and cannot be shared.  6.9.14 The West Sussex serious case review 'John' (2014)34, highlighted that 'Joint working between Police and Children's Social Work in West Sussex is less child focused and less effective when CID or uniform respond in place of the Police child protection team'. HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.9.15 There is little information on the prevalence of this suspicion between information sharing of counter terrorism officers. Tower Hamlets did share with the report authors that this had been a feature of their initial experiences in working in this field, which has been overcome as counter terrorist police have gained experience of working with children's social work services. Similarly, the Brighton & Hove Director of Children's Services told the reviewers of hearing this from some colleagues elsewhere in the country. In Tower Hamlets it was additionally queried if the Home office has yet reached this understanding of the need for information sharing in situations which involve safeguarding concerns.  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.9.16 There are recognised positive outcomes for children's safeguarding arising from the partnership working between social workers and police officers. Potential weak links in this partnership working can arise if the police officers involved do not fully understand the principle that the 'Welfare of the Child is Paramount' and what this means in terms of information sharing within the police and with other agencies. For police officers working in counter terrorism, there may be times when there are concerns that sharing particular sensitive pieces of information relating to children may be premature (e.g. due to lack of evidence) and/or may prejudice an ongoing investigation and in so doing risk the security and welfare of the wider population, including other children. So as to ensure there is adequate information sharing and that the welfare of the child is paramount, there needs to be mutual trust between agencies and professionals, and processes which enable the communication of such sensitive information. Additionally all police officers need a basic understanding of children's safeguarding, and those that represent the agency at forums such as child protection conferences have to understand the police role is to share information as opposed to collecting intelligence.    58   FINDING 9: The lack of a well established working relationship between counter terrorism police officers and other agencies can lead to an atmosphere of suspicion between professionals of inappropriate confidentiality, which could compromise children's safeguarding.      CONSIDERATIONS FOR THE LSCB  Is there clarity around how police officers resolve potential conflicts between the security of the state and the safeguarding of children involved in such investigations?  Is there confidence that information is reliably shared, between and within agencies, in line with the principle that the 'Welfare of the Child is Paramount'?  Are there arrangements now in place to ensure that police representation at child protection conferences will always include an officer / member of staff who understands the child protection process and the role of police at that meeting  6.10 FINDING 10 Does the timely and constructive response of Brighton & Hove to the newly identified safeguarding risks to children posed by radicalisation, represent a systems strength? 6.10.1 This finding relates to the work undertaken by all the agencies in Brighton & Hove following the discovery in February 2014 that the two siblings and another young person had gone missing. It recognises the constructive response that occurred in a crisis and the development of ways to provide a more effective response to this newly identified threat to young people's safety. It considers the changes made to processes, practice and working relationships to help prevent other young people at risk of radicalisation and travelling to Syria. 6.10.2 The systems locally, nationally and internationally up to this point had not considered young people to be at risk of either travelling to Syria or vulnerable to recruitment as child soldiers.  At that time there was no national or EU guidance on counter terrorism and risk to young people. Guidance did not appear until January 2015 in the form of the EU strategy paper 'Outline of the counter-terrorism strategy for Syria and Iraq, with particular focus on foreign fighters', which on counter-terrorism points to EU member-states’ obligations under the UN Committee on the Rights of the Child (CRC) and counter terrorism. However it is a very cursory mention of EU member states’ obligations under the CRC and does not amount to a specific guideline on how the rights and vulnerabilities of children are most appropriately addressed in national counter-terrorism.  HOW DID THE ISSUE MANIFEST IN THIS CASE 6.10.3 The lack of knowledge and understanding of risks posed by radicalisation in 2013 is highlighted by the fact that when the Channel Panel met to discuss sibling X in November 2013, the new information shared that day of sibling P being in Turkey, possibly supporting Syrian refugees, rang no alarm bells. There was no consideration of the possibility that he might be drawn into the conflict or of any impact on his siblings.  59  6.10.4 Following the identification in February 2014 that the boys were missing, services quickly worked with the mother to try and establish the boys whereabouts. Initially information from the family indicated they were visiting family members, but the mother did after a few weeks express concerns that they may travel to Syria to fight. At that time police intelligence also led professionals to believe they could be at risk of travelling to Syria, though their exact location was not known.  6.10.5 Following this, at both a senior strategic level and at operational level, systems regarding young people at risk of travelling were developed. It is thought that the rapid response may have been in part as a result of the Chief Executive, at that time, being a social worker herself and recognising the need to respond to this news as a safeguarding issue. As a consequence the Director of Children Services, the Assistant Director of Social Work and the Head of Safeguarding were all involved in the senior managers strategic meetings to share information and plan responses.  6.10.6 Critically, concerns were raised with regard to the possibility of siblings Q and Y being at risk of travelling along with their wider friendship group. As a result a cohort of young people were identified as being at possible risk of travelling and/or radicalisation through their social networks and use of social media. Also considered were those young people who had recently converted to Islam and those where families had raised concerns. 