With a simple question, commissioner Ted Hughes got to the nut of Darlene MacDonald's testimony Tuesday morning. The former CEO of Winnipeg CFS (and current provincial Children's Advocate) was trying to explain the Gordian knot of policies, standards and guidelines governing the behaviour of social workers during her tenure.
At issue was whether it was clearly written social workers were compelled to see a child at risk before closing her file. That's a requirement now, but wasn't necessarily when Phoenix's case was closed in 2004 and again in 2005 without the child being seen.
"The child was the subject of the referral," she said in response to questioning by general authority Kris Saxberg. "That child should have been seen."
They niggled back and forth over whether this was a minimum requirement or a best practice, and whether the directive was formally spelled out in any manual at the time.
Hughes looked at MacDonald. "You're saying a social worker with some experience and some common sense would know that?" Hughes asked her. "That's right," she replied.
But common sense, as my lovely husband is fond of saying, is not that common. It seems to have been in particularly short supply at Winnipeg Child and Family Services when the agency became part of the provincial government in 1999 and later when devolution began. The strain on workers cannot be overstated. They didn't know if they'd have jobs when all was said and done, and their workload increased as they prepared files for transfer.
As the inquiry has heard repeatedly, it was a time of chaos.
During Phoenix's short life, MacDonald was a CFS program manager, overseeing the work of a slew of colleagues who have already been witnesses at this inquiry. She did not have direct contact with front-line workers or their supervisors. MacDonald became CEO when the reports into Phoenix's death were underway.
It seems no one knew the formal rules of engagement for exemplary child-protection work while the child's file was opened and closed like shutters in a windstorm. Some staff were hired right out of school and might not receive training in key areas for a year. Turnover was constant. It would seem a set of strict guidelines would be an imperative.
MacDonald certainly had expectations of her staff. The history of a file should be read carefully, she said, to tell a worker how many times a file had been opened and closed, what sort of resources a family had and what sort of issues were at play. Those were her expectations, but testimony has shown Phoenix's file was rarely examined in depth.
So which rules laid out the expectations? MacDonald used a set of 1998 guidelines as a fallback. The "blue books" were in every office. Those standards were overwritten by a new set of case-management standards that had been tested and were supposed to be in use by Jan. 1, 2002. Devolution delayed that plan.
"It was a confusing time and the standards that the workers were looking at were probably the '88 standards," she testified. In a December 2003 memo to her bosses, MacDonald expressed her concerns.
"Would you please clarify the expectations of the Child Protection Branch and General Authority with respect to the Draft Standards," she wrote. In February 2004, the issue still wasn't resolved.
In 2006, reports into the circumstances of Phoenix's death and the involvement of CFS were underway. One writer, senior management was told, "has raised concerns that not all staff seem to be aware of the Branch Policy Manual."
Phoenix's death brought change to CFS, the inquiry has been told. Staff have been added and policies and procedures clarified. Social workers must see all the children in a family during a specified time period. The basic requirement that a child at risk be seen surely doesn't have to be written in any manual.
Common sense, as commissioner Hughes clarified, should have made that clear.