Children's pounds 2 billion welfare services 'fail for lack of focus': Government asked to intervene - Up to 40 per cent of children in residential care do not attend school. Rosie Waterhouse reports

Health and welfare services for children in need are inadequate, unfocused and unco-ordinated despite authorities spending pounds 2bn a year, according to a damning report by the Audit Commission published today.

After conducting an 18-month review of services provided by health, social services and education authorities, the commission is so concerned that it is taking the unusual step of asking the Government to make it mandatory for agencies to publish joint child-care plans.

The survey found that only a quarter of authorities visited had developed a joint approach to planning for children in need; few had developed procedures for assessing needs or for evaluating the benefits and results of services provided. Authorities had failed to adapt to new legislation under which health, education and social services were intended to be supplied according to needs.

The report, Seen but not Heard, highlighted serious inadequacies in services for some of the most vulnerable children:

Up to 40 per cent of children in residential care do not attend school and yet three-quarters of social services and education authorities do not work together to resolve the problem. Almost half of the authorities visited failed to draw up a leaving care plan to prepare young people before leaving foster or residential care.

Only 25 per cent of parents with disabled children are satisfied the services are well-co- ordinated. Confusion and friction exist between agencies over who should provide special aids and equipment. Services are unfocused and unrelated to needs. Parents need better information about services and GPs need to be more sensitive to their concerns.

Agencies tended to be reactive rather than proactive in caring for children and families under stress. Social services had little spare time to organise support for families who are not 'in crisis' and regard children 'in need' as a low priority. Up to two-thirds of suspected at-risk cases investigated were dropped. No other services were offered to a large minority of families where investigations were dropped and after evaluation they were not placed on child protection registers. The large number of abandoned child abuse investigations caused trauma to families and were a drain on resources. Family centres, earlier intervention and help with parenting skills or day care can help to prevent family breakdown, reduce the chances of child abuse and deter children from becoming delinquents.

The work of health visitors is unco-ordinated and isolated from health managers and as a result many make routine visits to all families, whatever their circumstances, potentially wasting time and resources that should be targeted on families most in need.

The report makes a series of recommendations for improving services for children in need. These include assessing the overall needs of children and families in their area and planning to meet those needs; children with disabilities should be given a higher priority; agencies should develop ways of checking whether services provided are effective; and authorities must work together to plan and deliver services.

Andrew Foster, controller of the Audit Commission, said he was particularly concerned at the high proportion of children in residential homes who were not attending school. 'In our census we found on average 30 per cent, and as many as 42 per cent of children, were not going to school. This is shocking and totally unacceptable. There is a failure of education and social services to get their act together and in 75 per cent of authorities there wasn't any co- ordinated effort to tackle the problem.'

Supporting the recommendations David Blunkett, Labour's health spokesman, said: 'There should be greater attention to prevention rather than formal legalistic procedures. Early intervention, community development and support for families under stress makes more sense than belated and isolated intervention when matters have reached a crisis.'