6.10.7 From this point onwards, what is striking is the way that agencies all came together, sharing information, and openly debating the issues raised for the system's abilities in responding to this newly identified risk. The way this was done is described in the following. Child protection conferences in individual children 6.10.8 Just prior to the report of the first death in April 2014, the concerns regarding travel resulted in a strategy to link Child Protection and Prevent processes. All the young people identified as at risk of travelling or thought to be at risk of radicalisation were considered under child protection procedures and subject to initial child protection conferences. In all cases consideration was also given to whether a referral to Channel was required.  6.10.9  The main features of the new process were, and have remained:  All concerns regarding radicalisation to be referred to MASH35 and a single assessment undertaken and the prevent coordinator informed  One consistent child protection conference chair deals with all the radicalisation child protection conferences and reviews  When a child is placed on a child in need plan (as opposed to a child protection plan), that chair will also manage the Child in Need review meetings. Strategic management groups 6.10.10 In the weeks prior to the first death a multi-agency strategic risk management group was developed, incorporating children and adult services along with wider partners. This was based on a model developed between the police and the community safety team to manage and oversee responses to anti-social behaviour in the city.  60  6.10.11 The strategic functions have now been absorbed into the new Prevent Board, a senior management group. This includes the Head of Safeguarding, Heads of Services (from adult and children services as well as partner agencies), police officers (from the local safeguarding team, Prevent and SECTU (South East Counter Terrorism Unit). They continue to meet on a bi monthly basis to ensure robust multi agency oversight of operational delivery.  In particular this looks at management of those young people transitioning from children to adulthood, where they may be concerns, but their level of risk does not meet the threshold for Prevent or where a Channel intervention is refused. The group also monitors protocol and delivery procedures and ensures any gap in the system is addressed. 6.10.12 Changes to Prevent through the Counter Terrorism and Security Act, 2015 and the placing of Channel on a statutory footing has enabled the strengthening of the multi-agency partnership. This has a dedicated Prevent coordinator, who links into and works with wider partnership and communities. The Prevent Board was established and the Channel meeting became the process by which a multi-agency approach identifies and provides support to those who might be at risk of being drawn into terrorist-related activity. There is now consistent representation from adult and children services, as well as wider partner agencies, including health at all Channel meetings. Practitioners working with the family/ Channel nominee are additionally invited to the meetings.  Use of legal interventions 6.10.13 In September 2014 coordinated action between the SECTU and Brighton & Hove City Council (BHCC) demonstrated advances in the capacity of agencies to respond swiftly and effectively to young people understood to have been subject of attempts to radicalise them and persuade them to travel. Police intercepted a young person en-route to Turkey, who had been assisted to travel without parental consent. The young person was taken into police protection before reaching the airport. Urgent legal advice was obtained resulting in a successful application to make the young person a ward of the High Court, believed to be the first application of its type. This response recognised the risk, identified it as a safeguarding issue, generated prompt co-ordinated action so as to disrupt the plan for travel, and thereafter provided additional legal protection, including restrictions on travel sanctioned by the high court.  HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.10.14 Following the Ofsted inspection in 2015, Ofsted met with Brighton & Hove managers and practitioners and spoke of disseminating, as a good practice example, the model developed locally around the identification and prevention of young people at risk of travelling. Ofsted has not yet published this good practice report which was understood to be highlighting the fast and effective responses of Brighton & Hove to this newly identified area of work. 6.10.15 The response suggests a strong multi-agency environment in Brighton & Hove, able, once aware of risks, to adapt and provide an integrated approach across and within agencies. 6.10.16 This underlying desire to learn and respond to what happened is also demonstrated by the LSCB decision, following the death of sibling W, aged eighteen, to undertake an internal learning review . There was a wish by all agencies in the city to look at and learn from how they had worked with this young man and his family, so as to prevent further young people from travelling. Following the death of sibling X, given the fact that he was  61  under 18 at the time of his death, a decision was made to undertake a serious case review. To the knowledge of the review team, this remains the only serious case review that has been undertaken in response to the deaths of children who have gone to be part of wars abroad.   HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.10.17 Home Office statistics36 show that in the year up to March 2015 in Great Britain, there were 299 arrests for terrorism-related offences, an increase of 31% compared with the previous year and the highest number since data collection started in September 2001.  In October 2015, of 800 people referred to Channel37 the government’s de-radicalisation programme in the UK, one third were under the age of 18.  6.10.18 This has led to a significant new area of safeguarding children. Because of the lack of knowledge to date and research of how to best deliver such services, local authorities and partner agencies have had to quickly adapt and create policies and processes that are child focused. WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.10.19 The ability of the system to learn in response to newly identified risks to children's safety has been critical in the implementation of more robust processes. This has enabled measures being taken which have contributed to preventing other children from travelling, including the use of legal intervention. This has demonstrated the development of joint working processes and a greater understanding between social work teams, Prevent, SECTU and the police vulnerable person team. CONSIDERATIONS FOR THE LSCB 6.10.20 There are no considerations for the LSCB arising from this positive finding.  6.11 FINDING 11 Does the multi-agency safeguarding system have the resources and strategies available to consistently help abused women and children from minority cultural backgrounds, if they fear that co-operating with statutory authorities could lead to the loss of support of their wider family and community? HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.11.1 Initially the mother and children wanted the help of statutory authorities in 2010, when allegations were made about domestic and physical abuse. The mother co-operated with professional advice, moving from the family home with her children. However, despite bail conditions, professionals believe that the father continued to have contact with his wife and children, but the mother was not open about this. The police understood that this contact led to the children being pressurised into retracting their statements.  