Study Review

Signs of Safety

A strengths-based, safety-orientated approach to casework designed for use throughout the safeguarding process

Outcome Overall

This rating shows how effective the intervention is at achieving the evaluated outcome.

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Strength of

This rating shows how confident we can be about a finding, based on how the research was designed and carried out.

Entry to care Overall effectiveness: 0 (maximum 2) Strength of evidence : 0 (maximum 3)

Headline points

  • This summary comes from the original systematic review: Sheehan, L., O’Donnell, C., Brand, S. L., Forrester, D., Addiss, S., El-Banna, A., Kemp, A., & Nurmatov, U. (2018) Signs of Safety: a mixed methods systematic review, Cardiff University, Wales, UK
  • This framework is widely used internationally
  • Currently no evidence to suggest that Signs of Safety has a positive effect on reducing the need for children to enter care
  • The evidence available for review was very low strength

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What is this?

The Signs of Safety (SoS) framework was developed in Western Australia in the 1990s. Drawing on Solution Focused Brief Therapy (SFBT), it is a strengths-based, safety-orientated approach to casework designed for use throughout the safeguarding process. The framework’s creators highlight risk assessment and case planning as central features of the Signs of Safety process.

The framework has received a lot of interest internationally, and has been implemented in the USA, Canada, the UK, Sweden, The Netherlands, New Zealand and Japan. However, no systematic reviews of the evidence for SoS had previously been published. This information is based on a recent systematic review carried out by Cardiff University, the research partner for the What Works Centre for Children’s Social Care.

How is it meant to work?

SoS aims to stabilise and strengthen families through collaboration to identify and harness their strengths and resources. This places relationships between social workers and parents at the centre of child protection.

What are the evaluated outcomes?

  • Entry to care

How effective is it?

Current evidence suggests that overall, Signs of Safety has no effect on reducing the need for children to enter care. This finding is based on very low strength evidence.

Where has it been studied?

Signs of Safety has been studied in countries including the UK, Australia, Denmark, the Netherlands, New Zealand, Canada and the USA. Four quantitative studies were available for analysis in this review. Two of these studies were carried out in the Netherlands, one in Denmark and one in Canada. No quantitative evaluations from the UK were available.

When, where and how does it work?

Although there was no evidence of effectiveness, there is a relatively well developed theory about how SoS is intended to work. This can help the sector think about how SoS might be carried out and evaluated more rigorously.

One aspect is the overarching links between the main components of SoS and its expected outcomes. These main components are:

  • Balancing safety and risk – by recognising protective factors and strengths where appropriate
  • Being child friendly and communicating clearly in a manner that everyone involved can understand
  • Working in partnership with families and external agencies
  • Viewing parents and children as experts in their own lives
  • Being clear, open and honest, and looking for exceptions to challenge and co-develop plans for the future.

Each group (social workers, children, parents, other professionals and non-professionals) has a role to play in the SoS mechanism. For example, the social worker needs to enable the child to trust them, so that the child can communicate openly, and consent to the social worker relaying their thoughts to the parent.

If this happens as intended, the social worker can use their relationship with the parent to prompt a ‘turning point’. The ‘turning point’ is an important feature of SoS. It requires social workers to use what children say about their situation, in their own words, to help the parent to reflect on risks, take responsibility, and make changes.

While this type of engagement appears to be central to the model, there is not much existing literature on how wider family members and carers might be engaged through SoS.

What are the costs and benefits?

There is currently no information on the cost-benefit of this intervention. Only three of the 38 included studies mentioned cost effectiveness, and none of these conducted a full economic analysis.

How is it implemented?

There was limited information on how Signs of Safety had been implemented, meaning it was difficult to work out what implementation had occurred in different studies, and how much this differed from the licensed model. The evidence found suggests implementation of SoS is complex. This makes it difficult to judge the extent to which the finding of no evidence of effect is due to incomplete implementation.

Only seven of the included studies looked to evaluate the implementation process, and these used a range of methods (including observation, interviews and self-report). There is also some debate about whether the key aspects of implementation should be observed at organisational level, in terms of service design, or at a more individual level, in the use of SoS tools among frontline staff.

Who can deliver it?

The creators of Signs of Safety originally developed the framework as a tool for use by child protection social workers. Recent research in England indicates that in practice Signs of Safety is often used more broadly than this. For example, in Wokingham all social workers were trained in the Signs of Safety approach, including their early help, duty triage and assessment teams.

In Tower Hamlets their Signs of Safety training was developed in partnership with colleagues in health, and in Wakefield they aimed to adopt the Signs of Safety framework across all partner agencies to improve partnership working. A 2017 study of Signs of Safety in England found that when local authorities had trained partner agencies in Signs of Safety, they reported improved communication, particularly over referrals to social care.

What are the training and supervision requirements?

When Signs of Safety was piloted in 10 areas as part of the Children’s Social Care Innovation Programme, training arrangements tended to involve:

  • Basic two-day training for social workers and other professionals
  • Advanced five-day training for managers
  • Half-day coaching sessions for practice leaders

However, training was arranged and implemented differently in each of the 10 sites involved in this pilot. In some areas the 5-day training was viewed as essential for every social worker but in other areas this training was reserved for managers, practice leaders and other selected practitioners.

Supervision arrangements also varied and were determined locally. The evaluation found that it is important to practitioners that supervision is provided from an early stage of implementation. Among practitioners who completed a survey for this evaluation, three quarters were receiving Signs of Safety case supervision and two thirds had access to group supervision.

What supports good implementation?

Several factors were noted as important facilitators and barriers of implementation. For individuals, training was seen to be vital, but staff turnover meant this needs to be a rolling programme of training rather than a one-off event. The availability of trainers was also raised as a challenge, as was the high financial cost of licensing the model.

At organisational level, the evidence suggests culture and reporting practices could prove challenging for SoS. On the other hand, system changes that were led by engaged senior leaders who remained close to practice, and supportive of staff development, were argued to help with successful delivery.

Implementing SoS is thought to take some time, with one study suggesting an implementation period of five years. Little is known about the journey from initial launch to full implementation. Nonetheless, organisations looking to implement SoS would be advised to carefully consider how long might be needed to embed the model.

In summary...

  • Signs of Safety (SoS) is a widely used framework that aims to reduce the need for children to enter care, through a strengths-based approach
  • The review published by the What Works Centre for Children's Social Care in 2018 is the first systematic review of the literature on SoS
  • This review found no evidence that SoS is effective in reducing the need for children to enter care. The evidence available for review was very low strength
  • Evidence on implementation of SoS was varied, and no standardised measure of whether SoS is being well implemented has been used
  • Embedding SoS may take a significant amount of time, but little is known about the journey from initial launch to full implementation
  • There has not been a full economic evaluation of SoS, so we do not know how cost effective the model is.

Further resources

This summary comes from an original systematic review called: Signs of Safety: Findings from a mixed-methods systematic review focussed on reducing the need for children to be in care. (Sheehan, L., O’Donnell, C., Brand, S. L., Forrester, D., Addiss, S., El-Banna, A., Kemp, A., Nurmatov, U.). Published 2018.