6.11.2 Whilst the mother and children were no longer living in the family home, and there were no further reports of physical violence towards her, it is likely that the coercion  62  and control aspects of domestic abuse will continue to have been a feature of family dynamics, compounded by the mother's social isolation and lack of alternative support. This context would have made it extremely difficult for the mother to be totally open and co-operate effectively with professionals, given the father's continued visits and involvement with the siblings, both before and during the period under review.  6.11.3 This could have been exacerbated by family and immediate cultural factors, which may have inhibited the mother from being able to speak openly and without fear: professional understanding was that she was unsupported by extended family members and by other members of the family's community. Moreover her husband's high status within that community, may have been another factor in discouraging her to speak openly. By protecting herself and her children, the mother may have lost her own community supports. Attempts to link the mother to other Muslim support groups ultimately failed, because the groups were either too far away, in London, or the mother did not wish to attend. The reasons for this are not known albeit one practitioner working with the family suspected she was worried that anything she said would be reported to the father. 6.11.4 The father himself, after some initial contact with social workers, declined to have contact or to access services to address his behaviour.  HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.11.5 Practitioners spoke in the review of the lack of BAME specific services for victims and perpetrators of domestic abuse in Brighton & Hove; the services offered, such as those in London, will be too far for most parents.  6.11.6 The review team additionally questioned whether practitioners feel sufficiently confident in dealing with such sensitive issues with individuals from different cultures and beliefs, where there may be different attitudes to state intervention in family life.  6.11.7 An internal multi-agency case review in Brighton & Hove in 2016 addressed specific cultural issues and questions whether 'professionals in Brighton & Hove are sufficiently supported to work effectively with women and children experiencing domestic abuse (who don’t recognise this as abusive because they see it as being culturally normal) where the perpetrators of the abuse use the issue of race and culture to threaten professionals?' In this context families may explain (and understand) the abusive behaviour as part of cultural and religious norms and practices, and professional intervention is interpreted as lacking respect for such cultures or of being racist.  6.11.8 Within particular cultures there may be even greater disincentives to being open about abuse within the family, as statutory intervention can risk the family's position within their own community. It is of note that at one of the meetings with representatives from the Muslim community, reference was made to the negative implications for victims who follow professional advice which results in breaking up the family; this could lead to the isolation of such victims from their community. The involvement of the Imam in supporting victims of domestic abuse was suggested as the way forward. However, without training around domestic abuse for Imams and other members of the mosque. there is a risk that victims of abuse may not be adequately protected from further harm.    63  HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.11.9 It is not known or evidenced how prevalent it is, either in Brighton & Hove or nationally, if professionals find it more challenging when trying to support children and families experiencing domestic abuse from particular communities.  WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.11.10 If fear of being isolated from wider support networks (as provided by extended families, communities and religious institutions) discourages abuse victims from seeking help, the risk of children continuing to be significantly harmed is increased.   FINDING 11: Does the multi-agency safeguarding system have the resources and strategies available to consistently help abused women and children from minority cultural backgrounds, if they fear that co-operating with statutory authorities could lead to the loss of support of their wider family and community?  CONSIDERATIONS FOR THE LSCB  Is there sufficient understanding of the different cultural factors that can influence the ability of professionals to intervene effectively in domestic abuse, and how victims may experience more difficulty speaking openly within some parts of society and within some cultures?  Is the right infrastructure in place for the development of domestic abuse services able to meet the specific needs of the BAME communities in Brighton & Hove?   Is there a need to engage directly with Imams and members of Mosques, to deliver training and consultancy around domestic abuse, child safeguarding and child protection? Will it be more effective for such provision to take place within the Mosque itself?  6.12 FINDING 12 Do practitioners in Brighton & Hove have sufficient curiosity, knowledge and skills to explore the role of culture, identity, gender, religion, beliefs and potential divided loyalties experienced by some children and families? 6.12.1 The impact of global events in recent years has led to the arrival in the UK, including Brighton & Hove, of families and unaccompanied children, some of whom have undergone traumatic events prior to their arrival. Many of these will have been forced out of their homes and environment, some will have suffered abuse and some torture, some will have witnessed atrocities and some will have lost close family and friends. They will have found themselves relocated to a different culture and possibly experiencing financial difficulties and hardships, along with the fact of, or threat of, hostile reactions from parts of the community in which they find themselves.  6.12.2 This finding concerns the challenges practitioners experience in understanding how to support children and families from such different cultures and countries, who may be subject to conflicting identities and political or religious loyalties. The links between the  64  search for identity and the potential risks of radicalisation can only be understood and recognised through such work. 6.12.3 This is especially significant in understanding adolescents, for whom the issue of identity is developmentally significant, especially if they perceive themselves as different to those around them. Difference can be for a variety of reasons, but when the young person or their family originate from another country, or if they belong to a minority group, such differences are more obvious. This can apply both to those who display overt signs of inner distress and those who seem to be functioning well in society. 6.12.4 In working with young people in these circumstances, practitioners and agencies need to be able to understand the:  importance of getting information about family history and the need to access agency records in doing this    part that identity and belief systems play in the development of children and teenagers   wide ranging impact on children of mixed and conflicted internal and external identities HOW DID THIS MANIFEST IN THIS CASE? 6.12.5 There was insufficient understanding of the history of the family as well as the role of identity, religion, culture, family and community in the lives of the children and their parents, including the existence or not of Islamist thinking (see 3.2.7). This was illustrated in the conversations held with practitioners as part of this serious case review, who reflected on what they realise now that they did not know, or did not pay enough attention to at the time:  The family's history, including why they left their country of origin and the political links of the wider family: whilst this was known to Children's Social Work, this service was not involved for most of the period under review and youth offending staff did not access the background information.   Although all knew the religion of the family was Muslim, there was little knowledge or curiosity around which Mosque they attended, whether they were Sunni or Shia and the meaning of identity, religion and culture to each individual family member - accepting on face value that the boys were not observant in 2012 and so would not be attending the Mosque where the father was an important figure.  There was some awareness at the time that leaving the family home and making the allegations against father, was casting the family adrift, not just from the father, but extended family in Brighton & Hove (and abroad) and possibly the wider community to which they belonged - however, the impact of this on maternal ability to cope, on an adolescent need for identity and belief and on conflicted loyalties to family was less well understood or not acted upon.   Attempts were made to provide support from elsewhere for the mother via Arabic speaking groups; however, there were insufficient local resources and she did not feel able to make use of those that were there: according to a  65  practitioner this was because of her own conflicted (and misplaced) feelings of shame and her wish to focus on her sons' welfare.   Lack of full understanding of the enduring impact of coercion and control issues associated with domestic abuse, which can persist even after the mother and children ceased to live with the father   Lack of consideration of gender issues in the allocation of the case, and the advisability of a joint allocation to both a male and a female worker, so that if the mother preferred a woman this could be provided, and if the boys a man this could also be addressed  There were attempts to allocate staff with an understanding of the culture, but local resources are limited in this respect  All staff spoke of their limited understanding at the time of faith (including Islam) issues in general and of the safeguarding risk of radicalisation: two practitioners spoke of seeking out their own training on faith and Islam via a Mosque in another area  Training that has been provided on the role of Prevent and the Channel Panel did not assist them in understanding what their own role in this should be  6.12.6 Following a succession of youth offending social workers, including duty cover, the autumn of 2013 saw the beginnings of the benefits to the Youth Offending Service restructure, and ability to recruit experienced and qualified social workers. This led to both siblings Q and W having consistent workers and identification of the need for a referral to CAMHS for Q in recognition of the impacts of early trauma as well as the need for work around identity and beliefs. 6.12.7  A skilled social worker and therapist from RU-OK38, experienced in working with young people with underlying identity conflicts, undertook individual and joint work with sibling Q. This saw the beginning, in early 2014, of a promising model of service delivery, with input from both male and female experienced and skilled social workers.  6.12.8 Whilst the issue of identity and beliefs is important in all work with adolescents, this case highlights the fact that this is not just an issue for young people who display overt behaviour problems, such as substance misuse or anti-social behaviour. Sibling P was highly regarded by all those with whom he had contact. Whilst it was known that he was organising activities in the gym at the rear of a place of worship, his presence re-assured staff in the community safety department of the local authority (when the school were concerned in 2013) about the involvement of young people in this activity (see finding 8).  6.12.9 It is now better understood that although P may not have displayed overt signs of inner conflict, like his siblings he had experienced childhood trauma and he was drawn to identification with global events, which led him to travel to Turkey and Syria. It is not known whether he initially went to be part of an aid convoy (as originally understood) or if his intention was always to be part of the fighting. His role in influencing his younger siblings to travel is also not known to the serious case review. HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.12.10 Many families and children manage to adapt to their new surroundings and thrive. However, there will be some whose past history, or current circumstances, will affect current parenting abilities. Some children may also find it more difficult to adjust and  66  show signs of disturbed behaviour, whilst others may not display their trauma and inner conflicts, appearing to function well.  6.12.11 For some adults and children the events in the world and the continuing struggles in their land of origin, or other places with cultural links, will be an extremely important part of their identity and their current lives. For some there will be identification with struggles and fighting abroad, and for a very small number a feeling that their duty is to be part of this.  6.12.12 Recent years have led to many changes in the world, especially in North Africa and the Middle East (see section 3). The impact on residents of the UK has been recent and is only being understood more widely now, since the recognition of the 'push' and 'pull' factors internationally for people to go and fight in Syria, usually with one of the various factions that oppose the Assad regime.  6.12.13 There has been longstanding recognition for practitioners to consider identity, religion, race and culture within assessments, as well as a history of training being provided on this. However, what is apparent speaking to staff as part of this review is that there are obstacles in doing this, partly through lack of knowledge of individual cultures, but also through a lack of confidence in knowing how to ask the right questions without being perceived as prying or being considered racist. 6.12.14 This can be particularly difficult if a family's previous experiences have made them wary of trusting officials, whether the professionals are in universal services, such as health and education, or in targeted services for those needing more support. 6.12.15 What is clear is that whilst practice is still developing in this field, practitioners involved with this family now recognise the need for universal services39 to be more professionally curious about the history of families and children. Schools involved in this case review spoke of admission processes becoming pro-active in doing this, in one case involving a third sector organisation to routinely become involved when children arrive from abroad, so as to have someone skilled exploring the child's history and experiences. 6.12.16 The new adolescent 'pod' within Children's Social Work services aims to provide consistent relationships which may help this task, albeit the family in this case did have a consistent relationship with the FIP worker, but still did not speak openly about their past history. Key to this will be the ability of services to be able to engage young people. HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.12.17 Whilst the radicalisation of children into jihadism40  in the UK is considered to be a new phenomena, Deeyah Khan's film 'Jihad, a story of the others' 41 shows that this phenomena involving young people is not new, albeit the individuals in the film may have been young adults when they were radicalised. The film shows that for three generations, young people across Europe have fallen prey to extremist groups and fought, killed and died with mujahideen42 movements from Afghanistan, Bosnia, and Kashmir, to Chechnya and Burma. 6.12.18 Khan speaks to a number of those who were involved in such wars in the past. Some describe childhood experiences of racism, abuse, victimisation and a lack of acceptance within their family and the wider society. One explains the attraction of jihadism in terms of 'unconditional acceptance' and another of providing 'family, understanding and belonging'. The feeling of having a 'raging anger', 'crisis of identity' and 'disaffection'  67  being replaced by a sense of 'heroism', 'fulfilling your duty' and fighting 'for the sake of Allah'.  6.12.19 Counter extremism expert and Imam, Alyas Karmani, who appears in the film, spoke in Brighton on 08.11.16 (at a screening of the film) of the underlying trauma common to those recruited into extremism. He referred to the identity issues for young people due to the conflict between their home and culture, and the culture of mainstream society. He spoke of teenagers at risk of being radicalised because they feel isolated in 'sexualised' British society, and resent not having the same freedoms of Western youths to have girlfriends and intimate relationships. Rather than it being primarily around being attracted to a particular ideology, some young people find this a way of dealing with their conflicting emotions, and underlying anger. 6.12.20 Work being undertaken at Kings College, London's International Centre for the Study of Radicalisation, provides insights into the psychology of radicalisation. Maher43 states: '.... strip away all the grievances and myriad individual triggers that might drive an individual to join an extremist group and you find underlying issues of identity and belonging........... ... issues of identity have long been recognised as being central to radicalisation and are not unique to Muslims. Look at the jackboots of the English Defence League and Britain First, or their counterparts like Germany’s far-right party, Pegida to get a sense of how others are moving towards violent — or at least confrontational — extremism.' ... The underlying ingredients are always the same: righteous indignation, defiance, a sense of persecution and a refusal to conform.' 6.12.21 Whilst working with diversity and issues of identity and belief may not be new, the safeguarding risks of UK children (as opposed to adults) going abroad to fight in a war is newly identified. Brighton & Hove in common with other authorities is faced with the dilemma of how to work in this new global context. 6.12.22 This case has led to Brighton & Hove agencies identifying other children who may be at risk, focusing partly on peer group links. Some of the cohort identified were children who had converted to Islam and identified themselves with being 'victims'. In one case there was a white boy, who perceived that he had been subject to racism, saying to police they had arrested him because he was a Muslim and would not have done so if he had been white. WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.12.23 Given the increasing diversity of the UK population, it is important that practitioners are professionally curious, and able to assess and identify any particular needs the family may have for support. This requires knowledge, confidence and skills in being able to explore people's history and the significance to them of their identity, culture and beliefs. Without this it is less likely that needs will be identified in a timely manner and more likely assessments flawed.  6.12.24 The chances of being able to build an effective relationship with children and families, requires attention to be paid to identity, culture and belief systems. For example, whilst this may or may not have applied in this particular case, some Muslim women may not wish to have a male social worker, or if they did so this could impact on their status  68  within their family or community. Similarly there will be some young men (who follow an orthodox Salafi doctrine) who would not wish to have to speak with a woman in such circumstances, and this could impact on the possibility of providing support and help to adolescent boys.  The priority must centre on the children's welfare, which needs to be facilitated by allocation of staff best able to work with the family.   6.12.25 It is particularly important for practitioners in all services to be curious about history (and access agency records), to be comfortable speaking about identity, culture, race, belief and value systems and to identify when consultation is required about the need or not for referral for therapeutic services or for targeted services, including Prevent / Channel.  6.12.26 Practitioners need awareness of global events and consequent impact on different local communities, along with familiarity with risk indicators for radicalisation. However, it is important to be aware that the risk of radicalisation is not only apparent in terms of overt behaviour disturbance, but can additionally involve the apparently perfectly socialised young people as well as those from different cultures and backgrounds (including those from the far right politically). 6.12.27 If staff working with families do not understand the culture, background and influences on families it will be harder to be able to be sensitive to possible risks due to radicalisation and when necessary to challenge information provided by individuals. 6.12.28 Some of those who will be vulnerable to radicalisation will have no contact with specialist services. Consequently it is particularly important for universal services' staff to be equipped with the skills and confidence to understand identity and cultural issues.  FINDING 12:  Do practitioners have sufficient curiosity, knowledge and skills to explore the role of culture, identity, beliefs and potential divided loyalties experienced by some children and families?    CONSIDERATIONS FOR THE LSCB  What knowledge is there of the needs of the different cultures, religious and belief communities in Brighton & Hove and what this means when providing professional help to a family? How do new staff acquire knowledge on the cultural diversity of Brighton & Hove?    How are staff supported to be curious about a family’s life in another county or where they go when they are visiting family abroad?  How can the LSCB facilitate agencies to equip staff, including managers, with knowledge, skills and training, including professional curiosity, so that they routinely consider cultural, identity and religious / belief issues from the first point of contact, including the collection of family history for new arrivals to Brighton & Hove?  Is the important role of staff in universal services understood as having the prime role in exploring such issues with children and families?  A common finding from serious case reviews is that practitioners do not access historical files to get an understanding on the context of presenting symptoms: how can this become a routine part of practice? Are there ways of working that could be put into place that make this a routine part of a practitioners approach to working with families? How does the system carry through professional curiosity and nurture it?  69   Given the importance of building a relationship with alienated young people, is there sufficient consideration given to what factors need to be taken into account in selecting the allocated practitioners and the use of joint work within and across services? In particular are cultural and gender criteria considered routinely?  Is the ethnic mix of staff in all agencies a reflection of the local population? If not should steps be taken to move towards this?  How do we develop an understanding across services of children and young people's needs to support their identity and sense of belonging?  6.13 FINDING 13 Brighton & Hove statutory agencies have insufficient knowledge about, and understanding of,  local minority ethnic and faith community groups and how best to work together  to safeguard children, including those at risk of exploitation of local children into radicalisation. 6.13.1 Findings 7 and 13 address a research question for this serious case review (see 2.3.1): 'What further support and resilience-building could the community as a whole provide to support children and young people at risk of radicalisation?'.  6.13.2 This finding looks at the extent to which statutory agencies work together with community groups and finding 7 considers the professional practice issues raised by those who did speak with the authors and members of the review team. HOW DID THE ISSUE MANIFEST IN THIS CASE? 6.13.3 In order to explore how statutory agencies and the community could better work together to support children vulnerable to exploitation into radicalisation, the lead reviewers sought to speak with representatives of the three Mosques in Brighton & Hove and with representatives of the community organisations. Two meetings were held with representatives of community groups and one with representatives of the Mosques, including two Imams. Some of the Mosque representatives were also representatives of community groups. 6.13.4 The meetings were intended as an opportunity to both explain what was emerging from the review, and seek ideas about how we can all work together to better support children and young people at risk of exploitation through radicalisation. To some extent this dialogue was started, as outlined in finding 7.  6.13.5 The independent lead reviewer at the first meeting observed that interaction between the community representatives and those members of the local authority present, tended at times to become an enthusiastic explanation of new initiatives by managers present, instead of a meaningful dialogue. The latter involves listening, and then exploring, the views and perceptions of the community representatives, even if this might surface areas of debate.  6.13.6 This perception of the dialogue was reinforced by comments made by the community group representatives at the first meeting:  70   One repeatedly apologised for keeping on returning to the very important subject of low self-esteem (see finding 7), despite the fact that her/his contributions were highly relevant  Another, in response to being asked her/his views, said that s/he was uncertain if they had come to listen as opposed to give their views 6.13.7 At the next two meetings held the issue of whether or not community representatives felt 'heard' was further explored. We were told that there is a pressure of time on the few individuals who do try to meet with the statutory authorities. However it was felt that the community is not always 'kept in the loop' after being consulted, the local authority do not always come back and explain the outcome of discussions and their views are often not 'heard'.  6.13.8 In particular there is a perception that when racial harassment incidents are reported to statutory agencies, nothing is heard back of the outcome of the reports and there is little sense of things changing. 6.13.9 In discussion around the best way to have communication with the community, it was explained that the Brighton Muslim population is diverse, originating from a large number of countries. However, we were told that they all mix within the Mosques, and the Imams are the best point of contact, especially if meetings are held in the Mosque. 6.13.10 There was very positive feedback of the communication with community groups that takes place through 'One Voice', which developed in the wake of the boys disappearance and has continued meeting, at least quarterly. The aims include providing a conduit to alert statutory services of community tensions, to work together to respond to tensions, to give out clear messages that extremism will not be tolerated, to promote understanding across diverse cultures and faiths and provide a platform to respond to the ongoing concerns of radicalisation of young people. HOW DO WE KNOW IT IS AN UNDERLYING ISSUE AND NOT SOMETHING UNIQUE TO THIS CASE?  6.13.11 Whilst the local authority does liaise regularly with community groups, in a variety of ways, it is not clear whether or not BAME community members feel they are listened to and heard, as opposed to consulted about various policy and service developments. It is of note that some of those present at the meetings made a point about it being good to be 'listened to'.  6.13.12 Managers participating in the review have also reflected that in the past there has been insufficient recognition of the needs and views of the BAME communities as a whole. A senior manager, with experience of working in other cities, described the relative lack of communication between statutory agencies and Mosques in Brighton. The reasons for this are not well understood, but thought to be linked with the small size of the BAME population in Brighton & Hove as described in section 3.4, and consequent lack of experience of statutory agencies .  HOW PREVALENT AND WIDESPREAD IS THE ISSUE? 6.13.13 The extent to which this is a widespread issue is not known by the review team. However anecdotal comments made by those who have worked in other areas and regions of the UK indicate that in some places where there has been a longer history and/or larger numbers of members of ethnic and/or faith minorities, experience  71  developed over time has enabled better practice to develop  in communicating, consulting and in particular listening to the needs and views of minority groups.  6.13.14 Nationally, there has been debate around the role of Prevent and the way it has been implemented (see finding 7). As part of this response, some Muslim community groups have expressed frustration that the government is not listening to feedback from Muslim communities and a need to rethink the methodology of the Prevent agenda.  This may be an indication of the more widespread ways of insufficient listening to the communities about the best way to achieve the aims of Prevent.   WHY DOES IT MATTER? WHAT ARE THE IMPLICATIONS FOR THE RELIABILITY OF THE          MULTI-AGENCY CHILD PROTECTION SYSTEM?  6.13.15 There is an increased recognition of the safeguarding concerns for young people who are exploited into radicalisation. It is also identified that the Muslim community itself may be in the best position to advise government and local authorities on how best to protect their children who may be vulnerable to such exploitation. To do so it is vital that community groups are provided with an opportunity to not just be consulted by policy makers, but to have their views heard. This should enable more effective collaborative work to devise and implement the most effective means of supporting children and minimising the risk of them being vulnerable to exploitation.  FINDING 13: Brighton & Hove statutory agencies have insufficient knowledge about, and understanding of, local minority ethnic and faith community groups and how best to work together to safeguard children, including those at risk of exploitation into radicalisation.    CONSIDERATIONS FOR THE LSCB  How best to engage with Muslim communities in Brighton & Hove so as to facilitate their voices being heard and taken into account in the development of policies and services to support children who may become vulnerable to becoming exploited through radicalisation?   To consider how to engage local Mosques in discussion of how best to support children and safeguard them from exploitation through radicalisation    To consider how best to engage local Mosques in the work of the LSCB     72  7 CONCLUSIONS 7.1.1 The discovery that young people from Brighton & Hove had travelled to join the conflict in Syria and then get killed in the war has had a major impact on the understandings of the risks posed to children through exploitation into radicalisation. This has led to changes in systems and processes in the way such concerns are referred and assessed, with responsibility for this resting initially with the MASH. Closer working relationships and processes between safeguarding and Prevent and Channel processes were implemented from 2014. Recently, in line with the emerging findings from this review, the Head of Safeguarding, (a member of the review team for this serious case review) has taken over as the Channel Panel chair.    7.1.2 There was no knowledge amongst practitioners that the siblings were at risk of travel. This represents the real challenge for professionals in being able to identify children that are being exploited into radicalisation, especially in the context of the role the internet plays in accessing children and encouraging secrecy. The findings of this review relate mainly to the challenges for professionals in being able to provide effective help and support to children who have suffered trauma in their early childhood. These are the children that are more likely to be vulnerable to all types of exploitation and/or becoming involved in various risk taking anti-social behaviour. The impact of the adolescent search for identity, for some, can mean that vulnerability to exploitation through radicalisation is a particular risk, and may affect a broad range of young people, not just those whose behaviour already indicates that they are vulnerable.  7.1.3 The review has identified also the need for practitioners to have a greater understanding of, and curiosity about, the role of culture, identity, gender, religion and beliefs on children and the potential impact this can have on adolescent's self-esteem. There remains a need to support staff to be able to have the necessary tools, skills and knowledge to address these issues.  7.1.4 Since 2014, there has been a major restructuring of adolescent services and there is a need to consolidate this progress to be able to provide a holistic and flexible service, able to meet children's needs at the time when they are accessible. Integral to this is the urgent requirement to be able to provide therapeutic services for those who have suffered, or continue to suffer, trauma. Again such a service needs to be flexible, accessible and part of the entire adolescent offer. 7.1.5 There has been considerable efforts to engage with Mosques and community groups in the City, especially since 2014. This has resulted in some good communications and consultations, especially in relation to One Voice. However, this review indicates that there remains considerable work to develop more effective partnership working between statutory agencies on the one hand and the Mosques and Muslim community groups on the other.   73  APPENDIX: REVIEW TEAM MEMBERSHIP The review team consisted of the agency representatives listed in the table below, working closely with the three lead reviewers and independent consultant identified in 2.4 of the main report.   7.2 ROLE 7.3 AGENCY Head of Safeguarding, Families, Children & Learning Brighton & Hove City Council Integrated Team for Families Manager Brighton & Hove City Council Head of Community Safety Brighton & Hove City Council Head of Behaviour & Attendance Brighton & Hove City Council Principal Lawyer Brighton & Hove City Council Head of Temporary Accommodation & Allocation,  Brighton & Hove City Council Head Of Service (Assessment, Rehabilitation & IOM) Kent, Surrey & Sussex Community Rehabilitation Company Child Protection & Safeguarding Manager Sussex Police Inspector, Sussex Police, Force Counter Terrorism Intelligence Unit Sussex Police Senior Probation Officer & NOMS Probation Counter Terrorism Lead (S&E Region) National Probation Service Designated Nurse Brighton & Hove CCG   74  GLOSSARY OF TERMS  BAME Black and Asian Minority Ethnic Groups BHCC Brighton & Hove City Council CAMHS Children & Adolescent Mental health Services Child in Need plan A child in need plan is drawn up following an assessment which identifies the child as having complex needs and where a coordinated response is needed in order that the child's needs can be met.  Child Protection plan Where a Child Protection Conference determines that a child is at continuing risk of Significant Harm, a multi-agency Child Protection Plan is formulated to protect the child. A Core Group of professionals, including the Lead Social Worker, are responsible for keeping the Child Protection Plan up to date and co-ordinating inter-agency activities within it. FIP Family Intervention Project MASH Multi-agency Safeguarding Hub MOPG/1 The previous term used prior to SCARF (see below) RU-OK Young Peoples (under 18) Substance Misuse Service RISE Service for Victims of Domestic Violence and Abuse SCARF The SCARF (Single Combined Assessment of Risk Form) is a risk assessment completed by the police and sent to MASH when a child has come to the attention of the police SECTU South East Counter Terrorism Unit YOS Youth Offending Service s.47, Children Act 1989 Section 47 of the Children Act 1989 provides the legal duty on local authorities to undertake a child protection enquiry whenever there is ' have reasonable cause to suspect that a child who lives, or is found, in their area is suffering, or is likely to suffer, significant harm,' s.115, Crime and Disorder Act 1998 Any person may disclose information to a relevant authority under Section 115 of the Crime and Disorder Act 1998, ‘where disclosure is necessary or expedient for the purposes of the Act (reduction and prevention of crime and disorder)’. [11] ‘Relevant authorities’, broadly, are the police, local authorities, health authorities (clinical commissioning groups) and local probation boards           75  ENDNOTES  1. Fish, Munro & Bairstow; Learning Together (SCIE 2008)  2. Radicalisation is defined as children and young people who are at risk of being drawn into extremist or terrorist related activity  3. www.scie.org.uk/children/safeguarding/case-reviews/learning-into-practice-project/files/lipp-project-report.pdf  4. www.bbc.co.uk/news/world-middle-east-18048033  5. www.bbc.co.uk/news/world-middle-east-16047709  6. www.bbc.co.uk/news/world-middle-east-16047709  7. Guidance for specified authorities in England and Wales on the duty in the Counter-Terrorism and Security Act 2015 to have due regard to the need to prevent people from being drawn into terrorism (HM Government 2015)  8. Section 5 of the Roots of Radicalisation, Volume 1, House of Commons, 2012  9. www.bbc.co.uk/news/world-middle-east-24856553  10. http://www.bbc.co.uk/news/uk-25022097  11. The serious case review into the case of a mother who killed herself and her disabled daughter after suffering years of harassment from a local gang (Leicestershire and Rutland Safeguarding Adults Board, 2008)  12. The community trigger is the term generally applied to the response to complaints section of the anti-social behaviour, crime and policing act (2014); this enables victims to REQUIRE agencies to carry out a review of their response to the anti-social behaviour they reported, if they feel they did not get a satisfactory response  13. C A Vincent, Analysis of clinical incidents: a window on the system not a search for root causes (2004)  14. www.scie.org.uk/publications/ataglance/ataglance01.asp   15. The Brooke Serious Case Review into Child Sexual Exploitation, (March 2016) www.bristol.gov.uk/documents/20182/34760/Serious+Case+Review+Operation+Brooke+Overview+Report   16. Serious Case Review into Child Sexual Exploitation in Oxfordshire: from the experiences of Children A, B, C, D, E, and F (OSCB 26.02.15) www.oscb.org.uk/wp-content/uploads/SCR-into-CSE-in-Oxfordshire-FINAL-FOR-WEBSITE.pdf  17. Hounslow Safeguarding Children Board, Anita B serious case review, September 2016  18. See The Brooke Report into Child Sexual Exploitation, Bristol LSCB, March 2016  76  19. How safe are our children? NSPCC, 2015  20. That difficult Age: Developing a more effective response to risk in adolescence. RIP, 2014   21. That difficult age: developing a more effective response to adolescence .RIP, 2014  22. Working Together to Safeguard Children,  DfE 2013 and 2015  23. MASH is the multi-agency safeguarding hub, where contacts are screened to determine further action required, and the agency / agencies responsible for this  24. The SCARF (Single Combined Assessment of Risk Form) is a risk assessment completed by the police and sent to MASH when a child has come to the attention of the police  25. Digital Dangers, Barnardos 2015   26. ‘How Radicalisation Happens' Silke and Brown,  November 2015 (appendix to Judgement in London Borough of Tower Hamlets v B [2016] EWHC 1707 (Fam)  27. A. Kule and Z. Gül, ‘How individuals join terrorist organizations in Turkey: An empirical study on DHKP‐C, PKK, and Turkish Hezbollah’, The Global: A Journal of Policy and Strategy, Vol.1, No.1 (2015), quoted by Silke and Brown ibid  28. www.brookings.edu/~/media/research/files/papers/2015/03/isis-twitter-census-berger-morgan/isis_twitter_census_berger_morgan.pdf (accessed 00:51 – 12/06/2016)  29. Safe and Well at School Survey 2015, Public Health Schools Programme  30. www.theguardian.com/uk-news/2016/oct/19/muslim-council-britain-set-up-alternative-counter-terror-scheme   31. Guidance for specified authorities in England and Wales on the duty in the Counter-Terrorism and Security Act 2015 to have due regard to the need to prevent people from being drawn into terrorism (HM Government 2015)  32. http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidencedocument/home-affairs-committee/countering-extremism/written/27920.pdf (January 2016)  33. London Borough of Tower Hamlets v B [2015] EWHC 2491 (Fam)  34. www.westsussexscb.org.uk/wp-content/uploads/WSSCB-SCR-report-01-04-14.pdf   35. Multi-agency Safeguarding Hub  36. Operation of police powers under the Terrorism Act 2000 and subsequent legislation: Arrests, outcomes and stop and search, Great Britain financial year ending 31 March 2015, statistical bulletin 04/14, Home Office, September 2015.  37. Operation of police powers under the Terrorism Act 2000 and subsequent legislation: Arrests, outcomes and stop and search, Great Britain financial year ending 31 March 2015, statistical bulletin 04/14, Home Office, September 2015.  38. Ru-ok? is a young people's substance misuse service in Brighton & Hove  77  39. Universal services refers to those services provided to all children e.g. schools, health visitors, school nurses, GPs  40. Jihadi, or jihadist, refers to a person who believes that an Islamic state governing the entire community of Muslims must be created, and that this necessity justifies violent conflict with those who stand in its way  41. Deeyah Khan's film 'Jihad, a story of the others' http://fuuse.net/jihad-a-story-of-the-others/ 2016  42. Mujahideen are Muslim guerrilas who engage in Holy Jihad Some people call Mujahideens terrorists some people call them freedom fighter  43. 'The roots of radicalisation? It’s identity, stupid,' Shiraz Maher, Senior Research Fellow, Kings College, published in The Guardian 2015       